1
|
Herbold J, Elmohsen E, Gutierrez G, Helgesen M, Babyar S. Prediction of Discharge Destination After Inpatient Rehabilitation for Stroke Using Mobility and Self-Care Assessment in Section GG of the Inpatient Rehabilitation Facility - Patient Assessment Instrument. Arch Rehabil Res Clin Transl 2023; 5:100292. [PMID: 38163021 PMCID: PMC10757179 DOI: 10.1016/j.arrct.2023.100292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective To determine the ability of Section GG of the Inpatient Rehabilitation Facility - Patient Assessment Inventory (Section GG)'s quantification of mobility and self-care to predict discharge destination for persons with stroke after inpatient rehabilitation. Design Retrospective, observational cohort study. Setting 150-bed inpatient rehabilitation facility within a metropolitan health system. Participants Consecutive sample of adults and older adults with stroke admitted for inpatient rehabilitation from January 2020 to June 2021 (N=1051). Subjects were excluded for discharge to acute care or hospice or if they had COVID-19. Intervention None. Main Outcome Measures Section GG self-care and mobility scores used in reimbursement formulation by Centers for Medicare and Medicaid at admission to inpatient rehabilitation; age; sex; prior living situation; discharge setting. Logistic regression examined binary comparisons of discharge destinations. Receiver operating characteristic (ROC) curves determined cut-off admission Section GG scores for binary comparisons. Results Logistic regression demonstrated that presence of a caregiver in the home was consistently the strongest predictor (P<.001) and admission Section GG scores were significant secondary factors in determining the discharge destination. An admission Section GG cut-off score of 33.5 determined home with homecare vs skilled nursing facility and a cut-off of 36.5 determined discharge to home with outpatient care vs skilled nursing facility. Conclusion Clinicians responsible for discharge decisions for patients with stroke after inpatient rehabilitation might start by determining the presence of a caregiver in the home and then use Section GG cut-off scores to guide decisions about home (with or without homecare) vs SNF destinations. Such guidance is not advised for the home with outpatient services vs home with homecare decision; clinical judgment is needed to determine the best discharge plan because this ROC had a less robust area under the curve. Sex and race/ethnicity were not determining factors for binary choices of discharge destinations.
Collapse
Affiliation(s)
- Janet Herbold
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY
| | - Ebrahim Elmohsen
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Gino Gutierrez
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Michael Helgesen
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| | - Suzanne Babyar
- Post Acute Services, Burke Rehabilitation Hospital, White Plains, NY
- Department of Physical Therapy, Hunter College, The City University of New York, New York, NY
| |
Collapse
|
2
|
Jiang Z, Zhi N, Liu G, Sun X, Chen X, Ma D, Guo M, Wang S, Zhang H. Electroacupuncture for post-stroke urinary incontinence: a systematic review and meta-analysis with trial sequential analysis. Front Neurol 2023; 14:1282580. [PMID: 38046590 PMCID: PMC10693342 DOI: 10.3389/fneur.2023.1282580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/20/2023] [Indexed: 12/05/2023] Open
Abstract
Background The evidence for the effectiveness of electroacupuncture (EA) for post-stroke urinary incontinence (PSUI) patients remains unclear. Therefore, the purpose of this systematic review and meta-analysis was to assess the efficacy of EA for PSUI. Methods and analysis Eight English and Chinese databases were searched from their inception until 1 August 2023 to collect randomized controlled trials (RCTs) that investigated the effect of EA on PSUI. Two reviewers independently selected studies that met the eligibility criteria, extracted the necessary data, and assessed the risk of bias for included studies using Cochrane Handbook version 5.1.0. Meta-analysis was performed using Review Manager software (version 5.4.1). Publication bias detection was conducted using STATA (version 16.0). Sequential analysis was performed using TSA 0.9.5.10 Beta. The Grading of Recommendations Assessment, Development, and Evaluation System (GRADE) was used for assessing the certainty of evidence. Results We included 15 RCTs involving a total of 1,414 patients. The narrative analysis revealed that compared with sham EA, genuine EA exhibited greater efficacy in reducing occurrences of 24-h urinary incontinence while also enhancing maximum cystometric capacity (MCC). Moreover, this effect remained significant even during the 3-month follow-up period. Fourteen studies were encompassed within the quantitative analysis. In contrast to active interventions, EA did not yield an improvement in the responder rate (RR 1.53, 95% CI 0.61 to 3.80, p = 0.36). When compared with basic treatments, the combination of EA with them led to a reduction in 24-h