Disability and rehabilitation
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To investigate the attitudes and beliefs held by referrers and service providers of an Australian Early Supported Discharge (ESD) service called "Rehabilitation in the Home" (RITH); with particular consideration of factors that may influence referral to RITH. ⋯ Differences in views held by referrers and ESD service providers were identified in this study that could lead to inconsistencies in patient selection for, and under-utilization of, ESD services. Improved communication between referrers and ESD service providers, for instance attendance of RITH staff at inpatient team meetings, could ameliorate some of these misconceptions. On-going education of referrers about service capability is essential to ensure timely transfer of appropriate clients to ESD services.
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Sexual disorders after stroke are thought to be due to multiple etiologies, including both organic and psychosocial causes. Sexual function in post-stroke patients is often disregarded by healthcare professionals although sexuality is a fundamental part of quality of life. Beside pharmacological treatment, one of the most important, but underestimated, success factors of SD therapy is undeniably a proper counseling, which is mandatory to provide correct information on post-stroke sexuality helping the patients and their partners to regain intimacy.
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Comparative Study
The spinal cord independence measure: how much change is clinically significant for spinal cord injury subjects.
To calculate the clinical significance of the SCIM III according to distribution-based approaches. ⋯ An improvement of at least four points of the total SCIM is needed to obtain a small significant improvement and of 10 points to obtain a substantial improvement. The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress.
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Comparative Study
Sexuality after stroke: patient counseling preferences.
Sexual dysfunction is common after stroke, but is frequently not addressed by healthcare providers. The aim of this study was to examine patient preferences for counseling related to sexuality post-stroke. ⋯ Many stroke survivors experience sexual dysfunction and indicate a desire for additional information and counseling from healthcare providers. Preferences regarding the timing of such counseling vary, creating challenges for optimizing the delivery of this care. IMPLICATIONS FOR STROKE REHABILITATION: Sexual dysfunction is common after stroke, but is frequently not addressed by healthcare providers. Many stroke survivors experience sexual dysfunction and indicate a desire for additional information and counseling from healthcare providers. Most stroke survivors identify sexuality as an important issue in their post-stroke rehabilitation. Exploring individual stroke survivor counseling preferences periodically over the course of recovery may be a useful strategy for delivering the desired information at the most appropriate time.
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To document in workers having a work disability due to a musculoskeletal disorder (MSD), the presence and variation over time of their intolerance of uncertainty and its maintenance factors as defined in Dugas et al.'s generalized anxiety disorder (GAD) model, i.e. worries, negative problem orientation, beliefs about the usefulness of worrying, cognitive avoidance and their consequences on depressive symptoms. ⋯ Workers with an MSD causing a work disability averaging one year in length and enrolled in a work rehabilitation program exhibited a high level of anxiety at the beginning of the work rehabilitation program. Workers perceived a usefulness in worrying and presented some intolerance of uncertainty and some cognitive avoidance strategies. According to Dugas et al.'s GAD model, the intensity of the symptoms associated with GAD development and maintenance factors was, however, not typical of a GAD. IMPLICATION FOR REHABILITATION: A reconceptualization of the problem in terms of reducing the work disability rather than reducing pain may constitute a promising avenue to reduce anxiety symptoms. Future studies should look at the specific impact of work exposure, not only on pain symptoms but also on worries. The high level of anxiety and the reported worries by workers stresses the importance of studying the hypothesis of a workplace phobia in order to improve clinical practice guidelines.