Spatial neglect in stroke patients after discharge from rehabilitation to own home: a mixed method study
ABSTRACT Purpose To explore the usefulness of conventional tests for assessing spatial neglect and contrast these tests with daily challenges encountered by patients after discharge from rehabilitation to home. Methods A mixed method prospective study of 15 patients with neglect after a righthemisphere stroke,51 month after discharge to home. Data were obtained from: (1) Catherine Bergego Scale (CBS), (2) star cancellation and figure copying and (3) observations and interviews. Qualitative data were analysed with content analysis and quantitative data with non-parametric statistics. The data were presented in a ‘mixing matrix’ and integrated by ‘following threads’. Finally, a synthesis was written into a vignette. Results The CBS significantly underestimated fluctuations and did not capture important items of neglect. The star cancellation and figure copying did not identify neglect in mildly affected participants. Left starting point in the star cancellation and a characteristic process of drawing in figure copying were observed in all participants. Conclusion Traditional numerical interpretations of paper-pencil tests inadequately confirmed mild neglect. Starting points of the star cancellation and observation of drawing should be incorporated into screening procedures. Assessment strategies need improvement to identify patients with subtle forms of neglect.
|Published in||Disability and Rehabilitation|