Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

Abstract:

OBJECTIVES:This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. DESIGN:Multi-site prospective observational cohort study. SUBJECTS:Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. METHODS:Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. RESULTS:Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p < 0.05). CONCLUSIONS:This study highlights the importance of pre-morbid function and social factors in addition to post-stroke function in the decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

journal_name

J Rehabil Med

authors

Hakkennes S,Hill KD,Brock K,Bernhardt J,Churilov L

doi

10.2340/16501977-1065

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

24-31

issue

1

eissn

1650-1977

issn

1651-2081

journal_volume

45

pub_type

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