Lexell Eva Månsson, Flansbjer Ulla-Britt, Lexell Jan
Department of Health Sciences, Lund University , Lund , Sweden and.
Disabil Rehabil. 2014;36(5):373-8. doi: 10.3109/09638288.2013.797506. Epub 2013 Jun 4.
To assess self-perceived performance and satisfaction with performance of daily activities in persons with multiple sclerosis (MS) on admission to and at discharge from interdisciplinary rehabilitation.
A retrospective study with a pre-post design. Twenty-seven women and 16 men with MS (mean age 51 years; median EDSS 6.5) participated in an individualised, goal-oriented, interdisciplinary, rehabilitation programme (average length 4 weeks). The Canadian Occupational Performance Measure (COPM) was used on admission to rehabilitation and at discharge.
On admission, the persons prioritised 216 activities that they perceived difficult to perform (mean number 3, range 2-8). Of these, 136 (63%) were in the COPM area of self-care, 52 (24%) in productivity and 28 (13%) in leisure. The lowest mean ratings of performance were found in the subgroups active recreation, community management and socialisation, and for satisfaction in the subgroup socialisation. For about 60% of the 216 prioritised activities, ratings of COPM performance as well as satisfaction were higher at discharge than on admission. For 18 (42%) and 24 (56%) persons, respectively, the mean change scores of performance and of satisfaction were equal to or greater than 2.0 at discharge, indicating a clinically significant change.
Persons with MS can experience problems with all types of daily activities upon admission to rehabilitation, but also perceive improvements in their performance and satisfaction with performance in these activities at discharge from rehabilitation. Using patient-reported outcome measures, such as the COPM, may contribute to a broader understanding of the benefits of interdisciplinary rehabilitation in persons with MS. Implications for Rehabilitation Persons with MS can perceive problems with all types of daily activities which have to be considered during interdisciplinary rehabilitation. Following interdisciplinary rehabilitation, persons with MS can perceive improvements in their performance and satisfaction with performance in all types of daily activities. Patient-reported outcome measures can contribute to a broader understanding of the benefits of interdisciplinary rehabilitation in persons with MS.
评估多发性硬化症(MS)患者在接受跨学科康复治疗入院时和出院时对日常活动表现的自我认知以及对表现的满意度。
一项采用前后设计的回顾性研究。27名患有MS的女性和16名男性(平均年龄51岁;中位扩展残疾状态量表[EDSS]为6.5)参与了一项个性化、目标导向、跨学科的康复计划(平均时长4周)。在康复治疗入院时和出院时使用了加拿大职业表现测量量表(COPM)。
入院时,患者们列出了216项他们认为难以完成的活动(平均每项3项,范围为2 - 8项)。其中,136项(63%)属于COPM中的自我照顾领域,52项(24%)属于生产力领域,28项(13%)属于休闲领域。在积极娱乐、社区管理和社交亚组中发现表现的平均评分最低,而在社交亚组中满意度最低。对于216项优先列出的活动中的约60%,出院时COPM表现评分以及满意度均高于入院时。分别有18名(42%)和24名(56%)患者在出院时表现和满意度的平均变化得分等于或大于2.0,表明有临床显著变化。
MS患者在康复治疗入院时在各类日常活动中都会遇到问题,但在康复治疗出院时也能察觉到自身在这些活动中的表现及对表现的满意度有所改善。使用患者报告结局测量指标,如COPM,可能有助于更全面地理解跨学科康复对MS患者的益处。对康复的启示MS患者在各类日常活动中都会察觉到问题,这在跨学科康复过程中必须予以考虑。经过跨学科康复后,MS患者在各类日常活动中的表现及对表现的满意度都能察觉到改善。患者报告结局测量指标有助于更全面地理解跨学科康复对MS患者的益处。