Factors related to met needs for rehabilitation 6 years after stroke


Autoři: Charlotte Ytterberg aff001;  Hanne Kaae Kristensen aff003;  Malin Tistad aff001;  Lena von Koch aff001
Působiště autorů: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden aff001;  Karolinska University Hospital, Huddinge, Sweden aff002;  Research Unit in Rehabilitation, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark aff003;  Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark aff004;  School of Education, Health and Social Studies, Dalarna University, Falun, Sweden aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227867

Souhrn

Introduction

Research on stroke rehabilitation mainly concerns the first year of recovery, and there is a lack of knowledge regarding long-term rehabilitation needs and associated factors.

Aim

The aim was to explore the perceived needs for rehabilitation services of people six years after stroke and factors associated with having rehabilitation services needs met.

Methods

The study was a 6-year follow up of a prospective study on the rehabilitation process after stroke. Data on perceived needs for rehabilitation, personal factors, disease specific factors, and patient-reported disability were collected through face-to-face interviews in the participants’ homes. Logistic regression models were created to explore associations between having rehabilitation services needs met in 11 problem areas (dependent variable) and the independent variables: involvement in decisions regarding care and treatment, sex, age, sense of coherence, self-defined level of private financing, stroke severity, frequency of social everyday activities, perceived impact of stroke, and life satisfaction.

Results

The 121 participants had a mean age of 63 years at stroke onset and 58% were men. In all problem areas the majority (53–88%) reported having needs met at six years after stroke, however 47% reported unmet needs regarding fatigue and 45% regarding mobility. A lower perceived impact on participation was found to be associated with having rehabilitation services needs met in seven problem areas: mobility, falls, pain, fatigue, concentration, memory, and sight. The strongest association for having needs met was found for the independent variable, involvement in care and treatment, within the three problem areas mobility, falls, and speaking.

Conclusion

In a long-term perspective, there were several modifiable factors associated with having rehabilitation services needs met. The most prominent were perceived involvement in care and treatment, and perceived participation. These factors had a stronger association with having rehabilitation services needs met than disease specific factors six years after stroke.

Klíčová slova:

Activities of daily living – Decision making – Emotions – Fatigue – Finance – Incontinence – Pain sensation – Prospective studies


Zdroje

1. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):e56–e528. doi: 10.1161/CIR.0000000000000659 30700139

2. Northcott S, Moss B, Harrison K, Hilari K. A systematic review of the impact of stroke on social support and social networks: associated factors and patterns of change. Clin Rehabil. 2016;30(8):811–31. doi: 10.1177/0269215515602136 26330297

3. Jaracz K, Grabowska-Fudala B, Gorna K, Kozubski W. Consequences of stroke in the light of objective and subjective indices: a review of recent literature. Neurol Neurochir Pol. 2014;48(4):280–6. doi: 10.1016/j.pjnns.2014.07.004 25168328

4. Verberne DPJ, Post MWM, Kohler S, Carey LM, Visser-Meily JMA, van Heugten CM. Course of Social Participation in the First 2 Years After Stroke and Its Associations With Demographic and Stroke-Related Factors. Neurorehabil Neural Repair. 2018;32(9):821–33. doi: 10.1177/1545968318796341 30178696

5. Lindsay P, Furie KL, Davis SM, Donnan GA, Norrving B. World Stroke Organization global stroke services guidelines and action plan. Int J Stroke. 2014;9 Suppl A100:4–13.

6. Wade D. Rehabilitation—a new approach. Part four: a new paradigm, and its implications. Clin Rehabil. 2016;30(2):109–18. doi: 10.1177/0269215515601177 26715679

7. Dworzynski K, Ritchie G, Playford ED. Stroke rehabilitation: long-term rehabilitation after stroke. Clin Med (Lond). 2015;15(5):461–4.

