评估多组分个体化物理治疗方案对居家接受临终关怀服务患者的影响。

Assessment of the effects of a multi-component, individualized physiotherapy program in patients receiving hospice services in the home.

机构信息

Institute of Health Sciences, Medical College of Rzeszow University, Rzeszow, Poland.

出版信息

BMC Palliat Care. 2020 Jul 9;19(1):101. doi: 10.1186/s12904-020-00600-6.

DOI:10.1186/s12904-020-00600-6

PMID:32646517

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7350635/

Abstract

BACKGROUND

The interest in physiotherapy programs for individuals in hospice is increasing. The aim of our study was to assess the impact of a multi-component, individualized physiotherapy program on the functional and emotional conditions and quality of life of patients receiving hospice services in the home.

METHODS

The study included 60 patients (mean 66.3 years) receiving hospice services in the home. A model of a physiotherapy program was designed, including breathing, strengthening, transfer, gait, balance, functional, and ergonomic exercises, as well as an adaptation of the patient's living environment to functional needs. The tests were performed before and after the intervention. The study used the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales, the World Health Organization Quality of Life - Bref (WHOQOL-BREF), the Visual Analogue Scale (VAS) pain scale, the Tinetti POMA Scale, and the Geriatric Depression Scale (GDS). To enable comparison of our results worldwide, a set of International Classification of Functioning, Disability and Health (ICF) categories was used.

RESULTS

The average functional level of the ADL (mean 2.9) and the IADL (mean 11.9), as well as the WHOQOL-BREF (mean 46.4) of the patients before the intervention were low, whereas the intensity of pain (VAS mean 5.8), the risk of falling (Tinetti mean 8.2), and depression (GDS mean 16.7) were recorded as high. After the completion of the intervention program, a significant improvement was found in the ADL (mean 4.0), IADL (mean 13.9), WHOQOL-BREF (mean 52.6), VAS (mean 5.1), risk of falling (Tinetti mean 12.3), and GDS (mean 15.7) scores.

CONCLUSIONS

The physiotherapeutic intervention had a significant impact on improving the performance of ADL, as well as the emotional state and quality of life of patients receiving hospice services in the home. The results of our research provide evidence of the growing need for physiotherapy in individuals in hospice and for comprehensive assessment by means of ICF. Registered 02.12.2009 in the Research Registry ( https://www.researchregistry.com/why-register ) under the number research registry 5264.

摘要

背景

人们对临终关怀患者的物理治疗方案越来越感兴趣。我们的研究目的是评估多组分个体化物理治疗方案对居家接受临终关怀服务患者的功能和情绪状况以及生活质量的影响。

方法

本研究纳入了 60 名（平均年龄 66.3 岁）居家接受临终关怀服务的患者。设计了一种物理治疗方案模型，包括呼吸、强化、转移、步态、平衡、功能和人体工程学锻炼，以及对患者生活环境适应功能需求的调整。干预前后进行了测试。研究使用了日常生活活动（ADL）和工具性日常生活活动（IADL）量表、世界卫生组织生活质量-简明量表（WHOQOL-BREF）、视觉模拟量表（VAS）疼痛量表、Tinetti POMA 量表和老年抑郁量表（GDS）。为了能够在全球范围内比较我们的结果，使用了一套国际功能、残疾和健康分类（ICF）类别。

结果

干预前，患者的 ADL（平均 2.9）和 IADL（平均 11.9）的平均功能水平以及 WHOQOL-BREF（平均 46.4）较低，而疼痛强度（VAS 平均 5.8）、跌倒风险（Tinetti 平均 8.2）和抑郁（GDS 平均 16.7）较高。完成干预方案后，ADL（平均 4.0）、IADL（平均 13.9）、WHOQOL-BREF（平均 52.6）、VAS（平均 5.1）、跌倒风险（Tinetti 平均 12.3）和 GDS（平均 15.7）评分显著提高。

结论

物理治疗干预对改善居家接受临终关怀服务患者的日常生活活动能力、情绪状态和生活质量具有显著影响。我们的研究结果为临终关怀患者对物理治疗的需求不断增加以及通过 ICF 进行全面评估提供了证据。于 2009 年 12 月 02 日在 Research Registry（https://www.researchregistry.com/why-register）注册，注册号为 research registry 5264。