Department of Rehabilitation Medicine, University of Washington, Seattle, Washington.
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington.
Arch Phys Med Rehabil. 2022 Aug;103(8):1684-1692. doi: 10.1016/j.apmr.2022.02.016. Epub 2022 Mar 17.
Conducting high-quality clinical research is dependent on merging scientific rigor with the clinical environment. This is often a complex endeavor that may include numerous barriers and competing interests. Overcoming these challenges and successfully integrating clinical research programs into clinical practice settings serving rehabilitation outpatients is beneficial from both a logistical perspective (eg, supports efficient and successful research procedures) and the establishment of a truly patient-centered research approach. Leveraging our experience with navigating this research-clinical care relationship, this article (1) proposes the Patient-Centered Framework for Rehabilitation Research, a model for integrating patient-centered research in an outpatient clinical setting that incorporates a collaborative, team-based model encompassing patient-centered values, as well as strategies for recruitment and retention, with a focus on populations living with disabilities or chronic diseases; (2) describes application of this framework in a comprehensive specialty multiple sclerosis center with both general strategies and specific examples to guide adaptation and implementation in other settings; and (3) discusses the effect of the framework as a model in 1 center, as well as the need for additional investigation and adaptation for other populations. The 5 interconnected principles incorporated in the Framework and which prioritize patient-centeredness include identifying shared values, partnering with the clinical setting, engaging with the population, building relationships with individuals, and designing accessible procedures. The Patient-Centered Framework for Rehabilitation Research is a model presented as an adaptable roadmap to guide researchers in hopes of not only improving individual patients' experiences but also the quality and relevance of rehabilitation research as a whole. Future investigation is needed to test the Framework in other settings.
开展高质量的临床研究取决于将科学严谨性与临床环境相结合。这通常是一项复杂的任务,可能包括许多障碍和利益冲突。克服这些挑战,并成功地将临床研究项目整合到为康复门诊患者服务的临床实践环境中,从逻辑角度(例如,支持高效和成功的研究程序)和建立真正以患者为中心的研究方法的角度来看都是有益的。利用我们在这一研究-临床护理关系方面的经验,本文(1)提出了以患者为中心的康复研究框架,该框架是将以患者为中心的研究整合到门诊临床环境中的模型,采用了协作的、以团队为基础的模式,包含以患者为中心的价值观,以及招募和保留策略,重点是患有残疾或慢性病的人群;(2)描述了该框架在一个综合性的多发性硬化症专业中心的应用,包括一般策略和具体示例,以指导在其他环境中的适应和实施;(3)讨论了该框架作为一个模型在一个中心的效果,以及在其他人群中进行额外调查和适应的必要性。该框架包含的 5 个相互关联的原则,优先考虑以患者为中心,包括确定共同价值观、与临床环境合作、与人群接触、与个人建立关系以及设计可访问的程序。以患者为中心的康复研究框架是一个可适应的路线图模型,旨在为研究人员提供指导,希望不仅能改善患者的个体体验,还能提高整个康复研究的质量和相关性。需要进一步的研究来检验该框架在其他环境中的适用性。