What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure
Background Approximately 80% of people who survive a stroke have on average five other conditions and a wide range of psychosocial issues. Attention to biopsychosocial issues has led to the identification of ‘complex patients’. No single definition of ‘patient complexity’ exists; therefore, applied...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2016-01-01
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| Series: | Journal of Comorbidity |
| Online Access: | https://doi.org/10.15256/joc.2016.6.63 |
| _version_ | 1818555291975811072 |
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| author | Michelle L.A. Nelson Elizabeth Hanna Stephen Hall Michael Calvert |
| author_facet | Michelle L.A. Nelson Elizabeth Hanna Stephen Hall Michael Calvert |
| author_sort | Michelle L.A. Nelson |
| collection | DOAJ |
| description | Background Approximately 80% of people who survive a stroke have on average five other conditions and a wide range of psychosocial issues. Attention to biopsychosocial issues has led to the identification of ‘complex patients’. No single definition of ‘patient complexity’ exists; therefore, applied health researchers seek to understand ‘patient complexity’ as it relates to a specific clinical context. Objective To understand how ‘patient complexity’ is conceptualized by clinicians, and to position the findings within the existing literature on patient complexity. Methods A qualitative descriptive approach was utilized. Twenty-three stroke rehabilitation clinicians participated in four focus groups. Results Five elements of patient complexity were identified: medical/functional issues, social determinant factors, social/family support, personal characteristics, and health system factors. Using biopsychosocial factors to identify complexity results in all patients being complex; operationalization of the definition led to the identification of systemic elements. A disconnect between acute, inpatient rehabilitation and community services was identified as a trigger for increased complexity. Conclusions Patient complexity is not a dichotomous state. If applying existing complexity definitions, all patients are complex. This study extends the understanding by suggesting a structural element of complexity from manageable to less manageable complexity based on ability to discharge. |
| first_indexed | 2024-12-12T09:51:27Z |
| format | Article |
| id | doaj.art-de38f2ba42f7488591ab48c2dd8253cd |
| institution | Directory Open Access Journal |
| issn | 2235-042X |
| language | English |
| last_indexed | 2024-12-12T09:51:27Z |
| publishDate | 2016-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Comorbidity |
| spelling | doaj.art-de38f2ba42f7488591ab48c2dd8253cd2022-12-22T00:28:15ZengSAGE PublishingJournal of Comorbidity2235-042X2016-01-01610.15256/joc.2016.6.63What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge PressureMichelle L.A. NelsonElizabeth HannaStephen HallMichael CalvertBackground Approximately 80% of people who survive a stroke have on average five other conditions and a wide range of psychosocial issues. Attention to biopsychosocial issues has led to the identification of ‘complex patients’. No single definition of ‘patient complexity’ exists; therefore, applied health researchers seek to understand ‘patient complexity’ as it relates to a specific clinical context. Objective To understand how ‘patient complexity’ is conceptualized by clinicians, and to position the findings within the existing literature on patient complexity. Methods A qualitative descriptive approach was utilized. Twenty-three stroke rehabilitation clinicians participated in four focus groups. Results Five elements of patient complexity were identified: medical/functional issues, social determinant factors, social/family support, personal characteristics, and health system factors. Using biopsychosocial factors to identify complexity results in all patients being complex; operationalization of the definition led to the identification of systemic elements. A disconnect between acute, inpatient rehabilitation and community services was identified as a trigger for increased complexity. Conclusions Patient complexity is not a dichotomous state. If applying existing complexity definitions, all patients are complex. This study extends the understanding by suggesting a structural element of complexity from manageable to less manageable complexity based on ability to discharge.https://doi.org/10.15256/joc.2016.6.63 |
| spellingShingle | Michelle L.A. Nelson Elizabeth Hanna Stephen Hall Michael Calvert What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure Journal of Comorbidity |
| title | What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure |
| title_full | What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure |
| title_fullStr | What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure |
| title_full_unstemmed | What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure |
| title_short | What Makes Stroke Rehabilitation Patients Complex? Clinician Perspectives and the Role of Discharge Pressure |
| title_sort | what makes stroke rehabilitation patients complex clinician perspectives and the role of discharge pressure |
| url | https://doi.org/10.15256/joc.2016.6.63 |
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