The Impact of Severity, Timing, and Sex on Outcomes of Inpatient Stroke Rehabilitation
Date
2020-01-08
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Stroke severity and time to rehabilitation admission are important factors in influencing stroke rehabilitation outcomes. We aimed to determine the impact of: (1) stroke severity and timing to inpatient rehabilitation admission on length of stay, functional gains, and discharge destination; and (2) age and sex differences in time to rehabilitation, length of stay in rehabilitation, and discharge destination for stroke patients in Alberta. The first manuscript offers a discussion of post-positivist critical multiplism and its value for nursing research and describes the steps for conducting critical multiplist nursing research using stroke rehabilitation as an example. We identify that post-positivist critical multiplism offers a useful, rigorous approach that relies on a step-by-step method and a collaboration with a team of scholars who offer different perspectives, open questioning and critique, and rigorous attention to minimize biases throughout the research process. We examined a large retrospective cohort to address the research aims. In the second paper, we identified that length of time to rehabilitation admission was not significantly different between stroke severities. Individuals with moderate and severe stroke made significantly larger FIM gains than mild stroke during inpatient rehabilitation. LOS was longer with increasing stroke severity. Time to inpatient rehabilitation admission had small, but significant impacts on functional gains and LOS. Patients with shorter times to rehabilitation admission and those with mild stroke were more likely to be discharged home without needing health services. In the third paper, we identified that mean length of time from acute care admission to inpatient rehabilitation admission was not significantly different between males and females. There was no significant difference in mean FIM change between males and females during inpatient rehabilitation. Mean LOS in rehabilitation was slightly longer among females compared to males. Male patients and those of younger age were more likely than females and those of older age to be discharged home without needing homecare. In conclusion, stroke severity had a significant impact on the conduct of inpatient rehabilitation. The impact of timing on functional gains and LOS was small. Differences in LOS and discharge destination based on sex and age were significant.
Description
Keywords
Critical multiplism, methodology, nursing, paradignms, philosophy, Postpositivism, Research, Science, Stroke, Inpatient rehabilitation, Functional outcomes, Length of time waiting, Length of stay, Discharge destination, Stroke rehabilitation, Sex differences
Citation
Tanlaka, E. F. (2020). The Impact of Severity, Timing, and Sex on Outcomes of Inpatient Stroke Rehabilitation (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.