Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, Brescia, Italy.
Ann Med. 2021 Dec;53(1):470-477. doi: 10.1080/07853890.2021.1900592.
To compare disability changes measured with the Respiratory ICF Maugeri core set on COPD patients, recovering from acute exacerbation with and without hospitalization, submitted to pulmonary rehabilitation (PR).
All COPD inpatients admitted for rehabilitation in 9 Respiratory Units (January-August 2019) were considered eligible. 2066 patients were included (540 discharged from an acute Hospital = Hospital group and 1526 coming from their home = Home group). Healthcare professionals filled, in a digitalized chart, the Respiratory ICF Maugeri core set (26 items), assessing ICF categories at admission and discharge.
The baseline distribution of the more severe ICF qualifiers was higher in the Hospital group ( < .001) when compared to the Home group. After rehabilitation, all patients -irrespective of hospitalization need- statistically decreased the rate of the higher ICF qualifiers ( < .0001). Hospital group improved more both the rate of qualifiers ≥2 [Δ: -21.32 (22.41) vs -15.48 (17.32), < .001] and the rate of qualifiers 0-1 [Δ: + 18.38 (24.67) vs 13.25 (19.13), < .001] than Home group.
Disability measured with the "Respiratory ICF Maugeri core set" after PR improves in COPD patients recovering from acute exacerbation irrespective of hospitalization need. Its use an additional outcome remains to be further elucidated.KEY MESSAGESRoutine implementation of an ICF set for chronic respiratory diseases can enhance a patient-centered approach in rehabilitation for different severity conditions.Pulmonary rehabilitation (PR) seems to improve global disability measured with the Respiratory ICF Maugeri core set in COPD patients recovering from acute exacerbation irrespective of hospitalization need, suggesting the use of ICF set as additional PR outcome.The description, through the ICF language, of rehabilitative needs of patients, coming "from-Home" and "from-Hospital" settings, could help staff and instrument organization.
比较患有慢性阻塞性肺疾病（COPD）并在急性加重期接受和未接受住院治疗后接受肺康复（PR）的患者，使用呼吸 ICF Maugeri 核心集测量的残疾变化。
所有因康复而入住 9 个呼吸科病房（2019 年 1 月至 8 月）的 COPD 住院患者均被认为符合条件。共纳入 2066 例患者（540 例从急性医院出院=医院组，1526 例从家中出院=家庭组）。医疗保健专业人员在数字化图表中填写了呼吸 ICF Maugeri 核心集（26 项），在入院和出院时评估 ICF 类别。
与家庭组相比，医院组基线时更严重的 ICF 定性分布更高（<.001）。康复后，所有患者-无论是否需要住院治疗-统计上都降低了更高的 ICF 定性的比率（<.0001）。与家庭组相比，医院组改善了更高的定性比率（Δ：-21.32（22.41）与-15.48（17.32），<.001）和定性比率 0-1（Δ：+18.38（24.67）与 13.25（19.13），<.001）。
接受 PR 治疗后，从急性加重中恢复的 COPD 患者使用“呼吸 ICF Maugeri 核心集”测量的残疾状况得到改善，无论其住院需求如何。其作为额外结果的使用仍有待进一步阐明。
为慢性呼吸系统疾病实施 ICF 集可以增强康复治疗中不同严重程度条件下的以患者为中心的方法。肺康复（PR）似乎可以改善从急性加重中恢复的 COPD 患者的整体残疾状况，无论其是否需要住院治疗，这表明使用 ICF 集作为 PR 的额外结果。通过 ICF 语言描述来自“家庭”和“医院”环境的患者康复需求，可以帮助工作人员和仪器组织。
