Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR) and Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.
Clin Rehabil. 2020 May;34(5):571-583. doi: 10.1177/0269215520905112. Epub 2020 Feb 10.
There is no agreement about or understanding of what rehabilitation is; those who pay for it, those who provide it, and those who receive it all have different interpretations. Furthermore, within each group, there will be a variety of opinions. Definitions based on authority or on theory also vary and do not give a clear description of what someone buying, providing, or receiving rehabilitation can actually expect.
This editorial extracts information from systematic reviews that find rehabilitation to be effective, to discover the key features and to develop an empirical definition.
The evidence shows that rehabilitation may benefit any person with a long-lasting disability, arising from any cause, may do so at any stage of the illness, at any age, and may be delivered in any setting. Effective rehabilitation depends on an expert multidisciplinary team, working within the biopsychosocial model of illness and working collaboratively towards agreed goals. The effective general interventions include exercise, practice of tasks, education of and self-management by the patient, and psychosocial support. In addition, a huge range of other interventions may be needed, making rehabilitation an extremely complex process; specific actions must be tailored to the needs, goals, and wishes of the individual patient, but the consequences of any action are unpredictable and may not even be those anticipated.
Effective rehabilitation is a person-centred process, with treatment tailored to the individual patient's needs and, importantly, personalized monitoring of changes associated with intervention, with further changes in goals and actions if needed.
对于康复的含义,没有达成共识或理解;支付费用的人、提供服务的人以及接受服务的人对此都有不同的解释。此外,在每个群体中,都会有各种各样的观点。基于权威或理论的定义也各不相同,无法清晰地描述购买、提供或接受康复服务的人实际可以期望得到什么。
本社论从发现康复有效的系统评价中提取信息,以发现关键特征并制定经验定义。
证据表明,康复可能使任何因任何原因导致的长期残疾的人受益,它可以在疾病的任何阶段、任何年龄、在任何环境中进行。有效的康复依赖于一个由多学科专家组成的团队,在疾病的生物心理社会模式下工作,并朝着共同的目标进行协作。有效的一般干预措施包括运动、任务练习、患者教育和自我管理,以及心理社会支持。此外,可能还需要一系列其他干预措施,这使得康复成为一个极其复杂的过程;具体的行动必须根据患者的需求、目标和意愿进行调整,但任何行动的后果都是不可预测的,甚至可能不是预期的。
有效的康复是一个以患者为中心的过程,治疗针对患者的个体需求进行定制,并且重要的是,对与干预相关的变化进行个性化监测,如果需要,还可以进一步调整目标和行动。