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Abstract
Purpose: To evaluate the impact of a person-centred, community rehabilitation service on outcomes for people with a neurological condition, in the first year of service.
Method: A prospective, observational, pre-post study was conducted with 206 people who had a neurological condition and attended the rehabilitation service to restore function (e.g., Stroke); maximize recovery in an ongoing situation (e.g., Spina Bifida); or maximize function and independence while preparing for inevitable decline (e.g., Parkinson’s Disease). Outcomes were measured via self-report questionnaires, prior to, and following three months of rehabilitation. The primary outcome was achievement of self-identified goals, measured by the Patient-Specific Functional scale. Secondary outcomes included the Lawton Instrumental Activities of Daily Living (IADL) scale, EQ-5D-5L European Quality of Life scale, and ICECAP-O – Index of Capability for Older Adults and health and medical resource use.
Results: Participants demonstrated significant goal achievement and a significant reduction in health and medical resource use. There were small positive changes in the Lawton IADL, EQ-5D-5L, and ICECAP-O however these changes were not significant.
Conclusions: In the first year of operation, the community rehabilitation service made a significant impact on outcomes for individuals with a neurological condition. Further research is required to identify appropriate measures of activities of daily living and quality of life that reflect person-centred rehabilitation outcomes for restoring function, maximizing function, or preparing for functional decline.
Self-identified goals are an important guide for achievement of meaningful outcomes for individuals with a neurological condition.
Person-centred outcome measures are required to evaluate the benefits of a person-centred community rehabilitation service for individuals with a neurological condition.
Implications for Rehabilitation
Acknowledgements
The authors would like to thank all the individuals with neurological conditions and their support persons who shared their time and their story. They would also like to thank staff of James Cook University and Northern Australia Primary Health Ltd. for their support of this project, particularly Julie Scheuber, Paul Wise, Nicole Hunt, Lawrence Brown, and Hayley Wilson.
Disclosure statement
The authors report no declarations of interest.
Funding information
This study was supported by the Northern Australia Primary Health Ltd. (formerly Townsville Mackay Medicare Local) and James Cook University under the National Partnership Agreement, Australian Government Department of Health and Ageing.