Røe Cecilie, Bautz-Holter Erik, Andelic Nada, Søberg Helene Lundgaard, Nugraha Boya, Gutenbrunner Christoph, Boekel Andrea, Kirkevold Marit, Engen Grace, Lu Juan
Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
Arch Rehabil Res Clin Transl. 2022 Apr 13;4(2):100197. doi: 10.1016/j.arrct.2022.100197. eCollection 2022 Jun.
To identify factors related to the organization of rehabilitation services that may influence patients' functional outcome and make recommendations for categories to be used in the reporting of rehabilitation interventions.
A systematic review based on a search in MEDLINE indexed journals (MEDLINE [OVID], Cumulative Index of Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials) until June 2019.
In total 8587 candidate randomized controlled trials reporting on organizational factors of multidisciplinary rehabilitation interventions and their associations with functional outcome. An additional 1534 trials were identified from June 2019 to March 2021. Quality evaluation was conducted by 2 independent researchers. The organizational factors were classified according to the International Classification for Service Organization in Health-related Rehabilitation 2.0.
In total 80 articles fulfilled the inclusion criteria. There was a great heterogeneity in the terminology and reporting of service organization across all studies. Aspects of Settings including the Mode of Service Delivery was the most explicitly analyzed organizational category (44 studies). The importance of the integration of rehabilitation in the inpatient services was supported. Furthermore, several studies documented a lack of difference in outcome between outpatient vs inpatient service delivery. Patient Centeredness, Integration of Care, and Time and Intensity factors were also analyzed, but heterogeneity of interventions in these studies prohibited aggregation of results.
Settings and in particular the way the services were delivered to the users influenced functional outcome. Hence, it should be compulsory to include a standardized reporting of aspects of service delivery in clinical trials. We would also advise further standardization in the description of organizational factors in rehabilitation interventions to build knowledge of effective service organization.
确定与康复服务组织相关的、可能影响患者功能结局的因素，并为康复干预报告中使用的类别提出建议。
基于对MEDLINE索引期刊（MEDLINE [OVID]、护理及相关健康文献累积索引、PsycINFO、Cochrane对照试验中心注册库）截至2019年6月的检索进行的系统评价。
共有8587项关于多学科康复干预组织因素及其与功能结局关联的候选随机对照试验。2019年6月至2021年3月又识别出1534项试验。由2名独立研究人员进行质量评估。组织因素根据《健康相关康复服务组织国际分类2.0》进行分类。
共有80篇文章符合纳入标准。所有研究中服务组织的术语和报告存在很大异质性。包括服务提供模式在内的环境方面是分析最明确的组织类别（44项研究）。支持康复纳入住院服务的重要性。此外，多项研究记录了门诊与住院服务提供在结局上缺乏差异。还分析了以患者为中心、护理整合以及时间和强度因素，但这些研究中干预措施的异质性阻碍了结果的汇总。
环境，特别是向用户提供服务的方式，影响功能结局。因此，临床试验中应强制纳入服务提供方面的标准化报告。我们还建议进一步规范康复干预中组织因素的描述，以积累有效服务组织的知识。
