Gagin Roni, HaGani Neta, Levy Itay, Norman Doron
Rambam Medical Center, Haifa, Israel.
J Patient Exp. 2020 Dec;7(6):1715-1723. doi: 10.1177/2374373519892764. Epub 2019 Dec 5.
Home-based rehabilitation (HBR) was previously found to be associated with positive outcomes that are equal to inpatient rehabilitation. Few studies have examined the challenges patients are facing during rehabilitation and recovery and their satisfaction from HBR.
The purpose of this study was to examine the overall satisfaction and reported outcomes of HBR.
A telephone survey was conducted among 146 orthopedic surgery patients who participated in an HBR program, at the end of the HBR and 6 months after. The questionnaire included information about level of independence, satisfaction from HBR, and difficulties during HBR.
The overall satisfaction was high (73.1%). Patients reported on improvements in level of independence between the time of hospital discharge, the end of the program ( = .0001), and the 6 months follow-up ( = .004). Long wait for beginning of HBR, being a widower, and residing in a facility or with a nonfamilial caregiver were associated significantly with less general well-being and independence. The repeated measures analysis showed age lower than 71 and private health insurance ownership were associated with a better recovery. The most common difficulties reported were physical difficulties, lack of function, and caregivers' burden.
Patients and families need more emotional, social, and physical support during HBR. The increase in health services delivered in community settings requires a more clear-cut policy and supervision for HBR and the follow-up services.
先前发现居家康复(HBR)与等同于住院康复的积极结果相关。很少有研究探讨患者在康复和恢复过程中面临的挑战以及他们对居家康复的满意度。
本研究的目的是调查居家康复的总体满意度和报告的结果。
对146名参与居家康复计划的骨科手术患者在居家康复结束时和结束后6个月进行了电话调查。问卷包括关于独立程度、对居家康复的满意度以及居家康复期间困难的信息。
总体满意度较高(73.1%)。患者报告在出院时、计划结束时(P = .0001)和6个月随访时(P = .004)独立程度有所改善。等待居家康复开始的时间较长、丧偶以及居住在机构或由非家庭照顾者照顾与总体幸福感和独立性显著降低相关。重复测量分析表明,年龄低于71岁和拥有私人医疗保险与更好的恢复相关。报告的最常见困难是身体困难、功能缺失和照顾者负担。
患者和家庭在居家康复期间需要更多的情感、社会和身体支持。社区环境中提供的医疗服务增加需要对居家康复和后续服务制定更明确的政策和监督。