Factors related to met needs for rehabilitation 6 years after stroke

PLoS One. 2020 Jan 15;15(1):e0227867. doi: 10.1371/journal.pone.0227867. eCollection 2020.

Abstract

Introduction: Research on stroke rehabilitation mainly concerns the first year of recovery, and there is a lack of knowledge regarding long-term rehabilitation needs and associated factors.

Aim: The aim was to explore the perceived needs for rehabilitation services of people six years after stroke and factors associated with having rehabilitation services needs met.

Methods: The study was a 6-year follow up of a prospective study on the rehabilitation process after stroke. Data on perceived needs for rehabilitation, personal factors, disease specific factors, and patient-reported disability were collected through face-to-face interviews in the participants' homes. Logistic regression models were created to explore associations between having rehabilitation services needs met in 11 problem areas (dependent variable) and the independent variables: involvement in decisions regarding care and treatment, sex, age, sense of coherence, self-defined level of private financing, stroke severity, frequency of social everyday activities, perceived impact of stroke, and life satisfaction.

Results: The 121 participants had a mean age of 63 years at stroke onset and 58% were men. In all problem areas the majority (53-88%) reported having needs met at six years after stroke, however 47% reported unmet needs regarding fatigue and 45% regarding mobility. A lower perceived impact on participation was found to be associated with having rehabilitation services needs met in seven problem areas: mobility, falls, pain, fatigue, concentration, memory, and sight. The strongest association for having needs met was found for the independent variable, involvement in care and treatment, within the three problem areas mobility, falls, and speaking.

Conclusion: In a long-term perspective, there were several modifiable factors associated with having rehabilitation services needs met. The most prominent were perceived involvement in care and treatment, and perceived participation. These factors had a stronger association with having rehabilitation services needs met than disease specific factors six years after stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Aged, 80 and over
  • Disabled Persons / rehabilitation*
  • Female
  • Health Services Needs and Demand
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Patient Satisfaction
  • Prospective Studies
  • Stroke / epidemiology*
  • Stroke / physiopathology
  • Stroke Rehabilitation*
  • Surveys and Questionnaires

Grants and funding

LvK: Swedish Research Council 2007-3087 and 2013-2806 http://www.vr.se/, Stockholms Läns Landsting 2006-0700 https://www.sll.se/. CY: Swedish Stroke Association www.strokeforbundet.se/ and the Promobilia Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.