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Rehabilitation team decisions on discharge housing for stroke patients

journal contribution
posted on 29.05.2019, 00:00 by Carolyn Unsworth, SA Thomas, KM Greenwood
For older people who have had a stroke, appropriate housing can promote independence and well being. However, suboptimal team accommodation recommendations may result in placement of an individual where their needs are not met, and their skills are not maximized. Although clinical judgments regarding patient discharge are routinely made by rehabilitation teams, this area has received limited research attention. This study examines how rehabilitation teams determine the most appropriate housing to recommend to stroke patients after their discharge from hospitals. A Social Judgment Theory approach was used to document and analyze the accommodation recommendations and policies of 13 rehabilitation teams (clinician n = 74). Teams were asked to consider 50 hypothetical stroke patients, and determine the most appropriate discharge housing to recommend to these patients. Each stroke patient was described in terms of 8 attributes: mobility status, ability to manage their own affairs, patient's choice of housing, personal activity of daily living (ADL) skills, domestic and community ADL skills, general health status, social situation, and premorbid living arrangements. Clinicians were provided with a response scale on which to record their recommendations. The results showed considerable yet reliable differences among teams concerning recommendations made, and judgment policies adopted. Although the highly structured and hypothetical nature of this research limits the external validity of findings, the results suggest that teams may also face difficulties with housing recommendations in the more complex clinical environment. Further studies to assess actual clinical team decision making are needed. Such studies could lead to the development of a standardized research-based protocol to help teams formalize and optimize their housing recommendations.

Funding

Category 2 - Other Public Sector Grants Category

History

Volume

76

Issue

4

Start Page

331

End Page

340

Number of Pages

10

ISSN

0003-9993

Publisher

W.B. Saunders Co.

Peer Reviewed

Yes

Open Access

No

Acceptance Date

03/11/1994

External Author Affiliations

Tufts University, Medford, Massachusetts

Era Eligible

No

Journal

Archives of Physical Medicine and Rehabilitation

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