Actual vs best practice for families post-stroke according to three rehabilitation disciplines
Annie Rochette, Nicol Korner-Bitensky and Johanne Desrosiers
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.
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