Stroke Rehabilitation Assessment Tools Survey Final · PDF fileStroke Rehabilitation...
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Stroke Rehabilitation Assessment Tools Survey
Final Report
October 2011
2
Stroke Rehabilitation Assessment Tools Survey
Northeastern and Northwestern Ontario Stroke Networks
Final Report – October 2011
Table of Contents
Topic Page
Executive Summary 3
Background 4
Purpose 4
Methods 5
Table 1: Assessment Tools Surveyed 6
Findings 7
Table 2: Respondents 7
Table 3: Use of Selected Stroke Rehabilitation Assessment Tools in NEO & NWO 8
Figures 1-6: Top Tools Reported by Clinician Group 9
Figures 7-8: Electronic Resources - Awareness and Usage 14
Next Steps 16
Appendix 1: Survey Template 18
Appendix 2: Physiotherapy Demographics and Discipline Specific Information 20
Appendix 3: Occupational Therapy Demographics and Discipline Specific Information 23
Appendix 4: Speech Language Pathology Demographics and Discipline Specific Information 26
Appendix 5: Social Work Demographics and Discipline Specific Information 29
Appendix 6: Recreation Demographics and Discipline Specific Information 32
Appendix 7: Psychology Demographics and Discipline Specific Information 35
Commonly Used Abbreviations
Full Name Abbreviation Full Name Abbreviation
Berg Balance Scale BBS Northwestern Ontario NWO
Boston Diagnostic Aphasia Examination
BDAE Occupational Therapist OT
Canadian Best Practice Recommendations for Stroke Care
CPBRSC Physiotherapy PT
Chedoke McMaster Stroke Assessment
CMSA Psychologist or Psychological Associate
Psych
Montreal Cognitive Assessment MOCA Social Worker SW
Northeast(ern) NE Speech Language Pathologist
SLP
Northwest(ern) NW Therapeutic Recreationist or Recreation Therapist
Rec
Northeastern Ontario NEO
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 3
Executive Summary
In May/June 2011 a survey was developed and distributed to determine to what extent rehabilitation
clinicians in northeastern (NE) and northwestern (NW) Ontario use standardized, valid assessment tools to
evaluate patient’s stroke-related impairments and functional status. Assessment tools that were included
were drawn from Canadian Best Practice recommendations and only included those that are currently
available to clinicians. Additionally, the survey results were used to determine the extent to which the “core
set” of assessment tools *Berg Balance Scale, Montreal Cognitive Assessment, Chedoke-McMaster Stroke
Assessment, Boston Diagnostic Aphasia Examination, AlphaFIM®/FIM® Instruments (not specifically surveyed
as regional use already determined)] as recommended by the Provincial Outcome Measures Working Group
(Jan 2010) were being utilized. Clinicians were also surveyed regarding their familiarity with electronic
resources for assessment tools. The information gathered from the survey and the work of other regional
stroke networks is currently being used to identify educational opportunities, barriers and facilitators
towards the use of assessment tools and to help facilitate improved communication and information transfer
between rehabilitation providers across the care continuum.
The survey was sent to a total of 493 (253 NE, 240 NW) clinicians (OT, PT, Psych, Rec, SLP, SW). Overall
response rate was 36%. There was strong use reported for the core set of assessment tools: Berg Balance
Scale (98% PT, 28% OT), Montreal Cognitive Assessment (89% OT), Chedoke-McMaster Stroke Assessment
(66% PT, 21% OT) and Boston Diagnostic Aphasia Examination (74% SLP). In reviewing the data from an
urban/rural perspective, there was no apparent difference in the overall use of the core set of assessment
tools between clinicians practicing in these environments. In the NE AlphaFIM® and FIM® are being utilized
by 5 hospitals, all 5 hospitals have designated rehabilitation beds and 4 of the hospitals are either a district or
the regional stroke centre. In the NW AlphaFIM® is being utilized by 4 hospitals, including the regional stroke
centre, the FIM® is being utilized by the 1 NW hospital with designated rehab beds. Additional commonly
used assessment tools reported included: OSOT Perceptual Evaluation, Mini Mental State Examination, 9
Hole Peg Test, Box and Block Test, Motor-Free Visual Perception Test, Line Bisection Test, Visual Analogue
Scale and Numeric Rating Scale for pain, Timed Up and Go Test, 6 Minute Walk Test, Western Aphasia
Battery, Geriatric Depression Scale and the Beck Depression Inventory. Many tools not included in the
Canadian Best Practice Recommendations for Stroke Care were also being utilized. The majority of
respondents, both urban and rural, were familiar with electronic resources for assessment tools. However
some respondents were unaware that the following websites existed: StrokEngine Assess (45% unaware),
Evidence-Based Review of Stroke Rehabilitation (41% unaware) and Canadian Best Practice
Recommendations for Stroke Care (20% unaware). Action plans to address identified regional priorities
around the use of assessment tools are in development.
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 4
Background
The Northeastern (NE) and Northwestern (NW) Ontario Stroke Networks support the uptake and
dissemination of information regarding best practices in stroke care.
Published in 2010, the Canadian Best Practice Recommendations for Stroke Care (CBPRSC) state that:
“Clinicians should use standardized, valid assessment tools to evaluate the patient’s stroke-related
impairments and functional status” (5.1.iv.).
Other stroke networks in Ontario have also completed various activities (forums, workshops, educational
events, surveys, etc…) to collect and disseminate information on use of stroke rehabilitation assessment tools
across the continuum of care in their regions. As such, a need to define the current state regarding use of
assessment tools in NE and NW Ontario was identified.
Purpose
An electronic survey was used to determine to what extent Canadian Best Practice Recommendation 5.1.iv
(2010) is being implemented throughout NE and NW Ontario.
Additionally, the survey results will be used to help determine the extent to which the “core set” of
assessment tools [Berg Balance Scale, AlphaFIM®/FIM®, Montreal Cognitive Assessment, Chedoke-McMaster
Stroke Assessment, Boston Diagnostic Aphasia Examination] as recommended by the Provincial Outcome
Measures Working Group (Jan 2010) are being utilized.
The survey results will also assist in the:
identification of educational opportunities with respect to assessment tools
identification of barriers towards the use of assessment tools in order to develop strategies to support
uptake where feasible
facilitation of improved communication and information transfer between rehabilitation providers across
the care continuum
The survey results from the NE and NW Ontario Stroke Networks will add to provincial body of knowledge
regarding the use of assessment tools within the Ontario Stroke System.
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 5
Methods
Data Collection:
An electronic survey was distributed using Survey MonkeyTM. Assessment tools that were included were
drawn from the 2008 and 2010 CBPRSC reports and only included those that are currently available (see
Table 1). The AlphaFIM®/FIM® Instruments were not included as the extent of regional usage has been
determined. Three pain rating scales were included as the domain of “pain” was reported by clinicians in
other provincial stroke assessment tool forums as being a domain that required consideration. In order to
encourage participation, clinicians were offered the opportunity to submit their email address to be entered
into a prize draw. Two $25.00 Gift Cards were randomly awarded after the survey deadline. The information
provided in the survey was not linked to the email address provided.
Participants Surveyed: Physiotherapists (PT), Psychologists or Psychological Associates (Psych), Occupational
Therapists (OT), Speech Language Pathologists (SLP), Social Workers (SW), Therapeutic
Recreationists/Recreation Therapists (Rec) who treat adults with stroke in publically funded hospital-based
programs (acute care, in-patient/ out-patient rehabilitation or CCC, day programs), home/community settings
and urban/rural environments were targeted for the survey. Therapists working in the long term care,
paediatric and private sectors were not specifically surveyed.
E-Mail Distribution Strategy: The link to the survey was e-mailed to:
Clinicians (PT, Psych, OT, SLP, SW, Rec)
Managers of hospital rehabilitation programs for distribution
Managers of CCAC rehab contract providers for distribution
Professional practice leaders of OT, PT, Rec, SLP and SW for distribution
Timeframe: The data for the survey was collected between May 15, 2011 and June 8, 2011.
