Saltychev Mikhail, Tarvonen-Schröder Sinikka, Bärlund Esa, Laimi Katri
Departments of aPhysical and Rehabilitation Medicine bRehabilitation and Brain Trauma, Turku University Hospital and University of Turku, Turku cSatakunta University of Applied Sciences, Pori, Finland.
Int J Rehabil Res. 2014 Sep;37(3):229-35. doi: 10.1097/MRR.0000000000000065.
To assess quantitative differences between rehabilitation team, rehabilitants, and significant others in opinions on functioning of subacute stroke survivors. During inpatient interdisciplinary neurorehabilitation, the interdisciplinary team, nurses, rehabilitants, and significant others reported their opinions on the functioning of consecutive 62 rehabilitants. Data were gathered using the structured form based on the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for Stroke. Agreement between observers on the presence and severity of restrictions in functioning was analyzed. The strongest agreement between different observers on all studied ICF categories was achieved between the interdisciplinary team and nurses (weighted squared κ=0.7-0.9). The weakest agreement was detected between the team and rehabilitants (weighted squared κ=0.1-0.6). Support by family was found to be an important facilitating factor of functioning by all observers. Limitations in cognitive activity were identified less frequently than other restrictions. Opinions on restrictions in functioning may differ between the interdisciplinary team, rehabilitants, and significant others. These differences can be assessed quantitatively and documented using the ICF Core Set for Stroke. This potential observer-dependent discrepancy should be taken into account during the process of neurorehabilitation.
评估康复团队、康复患者及其重要他人对亚急性卒中幸存者功能状况看法的定量差异。在住院期间的跨学科神经康复过程中，跨学科团队、护士、康复患者及其重要他人报告了他们对连续62名康复患者功能状况的看法。使用基于《国际功能、残疾和健康分类》（ICF）中风简要核心集的结构化表格收集数据。分析了观察者之间在功能受限的存在和严重程度方面的一致性。在所有研究的ICF类别中，跨学科团队和护士之间不同观察者之间的一致性最强（加权平方κ=0.7 - 0.9）。团队与康复患者之间的一致性最弱（加权平方κ=0.1 - 0.6）。所有观察者均发现家庭支持是功能发挥的重要促进因素。认知活动受限的识别频率低于其他限制。跨学科团队、康复患者及其重要他人对功能受限的看法可能存在差异。这些差异可以使用ICF中风核心集进行定量评估和记录。在神经康复过程中应考虑这种潜在的观察者依赖性差异。
