Deans' stroke musings: The influence of patient-centredness during goal-setting in stroke rehabilitation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, November 15, 2016

The influence of patient-centredness during goal-setting in stroke rehabilitation

I bet this patient centered goal setting is still influenced by the staff, biasing what survivors expectations should be. The goal should be 100% recovery but I bet implicit and explicit interference from hospital staff relegates the goals to maybe walking, eating and dressing.
http://etheses.bham.ac.uk/7033/

Abstract

Background: Guidelines suggest that rehabilitation for people with stroke should adopt patient-centred goal-setting (PCGS).
Methods: A literature review and two qualitative studies were done in an acute stroke-unit. Study one aimed to explore influence of PCGS within stroke rehabilitation. Patients with stroke, with ability to participate and staff caring for them were included. Data collection involved interviews, observations, document analysis and focus-groups. Analysis involved sequential and intra-case analysis methods.
Study two aimed to build a resource to improve PCGS and evaluate its feasibility and appropriateness. Based on Study one and review, a resource (T-PEGS) was developed and applied in this setting. Patients with same criteria as Study one and staff who agreed to act as keyworkers were recruited. Data collection and analysis methods were similar to Study one.
Findings: Study one, with thirteen patients and twelve professionals, revealed limited application of PCGS due to participants’ health beliefs, limitations in knowledge and resources. Study two involved five patients and five staff who applied T-PEGS; recording of psychosocial goals, information sharing and rapport between patients and professionals had improved.
Conclusion: T-PEGS seemed to improve PCGS locally. Small study-size and single site limit generalisability. Future work should explore mechanisms and effectiveness of T-PEGS.