urinary incontinence occurrences (MD -0.56, 95% CI -0.60 to -0.52, p < 0.00001), an improvement in MCC (MD 43.23, 95% CI 28.86 to 57.60, p < 0.00001), and a decrease in residual urine volume (RUV; MD -19.99, 95% CI -29.75 to -10.23, p < 0.0001). However, it did not lead to an increase in the responder rate (RR 1.39, 95% CI 0.88 to 2.20, p = 0.16). In comparison to basic treatments combined with active interventions, the amalgamation of EA and them led to an increase in the responder rate (RR 1.24, 95% CI 1.14 to 1.35, p < 0.00001), a reduction in 24-h urinary incontinence occurrences (MD -2.90, 95% CI -5.26 to -0.55, p = 0.02), a decrease in International Consultation on Incontinence Questionnaire-Short Form scores, and an improvement in both MCC (MD 42.11, 95% CI 23.26 to 60.96, p < 0.0001) and RUV (MD 42.11, 95% CI 23.26 to 60.96, p < 0.0001). Furthermore, all reported adverse effects associated with EA were mild. The trial sequential analysis suggested that a sufficient sample size was available to yield results. However, the level of evidence was predominantly assessed as low or very low. Conclusion Electroacupuncture improved post-stroke urinary incontinence with no serious adverse effects. Caution is warranted due to methodological issues, and more high-quality studies are required to confirm its efficacy and safety.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023449599, Identifier CRD42023449599.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Hong Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
3
|
Hong GR, Chun MH. Relation between Lower Urinary Tract Dysfunction and Functional Outcome in Patients After Brain Tumor Resection. BRAIN & NEUROREHABILITATION 2023; 16:e11. [PMID: 37554257 PMCID: PMC10404806 DOI: 10.12786/bn.2023.16.e11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/28/2023] [Accepted: 04/07/2023] [Indexed: 08/10/2023] Open
Abstract
This study aimed to compare functional outcomes after rehabilitation with initial degree of urinary retention (UR) in patients operated on for brain tumors. Medical records of 61 patients transferred to the Department of Rehabilitation Medicine of single center, from January 2011 to December 2021, were reviewed retrospectively. Patient data included post-void residual (PVR) urine, tumor characteristics, and functional status. Functional status was evaluated on the Mini-Mental Status Examination (MMSE), Modified Barthel Index (MBI), Functional Ambulation Category (FAC), Modified Rankin Scale (mRS), Motricity Index (MI)-lower limb, and Berg Balance Scale (BBS). MMSE, FAC, mRS, and MI-lower limb were re-evaluated 3 weeks after standard inpatient rehabilitation. Twenty-four patients were in the UR group and 37 in the non-UR group. Initial MMSE, MBI, BBS, FAC, and mRS were significantly worse in the UR group, and both groups showed significant functional improvement after rehabilitation. After rehabilitation, MMSE, FAC, MRS, MI-lower were still worse in the UR group, but the degree of improvement between the groups was not significantly different. Rehabilitation was shown to be effective for brain tumor patients regardless of UR. Initial UR after brain tumor surgery is significantly associated with poor functional status in both the early stages of rehabilitation and after rehabilitation.
Collapse
Affiliation(s)
- Ga Ram Hong
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
4
|
Fujita T, Yamane K, Yamamoto Y, Sone T, Ohira Y, Otsuki K, Iokawa K. Age-stroke related dysfunction interaction associated with home discharge of stroke inpatients in the rehabilitation ward. Medicine (Baltimore) 2023; 102:e34152. [PMID: 37352048 PMCID: PMC10289490 DOI: 10.1097/md.0000000000034152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/06/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023] Open
Abstract
The purpose of this study was to investigate whether interactions exist among cognitive and physical functions and activities of daily living (ADL) associated with home discharge of stroke patients in the rehabilitation ward. The subjects were 231 patients with a first stroke. Age, gender, affected side, the stroke impairment assessment set, ADL and discharge destination were collected from the medical record. Using a decision tree, a combination of variables that might have an interaction effect associated with home discharge was extracted. The existence of an interaction between the extracted variables was confirmed by logistic regression analysis. A combination of total score of the stroke impairment assessment set (≤27 points) and age (>76.5 years) at admission was extracted from the decision tree. As a result of the logistic regression analysis, this interaction term was significantly associated with home discharge. The findings of the present study suggest that there is an interaction between age and stroke-related dysfunction related to home discharge. Stroke patients aged over 76.5 years with the stroke impairment assessment set score of 27 or less at admission to the rehabilitation ward may need rehabilitation program considering the difficulty of home discharge.
