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津巴布韦公立医院重症监护病房患者概况及物理治疗模式:一项描述性横断面研究。

Profile of patients and physiotherapy patterns in intensive care units in public hospitals in Zimbabwe: a descriptive cross-sectional study.

作者信息

Tadyanemhandu Cathrine, Manie Shamila

机构信息

Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, PO Box AV 178., Avondale, Harare, Zimbabwe.

Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.

出版信息

BMC Anesthesiol. 2015 Oct 7;15:136. doi: 10.1186/s12871-015-0120-y.

Abstract

BACKGROUND

Physiotherapy is integral to patient management in the Intensive Care Unit. The precise role that physiotherapists play in the critical care differs significantly worldwide. The aim of the study was to describe the profile of patients and the current patterns of physiotherapy services delivered for patients admitted in the five public hospital intensive care units in Zimbabwe.

METHODS

A prospective record review was performed and records of all consecutive patients admitted into the five units during a two months period were included in the analysis. The data was collected using a checklist and the following were recorded for each patient: 1) demographic information, 2) admission diagnoses, 3) surgery classification, 4) method and time of mechanical ventilation 5) physiotherapy techniques and frequency and 6) the length of stay.

RESULTS

A total of 137 patients were admitted to five units during the study. The mean age of patients in the study was 36.0 years (SD = 16.6). A mortality rate of 17.5 % was observed with most of the patients being below the age of 45 years. The majority of the patients, 61(45 %) had undergone emergency surgery and were in the ICU for postoperative treatment, whilst only 19(14 %) were in the units for clinical treatment (non-surgical). On admission, 72(52.6 %) of the patients were on mechanical ventilation. The mean duration on mechanical ventilation for patients was 4.0 days (SD =2.7) and a length of stay in the unit of 4.5 days (SD = 3.0). Of the patients who were admitted into the ICU 120 (87.6 %) had at least one session of physiotherapy treatment during their stay. The mean number of days physiotherapy treatment was received was 3.71 (SD = 3.14) days. The most commonly used physiotherapy techniques were active assisted limb movements (66.4 %), deep breathing exercises (65.0 %) and forced expiratory techniques (65.0 %).

CONCLUSION

A young population admitted in the ICU for post-surgical treatment was observed across all hospital ICUs. The techniques which were executed in Zimbabwean ICUs showed that the goal of the physiotherapy treatment was mainly to prevent and treat respiratory complications and a culture of promoting bed rest still existed.

TRIAL REGISTRATION

PACTR201408000829202.

摘要

背景

物理治疗是重症监护病房患者管理的重要组成部分。在全球范围内,物理治疗师在重症监护中所起的具体作用存在显著差异。本研究的目的是描述津巴布韦五家公立医院重症监护病房收治患者的概况以及目前为这些患者提供的物理治疗服务模式。

方法

进行前瞻性记录回顾,分析两个月期间连续收治到这五个科室的所有患者的记录。使用检查表收集数据,为每位患者记录以下信息:1)人口统计学信息,2)入院诊断,3)手术分类,4)机械通气方法和时间,5)物理治疗技术及频率,6)住院时间。

结果

研究期间共有137名患者被收治到五个科室。研究中患者的平均年龄为36.0岁(标准差 = 16.6)。观察到死亡率为17.5%,大多数患者年龄在45岁以下。大多数患者,即61名(45%)接受了急诊手术,在重症监护病房进行术后治疗,而只有19名(14%)在科室接受临床治疗(非手术)。入院时,72名(52.6%)患者接受机械通气。患者机械通气的平均持续时间为4.0天(标准差 = 2.7),在科室的住院时间为4.5天(标准差 = 3.0)。在入住重症监护病房的患者中,120名(87.6%)在住院期间至少接受了一次物理治疗。接受物理治疗的平均天数为3.71天(标准差 = 3.14)。最常用的物理治疗技术是主动辅助肢体运动(66.4%)、深呼吸练习(65.0%)和用力呼气技术(65.0%)。

结论

在所有医院的重症监护病房中,观察到收治的是因手术治疗而入住的年轻患者群体。津巴布韦重症监护病房所采用的技术表明,物理治疗的目标主要是预防和治疗呼吸并发症,并且仍然存在促进卧床休息的文化。

试验注册

PACTR201408000829202

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