Inclusion of stroke patients in expanded cardiac rehabilitation services: a cross-national qualitative study with cardiac and stroke rehabilitation professionals

2021 ◽  
pp. 1-13
Author(s):  
Isabelle Jeffares ◽  
Niamh A. Merriman ◽  
Frank Doyle ◽  
Frances Horgan ◽  
Anne Hickey
Keyword(s):  
Qualitative Study ◽  
Cardiac Rehabilitation ◽  
Stroke Rehabilitation ◽  
Rehabilitation Services ◽  
Stroke Patients ◽  
Rehabilitation Professionals ◽  
Cross National

scholarly journals Results of the Belgian Sentinel Network of general practitioners on the involvement of therapists in stroke rehabilitation

2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Silke Francois ◽  
Viviane Van Casteren ◽  
Katrien Vanthomme ◽  
Liesbeth Borgermans ◽  
Dirk Devroey
Keyword(s):  
Nursing Home ◽  
Stroke Rehabilitation ◽  
Occupational Therapists ◽  
Critical Event ◽  
Rehabilitation Services ◽  
Speech And Language ◽  
Language Therapy ◽  
Stroke Patients ◽  
Sentinel Network ◽  
Sentinel Practices

This study examines which therapists are involved in the rehabilitation of stroke survivors in Belgium at different points in time. A nationwide registration of stroke patients was provided by 199 and 189 family physicians working in sentinel practices for the years 2009 and 2010 respectively. 326 patients who were diagnosed with stroke were included. Patients with paralysis/paresis received significant more physiotherapy after one month (63%) compared to non-paralysed patients (38%) (P=0.005). Residing in a nursing home was associated with higher proportions of patients receiving physiotherapy, both after one (P=0.003) and six (P=0.002) months. 31% of patients with aphasia were treated by a speech and language therapist after one month, which decreased after six months to 20%. After six months, the patients in a nursing home received significant more often speech and language therapy (P=0.004), compared to patients living at home. The proportion of patients receiving stroke rehabilitation services provided by physiotherapists, speech/language therapists and occupational therapists is rather low, especially 6 months after the critical event.

Abstract T P119: Challenges Associated with Access to Stroke Rehabilitation for Patients with Cognitive Impairment in Toronto

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Elizabeth Linkewich ◽  
Nicola Tahair ◽  
Michelle Donald ◽  
Sylvia Quant
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Rehabilitation ◽  
Stroke Rehabilitation ◽  
Best Practice ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Services ◽  
Cognitive Screening ◽  
Stroke Patients ◽  
Referral Decisions ◽  
Rehabilitation Facilities

Background: Cognitive Impairment (CI) affects up to 60% of stroke survivors and is associated with poorer recovery and decreased function. Toronto clinicians report limited access to inpatient rehabilitation for stroke patients with CI. Purpose: To inform system planning that aligns with best practice for stroke patients with CI, the Toronto Stroke Networks examined: 1) access to inpatient rehabilitation services for stroke patients with CI; 2) facility differences with respect to referral decisions; and 3) the frequency of documented standardized cognitive screening (SCS) in inpatient rehabilitation referrals. Methods: Data were abstracted from the E-Stroke Rehab Referral System for fiscal years 2012-2014. Initial high intensity rehabilitation (HIR) referrals for 5 rehabilitation facilities in Toronto were analyzed to examine: percentage of referrals accepted, declined, and declined due to CI, and percentage of referrals reporting SCS in referral documentation. These data were further stratified by facility. A survey of cognitive rehabilitation was completed across 6 rehabilitation facilities. Results: There are no cognitive rehabilitation services that cater specifically to stroke patients reported in Toronto. Of the total number of HIR referrals (n=5005), 68.3% of initial referrals were accepted and 18.2% declined. Of the declined referrals (n=910), 17.5% were declined due to CI with variability across the 5 rehabilitation facilities ranging from 0.6 to 46.5%. Further, when examining referrals that were pending a decision or declined due to CI (n=508), 78.5% (range 48-100%) of these referrals across, 10 referring acute care facilities, had no documented SCS. Conclusions: Stroke patients with CI do not have adequate or consistent access to stroke rehabilitation across sites within Toronto. Additionally, there is a lack of documented SCS in rehabilitation referrals, which could impact access to rehabilitation. This work will further inform educational initiatives that support increased access to inpatient rehabilitation for persons with stroke and CI.