Collapse
Affiliation(s)
- Takaaki Fujita
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Fukushima, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Fukushima, Japan
| | - Toshimasa Sone
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Yoko Ohira
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Fukushima, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Kita-Fukushima Medical Center, Date, Fukushima, Japan
| | - Kazuaki Iokawa
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Fukushima, Japan
| |
Collapse
|
5
|
Higashi Y, Kaneda T, Yuri Y, Horimoto T, Somei Y, Hirayama K. Development of toileting behaviour evaluation for Japanese older patients using wheelchairs in a hospital setting: a validation study. BMC Geriatr 2023; 23:353. [PMID: 37280510 DOI: 10.1186/s12877-023-04069-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Ageing limits the activities of daily living (ADLs). Among ADLs, a lack of toileting independence causes a decline in the quality of life, mental health, and social participation. Therefore, occupational therapists spend considerable time assessing toileting disability based on various assessment methods for toileting behaviour. However, these assessment methods have issues with the grading levels, number of items, and diseases covered, and they fail to evaluate toileting behaviour accurately and sensitively. Hence, this study developed a Toileting Behaviour Evaluation (TBE) on a 6-point ordinal scale for patients using wheelchairs, with 22 activity components for various diseases. METHODS This study examined the reliability and validity of the TBE in acute and subacute hospitals in Japan. To this end, two occupational therapists assessed 50 patients for inter-rater reliability at different times and one assessed them twice within 7-10 days for intra-rater reliability using the TBE. Furthermore, occupational therapists assessed 100 patients for internal consistency using the TBE and for concurrent validity using the TBE and Functional Independence Measure (FIM). The patients had been diagnosed with various diseases. This study used the weighted kappa coefficient for statistical analysis of the inter-rater and intra-rater reliability, Cronbach's alpha coefficient for internal consistency, and Spearman's rank correlation coefficient for concurrent validity. We performed all statistical analyses using the IBM SPSS Statistics ver. 25 for Windows. All P-values < 0.05 were considered statistically significant. RESULTS The minimum weighted kappa coefficients for the inter-rater and intra-rater reliability for each item were 0.67 and 0.79, respectively. Cronbach's alpha was 0.98 for the 22 items. The Spearman's rank correlation coefficient between the mean scores on the TBE and FIM for toilet-related items was 0.74 (P < .01). CONCLUSIONS The TBE demonstrated good reliability and validity. This means that therapists can use it to identify impaired toileting behaviour. However, the relationship between impairments and each item of toileting behaviour should be explored in future studies. Additionally, studies should examine the creation of a specific index of functions of independence in each toileting behaviour.
Collapse
Affiliation(s)
- Yasuhiro Higashi
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16, Nankokita, Suminoe, Osaka, 559-8611, Japan.
- Department of Rehabilitation, Kansai Rehabilitation Hospital, 3-11-1, Sakuranocho, 560-0054, Toyonaka, Osaka, Japan.
| | - Toshikatsu Kaneda
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16, Nankokita, Suminoe, Osaka, 559-8611, Japan
- Department of Rehabilitation, Kansai Rehabilitation Hospital, 3-11-1, Sakuranocho, 560-0054, Toyonaka, Osaka, Japan
| | - Yoshimi Yuri
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16, Nankokita, Suminoe, Osaka, 559-8611, Japan
| | - Takumi Horimoto
- Department of Rehabilitation, Osaka General Hospital of West Japan Railway Company, 1-2-22, Matsuzakicho, 545-0053, Abeno, Osaka, Japan
| | - Yuta Somei
- Department of Rehabilitation, Kansai Rehabilitation Hospital, 3-11-1, Sakuranocho, 560-0054, Toyonaka, Osaka, Japan
| | - Kimiaki Hirayama
- Department of Rehabilitation, Kiba Hospital, 4-2-8, Iwatacho, 578-0941, Higashiosaka, Osaka, Japan
| |
Collapse
|
6
|
Özden F, Özkeskin M, Tümtürk İ, Yalçın M. The investigation of cognition, proprioception, sensory and physical function in stroke patients with urinary incontinence. Int Urol Nephrol 2023:10.1007/s11255-023-03647-5. [PMID: 37253930 DOI: 10.1007/s11255-023-03647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE This study aimed to investigate cognition, proprioception, and sensory/physical function in stroke patients with urinary incontinence (UI). METHODS A prospective cross-sectional study was conducted on 53 individuals with stroke (23 had UI and 21 matched controls). The Incontinence Impact Questionnaire Short Form (IIQ-7) and Urogenital Distress Inventory (UDI-6) were used to assess the patients' UI symptoms. Participants were also evaluated with Mini-Mental State Examination (MMSE), Barthel Index (BI), Fugl-Meyer Sensory Assessment (FMA-S), Five Times Sit to Stand Test (FTSST), Functional Reach Test (FRT) and Proprioception Test. RESULTS FTSST, FRT and FMA-S were better in stroke subjects without UI (p < 0.05). There was a moderate correlation between IIQ-7 with FMA-S, FTSST and proprioception (left extremity) (r1: - 0.415, r2: 0.440, r3: 0.430, p < 0.05) and a low correlation with BI (r: - 0.356, p < 0.05). CONCLUSION Individuals with UI had worse sensory/motor function and static balance. Stroke patients with UI were more dependent, had less sensory function, and had worse lower extremity muscle strength and proprioception as the level of urinary incontinence increased. To reduce urinary incontinence, emphasis on motor/sensory function, balance, and proprioception should be considered.
