141st APHA Annual Meeting

In This section

290641
Outcome measure selection in community-based stroke rehabilitation: An exploration of therapists' current practice in Scotland

Tuesday, November 5, 2013

Thilo Kroll, PhD , School of Nursing & Midwifery / Social Dimensions of Health Institute, University of Dundee, Dundee, United Kingdom
Helen Moore, PhD , School of Nursing and Midwifery/Social Dimensions of Health Institute, University of Dundee, Dundee, United Kingdom
Jacqui Morris, PhD , School of Nursing and Midwifery, University of Dundee, Dundee, United Kingdom
Lisa Salisbury, PhD , University of Edinburgh, Edinburgh, United Kingdom
Frederike van Wijk, PhD , Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
James Law, PhD , Institute of Health and Society, University of Newcastle, Newcastle, United Kingdom
John Dennis , NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
Background: Stroke rehabilitation needs to be evidence-based, equitable and patient-centred and should therefore achieve outcomes that are of personal relevance to the service user. However, converging evidence indicates a gap between research, policy and clinical practice in terms of stroke outcome assessment.

Aim: To examine the rationale for selection of outcome measures currently in use by UK rehabilitation professionals in community stroke rehabilitation.

Method: Senior stroke rehabilitation therapists were invited to participate in a web-based Scotland-wide survey, which explored current outcome measure, rationale for selection, fit with patient preferences, and professional characteristics. The survey was piloted prior to use and refined with input from steering group members. 12 rehabilitation therapists further took part in in-depth follow-up interviews exploring the rationale behind choosing particular outcome measures.

Results: 110 participants (49 physiotherapists, 39 occupational therapists, 22 Speech and language therapists) completed the web-based survey. Most (60%) reported that relevance to patients was the primary driver for choosing outcome measures. Accessibility was of primary importance to only 8.7% of respondents. 35.6% of therapists reported dissatisfaction with existing outcome measures in terms of their relevance for patients. Interviews revealed the complexities of measuring outcomes, which are relevant to patients in the community setting and different outcome measurement philosophies across disciplines.

Conclusion: As policy and practice is shifting towards greater patient-centredness in rehabilitation and assessment, choice of outcome measures is driven by relevance. However, accessibility is not key to therapists' choice of outcome measures despite emphasis on service user inclusion.

Learning Areas:
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe the rationale for selection of outcome measures currently in use by UK rehabilitation professionals in community stroke rehabilitation.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD in psychology; 20 years of disability-related health research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.