The impact of inpatient neurorehabilitation on psychological well-being on discharge and at 3 month follow-up.
BACKGROUND
Neurological rehabilitation aims to improve quality of life of patients with acute and chronic neurological conditions. Much of the existing research focuses on the impact of rehabilitation on physical functioning, with less emphasis on emotional wellbeing. This study assessed changes in psychological functioning in patients on discharge from rehabilitation and three months after discharge.


METHODS
Patients admitted over a six-month period to a neurological rehabilitation unit were recruited prospectively to this study. Psychological functioning was measured by the self-report General Health Questionnaire and the Hospital Anxiety and Depression Scale. In addition, physical functioning was measured by the Barthel index and Functional Independence Measure.


RESULTS
Psychological functioning was found to be significantly improved with rehabilitation. However, after three months, patients' scores returned to pre-treatment values. Anxiety was consistently elevated on admission, discharge and follow-up. In contrast, physical functioning improved from admission to discharge and was maintained at follow-up assessment.


CONCLUSIONS
Rehabilitation services need to focus more on psychological functioning after discharge and identify effective strategies to maintain wellbeing.
O'Connor
Rory J
RJ
Rehabilitation Group, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Cano
Stefan J
SJ
Thompson
Alan J
AJ
Playford
E Diane
ED
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000503:physiopathology / Q000523:psychology; D003710:Demography; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010351:Patient Discharge; D011788:Quality of Life; D012047:Rehabilitation Centers; D016896:Treatment Outcome