Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Regional Center for Knowledge Translation in Rehabilitation, Sunnaas Hospital, Oslo, Norway.
Disabil Rehabil. 2022 Dec;44(25):7947-7957. doi: 10.1080/09638288.2021.2003879. Epub 2021 Dec 2.
We explored the content and attainment of rehabilitation goals the first year after rehabilitation among patients with rheumatic and musculoskeletal diseases.
Participants ( = 523) recorded goals in the Patient Specific Functional Scale at admission and reported goal attainment at admission, discharge, and 12 months after rehabilitation on an 11-point numeric rating scale. Goal content was linked to the ICF coding system and summarized as high, maintained, or no attainment. Changes in absolute scores were investigated using paired samples t-tests.
Goals had high attainment with a significant positive change (-1.83 [95% CI -2.0, -1.65], > 0.001) during rehabilitation, whereas goals had no attainment with a significant negative change (0.36 [0.14, 0.57], > 0.001) between discharge and 12 months after rehabilitation. Goals focusing on everyday routines, physical health, pain management, and social or work participation were highly attained during rehabilitation. Goals that were difficult to enhance or maintain after rehabilitation addressed everyday routines, physical health, and work participation.
The positive changes in goal attainment largely occurred during rehabilitation, but they appeared more difficult to maintain at home. Therefore, rehabilitation goals should be reflected in the follow-up care planned at discharge.Implications for rehabilitationThe contents of rehabilitation goals reflect the complexity and wide range of challenges patients with rheumatic and musculoskeletal diseases experience.Positive changes in goal attainment largely occur during rehabilitation and appear to be more difficult to enhance or maintain at home.Rehabilitation interventions and follow-up care should be tailored to support patients in maintaining their attained goals for healthy self-management.Rehabilitation goals should be reflected in the follow-up care planned at discharge.
本研究旨在探讨风湿性和肌肉骨骼疾病患者康复后第一年的康复目标内容和达成情况。
参与者(n=523)在入院时使用患者特定功能量表记录目标,并在入院、出院和康复后 12 个月时使用 11 点数字评分量表报告目标达成情况。目标内容与国际功能、残疾和健康分类(ICF)编码系统相关联,并总结为高度达成、维持或未达成。使用配对样本 t 检验研究绝对评分的变化。
康复期间,目标达成度较高,且具有显著的积极变化(-1.83 [95%置信区间 -2.0,-1.65], > 0.001),而出院至康复后 12 个月期间,目标达成度较低,具有显著的消极变化(0.36 [0.14,0.57], > 0.001)。康复期间,日常生活、身体健康、疼痛管理和社会或工作参与等方面的目标高度达成。而那些在康复后难以增强或维持的目标则涉及日常生活、身体健康和工作参与。
目标达成的积极变化主要发生在康复期间,但在家中似乎更难维持。因此,康复目标应反映在出院时计划的随访护理中。
康复目标的内容反映了风湿性和肌肉骨骼疾病患者所经历的复杂性和广泛挑战。目标达成的积极变化主要发生在康复期间,但在家中似乎更难增强或维持。康复干预和随访护理应根据患者的情况进行定制,以支持他们维持健康自我管理方面的已达成目标。康复目标应反映在出院时计划的随访护理中。