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 6
Table 1: Assessment Tools Surveyed
Name of Measure (Abbreviation)
American Speech-Language-Hearing Association Functional Assessment of Communication Skills (ASHA-FACS)
Assessment of Life Habits – Leisure Subscale (LIFE-H)
Beck Depression Inventory (BDI)
Behavioural Inattention Test (BIT)
Berg Balance Scale (BBS)
Boston Diagnostic Aphasia Examination (BDAE)
Box and Block Test (BBT)
Chedoke Arm and Hand Activity Inventory (CAHAI)
Chedoke-McMaster Stroke Assessment - Impairment Inventory (CMSA)
Chedoke-McMaster Stroke Assessment - Impairment Inventory Shoulder Pain (CMSA-SP)
Comb and Razor Test (CRT)
Frenchay Aphasia Screening Test (FAST)
Geriatric Depression Scale (GDS)
Hospital Anxiety and Depression Scale (HADS)
Line Bisection Test (LBT)
Mini Mental State Examination (MMSE)
Modified Ashworth Scale (MAshS)
Montreal Cognitive Assessment (MOCA)
Motor-free Visual Perception Test (MVPT)
Nine Hole Peg Test (NHPT)
Numeric Pain Rating Scale (NPRS)
OSOT Perceptual Evaluation (OSOT)
Reintegration to Normal Living Index (RNLI)
Six Minute Walk Test (6MWT)
Stroke Impact Scale (SIS)
Timed Up and Go Test (TUG)
Toronto Beside Swallowing Screening Test (TOR-BSST)
Visual Analogue Pain Scale (VAS)
Western Aphasia Battery (WAB)
Wong-Baker FACES Pain Rating Scale (WBFPRS)
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 7
Findings
Respondents
The survey was sent to a total of 493 clinicians (253 NE, 240 NW). Eighteen clinicians indicated that they did
not treat people with stroke and therefore were not eligible to participate in the survey. Overall response
rate was 36%, representing clinicians from a variety of disciplines, practice locations and settings (e.g.
urban/rural, rehab/acute care/community). See Table 2 below and Appendices 2-7 for more detailed
information on respondent demographics.
Table 2: Respondents
PT OT SLP SW Rec Psych TOTAL
NE SENT 95 73 26 45 12 2 253
NE RESPONSES 30 26 13 16 8 1 94
% RESPONSE RATE 32% 36% 50% 36% 67% 50% 37%
NW SENT 57 69 24 48 38 4 240
NW RESPONSES 26 15 7 4 8 3 63
% RESPONSE RATE 46% 22% 29% 8% 21% 75% 26%
Use of Recommended Stroke Rehabilitation Assessment Tools in NE and NW Ontario
The use of selected stroke rehabilitation assessment tools by clinicians in NE and NW Ontario is illustrated in
Table 3.
There was strong use reported for the core set of assessment tools: Berg Balance Scale (98% PT, 28% OT),
Montreal Cognitive Assessment (89% OT), Chedoke-McMaster Stroke Assessment (66% PT, 21% OT) and
Boston Diagnostic Aphasia Examination (74% SLP). Please refer to Table 3, core set is highlighted.
Although not included in the survey, as regional use has been determined, there is significant regional uptake
with respect to the use of the AlphaFIM® and FIM® Instruments. In the NE, AlphaFIM® and FIM® are being
utilized by 5 hospitals, all 5 hospitals have designated rehabilitation beds and 4 of the hospitals are either a
district or the regional stroke centre. In the NW AlphaFIM® is being utilized by 4 hospitals, including the
regional stroke centre, the FIM® is being utilized by the 1 NW hospital with designated rehab beds.
Additional commonly used assessment tools reported included the OSOT Perceptual Evaluation, Mini Mental
State Examination, 9 Hole Peg Test, Box and Block Test, Motor-Free Visual Perception Test, Line Bisection
Test, Visual Analogue Scale and Numeric Rating Scale for pain, Timed Up and Go Test, 6 Minute Walk Test,
Western Aphasia Battery, Geriatric Depression Scale and the Beck Depression Inventory. Figures 2-7 display
the top tools reported on the survey by each professional discipline. Note that for OT, PT, SLP and Psych the
top tools are identified as those having 50% use in at least one region. In SW and Rec, no one tool was
identified as being used by 50% of respondents and as such, 20% was used to identify the top tools
reported.
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 8
Table 3: Use of Selected Stroke Rehabilitation Assessment tools in NEO & NWO
NW NE NW NE NW NE NW NE NW NE NW NE
N=15 N=26 N=26 N=30 N=7 N=13 N=4 N=16 N=8 N=8 N=3 N=1
Name of Tool
American Speech-Language-Hearing
Association Functional Assessment of
Communication Skills (ASHA-FACS) n/a n/a n/a n/a 29% 15% n/a n/a n/a n/a n/a n/a
Assessment of Life Habits (LIFE-H) Leisure
Subscale 0% 0% 0% 0% n/a n/a 0% 6% 13% 0% 0% 0%
Beck Depression Inventory (BDI) 27% 8% 8% 0% 0% 0% 0% 24% 0% 0% 67% 100%
Behavioural Inattention Test (BIT) 7% 23% n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a
Berg Balance Scale (BBS) 33% 23% 96% 100% n/a n/a n/a n/a n/a n/a n/a n/a
Boston Diagnostic Aphasia Examination
(BDAE) n/a n/a n/a n/a 71% 77% n/a n/a n/a n/a n/a n/a
Box and Block Test (BBT) 47% 35% 4% 0% n/a n/a n/a n/a n/a n/a n/a n/a
Chedoke Arm and Hand Activity Inventory
(CAHAI) 27% 54% 12% 47% n/a n/a n/a n/a n/a n/a n/a n/a
Chedoke McMaster Stroke Assessment
(CMSA) - Impairment Inventory 7% 35% 54% 77% n/a n/a n/a n/a n/a n/a n/a n/a
Chedoke McMaster Stroke Assessment -
Impairment Inventory Shoulder Pain
(CMSA-SP) 7% 15% 46% 53% n/a n/a n/a n/a n/a n/a n/a n/a
Comb and Razor Test (CRT) 7% 31% n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a
Frenchay Aphasia Screening Test (FAST) n/a n/a n/a n/a 0% 8% n/a n/a n/a n/a n/a n/a
Geriatric Depression Scale (GDS) 27% 35% 15% 3% 0% 0% 25% 44% 13% 0% 100% 0%
Hospital Anxiety and Depression Scale
(HADS) 7% 0% 8% 7% 0% 0% 25% 19% 13% 0% 33% 0%
Line Bisection Test (LBT) 40% 85% n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a
Mini Mental State Examination (MMSE) 73% 69% 23% 23% 0% 0% 0% 13% n/a n/a 0% 0%
Modified Ashworth Scale (MAshS) 0% 0% 15% 27% n/a n/a n/a n/a n/a n/a n/a n/a
Montreal Cognitive Assessment (MOCA) 93% 85% 8% 13% 14% 23% 0% 13% n/a n/a 67% 0%
Motor-free Visual Perception Test (MVPT) 40% 77% n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a
Nine Hole Peg Test (NHPT) 53% 39% 4% 0% n/a n/a n/a n/a n/a n/a n/a n/a
Numeric Pain Rating Scale (NPRS) 40% 54% 58% 73% n/a n/a 0% 19% 13% 25% n/a n/a
OSOT Perceptual Evaluation (OSOT) 73% 73% n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a
Reintegration to Normal Living Index
(RNLI) 0% 0% 4% 0% n/a n/a 0% 0% 13% 13% 0% 0%
Six Minute Walk Test (6MWT) 0% 4% 54% 53% n/a n/a n/a n/a n/a n/a 0% 0%
Stroke Impact Scale (SIS) 0% 4% 4% 10% 0% 8% 0% 6% 0% 0% n/a n/a
Timed Up and Go Test (TUG) 13% 8% 65% 73% n/a n/a n/a n/a n/a n/a n/a n/a
Toronto Beside Swallowing Screening Test
(TOR-BSST) n/a n/a n/a n/a 0% 8% n/a n/a n/a n/a n/a n/a
Visual Analogue Pain Scale (VAS) 13% 39% 73% 73% n/a n/a 0% 19% 13% 0% n/a n/a
Western Aphasia Battery (WAB) n/a n/a n/a n/a 100% 69% n/a n/a n/a n/a n/a n/a
Wong-Baker FACES Pain Rating Scale
(WBFPRS) 0% 0% 0% 10% n/a n/a n/a n/a n/a n/a n/a n/a
Recommended for inclusion in 'Core Set' of Outcome Measures
PSYCH
% Using
OT PT SLP SW TR
Highlighted = Recommended for inclusion in “core set” of assessment tools
n/a = discipline was not asked about this tool in the survey as it would generally not be applicable or commonly used by the specific discipline
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 9
TOP TOOLS REPORTED (>50% USE IN AT LEAST ONE REGION)
Figure 1: Occupational Therapy Top Tools
Figure 2: Physiotherapy Top Tools
Name of Measure (Abbreviation): Berg Balance Scale (BBS); Chedoke Arm and Hand Activity Inventory (CAHAI); Chedoke-McMaster Stroke Assessment - Impairment Inventory (CMSA); Chedoke-McMaster Stroke Assessment – Shoulder Pain (CMSA-SP); Line Bisection Test (LBT); Mini Mental State Examination (MMSE); Montreal Cognitive Assessment (MOCA); Motor-free Visual Perception Test (MVPT); Nine Hole Peg Test (NHPT); Numeric Pain Rating Scale (NPRS); OSOT Perceptual Evaluation (OSOT); Six Minute Walk Test (6MWT); Timed Up and Go Test (TUG); Visual Analogue Pain Scale (VAS)
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 10
TOP TOOLS REPORTED (>50% USE IN AT LEAST ONE REGION)
Figure 3: Speech Language Pathology Top Tools
Figure 4: Psychology Top Tools
Name of Measure (Abbreviation): Beck Depression Inventory (BDI); Boston Diagnostic Aphasia Examination (BDAE); Geriatric Depression Scale (GDS); Montreal Cognitive Assessment (MOCA); Western Aphasia Battery (WAB)
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 11
TOP TOOLS REPORTED (>20% USE IN AT LEAST ONE REGION)*
*No one tool was identified as being used by > 50% of respondents from Recreation or Social Work
Figure 5: Recreation Top Tools
Figure 6: Social Work Top Tools
Name of Measure (Abbreviation): Beck Depression Inventory (BDI); Geriatric Depression Scale (GDS); Hospital Anxiety and Depression Scale (HADS); Numeric Pain Rating Scale (NPRS)
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 12
Overview of Common Themes in “Core” Assessment Tools
When reviewing the data collected from the four core assessment tools captured in the survey, there was
nearly complete consensus from those who frequently (>50% of the time) administered the core set that
each tool took a reasonable length of time to complete.
