Journal
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
Volume 27, Issue 11, Pages 3224-3235Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jstrokecerebrovasdis.2018.07.013
Keywords
Stroke; rehabilitation; needs assessment; outcome and process assessment; referral and consultation; quality improvement
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Funding
- Vasterbotten County Council
- Umea University (ALF Foundation)
- Swedish Stroke Foundation (Stroke Riksforbundet)
- Northern Swedish Stroke Fund (Strokeforskning I Norrland Insamlingsstiftelse)
- Swedish Heart and Lung Foundation
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Background: Unmet rehabilitation needs are common among stroke survivors. We aimed to evaluate whether a comprehensive graphic Rehab-Compass, a novel combination of structured patient-reported outcome measures, was feasible and useful in facilitating a capture of patients' rehabilitation needs in clinical practice. Methods: A new graphic overview of broad unmet rehabilitation needs covers deficits in functioning, daily activity, participation, and quality of life. It was constructed by using 5 patient-oriented, well-validated, and reliable existing instruments with converted data into a 0 (worst outcome) to 100 (best outcome) scale but unchanged in terms of variable properties. Satisfaction of the Rehab-Compass (TM) was studied by a qualitative interview of 9 patients with stroke and 3 clinicians. Practical feasibility and capacity of the instrument were evaluated in a cross sectional study with 48 patients at 5-month follow-ups after subarachnoid hemorrhage. Results: The Rehab-Compass (TM) identified and graphically visualized a panoramic view of the multidimensional needs over time which was completed before clinical consultation. The Rehab-Compass (TM) appeared to be feasible and time efficient in clinical use. The interviews of both patients and clinicians showed high satisfaction when using the Rehab-Compass (TM) graph. In the studied stroke patients, the Rehab-Compass (TM) identified memory and processing information, fatigue, mood, and pain after subarachnoid hemorrhage as the most common problems. Conclusions: The graphic Rehab-Compass (TM) seems to be a feasible, useful, and time-saving tool for identification of unmet rehabilitation needs among stroke survivors in clinical practice. Further research is needed to make the Rehab-Compass (TM) more concise and evaluate the instrument among different stroke subgroups.
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