Ostwald Sharon K, Godwin Kyler M, Cheong Hee, Cron Stanley G
Center on Aging, University of Texas School of Nursing at Houston, Houston, Texas, USA.
Top Stroke Rehabil. 2009 Jan-Feb;16(1):80-91. doi: 10.1310/tsr1601-80.
To identify the percentage of persons with stroke resuming therapy within 4 weeks of inpatient rehabilitation discharge, to compare the characteristics of those who did and did not resume therapy, and to determine the predictors of resuming physical (PT), occupational (OT), and speech (ST) therapy.
Sociodemographic, stroke-related, and therapy data for persons with stroke (N = 131) were abstracted from inpatient rehabilitation charts. FIM, Stroke Impact Scale, Geriatric Depression Scale, and data on therapy received after discharge were also collected.
Logistic regression models demonstrated that minorities were less likely to resume PT (odds ratio [OR] = 0.30) and OT (OR = 0.25). Survivors with neglect/visual-field cut/spatial-perceptual loss were 2-3 times more likely to resume PT, OT, and ST. Survivors with higher scores on the SIS Physical domain subscale were less likely to resume PT (OR = 0.98) and OT (OR = 0.97). Men were 3.3 times more likely to have OT than women. Those with comprehensive health insurance were 11.2 times more likely to receive ST.
The benefits of outpatient therapy are not universally available to all persons with stroke. Further research needs to explore the factors that hinder the prompt resumption of therapy for minority and female persons with stroke and to test appropriate interventions.
确定中风患者在住院康复出院后4周内恢复治疗的比例，比较恢复治疗和未恢复治疗患者的特征，并确定恢复物理治疗（PT）、职业治疗（OT）和言语治疗（ST）的预测因素。
从住院康复病历中提取中风患者（N = 131）的社会人口统计学、中风相关和治疗数据。还收集了功能独立性测量量表（FIM）、中风影响量表、老年抑郁量表以及出院后接受治疗的数据。
逻辑回归模型显示，少数族裔恢复PT（比值比[OR] = 0.30）和OT（OR = 0.25）的可能性较小。伴有忽视/视野缺损/空间感知丧失的幸存者恢复PT、OT和ST的可能性高出2至3倍。中风影响量表身体领域子量表得分较高的幸存者恢复PT（OR = 0.98）和OT（OR = 0.97）的可能性较小。男性接受OT的可能性是女性的3.3倍。拥有综合健康保险的患者接受ST的可能性高出11.2倍。
并非所有中风患者都能普遍获得门诊治疗的益处。需要进一步研究探索阻碍少数族裔和女性中风患者及时恢复治疗的因素，并测试适当的干预措施。