Respondents who frequently administered the tools were asked to rate the ‘usefulness of the tool’ on a five
point scale across four categories. The categories were: Establishing a baseline measure; measuring progress
or change; communicating the patient’s status; and assisting with identification of goals (see Appendix 1,
question 1.c). The majority of the respondents rated all of the four tools as either extremely or very useful for
establishing a baseline measure. The same findings occurred for measuring progress or change and
communicating the patient’s status with the exception of the BDAE which was rated as either very useful or
useful. Reponses for rating the ‘usefulness’ of assisting with the identification of goals were more
widespread for three of the tools with the exception of the BDAE which was rated as very useful or useful
again. When reviewing the responses for the ‘usefulness’ of all the tools, only one individual gave a rating of
not useful and that was by an OT with reference to the MOCA's assistance with identification of goals.
In reviewing the data from an urban/rural perspective, there was no apparent difference in the overall use of
the core set of assessment tools between clinicians practicing in these environments. However, it was
observed that in some of the rural communities, there was increased use of tools by clinicians who may not
traditionally administer that assessment. For example, urban PT’s generally did not administer the MOCA
citing that the OT’s usually assessed cognition. However some rural PT’s did use the MOCA as they may not
have had access to OT’s as part of their interdisciplinary team.
The survey explored some common reasons as to why a tool may be used infrequently or not at all, which are
summarized under the subheadings below. However, two of the choices (the cost of the tools and licensing
requirements) appeared to be non-issues as they were mentioned only once for one specific tool, the CMSA.
Montreal Cognitive Assessment (MOCA)
The survey results for both the NE and NW showed that the MOCA was primarily administered by the OTs.
Physiotherapy, psychology and social work occasionally or rarely administered it. The primary reason for the
other professions not using it was they felt it was not applicable to their profession/area of practice or that
the OTs at their site administered it. Furthermore, approximately one third of the PTs were unaware this tool
existed and a small percentage (10% - 20%) of the SWs and PTs cited lack of training as the reason why they
were not using it. Within the comments on the measure, one OT who used it less frequently stated that
he/she was “…awaiting further study re use of the MOCA with stroke patients”.
Chedoke-McMaster Stroke Assessment - Impairment Inventory (CMSA)
In the NE, approximately three quarters of the PTs administered the CMSA and of those, half of them did so
frequently (>50% of the time). In comparison, in the NW approximately half of the PTs administered the tool
and of those, one third did so frequently.
In the NE, slightly more than one third of the OTs administered the CMSA and similar to the PTs half of them
did so frequently. A very small percentage (< 10%) of the NW OTs reported administering it and only did so
rarely due to lack of training and time.
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 13
For both disciplines in both regions, lack of time to administer or not finding the tool to be clinically useful
were common themes for infrequently (≤ 50% of the time) or not using the tool at all. Therapists in acute
care most often commented on time constraints, however it was a consistent theme across the continuum
from acute to community care.
A small percentage of the NE PTs and OTs cited lack of training/expertise as reasons why they were
administering it infrequently or not at all, whereas, in the NW a quarter of the therapists reported that as the
reason. For both regions, a small percentage the OT group also indicated that they didn’t use the CMSA as it
was not applicable for their area of practice, that PTs administered it, and a very small percentage were
unaware that this tool existed.
Boston Diagnostic Aphasia Examination (BDAE)
In both regions approximately three quarters of the SLPs use the BDAE, and of those, a quarter used it
frequently.
Lack of time to administer, across the continuum from acute to community care was the most common
reason for either infrequently or not using the tool. Lack of training was only reported on one occasion.
Further comments noted that other tools are more useful in the community setting given the client
demographics. One SLP commented more severe stroke patients are better suited to assessment using the
Western Aphasia Battery, a tool which was reported to be commonly used by both NE and NW SLP’s.
Berg Balance Scale (BBS)
In both regions all PTs use the BBS with the exception of one individual who reported not using it because it
was not applicable to their area of practice as their clients were very low functioning. In the NE eighty
percent of the PTs use the BBS frequently versus eighty-eight percent in the NW.
For OTs and PTs in both regions the issue of time constraints was raised by those who did not administer the
tool as frequently. The OTs who did not administer the BBS primarily cited that the PTs administered it or
that it was not applicable for their area of practice. Lack of training/expertise was also indicated in the NW
by a small percentage of OT respondents.
Other Commonly Used Tools
Many tools not included in the Canadian Best Practice Recommendations for Stroke Care were also being
utilized by clinicians. Examples of additional tools being utilized in stroke rehabilitation in NE and NW Ontario
include the Community Balance and Mobility Scale, Trail Making A and B Tests, Boston Naming Test,
Cognitive Assessment Scale for the Elderly, Leisure Motivational Scale and Wisconsin Card Sorting Test.
Appendices 2-7 outline for each discipline the variety of other tools reported to be used in stroke
rehabilitation.
Use of Electronic Resources
As illustrated in Figures 7 and 8, the majority of respondents were familiar with electronic resources for
assessment tools. However some respondents were unaware that the following websites existed:
StrokEngine Assess (45% unaware), Evidence-Based Review of Stroke Rehabilitation (41% unaware) and
Canadian Best Practice Recommendations for Stroke Care (20% unaware).
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 14
Figure 7: NW Electronic Resources: Awareness and Usage
Stroke Assessment Tools Survey - All Clinicians - NW
2010 Canadian Best Practice Recommendations for Stroke Care (www.strokebestpractices.ca)
Answer Options Response
Count Response Percent
Unaware this website existed 9 14%
Aware of website however have not looked at it 18 29%
Visited the website once 16 25%
Visited it 2-5 times 13 21%
Visited it greater than 5 times 7 11%
Total 63 100%
EBRSR: Evidence-Based Review of Stroke Rehabilitation (www.ebrsr.com)
Answer Options Response
Count Response Percent
Unaware this website existed 26 41%
Aware of website however have not looked at it 12 19%
Visited the website once 7 11%
Visited it 2-5 times 9 14%
Visited it greater than 5 times 9 14%
Total 63 100%
StrokEngine Assess (www.medicine.mcgill.ca/strokengine-assess)
Answer Options Response
Count Response Percent
Unaware this website existed 27 43%
Aware of website however have not looked at it 9 14%
Visited the website once 12 19%
Visited it 2-5 times 7 11%
Visited it greater than 5 times 8 13%
Total 63 100%
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 15
Figure 8: NE Electronic Resources: Awareness and Usage
Stroke Assessment Tools Survey - All Clinicians NE
2010 Canadian Best Practice Recommendations for Stroke Care (www.strokebestpractices.ca)
Answer Options Response
Count Response Percent
Unaware this website existed 24 26%
Aware of website however have not looked at it 15 16%
Visited the website once 13 14%
Visited it 2-5 times 32 34%
Visited it greater than 5 times 10 11%
TOTAL 94 100%
EBRSR: Evidence-Based Review of Stroke Rehabilitation (www.ebrsr.com)
Answer Options Response
Count Response Percent
Unaware this website existed 39 41%
Aware of website however have not looked at it 22 23%
Visited the website once 6 6%
Visited it 2-5 times 12 13%
Visited it greater than 5 times 15 16%
TOTAL 94 100%
StrokEngine Assess (www.medicine.mcgill.ca/strokengine-assess)
Answer Options Response
Count Response Percent
Unaware this website existed 43 46%
Aware of website however have not looked at it 11 12%
Visited the website once 9 10%
Visited it 2-5 times 11 12%
Visited it greater than 5 times 20 21%
TOTAL 94 100%
Stroke Rehabilitation Assessment Tools Survey Final Report – October 2011 16
Next Steps
Discuss survey findings with each stroke network’s steering committees, advisory and professional
practice groups.
Develop educational strategies to enhance uptake and awareness of the core set of assessment tools
and of the resources available to support clinicians. During this process, take into account and build
on previous strategies developed by provincial counterparts such as the regional rehabilitator
coordinators and the Ontario Regional Educators Group (OREG).
