Rice Danielle B, McIntyre Amanda, Mirkowski Magdalena, Janzen Shannon, Viana Ricardo, Britt Eileen, Teasell Robert
Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, Main Building Room B3025, 550 Wellington Road, N6C 0A7, London, ON, Canada(∗).
Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute, Parkwood Institute, London, ON, Canada(†).
PM R. 2017 Sep;9(9):856-865. doi: 10.1016/j.pmrj.2016.12.004. Epub 2017 Jan 8.
Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting.
To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke.
Retrospective chart review.
Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation.
Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013.
Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations.
Goal satisfaction scores.
A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001).
Within an outpatient stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients set were related to their goal satisfaction scores, with impairment-based goals being rated significantly higher than activity-based and participation-based goals.
III.
目标设定对康复期间的中风恢复可产生积极影响。患者参与目标制定可确保设定与个人相关的目标，并能提高对康复体验的满意度，同时改善中风缺陷的恢复情况。然而，这尚未在中风门诊康复环境中得到研究。
评估中风患者在门诊康复期间实现自选目标的满意度。
回顾性病历审查。
参加多学科门诊康复项目的中风患者，他们在康复期间设定了至少1个目标。
2010年1月至2013年12月期间通过门诊康复项目接受治疗的中风康复患者。
在康复入院和出院时，患者对实现他们想要达成的目标的能力进行满意度评分。研究人员独立整理并标记目标的反复出现的主题。目标进一步被分类到国际功能、残疾和健康分类（ICF）类别中。为了比较患者对目标满意度的认知，对3种ICF目标分类进行重复测量方差分析。
目标满意度评分。
共有286名患者纳入分析。患者目标集中在改善手部功能、移动性和认知等主题上。目标也被分类到ICF类别中，其中基于损伤和基于活动受限的目标占主导。与基于活动和基于参与的目标相比，基于损伤目标的患者在入院和出院时对实现目标的满意度更高（P < .001）。患者在康复项目出院时对其列出的第一、第二和第三个目标的满意度均显著提高（P < .001）。
在门诊中风康复环境中，患者设定的目标多种多样，主要基于损伤。接受治疗后，实现目标的满意度显著提高。患者设定的目标类型与他们的目标满意度评分相关，基于损伤的目标评分显著高于基于活动和基于参与的目标。
III级。
