患者的不满意状况:对康复过程的深入调查

Patient dissatisfaction: Insights into the rehabilitation process

Most patients admitted for inpatient rehabilitation find it beneficial even wh en there is little change in physical disability. The aim of this study was to d etermine the characteristics of patients who felt that they had not benefited fr om inpatient rehabilitation and to delineate the underlying reasons for this per ception. From a database of 331 patients admitted to a neurological rehabilitati on unit over a three year period, we ascertained those with a low score < 5) on a self rated visual analogue scale (VAS) regarding their perception of the ben efit of rehabilitation. We investigated their disability outcomes, aspects of th e rehabilitation process through analysis of integrated care pathways, and from inspection of the multidisciplinary record identified specific adverse factors w hich might contribute to dissatisfaction. Low VAS scores were detected in 6%of patients (n = 19). These did not correlate with baseline demographic factors or disability levels, but were associated with unresolved external problems regardi ng community care and accommodation, and conflicts between patients and therapis ts. We conclude that from the patientsperspective, successful inpatient rehabi litation depends on adequate attention given to community based issues and heal th care professionals recognising patientsneeds. When these two conditions are not fulfilled, patients are more likely to express a lack of satisfaction with their rehabilitation.