as Dr. Steven Wolf writes, a rehabilitation stroke expert and professor at Emory University School of Medicine in Atlanta. "Stroke patients need to rely more on their own problem solving to regain mobility".
You're on your own, figure out your own stroke rehabilitation. Eventually after discharge all stroke patients have to do this since there are no publicly available stroke protocols to follow.
http://cre.sagepub.com/content/early/2016/07/14/0269215516658938.abstract
- 1International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia
- 2Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
- 3NHMRC Centre of Research Excellence, Stroke Rehabilitation and Brain Recovery
- 4Stroke and Ageing Research Centre, Monash University, Victoria, Australia
- Elizabeth A Lynch, International Centre for Allied Health Evidence, Department of Health Sciences, University of South Australia, GPO Box 2471, Adelaide 5001, Australia. Email: elizabeth.lynch@adelaide.edu.au
Abstract
Objective: To explore the factors perceived to affect rehabilitation assessment and referral practices for patients with stroke.
Design: Qualitative study using data from focus groups analysed thematically and then mapped to the Theoretical Domains Framework.
Setting: Eight acute stroke units in two states of Australia.
Subjects: Health professionals working in acute stroke units.
Interventions: Health
professionals at all sites had participated in interventions to improve
rehabilitation assessment and referral practices,
which included provision of copies of an
evidence-based decision-making rehabilitation Assessment Tool and
pathway.
Results: Eight focus
groups were conducted (32 total participants). Reported rehabilitation
assessment and referral practices varied
markedly between units. Continence and mood were
not routinely assessed (4 units), and people with stroke symptoms were
not
consistently referred to rehabilitation (4
units). Key factors influencing practice were identified and included
whether health
professionals perceived that use of the
Assessment Tool would improve rehabilitation assessment practices
(theoretical domain
‘social and professional role’); beliefs about
outcomes from changing practice such as increased equity for patients or
conversely
that changing rehabilitation referral patterns
would not affect access to rehabilitation (‘belief about consequences’);
the
influence of the unit’s relationships with other
groups including rehabilitation teams (‘social influences’ domain) and
understanding
within the acute stroke unit team of the purpose
of changing assessment practices (‘knowledge’ domain).
Conclusion: This study
has identified that health professionals’ perceived roles, beliefs
about consequences from changing practice and
relationships with rehabilitation service
providers were perceived to influence rehabilitation assessment and
referral practices
on Australian acute stroke units.
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