Consider the target audience in developing strategies. Although there may be excellent uptake of the
tool such as the BBS by PTs who regularly administer the tool we need to also consider the other
team members who do not administer the tool. In order to have a common/shared language they
need to have a basic understanding of what the reported scores mean. Consider use of
communiqués or the possibility of having Lunch and Learn sessions via videoconference providing an
overview of the core tools.
Look further into the demographics of the respondents (profession, district, area(s) of practice) who
expressed interest in learning more about a specific recommended tool. For example, one SLP
commented ‘Would be very interested in training related to the TOR-BSST’. For comments such as
this, we might consider a communiqué to the appropriate professions that at minimum would
provide information on how to access education on the tool.
Survey and Final Report prepared by:
Jenn Fearn
Regional Rehabilitation Coordinator
NEO Stroke Network
Hôpital régional de Sudbury Regional Hospital
41 Ramsey Lake Road, Sudbury, ON P3E 5J1
Ph. 705.523.7100 ext. 1718
Fax. 705.523.7170
Email: [email protected]
Web: www.neostrokenetwork.com
Esmé French
Regional Stroke Rehabilitation Specialist
NWO Regional Stroke Network
201-984 Oliver Road
Thunder Bay, ON P7B 7C7
Ph. 807.684.6498
Fax. 807. 684.5883
Email: [email protected]
Web: www.nwostroke.ca
17
Appendices
Appendix 1: Survey Template
Appendix 2: Physiotherapy Demographics and Discipline Specific Information
Appendix 3: Occupational Therapy Demographics and Discipline Specific Information
Appendix 4: Speech Language Pathology Demographics and Discipline Specific Information
Appendix 5: Social Work Demographics and Discipline Specific Information
Appendix 6: Recreation Demographics and Discipline Specific Information
Appendix 7: Psychology Demographics and Discipline Specific Information
18
Appendix 1: Survey Template
Demographic information collected:
Profession
Location of practice [region, district, urban/rural (size of community) and setting (rehab, acute
care etc.)]
Years of clinical experience (general and stroke specific)
Average percentage of caseload that patients with stroke represent
Outcome Measure Specific Questions:
For each outcome measure, the following questions were asked:
1. Do you use this tool? Yes No
A response of Yes led to the following questions:
a. In what percentage of cases do you use this tool with your patients with stroke?
If the clinician responded occasionally or rarely ( 50 %) they were asked the following:
i. Could you please elaborate why you only occasionally or rarely use this tool? If more than one reason, select all that apply.
o Lack of time to administer o Lack of training/expertise o Not clinically useful (information does not inform my practice) o Not clinically appropriate (another measure is more appropriate) o Cost of the tool o Other, please specify:
b. Is the length of time to administer the tool reasonable?
c. In the following questions, please rate the usefulness of the tool by selecting the number that
best reflects the tool in each circumstance (1=not useful 5=extremely useful, n/a)
i. Establishing a baseline measure ii. Measuring progress or change
iii. Communicating the patient’s status iv. Assisting with identification of goals
A response of No led to the following question:
a. Could you please elaborate why you do not use this tool? If more than one, select all that apply.
o Lack of time to administer o Lack of training/expertise o Not clinically useful (information does not inform my practice) o Not clinically appropriate (another measure is more appropriate) o Not applicable for my profession/area of practice o Cost of the tool o Licensing requirements o Unaware this tool existed o Other, please specify
19
2. Please list any other tools you commonly use with your patients with stroke. If they were developed
by your facility please provide a brief description of their purpose i.e. Smith test (Swallowing Screen)
3. If you have any further comments you wish to provide, feel free to provide them here.
A general question was asked to determine the participant’s familiarity with electronic resources that contain information regarding assessment tools in stroke rehabilitation.
4. Please indicate your familiarity/usage of the following 3 websites?
(unaware this website existed visited it greater than 5 times)
1. StrokEngine Assess (www.medicine.mcgill.ca/strokengine-assess)
2. Evidence-Based Review of Stroke Rehabilitation (www.ebrsr.com)
3. Canadian Best Practice Recommendations for Stroke Care (www.strokebestpractices.ca)
20
Appendix 2: Physiotherapy Demographics and Discipline Specific Information
Answer
OptionsThunder Bay 69.2% 18
West of Thunder Bay 23.1% 6
East of Thunder Bay 7.7% 2
Thunder BayWest of Thunder
Bay
East of
Thunder Bay
Response
Percent
Response
Count
17 0 0 65.4% 17
1 5 0 23.1% 6
0 1 2 11.5% 3
26
0
Thunder Bay West of Thunder East of Response Response 2 4 2 30.8% 8
8 2 2 46.2% 12
1 2 2 19.2% 5
4 3 2 34.6% 9
2 0 0 7.7% 2
5 1 0 23.1% 6
1 1 0 7.7% 2
260
Community, LTC
Thunder BayWest of Thunder
Bay
East of
Thunder Bay
Response
Percent
Response
Count
2 0 1 11.5% 3
6 0 0 23.1% 6
3 1 0 15.4% 4
5 4 1 38.5% 10
2 1 0 11.5% 3
26
0
Thunder BayWest of Thunder
Bay
East of
Thunder Bay
Response
Percent
Response
Count
3 0 1 15.4% 4
7 1 0 30.8% 8
3 3 0 23.1% 6
4 1 1 23.1% 6
1 1 0 7.7% 2
26
0
Thunder BayWest of Thunder
Bay
East of
Thunder Bay
Response
Percent
Response
Count
7 5 1 50.0% 13
6 0 0 23.1% 6
1 1 0 7.7% 2
1 0 1 7.7% 2
3 0 0 11.5% 3
26
0
Stroke Assessment Tools Survey - Demographics NW Physio
Please select the geographical district(s) you practice in:
Response Percent & Count
answered question 26
skipped question 0
answered questionskipped question
What size of setting(s) do you practice in? Please check all that apply.
Please select the geographical district(s) you
Answer Options
Population ≥ 40 000
Population 5000 - 39 999
Population < 5000
answered question
skipped question
Please indicate the setting(s) that you work in. If more than one, select all that apply.
Please select the geographical district(s) you
Answer OptionsAcute Care
In-patient Rehabilitation
Complex Continuing Care
Out-patient Rehabilitation
Hospital-based Day Program
Home Care/CCAC
Other (please specify)
0-1
2-5
6-10
11-19
20+
Please indicate your total number of years of clinical experience (not stroke specific): Please select the geographical district(s) you
Answer Options
Answer Options
0-1
2-5
6-10
11-19
answered question
skipped question
Please indicate your total number of years of clinical experience working with people who have had a stroke: Please select the geographical district(s) you
76-100
answered question
skipped question
Answer Options
0-10
11-25
26-50
51-75
20+
answered question
skipped question
Please estimate the average percentage of your caseload that patients with stroke represent:
Please select the geographical district(s) you
21
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
20.0% 6
20.0% 6
20.0% 6
40.0% 12
30
0
Alg o ma T imminsNip iss ing -
T e miska mingSud b ury
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
5 4 1 6 53.3% 16
1 2 4 4 36.7% 11
0 0 1 2 10.0% 3
30
0
Alg o ma T imminsNip iss ing -
T e miska mingSud b ury
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
6 5 3 6 66.7% 20
4 4 1 8 56.7% 17
5 4 2 2 43.3% 13
5 3 3 3 46.7% 14
0 0 0 2 6.7% 2
0 2 4 1 23.3% 7
1 1 0 1 10.0% 3
30
0
LTC and elCAP beds in LTC facility, LTC, private practice, retirement homes
Alg o ma T imminsNip iss ing -
T e miska mingSud b ury
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 0 0.0% 0
0 3 1 1 16.7% 5
1 0 0 1 6.7% 2
4 2 1 4 36.7% 11
1 1 4 6 40.0% 12
30
0
Alg o ma T imminsNip iss ing -
T e miska mingSud b ury
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 1 0 1 6.7% 2
0 2 1 1 13.3% 4
2 0 1 1 13.3% 4
3 3 0 5 36.7% 11
1 0 4 4 30.0% 9
30
0
Alg o ma T imminsNip iss ing -
T e miska mingSud b ury
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
3 3 6 5 56.7% 17
3 3 0 3 30.0% 9
0 0 0 1 3.3% 1
0 0 0 2 6.7% 2
0 0 0 1 3.3% 1
30
0
Stroke Assessment Tools Survey - Demographics NE Physio
Answe r Op tio ns
Timmins
Sudbury-Manitoulin
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Home Care/CCAC
a nswe re d q ue stio n
sk ip p e d q ue stio n
Hospital-based Day Program
sk ip p e d q ue stio n
In-patient Rehabilitation
Wha t s ize o f se tting d o yo u p ra ctice in?
