Danielle B Rice1, Amanda McIntyre2, Magdalena Mirkowski3, Shannon Janzen4, Ricardo Viana5, Eileen Britt6, Robert Teasell7. 1. Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, Main Building Room B3025, 550 Wellington Road, N6C 0A7, London, ON, Canada(∗). Electronic address: danielle.rice@sjhc.london.on.ca. 2. Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada(†). 3. Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada(‡). 4. Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada(§). 5. Department of Physical Medicine & Rehabilitation, St. Joseph's Health Care, Parkwood Institute, London, ON, Canada; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada(‖). 6. Department of Physical Medicine & Rehabilitation, St. Joseph's Health Care, Parkwood Institute, London, ON, Canada(¶). 7. Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada; Department of Physical Medicine & Rehabilitation, St. Joseph's Health Care, Parkwood Institute, London, ON, Canada; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada(#).
Abstract
BACKGROUND: Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. OBJECTIVE: To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. DESIGN: Retrospective chart review. SETTING: Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. PARTICIPANTS: Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. METHODS: Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. MAIN OUTCOME MEASURE: Goal satisfaction scores. RESULTS: A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001). CONCLUSION: Within an outpatient stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients set were related to their goal satisfaction scores, with impairment-based goals being rated significantly higher than activity-based and participation-based goals. LEVEL OF EVIDENCE: III.
BACKGROUND: Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a strokeoutpatient rehabilitation setting. OBJECTIVE: To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. DESIGN: Retrospective chart review. SETTING:Strokepatients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. PARTICIPANTS: Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. METHODS: Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. MAIN OUTCOME MEASURE: Goal satisfaction scores. RESULTS: A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001). CONCLUSION: Within an outpatientstroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients set were related to their goal satisfaction scores, with impairment-based goals being rated significantly higher than activity-based and participation-based goals. LEVEL OF EVIDENCE: III.
Authors: Neus Gual; Laura Mónica Pérez; Carmina Castellano-Tejedor; Pilar Lusilla-Palacios; Judith Castro; Luís Soto-Bagaria; Laura Coll-Planas; Marta Roqué; Ana Belen Vena; Benito Fontecha; Jose M Santiago; Eva Månsson Lexell; Carlos Chiatti; Susanne Iwarsson; Marco Inzitari Journal: BMC Geriatr Date: 2020-09-04 Impact factor: 3.921
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