Use of outcome measures in stroke rehabilitation in the transition from hospital to home-based rehabilitation

Publikation: KonferencebidragPoster

Relevance: Stroke is one of the major chronic diseases leading to long-term disability. Stroke treatment has improved and in-hospital stays have been reduced, leading to increasing emphasis on home-based rehabilitation. The transition from hospital to home-based rehabilitation is critical, as vital information can be lost as the rehabilitation teams change. Using relevant instruments to describe functioning is a way of ensuring continuity in the transition.
Clinical guidelines recommend use of reliable and valid instruments in the transition, but recommendations on which outcome measures to use are vague.
Purpose: The purpose was to examine the use of outcome measures used in clinical practice in the transition from hospital to home-based rehabilitation.
Methods/Analysis: A questionnaire were sent to the heads of 26 hospitals discharging patients with stroke and 52 municipalities' health services treating stroke patients at home in three regions in Denmark. The three regions have a total population of three million.
The survey was targeted at health care professionals that typically take part in municipal health service: nurses, physiotherapists, occupational therapists, speech-language pathologists, nursing assistants and neuropsychologists.
The questionnaire had one open-ended question: “Which instruments, outcome measures or tests are commonly used to describe functioning in persons with stroke?”. The questionnaire underlined that only instruments routinely used to assess functioning were to be reported.
Data were subjected to descriptive analysis. Instruments were separated into standardised (published) and “others”.
Results: 85% of the hospitals and 90% of the municipalities returned the questionnaire. 95% of the hospitals and 96% of the municipalities used standardised instruments.
The hospitals reported 61 standardised instruments and 45 “other”. The municipalities reported 60 standardised instruments and 53 “other”.
A total of 89 standardised instruments were used to describe functioning in stroke patients.
No instrument was used in every hospital or municipality, and a majority of the instruments were used in just one or two places.
The different health professionals reported diverse use of standardised instruments, with occupational therapists at hospitals being the most frequent users and nurses reporting the least use of standardised instruments. In 79% of the hospitals and 89% of the municipalities, PTs used standardised instruments.
Discussion and conclusions: Health professionals are encouraged to use evidence-based practice, including the use of valid and reliable instruments in health care transitions, but there are no recommendations on which instruments to use. This survey of more than half the Danish health care sector shows that the vast majority of services use standardised instruments, but there is absolutely no consensus in the selection of instruments.
Impact and Implications: There is a strong need for recommendations on which outcome measures should be used in stroke rehabilitation, especially in the transition between hospital and home-based rehabilitation.
A nationwide, interprofessional and intersectional group is currently discussing recommendations for the use of outcome measures in stroke rehabilitation. Results from this group will be presented at the conference.
Funding Acknowledgement: The study was supported by Central Denmark Region and Aarhus University.
Udgivelsesårnov. 2016
StatusUdgivet - nov. 2016
BegivenhedThe European Region of the World Confederation for Physical Therapy - Liverpool, Liverpool, Storbritannien
Varighed: 10 nov. 201612 nov. 2016
Konferencens nummer: 4


KonferenceThe European Region of the World Confederation for Physical Therapy

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