Algoma
Answe r Op tio ns
Other (please specify)
a nswe re d q ue stio n
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
sk ip p e d q ue stio n
Answe r Op tio ns
0-1
2-5
6-10
Complex Continuing Care
Out-patient Rehabilitation
Acute Care
11-19
Answe r Op tio ns
2-5
20+
sk ip p e d q ue stio n
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
6-10
11-19
0-1
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a s tro ke :
a nswe re d q ue stio n
20+
a nswe re d q ue stio n
76-100
a nswe re d q ue stio n
sk ip p e d q ue stio n
Answe r Op tio ns
0-10
11-25
26-50
51-75
Nipissing-Temiskaming
Urban (population ≥ 40 000)
Rural (population < 40 000)
Answe r Op tio ns
Both Urban and Rural
a nswe re d q ue stio n
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
22
PHYSIOTHERAPY – REPORTED USE OF OTHER TOOLS
REPORTED BY BOTH NE & NW
Community Balance and Mobility Scale (CBMS)
Functional Independence Measure (FIM) ®
Alpha FIM®
Tinetti Balance Test
2 minute walk test REPORTED BY NE ONLY
Elderly Mobility Scale REPORTED BY NW ONLY
Clinical Outcome Variables Scale
Gait speed
10 m walk test
Activities-specific Balance Confidence Scale (ABC Scale)
Action Plans for goal setting
Manual muscle testing - Oxford scale
Modified sphygmomanometer or myometer for assessing muscle strength
Range of motion - goniometer
Functional reach test
Morse fall risk assessment
National Institutes of Health Stroke Scale (NIHSS)
Gait assessment
PT OTHER COMMENTS NW
I strictly take outpatient neuro clients so the CMSA scale is much too long to be useful for both client and clinician. I have access to the electronic medical record and see the scores that the inpatient physiotherapist has assessed, but I do not redo this score.
For a lot of the self-report measures, it is difficult in clinical practice to complete them due to time restrictions. Also, there is often cognitive difficulties and/or communication issues that makes their administration difficult. It would be good to have them completed as they do have an impact on our therapy. Perhaps not directly but definitely indirectly.
Working within in a team and having other team members (ie. Psych or Social work) administer these outcome measures would be helpful.
I do not actively treat many post-stroke clients in my current position (less than 2 a year)
Due to low number of stroke patients per year, there is not a large focus/amount of time spent on learning or attempting to implement a lot of the aforementioned assessment and outcome tools. Perhaps a seminar introducing the previously mentioned tools would be of benefit for those therapists in the area that treat stroke patients so that an informed decision could be made on an individual basis about which tools would be the most appropriate one(s) to use in each particular setting.
NE
Due to caseload demands, standardized tools are not commonly used. Functional assessments are used to determine course of treatment and measure progress.
I realize, even prior to this survey that I need to be using more outcome measures. However, as I've mentioned, stroke patients make up such a small percentage of my clientele, it is hard to feel confident in using them. Also, time is definitely an issue with many of these, as I am a sole-charge physiotherapist covering many different areas.
Do not use all the outcome measurements on every client, more appropriate with some than others. Am limited in the time it takes to do the assessment (and therefore thoroughness) as our agency feels that 1 1/2 hours for an assessment, including travel time & paper work is sufficient.
23
Appendix 3: Occupational Therapy Demographics and Discipline Specific Information
Response
PercentResponse Count
73.3% 11
20.0% 3
13.3% 2
15
Thunder BayWest of Thunder
Bay
East of Thunder
Bay
Response
Percent
Response
Count
8 0 1 53.3% 8
2 3 1 33.3% 5
3 0 2 26.7% 4
15
0
Thunder BayWest of Thunder
Bay
East of Thunder
Bay
Response
Percent
Response
Count
4 1 1 40.0% 6
3 1 0 26.7% 4
1 0 0 6.7% 1
2 1 0 20.0% 3
0 0 0 0.0% 0
2 1 2 26.7% 4
2 1 0 20.0% 3
15
0
contract work for veteran's affairs
community geriatric psychiatry
Mental Health Case management in the community
Thunder BayWest of Thunder
Bay
East of Thunder
Bay
Response
Percent
Response
Count
1 0 0 6.7% 1
1 2 0 20.0% 3
2 1 0 20.0% 3
3 0 0 20.0% 3
4 0 2 33.3% 5
15
0
Thunder BayWest of Thunder
Bay
East of Thunder
Bay
Response
Percent
Response
Count
1 0 0 6.7% 1
5 2 1 46.7% 7
2 1 0 20.0% 3
0 0 1 6.7% 1
3 0 0 20.0% 3
15
0
Thunder BayWest of Thunder
Bay
East of Thunder
Bay
Response
Percent
Response
Count
5 1 1 46.7% 7
2 2 1 26.7% 4
1 0 0 6.7% 1
0 0 0 0.0% 0
3 0 0 20.0% 3
15
0
76-100
answered question
skipped question
Answer Options
0-10
11-25
26-50
51-75
20+
answered question
skipped question
Please estimate the average percentage of your caseload that patients with stroke represent:
Please select the geographical district(s) you practice
Answer Options
0-1
2-5
6-10
11-19
skipped question
Please indicate your total number of years of clinical experience working with people who have had a stroke:
Please select the geographical district(s) you practice
2-5
6-10
11-19
20+
answered question
Please select the geographical district(s) you practice
Answer Options
0-1
Home Care/CCAC
Other (please specify)
answered question
skipped question
Please indicate your total number of years of clinical experience (not stroke specific):
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Out-patient Rehabilitation
Hospital-based Day Program
Please indicate the setting(s) that you work in. If more than one, select all that apply.
Please select the geographical district(s) you practice
in:
Answer Options
Population ≥ 40 000
Population 5000 - 39 999
Population < 5000
answered question
skipped question
Answered Question
Stroke Assessment Tools Survey - Demongraphics NW OT
Thunder Bay
Please select the geographical district(s) you practice in:
Answer Options
What size of setting(s) do you practice in? Please check all that apply.
Please select the geographical district(s) you practice
Answer Options
East of Thunder Bay
West of Thunder Bay
24
Response PercentResponse
Count
11.5% 3
26.9% 7
30.8% 8
38.5% 10
26
Algoma Timmins Nipissing-
Temiskaming
Sudbury-
Manitoulin
Response
Percent
Response
Count
2 4 5 8 65.4% 17
0 3 3 1 26.9% 7
1 0 0 1 7.7% 2
26
0
Algoma Timmins Nipissing-
Temiskaming
Sudbury-
Manitoulin
Response
Percent
Response
Count
2 4 5 3 53.8% 14
2 4 4 5 57.7% 15
2 3 4 0 34.6% 9
1 5 4 4 46.2% 12
0 0 0 0 0.0% 0
1 2 1 1 19.2% 5
1 1 1 0 11.5% 3
26
0
Minor Procedures Clinic
LTC
Interim Long Term Care
Algoma Timmins Nipissing-
Temiskaming
Sudbury-
Manitoulin
Response
Percent
Response
Count
0 0 3 3 23.1% 6
0 0 0 2 7.7% 2
0 2 0 0 7.7% 2
0 3 3 5 34.6% 9
3 2 2 0 26.9% 7
26
0
Algoma Timmins Nipissing-
Temiskaming
Sudbury-
Manitoulin
Response
Percent
Response
Count
0 0 3 3 23.1% 6
0 1 0 3 15.4% 4
0 1 0 0 3.8% 1
1 5 3 4 42.3% 11
2 0 2 0 15.4% 4
26
0
Algoma Timmins Nipissing-
Temiskaming
Sudbury-
Manitoulin
Response
Percent
Response
Count
2 3 3 3 34.6% 9
1 2 2 2 26.9% 7
0 2 2 3 26.9% 7
0 0 1 2 11.5% 3
0 0 0 0 0.0% 0
26
0
answered question
skipped question
Please estimate the average percentage of your caseload that patients with stroke represent:
Please select the geographical district(s) you practice in:
answered question
skipped question
Answer Options
0-10
11-25
26-50
51-75
76-100
20+
answered question
skipped question
Please indicate your total number of years of clinical experience working with people who have had a stroke:
Please select the geographical district(s) you practice in:
Answer Options
0-1
2-5
6-10
11-19
20+
answered question
skipped question
Please indicate your total number of years of clinical experience (not stroke specific):
Please select the geographical district(s) you practice in:
Answer Options
0-1
2-5
6-10
11-19
Other (please specify)
Answer Options
Acute Care
In-patient Rehabilitation
Complex Continuing Care
answered question
Rural (population < 40 000)
Both Urban and Rural
What size of setting do you practice in?
Please select the geographical district(s) you practice in:
Out-patient Rehabilitation
Hospital-based Day Program
Home Care/CCAC
skipped question
Please indicate the setting(s) that you work in. If more than one, select all that apply.
