远程康复对患者康复计划依从性的影响：一项混合方法试验方案
Effects of Telerehabilitation on Patient Adherence to a Rehabilitation Plan: Protocol for a Mixed Methods Trial.
作者信息
Gaboury Isabelle, Tousignant Michel, Corriveau Hélène, Menear Matthew, Le Dorze Guylaine, Rochefort Christian, Vachon Brigitte, Rochette Annie, Gosselin Sylvie, Michaud François, Bollen Jessica, Dean Sarah
机构信息
Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada.
School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
出版信息
JMIR Res Protoc. 2021 Oct 28;10(10):e32134. doi: 10.2196/32134.
BACKGROUND
Strong evidence supports beginning stroke rehabilitation as soon as the patient's medical status has stabilized and continuing following discharge from acute care. However, adherence to rehabilitation treatments over the rehabilitation phase has been shown to be suboptimal.
OBJECTIVE
The aim of this study is to assess the impact of a telerehabilitation platform on stroke patients' adherence to a rehabilitation plan and on their level of reintegration into normal social activities, in comparison with usual care. The primary outcome is patient adherence to stroke rehabilitation (up to 12 weeks), which is hypothesized to influence reintegration into normal living. Secondary outcomes for patients include functional recovery and independence, depression, adverse events related to telerehabilitation, use of services (up to 6 months), perception of interprofessional shared decision making, and quality of services received. Interprofessional collaboration as well as quality of interprofessional shared decision making will be measured with clinicians.
METHODS
In this interrupted time series with a convergent qualitative component, rehabilitation teams will be trained to develop rehabilitation treatment plans that engage the patient and family, while taking advantage of a telerehabilitation platform to deliver the treatment. The intervention will be comprised of 220 patients who will take part in stroke telerehabilitation with an interdisciplinary group of clinicians (telerehabilitation group) versus face-to-face standard of care (control group: n=110 patients).
RESULTS
Our Research Ethics Board approved the study in June 2020. Data collection for the control group is underway, with another year planned before we begin the intervention phase.
CONCLUSIONS
This study will contribute to the minimization of both knowledge and practice gaps, while producing robust, in-depth data on the factors related to the effectiveness of telerehabilitation in a stroke rehabilitation continuum. Findings will inform best practice guidelines regarding telecare services and the provision of telerehabilitation, including recommendations for effective interdisciplinary collaboration regarding stroke rehabilitation.
TRIAL REGISTRATION
ClinicalTrials.gov NCT04440215; https://clinicaltrials.gov/ct2/show/NCT04440215.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32134.
背景
有力证据支持在患者病情稳定后尽快开始卒中康复治疗，并在急性护理出院后持续进行。然而，在整个康复阶段，患者对康复治疗的依从性一直不尽人意。
目的
本研究旨在评估远程康复平台对卒中患者康复计划依从性以及重新融入正常社会活动水平的影响，并与常规护理进行比较。主要结局是患者对卒中康复的依从性（长达12周），假设其会影响重新融入正常生活。患者的次要结局包括功能恢复和独立性、抑郁、与远程康复相关的不良事件、服务使用情况（长达6个月）、对跨专业共同决策的认知以及所接受服务的质量。将与临床医生一起衡量跨专业协作以及跨专业共同决策的质量。
方法
在这个具有收敛性定性成分的中断时间序列研究中，康复团队将接受培训，以制定让患者和家属参与的康复治疗计划，同时利用远程康复平台提供治疗。干预措施将包括220名患者，他们将与一组跨学科临床医生一起参与卒中远程康复（远程康复组），而另一组为面对面标准护理（对照组：n = 110名患者）。
结果
我们的研究伦理委员会于2020年6月批准了该研究。对照组的数据收集正在进行中，计划在开始干预阶段前再进行一年的收集。
结论
本研究将有助于最大限度地减少知识和实践差距，同时生成关于远程康复在卒中康复连续过程中有效性相关因素的有力、深入数据。研究结果将为远程护理服务和远程康复提供的最佳实践指南提供信息，包括关于卒中康复有效跨学科协作的建议。
试验注册
ClinicalTrials.gov NCT04440215；https://clinicaltrials.gov/ct2/show/NCT04440215。
国际注册报告识别码（IRRID）：DERR1-10.2196/32134。
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