Article

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 right hemisphere stroke, <1 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. Implications for Rehabilitation Findings
demonstrate that identification of spatial neglect and the way symptoms of
neglect impact on daily life functioning of stroke patients must be carefully
pursued by health-care professionals working in stroke rehabilitation. Areas that
should receive professional attention in the rehabilitation process include:
preparing patients and their family for fluctuations related to neglect in the
patient's own home, locating issues that might impact safety, and identifying
unique factors that either enhance or diminish neglect within each patient's
daily life context. The results of this study could be used to develop more
wide-ranging assessment strategies to assist health-care professionals in
identifying neglect after hospital discharge, for instance by expanding existing
ecological assessment tools and including qualitative evaluation of test performance in paper-pencil tests, such as the star cancellation and figure copying.

Langue : ANGLAIS