Affiliations: [a] University of Surrey, School of Psychology, Guildford, UK | [b] Sussex Partnership NHS Foundation Trust, Worthing, UK | [c] Virgin Care, Department of Psychology, Haslemere, UK | [d] University of Technology Sydney, Discipline of Clinical Psychology, Sydney, Australia | [e] University of Sussex, School of Psychology, Brighton, UK
Correspondence:
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Address for correspondence: Professor Ian Kneebone, University of Technology Sydney, Graduate School of Health, PO Box 123, Broadway, NSW 2007, Australia. Tel.: +61 2 9514 1448; E-mail: [email protected].
Abstract: BACKGROUND:It is important to evaluate change in order to re-assure commissioners, staff and patients of the effectiveness of interventions, but also in order to identify areas for improvement. OBJECTIVE:To consider whether analysis of improvement at the level of the individual, taking into account measurement error, may offer a further valuable way to assess change and inform service development over considering change at the group level in a post-acute neuro-rehabilitation unit. METHOD:Pre and post intervention Scores on the FIM+FAM Full Scale and Cognitive and Motor subscales were considered for eighteen patients aged between 35 and 81 with mixed diagnoses who attended a post-acute inpatient neuro-rehabilitation unit for treatment. RESULTS:Statistically significant improvements were achieved on the FIM+FAM Full Scale and Cognitive and Motor subscales in a whole group analysis. Reliable change analyses for each patient within each subscale however identified only half of the sample achieved reliable improvement within the Motor domain and just one person within the Cognitive domain (5.6%). CONCLUSIONS:Findings are consistent with the emphasis of the rehabilitation unit on physical/motor function, and unsurprising as many of those assessed had multiple sclerosis, an often deteriorative condition. Use of reliable change analysis allowed a more detailed understanding of intervention impact, potentially identifying what services reliably work for whom, thereby informing future planning.
