Colquhoun Heather, Letts Lori, Law Mary, MacDermid Joy, Edwards Mary
School of Rehabilitation Sciences, McMaster University, Institute for Applied Health Sciences Building, Hamilton, Ontario, Canada.
Aust Occup Ther J. 2010 Apr;57(2):111-7. doi: 10.1111/j.1440-1630.2009.00784.x.
BACKGROUND/AIM: Routinely using outcome measures as an integral component of practice has been encouraged for decades yet has not been widely adopted. There are many reasons to measure outcomes yet any positive effect of measurement on our programs or clients has not been substantiated. If the time-consuming nature of outcome measurement is to be encouraged, we need to begin addressing larger questions of the value of outcome measurement on care and outcomes. This cohort study evaluated the impact of routinely administering the Canadian Occupational Performance Measure on client outcomes on a geriatric rehabilitation unit.
Changes in Functional Independence Measure™ scores between an experimental group (n = 45) that received the routine use of the Canadian Occupational Performance Measure for evaluation/planning versus a historical comparison group (n = 58) that received 'usual' care were analysed using generalised linear modeling.
Both groups had significant changes in Functional Independence Measure™ scores over time. Results for differences between groups were inconclusive with a significantly underpowered analysis; however, results suggest that a medium to large effect of this intervention cannot be expected.
Results are significant for the field of routine outcome measurement, suggesting that when adding the Canadian Occupational Performance Measure to routine assessment within an inpatient rehabilitation setting, substantially improved Functional Independence Measure™ score outcomes should not be expected. The value of routine outcome measurement on client outcomes remains largely unexplored. Routinely, using outcome measures requires additional research to determine the specific benefits to our programs and client outcomes.
背景/目的:几十年来,一直鼓励将结果测量作为实践的一个组成部分,但尚未得到广泛采用。测量结果有很多原因,但测量对我们的项目或客户的任何积极影响都尚未得到证实。如果要鼓励结果测量的耗时性,我们需要开始解决有关结果测量对护理和结果的价值的更大问题。这项队列研究评估了在老年康复病房常规使用加拿大职业表现测量对客户结果的影响。
使用广义线性模型分析了接受常规使用加拿大职业表现测量进行评估/规划的实验组(n = 45)与接受“常规”护理的历史对照组(n = 58)之间功能独立性测量™分数的变化。
两组的功能独立性测量™分数均随时间有显著变化。由于分析的效能明显不足,两组之间差异的结果尚无定论;然而,结果表明不能期望这种干预有中等至较大的效果。
结果对于常规结果测量领域具有重要意义,表明在住院康复环境中将加拿大职业表现测量添加到常规评估中时,不应期望功能独立性测量™分数结果会有实质性改善。常规结果测量对客户结果的价值在很大程度上仍未得到探索。通常,使用结果测量需要更多研究来确定对我们的项目和客户结果的具体益处。