Needs assessment of individuals with stroke after discharge from hospital stratified by acute Functional Independence Measure score

Abstract

Purpose: To determine the needs, barriers and facilitators of function in individuals with stroke after discharge from hospital. To examine the results stratified by the patient's acute score (<41, 41-80, >80) on the functional independence measure (FIM).

Method: This was a cohort study of 209 patients who had been admitted to hospital because of stroke. Patients were interviewed following hospital discharge using a semi-structured interview and asked to complete and return a quantitative closed-ended survey.

Results: For most domains, frequencies of needs varied across the FIM groups. Combining all FIM groups, the interview showed needs related to: physical impairments (35%), time for recovery (33%), education (28%), medical advice (25%), therapies and services (21%), social needs (19%) and emotional needs (18%). From the interview, the most frequent barriers were physical impairments (55%) and emotional concerns (40%). Common facilitators were family support (54%), therapies and medical care (40%) and personal attitudes (22%). Additional needs from the survey concerned: IADL, mobility, ADL, recreation, finances, communication and employment. Additional barriers from the survey were: attitudes, social participation, environments and limited services.

Conclusions: There is a large and varied number of needs and barriers following discharge from hospital that have planning and advocacy implications for rehabilitation teams.