Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke : an explorative observational study

BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08). CONCLUSIONS: Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.

Theoretical and experimental optical holography

The intent of this paper is to present an analysis of optical holography. Both the physical theory behind holography and the experimental techniques used in making holograms will be presented. To accomplish this goal, the paper is divided into two independent sections: the theoretical section followed by the experimental section. Each section is intended to be a complete unit. The Theoretical Section is an exposure to the theory behind holography. This consists of a review of the concepts of interference and diffraction. followed by a brief review of partial coherence. The remaining part of the Theoretical Section is devoted to the mathematical analysis of optical holography. The Experimental Section begins with an introduction to the equipment and facilities currently available for optical holography at Colby College. Holographic procedures is dominated by the description of transmission holography (v.s. reflection. or white-light. holography). After these general holographic procedures a few variations on the basic transmission hologram are presented. The experimental section will end with an introduction to holographic interferometry, a major application of holographic techniques.