Significant differences in evaluation of disability and health (ICF) core sets between stroke rehabilitants and rehabilitation team during the first year.

Abstract

Assessing functional abilities in stroke rehabilitation is essential, combining subjective self-reports with objective clinical evaluations. This study aimed to compare self-reported impairments from stroke patients with rehabilitation team evaluations using the ICF stroke core set at 3 time points: 1 month post-discharge, after 6 months, and 12 months post-diagnosis. Additionally, the study sought to identify ICF subdomains most impacting health-related quality of life (HRQOL) as measured by EQ-5D. This longitudinal, retrospective observational study included consecutive 118 stroke patients at the Satahospital Rehabilitation Unit (2021-2022). Results showed that, 1 month after discharge, patients rated their functioning higher than team assessments, particularly in cognitive domains. By 12 months, patients' self-reports indicated lower functioning than team evaluations, with discrepancies diminishing over time. Objective assessments revealed significant improvements in mobility, self-care, and cognitive functions, while patients reported progress in life activities and social interactions but little change in physical or cognitive domains. Depression levels and self-care ability (washing) were the strongest predictors of improved HRQOL. These findings reveal that patients initially overestimate their abilities, influenced by a lack of awareness and emotional factors, while rehabilitation teams provide more objective evaluations and individualized rehabilitation. Integrated assessment frameworks combining subjective and objective perspectives are crucial to optimizing rehabilitation outcomes.