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Addressing the Evidence Gap in Stroke Rehabilitation for Complex Patients: A Preliminary Research Agenda.
Nelson, Michelle L; McKellar, Kaileah A; Munce, Sarah; Kelloway, Linda; Hans, Parminder Kaur; Fortin, Martin; Lyons, Renee; Bayley, Mark.
Afiliación
  • Nelson ML; Bridgepoint Collaboratory, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada. Electronic address: Michelle.nelson@sinaihealthsystem.ca.
  • McKellar KA; Bridgepoint Collaboratory, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.
  • Munce S; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
  • Kelloway L; Cardiac Care Network of Ontario, Toronto, Ontario, Canada.
  • Hans PK; Bridgepoint Collaboratory, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.
  • Fortin M; Department of Family Medicine, Sherbrooke University, Sherbrooke, Quebec, Canada.
  • Lyons R; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Bayley M; University of Toronto, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Arch Phys Med Rehabil ; 99(6): 1232-1241, 2018 06.
Article en En | MEDLINE | ID: mdl-28947162
Evidence suggests that a stroke occurs in isolation (no comorbid conditions) in less than 6% of patients. Multimorbidity, compounded by psychosocial issues, makes treatment and recovery for stroke increasingly complex. Recent research and health policy documents called for a better understanding of the needs of this patient population, and for the development and testing of models of care that meet their needs. A research agenda specific to complexity is required. The primary objective of the think tank was to identify and prioritize research questions that meet the information needs of stakeholders, and to develop a research agenda specific to stroke rehabilitation and patient complexity. A modified Delphi and World Café approach underpinned the think tank meeting, approaches well recognized to foster interaction, dialogue, and collaboration between stakeholders. Forty-three researchers, clinicians, and policymakers attended a 2-day meeting. Initial question-generating activities resulted in 120 potential research questions. Sixteen high-priority research questions were identified, focusing on predetermined complexity characteristics-multimorbidity, social determinants, patient characteristics, social supports, and system factors. The final questions are presented as a prioritized research framework. An emergent result of this activity is the development of a complexity and stroke rehabilitation research network. The research agenda reflects topics of importance to stakeholders working with stroke patients with increasingly complex care needs. This robust process resulted in a preliminary research agenda that could provide policymakers with the evidence needed to make improvements toward better-organized services, better coordination between settings, improved patient outcomes, and lower system costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Apoyo Social / Determinantes Sociales de la Salud / Investigación en Rehabilitación / Rehabilitación de Accidente Cerebrovascular / Multimorbilidad Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Humans Idioma: En Revista: Arch Phys Med Rehabil Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Apoyo Social / Determinantes Sociales de la Salud / Investigación en Rehabilitación / Rehabilitación de Accidente Cerebrovascular / Multimorbilidad Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Humans Idioma: En Revista: Arch Phys Med Rehabil Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos