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Identifying Unmet Rehabilitation Needs in Patients After Stroke With a Graphic Rehab-CompassTM
Authors:Gustaf Magaard  Per Wester  Richard Levi  Peter Lindvall  Emma Gustafsson  Arzhang Nazemroaya Sedeh  Malin Lönnqvist  Stina Berggren  Kristin Nyman  Xiaolei Hu
Affiliation:2. Public Health and Clinical Medicine, Umeå University, Sweden;3. Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden;4. Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stochholm, Sweden
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  rehabilitation  needs assessment  outcome and process assessment  referral and consultation  quality improvement  SAH  Subarachnoid Hemorrhage  aSAH  aneurysmal Subarachnoid Hemorrhage  ADL  Activities of Daily Life  SIS  Stroke Impact Scale  HAD  Hospital Anxiety and Depression Scale  FSS  Fatigue Severity Scale  mRSq  modified Rankin Scale questionnaire  MoCA  Montreal Cognitive Assessment  EQ-5D  EuroQol Five Dimensions questionnaire  ICF  International Classification of Functioning, disability, and health  FIM+FAM  Functional Independence/Assessment Measurement  PSC  Post Stroke Checklist  ICHOM  International Consortium for Health Outcomes Measurement  IQR, Interquartile range  TM, Trademark
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