8. Erikson A, Karlsson G, Tham K. Living with the long-term consequences 11–13 years after stroke: A phenomenological study. J Rehabil Med. 2016;48(10):847–52. doi: 10.2340/16501977-2161 27797394

9. Ytterberg C, Dyback M, Bergstrom A, Guidetti S, Eriksson G. Perceived impact of stroke six years after onset, and changes in impact between one and six years. J Rehabil Med. 2017;49(8):637–43. doi: 10.2340/16501977-2258 28792583

10. Socialstyrelsen. Livssituationen två år efter stroke En uppföljning av strokedrabbade och deras nörstående 2004.

11. Tistad M, Tham K, von Koch L, Ytterberg C. Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke: an explorative observational study. BMC Neurol. 2012;12(1):40.

12. Kristensen HK, Tistad M, von Koch L, Ytterberg C. The importance of patient involvement in stroke rehabilitation. PLoS One. 2016;11(6):e0157149. doi: 10.1371/journal.pone.0157149 27285997

13. McKevitt C, Fudge N, Redfern J, Sheldenkar A, Crichton S, Rudd AR, et al. Self-Reported Long-Term Needs After Stroke. Stroke. 2011;42(5):1398–403. doi: 10.1161/STROKEAHA.110.598839 21441153

14. Ullberg T, Zia E, Petersson J, Norrving B. Perceived Unmet Rehabilitation Needs 1 Year After Stroke: An Observational Study From the Swedish Stroke Register. Stroke. 2016;47(2):539–41. doi: 10.1161/STROKEAHA.115.011670 26732564

15. Olaiya MT, Cadilhac DA, Kim J, Nelson MR, Srikanth VK, Andrew NE, et al. Long-term unmet needs and associated factors in stroke or TIA survivors: An observational study. Neurology. 2017;89(1):68–75. doi: 10.1212/WNL.0000000000004063 28566545

16. Andrew NE, Kilkenny M, Naylor R, Purvis T, Lalor E, Moloczij N, et al. Understanding long-term unmet needs in Australian survivors of stroke. Int J Stroke. 2014;9 Suppl A100:106–12.

17. van de Port IG, van den Bos GA, Voorendt M, Kwakkel G, Lindeman E. Identification of risk factors related to perceived unmet demands in patients with chronic stroke. Disabil Rehabil. 2007;29(24):1841–6. doi: 10.1080/09638280601129157 17852229

18. op Reimer WJ, Scholte de Haan RJ, Rijnders PT, Limburg M, van den Bos GA. Unmet care demands as perceived by stroke patients: deficits in health care? Qual Health Care. 1999;8(1):30–5. doi: 10.1136/qshc.8.1.30 10557667

19. Kersten P, Low JT, Ashburn A, George SL, McLellan DL. The unmet needs of young people who have had a stroke: results of a national UK survey. Disabil Rehabil. 2002;24(16):860–6. doi: 10.1080/09638280210142167 12450462

20. Pound P, Tilling K, Rudd AG, Wolfe CD. Does patient satisfaction reflect differences in care received after stroke? Stroke. 1999;30(1):49–55. doi: 10.1161/01.str.30.1.49 9880387

21. Levack WM, Weatherall M, Hay-Smith EJ, Dean SG, McPherson K, Siegert RJ. Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation. Cochrane Database Syst Rev. 2015(7):CD009727. doi: 10.1002/14651858.CD009727.pub2 26189709

22. Tistad M, von Koch L, Sjostrand C, Tham K, Ytterberg C. What aspects of rehabilitation provision contribute to self-reported met needs for rehabilitation one year after stroke—amount, place, operator or timing? Health Expect. 2013;16(3):e24–35. doi: 10.1111/hex.12095 23796012

23. Tistad M, Ytterberg C, Tham K, von Koch L. Poor concurrence between disabilities as described by patients and established assessment tools three months after stroke: A mixed methods approach. J Neurol Sci. 2012;313(1–2):160–6. doi: 10.1016/j.jns.2011.08.038 21937062

24. WHO. WHO Framework on integrated people-centred health services http://www.who.int/servicedeliverysafety/areas/people-centred-care/en/2016 [

25. Dean SG, Siegert RJ, Taylor W. Interprofessional rehabilitation: a person-centred approach. New York: John Wiley & Sons; 2012.

