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- Palmcrantz, S, et al.
(författare)
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Development and validation of the Swedish national stroke register Riksstroke's questionnaires in patients at 3 and 12 months after stroke: a qualitative study
- 2018
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 8:2, s. e018702-
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Tidskriftsartikel (refereegranskat)abstract
- Because healthcare and community organisations and treatment methods are always changing, continuous changes might also be needed in questionnaires that register patient-reported outcomes (PRO) and patient-reported experiences (PRE) of healthcare interventions and community support. Thus, the aim of this study was to test the content and face validity, including the readability, of two questionnaires used by the Swedish national stroke register Riksstroke to register PRO and PRE at 3 and 12 months poststroke.DesignClinicians’ and patients’ knowledge and experiences of current care, rehabilitation, community support and functioning after stroke as well as comments noted regarding the content and layout of the questionnaires were retrieved in focus-groups with expert clinicians and in patient interviews analysed with content analysis. A workgroup of experts with experience in stroke care, rehabilitation and research repeatedly revised the questionnaires regarding content, layout and consistency throughout the validation process.ParticipantsThe participants included allied healthcare professionals, nurses and physicians with extensive experience of working with stroke care and rehabilitation (expert clinicians) as well as patients who had suffered a stroke 3 or 12 months earlier and who were purposefully selected among those who had completed and returned the 3-month questionnaire.SettingExpert clinicians met at their work place in focus-groups. Patients were interviewed where they resided, that is, in their home or nursing home, including rural, town and city areas in Sweden.ResultsBased on clinical expertise and comments from the patients (n=47), the questionnaires were revised and then found to be valid in terms of content validity and face validity, including readability.ConclusionsThe present evaluation emphasises the need for testing aspects of validity, including readability, of questionnaires addressing PRO and PRE and for the recurrent revision of such questionnaires in order to maintain their validity in a society undergoing constant change.
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- Sommerfeld, DK, et al.
(författare)
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Disability test 10 days after acute stroke to predict early discharge home in patients 65 years and older
- 2001
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 15:5, s. 528-534
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify prognostic instruments for the planning of care after acute stroke. Design: Prospective study. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive acute stroke patients ≥65 years old. Main outcome measures: Univariate and multivariate survival analyses. Length of hospital stay and residential form up to three months after onset. Results: The average length of stay was significantly shorter if age <80 years, male, living with another person, normal sensory ability, Barthel Index (BI) score ≥35 and Rivermead Mobility Index (RMI) score ≥4, assessed 10 days after onset. Multivariate analysis, also including BI subtests, showed that RMI score ≥4, which corresponds to the ability to rise from a chair in less than 15 seconds and remain erect for 15 seconds with or without aid, 10 days after onset, had the greatest impact on early discharge home after acute stroke, together with normal bladder function (BI subtest six), normal sensory ability and living with another person. Conclusion: The best predictor of early discharge home, 10 days after stroke onset, was the ability to rise from a chair with or without aid. This simple and quickly conducted test requires no special equipment and in the present study had a very high predictive value.
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- Sommerfeld, DK, et al.
(författare)
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The impact of somatosensory function on activity performance and length of hospital stay in geriatric patients with stroke
- 2004
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 18:2, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate in geriatric patients with stroke the relationship between somatosensory function, activity performance and the length of stay (LOS) in either hospital or nursing home. Design: Survey. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive patients with acute stroke ≥65 years old. Main outcome measures: Clinically assessed somatosensory function, activity of daily living according to the Barthel Index (BI) (0–100 points), mobility according to the Rivermead Mobility Index (RMI) (0–15 points) and LOS. Results: Ten days after stroke onset, the patients with normal ( n = 46), impaired ( n = 31) and nonassessable ( n = 38) somatosensory function scored 85, 40 and 0 points respectively on the BI, and 8.5, 2 and 0 points respectively on the RMI. Forty-one of 46 patients (89%) with normal somatosensory function were discharged home within three months, compared with 10 of 31 patients (32%) with impaired somatosensory function and three of 38 patients (8%) who were nonassessable. These between-group differences were statistically significant ( p < 0.001). Multiple regression, to adjust for the impact of age, social situation and bladder function on outcome still proved a statistically significant ( p < 0.001) predictive value of normal somatosensory function. Conclusions: Normal somatosensory function is related to high activity levels and short LOS more often than somatosensory impairment is related to activity limitations and long LOS.
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- Welmer, AK, et al.
(författare)
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Hemiplegic limb synergies in stroke patients
- 2006
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Ingår i: American journal of physical medicine & rehabilitation. - : Ovid Technologies (Wolters Kluwer Health). - 0894-9115. ; 85:2, s. 112-119
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Tidskriftsartikel (refereegranskat)
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- Welmer, AK, et al.
(författare)
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Spasticity and its association with functioning and health-related quality of life 18 months after stroke
- 2006
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Ingår i: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 21:4, s. 247-253
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> There is no consensus concerning the presence of spasticity or the relationship between spasticity and functioning and spasticity and health-related quality of life (HRQL) in the stable phase after stroke. <i>Objective:</i> The aim of the present study was to describe, 18 months after stroke, the frequency of spasticity and its association with functioning and HRQL. <i>Methods:</i> In a cohort of 66 consecutive patients with first-ever stroke, studied prospectively, the following parameters were assessed 18 months after stroke: spasticity, by the Modified Ashworth Scale (0–4 points with 1+ as the modification), muscle stiffness, by self-report, abnormal tendon reflexes, by physical examination, motor performance, by the Lindmark Motor Assessment Scale, mobility, by the Rivermead Mobility Index, activities of daily living, by the Barthel Index, and HRQL, by the Swedish Short Form 36 Health Survey Questionnaire (SF-36). <i>Results:</i> Of 66 patients studied, 38 were hemiparetic; of these, 13 displayed spasticity, 12 had increased tendon reflexes, and 7 reported muscle stiffness 18 months after stroke. Weak (r < 0.5) to moderate (r = 0.5–0.75) correlations were seen between spasticity and functioning scores. Correlations between spasticity and HRQL were generally weak (r < 0.5). Hemiparetic patients without spasticity had significantly better functioning scores and significantly better HRQL on 1 of the 8 SF-36 health scales (physical functioning) than patients with spasticity. <i>Conclusions:</i> Few patients displayed spasticity 18 months after stroke. Spasticity might contribute to impairment of movement function and to limitation of activity, but seems to have a less pronounced effect on HRQL.
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