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"Everyone needs rehab, but...": exploring post-stroke rehabilitation referral and acceptance decisions.
- Source :
- Disability & Rehabilitation; Aug2022, Vol. 44 Issue 17, p4717-4728, 12p
- Publication Year :
- 2022
-
Abstract
- To explore the decision-making processes and experiences of acute and rehabilitation clinicians, regarding referral and acceptance of patients to rehabilitation after stroke. Multi-site rapid ethnography, involving observation of multidisciplinary case conferences, interviews with acute stroke and rehabilitation clinicians, and review of key documents within five (5) acute stroke units (ASUs) in Queensland, Australia. A cyclical, inductive content analysis was performed. Seven key themes were identified, revealing the complex nature of post-stroke rehabilitation referral and acceptance decision making. Although the majority of clinicians felt that all patients could benefit from rehabilitation, they acknowledged this could not always be the case. Rehabilitation potential and goals were considered by clinicians, but decision making was impacted by ASU context and team processes, rehabilitation service availability and access procedures, and the relationships between the acute and rehabilitation clinicians. Patients and families were not actively involved in the decision-making processes. Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients. Referral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs. Clear and straightforward access procedures and positive relationships between acute and rehabilitation clinicians have a positive impact on referral decision making. Stroke services should review their processes to ensure shared decision making is facilitated when patients require access to rehabilitation. [ABSTRACT FROM AUTHOR]
- Subjects :
- HUMAN research subjects
RESEARCH methodology
TIME
PHYSICIANS' attitudes
INTERVIEWING
ETHNOLOGY research
STROKE units
INFORMED consent (Medical law)
STROKE rehabilitation
MEDICAL referrals
HEALTH care teams
FIELD notes (Science)
DESCRIPTIVE statistics
RESEARCH funding
DECISION making in clinical medicine
JUDGMENT sampling
DATA analysis software
CONTENT analysis
Subjects
Details
- Language :
- English
- ISSN :
- 09638288
- Volume :
- 44
- Issue :
- 17
- Database :
- Complementary Index
- Journal :
- Disability & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 158752226
- Full Text :
- https://doi.org/10.1080/09638288.2021.1918770