scholarly journals Co-constructing engagement in stroke rehabilitation: a qualitative study exploring how practitioner engagement can influence patient engagement

2017 ◽  
Vol 31 (10) ◽  
pp. 1396-1405 ◽  
Author(s):  
Felicity AS Bright ◽  
Nicola M Kayes ◽  
Christine Cummins ◽  
Linda M Worrall ◽  
Kathryn M McPherson
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Patient Engagement ◽  
Emotional Response ◽  
Stroke Rehabilitation ◽  
The Other ◽  
Rehabilitation Services ◽  
Engagement And Disengagement ◽  
The Voice ◽  
Communication Disability

Objective: To explore how practitioner engagement and disengagement occurred, and how these may influence patient care and engagement. Design: A qualitative study using the Voice Centred Relational Methodology. Data included interviews, focus groups and observations. Setting: Inpatient and community stroke rehabilitation services. Subjects: Eleven people experiencing communication disability after stroke and 42 rehabilitation practitioners. Interventions: Not applicable. Results: The practitioner’s engagement was important in patient engagement and service delivery. When patients considered practitioners were engaged, this helped engagement. When they considered practitioners were not engaged, their engagement was negatively affected. Practitioners considered their engagement was important but complex. It influenced how they worked and how they perceived the patient. Disengagement was taboo. It arose when not feeling confident, when not positively impacting outcomes, or when having an emotional response to a patient or interaction. Each party’s engagement influenced the other, suggesting it was co-constructed. Conclusions: Practitioner engagement influenced patient engagement in stroke rehabilitation. Practitioner disengagement was reported by most practitioners but was often a source of shame.

scholarly journals Impact of Multidisciplinary Stroke Post-Acute Care on Cost and Functional Status: A Prospective Study Based on Propensity Score Matching

2021 ◽  
Vol 11 (2) ◽  
pp. 161
Author(s):  
Chong-Chi Chiu ◽  
Jhi-Joung Wang ◽  
Chao-Ming Hung ◽  
Hsiu-Fen Lin ◽  
Hong-Hsi Hsien ◽  
...  
Keyword(s):  
Propensity Score ◽  
Functional Status ◽  
Propensity Score Matching ◽  
Acute Care ◽  
Medical Cost ◽  
Economic Burden ◽  
Stroke Rehabilitation ◽  
Stroke Patients ◽  
The Impact ◽  
Post Acute Care

Few papers discuss how the economic burden of patients with stroke receiving rehabilitation courses is related to post-acute care (PAC) programs. This is the first study to explore the economic burden of stroke patients receiving PAC rehabilitation and to evaluate the impact of multidisciplinary PAC programs on cost and functional status simultaneously. A total of 910 patients with stroke between March 2014 and October 2018 were separated into a PAC group (at two medical centers) and a non-PAC group (at three regional hospitals and one district hospital) by using propensity score matching (1:1). A cost–illness approach was employed to identify the cost categories for analysis in this study according to various perspectives. Total direct medical cost in the per-diem-based PAC cohort was statistically lower than that in the fee-for-service-based non-PAC cohort (p < 0.001) and annual per-patient economic burden of stroke patients receiving PAC rehabilitation is approximately US $354.3 million (in 2019, NT $30.5 = US $1). Additionally, the PAC cohort had statistical improvement in functional status vis-à-vis the non-PAC cohort and total score of each functional status before rehabilitation and was also statistically significant with its total score after one-year rehabilitation training (p < 0.001). Early stroke rehabilitation is important for restoring health, confidence, and safe-care abilities in these patients. Compared to the current stroke rehabilitation system, PAC rehabilitation shortened the waiting time for transfer to the rehabilitation ward and it was indicated as an efficient policy for treatment of stroke in saving medical cost and improving functional status.

