Aadal Lena, Pallesen Hanne, Arntzen Cathrine, Moe Siri
Head of Clinical Nursing Research, Cand. Cur, Ph.D., Associate Professor, Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Voldbyvej 15, DK-8450 Hammel, Denmark.
Head of Clinical Physiotherapy Research, Cand. Scient. san., Ph.D., Associate Professor, Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Voldbyvej 15, DK-8450, Denmark.
Rehabil Res Pract. 2018 Oct 25;2018:1972190. doi: 10.1155/2018/1972190. eCollection 2018.
To explore and compare the content of rehabilitation practices in, respectively, a Danish and a Norwegian region, focusing on how the citizens' rehabilitation needs are met during rehabilitation in the municipalities.
Six Danish and five Norwegian cases were followed 12 months after the onset of stroke. Field work and focus group interviews with multidisciplinary teams in the municipalities were conducted. The conceptual frame of the International Classification of Functioning was used to outline general patterns and local variation in the rehabilitation services.
Each of the settings faces different challenges and opportunities in the provision of everyday life-supportive rehabilitation services. Rehabilitation after stroke in both settings basically follows the same guidelines, but the organization of rehabilitation programmes is more specialized in Denmark than in Norway. Team organization, multidisciplinarity, and collaboration to assess and target the patients' needs characterized the Danish rehabilitation services. Decentralized coordination and monodisciplinary contributions with scarce or unsystematic collaboration were common in the Norwegian cases. Seamless holistic rehabilitation was challenged in both countries, but more notably in Norway. The municipal services emphasized physical functioning, which could conflict with the patients' needs. Cognitive disturbances to and aspects of activity or participation were systematically addressed by the interdisciplinary teams in Denmark, while practitioners in Norway found that these disturbances were scarcely addressed.
The study showed major differences in municipal stroke rehabilitation services in the Northern Norway and Central Denmark Regions-in their ability to conduct everyday life-supportive rehabilitation services. Despite the fact that biopsychosocial conceptions of disease and illness, as recommended in the ICF, have been generally accepted, they seemed scarcely implemented in the political and health managerial arenas, especially in Norway. These national diversities can partly be explained by the size of the municipalities and the available health profiles in delivering patient and family-centred rehabilitation services.
探索并比较丹麦和挪威某地区康复实践的内容，重点关注市政当局在康复过程中如何满足公民的康复需求。
对6例丹麦和5例挪威中风患者发病12个月后进行随访。在市政当局对多学科团队开展了实地调研和焦点小组访谈。运用国际功能、残疾和健康分类的概念框架来勾勒康复服务的总体模式和局部差异。
在提供支持日常生活的康复服务方面，每个地区都面临着不同的挑战和机遇。两个地区的中风后康复基本遵循相同的指导方针，但丹麦的康复计划组织比挪威更具专业性。丹麦的康复服务以团队组织、多学科性以及协作评估和确定患者需求为特点。挪威的案例中常见的是分散协调和单一学科的贡献，协作稀缺或缺乏系统性。无缝整体康复在两国都受到挑战，但在挪威更为明显。市政服务强调身体功能，这可能与患者需求相冲突。丹麦的跨学科团队系统地解决了认知障碍以及活动或参与方面的问题，而挪威的从业者发现这些障碍几乎没有得到解决。
该研究表明，挪威北部和丹麦中部地区在市政中风康复服务方面存在重大差异——即在开展支持日常生活的康复服务方面的能力。尽管国际功能、残疾和健康分类所推荐的疾病和病症的生物心理社会观念已被普遍接受，但它们在政治和卫生管理领域似乎几乎没有得到实施，尤其是在挪威。这些国家间的差异部分可以通过市政当局的规模以及在提供以患者和家庭为中心的康复服务方面现有的健康状况来解释。
