Sunnerhagen K S, Francisco G E
The Institute of Neuroscience and Physiology - Section for Clinical Neuroscience and Rehabilitation, Gothenburg University, Göteborg, Sweden.
Acta Neurol Scand. 2013 Nov;128(5):305-10. doi: 10.1111/ane.12128. Epub 2013 Apr 18.
Stroke is a major public health concern, with estimated 16 million people worldwide experiencing first-time strokes each year, a number that is expected to rise. Two-thirds of those experiencing a stroke are younger than 70 years of age. Stroke is a leading cause of disability in adults as a result of major sequelae that include spasticity, cognitive impairment, paresis, and depression. Disabling spasticity, defined as spasticity severe enough to require intervention, occurs in 4% of stroke survivors within 1 year of first-time stroke. The aim of this report is to focus instead on a discussion of patient-provider communication, and its role in post-stroke spasticity (PSS) rehabilitation within the context of patient-centered health care. A discussion based on a review of the literature, mainly since 2000. Problems within communication are identified and suggestion to enhance communication are proposed thus improving patient-centered goal setting/goal achievement for the effective management of spasticity rehabilitation. These are as follows: (i) involving family members, (ii) educating patients and family members on stroke and rehabilitation, and (iii) establishing a common definition for long-term goals. Increased communication among physicians, patients, and payers may bridge some of the gaps and increase the effectiveness of PSS rehabilitation and management.
中风是一个重大的公共卫生问题，据估计，全球每年有1600万人首次中风，而且这一数字预计还会上升。三分之二的中风患者年龄在70岁以下。由于包括痉挛、认知障碍、轻瘫和抑郁在内的主要后遗症，中风是成年人残疾的主要原因。致残性痉挛被定义为严重到需要干预的痉挛，在首次中风后1年内，4%的中风幸存者会出现这种情况。本报告的目的是转而关注医患沟通的讨论，以及在以患者为中心的医疗保健背景下，医患沟通在中风后痉挛（PSS）康复中的作用。本次讨论基于对主要自2000年以来的文献综述。识别沟通中存在的问题，并提出加强沟通的建议，从而改善以患者为中心的目标设定/目标达成情况，以有效管理痉挛康复。具体如下：（i）让家庭成员参与进来；（ii）对患者和家庭成员进行中风及康复方面的教育；（iii）为长期目标建立一个共同的定义。医生、患者和支付方之间加强沟通可能会弥合一些差距，提高PSS康复和管理的有效性。
