A â€client-centred activities of daily livingâ€ intervention for persons with stroke: One-year follow-up of a randomized controlled trial

Guidetti, Susanne; Ranner, Maria; Tham, Kerstin; Andersson, Magnus; Ytterberg, Charlotte; Koch, Lena von

doi:10.2340/16501977-1981

Cited by 42 publications

(59 citation statements)

References 33 publications

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“…Eight RCTs described in nine publications compared home-visiting programs with the usual care [14,21,24,25,34,35,36,37]. Two studies compared an early support discharge (ESD) with home-visiting programs to the conventional hospital care [14,19].…”

Section: Resultsmentioning

confidence: 99%

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

Wang

Yang

Shi

et al. 2017

IJERPH

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Stroke is a major cause of disability and mortality worldwide; yet; prior to this study; there had been no sufficient evidence to support the effectiveness of various transitional care interventions (TCI) on the disability and mortality of stroke survivors. This meta-analysis aimed to assess the effectiveness of TCI in reducing mortality and improving the activities of daily life (ADL) of stroke patients. PubMed; Web of Science; OVID; EMBASE; CINAHL; and Sino-Med were searched for articles published before November 2016. Thirty-one randomized controlled trials (RCTs) were identified in the study. This analysis showed that the total effect of TCI on reducing mortality was limited (Risk Ratio (RR) = 0.86; 95% Confidence Interval (CI): 0.75–0.98); that only home-visiting programs could reduce mortality rates (RR = 0.34; 95% CI: 0.17–0.67) compared with usual care; and that the best intervention was led by a multidisciplinary team (MT) ≤3 months (RR = 0.19; 95% CI: 0.05–0.71). In addition; home-visiting programs also produced ADL benefit (RR = 0.56; 95% CI: 0.31–0.81). Overall; there was a statistically significant difference in improving patients’ independence between TCI and usual care (RR = 1.12; 95% CI: 1.02–1.23). However; none of the interventions was effective when they were differentiated in the analysis. It is the conclusion of this study that home-visiting programs; especially those led by MTs; should receive the greatest consideration by healthcare systems or providers for implementing TCI to stroke survivors.

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Section: Resultsmentioning

confidence: 99%

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

Wang

Yang

Shi

et al. 2017

IJERPH

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“…Independent variables were drawn from the data collection, described in detail elsewhere, 11,12 of the randomized controlled trial: client socio-demographic data (age, education, gender, marital status), client disease related factors (the Frenchay Activity Index, 23 stroke severity); and healthcare setting, (inpatient versus outpatient rehabilitation, and county council). Client-provider interaction has been linked to client characteristics and clinical settings 24,25 and it was hypothesized that these factors could influence the documentation.…”

Section: Methodsmentioning

confidence: 99%

Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

et al. 2016

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Objective:The aim of the present study was to compare client-centeredness as it was documented by the occupational therapists in the units randomized to the intervention clusters with documentation by occupational therapists in the control clusters.Design:Comparison of medical records.Setting:The study is conducted in a context of a randomized controlled trial in Sweden, with 16 post-stroke rehabilitation units cluster randomized to intervention or control group.Subjects:Occupational therapist documentation in medical records of 279 clients with stroke.Main measures:The medical records were reviewed for their level of client-centeredness using a protocol developed from the Stewart et al model. The occupational therapists in the intervention groups participated in a workshop training to enhance their client-centeredness.Results:Occupational therapists with training in client-centeredness documented significantly more on goal setting (OR = 4.1; 95% CI, 1.87-8.81), on client participation in goal setting (OR=11.34; 95% CI, 5.97-21.57), on how the goals could be reached (OR=2.8; 95% CI, 1.7-4.62), on client participation in how goals could be reached (OR=4.56; 95% CI, 2.73-7.64), on the follow-up on goals (OR=5.77; 95% CI, 2.78-11-98) and on client participation in follow-up on goals (OR=7.44, 95% CI, 4.33-12.8). This association remained after adjustment for healthcare setting, client socio-demographic variables, and stroke severity.Conclusion:Documentation of goal setting and client participation in goal setting can be influenced by training.

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“…One review 76 focused on the values and attitudes associated with person-centred care, suggesting it requires an organizational culture with six characteristics: The similarities between rehabilitation and person-centred care is obvious, and there is also evidence that care described as person-centred is effective, 78,79 but not always. 80,81 Finally, this person-centred approach has already been recognized in one definition of rehabilitation, adopted by the American Thoracic Society (ATS) and the European Respiratory Society (ERS) 4…”

Section: Conundrum and Solutionmentioning

confidence: 99%

What is rehabilitation? An empirical investigation leading to an evidence-based description

2020

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Background: There is no agreement about or understanding of what rehabilitation is; those who pay for it, those who provide it, and those who receive it all have different interpretations. Furthermore, within each group, there will be a variety of opinions. Definitions based on authority or on theory also vary and do not give a clear description of what someone buying, providing, or receiving rehabilitation can actually expect. Method: This editorial extracts information from systematic reviews that find rehabilitation to be effective, to discover the key features and to develop an empirical definition. Findings: The evidence shows that rehabilitation may benefit any person with a long-lasting disability, arising from any cause, may do so at any stage of the illness, at any age, and may be delivered in any setting. Effective rehabilitation depends on an expert multidisciplinary team, working within the biopsychosocial model of illness and working collaboratively towards agreed goals. The effective general interventions include exercise, practice of tasks, education of and self-management by the patient, and psychosocial support. In addition, a huge range of other interventions may be needed, making rehabilitation an extremely complex process; specific actions must be tailored to the needs, goals, and wishes of the individual patient, but the consequences of any action are unpredictable and may not even be those anticipated. Conclusion: Effective rehabilitation is a person-centred process, with treatment tailored to the individual patient’s needs and, importantly, personalized monitoring of changes associated with intervention, with further changes in goals and actions if needed.

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A â€client-centred activities of daily livingâ€ intervention for persons with stroke: One-year follow-up of a randomized controlled trial

Abstract: Further research is required to understand the benefits of client-centred interventions.

Cited by 42 publications

References 33 publications

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

What is rehabilitation? An empirical investigation leading to an evidence-based description

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A â€client-centred activities of daily livingâ€ intervention for persons with stroke: One-year follow-up of a randomized controlled trial

Abstract: Further research is required to understand the benefits of client-centred interventions.

Cited by 42 publications

References 33 publications

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

What Type of Transitional Care Effectively Reduced Mortality and Improved ADL of Stroke Patients? A Meta-Analysis

Training in client-centeredness enhances occupational therapist documentation on goal setting and client participation in goal setting in the medical records of people with stroke

What is rehabilitation? An empirical investigation leading to an evidence-based description

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A â€client-centred activities of daily livingâ€ intervention for persons with stroke: One-year follow-up of a randomized controlled trial