Collapse
Affiliation(s)
- Fatih Özden
- Köyceğiz Vocational School of Health Services, Department of Health Care Services, Muğla Sıtkı Koçman University, Köyceğiz, 48800, Muğla, Turkey.
| | - Mehmet Özkeskin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ege University, İzmir, Turkey
| | - İsmet Tümtürk
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Süleyman Demirel University, Isparta, Turkey
| | - Mustafa Yalçın
- Department of Physiotherapy and Rehabilitation, Bursa Çekirge State Hospital, Bursa, Turkey
| |
Collapse
|
7
|
Gledhill K, Bucknall TK, Lannin NA, Hanna L. Defining ready for discharge from sub-acute care: a qualitative exploration from multiple stakeholder perspectives. BMC Health Serv Res 2023; 23:425. [PMID: 37131178 PMCID: PMC10153031 DOI: 10.1186/s12913-023-09285-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/14/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Planning discharges from subacute care facilities is becoming increasingly complex due to an ageing population and a high demand on services. The use of non-standardised assessments to determine a patient's readiness for discharge places a heavy reliance on a clinician's judgement which can be influenced by system pressures, past experiences and team dynamics. The current literature focusses heavily on discharge-readiness from clinicians' perspectives and in the acute care setting. This paper aimed to explore the perceptions of discharge-readiness from the perspectives of key stakeholders in subacute care: inpatients, family members, clinicians and managers. METHODS A qualitative descriptive study was conducted, exploring the views of inpatients (n = 16), family members (n = 16), clinicians (n = 17) and managers (n = 12). Participants with cognitive deficits and those who did not speak English were excluded from this study. Semi-structured interviews and focus groups were conducted and audio-recorded. Following transcription, inductive thematic analysis was completed. RESULTS Participants identified that there are both patient-related and environmental factors that influence discharge-readiness. Patient-related factors discussed included continence, functional mobility, cognition, pain and medication management skills. Environmental factors centred around the discharge (home) environment, and were suggested to include a safe physical environment alongside a robust social environment which was suggested to assist to fill any gaps in functional capabilities (i.e. patient-related factors). CONCLUSIONS These findings make a unique contribution to the literature by providing a thorough exploration of determining discharge-readiness as a combined narrative from the perspectives from key stakeholders. Findings from this qualitative study identified key personal and environmental factors influencing patients' discharge-readiness, which may allow health services to streamline the determination of discharge-readiness from subacute care. Understanding how these factors might be assessed within a discharge pathway warrants further attention.
Collapse
Affiliation(s)
- Kate Gledhill
- School of Health and Social Development, Deakin University, Geelong, Australia.
- School of Primary and Allied Healthcare, Monash University, Frankston, Australia.
- Department of Occupational Therapy, School of Primary Health and Allied Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, VIC, 3199, Australia.
