Actual vs best practice for families post-stroke according to three rehabilitation disciplines

J Rehabil Med. 2007 Sep;39(7):513-9. doi: 10.2340/16501977-0082.

Abstract

Objective: To investigate occupational therapists', physiotherapists' and speech language pathologists' family-related rehabilitation practice post-stroke and its association with clinician and environmental variables.

Methods: A Canadian cross-sectional telephone survey was conducted on 1755 clinicians. Three case studies describing typical patients after stroke receiving acute care, in-patient rehabilitation, or community rehabilitation, and including specific descriptors regarding family stress and concern, were used to elicit information on patient management.

Results: One-third of the sample identified a family-related problem and offered a related intervention, but only 12/1755 clinicians indicated that they would typically use a standardized assessment of family functioning. Working in the community out-patient setting was associated (OR 9.16), whereas working in a rehabilitation in-patient setting was negatively associated (OR 0.58) with being a problem identifier, the reference group being acute care. Being a PT (OR 0.53) or an SLP (OR 0.49) vs an OT was negatively associated with being a problem identifier, whereas being older (OR 1.02 ) or working in Ontario (OR 1.58) was associated with being a problem identifier. To work in a community out-patient setting (OR 2.43), being older clinicians (OR 1.02) or not perceiving their work environment being supportive of an on-going professional learning (OR 1.72) was associated with being an intervention user,whereas being a PT (OR 0.50) was negatively associated with being a user.

Conclusion: For these 3 disciplines, the prevalence of a family-related focus is low post-stroke. Given the increasing evidence regarding the effectiveness of family-related interventions on stroke outcomes, it is imperative that best practice is implemented.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada
  • Community Health Services
  • Cost of Illness
  • Cross-Sectional Studies
  • Family / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy
  • Outcome Assessment, Health Care
  • Physical Therapy Modalities
  • Speech Therapy
  • Spouses / psychology*
  • Stroke / psychology
  • Stroke Rehabilitation*
  • Surveys and Questionnaires