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采用小组流程促进下肢截肢后的手动轮椅技能:嵌套混合方法初步研究。

Facilitating manual wheelchair skills following lower limb amputation using a group process: A nested mixed methods pilot study.

机构信息

Central Adelaide Local Health Network, Department of Health and Wellbeing, South Australian Government, Hampstead Rehabilitation Centre, Lightsview, South Australia, Australia.

Allied Health Science and Human Practice, The University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Aust Occup Ther J. 2021 Dec;68(6):490-503. doi: 10.1111/1440-1630.12759. Epub 2021 Jul 28.

Abstract

INTRODUCTION

The manual wheelchair skills training programme is used to structure teaching manual wheelchair use for people following injury or disability. This pilot study aimed to explore the outcomes of introducing a group wheelchair skills training programme on skill performance, confidence and frequency of wheelchair use for people with lower limb amputation in a rehabilitation setting from the perspective of participants and group facilitators.

METHOD

This pilot study used a two-phase mixed methods nested design. Eleven people with lower limb amputations received a minimum of two 45-min wheelchair skills sessions, using the Wheelchair Skills Training Program, delivered in a mix of group and one-to-one sessions. In phase one, wheelchair skill performance, confidence and frequency were measured using the Wheelchair Skills Test Questionnaire-Version 5.0, goal achievement was measured through the Functional Independence Measure and Goal Attainment Scale. These measures were repeated in phase two. Nested within phase two was qualitative data collection. Interviews were conducted with eight participants and a focus group held with three programme facilitators, to gather their perceptions of the training process. Descriptive statistics were used to analyse and report quantitative data and thematic analysis was used to combine qualitative data from the two participant groups.

RESULTS

Post intervention, the mean Wheelchair Skills Test Questionnaire score increased in performance (42.3 ± 13.4), confidence (33.9 ± 20.7) and frequency (33.9 ± 27.3). Goal Attainment was achieved or exceeded by 91% of all participants. Four themes were developed from qualitative data including, "motivators driving learning," "delivery methods, structure and profile of the Wheelchair Skills Training Program," "managing risk and safety" and "confidence in wheelchair use."

CONCLUSIONS

The pilot study found that The Wheelchair Skills Training Program can improve wheelchair performance, confidence and frequency to support enhanced safety, independence and quality of life for people with lower limb amputations.

摘要

简介

手动轮椅技能培训计划用于为受伤或残疾后使用手动轮椅的人提供结构化教学。这项初步研究旨在从参与者和小组导师的角度探讨在康复环境中引入小组轮椅技能培训计划对下肢截肢者的技能表现、信心和轮椅使用频率的影响。

方法

本初步研究采用两阶段混合方法嵌套设计。11 名下肢截肢者接受了至少 2 次 45 分钟的轮椅技能课程,使用轮椅技能培训计划,以小组和一对一的混合形式进行。在第一阶段,使用轮椅技能测试问卷第 5.0 版测量轮椅技能表现、信心和频率,使用功能独立性测量和目标实现量表测量目标的实现。在第二阶段重复了这些测量。第二阶段内嵌套了定性数据收集。对 8 名参与者进行了访谈,并与 3 名方案导师举行了焦点小组会议,以了解他们对培训过程的看法。使用描述性统计分析和报告定量数据,并使用主题分析将来自两个参与者群体的定性数据结合起来。

结果

干预后,轮椅技能测试问卷的平均得分在表现(42.3±13.4)、信心(33.9±20.7)和频率(33.9±27.3)方面均有所提高。所有参与者中 91%的目标都得到了实现或超过。从定性数据中得出了四个主题,包括“推动学习的动机”、“轮椅技能培训计划的交付方法、结构和概况”、“管理风险和安全”以及“对轮椅使用的信心”。

结论

初步研究发现,轮椅技能培训计划可以提高轮椅的性能、信心和频率,以支持提高下肢截肢者的安全性、独立性和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dfa/9290744/f1e1613f7cbb/AOT-68-490-g002.jpg

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