Division of Occupational Therapy, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Fack 23 200, S 141 83, Huddinge, Sweden.
BMC Neurol. 2012 Jun 18;12:40. doi: 10.1186/1471-2377-12-40.
People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke.
The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses.
Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08).
Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.
中风患者通常会报告康复需求未得到满足。我们使用患者满意度模型，研究了中风后 3 个月个体特征，这些特征预测了中风后 12 个月的康复需求未得到满足或对医疗服务不满意，或者与中风后 12 个月的康复需求未得到满足或对医疗服务不满意有关。
参与者（n=175）在瑞典卡罗林斯卡大学医院的中风病房接受治疗。使用问卷收集“康复需求未得到满足”和“对护理不满意”两个依赖变量。将中风严重程度、中风影响量表（SIS）的各个领域、心理一致感量表（SOC）和社会人口统计学因素作为四个逻辑回归分析的自变量。
12 个月时康复需求未得到满足由 3 个月时的力量（SIS）（优势比（OR）7.05）预测，与 12 个月时的手部功能（SIS）（OR 4.38）和自我评估恢复不佳（SIS）（OR 2.46）相关。对护理不满意由 SOC（OR 4.18）和参与度（SIS）（OR 3.78）预测，与 SOC（OR 3.63）和力量（SIS）（OR 3.08）相关。
33%的参与者报告康复需求未得到满足，14%的参与者对所接受的护理不满意。为了满足康复需求，康复服务在提供康复服务的时间上可能需要更加灵活。长期服务，定期重新评估，并更加注重了解患者及其社交网络的体验，可能能够更好地提供满足患者需求和帮助人们重新定位的服务；这尤其适用于应对能力较差的患者。
