Important-performance analysis to conceptualize goal priorities in community dwelling stroke survivors

Abstract

ABSTRACT Background It is important for clinicians to have a better understanding of stroke survivor’s goals. Important performance analysis (IPA) is a tool that could be utilized to identify goal priorities in rehabilitation. Objectives To examine the utility of the IPA method to identify goal priorities in a diverse group of community dwelling stroke survivors. Methods Thirty-eight stroke survivors completed private structured interviews and were asked to rate their perceived importance and performance of 37 goal areas. Important-performance analysis (IPA) was utilized to determine goal priorities for the overall sample. Different IPA methods used to identify goal priorities were compared. Goal priorities were also compared by age (dichotomized as <65 and ≥65 years) and sex (male or female). Results The IPA method effectively separated the goals into the four quadrants, and distinguished which goals were a priority for the sample of stroke survivors. The five goals that were consistently identified as a focus area were: hand function, driving, balance, memory, and arm strength. Men rated mood control as more important than women (p = .046). The two goals rated as being more important for those older than 65 were home accessibility (p = .008) and skin health (p < .001). Conclusions Stroke survivors continue to have goals related to their stroke recovery in the years after their stroke. Both current performance as well as perceived importance should be considered during goal discussions with stroke survivors. IPA can help identify goal priorities in this population.