Article

Spatial neglect commonly occurs after stroke and predicts poor
rehabilitation outcomes. However, this disorder is under-recognized in clinical
practices, which may result from the failure to document its presence. This study
aimed to identify the predictors for documentation of spatial neglect in
inpatient rehabilitation facilities. METHOD: We performed a comprehensive chart
review to investigate whether the presence of spatial neglect was documented in
74 neglect patients' clinical notes recorded by physicians, nurses, or
occupational therapists (OTs), or in team conference notes. Independent variables
included neglect severity, length of stay, Functional Independence Measure at
admission and discharge. RESULTS: Of the 74 neglect patients, 75.7% were
documented by OTs, 63.5% by physicians, and 17.6% by nurses. Although 93.2% of
neglect patients were recognized by at least one clinician group, only 31.1% were
discussed in multidisciplinary team conferences. Neglect patients who were
documented by physicians were more likely to be documented in team conferences.
While no factors predicted whether a neglect patient would be documented by
nurses or OTs, we found significant predictors for neglect documentation in
physician and team conference notes. The odds of being documented by physicians
were increasingly greater with poorer efficiency of cognitive rehabilitation
(odds ratio = 0.70). The odds of being discussed in team conferences were
increasingly greater with more severe neglect (odds ratio = 0.98), and with
longer stay in hospitalization (odds ratio = 1.06). CONCLUSIONS:
Multidisciplinary care may not involve as much interdisciplinary communication as
needed to document important disease states. Stroke rehabilitation professionals
should be able to recognize spatial neglect independently and document it
consistently.

Langue : ANGLAIS