26. Parsons JGM, Plant SE, Slark J, Tyson SF. How active are patients in setting goals during rehabilitation after stroke? A qualitative study of clinician perceptions. Disabil Rehabil. 2018;40(3):309–16. doi: 10.1080/09638288.2016.1253115 27866416

27. Pallesen H, Aadal L, Moe S, Arntzen C. Gateway to Recovery: A Comparative Analysis of Stroke Patients’ Experiences of Change and Learning in Norway and Denmark. Rehabil Res Pract. 2019;2019:1726964. doi: 10.1155/2019/1726964 30775038

28. Plant SE, Tyson SF, Kirk S, Parsons J. What are the barriers and facilitators to goal-setting during rehabilitation for stroke and other acquired brain injuries? A systematic review and meta-synthesis. Clin Rehabil. 2016;30(9):921–30. doi: 10.1177/0269215516655856 27496701

29. Langhorne P, Bernhardt J, K G. Stroke Rehabilitation. The Lancet. 2011;377:1693–702.

30. Brown M, Levack W, McPherson KM, Dean SG, Reed K, Weatherall M, et al. Survival, momentum, and things that make me “me”: patients’ perceptions of goal setting after stroke. Disabil Rehabil. 2014;36(12):1020–6. doi: 10.3109/09638288.2013.825653 23962191

31. Rose A, Rosewilliam S, Soundy A. Shared decision making within goal setting in rehabilitation settings: A systematic review. Patient Educ Couns. 2017;100(1):65–75. doi: 10.1016/j.pec.2016.07.030 27486052

32. Armstrong MJ. Shared decision-making in stroke: an evolving approach to improved patient care. Stroke Vasc Neurol. 2017;2(2):84–7. doi: 10.1136/svn-2017-000081 28959495

33. Palmcrantz S, Holmqvist LW, Sommerfeld DK, Tistad M, Ytterberg C, von Koch L. Differences between younger and older individuals in their use of care and rehabilitation but not in self-perceived global recovery 1year after stroke. J Neurol Sci. 2012;321(1–2):29–34. doi: 10.1016/j.jns.2012.07.024 22846794

34. Antonovsky A. The structure and properties of the sense of coherence scale. Soc Sci Med. 1993;36(6):725–33. doi: 10.1016/0277-9536(93)90033-z 8480217

35. Mahoney F, Barthel D. Functional evaluation: the Barthel Index. Maryland St Med J. 1965;14:61–5.

36. Govan L, Langhorne P, Weir CJ. Categorizing Stroke Prognosis Using Different Stroke Scales. Stroke. 2009;40(10):3396–9. doi: 10.1161/STROKEAHA.109.557645 19661471

37. Wade DT, Legh-Smith J, Langton Hewer R. Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehabil Med. 1985;7(4):176–81. doi: 10.3109/03790798509165991 4093249

38. Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999;30(10):2131–40. doi: 10.1161/01.str.30.10.2131 10512918

39. Viitanen M, Fugl-Meyer K, Bernspang B, Fugl-Meyer A. Life satisfaction in long-term survivors after stroke. Scand J Rehabil Med. 1988;20:14–24.

40. Fugl-Meyer AR, Melin R, Fugl-Meyer KS. Life satisfaction in 18-to 64-year-old Swedes: In relation to gender, age, partner and immigrant status. J Rehabil Med. 2002;34(5):239–46. doi: 10.1080/165019702760279242 12392240

41. Blomgren C, Samuelsson H, Blomstrand C, Jern C, Jood K, Claesson L. Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue. PLoS One. 2019;14(5):e0216822. doi: 10.1371/journal.pone.0216822 31095631

42. Singam A, Ytterberg C, Tham K, von Koch L. Participation in Complex and Social Everyday Activities Six Years after Stroke: Predictors for Return to Pre-Stroke Level. PLoS One. 2015;10(12):e0144344. doi: 10.1371/journal.pone.0144344 26658735