Please select the geographical district(s) you practice in:
Urban (population ≥ 40 000)
Algoma
Sudbury-Manitoulin
answered question
Answer Options
Nipissing-Temiskaming
Timmins
Answer Options
Stroke Assessment Tools Survey - Demongraphics NE OT
Please select the geographical district(s) you practice in:
25
OCCUPATIONAL THERAPY – REPORTED USE OF OTHER TOOLS
REPORTED BY BOTH NE & NW
Trail Making A and B
Clock Drawing Test
Alpha FIM®
Cognitive Assessment of Minnesota
JAMAR hand and pinch strength assessments.
Canadian Occupational Performance Measure (COPM)
Cognitive Competency Test
Functional Independence Measure (FIM)®
REPORTED BY NE ONLY
Independent Living Scales
Goal Attainment Scale
Test of Everyday Attention
Rivermead Behavioural Memory Test
Protocole d'Examen Cognitif de la Personne Agee (PECPA)
Cognitive Assessment Scale for the Elderly (CASE)
"perceptual screen" - includes letter cancellation, read & write sentence, draw front view of house, person
Brain Injury Visual Assessment Battery for Adults (BIVABA)
Sunnybrook Neglect Assessment Protocol (SNAP)
Manual Muscle Testing
Behavioural Assessment of the Dysexecutive Syndrome (BADS) REPORTED BY NW ONLY
National Institutes of Health Stroke Scale
Functional assessment: e.g. observe transfers from tub, chair, bed, toilet, focus on practical activities Home safety assessment: e.g. measure doorways, recommend ramps
Reviewing goals such as cooking, bathing, mobility
Gardner Test of Visual Perceptual Skills (non-motor)
OT OTHER COMMENTS NW
There are a few standardized assessment tools that are new to me and I do hope that there will be some training provided so all clinicians dealing with stroke clients will have more awareness of the tools that are out there.
Active rehabilitation is not taking place in the community specifically the client's home. Implementing standardized tools is simply not effective use of time when the client is discharged from home care after 2-4 visits.
Primary focus seems to been ensuring home safety and accessibility versus improving overall function. Clients who have participated in an in-pt rehab program often return as an out-pt which limits the role of active home care therapy. I do feel that a more significant role can be played by home care OT, Pt, etc.
Therapy in the client's residence can be very effective for some clients at assisting them in re-engaging in their routine activities.
NE
Some outcome measures, I feel are inappropriate to use, because you are penalized if you've had your stroke a while back whether it be 3, 6 12 months or more.
I feel these outcome are biased and these scores are looked at by other health care professionals and decisions are made based on these scores. Even though a client may have a low score, maybe they just need the right therapy to improve and often these scores mask their potential.
When working in augmentative communication, I'm not sure if I would be missing an assessment tool that I could be using. At this time, I don't use any.
26
Appendix 4: Speech Language Pathology Demographics and Discipline Specific Information
57.1% 4
28.6% 2
28.6% 2
7
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
4 0 1 57.1% 4
1 2 1 42.9% 3
1 0 2 28.6% 2
7
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 1 1 42.9% 3
2 1 1 57.1% 4
0 0 0 0.0% 0
1 0 0 14.3% 1
0 0 0 0.0% 0
1 2 2 57.1% 4
1 0 1 14.3% 1
7
0
private practice
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 1 0 14.3% 1
2 0 1 28.6% 2
0 0 0 0.0% 0
2 0 1 42.9% 3
0 1 0 14.3% 1
7
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 1 0 14.3% 1
2 1 1 42.9% 3
0 0 0 0.0% 0
2 0 1 42.9% 3
0 0 0 0.0% 0
7
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 1 14.3% 1
0 1 0 14.3% 1
3 0 1 42.9% 3
1 1 0 28.6% 2
0 0 0 0.0% 0
7
0
East of Thunder Bay
West of Thunder Bay
Population < 5000
Thunder Bay
Stroke Assessment Tools Survey - Demographics NW Speech Language Pathology
W ha t s ize o f se tting (s) d o yo u p ra ctice in? Ple a se che ck a ll tha t a p p ly .
Answe r Op tio ns
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
sk ip p e d q ue stio n
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns Re sp o nse Pe rce nt & Co unt
Population ≥ 40 000
Population 5000 - 39 999
a nswe re d q ue stio n
0-1
Home Care/CCAC
Other (please specify)
a nswe re d q ue stio n
Acute Care
In-patient Rehabilitation
6-10
20+
Answe r Op tio ns
0-1
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
Answe r Op tio ns
2-5
Out-patient Rehabilitation
11-19
76-100
a nswe re d q ue stio n
sk ip p e d q ue stio n
Answe r Op tio ns
0-10
11-25
26-50
51-75
Answe re d Que stio n
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a
s tro ke :
2-5
6-10
11-19
20+
a nswe re d q ue stio n
a nswe re d q ue stio n
Answe r Op tio ns
Hospital-based Day Program
Complex Continuing Care
sk ip p e d q ue stio n
27
Re sp o nse
Pe rce nt
Re sp o nse Co unt
23.1% 3
0.0% 0
46.2% 6
30.8% 4
13
Alg o ma T imminsNip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
2 0 3 4 69.2% 9
0 0 2 0 15.4% 2
1 0 1 0 15.4% 2
13
Alg o ma T imminsNip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
2 0 4 1 53.8% 7
2 0 4 3 69.2% 9
2 0 4 0 46.2% 6
2 0 4 1 53.8% 7
0 0 0 0 0.0% 0
1 0 3 0 30.8% 4
1 0 0 0 7.7% 1
13
private practice
Alg o ma T imminsNip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 1 7.7% 1
1 0 3 1 38.5% 5
0 0 0 2 15.4% 2
2 0 2 0 30.8% 4
0 0 1 0 7.7% 1
13
Alg o ma T imminsNip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 1 7.7% 1
1 0 3 1 38.5% 5
1 0 0 2 23.1% 3
1 0 3 0 30.8% 4
0 0 0 0 0.0% 0
13
Alg o ma T imminsNip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 0 1 1 23.1% 3
0 0 2 0 15.4% 2
1 0 0 1 15.4% 2
1 0 2 0 23.1% 3
0 0 1 2 23.1% 3
13a nswe re d q ue stio n
0-10
11-25
26-50
51-75
6-10
20+
a nswe re d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a s tro ke :
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
2-5
Answe r Op tio ns
0-1
Answe r Op tio ns
11-19
20+
a nswe re d q ue stio n
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
76-100
0-1
2-5
6-10
11-19
Answe r Op tio ns
a nswe re d q ue stio n
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
Hospital-based Day Program
Home Care/CCAC
Other (please specify)
Answe r Op tio ns
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Rural (population < 40 000)
Both Urban and Rural
a nswe re d q ue stio n
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
Answe r Op tio ns
Urban (population ≥ 40 000)
Timmins
Nipissing-Temiskaming
Out-patient Rehabilitation
Answe r Op tio ns
Algoma
Sudbury-Manitoulin
a nswe re d q ue stio n
Wha t s ize o f se tting d o yo u p ra ctice in?
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Stroke Assessment Tools Survey - Demographics NE Speech Language Pathology
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
28
SPEECH LANGUAGE PATHOLOGY – REPORTED USE OF OTHER TOOLS
REPORTED BY BOTH NE & NW
Reading Comprehension Battery for Aphasia (RCBA) Boston Naming Test Frenchay Dysarthria Assessment Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) Assessment of Intelligiblity of Dysarthric Speech
REPORTED BY NE ONLY Burns Left and Right Hemisphere Inventory Woodcock Johnson - passage comprehension subtest Discourse Comprehension Test Swallowing Screening for TIA/CVA - developed at facility Cognitive-Linguistic Quicktest Western Aphasia Battery – Revised (bedside) (WAB-R) Butt Non-Verbal Reasoning Test Test of Adolescent/Adult Word Finding Reading Comprehension Battery for Adults with Aphasia Apraxia Battery for Adults (ABA-2) Communication Activities of Daily Living (CADL-2) Examining for Aphasia - 4 (EFA-4) Test for Adolescent and Adult Word-Finding Cognitive-Linguistic Quick Test Ross Information Processing Assessment (RIPA) REPORTED BY NW ONLY Sentence/Discourse Comprehension Test Adapted version of the Morton Plant Mease Health Care Screening tool for Stroke-Dysphagia Screen
SLP OTHER COMMENTS NW It is so great that you are doing this survey! I am very interested in improving my knowledge and skills in this area! NE Would be very interested in training related to the TOR-BSST
29
Appendix 5: Social Work Demographics and Discipline Specific Information
75.0% 3
25.0% 1
0.0% 0
4
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r
Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
2 0 0 50.0% 2
0 0 0 0.0% 0
1 1 0 50.0% 2
4
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r
Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 1 0 25.0% 1
1 0 0 25.0% 1
1 0 0 25.0% 1
1 0 0 25.0% 1
0 0 0 0.0% 0
0 0 0 0.0% 0
1 0 0 25.0% 1
4
0
hospital palliative
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r
Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 0.0% 0
0 0 0 0.0% 0
1 0 0 25.0% 1
1 1 0 50.0% 2
1 0 0 25.0% 1
4
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r
Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 0.0% 0
1 1 0 50.0% 2
1 0 0 25.0% 1
1 0 0 25.0% 1
0 0 0 0.0% 0
4
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r
Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
2 1 0 75.0% 3
0 0 0 0.0% 0
1 0 0 25.0% 1
0 0 0 0.0% 0
0 0 0 0.0% 0
4
0
Answe re d Que stio n
W ha t s ize o f se tting (s) d o yo u p ra ctice in? Ple a se che ck a ll tha t a p p ly .
