Functioning and Disability
Evan H. Kwong, MD, MSc
1-PhD Candidate, 2-Physician, 3-Clinical Assistant Professor
1) Queen's University PhD Program in Health Quality; 2) Providence Health Care Division of Physical Medicine and Rehabilitation; 3) University of British Columbia Division of Physical Medicine and Rehabilitation
Vancouver, British Columbia, Canada
Sunaina Chopra, MSc in Rehabilitation Science
Graduate Student (MPT/PhD Candidate in Rehabilitation Science)
1) Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada; 2) Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
Vancouver, British Columbia, Canada
Elizabeth Moulton, PhD
Professor
School of Nursing, St. Lawrence College
Kingston, Ontario, Canada
Christina Godfrey, PhD
Professor
Queen’s University School of Nursing
Kingston, Ontario, Canada
Nora Fayed, PhD
Associate Professor
Queen’s University School of Rehabilitation Therapy
Kingston, Ontario, Canada
Kimberley Sears, PhD
Professor
Queen’s University School of Nursing
Kingston, Ontario, Canada
Ideally patients undergoing stroke rehabilitation are involved in the goal setting processes, and clinically documented rehabilitation goals should therefore directly represent what they would like to achieve. The objective of this study was to examine and describe clinically documented inpatient stroke rehabilitation goals using the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF) framework.
Design:
This retrospective descriptive study was done at a single academic rehabilitation hospital where rehabilitation goals are routinely documented. Firstly, a feasibility study was completed to test the processes for extracting documented rehabilitation goal statements from the clinical records. Then, the full study was completed, including linking of the goals to the WHO ICF and descriptive analysis of the ICF categories by frequency counts and percentages.
Results:
A total of 466 inpatient stroke rehabilitation admissions lasting > 7 days from January 1, 2020, through March 31, 2023, were included. For the 7,989 documented rehabilitation goals extracted, the top ten second-level ICF categories were: d450 (Walking), d465 (Moving around using equipment), d460 (Moving around in different locations), d420 (Transferring oneself), d540 (Dressing), d530 (Toileting), d630 (Preparing meals), d415 (Maintaining a body position), and d510 (Washing oneself). There were also differences based upon demographics, stroke location, functional independence measure (FIM) scores, and timepoints during rehabilitation admission.
Conclusion:
This is the largest known descriptive study of documented inpatient stroke rehabilitation goals from a single academic rehabilitation hospital. The documented goals were mostly linked to activities and participation, consistent with previous studies on patient-reported inpatient stroke rehabilitation goals. This indicates that the documented goals may in fact directly represent what the patient would like to achieve. Additionally, the secondary descriptive results based upon demographics, stroke location, FIM scores, and timepoints lead to future research opportunities.