scholarly journals Stroke patients' perceptions of home blood pressure monitoring: a qualitative study

2011 ◽  
Vol 61 (590) ◽  
pp. e604-e610 ◽  
Author(s):  
Shazia Ovaisi ◽  
Judith Ibison ◽  
Miranda Leontowitsch ◽  
Geoff Cloud ◽  
Pippa Oakeshott ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Stroke Patients

The Reform of Home Care Services in Ontario: Opportunity Lost or Lesson Learned?

2007 ◽  
Vol 74 (3) ◽  
pp. 208-216 ◽  
Author(s):  
Glen Randall
Keyword(s):  
Home Care ◽  
Physical Therapists ◽  
Critical Role ◽  
Care Program ◽  
Home Care Services ◽  
Rehabilitation Services ◽  
Hospital Discharges ◽  
Rehabilitation Professionals ◽  
Care Services ◽  
Commission Report

Background. With the release of the Romanow Commission report, Canadian governments are poised to consider the creation of a national home care program. If occupational and physical therapists are to have input in shaping such a program, they will need to learn from lost opportunities of the past. Purpose. This paper provides an overview of recent reforms to home care in Ontario with an emphasis on rehabilitation services. Method. Data were collected from documents and 28 key informant interviews with rehabilitation professionals. Results. Home care in Ontario has evolved in a piecemeal manner without rehabilitation professionals playing a prominent role in program design. Practice Implications. Rehabilitation services play a critical role in facilitating hospital discharges, minimizing readmissions, and improving the quality of peoples' lives. Canadians will benefit if occupational and physical therapists seize the unique opportunity before them to provide meaningful input into creating a national home care program.

Psychometric Comparisons of 2 Versions of the Fugl-Meyer Motor Scale and 2 Versions of the Stroke Rehabilitation Assessment of Movement

2008 ◽  
Vol 22 (6) ◽  
pp. 737-744 ◽  
Author(s):  
I-Ping Hsueh ◽  
Miao-Ju Hsu ◽  
Ching-Fan Sheu ◽  
Su Lee ◽  
Ching-Lin Hsieh ◽  
...  
Keyword(s):  
Stroke Rehabilitation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Stroke Patients ◽  
Chronic Patients ◽  
Retest Reliability ◽  
Intraclass Correlation Coefficients ◽  
Mild Stroke ◽  
Test Retest Reliability ◽  
Rehabilitation Assessment

Objective. To provide empirical justification for selecting motor scales for stroke patients, the authors compared the psychometric properties (validity, responsiveness, test-retest reliability, and smallest real difference [SRD]) of the Fugl-Meyer Motor Scale (FM), the simplified FM (S-FM), the Stroke Rehabilitation Assessment of Movement instrument (STREAM), and the simplified STREAM (S-STREAM). Methods. For the validity and responsiveness study, 50 inpatients were assessed with the FM and the STREAM at admission and discharge to a rehabilitation department. The scores of the S-FM and the S-STREAM were retrieved from their corresponding scales. For the test-retest reliability study, a therapist administered both scales on a different sample of 60 chronic patients on 2 occasions. Results. Only the S-STREAM had no notable floor or ceiling effects at admission and discharge. The 4 motor scales had good concurrent validity (rho ≥ .91) and satisfactory predictive validity (rho = .72-.77). The scales showed responsiveness (effect size d ≥ 0.34; standardized response mean ≥ 0.95; P < .0001), with the S-STREAM most responsive. The test-retest agreements of the scales were excellent (intraclass correlation coefficients ≥ .96). The SRD of the 4 scales was 10% of their corresponding highest score, indicating acceptable level of measurement error. The upper extremity and the lower extremity subscales of the 4 showed similar results. Conclusions. The 4 motor scales showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The S-STREAM is recommended because it is short, responsive to change, and able to discriminate patients with severe or mild stroke.

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