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dc.contributor.authorGrimley, Rohan S-
dc.contributor.authorRosbergen, Ingrid Cm-
dc.contributor.authorGustaffson, Louise-
dc.contributor.authorHorton, Eleanor-
dc.contributor.authorGreen, Theresa-
dc.contributor.authorCadigan, Greg-
dc.contributor.authorCadilhac, Dominique A-
dc.contributor.authorKuys, Suzanne-
dc.identifier.citationClinical rehabilitation 2019; 33(7): 1252-1263-
dc.description.abstractTo describe current practice and investigate factors associated with selection for rehabilitation following acute stroke. Prospective observational cohort study. Seven public hospitals in Queensland, Australia. Consecutive patients surviving acute stroke. Rehabilitation selection processes are assessment for rehabilitation needs, referral for rehabilitation and receipt of rehabilitation. Functional impairment following stroke is modified Rankin Scale (mRS). We recruited 504 patients, median age 73 years (interquartile range (IQR) = 62-82), between July 2016 and January 2017. Of these, 90% (454/504) were assessed for rehabilitation needs, 76% (381/504) referred for rehabilitation, and 72% (363/504) received any rehabilitation. There was significant variation in all rehabilitation selection processes across sites (P < 0.05). In multivariable analyses, stroke unit care (odds ratio (OR) = 2.7; 95% confidence interval (CI) = 1.1, 6.6) and post stroke functional impairment (severe stroke mRS 4-5: OR = 10.9; 95% CI = 4.9, 24.6) were associated with receiving an assessment for rehabilitation. Receipt of rehabilitation was more likely following assessment (OR = 6.5; 95% CI = 2.9, 14.6) but less likely in patients with dementia (OR = 0.2; 95% CI = 0.1, 0.9), end-stage medical conditions (OR = 0.4; 95% CI = 0.2, 0.8) or ischaemic stroke (OR = 0.4; 95% CI = 0.1, 0.9). The odds of receiving rehabilitation increased with greater impairment: OR = 3.0 (95% CI = 1.5, 4.9) for mRS 2-3 and OR = 12.5 (95% CI = 6.5, 24.3) for mRS 4-5. Among patients with mild-moderate impairment (mRS 2-3), 39/117 (33%) received no rehabilitation. There was significant inter-site variation in rehabilitation selection processes. The major factors influencing rehabilitation access were assessment for rehabilitation needs, co-morbidities and post-stroke functional impairment. Gaps in access to rehabilitation were found in those with mild to moderate functional impairment.-
dc.titleAssessment and selection for rehabilitation following acute stroke: a prospective cohort study in Queensland, Australia.-
dc.typeJournal Article-
dc.identifier.journaltitleClinical rehabilitation-
dc.identifier.affiliationSunshine Coast Clinical School, The University of Queensland, Birtinya, QLD, Australiaen
dc.identifier.affiliationCentre for Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, QLD, Australiaen
dc.identifier.affiliationSchool of Allied Health Sciences, Griffith University, Brisbane, QLD, Australiaen
dc.identifier.affiliationSchool of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australiaen
dc.identifier.affiliationAllied Health Services, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australiaen
dc.identifier.affiliation7 School of Nursing, Midwifery & Paramedicine, University of the Sunshine Coast, Maroochydore, QLD, Australiaen
dc.identifier.affiliationFaculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australiaen
dc.identifier.affiliationStroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australiaen
dc.identifier.affiliationThe Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationQueensland State-Wide Stroke Clinical Network, Clinical Excellence Division, Queensland Department of Health, Brisbane, QLD, Australiaen
dc.identifier.affiliationFaculty of Health, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australiaen
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