Stroke is one of the health problems in today's civilized society so that it is the third cause of mortality after cardiovascular diseases and cancer worldwide (1). According to the available statistics, each year 500,000 people suffer from stroke for the first time, 100,000 suffer from stroke for the second time, and nearly 160,000 people die from stroke (2). No comprehensive and national study has been performed in Iran on the prevalence and incidence of stroke. Based on provincial and regional studies, the annual incidence rate is estimated between 113 and 149 per 100,000 at all ages and more than 500 cases per 100000 people in the over 45-years old population (3).
In addition to mortality, physical impairment and disorders caused by these diseases remain a major social problem in terms providing cares in the hospital and at home (4). On the other hand, the disabilities of these patients and the resulting psychological problems are of other problems (5). Patients are exposed to several complications following a stroke, including losing balance, musculoskeletal problems, swallowing difficulties, bladder and bowel dysfunction, inability to perform self-care activities, and loss of skin health (2, 6).
The acute phase of the disease may take only a few days, however, the patient's recovery is a gradual and slow process and it usually takes a long time to stabilize the patient's condition (6). Pharmaceutical treatment is used to recover the stroke and multiple complications, while the main treatment is the continuous and long-term rehabilitation (7). When the acute phase of the disease is abolished, the patient care consists of immediate initiation of rehabilitation for any impairment (4, 8). Since stroke has unexpected and destructive effects on the patients’ lives, it leads to changes in their lifestyles and ultimately their quality of lives (7).
Patients suffering from a stroke are restricted in their routine lives and basic daily activities. Rehabilitation plays a key role in improving the status of these patients (9). The results of Clarke et al. study indicated that the functional status of patients with stroke can be improved using care program educations (10).
Considering that more than 60% of stroke survivors experience varying degrees of impairment, rehabilitation should be used as an important part of the health program of these patients in order to improve the quality of life and reduce the destructive impacts of a stroke (11). The rehabilitation process in stroke may take several years (12). Studies have indicated that rehabilitation programs encounter severe constraints due to the factors such as high rehabilitation costs and movement constraints in patients, as well as the difficulties to travel (9). Therefore, designing and using a home-based care program is an effective way to meet these needs for services (4).
Recent changes in health care systems in the world require providing long-term and complex cares at home provided by family members (4, 13). Family-based care is an innovative approach to planning, providing, and evaluating the health cares and promoting health. This approach is imperative as it unifies the patients, health care providers, and families in all aspects of care (14). Considering the long-term complications in these patients, the family is the most effective social institution that can provide physical and emotional supports for patient rehabilitation (4, 11).
Therefore, the effective and powerful presence of family members on the bedside and in the patient care program can have a notable effect on the rehabilitation of the stroke patient. Hence, given the importance of the subject, its helpful results for planning the care and rehabilitation programs for patients, and the need for a study in this field, this study aimed to determine the effect of family-based home care program on the health status of hemiplegic patients with stroke.