Cahow Claire, Skolnick Susan, Joyce Joan, Jug Julie, Dragon Charlotte, Gassaway Julie
Craig Hospital, Englewood, Colorado, USA.
J Spinal Cord Med. 2009;32(3):298-306. doi: 10.1080/10790268.2009.11760783.
BACKGROUND/OBJECTIVE: Outcomes research of therapeutic recreation (TR) activities and interventions for spinal cord injury (SCI) rehabilitation is made more difficult by a lack of uniform descriptions and the absence of a formal treatments classification system (taxonomy). The objective of this study was to describe a taxonomy developed by Certified Therapeutic Recreation Specialists.
TR lead clinicians and researchers from 6 SCI rehabilitation centers developed a TR documentation system to describe the details of each TR session involving patients with SCI enrolled in the SCIRehab study. The SCIRehab study uses the practice-based evidence methodology, a rigorous observational methodology that examines current practice without introducing additional treatments, to capture details of each TR session for 1,500 SCI rehabilitation patients at 6 US inpatient SCI rehabilitation facilities. This may be the first attempt to document the many details of the TR rehabilitation process for patients with SCI.
The TR taxonomy consists of 6 activities (eg, leisure education and counseling, outings, and leisure skill work in center) and activity-specific interventions, as well as time spent on each activity. Activity descriptions are enhanced with additional details that focus on assistance needs for each activity, patient ability to direct care, and patient/family involvement, which may help to determine TR activity selection.
Development and application of a TR taxonomy, which is comprehensive for patients with SCI and efficient to use, are feasible despite significantly different TR programs at the 6 SCIRehab centers.
背景/目的:由于缺乏统一的描述以及正式的治疗分类系统,脊髓损伤(SCI)康复的治疗性娱乐(TR)活动及干预的结果研究变得更加困难。本研究的目的是描述由认证治疗性娱乐专家开发的一种分类系统。
来自6个SCI康复中心的TR首席临床医生和研究人员开发了一个TR记录系统,以描述参与SCIRehab研究的SCI患者的每次TR治疗的详细情况。SCIRehab研究采用基于实践的证据方法,这是一种严格的观察方法,在不引入额外治疗的情况下检查当前实践,以获取美国6家住院SCI康复机构中1500名SCI康复患者每次TR治疗的详细情况。这可能是首次尝试记录SCI患者TR康复过程的诸多细节。
TR分类系统包括6项活动(如休闲教育与咨询、外出活动以及中心内的休闲技能训练)和特定活动的干预措施,以及每项活动所花费的时间。活动描述通过额外细节得到强化,这些细节关注每项活动的协助需求、患者指导护理的能力以及患者/家庭的参与情况,这可能有助于确定TR活动的选择。
尽管6个SCIRehab中心的TR项目存在显著差异,但开发并应用一种对SCI患者全面且使用高效的TR分类系统是可行的。