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Aim: To explore what the obstacles are that deter patients from continuing stroke rehabilitation after discharge from hospital in Singapore. Methods: In this qualitative study, individual semi-structured telephone interviews were undertaken and analysed using inductive thematic analysis. Thirty one stroke patients, who had been discharged from the hospital after inpatient rehabilitation (mean age=66.46 years, mean duration postdischarge= 95.82 days), were interviewed. Results: Five themes were identified as obstacles to post-discharge stroke rehabilitation including: the means to access rehabilitative services; lapse in discharge coordination; family members’ views and actions; discrepancies in expectation; and the perception that rehabilitation is simple. Participants indicated a need for timely and appropriate information, delivered according to their individualised needs. Conclusion: Study findings revealed that the absence of a smooth transition through the continuum of stroke care and not having a common understanding of rehabilitation accounts for the lack of adherence to therapy recommendations. The results suggest that clinicians need to be more aware of their role in providing well-coordinated information about therapy. The study also highlighted the need to review the goal-setting processes that guide the course of rehabilitation. Goals should be more patient-centred to reduce the discrepancies in expectations of rehabilitation. There needs to be a greater involvement of carers in discharge planning to minimise the dissatisfaction in care arrangements and information delivery. [ABSTRACT FROM AUTHOR]

Aim: To explore what the obstacles are that deter patients from continuing stroke rehabilitation after discharge from hospital in Singapore. Methods: In this qualitative study, individual semi-structured telephone interviews were undertaken and analysed using inductive thematic analysis. Thirty one stroke patients, who had been discharged from the hospital after inpatient rehabilitation (mean age=66.46 years, mean duration postdischarge= 95.82 days), were interviewed. Results: Five themes were identified as obstacles to post-discharge stroke rehabilitation including: the means to access rehabilitative services; lapse in discharge coordination; family members’ views and actions; discrepancies in expectation; and the perception that rehabilitation is simple. Participants indicated a need for timely and appropriate information, delivered according to their individualised needs. Conclusion: Study findings revealed that the absence of a smooth transition through the continuum of stroke care and not having a common understanding of rehabilitation accounts for the lack of adherence to therapy recommendations. The results suggest that clinicians need to be more aware of their role in providing well-coordinated information about therapy. The study also highlighted the need to review the goal-setting processes that guide the course of rehabilitation. Goals should be more patient-centred to reduce the discrepancies in expectations of rehabilitation. There needs to be a greater involvement of carers in discharge planning to minimise the dissatisfaction in care arrangements and information delivery. [ABSTRACT FROM AUTHOR]

Aim: To determine whether providing therapy staff with objective information regarding the nature of visual impairment enhances functional recovery of stroke survivors. Methods: A mixed methodology incorporated a pilot randomized controlled trial (RCT) and qualitative study. Patients presenting acutely with functional disability and suspected visual deficit, underwent visual assessment. Patients with visual impairment were recruited; all subjects received rehabilitation. The sample was randomized to group A (control) where details of visual assessment were withheld from therapy staff and group B (experimental) where details of visual assessment were disclosed. Functional measures (Functional Independent Measure, timed walk) were recorded at baseline and 6-week follow-up. Health professionals participated in a focus group to discuss the perceived influence of the additional visual assessment service on functional outcome. Findings: 64 patients were recruited over 18 months (group A=31; group B=33). Drop out resulted in 19 subjects in group A and 20 in group B for full analysis. Significant functional improvement was noted in both groups, no significant difference was found between groups. Health professionals reported a perceived positive impact from the vision assessment service. Conclusions: Provision of visual assessment information did not influence functional recovery. Qualitative findings indicated perceived benefits from the provision of the vision assessment service. [ABSTRACT FROM AUTHOR]

Aim: To determine whether providing therapy staff with objective information regarding the nature of visual impairment enhances functional recovery of stroke survivors. Methods: A mixed methodology incorporated a pilot randomized controlled trial (RCT) and qualitative study. Patients presenting acutely with functional disability and suspected visual deficit, underwent visual assessment. Patients with visual impairment were recruited; all subjects received rehabilitation. The sample was randomized to group A (control) where details of visual assessment were withheld from therapy staff and group B (experimental) where details of visual assessment were disclosed. Functional measures (Functional Independent Measure, timed walk) were recorded at baseline and 6-week follow-up. Health professionals participated in a focus group to discuss the perceived influence of the additional visual assessment service on functional outcome. Findings: 64 patients were recruited over 18 months (group A=31; group B=33). Drop out resulted in 19 subjects in group A and 20 in group B for full analysis. Significant functional improvement was noted in both groups, no significant difference was found between groups. Health professionals reported a perceived positive impact from the vision assessment service. Conclusions: Provision of visual assessment information did not influence functional recovery. Qualitative findings indicated perceived benefits from the provision of the vision assessment service. [ABSTRACT FROM AUTHOR]