The process of stroke rehabilitation: what happens and why

Tyson, S; Turner, G

Abstract

Objective: To assess the process of hospital-based stroke rehabilitation.
Design: A criterion-based process audit, combined with surveys of patient and
staff opinions and basic outcome measures.
Setting: All wards and units treating stroke patients in a health care district,
including an acute and a community National Health Service (NHS) trust.
Subjects: Process audit: documented notes of 115 stroke patients admitted
over a four-month period. Patient satisfaction survey: 93 surviving stroke
patients. Staff opinion survey: Hospital doctors, therapists and nurses treating
stroke patients throughout the district.
Results: A disappointingly poor level of service. The main shortcomings were
poor assessment of impairment (pass rate, 46%), inadequate communication
between staff and with patients and carers (pass rate, 43%), and an absence
of rehabilitation beyond the basic of activities of daily living and indoor
mobility (pass rate for assessment of disability and emotional need, 50%).
Thirty-three per cent of patients were dissatisfied with the hospital-based
service they received, particularly lack of therapy, information and recovery.
The main reasons for these shortcomings were low priority given to stroke
patients, lack of time, shortage of staff, and lack of knowledge and
awareness of stroke amongst the staff. Rehabilitation units and elderly care
tended to perform better than general medical units in areas of assessment
of impairment, self-care skills and mobility, and wheelchair provision.
Conclusions: Evidence from previous publications suggests that this service
was no worse than in other districts, but this audit methodology, by
comprehensively examining many aspects of a service together, is better able
to reveal inadequacies.

Citation

Tyson, S., & Turner, G. (1999). The process of stroke rehabilitation: what happens and why. Clinical Rehabilitation, 13, 322-332

• Journal Article Type: Article
• Publication Date: Jan 1, 1999
• Deposit Date: Mar 23, 2010
• Journal: Clinical Rehabilitation
• Print ISSN: 0269-2155
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Pages: 322-332