School of Health and Social Care, Teesside University, Middlesbrough, UK.
Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Teesside University, Middlesbrough, UK.
Disabil Rehabil. 2019 Nov;41(23):2731-2749. doi: 10.1080/09638288.2018.1473508. Epub 2018 Jun 18.
The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life.: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers. One hundred and one findings were extracted. Meta-aggregation was used to synthesize findings. Seven 'synthesized findings' [SF] were produced: Interactions with some professionals provide active participation, choice, confidence and autonomy [SF1]; Interactions with some professionals are disempowering and depersonalized [SF2]; Effective communication, specialist knowledge and an individualized approach to information provision is needed [SF3]; Indicators of success vary and may not be clear [SF4]; Informal support from family/friends is valued [SF5]; Opportunities for peer support/social interaction is valued [SF6]; Coordination required to ensure continuity during transition to community [SF7]. Patient reported experiences identified common factors associated with process quality (respect, choice, autonomy, information provision, communication) and activities of patient centered care (personalized care, shared decision-making, self-management support) despite heterogeneity of neurological conditions, service configurations, and geographical location. These factors impact quality of life.Implications for RehabilitationPatient reported experiences provide useful information about courtesy, respect, choice, autonomy, information provision, and communication.Outcomes of self-efficacy and self-management are important for people with stable and progressive long-term neurological conditions.Interactions with individual professionals influence engagement, self-efficacy, and self-management for people with long-term neurological conditions.Training for health and social care professionals should develop the advanced communication skills and behavior required to facilitate self-efficacy and self-management.
本研究旨在确定患有长期神经系统疾病的患者在使用社区康复和/或支持服务时的报告体验，以及他们对生活质量的看法。：从 2005 年至 2016 年，在九个电子数据库中搜索了符合纳入标准的同行评议定性研究。三名评审员对 37 篇纳入的论文进行了批判性评估、数据提取和质量评估。共提取了 101 项发现。使用元聚合综合发现。生成了七个“综合发现”[SF]：与某些专业人员的互动提供了积极的参与、选择、信心和自主权[SF1]；与某些专业人员的互动会削弱能力和缺乏人性化[SF2]；需要有效的沟通、专业知识和个性化的信息提供方法[SF3]；成功的指标各不相同，可能不明确[SF4]；家庭/朋友的非正式支持受到重视[SF5]；重视同伴支持/社交互动的机会[SF6]；需要协调以确保在向社区过渡期间的连续性[SF7]。患者报告的体验确定了与过程质量（尊重、选择、自主权、信息提供、沟通）和以患者为中心的护理活动（个性化护理、共同决策、自我管理支持）相关的常见因素，尽管神经系统疾病、服务配置和地理位置存在异质性。这些因素影响生活质量。康复的意义患者报告的体验提供了有关礼貌、尊重、选择、自主权、信息提供和沟通的有用信息。自我效能和自我管理的结果对稳定和进展性长期神经系统疾病患者很重要。与个别专业人员的互动会影响长期神经系统疾病患者的参与、自我效能和自我管理。卫生和社会保健专业人员的培训应培养促进自我效能和自我管理所需的高级沟通技巧和行为。
