Ontology highlight
ABSTRACT: Objectives:
To determine the factors affecting clinical decision-making about which patients should receive stroke rehabilitation.Methods:
Data sources (MEDLINE, CINAHL, AMED and PsycINFO) were searched systematically from database inception to August 2018. Full-text English-language studies of data from stroke clinicians were included. Studies of patients were excluded. The included studies were any design focussed on clinical decision-making for referral or admission into stroke rehabilitation. Summary factors were compiled from each included study. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.Results:
After removing duplicates, 1915 papers were identified, of which 13 met the inclusion criteria. Eight included studies were qualitative and one used mixed methods. A total of 292 clinicians were included in the studies. Quality of the included studies was mixed. Patient-level and organizational factors as well as characteristics of individual clinicians contributed to decisions about rehabilitation. The most often described factors were patients' pre- and poststroke function ( n?=?6 studies), presence of dementia ( n?=?6), patients' social/family support ( n?=?6), organizational service pressures ( n?=?7) and the decision-making clinician's own knowledge ( n?=?5) and emotions ( n?=?5).Conclusion:
The results highlight a lack of clinical guidance to aid decision-making and reveal that a subjective approach to rehabilitation decision-making influenced by patient-level and organizational factors alongside clinicians' characteristics occurs across services and countries.
SUBMITTER: Longley V
PROVIDER: S-EPMC6348456 | biostudies-literature | 2019 Feb
REPOSITORIES: biostudies-literature
Longley Verity V Peters Sarah S Swarbrick Caroline C Bowen Audrey A
Clinical rehabilitation 20181029 2
<h4>Objectives:</h4>To determine the factors affecting clinical decision-making about which patients should receive stroke rehabilitation.<h4>Methods:</h4>Data sources (MEDLINE, CINAHL, AMED and PsycINFO) were searched systematically from database inception to August 2018. Full-text English-language studies of data from stroke clinicians were included. Studies of patients were excluded. The included studies were any design focussed on clinical decision-making for referral or admission into strok ...[more]