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周六物理治疗服务可能会缩短住院康复患者的住院时间:一项随机对照试验。

A Saturday physiotherapy service may decrease length of stay in patients undergoing rehabilitation in hospital: a randomised controlled trial.

作者信息

Brusco Natasha K, Shields Nora, Taylor Nicjolas F, Paratz Jennifer

机构信息

La Trobe University, Australia.

出版信息

Aust J Physiother. 2007;53(2):75-81. doi: 10.1016/s0004-9514(07)70039-9.

Abstract

QUESTION

Is additional Saturday physiotherapy intervention beneficial for inpatients undergoing rehabilitation?

DESIGN

Randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis.

PARTICIPANTS

Two hundred and sixty-two inpatients undergoing rehabilitation in an Australian metropolitan hospital.

INTERVENTION

The experimental group received physiotherapy intervention from Monday to Saturday and the control group from Monday to Friday.

OUTCOME MEASURES

Primary outcomes were hospital and physiotherapy length of stay. Secondary measures were collected to reflect patient outcomes (health state, independence, activity, flexibility and strength) and burden of care (discharge destination, adverse events, and follow-up physiotherapy intervention).

RESULTS

There was a 3.2 day reduction for the experimental group (95% CI -0.5 to 6.9) in hospital length of stay and a 2.5 day reduction (95% CI -0.9 to 5.9) in physiotherapy length of stay. There was no significant between-group difference in change from admission to discharge for most of the secondary patient outcomes (health state, independence, activity, flexibility). The risk of the experimental group being categorised as strong relative to the control group was 1.2 (95% CI 0.99 to 1.50). The risk of not being discharged home, of having an adverse event, or requiring follow-up physiotherapy intervention was no greater for the experimental group than the control group.

CONCLUSION

The provision of additional Saturday physiotherapy intervention resulted in a trend to shorter hospital and physiotherapy length of stay without affecting patient outcome unfavourably or increasing burden of care, suggesting that a larger multicentre trial is warranted.

摘要

问题

额外的周六物理治疗干预对正在接受康复治疗的住院患者有益吗?

设计

采用隐藏分配、评估者盲法和意向性分析的随机对照试验。

参与者

澳大利亚一家大都市医院的262名正在接受康复治疗的住院患者。

干预措施

实验组从周一至周六接受物理治疗干预,对照组从周一至周五接受物理治疗干预。

观察指标

主要指标为住院时间和物理治疗时间。收集次要指标以反映患者的治疗结果(健康状况、独立性、活动能力、灵活性和力量)以及护理负担(出院去向、不良事件和后续物理治疗干预)。

结果

实验组的住院时间缩短了3.2天(95%可信区间为-0.5至6.9),物理治疗时间缩短了2.5天(95%可信区间为-0.9至5.9)。在大多数次要患者治疗结果(健康状况、独立性、活动能力、灵活性)方面,从入院到出院的组间变化无显著差异。与对照组相比,实验组被归类为强壮的风险为1.2(95%可信区间为0.99至1.50)。实验组未出院回家、发生不良事件或需要后续物理治疗干预的风险并不高于对照组。

结论

提供额外的周六物理治疗干预有使住院时间和物理治疗时间缩短的趋势,且不会对患者治疗结果产生不利影响或增加护理负担,这表明有必要进行一项更大规模的多中心试验。

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