Important-performance analysis to conceptualize goal priorities in community dwelling stroke survivors

ABSTRACT

Background

It is important for clinicians to have a better understanding of stroke survivor’s goals. Important performance analysis (IPA) is a tool that could be utilized to identify goal priorities in rehabilitation.

Objectives

To examine the utility of the IPA method to identify goal priorities in a diverse group of community dwelling stroke survivors.

Methods

Thirty-eight stroke survivors completed private structured interviews and were asked to rate their perceived importance and performance of 37 goal areas. Important-performance analysis (IPA) was utilized to determine goal priorities for the overall sample. Different IPA methods used to identify goal priorities were compared. Goal priorities were also compared by age (dichotomized as <65 and ≥65 years) and sex (male or female).

Results

The IPA method effectively separated the goals into the four quadrants, and distinguished which goals were a priority for the sample of stroke survivors. The five goals that were consistently identified as a focus area were: hand function, driving, balance, memory, and arm strength. Men rated mood control as more important than women (p = .046). The two goals rated as being more important for those older than 65 were home accessibility (p = .008) and skin health (p < .001).

Conclusions

Stroke survivors continue to have goals related to their stroke recovery in the years after their stroke. Both current performance as well as perceived importance should be considered during goal discussions with stroke survivors. IPA can help identify goal priorities in this population.

KEYWORDS:

• Goals
• importance performance analysis
• outcomes
• stroke

Acknowledgments

This project was supported by grants from the National Institutes of Health (5P2CHD065702; 5T32AG000270), National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (90IF0071), and the Agency for Healthcare Research & Quality (5R24HS022134), and National Institute of Child Health and Human Development (K12 HD055929). The contents of this publication were developed under grants from the UTMB Claude D. Pepper Older Americans Independence Center and the Texas Resource on Minority Aging Research funded by the National Institute on Aging (NIA grant numbers 5P30AG024832; P30AG059301;1K01AG065492). The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official institutional position or any other federal agency, policy, or decision unless so designated by other official documentation.

The contents of this publication do not necessarily represent the policy of the NIDILRR, ACL, HHS, or NIA and you should not assume endorsement by the Federal Government. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy or official views of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.

Preliminary results of this study were presented in a poster presentation at ACRM: Hay, C. C., Pappadis, M. R., Graham, J., & Reistetter, T. A. (2017). The influence of gender and performance on stroke survivors’ goal prioritization. American Congress of Rehabilitation Medicine (ACRM) Conference, October 23-October 28, Atlanta, GA.

We thank Sarah Toombs Smith, PhD, ELS, Sealy Center on Aging, for assistance in editing this manuscript. Dr. Toombs Smith received no compensation for her work beyond her university salary.

Conflicts of interest

The authors have no competing interests to disclose. The authors also have no financial benefits to disclose.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

This work was supported by the Agency for Healthcare Research and Quality; National Institute on Aging; National Institute of Child Health and Human Development, National Institute on Disability, Independent Living, and Rehabilitation Research; National Institutes of Health.