The purpose of this study is to analyze the outlooks of senior policymakers/executives, medical staff, and patients as to the essence of the PCC approach. Secondarily, the study aims to describe the outcomes of rehabilitative care from patients’ point of view to analyze rehabilitation outcomes from medical staff’ and care recipients.
A mixed-method research. In the qualitative part of the study, sixty in-depth semi-structured interviews were performed to obtain relevant information from senior policymakers, medical staff, and patients who had experienced a cerebral event and were receiving care, in neurorehabilitation departments. The interviews with patients focused on examining their expectations of the rehabilitation process and its outcomes.
The quantitative part, related to the outcomes of rehabilitative care. Medical staff’s assessment of patients’ functioning was based on the Functional Independence Measurement (FIM) index. Patients’ assessment of their own functioning was evaluated after discharge by means of a telephone survey based on a validated questionnaire: PROMIS10 (Patient Reported Outcomes Measurement Information System). Outcome indicators in terms of both physical and mental functioning were collected. The survey took place among seventy patients who had undergone rehabilitation after a cerebral event.
Most of Policymakers and staff who were interviewed emphasized the importance of active listening and conducting a cooperative discourse for improvement in continuity of care and preparation for the discharge process, as well as treating the patient and his family as a single unit. Turning to rehabilitation outcomes, policymakers and staff noted that sometimes a good outcome in a medical-team’s eyes may seem different to a patient eyes.
As for the outcomes of rehabilitation from the patient’s standpoint, a significant relationship was found between patients’ assessment of their physical functioning and their assessment of their mental functioning. This reinforces the views expressed by interviewees, emphasizing the nexus of body and mind in the context of rehabilitation. The change in functioning, as assessed by medical teams, and patients’ assessment of the mental aspect is possible indicative of the importance of relating to the principles of the PCC approach, including empowerment of patients by providing them with emotional support and morale-boostingduring the rehabilitation process.
The underlying values of PCC and their impact on patients and staff justify the investment needed to apply the approach. It also related, the monitoring and measurement of outcome indicators from the standpoints of medical teams and patients.
Monitoring outcome indices— regular use of PROMIS10 questionnaires and FIM scores in all rehabilitation centers at the beginning and the end of care, periodic interviews among patients, updating the tools used for caregivers’ personal evaluations, and choosing an agreed-upon index to evaluate success in applying the PCC approach.
outcome indicators
PROMIS10
