[A cross-sectorial analysis of physio and occupational therapy pathways after stroke]

[Poststroke care in Germany : Results of an online survey of inpatient and outpatient experts in southern Germany]

BACKGROUND

To avoid long-term care after stroke and to promote occupational reintegration as well as to continue improving rehabilitation results, a good inpatient and outpatient care is necessary. More importantly a gapless transition into aftercare is required. The aim of this study was to gather expert opinions and experiences on the current care process during rehabilitation discharge and aftercare as well as to identify barriers and to discuss possible solutions.

METHODS

Clinicians from inpatient neurological rehabilitation, general practitioners and physiotherapists working in outpatient rehabilitation from Baden-Württemberg (BW) and Bavaria (BY) took part in an online survey on poststroke care (n = 77). The following topics were addressed: discharge process into follow-up care, follow-up care after rehabilitation; as well as cooperation and communication in the discharge process and during follow-up care. The online survey was conducted between 1 June 2017 and 3 August 2017 and was descriptively analyzed.

RESULTS

The perceptions of inpatient and outpatient experts with respect to significance and barriers of the factors involved in the discharge process and in the aftercare were mainly discrepant. In particular, the interdisciplinary cooperation and communication were criticized. Differences were mentioned depending on the occupational group, when asked about the leading cause that makes it difficult for the patient to return to their home environment.

DISCUSSION

Practitioner networks and standardized communication pathways can help to strengthen intradisciplinary and interdisciplinary cooperation and communication and thus achieve an improvement in the discharge process as well as in the aftercare system.

[Integration and utilization of physiotherapy in hospice and palliative care : A survey on clinical practice in Germany]

BACKGROUND

Palliative care is an approach that improves the quality of life of patients with incurable and progressive illnesses; therefore, in these situations physiotherapy can play an important role.

AIM

This study was carried out to examine the integration and utilization of physiotherapy in palliative and hospice care services in Germany.

METHODS

A cross-sectional survey including all palliative care units, specialized outpatient palliative care teams and hospices in Germany (n = 680) in 2013 was carried out.

RESULTS

The response rate was 43.5 % (n = 296). Physiotherapy is predominantly applied in palliative care units (79 %) but rarely in hospices (38 %) and outpatient palliative care teams (30 %). A structured physiotherapeutic assessment is rarely carried out even on palliative care units (26 %). Positive effects of physiotherapy are especially described for symptoms, such as edema, pain, constipation and dyspnea.

CONCLUSION

Despite its significant potential to relieve symptoms, physiotherapy is not systematically integrated into palliative care practice in Germany.