世界卫生组织基于社区的康复矩阵在理解创伤性脊髓损伤患者社区参与服务贡献方面的新应用：一项混合方法研究。
Novel Application of the World Health Organization Community-Based Rehabilitation Matrix to Understand Services' Contributions to Community Participation for Persons With Traumatic Spinal Cord Injury: A Mixed-Methods Study.
机构信息
From the Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (SSR, SY, CH, OO, AL-S); Cumming School of Medicine, University of Calgary, Calgary, Canada (SSR); Faculty of Science, University of British Columbia, Vancouver, Canada (SY); Alberta Health Services, Edmonton, Canada (CH, KKB, AL-S); Hospital General de México "Dr. Eduardo Liceaga," México City, Mexico (IP-B); Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada (AKR-M); Spinal Cord Injury Alberta, Edmonton, Canada (RM); Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH, RC); Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH); School of Public Health, University of Alberta, Edmonton, Canada (KKB); Provincial Research Data Services, Alberta Health Services, Edmonton, Canada (JB); Alberta Health Services, Calgary, Canada (RC); Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (RC); and Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada (RK).
出版信息
Am J Phys Med Rehabil. 2023 Sep 1;102(9):815-822. doi: 10.1097/PHM.0000000000002220. Epub 2023 Feb 26.
PURPOSE
The aim of the study is to use the World Health Organization community-based rehabilitation matrix for understanding services' contributions to foster community participation for people with traumatic spinal cord injury.
METHODS
This study used a convergent mixed-methods design with a quantitative arm describing the frequency with which services contributed to 22 of the community-based rehabilitation-matrix elements and a qualitative arm involving document reviews and stakeholder interviews. Results were integrated following Onwuegbuzie and Teddlie's method (i.e., quan + QUAL).
RESULTS
Twenty of the 22 (91%) of the World Health Organization community-based rehabilitation elements were addressed by traumatic spinal cord injury services. Five types of services were identified. Integrated results showed that the strengths of traumatic spinal cord injury services were as follows: (1) comprehensiveness; (2) essential medical services publicly funded; (3) numerous social protections available; and (4) highly active community-based organizations. Identified opportunities to improve these services were as follows: (1) increase specificity for traumatic spinal cord injury and (2) increase communication and integration among services.
CONCLUSIONS
Services available for people with traumatic spinal cord injury in the province studied address most of the elements of the World Health Organization community-based rehabilitation matrix. However, lack of cohesion between services could create gaps that hinder community participation. Addressing these gaps could improve the quality of life and outcomes of people with traumatic spinal cord injury.
目的
本研究旨在利用世界卫生组织基于社区的康复矩阵，了解服务对促进创伤性脊髓损伤患者社区参与的贡献。
方法
本研究采用了汇聚式混合方法设计，其中定量部分描述了服务对社区康复矩阵的 22 个要素中的 22 个要素的贡献频率，定性部分涉及文件审查和利益相关者访谈。结果按照 Onwuegbuzie 和 Teddlie 的方法（即 quan + QUAL）进行整合。
结果
创伤性脊髓损伤服务涉及到社区康复矩阵的 22 个要素中的 20 个（91%）。确定了五种类型的服务。综合结果表明，创伤性脊髓损伤服务的优势如下：（1）全面性；（2）基本医疗服务由公共资金资助；（3）有许多可用的社会保护；（4）高度活跃的社区组织。确定了改善这些服务的机会如下：（1）增加对创伤性脊髓损伤的针对性；（2）增加服务之间的沟通和整合。
结论
在所研究的省份，为创伤性脊髓损伤患者提供的服务涵盖了世界卫生组织基于社区的康复矩阵的大部分要素。然而，服务之间缺乏凝聚力可能会造成阻碍社区参与的差距。解决这些差距可以提高创伤性脊髓损伤患者的生活质量和结果。
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