Answe r Op tio ns
Population ≥ 40 000
Population 5000 - 39 999
Population < 5000
a nswe re d q ue stio n
sk ip p e d q ue stio n
Stroke Assessment Tools Survey - Demographics NW Social Work
Thunder Bay
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns
East of Thunder Bay
West of Thunder Bay
Re sp o nse Pe rce nt & Co unt
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
Answe r Op tio ns
Home Care/CCAC
Hospital-based Day Program
Acute Care
In-patient Rehabilitation
a nswe re d q ue stio n
Complex Continuing Care
Answe r Op tio ns
2-5
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
Other (please specify)
0-1
2-5
6-10
11-19
20+
a nswe re d q ue stio n
Out-patient Rehabilitation
a nswe re d q ue stio n
11-19
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve
ha d a s tro ke :
20+
sk ip p e d q ue stio n
6-10
Answe r Op tio ns
0-1
76-100
a nswe re d q ue stio n
sk ip p e d q ue stio n
Answe r Op tio ns
0-10
11-25
26-50
51-75
30
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
5 0 0 0 31.3% 5
0 2 0 0 12.5% 2
0 0 5 0 31.3% 5
0 0 0 4 25.0% 4
16
0
2 1 2 3 50.0% 8
0 0 2 0 12.5% 2
3 1 1 1 37.5% 6
16
4 1 1 2 50.0% 8
1 1 1 1 25.0% 4
1 1 1 0 18.8% 3
0 0 0 0 0.0% 0
0 0 0 0 0.0% 0
1 1 1 0 18.8% 3
0 0 1 1 12.5% 2
16
Discharge planning, seniors mental health
0 0 1 0 6.3% 1
0 1 1 0 12.5% 2
2 0 0 0 12.5% 2
3 1 2 0 37.5% 6
0 0 1 4 31.3% 5
16
1 1 1 0 18.8% 3
1 0 3 1 31.3% 5
3 0 0 1 25.0% 4
0 1 0 2 18.8% 3
0 0 1 0 6.3% 1
16
0
1 1 2 2 37.5% 6
3 1 2 1 43.8% 7
1 0 1 1 18.8% 3
0 0 0 0 0.0% 0
0 0 0 0 0.0% 0
16
0
Stroke Assessment Tools Survey - Demographics NE Social Work
0-10
a nswe re d q ue stio n
sk ip p e d q ue stio n
11-25
26-50
51-75
76-100
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
a nswe re d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
0-1
sk ip p e d q ue stio n
6-10
11-19
20+
a nswe re d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a
s tro ke :
0-1
2-5
6-10
11-19
20+
a nswe re d q ue stio n
2-5
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Out-patient Rehabilitation
Hospital-based Day Program
Home Care/CCAC
Other (please specify)
Urban (population ≥ 40 000)
Rural (population < 40 000)
a nswe re d q ue stio n
sk ip p e d q ue stio n
W ha t s ize o f se tting d o yo u p ra ctice in?
Both Urban and Rural
Timmins
Nipissing-Temiskaming
a nswe re d q ue stio n
Sudbury-Manitoulin
Algoma
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns
31
SOCIAL WORK –REPORTED USE OF OTHER TOOLS REPORTED BY BOTH NE & NW
none REPORTED BY NE ONLY
Developing a self medication administration tool in relation to discharge planning for all patients in rehab including stroke
Cognitive Assessment Scale for the Elderly (CASE)
Psycho-social Assessments REPORTED BY NW ONLY
none
SW OTHER COMMENTS NW
My role is very much as a discharge planner and not assessment. NE
It would be highly beneficial to have training geared to this topic. Often I have questions from my clients and I am searching for their answers however it would great to have an overall training to discuss the various elements that clients and workers face when assisting these clients. In this training I would include (funding options, resources for client and worker in Northern Ontario, overall understanding of the impact it has on the client and recovery, various tools as indicated in this questionnaire, etc).
I spend more time doing discharge planning than providing the social/emotional support re: stroke although do provide some on individual basis though not via formal assessment tool. Also wonder about the aphasia depression tool and is there also a depression tool for stroke patients in particular.
On an acute care floor the primary role of SW is to provide education and support. Formal testing often occurs during the Rehabilitation phase of their treatment.
32
Appendix 6: Recreation Demographics and Discipline Specific Information
87.5% 7
0.0% 0
12.5% 1
8
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
4 0 1 62.5% 5
2 0 0 25.0% 2
1 0 0 12.5% 1
8
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 0 0.0% 0
1 0 0 12.5% 1
0 0 1 12.5% 1
2 0 0 25.0% 2
2 0 0 25.0% 2
0 0 0 0.0% 0
4 0 0 50.0% 4
8
0
OTHER: vascular dementia, LTC x3
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 0 0 12.5% 1
0 0 0 0.0% 0
1 0 0 12.5% 1
3 0 1 50.0% 4
2 0 0 25.0% 2
8
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 0 0 12.5% 1
1 0 0 12.5% 1
1 0 0 12.5% 1
2 0 1 37.5% 3
2 0 0 25.0% 2
8
0
T hund e r Ba yW e st o f T hund e r
Ba y
Ea st o f
T hund e r Ba y
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 0 0 12.5% 1
3 0 1 50.0% 4
1 0 0 12.5% 1
2 0 0 25.0% 2
0 0 0 0.0% 0
8
0
Answe re d Que stio n
Population 5000 - 39 999
Thunder Bay
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns Re sp o nse Pe rce nt & Co unt
Stroke Assessment Tools Survey - Demographics NW Recreat ion
East of Thunder Bay
West of Thunder Bay
Population < 5000
W ha t s ize o f se tting (s) d o yo u p ra ctice in? Ple a se che ck a ll tha t a p p ly .
Answe r Op tio ns
Population ≥ 40 000
a nswe re d q ue stio n
sk ip p e d q ue stio n
Home Care/CCAC
Other (please specify)
Out-patient Rehabilitation
Hospital-based Day Program
Answe r Op tio ns
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u
p ra ctice in:
11-19
20+
2-5
6-10
11-19
20+
a nswe re d q ue stio n
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u
p ra ctice in:Answe r Op tio ns
0-1
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u
p ra ctice in:
a nswe re d q ue stio n
sk ip p e d q ue stio n
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a
s tro ke :
2-5
6-10
Answe r Op tio ns
0-1
sk ip p e d q ue stio n
Answe r Op tio ns
0-10
11-25
26-50
51-75
76-100
a nswe re d q ue stio n
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u
p ra ctice in:
a nswe re d q ue stio n
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
sk ip p e d q ue stio n
33
Re sp o nse Pe rce nt Re sp o nse Co unt
25.0% 2
0.0% 0
50.0% 4
25.0% 2
8
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
1 0 4 2 87.5% 7
0 0 0 0 0.0% 0
1 0 0 0 12.5% 1
8
0
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
2 0 1 0 37.5% 3
0 0 2 1 37.5% 3
1 0 3 0 50.0% 4
0 0 0 1 12.5% 1
0 0 0 0 0.0% 0
0 0 0 0 0.0% 0
1 0 0 0 12.5% 1
8
0
Other: Assess and Restore unit
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 1 0 12.5% 1
1 0 1 0 25.0% 2
0 0 0 0 0.0% 0
0 0 2 2 50.0% 4
1 0 0 0 12.5% 1
8
0
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 2 0 25.0% 2
1 0 0 0 12.5% 1
0 0 1 0 12.5% 1
0 0 1 2 37.5% 3
1 0 0 0 12.5% 1
8
0
Alg o ma T immins N ip iss ing -
T e miska ming
Sud b ury-
Ma nito ulin
Re sp o nse
Pe rce nt
Re sp o nse
Co unt
0 0 1 0 12.5% 1
0 0 1 0 12.5% 1
2 0 2 2 75.0% 6
0 0 0 0 0.0% 0
0 0 0 0 0.0% 0
8
0
Stroke Assessment Tools Survey - Demographics NE Recreat ion
76-100
sk ip p e d q ue stio n
2-5
6-10
sk ip p e d q ue stio n
Answe r Op tio ns
0-10
11-25
26-50
51-75
a nswe re d q ue stio n
11-19
20+
a nswe re d q ue stio n
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Ple a se e stima te the a ve ra g e p e rce nta g e o f yo ur ca se lo a d tha t p a tie nts with s tro ke re p re se nt:
a nswe re d q ue stio n
sk ip p e d q ue stio n
Answe r Op tio ns
0-1
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce wo rk ing with p e o p le who ha ve ha d a s tro ke :
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Out-patient Rehabilitation
Answe r Op tio ns
0-1
Ple a se ind ica te yo ur to ta l numb e r o f ye a rs o f c linica l e xp e rie nce (no t s tro ke sp e c ific ):
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Hospital-based Day Program
Home Care/CCAC
Other (please specify)
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns
Urban (population ≥ 40 000)
Rural (population < 40 000)
Both Urban and Rural
a nswe re d q ue stio n
sk ip p e d q ue stio n
Ple a se ind ica te the se tting (s) tha t yo u wo rk in. If mo re tha n o ne , se le c t a ll tha t a p p ly .
