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


CONCLUSIONS
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.
Rochette
Annie
A
School of Rehabilitation, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Quebec, Canada. annie.rochette@umontreal.ca
Korner-Bitensky
Nicol
N
Desrosiers
Johanne
J
D000328:Adult; D002170:Canada; D003153:Community Health Services; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D013070:Speech Therapy; D018454:Spouses / Q000523:psychology*; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires