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采用范围综述和概念分析方法来阐明后天性脑损伤后的康复潜力的意义。

Combining scoping review and concept analysis methodologies to clarify the meaning of rehabilitation potential after acquired brain injury.

机构信息

School of rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada.

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada.

出版信息

Disabil Rehabil. 2022 Mar;44(5):817-825. doi: 10.1080/09638288.2020.1779825. Epub 2020 Jun 18.

Abstract

PURPOSE

Clinicians make judgments about patients' rehabilitation potential because it is considered by many as a prerequisite for referral to rehabilitation. However, the concept is rarely defined. This research aimed to clarify the concept of rehabilitation potential in the context of acquired brain injury patient referral to post-acute rehabilitation.

METHOD

Literature search (conducted in Medline, CINAHL and Embase) and article selection followed a scoping review methodology while a concept analysis methodology guided data extraction and analysis.

RESULTS

Eighteen documents met inclusion criteria. Findings suggest four defining attributes of the concept. Rehabilitation potential (1) emerges from clinicians' interpretation of patient characteristics and is influenced by the health care environment, (2) involves the prediction of how a patient might improve with rehabilitation interventions, (3) is a multi-level concept and (4) can change over time. The most critical consequence to assessing a patient's rehabilitation potential is the impact on the patient's opportunity to access post-acute rehabilitation services.

CONCLUSION

Rehabilitation potential is a concept rooted in clinical reasoning. We propose an operational definition and a conceptual model to provide a solid foundation for future research to advance policy and clinical decision-making regarding equitable access to post-acute rehabilitation.IMPLICATIONS FOR REHABILITATIONRehabilitation potential is a concept rooted in clinical reasoning and emerges from clinicians' prediction of how a patient might improve with rehabilitation interventions.Rehabilitation potential is not a dichotomous concept but a multi-level concept with each level falling along a continuum.It may be inaccurate/inappropriate to definitively state that a patient has or does not have rehabilitation potential, as patients may demonstrate varying levels of rehabilitation potential.Rehabilitation potential can change with time requiring re-assessment to readjust recommendations accordingly with regards to appropriate rehabilitation interventions at any given time.

摘要

目的

临床医生对患者的康复潜力做出判断,因为许多人认为这是将患者转介至康复治疗的前提条件。然而,这个概念很少被定义。本研究旨在阐明在将脑损伤患者转介至康复后治疗的背景下,康复潜力的概念。

方法

文献检索(在 Medline、CINAHL 和 Embase 中进行)和文章选择遵循范围综述方法,而概念分析方法则指导数据提取和分析。

结果

符合纳入标准的有 18 篇文献。研究结果表明,该概念有四个定义属性。康复潜力(1)源于临床医生对患者特征的解释,并受医疗保健环境的影响;(2)涉及对患者接受康复干预可能改善的预测;(3)是一个多层次的概念;(4)会随时间变化。评估患者康复潜力的最关键后果是对患者获得康复后治疗服务机会的影响。

结论

康复潜力是一个根植于临床推理的概念。我们提出了一个操作性定义和一个概念模型,为未来的研究提供了坚实的基础,以推进有关公平获得康复后治疗的政策和临床决策。

对康复的意义

康复潜力是一个根植于临床推理的概念,源于临床医生对患者接受康复干预可能改善的预测。康复潜力不是一个二分概念,而是一个多层次的概念,每个层次都沿着一个连续体分布。准确地说患者有或没有康复潜力可能是不准确/不恰当的,因为患者可能表现出不同程度的康复潜力。康复潜力可能会随时间变化,需要重新评估,以便相应地调整关于任何特定时间适当康复干预的建议。

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