43. Elf M, Eriksson G, Johansson S, von Koch L, Ytterberg C. Self-Reported Fatigue and Associated Factors Six Years after Stroke. PLoS One. 2016;11(8):e0161942. doi: 10.1371/journal.pone.0161942 27575043

44. Norlander A, Carlstedt E, Jonsson AC, Lexell EM, Stahl A, Lindgren A, et al. Long-Term Predictors of Social and Leisure Activity 10 Years after Stroke. PLoS One. 2016;11(2):e0149395. doi: 10.1371/journal.pone.0149395 26901501

45. Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst Rev. 2014(4):CD001920. doi: 10.1002/14651858.CD001920.pub3 24756870

46. Veerbeek JM, van Wegen E, van Peppen R, van der Wees PJ, Hendriks E, Rietberg M, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014;9(2):e87987. doi: 10.1371/journal.pone.0087987 24505342

47. Regan EW, Handlery R, Liuzzo DM, Stewart JC, Burke AR, Hainline GM, et al. The Neurological Exercise Training (NExT) program: A pilot study of a community exercise program for survivors of stroke. Disabil Health J. 2019.

48. Wu S, Kutlubaev MA, Chun HY, Cowey E, Pollock A, Macleod MR, et al. Interventions for post-stroke fatigue. Cochrane Database Syst Rev. 2015;7:CD007030.

49. Woodman P, Riazi A, Pereira C, Jones F. Social participation post stroke: a meta-ethnographic review of the experiences and views of community-dwelling stroke survivors. Disabil Rehabil. 2014;36(24):2031–43. doi: 10.3109/09638288.2014.887796 24597937

50. Burton CR, Fargher E, Plumpton C, Roberts GW, Owen H, Roberts E. Investigating preferences for support with life after stroke: a discrete choice experiment. BMC Health Serv Res. 2014;14:63. doi: 10.1186/1472-6963-14-63 24507804

51. Satink T, Cup EH, Ilott I, Prins J, de Swart BJ, Nijhuis-van der Sanden MW. Patients’ views on the impact of stroke on their roles and self: a thematic synthesis of qualitative studies. Arch Phys Med Rehabil. 2013;94(6):1171–83. doi: 10.1016/j.apmr.2013.01.011 23337428

52. Lund A, Melhus M, Sveen U. Enjoyable company in sharing stroke experiences;—lifestyle groups after stroke. Scand J Occup Ther. 2018;25(2):127–35. doi: 10.1080/11038128.2017.1341958 28625085

53. Ekman I, Swedberg K, Taft C, Lindseth A, Norberg A, Brink E, et al. Person-centered care—ready for prime time. Eur J Cardiovasc Nurs. 2011;10(4):248–51. doi: 10.1016/j.ejcnurse.2011.06.008 21764386

54. Ali L, Fors A, Ekman I. Need of support in people with chronic obstructive pulmonary disease. J Clin Nurs. 2017.

55. Stacey D, Legare F, Lewis K, Barry MJ, Bennett CL, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4:CD001431. doi: 10.1002/14651858.CD001431.pub5 28402085

56. Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Making. 2015;35(1):114–31. doi: 10.1177/0272989X14551638 25351843

57. Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361–7. doi: 10.1007/s11606-012-2077-6 22618581

58. Wolf A, Moore L, Lydahl D, Naldemirci O, Elam M, Britten N. The realities of partnership in person-centred care: a qualitative interview study with patients and professionals. BMJ Open. 2017;7(7):e016491. doi: 10.1136/bmjopen-2017-016491 28716793

59. Slomic M, Christiansen B, Soberg HL, Sveen U. User involvement and experiential knowledge in interprofessional rehabilitation: a grounded theory study. BMC Health Serv Res. 2016;16(1):547. doi: 10.1186/s12913-016-1808-5 27716269

60. Sennfalt S, Norrving B, Petersson J, Ullberg T. Long-Term Survival and Function After Stroke. Stroke. 2018;50:53–61.


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