Huang M E, Wartella J E, Kreutzer J S
Rehabilitation and Research Center, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Medical College of Virginia Hospitals, Richmond, USA.
Arch Phys Med Rehabil. 2001 Nov;82(11):1540-6. doi: 10.1053/apmr.2001.26613.
To determine the relationship between functional outcome and quality of life (QOL) in patients with brain tumors receiving inpatient rehabilitation, and to assess the sensitivity of 4 assessment tools in measuring changes in that population.
Prospective study using longitudinal data collected from consecutively admitted patients.
Acute inpatient rehabilitation unit.
Ten patients with primary brain tumors admitted to an acute inpatient rehabilitation unit.
Patients participated in an inpatient interdisciplinary rehabilitation program that used the following disciplines: occupational therapy, rehabilitation therapy, recreational therapy, speech therapy, physical therapy, rehabilitation nursing and case management.
The FIM instrument, Disability Rating Scale (DRS), Karnofsky Performance Status Scale (KPS), Functional Assessment of Cancer Therapy-Brain (FACT-BR).
Improvement in total functional outcome was indicated by all 3 functional measures (FIM: F = 46.84, p < .05; DRS: F = 19.25, p < .05; KPS: F = 10.11, p < .05). Significant improvements were found between admission and discharge scores for the FIM and DRS. The KPS revealed significant improvement between admission and 3-month follow-up scores. All admission and discharge functional scales (FIM, DRS, KPS) correlated significantly with each other. No significant change was noted in the FACT-BR between admission and discharge scores, but FACT-BR scores did improve at 1- and 3-months postdischarge relative to admission. The FIM, KPS, and DRS did not show significant correlation with the FACT-BR. Ninety percent of patients were initially discharged to a home environment.
Although patients make functional gains during and after inpatient rehabilitation, gains in QOL are not significant until 1 month postdischarge. QOL does not appear to correlate well with functional outcomes. Further, the KPS is less sensitive than the FIM and DRS in detecting change in functional status.
确定接受住院康复治疗的脑肿瘤患者功能转归与生活质量（QOL）之间的关系，并评估4种评估工具在测量该人群变化方面的敏感性。
采用从连续入院患者收集的纵向数据进行前瞻性研究。
急性住院康复单元。
10例入住急性住院康复单元的原发性脑肿瘤患者。
患者参与了一个住院跨学科康复项目，该项目采用了以下学科：职业治疗、康复治疗、娱乐治疗、言语治疗、物理治疗、康复护理和病例管理。
FIM量表、残疾评定量表（DRS）、卡氏功能状态量表（KPS）、癌症治疗功能评估-脑（FACT-BR）。
所有3项功能指标均显示总功能转归有改善（FIM：F = 46.84，p < 0.05；DRS：F = 19.25，p < 0.05；KPS：F = 10.11，p < 0.05）。FIM和DRS的入院和出院分数之间有显著改善。KPS显示入院和3个月随访分数之间有显著改善。所有入院和出院功能量表（FIM、DRS、KPS）之间均显著相关。FACT-BR的入院和出院分数之间未发现显著变化，但FACT-BR分数在出院后1个月和3个月相对于入院时有所改善。FIM、KPS和DRS与FACT-BR未显示显著相关性。90%的患者最初出院后回到家中。
虽然患者在住院康复期间及之后功能有所改善，但生活质量的改善在出院后1个月才显著。生活质量似乎与功能转归相关性不佳。此外，KPS在检测功能状态变化方面比FIM和DRS敏感性低。
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