Changes in the ability to participate in and satisfaction with social roles and activities in patients in outpatient rehabilitation

Journal of Patient-Reported Outcomes, 2020 · DOI: https://doi.org/10.1186/s41687-020-00236-3 · Published: August 13, 2020

Patient Experience Rehabilitation Public Health

Simple Explanation

This study examines how outpatient rehabilitation affects patients' ability to participate in social activities and their satisfaction with these activities. It uses the PROMIS-APS and PROMIS-SPS questionnaires to measure these aspects at the start and end of rehabilitation. The research compares the scores of patients undergoing rehabilitation to those of the general Dutch population. It also assesses whether there are improvements in participation and satisfaction after the rehabilitation program. The study reveals that patients in outpatient rehabilitation have lower levels of participation and satisfaction compared to the general population. While there are some improvements after rehabilitation, they are relatively small.

Study Duration

April 1st and August 31st 2018

Participants

777 patients at admission, 209 at discharge

Evidence Level

Observational study

Key Findings

1
Patients undergoing outpatient rehabilitation had lower PROMIS-APS and PROMIS-SPS scores than the general Dutch population at both admission and discharge.
2
Small improvements were observed in PROMIS-APS and PROMIS-SPS scores after rehabilitation, with effect sizes of 0.16 and 0.31, respectively.
3
Patients who completed both admission and discharge measurements were significantly older and had a musculoskeletal condition and longer treatment duration.

Research Summary

The study aimed to describe levels and changes in participation, as assessed with the PROMIS-APS and the PROMIS-SPS short forms, of patients in outpatient rehabilitation. Patients undergoing outpatient rehabilitation had considerably lower PROMIS-APS and PROMIS-SPS T-scores short forms than the general Dutch population, and showed small T-score improvements at discharge. The study recommends further research using PROMIS CATs and personalized short forms to measure participation more precisely and to improve the validity of these measures in rehabilitation.

Practical Implications

Targeted Interventions

Rehabilitation programs should address the specific participation restrictions and satisfaction levels of patients to improve outcomes.

Measure Selection

Researchers should consider using PROMIS CATs or personalized short forms for more precise measurement of participation in rehabilitation settings.

Awareness of limitations

Healthcare professionals should be aware that improvements in participation may take more time than the duration of outpatient rehabilitation.

Study Limitations

1
Fewer patients completed the forms at discharge compared to admission, potentially introducing selection bias.
2
The study lacked comparator instruments or an anchor question at follow-up, limiting the ability to determine responsiveness and interpretability.
3
The number of patients at discharge were too low to calculate the effect size for four of the diagnostic categories.

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