Beyond the Hospital Walls: Factors Influencing Caregiver Readiness for Discharge in Stroke Patients and Implications for Nurse Practitioner–Led Transitional Care

Abstract

Stroke remains a leading cause of long-term disability worldwide, with early hospital discharge shifting complex caregiving responsibilities to family members who may be inadequately prepared. Caregiver readiness for discharge has emerged as a critical determinant of safe transitions from hospital to home, significantly influencing both patient and caregiver outcomes. This review synthesizes current evidence on factors affecting caregiver readiness for discharge among stroke caregivers and explores implications for nursing and nurse practitioner–led transitional care. Caregiver readiness is a multidimensional construct encompassing physical ability, knowledge, emotional preparedness, coping capacity, confidence, and access to support resources. Evidence suggests that readiness is shaped by an interplay of caregiver socio-demographic characteristics, physical and psychological health, caregiver–patient relationships, patient clinical status, hospitalization experiences, quality of discharge education, health system factors, and cultural context. Higher levels of caregiver readiness are consistently associated with improved medication adherence, better engagement in rehabilitation, fewer post-discharge complications, and reduced hospital readmissions, while also lowering caregiver burden, stress, and burnout. Standardized instruments such as the Readiness for Hospital Discharge Scale and the Family Readiness for Hospital Discharge Scale demonstrate good psychometric properties; however, variability in assessment timing and limited cultural validation—particularly in low- and middle-income countries—remain notable gaps. The predominance of cross-sectional studies highlights the need for longitudinal and interventional research, especially evaluating nurse practitioner–led strategies to enhance readiness. Nurses and nurse practitioners play a pivotal role in assessing caregiver readiness, providing structured and individualized education, and coordinating multidisciplinary transitional care. Integrating routine readiness assessment into stroke discharge planning and implementing culturally sensitive, evidence-based interventions may substantially improve post-stroke outcomes and support sustained recovery.