Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.
Shilpa Krishnan, Monique R Pappadis, Susan C Weller and 3 others
PMID 28320217WHAT IT FOUND
Stroke survivors often prioritized walking independently.
Caregivers often prioritized safety, falls, home changes, driving, and realistic mobility prognosis. Ask each person and caregiver before choosing mobility goals.
Key findings
01Walking independently was the most preferred mobility outcome among participants.
02Caregivers more often emphasized driving, fall prevention, home accommodations, and independent transfers than stroke survivors did.
03Many caregivers wanted realistic information about post-stroke mobility prognosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Participants were recruited by convenience sampling from community groups and facilities, so they may not represent all stroke survivors or caregivers. Some stroke survivors or caregivers declined, and not all caregivers identified by survivors participated. The number of participants who had skilled nursing facility rehabilitation was small, and no analyses by age, facility, or gender were done. Stroke severity and baseline function were not recorded, so preferences cannot be linked to how impaired the person was. Open-ended interviews may have missed activities that were taught or practiced during rehabilitation. Participants were probed about mobility only if they raised mobility issues, so mobility preferences may be incomplete. Two survivors had aphasia and were interviewed with cue cards and field notes, so their preferences may not have been fully explored. Participants were community dwelling and 1 to 30 years post stroke, so findings may not apply to acute inpatients. The study reports preferences and experiences. It does not test whether patient-centered goal setting improves outcomes.
Declared interests
The supplied text does not include a conflicts of interest or funding declaration. The journal metadata lists NIH and U.S. government PHS research support.
The easy way to misread this
Do not treat these preference themes as evidence that a mobility intervention works. The study asked people what mattered after rehabilitation. It did not test whether any goal-setting approach changed outcomes.