Algoma
Timmins
Nipissing-Temiskaming
Wha t s ize o f se tting d o yo u p ra ctice in?
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Answe r Op tio ns
Ple a se se le c t the g e o g ra p hica l d is tric t(s ) yo u p ra ctice in:
Sudbury-Manitoulin
a nswe re d q ue stio n
2-5
sk ip p e d q ue stio n
6-10
11-19
20+
a nswe re d q ue stio n
34
RECREATION – REPORTED USE OF OTHER TOOLS REPORTED BY BOTH NE & NW
none REPORTED BY NE ONLY
Leisure Motivational Scale (LMS)
Leisure Competence Measure (LCM)
Leisure Satisfaction Scale (LSS)
State Technical Institute's Leisure Assessment Process (STILAP)
Ohio Functional Assessment Battery
Laurentian Outing Functional Assessment Measure (LOFAM)
Leisurescope
Tinkertoy
Leisure Interest Measure (LIM)
Free Time Boredom Measurement
Leisure Satisfaction Measure (LSM)
Leisure Attitude Measurement (LAM)
Social Empowerment and Trust REPORTED BY NW ONLY
Leisure Barriers Assessment
REC OTHER COMMENTS NW
Please help educate us on these tools you have listed in the survey. I would like to implement.
Would love more workshops and training. NE
The OT’S do more of these tests. Outcomes are then put on chart for the rest of the team to read.
Many of the scales you asked about would be used by our social worker (all the depression ones). The leisure ones are more for people living in the community which is not my area of practice.
Recreation therapists do not do any of these tools/assessments....we get feedback from the OT/PT.
35
Appendix 7: Psychology Demographics and Discipline Specific Information
100.0% 3
0.0% 0
0.0% 0
3
Thunder BayWest of Thunder
Bay
East of
Thunder
Bay
Response
Percent
Response
Count
3 0 0 100.0% 3
0 0 0 0.0% 0
0 0 0 0.0% 0
3
0
Thunder BayWest of Thunder
Bay
East of
Thunder
Bay
Response
Percent
Response
Count
0 0 0 0.0% 0
1 0 0 33.3% 1
0 0 0 0.0% 0
1 0 0 33.3% 1
0 0 0 0.0% 0
0 0 0 0.0% 0
1 0 0 33.3% 1
3
0
Other: out patient neurology
Thunder BayWest of Thunder
Bay
East of
Thunder
Bay
Response
Percent
Response
Count
0 0 0 0.0% 0
0 0 0 0.0% 0
0 0 0 0.0% 0
3 0 0 100.0% 3
0 0 0 0.0% 0
3
0
Thunder BayWest of Thunder
Bay
East of
Thunder
Bay
Response
Percent
Response
Count
0 0 0 0.0% 0
0 0 0 0.0% 0
0 0 0 0.0% 0
3 0 0 100.0% 3
0 0 0 0.0% 0
3
0
Thunder BayWest of Thunder
Bay
East of
Thunder
Bay
Response
Percent
Response
Count
0 0 0 0.0% 0
1 0 0 33.3% 1
1 0 0 33.3% 1
1 0 0 33.3% 1
0 0 0 0.0% 0
3
0
Answered question
76-100
answered question
answered question
Answer Options
0-1
2-5
Please estimate the average percentage of your caseload that patients with stroke represent:
11-19
skipped question
Please indicate your total number of years of clinical experience working with people who have had a
stroke:
6-10
20+
skipped question
Answer Options
0-10
11-25
26-50
51-75
answered question
skipped question
In-patient Rehabilitation
Out-patient Rehabilitation
Answer Options
0-1
Home Care/CCAC
Other (please specify)
answered question
skipped question
2-5
6-10
11-19
20+
Please indicate the setting(s) that you work in. If more than one, select all that apply.
Population ≥ 40 000
Population 5000 - 39 999
Please indicate your total number of years of clinical experience (not stroke specific):
Hospital-based Day Program
Population < 5000
answered question
skipped question
Acute Care
Complex Continuing Care
Answer Options
Stroke Assessment Tools Survey - Demographics NW Psychology
East of Thunder Bay
West of Thunder Bay
Thunder Bay
What size of setting(s) do you practice in? Please check all that apply.
Answer Options
Please select the geographical district(s) you practice in:
Answer Options Response Percent & Count
36
Response
Percent
Response
Count
0.0% 0
0.0% 0
0.0% 0
100.0% 1
1
0
Response
Percent
Response
Count
0.0% 0
0.0% 0
100.0% 1
1
0
Response
Percent
Response
Count
0.0% 0
0.0% 0
0.0% 0
100.0% 1
0.0% 0
0.0% 0
0.0% 0
1
0
Response
Percent
Response
Count
0.0% 0
0.0% 0
0.0% 0
100.0% 1
0.0% 0
1
0
Response
Percent
Response
Count
0.0% 0
100.0% 1
0.0% 0
0.0% 0
0.0% 0
1
0
Response
Percent
Response
Count
0.0% 0
100.0% 1
0.0% 0
0.0% 0
0.0% 0
1
0
Stroke Assessment Tools Survey - Demographics NE Psychology
20+
answered question
skipped question
Answer Options
0-1
2-5
6-10
skipped question
26-50
51-75
76-100
answered question
Please estimate the average percentage of your caseload
that patients with stroke represent:
Answer Options
0-10
11-25
20+
answered question
skipped question
Please indicate your total number of years of clinical
experience working with people who have had a stroke:
0-1
2-5
6-10
11-19
11-19
skipped question
Please indicate the setting(s) that you work in. If more than
one, select all that apply.
answered question
skipped question
Please indicate your total number of years of clinical
experience (not stroke specific):
Answer Options
Out-patient Rehabilitation
Hospital-based Day Program
Home Care/CCAC
Other (please specify)
Please select the geographical district(s) you practice in:
Answer Options
Algoma
Timmins
What size of setting do you practice in?
Answer Options
Urban (population ≥ 40 000)
Rural (population < 40 000)
Nipissing-Temiskaming
Sudbury-Manitoulin
answered question
skipped question
Answer Options
Acute Care
In-patient Rehabilitation
Complex Continuing Care
Both Urban and Rural
answered question
37
PSYCHOLOGY – REPORTED USE OF OTHER TOOLS
REPORTED BY BOTH NE & NW
Wisconsin Card Sorting Test (WCST)
Behavior Rating Inventory of Executive Functioning – Adult Version (BRIEF-A). REPORTED BY NE ONLY
Ruff Neurobehavioral Inventory
Hamilton Depression Scale
Coping Response Inventory
Personality Assessment Inventory (PAI)
Beck Anxiety Inventory (BAI)
C omprehensive Test of Nonverbal Intelligence (CTONI)
Paced Auditory Serial Addition Test (PASAT)
REPORTED BY NW ONLY
Wechsler Adult Intelligence Scale-IV (WAIS IV)
Test of Premorbid Functioning (TOPF)
Wechsler Memory Scale IV - (WMS-IV)
Delis-Kaplan Executive Function System (D-KFES, Word Fluency)
Trailmaking Test
Depression Anxiety Stress Scale (DASS)
Patient Competency Rating Scale
PSYCHOLOGY OTHER COMMENTS NW
I have looked at the Best Practice Recommendations for Stroke, 2010 and really, there is very little for the work that I do... most of the recommendations tend to refer to physical/cognitive well being... and even mention family members, but very little on the emotional recovery while in an outpatient rehab. setting. I am very aware that depression/anxiety are common with folks who have had strokes.. and we see them on a Follow-up basis even after they are discharged, so I am meeting with clients years following CVA, on an as needed basis. The Best Practices guidelines seem to be most intense/stringent immediately following a stroke (which makes sense), but once past a certain window (let's say 9-12 months and beyond), recommendations seem to fade to nothing... sadly, stroke effects are life long, and depression can hit and recur throughout their lifetime. Once there is one depression, there is a greater likelihood of another and another... I think it would be good if the Best Practices Guidelines could look beyond the first year or so, to think about a lifetime of living with a stroke.
How are you defining Outcomes? Outcome measurement implies pre and post treatment testing, and it seemed to me that you are actually asking about clinically useful measures. Measures used clinically are not necessarily useful for looking at "outcomes"", as I have defined it above.
NE
none