title: Implementing the new CARF wellness standards.
abstract: Our objectives in this article are to provide background and practical applications of the implementation of the new wellness standards developed by the Commission on Accreditation of Rehabilitation Facilities (CARF). The focus of rehabilitation in the stroke population ideally extends beyond maximizing functioning and prevention of further debilitation, by addressing wellness and the opportunity to create a healthy lifestyle. This concept has been recognized by CARF, which has included new wellness standards for stroke rehabilitation. This article provides a framework for implementing these standards and trends related to prevalence, incidence, and prevention of stroke. The Transtheoretical Model of Change, as described by James Prochaska, is discussed in relation to facilitating lifestyle changes in stroke patients in the rehabilitation setting. Additionally, the Six Dimensions of Wellness Model by Dr Bill Hettler is presented as a framework for developing a wellness tool. Finally, we discuss the development, barriers, and implementation of a wellness tool used at Madonna Rehabilitation Hospital to exemplify a tangible strategy to meet the new CARF standards.
authors.affiliation: Integrative Health and Community Services, Madonna Rehabilitation Hospital, Lincoln, Nebraska.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nathenson
authors.affiliation: Department of Humanities and Social Sciences, Medical Sociology Oregon Institute of Technology, Klamath Falls, Oregon. Electronic address: sophialyn.nathenson@oit.edu.
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Nathenson
authors.affiliation: Rehabilitation Programs, Madonna Rehabilitation Hospital, Lincoln, Nebraska.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Divito
mesh_terms: D000203:Activities of Daily Living; D019091:Critical Pathways / Q000592:standards; D019983:Guideline Adherence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D015994:Incidence; D008019:Life Style; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D010342:Patient Acceptance of Health Care; D017410:Practice Guidelines as Topic / Q000592:standards*; D015995:Prevalence; D015397:Program Evaluation; D012047:Rehabilitation Centers / Q000592:standards*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: CARF; obesity; stroke; wellness