Service de médecine physique et de réadaptation, laboratoire HAVAE, pôle neuro-sciences tête et cou, université de Limoges, hôpital J.-Rebeyrol, CHU de Limoges, avenue du Buisson, 87042 Limoges, France.
Ann Phys Rehabil Med. 2012 Dec;55(9-10):641-56. doi: 10.1016/j.rehab.2012.08.011. Epub 2012 Sep 7.
Focus on the different therapeutic patient education (TPE) programs for stroke survivors found in the literature. Verify their content and efficacy.
A literature review was conducted by searching for entries from 1966 to 2011 in the Medline and Cochrane Library databases. The references for the accepted articles were taken into consideration and the articles corresponding to the criteria inclusion but not present within the initial search were selected. The keywords used were "self care", "self management", "patient education" and "stroke". Given the multiplicity of symptoms that may be addressed in TPE programs, and following expert advice, the symptoms were grouped after expanding the bibliographic search using the following, additional keywords: "dysphagia"; "swallowing disorder"; "urinary incontinence"; "caregiver"; "fall prevention"; "falling"; "injury"; "shoulder pain"; "physical activity"; "exercise"; "aphasia" and "cognitive impairment".
We found 30 article abstracts. In the end, we only accepted seven articles on general TPE programs that were well structured and detailed enough. The TPE programs found in the literature were often of questionable methodological quality. The multiplicity of symptoms led to very general TPE programs that covered all possible stroke after-effects. The purpose of these programs was to reduce stress and anxiety, to improve quality of life and to alleviate psychosocial after-effects. A change in caregiver and patient behavior was observed at times. We expanded the bibliographic search to include scientific arguments that could help implement TPE programs for more specific targets.
TPE programs for stroke survivors could be improved by standardizing and assessing programs that focus on a specific problem caused by the various possible after-effects of strokes. In order to promote education for stroke survivors, specific training for health care professionals and appropriate funding are necessary.
关注文献中针对脑卒中幸存者的不同治疗性患者教育（TPE）项目，验证其内容和疗效。
通过检索 Medline 和 Cochrane 图书馆数据库，从 1966 年至 2011 年的文献中进行了文献回顾。考虑了已接受文章的参考文献，并选择了符合纳入标准但未在初始搜索中包含的文章。使用的关键词是“自我护理”、“自我管理”、“患者教育”和“脑卒中”。鉴于 TPE 项目可能涉及多种症状，并且根据专家建议，在使用以下扩展文献检索的附加关键字：“吞咽障碍”、“吞咽障碍”、“尿失禁”、“照顾者”、“预防跌倒”、“跌倒”、“损伤”、“肩部疼痛”、“体力活动”、“锻炼”、“失语症”和“认知障碍”后，对 TPE 项目进行分组。
我们找到了 30 篇文章摘要。最后，我们仅接受了 7 篇关于结构良好且足够详细的一般 TPE 项目的文章。文献中发现的 TPE 项目的方法学质量往往存在问题。症状的多样性导致了涵盖所有可能的脑卒中后遗症的非常笼统的 TPE 项目。这些项目的目的是减轻压力和焦虑，提高生活质量，并缓解心理社会后遗症。有时观察到照顾者和患者行为的变化。我们扩展了文献检索，以纳入有助于为更具体的目标实施 TPE 项目的科学论据。
通过标准化和评估专注于由各种可能的脑卒中后遗症引起的特定问题的项目，可以改善针对脑卒中幸存者的 TPE 项目。为了促进脑卒中幸存者的教育，需要对医疗保健专业人员进行特定培训并提供适当的资金。
