Authors (including presenting author) :
Chan JSP, Chow ESL, Lee SKF, Wong TFW, Chan MYL, Lam KHM, Lee JKY, Chow KKT, Chan SH, Chak NNT, Chan MMY, Chau RMW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Restorative rehabilitation with 365-day-per-year-coverage(365-day) Physiotherapy for stroke was launched on 1October2019 in Kowloon Hospital(KH). Views from stakeholders’ is crucial for smooth transition of service.
Objectives :
Current-study aimed to evaluate the stakeholders’ satisfaction on the physiotherapy rehabilitation service for 365-day to traditional-weekday-coverage (Monday-to-Friday) for patient with stroke in Kowloon Hospital.
Methodology :
Patients with stroke, admitted to the intensive rehabilitation-ward of KH during 1October2018 to 31March2019 (period1:weekday-coverage-rehabilitation) and 1October2019 to 30November2019 (period2:365-day) were studied. Patients and corresponding-caregivers were included if they had the principal diagnosis of stroke from ICD9 code 430-436 and excluded if they were out-of-range. The recent experiences at-discharge were reported by using a simple satisfaction-survey towards physiotherapy service without(period1) or with(period2) 365-day rehabilitation. Five-point-scale questionnaire with 'very-dissatisfied' to 'very-satisfied’ was adopted. Admission and discharge Modified-Functional-Ambulation-Classification(MFAC) (reflecting the functional-ambulation), length-of-stay(LOS) and discharge-destination were captured. SPSS 23.0 was used for data analysis.
Result & Outcome :
Data from patients(N=157) with stroke aged 68.6±13.73years were analyzed. 58.6%(N=92) was male and 59.2%(N=93) diagnosis from cerebral infarction and 40.8%(N=64) from haemorrhage. MFAC demonstrated a median progression of 2 (N=157). Majority 82.17%(N=129) of discharge destination were home. 100%questionnaires were returned. In period 1(non-365-day), high satisfaction rate about the Physiotherapy-service for stroke rehabilitation was reported by Physiotherapist (100%(N=18)satisfied to very-satisfied(S-VS), 0.0%(N=0)neutral); reported by patient (97.6%(N=123) S-VS, 2.4%(N=3)neutral; reported by caregivers (87.3%(N=110) S-VS,12.7%(N=16)neutral). In period 2(365-day), persistent high satisfaction rate was reported by Physiotherapist (94.4%(N=17) S-VS, 5.6%(N=1)neutral); reported by patient (90.3%(N=28) S-VS, 9.7%(N=3)neutral; reported by caregivers (77.4%(N=24) S-VS, 22.6%(N=7)neutral). There was a 6-day reduction for the 365-day(p< 0.05) in LOS and no group-difference in change score for MFAC(p≥0.05). 365-day-service didn’t markedly impact on staff sentiment as reflected by persistent high Physiotherapist’s satisfaction. This might be related to heritage devotion in provision of weekend-cardiopulmonary-Physiotherapy. Similar high patient’s and carer’s satisfaction found in both groups in echoing previous research findings of predominant influence related with patient-physiotherapist interaction, physiotherapists’ attitude & behavior(Beattie et al., 2002,2005;Campanella et al.,2000). Implementation of 365-day restorative rehabilitation achieved earlier functional improvement but apparently didn’t further enhance patients’ & carers’ high satisfaction.
