Exploration and practice of home care mode for elderly with stroke disability based on ICF theory

Most existing studies on family care for older adults with stroke-related disability focus mainly on caregiving skills training, with limited integration of patients' functional status and rehabilitation needs into health promotion services. A total of 104 mildly to moderately disabled older adults with stroke and their primary caregivers were recruited from one medical and health care group between September 2023 and October 2024. Participants were randomly assigned to a control group (n = 52 families) or an intervention group (n = 52 families) using a computer-generated random sequence. The control group received routine inpatient care and discharge follow-up. The intervention group received an ICF theory-based home care program. Outcomes were assessed 2 weeks before discharge (discharge preparation) and 4 weeks after discharge (at home). The primary outcome was caregiver burden, and secondary outcomes were patients' quality of life, caregiving competence, and family functioning. After the intervention, the caregiver burden score was 74.31 ± 7.00 in the control group and 63.54 ± 10.41 in the intervention group (p < 0.001). The caregiving competence score was 50.84 ± 5.85 in the control group and 61.02 ± 7.73 in the intervention group (p < 0.001). The patients' quality of life score was 68.21 ± 9.38 in the control group and 78.54 ± 8.77 in the intervention group (p < 0.001). The family functioning (Family APGAR score) was 12.88 ± 2.49 in the control group and 14.06 ± 2.62 in the intervention group (p = 0.021). Significant group × time interaction effects were observed across all outcomes. An ICF-based home care program for mildly to moderately disabled older adults after stroke can effectively reduce caregiver burden, improve caregiving competence, and enhance patients' quality of life and family functioning.