Depaul Vincent G, Moreland Julie D, Dehueck Amy L
Physiotherapy Department, St. Joseph's Healthcare Hamilton ; School of Rehabilitation Science, McMaster University, Hamilton.
Joseph Brant Memorial Hospital, Burlington, Ont.
Physiother Can. 2013 Summer;65(3):204-14. doi: 10.3138/ptc.2012-14.
To determine the physiotherapy-related needs of people with stroke at discharge, 6 months after discharge, and 1 year after discharge from hospital, and to examine the results stratified by participants' acute Functional Independence Measure (FIM) scores.
A total of 241 adults with recent stroke were recruited into this longitudinal cohort study. As well as participating in a semi-structured interview that included questions about mobility needs and barriers, participants were asked to complete and return a closed-ended needs-assessment survey.
During the interview, participants reported needs and barriers related to motor control, walking, stairs, fatigue, prevention of falls, and access to physiotherapy services. The survey identified many more needs, including transfers, wheelchair use, higher-level balance and mobility skills, and access to physiotherapy and suitable exercise facilities. Frequencies of needs and barriers tended to be lower among participants with higher acute FIM scores. There was no consistent trend for needs and barriers to decrease over time.
Over the first year after discharge from hospital, people with stroke report a large and varied number of persistent mobility-related needs. Physiotherapists have a role to play in advocating for adequate follow-up services and informing health policy with respect to the needs of their patients with stroke.
确定脑卒中患者出院时、出院后6个月及出院后1年与物理治疗相关的需求,并按参与者急性功能独立性测量(FIM)评分对结果进行分层分析。
本纵向队列研究共招募了241名近期发生脑卒中的成年人。除参与包括有关活动需求和障碍问题的半结构化访谈外,参与者还被要求完成并返还一份封闭式需求评估调查问卷。
在访谈中,参与者报告了与运动控制、行走、上下楼梯、疲劳、预防跌倒以及获得物理治疗服务相关的需求和障碍。调查问卷还发现了更多需求,包括转移、轮椅使用、更高水平的平衡和移动技能,以及获得物理治疗和合适的运动设施。急性FIM评分较高的参与者中,需求和障碍的频率往往较低。需求和障碍随时间推移没有一致的减少趋势。
在出院后的第一年,脑卒中患者报告了大量且多样的持续存在的与活动相关的需求。物理治疗师在倡导提供充分的随访服务以及就脑卒中患者的需求为卫生政策提供信息方面可发挥作用。