农村地区肢体残疾患者过渡期护理方案的效果：一项随机对照试验。

Effects of a transitional care program for individuals with limbs disabilities living in a rural community: A randomized controlled trial.

机构信息

Department of Rehabilitation, Nanhai Hospital, Southern Medical University, Foshan, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China.

出版信息

Disabil Health J. 2021 Jan;14(1):100946. doi: 10.1016/j.dhjo.2020.100946. Epub 2020 Jun 13.

DOI:10.1016/j.dhjo.2020.100946

PMID:32565092

Abstract

BACKGROUND

Transitional care (TC) has been proven to be effective in addressing fragmented care and preventing adverse outcomes for chronically ill patients transitioning from hospital to home, but the definitive description of TC that was used successfully for individuals with limbs disability has not been formed in the context of health care reform in China.

OBJECTIVE

The aim of this study was to evaluate the effect of a TC program on health outcomes in individuals with limbs disability based on an original community for healthcare.

METHOD

It was a randomized controlled trial. Individuals in the intervention group received ongoing rehabilitation both at the specialized care center and at home through multidisciplinary team, while individuals in the control group received routine follow-up visits by primary healthcare physicians. Outcomes were measured by Short-Form Health Survey-36 (SF-36), Modified Barthel Index (MBI) and Caregiver Strain Index (CSI) at 3 and 6 months respectively.

RESULTS

A total of 84 participants were randomly assigned (intervention n = 42, control n = 42). Mean values of Physical Components Summary, an integral component of SF-36, was significantly better in the intervention group at 3 and 6 months (42.0 ± 2.3 and 44.3 ± 1.5 respectively). The same trend was observed in MBI (72.2 ± 6.8 and 78.6 ± 9.3 at 3 and 6 months respectively). But the significant improvement in CSI was only observed at 6 months. There were significant differences between groups in these scores except Mental Components Summary.

CONCLUSION

The TC program has been proven to be feasible and improve health-related outcomes.

摘要

背景

过渡性护理（TC）已被证明可有效解决医疗服务碎片化问题，并预防慢性病患者从医院过渡到家庭时出现不良结局，但在我国医疗改革背景下，尚未形成针对肢体残疾患者的 TC 明确定义。

目的

本研究旨在评估基于社区医疗的 TC 方案对肢体残疾患者健康结局的影响。

方法

这是一项随机对照试验。干预组患者在专科护理中心和家中通过多学科团队接受持续康复治疗，而对照组患者仅接受基层医疗保健医生的常规随访。分别于 3 个月和 6 个月采用健康调查简表 36 项（SF-36）、改良巴氏指数（MBI）和照顾者负担量表（CSI）评估结局。

结果

共有 84 名患者被随机分配（干预组 n=42，对照组 n=42）。在 3 个月和 6 个月时，SF-36 生理成分综合评分（其为一个整体组成部分）的平均值在干预组中显著更高（分别为 42.0±2.3 和 44.3±1.5）。MBI（分别为 72.2±6.8 和 78.6±9.3）也呈现出相同的趋势。但仅在 6 个月时观察到 CSI 的显著改善。这些评分中除了精神健康成分评分外，组间均存在显著差异。