What I Liked and Disliked about my Rehabilitation: Perceptions about the Quality of Services for Persons with a Head Injury
Objective: Our main objective was to examine preliminary descriptive data collected as part of a validation study of a questionnaire (PQRS-Montreal, Perception of Quality of Rehabilitation Services) to assess clients' perceptions of the delivery of head injury (HI) rehabilitation services. The questionnaire contains 61 items (5-point scale of agreement) relating to processes of care covering 5 dimensions (ecological approach, client-centered approach, accessibility, team approach, and continuity). Two open-ended questions about what clients appreciated and did not appreciate about their rehabilitation complete the questionnaire. We also sought to determine whether the responses to these questions identified any issues not included in the PQRS-Montreal.
Method: Data were collected at a facility (71%) or the client's home (29%). Respondents were 115 persons with HI (87 men and 28 women; mean age = 39.6 +16.5; GCS scores 3 to 15), who had received rehabilitation services in Québec in 2003-2004.
Results: Client perceptions, as measured with the PQRS-Montreal, varied. Mean item scores ranged from 2.0 to 4.7 and 62% had mean scores exceeding 4.0. Those with the lowest ratings concerned specific aspects of care (e.g. 'assessed impact of HI on your sexuality'), while those with the highest related mainly to the quality of the service providers (e.g. 'given warm welcome from team', team was competent'). Respondents to the open-ended questions also reported having appreciated the compassion/sensitivity of service providers and their competency. They did not appreciate aspects of care relating to decisional power about own rehab goals and to the provision of information. Issues about schedule changes, physical environment and length of time spent doing nothing were uncovered in these questions and were not addressed in the questionnaire.
Conclusion: Valid responses regarding the perceptions of the quality of services for persons with a HI can be obtained using the PQRS-Montreal and respondents generally rate service delivery quality as high. The open-ended questions provide another opportunity for clients to express themselves on other topics not directly addressed in the questionnaire.