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风湿和肌肉骨骼疾病患者康复中的随访护理和自我管理活动依从性:一项多中心队列研究的结果。

Follow-up care and adherence to self-management activities in rehabilitation for patients with rheumatic and musculoskeletal diseases: results from a multicentre cohort study.

机构信息

Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

Regional Center for Knowledge Translation in Rehabilitation, Sunnaas Hospital, Oslo, Norway.

出版信息

Disabil Rehabil. 2022 Dec;44(25):8001-8010. doi: 10.1080/09638288.2021.2008523. Epub 2021 Nov 30.

Abstract

PURPOSE

Follow-up care (FU-care) and self-management are recognized as important to ensure prolonged effects of rehabilitation. Objectives of this study were to explore current FU-care and self-management after specialized rehabilitation for patients with rheumatic and musculoskeletal diseases.

MATERIALS AND METHODS

This multicentre cohort study included 523 patients who self-reported need and plans for FU-care and plans for self-management activities (SMAs) at rehabilitation discharge. The FU-care received and adherence to SMA were self-reported after 4-, 8-, and 12-months. Predictors for received FU-care and adherence to SMA were explored in multiple logistic regression models.

RESULTS

Plans for FU-care were significantly associated with received FU-care. Younger age, better coping skills, and performing regular social activities and hobbies were significant predictors for received FU-care. Throughout the follow-up year, 221 (51%) participants had adherence to their SMA plans. Older age, regular physical activity, more severe pain, and performing regular social activities and hobbies were significant predictors for adherence to SMA. Participants with SMA adherence more often reported planned FU-care, and more frequently received the FU-care they needed.

CONCLUSIONS

Planning FU-care should be integrated in specialized rehabilitation. Patients with poor coping skills and sedentary lifestyle may need more support over longer time to implement behavioral changes for healthy self-management.Implications for rehabilitationPlanning follow-up should be integrated in specialized rehabilitation as it supports self-management and receiving follow-up at home.Patients with sedentary lifestyle, poor coping skills, and depression may need more support over longer time to implement healthy self-management.Structure and routines in daily life enhance self-management.

摘要

目的

随访护理(FU-care)和自我管理被认为对确保康复效果的持久至关重要。本研究的目的是探讨风湿和肌肉骨骼疾病患者在专门康复治疗后的 FU-care 和自我管理活动(SMAs)的现状。

材料和方法

这项多中心队列研究纳入了 523 名自我报告在康复出院时有 FU-care 需求和计划以及 SMA 计划的患者。在 4、8 和 12 个月后,自我报告了所接受的 FU-care 和 SMA 的依从性。在多项逻辑回归模型中探讨了接受 FU-care 和 SMA 依从性的预测因素。

结果

FU-care 计划与接受 FU-care 显著相关。年龄较小、应对能力较好、定期参加社会活动和爱好是接受 FU-care 的显著预测因素。在整个随访年中,221 名(51%)参与者遵守了他们的 SMA 计划。年龄较大、定期进行体育锻炼、疼痛更严重、定期参加社会活动和爱好是 SMA 依从性的显著预测因素。遵守 SMA 计划的参与者更常报告计划的 FU-care,并更常接受他们所需的 FU-care。

结论

应将 FU-care 计划纳入专门的康复治疗中。应对能力差和久坐不动的生活方式的患者可能需要更长时间的支持,以实施健康的自我管理行为改变。

康复意义

应将随访计划纳入专门的康复治疗中,以支持自我管理和在家中接受随访。生活方式久坐、应对能力差和抑郁的患者可能需要更长时间的支持,以实施健康的自我管理。日常生活中的结构和常规增强了自我管理。

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