Coster Wendy, Haley Stephen M, Jette Alan, Tao Wei, Siebens Hilary
Department of Occupational Therapy and Rehabilitation Counseling, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA 02215, USA.
Arch Phys Med Rehabil. 2007 Jul;88(7):928-35. doi: 10.1016/j.apmr.2007.03.037.
To examine the relations among cognitive and emotional function and other patient impairment and demographic variables and the performance of daily activities.
Cohort.
Acute inpatient rehabilitation, skilled nursing facilities, home care, and outpatient clinics.
Adults (N=534) receiving services for neurologic (32.3%), lower-extremity orthopedic (42.7%), or complex medical (24.9%) conditions. Mean age was 63.8 years; 55% were women; 88.6% were white; and the time since condition onset ranged from 0.2 to 3.9 years.
Not applicable.
Activity Measure for Post-Acute Care: applied cognitive, personal care and instrumental, and physical and movement scales; Mental Health Inventory-5 (MHI-5); and patient-identified problems (vision, grasp).
Path analyses resulted in good model fit both for the total sample and 3 patient subgroups (chi(2) test, P>.05; comparative fit index >.95). There was a significant (P<.05) direct relation between the applied cognitive, grasp, and personal care and instrumental variables in all patient groups. There were also significant indirect relations between the MHI-5, visual impairment, and grasp problems with the personal care and instrumental scale through an association with the applied cognitive scale. Strength and significance of associations between age, sex, and physical and movement and personal care and instrumental scales varied more across patient groups. The model R(2) for the personal care and instrumental scale for the total sample was .60, with R(2) values of .10, .72, and .62 for the lower-extremity orthopedic, neurologic, and complex medical groups, respectively.
Results suggest that variations in cognitive function, along with visual impairment and lower perceived well-being are associated with a patient's ability to complete daily activities. Rehabilitation professionals should consider cognitive and emotional factors as well as physical performance when planning treatment programs to restore daily activity function.
探讨认知与情感功能、其他患者损伤及人口统计学变量与日常活动表现之间的关系。
队列研究。
急性住院康复机构、专业护理机构、家庭护理机构和门诊诊所。
因神经疾病（32.3%）、下肢骨科疾病（42.7%）或复杂内科疾病（24.9%）接受服务的成年人（N = 534）。平均年龄为63.8岁；55%为女性；88.6%为白人；发病后时间为0.2至3.9年。
不适用。
急性后期护理活动量表：应用认知、个人护理与工具性、身体与运动量表；心理健康量表-5（MHI-5）；以及患者确定的问题（视力、抓握能力）。
路径分析显示，总样本和3个患者亚组的模型拟合良好（卡方检验，P>.05；比较拟合指数>.95）。在所有患者组中，应用认知、抓握能力以及个人护理与工具性变量之间存在显著的（P<.05）直接关系。通过与应用认知量表的关联，MHI-5、视力障碍和抓握问题与个人护理与工具性量表之间也存在显著的间接关系。年龄、性别与身体与运动以及个人护理与工具性量表之间关联的强度和显著性在不同患者组中差异更大。总样本中个人护理与工具性量表的模型R²为0.60，下肢骨科、神经疾病和复杂内科组的R²值分别为0.10、0.72和0.62。
结果表明，认知功能的差异，以及视力障碍和较低的幸福感与患者完成日常活动的能力相关。康复专业人员在规划恢复日常活动功能的治疗方案时，应考虑认知和情感因素以及身体表现。
