Sunday, January 22, 2017

Development and implementation of evidence-based practice guidelines for psychological interventions in post-stroke rehabilitation

You wouldn't need to solve psychological problems after stroke if you got them 100% recovered in a reasonable amount of time. Attack the true cause, not the side effects.
http://www.ehps.net/ehp/index.php/contents/article/view/2209
H. Kampling, C. Reese, O. Mittag

Abstract


Background: Main objectives of neurological rehabilitation are improvement of impairment and cognitive performance, as well as promotion of activities and participation. It is conducted in a multidisciplinary and setting, and psychological diagnostics and interventions are a pivotal part of it. Goal of this project was to develop practice guidelines for psychological interventions in the rehabilitation of stroke patients (funding: German Statutory Pension Insurance).

Methods: In order to foster implementation of the recommendations, we incorporated the following steps: 1) in order to base the content on best available evidence, we conducted a systematic search for guidelines, reviews and literature, 2) we surveyed all neurological rehabilitation facilities in Germany for information on current structures and practices, and 3) we discussed a preliminary draft of the recommendations with national experts (psychologists, physicians, scientists, therapists for oc[removed]void(0);cupational, speech and physical therapy, nurses, patients). In addition, a sample of stroke patients was asked for their opinion on certain recommendations.
In a final step we then consulted psychologists and medical directors of all neurological rehabilitation centres (N=344 questionnaires; N=172 centers), and asked for their appraisal on each recommendation (approval, rejection, or alternate suggestions).

Findings: Response rate was 35% (n=121). We received 870 suggestions. Approval was 97% on average (range: 88-100%).

Conclusion: The broad participation of clinicians, scientists and patients allowed us to develop detailed recommendations based on current evidence and best practice. Now, evidence-based and widely accepted recommendations for psychological interventions in post-stroke rehabilitation are available.(Where the fuck is the protocol located?) We expect that their implementation will improve neurological rehabilitation.

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