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

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 the...

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Main Authors: Hakkennes, S., Hill, Keith, Brock, K., Bernhardt, J., Churilov, L.
Format: Journal Article
Published: Stiftelsen Rehabiliteringsinformation 2012
Online Access:http://hdl.handle.net/20.500.11937/21483
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author Hakkennes, S.
Hill, Keith
Brock, K.
Bernhardt, J.
Churilov, L.
author_facet Hakkennes, S.
Hill, Keith
Brock, K.
Bernhardt, J.
Churilov, L.
author_sort Hakkennes, S.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-214832017-09-13T13:53:06Z Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making? Hakkennes, S. Hill, Keith Brock, K. Bernhardt, J. Churilov, L. 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. 2012 Journal Article http://hdl.handle.net/20.500.11937/21483 10.2340/16501977-1065 Stiftelsen Rehabiliteringsinformation fulltext
spellingShingle Hakkennes, S.
Hill, Keith
Brock, K.
Bernhardt, J.
Churilov, L.
Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title_full Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title_fullStr Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title_full_unstemmed Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title_short Selection for inpatient rehabilitation after severe stroke: What factors influence rehabilitation assessor decision making?
title_sort selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision making?
url http://hdl.handle.net/20.500.11937/21483