Authors (including presenting author) :
Fan FSY(1), Chiang WKH(2), Sze SYM(1), Li KCN(4), Leung PS(4), Wan JKM(5), Tong MH(6), Leung MKW(3), Tang MWS(1), Yu AHY(1)
Affiliation :
(1)Department of Medicine and Geriatrics, Shatin Hospital
(2)Physiotherapy Department, Shatin Hospital
(3)Department of Family Medicine, NTEC (4)Health Resources Centre, Shatin Hospital (5)Medical Social Work Department, NTEC
(6)Department of Community Outreach Services Team, NTEC
Keyword 1: :
Social prescribing
Keyword 2: :
Social prescription
Keyword 4: :
Parkinsonism
Keyword 5: :
Parkinson's disease
Introduction :
Neurological conditions such as stroke, parkinsonism, and dementia are frequently associated with long-term physical, cognitive, and psychosocial challenges. These conditions do not only affect patients’ independence and quality of life but also place significant demands on caregivers and healthcare systems. Social prescribing, which emphasizes the impact of social determinants of health on one’s well-being, has emerged as a person-centered approach to complement traditional medical management.
Objectives :
The programme aims to adopt an innovative approach to link patients with neurological diseases to the non-medical resources in their community to enhance their functional outcome and improve their social determinants of health. The individualized social prescribing interventions serve to address social isolation, physical inactivity, emotional distress and caregiver stress.
Methodology :
Eligible patients diagnosed with stroke, parkinsonism, or dementia admitted to the neurorehabilitation wards in Shatin Hospital were screened and referred by neurologists and Geriatric nurses to a well-being coordinator (WBC) who served as a social prescribing link worker. Following a holistic assessment, the WBC would develop personalized well-being plans to cater for the needs of the patients in both in-patient and out-patient settings. The interventions included volunteer service, art and culture, cognitive stimulation groups, social activities and community network engagement, computer and technology empowerment, provision of advice on exercise, health management and use of community facilities, and caregiver support network engagement. The WBC would continue to follow up the recruited patients, review and reinforce their compliance to the prescribed interventions for 3 to 6 months after discharge. Outcomes were measured using validated Chinese versions of Medical Outcomes Study Social Support Survey (MOS-SSS), UCLA Loneliness Scale 8 (ULS-8), Patient Health Questionnaire-9 (PHQ-9), Zarit 4-item Burden Interview (ZBI-4, for caregiver) at baseline and end of follow-up period. Patients’ consumption of health care service and their satisfaction on the overall programme were also studied.
Result & Outcome :
Since the start of the programme, 78 eligible patients (58 with stroke, 7 with parkinsonism and 8 with dementia) were screened and recruited. 20 patients had completed the programme with 3-6 months of post discharge follow-up. The average number of social prescriptions per patient was 5.74 with the overall compliance rate to the prescribed interventions being 83.6%. The average MOS-SSS improved from 55.5 to 62.63. The ZBI-4 improved from 2.4 to 0.8. The average length of in-patient stay (recruited patient group = 17.66 days vs overall patient group = 19.31 days), the rate of unplanned readmission within 28 days after discharge (recruited patient group = 4.2% vs overall patient group = 17.6%), the number of AED attendance (recruited patient group = 2.1 vs overall patient group = 2.63) and Family Medicine Clinic attendance within 1 year after discharge (recruited patient group = 2.16 vs overall patient group = 2.5) of the recruited patients were remarkably lower, compared to those of the specific patient groups overall. The satisfaction score was 4.8 out of 5 for the overall programme. The analysis of the other outcome measures was in progress but showed encouraging results. Conclusion:
Social prescribing offers a feasible, holistic, and sustainable adjunct to conventional neurological care. By addressing the social determinants of health, the programme supports recovery, promotes independence, and enhances quality of life in patients with neurological diseases. Further evaluation of long-term outcomes and scalability is warranted.
