Identifying Unmet Rehabilitation Needs in Patients After Stroke With a Graphic Rehab-Compass TM

J Stroke Cerebrovasc Dis. 2018 Nov;27(11):3224-3235. doi: 10.1016/j.jstrokecerebrovasdis.2018.07.013. Epub 2018 Aug 8.

Abstract

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-CompassTM 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-sectionalstudy with 48 patients at 5-month follow-ups after subarachnoid hemorrhage.

Results: The Rehab-CompassTM identified and graphically visualized a panoramic view of the multidimensional needs over time which was completed before clinical consultation. The Rehab-CompassTM appeared to be feasible and time-efficientin clinical use. The interviews of both patients and clinicians showed high satisfaction when using the Rehab-CompassTM graph. In the studied stroke patients, the Rehab-CompassTM identified memory and processing information, fatigue, mood, and pain after subarachnoid hemorrhage as the most common problems.

Conclusions: The graphic Rehab-CompassTM 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-CompassTM more concise and evaluate the instrument among different stroke subgroups.

Keywords: Stroke; needs assessment; outcome and process assessment; quality improvement; referral and consultation; rehabilitation.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Checklist
  • Clinical Decision-Making
  • Cross-Sectional Studies
  • Decision Support Techniques*
  • Feasibility Studies
  • Female
  • Health Services Needs and Demand*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment*
  • Patient Reported Outcome Measures*
  • Patient Satisfaction
  • Process Assessment, Health Care*
  • Quality of Life
  • Recovery of Function
  • Social Participation
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / psychology
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Treatment Outcome