The Importance of Patient Involvement in Stroke Rehabilitation.
OBJECTIVE
To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met.


METHODS
Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment.


RESULTS
The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading.


CONCLUSIONS
The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health services needs.
Health Sciences Research Centre, University College Lillebaelt, Odense, Denmark.|Research Unit in Rehabilitation, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
Hanne Kaae
HK
Kristensen
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.|School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
Malin
M
Tistad
Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.|Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
Lena von
Lv
Koch
Research Unit in Rehabilitation, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.|Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
Charlotte
C
Ytterberg
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006296:Health Services; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010358:Patient Participation / Q000379:methods; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation / Q000379:methods; D011795:Surveys and Questionnaires