| | - Tracey K Bucknall
- School of Nursing and Midwifery, Deakin University, Melbourne, Australia
- Alfred Health, Melbourne, Australia
- Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Natasha A Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Alfred Health, Melbourne, Australia
| | - Lisa Hanna
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute of Health Transformation, Deakin University, Geelong, Australia
| |
Collapse
|
8
|
Tarvonen-Schröder S, Niemi T, Koivisto M. Inpatient Rehabilitation After Acute Severe Stroke: Predictive Value of the National Institutes of Health Stroke Scale Among Other Potential Predictors for Discharge Destination. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:27536351231157966. [PMID: 37223636 PMCID: PMC10201155 DOI: 10.1177/27536351231157966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/25/2023] [Indexed: 05/25/2023]
Abstract
Background Research focusing on predictors for discharge destination after rehabilitation of inpatients recovering from severe stroke is scarce. The predictive value of rehabilitation admission NIHSS score among other potential predictors available on admission to rehabilitation has not been studied. Aim The aim of this retrospective interventional study was to determine the predictive accuracy of 24 hours and rehabilitation admission NIHSS scores among other potential socio-demographic, clinical and functional predictors for discharge destination routinely collected on admission to rehabilitation. Material and Methods On a university hospital specialized inpatient rehabilitation ward 156 consecutive rehabilitants with 24 hours NIHSS score ⩾15 were recruited. On admission to rehabilitation, routinely collected variables potentially associated with discharge destination (community vs institution) were analyzed using logistic regression. Results 70 (44.9%) of rehabilitants were discharged to community, and 86 (55.1%) were discharged to institutional care. Those discharged home were younger and more often still working, had less often dysphagia/tube feeding or DNR decision in the acute phase, shorter time from stroke onset to rehabilitation admission, less severe impairment (NIHSS score, paresis, neglect) and disability (FIM score, ambulatory ability) on admission, and faster and more significant functional improvement during the in-stay than those institutionalized. Conclusion The most influential independent predictors for community discharge on admission to rehabilitation were lower admission NIHSS score, ambulatory ability and younger age, NIHSS being the most powerful. The odds of being discharged to community decreased with 16.1% for every 1 point increase in NIHSS. The 3-factor model explained 65.7% of community discharge and 81.9% of institutional discharge, the overall predictive accuracy being 74.7%. The corresponding figures for admission NIHSS alone were 58.6%, 70.9% and 65.4%.
Collapse
Affiliation(s)
- Sinikka Tarvonen-Schröder
- Neurocenter, Turku University Hospital,
Turku, Finland
- Department of Clinical Neurosciences,
University of Turku, Turku, Finland
| | - Tuuli Niemi
- Neurocenter, Turku University Hospital,
Turku, Finland
- Department of Clinical Neurosciences,
University of Turku, Turku, Finland
- Department of Expert Services, Turku
University Hospital, Turku, Finland
| | - Mari Koivisto
- Neurocenter, Turku University Hospital,
Turku, Finland
- Department of Clinical Neurosciences,
University of Turku, Turku, Finland
- Department of Biostatistics, University
of Turku, Turku, Finland
| |
Collapse
|
9
|
Kohler M, Ott S, Mullis J, Mayer H, Kesselring J, Saxer S. Promoting urinary continence in people suffering a stroke: Effectiveness of a complex intervention-An intervention study. Nurs Open 2022; 9:1262-1275. [PMID: 35014765 PMCID: PMC8859089 DOI: 10.1002/nop2.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
Aim The study aimed to implement and measure effectiveness of a systematic continence management intervention in people suffering a stroke in undertaking rehabilitation. Design An intervention study was conducted. Methods In the first part of the study, patients were included in the control group and observed. After the training of the nursing staff, participants were assigned to the intervention group. The intervention consisted of screening, assessment, treatment, communication and evaluation. Results Forty‐six patients took part in the study, of which 35 were in the control and 11 in the intervention groups. Within the two groups, significant improvements in outcomes were mostly seen during the study. For the Incontinence Quality of Life Social Embarrassment scale, a significantly higher increase was observed for the intervention group. The improvement between admission and discharge in the intervention group was notably larger for the outcome's incontinence and quality of life.
Collapse
Affiliation(s)
- Myrta Kohler
- Rehabilitation Centre Valens, Valens, Switzerland.,Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Stefan Ott
- Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | | | - Hanna Mayer
- Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
| | | | - Susi Saxer
- Institute of Applied Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| |
Collapse
|
10
|
Kushner DS, Strasser DC. Stroke Inpatient Rehabilitation Team Conferences: Leadership and Structure Improve Patient Outcomes. J Stroke Cerebrovasc Dis 2020; 29:104622. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.104622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/27/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022] Open
|
11
|
Abstract
In the United States, we are blessed with many options for postacute care: inpatient rehabilitation facilities, long-term acute care hospitals, skilled nursing facilities, home health agencies, and outpatient rehabilitation. However, choosing the appropriate level of care can be a daunting task. It requires interdisciplinary input and involvement of all stakeholders. The decision should be informed by outcomes data specific to the patient's diagnosis, impairments, and psychosocial supports.
Collapse
Affiliation(s)
- Robert Samuel Mayer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 174, Baltimore, MD 21287, USA.
| | - Amira Noles
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 174, Baltimore, MD 21287, USA
| | - Dominique Vinh
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| |
Collapse
|
12
|
Vaughan CP, Fitzgerald CM, Markland AD. Management of Urinary Incontinence in Older Adults in Rehabilitation Care Settings. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|