Duke University Medical Center, Durham, NC, USA.
Top Stroke Rehabil. 2010 Jul-Aug;17(4):239-51. doi: 10.1310/tsr1704-239.
This article reviews theories and conceptual models that may be helpful in evaluating quality of care in rehabilitation, with a focus on the seminal Donabedian model of structure, process, and outcomes. In addition, this article reviews a variety of new theories and conceptual models that have been developed to expand the Donabedian model in areas specific to rehabilitation (eg, the multidisciplinary team, assistive technology), and it covers new approaches developed to help with implementing changes to improve quality. Directions for future research and development are identified, including the need for consensus and consistent use of terminology and measures and the need for quality measures with greater breadth, depth, and granularity that capture the complex interactions between the structure and processes of care unique to rehabilitation of physical disability.
本文回顾了可能有助于评估康复护理质量的理论和概念模型,重点介绍了开创性的 Donabedian 结构、过程和结果模型。此外,本文还回顾了各种新的理论和概念模型,这些模型是为了在康复特定领域(例如多学科团队、辅助技术)扩展 Donabedian 模型而开发的,还涵盖了为帮助实施改进质量的变革而开发的新方法。确定了未来的研究和发展方向,包括需要达成共识、一致使用术语和措施,以及需要更广泛、更深入和更细化的质量措施,以捕捉康复物理残疾护理独特的结构和过程之间的复杂相互作用。