An injury to the spinal cord causes immediate changes and can be overwhelming to the patient and their family. During inpatient rehabilitation, it has been observed that there is a significant difference between the expectations of the patient and the rehabilitation team member. 7, 9
Studies have focused on patient goal setting and how this impacts patient participation, discharge planning, and alignment of patient and therapist goals. Studies have shown that expectations of patient’s are never examined. These support the current study by explaining how important it is for the rehabilitation professional to understand factors that impact patient participation and how goals play a big part in discharge planning. 9, 12 The purpose of the study is for occupational therapists to learn about patients with spinal cord injuries, patient identified meaningful activities, therapist’s goal setting skills, and how the content of goals changes during inpatient rehabilitation. A pre-test/post-test pre-experimental design was used to test the research hypotheses. Eligibility was established by the researcher as the patient was admitted to The Ohio State University Medical Center, Dodd Rehabilitation Hospital. The sample was based on patient admissions from April 2009 through July 2009. The sample consisted of eight individuals who have a spinal cord injury as a result of a traumatic or non-traumatic event. The Flinn Performance Screening Tool (FPST) was used to identify the disability issues of patients with a spinal cord injury. Patient admission and discharge FPST scores were gathered plus the FPST scores of the occupational therapists on admission and discharge. Other information collected included; patient attendance to occupational therapy treatment, patient demographics, and discharge needs. Key personnel were used to administer the FPST and with the patient, were blinded to the anticipated results of the study. The occupational therapist completed the FPST on each patient at admission and at discharge. These scores were blinded to the patient and were entered into a database by the key personnel so that the occupational therapist was blinded to the results.
The data analysis included a frequency distribution to identify the commonly reported FPST items. A hit ratio was used to compare the FPST responses between the patient’s and the occupational therapist and between the FPST responses from the patient’s at admission and at discharge. The classification accuracy was established at .375 due to limited preliminary data to compare, the large number of FPST items, and the low risk to the patients involved in the study.
The top four categories reported by the patient’s were care for others, bathing/showering and financial management followed by community mobility. The top three categories from the OT’s perspective were bathing, feeding, and meal preparation. The categories with the highest hit ratios were personal devices and feeding. Seventy-two percent of the patient admission FPST scores were in agreement with the occupational therapists admission FPST scores. The categories with the highest hit ratios were personal devices and care for others. Seventy-six percent of the patient admission FPST scores were in agreement with the discharge FPST scores.