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Rehabilitation in acute stroke patients in German-speaking Switzerland
Heike M Geschwindner1, Horst Rettke, Wim J A van den Heuvel
1City of Zurich, Department of Heath and the Enviroment, City of Zurich Nursing Centres, Zurich, Switzerland. geschwindner@bluewin.ch
Principles:
The aim of this study was to obtain an overview of stroke-specialised rehabilitation facilities in German-speaking Switzerland, as well as the numbers of stroke patients treated. It also focused on the mode of goal-setting and evaluation, and the use of instruments to assess the patient's state and progress.
Method:
Out of 28 stroke rehabilitation facilities, 21 participated in a structured telephone interview. Of these, 18 institutions provided full data.
Results:
The results show that the facilities (n = 18) vary considerably in numbers of patients treated per year (Ø 124, range 7-500) and length of stay (Ø 40 +/- 17.23). Goal-setting and evaluation, including the setting of short term and long term goals, is a common feature. They differ, however, in terms of patient involvement, processes and professions participating in goal-setting and evaluation. A variety of instruments are used for patient assessment at admission and during rehabilitation. Admission to rehabilitation does not rely on standardised patient health status assessment.
Conclusions:
Stroke rehabilitation in German-speaking Switzerland embraces a heterogeneous landscape with respect to use of instruments, goal-setting and evaluation process and patient involvement. To facilitate comparison, the same core instruments for assessment and evaluation should be selected and consistently applied. Also, the admission criterion "potential for rehabilitation" should be transformed into a universally and scientifically valid term. The effect of patient involvement in goal-setting on rehabilitation outcome has not yet been investigated. Thus no recommendations can be made for the moment.
