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J Neurol Sci. 2012 Feb 15;313(1-2):160-6. doi: 10.1016/j.jns.2011.08.038. Epub 2011 Sep 19.

Poor concurrence between disabilities as described by patients and established assessment tools three months after stroke: a mixed methods approach.

Author information

1
Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Fack 23 200, 141 83 Huddinge, Sweden. malin.tistad@ki.se

Abstract

BACKGROUND:

Disability/problems, one phenomenon underlying people's need for health care services, can be viewed both from the perspectives of people with stroke (felt problems), and the health professionals (assessed problems).

OBJECTIVE:

The aim was to describe felt problems three months after stroke and to explore the concurrence between felt problems and assessed problems.

METHOD:

The patients (n=203) received care in the stroke units at Karolinska University Hospital, Sweden. Felt problems, drawn from an open question, were categorized. Results from established assessment tools: Katz Extended Index of ADL (KI); Barthel Index (BI) and Stroke Impact Scale (SIS) represented assessed problems. Items/domains in the assessment tools that corresponded to the categories of felt problems were identified and comparisons performed.

RESULT:

The category Fatigue had the largest number of felt problems (n=58, 28%). Fourteen out of the 24 categories of felt problems had corresponding items/domains in the assessment tools. KE/BI failed to identify 16-57% and SIS 0-33% of the felt problems.

CONCLUSION:

There was a substantial lack of concurrence between felt and assessed problems. The results indicate that the use of standardized instruments should be complemented by a dialog if health services are to be based on problems experienced by the patients.

PMID:
21937062
DOI:
10.1016/j.jns.2011.08.038
[Indexed for MEDLINE]

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