In the article Physiotherapy Needs Assessment of People with Stroke Following Discharge from Hospital, Stratified by Acute Functional Independence Measure Score, a needs assessment of stroke patients is conducted in a variety of patients. Each patient is classified either severely debilitated or moderately. Their goals are set accordingly, with more moderate disability setting goals associated with higher functioning and severe debilitation setting goals based in improved functionality. In conclusion, the needs of stroke victims were widespread and various. Physiotherapists working with stroke victims in in-patient facilities were largely needed over the course of time after patients were discharged from the hospital.
As discussed in the article, 49% of participants identified a specific unmet need for physiotherapy 1 month after being discharged. By the end of a year, only 30% felt they had specific unmet needs. This means that either participants went on to find answers of their own, or they dropped the desire to reach their initial unmet needs. Naturally, the lower the FIM, the greater amount of needs. Pointed out in the text, needs rarely diminished completely. In both cases of lower and higher level impairment, physiotherapists needed to be present to give the guidance toward accomplishing the next step. In many cases, physiotherapists don’t have the time to continue follow-ups and rehabilitation with former patients. However, I believe that to solve this dilemma, other health care professionals need to be recruited and available for victims of stroke long after their discharge from the hospital. These include exercise physiologists and physiotherapist aids, a long with mental health professions.
Physiotherapists and other allied health care professionals are needed for the whole process back to satisfactory functioning in stroke victim cases. Another factor associated with health care professionals is at work here. Due to a psychological term known as the ‘hedonic treadmill’, it’s understandable stroke victims rarely reached their desired level of perceived functioning. This suggests that psychiatrists, psychologists, and others in the mental health field should work a long side physiotherapists in setting realistic goals. If a mental health professional can help a stroke victim cope with their state of being, and gently approach realistic goals, then the stroke victim is less likely to approach their state of being in a cynical and depressed manner. Physiotherapists are well suited for helping regain motor skills, fitness levels, and other factors related to their scope of practice. What they are not well designed to do is soothe a stroke patient emotionally and mentally who isn’t making the desired progress, or who has unrealistic expectations. Further, out-patient treatment should be accommodating to stroke victims. Perhaps an exercise physiologist or a physiotherapist aid should conduct some movement analysis, screens, and other assessments at timely intervals. They also can be written prescription exercise programs by the original physiotherapist so that they can carry out the program. Stroke victims need to have set realistic goals, time-based incremental objectives, and a clear philosophy of what they want to accomplish. If either of these cogs in the wheel aren’t effective then the components need to be reevaluated.
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