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以患者为中心的康复模式:基于文献的范围综述和主题分析构建以患者为中心的成人物理康复概念与实践

Person-Centered Rehabilitation Model: Framing the Concept and Practice of Person-Centered Adult Physical Rehabilitation Based on a Scoping Review and Thematic Analysis of the Literature.

作者信息

Jesus Tiago S, Papadimitriou Christina, Bright Felicity A, Kayes Nicola M, Pinho Cátia S, Cott Cheryl A

机构信息

Global Health and Tropical Medicine (GHTM) & WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal.

School of Health Sciences, Oakland University, Rochester, MI.

出版信息

Arch Phys Med Rehabil. 2022 Jan;103(1):106-120. doi: 10.1016/j.apmr.2021.05.005. Epub 2021 Jul 3.

Abstract

OBJECTIVE

To develop a cross-professional model framing the concept and practice of person-centered rehabilitation (PCR) in adult populations, based on a scoping review and thematic analysis of the literature.

DATA SOURCES

Key databases (PubMed, Scopus, Cumulative Index to Nursing and Allied Health), snowballing searches, and experts' consultation were the data sources for English-language empirical or conceptual articles published from January 2007-February 2020.

STUDY SELECTION

Two independent reviewers selected adult-based articles addressing at least 1 of the 6 categories of PCR-related content, a priori specified in the published review protocol. From 6527 unique references, 147 were finally included in the analysis. Of those, 26 were exclusively conceptual articles.

DATA EXTRACTION

Two independent reviewers extracted textual data on what PCR entails conceptually or as a practice. No quality appraisals were performed as is typical in scoping reviews.

DATA SYNTHESIS

A thematic analysis produced thematic categories that were combined into an emergent model (the PCR Model), which was reviewed by 5 external experts. PCR was framed as a way of thinking about and providing rehabilitation services "with" the person. PCR is embedded in rehabilitation structures and practice across 3 levels: (1) the person-professional dyad; (2) the microsystem level (typically an interprofessional team, involving significant others); and (3) a macrosystem level (organization within which rehabilitation is delivered). Thematic categories are articulated within each level, detailing both the conceptual and practice attributes of PCR.

CONCLUSIONS

The PCR Model can inform both clinical and service organization practices. The PCR Model may benefit from further developments including obtaining wider stakeholders' input, determining relevance in different cultural and linguistic groups, and further operationalization and testing in implementation projects.

摘要

目的

基于对文献的范围综述和主题分析,构建一个跨专业模型,阐述成人群体中以患者为中心的康复(PCR)的概念与实践。

数据来源

关键数据库(PubMed、Scopus、护理及相关健康累积索引)、滚雪球式检索以及专家咨询,作为2007年1月至2020年2月发表的英文实证或概念性文章的数据来源。

研究选择

两名独立评审员选择以成人为基础的文章,这些文章涉及已发表的综述方案中预先指定的PCR相关内容的6个类别中的至少1个类别。从6527篇独特参考文献中,最终有147篇被纳入分析。其中,26篇为纯概念性文章。

数据提取

两名独立评审员提取关于PCR在概念上或实践中所包含内容的文本数据。如同范围综述中的典型做法,未进行质量评估。

数据综合

主题分析产生了主题类别,这些类别被整合到一个新出现的模型(PCR模型)中,该模型由5名外部专家进行了评审。PCR被构建为一种与患者“一起”思考和提供康复服务的方式。PCR嵌入于三个层面的康复结构和实践中:(1)患者 - 专业人员二元组;(2)微观系统层面(通常是一个跨专业团队,涉及重要他人);(3)宏观系统层面(提供康复服务的组织)。每个层面都阐述了主题类别,详细说明了PCR的概念和实践属性。

结论

PCR模型可为临床和服务组织实践提供参考。PCR模型可能会从进一步的发展中受益,包括获得更广泛利益相关者的投入、确定在不同文化和语言群体中的相关性,以及在实施项目中进一步进行操作化和测试。

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