ArticleJournal of comorbidity2016
What makes stroke rehabilitation patients complex? Clinician perspectives and the role of discharge pressure.
Article in Journal of comorbidity, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of Virtual Reality Therapy on Static Postural Control and Dynamic Balance in Stroke Patients: Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Bridging gaps in the care of people under the age of 60 with complex impairments through cross-indication home-based rehabilitation: a cross-sectional survey with experts in Germany.BMC health services research · 2026Article
- Swallow Strength and Skill Training with biofeedback In acute Post stroke dysphagia (ssSIP): a protocol for a multi-centre feasibility trial.Pilot and feasibility studies · 2026Article
- Advancing Neurological Rehabilitation: The BRAIN Framework for Clinical Reasoning in Neurophysiotherapy.Brain sciences · 2026Article
- Article
- Perspectives and Experiences of Cardiac Rehabilitation after Stroke-A Qualitative Study.Healthcare (Basel, Switzerland) · 2022Article
- Adherence to Post-Stroke Pharmacotherapy: Scale Validation and Correlates among a Sample of Stroke Survivors.Medicina (Kaunas, Lithuania) · 2022Article
- Impact of Cardiovascular Diseases on Ischemic Stroke Outcomes.Journal of integrative neuroscience · 2022Review
- Guideline adherence in speech and language therapy in stroke aftercare. A health insurance claims data analysis.PloS one · 2022Article
- Definition of patient complexity in adults: A narrative review.Journal of multimorbidity and comorbidity · 2022Review
- Article
- Peripherally misfolded proteins exacerbate ischemic stroke-induced neuroinflammation and brain injury.Journal of neuroinflammation · 2021Article
- Article
- Recovery after stroke: not so proportional after all?Brain : a journal of neurology · 2019Article
- Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.Disability and rehabilitation · 2018Article
- An analysis of depressive symptoms in stroke survivors: verification of a moderating effect of demographic characteristics.BMC psychiatry · 2017Article
- Article
- A critical appraisal of professional competency frameworks: What guidance is provided for stroke rehabilitation clinicians managing 'complexity'?Journal of multimorbidity and comorbidityReview
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundApproximately 80% of people who survive a stroke have on average five other conditions and a wide range of psychosocial issues. Attention to biopsychosocial issues has led to the identification of 'complex patients'. No single definition of 'patient complexity' exists; therefore, applied health researchers seek to understand 'patient complexity' as it relates to a specific clinical context.
objectiveTo understand how 'patient complexity' is conceptualized by clinicians, and to position the findings within the existing literature on patient complexity.
methodsA qualitative descriptive approach was utilized. Twenty-three stroke rehabilitation clinicians participated in four focus groups.
resultsFive elements of patient complexity were identified: medical/functional issues, social determinant factors, social/family support, personal characteristics, and health system factors. Using biopsychosocial factors to identify complexity results in all patients being complex; operationalization of the definition led to the identification of systemic elements. A disconnect between acute, inpatient rehabilitation and community services was identified as a trigger for increased complexity.
conclusionsPatient complexity is not a dichotomous state. If applying existing complexity definitions, all patients are complex. This study extends the understanding by suggesting a structural element of complexity from manageable to less manageable complexity based on ability to discharge.
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