The goal of this observational study is to assess the effects of nurse-led stroke transitional care in stroke survivors, caregivers and healthcare providers who participate in nurse-led stroke transitional care program to improve discharge preparedness, disease self-management and quality of life among stroke survivors. The main question it aims to answer is: does nurse-led stroke transitional care program improve discharge preparedness, disease self-management and quality of life among stroke survivors? Participants are currently participating in nurse-led stroke transitional care program as part of their medical care. Stroke survivors and their caregivers will be followed for six months period to assess their transitional care quality and clinical outcome measures.
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Self-efficacy among stroke survivors
Timeframe: 6 months after discharge
Quality of life among stroke survivors
Timeframe: 6 months after discharge
Discharge preparedness among survivors
Timeframe: within 1 month after discharge
Discharge preparedness among health care providers
Timeframe: within 1 month after discharge
Resilience among caregivers
Timeframe: 6 months after discharge
Quality of transition care among survivors and caregivers
Timeframe: within 1 month after discharge
Caregiver self-efficacy
Timeframe: 6 months after discharge