Wong Mabel Ngai-Kiu, Tong Horace, Cheung Mike Kwun-Ting, Ng Yuk-Mun, Yuan Huan-Ling, Lam Bess Yin-Hung, Fu Siu Ngor, Chan Chetwyn Che Hin
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China.
Front Rehabil Sci. 2023 Aug 4;4:1219662. doi: 10.3389/fresc.2023.1219662. eCollection 2023.
Body functions and structures, activities, and participation are the core components in the International Classification of Functioning, Disability, and Health (ICF) to identify post-stroke patients' health conditions. The specification of health conditions enhances the outcomes of post-stroke rehabilitation.
This study aimed to explore the extent and the processes in an ICF-based post-stroke rehabilitation program (ICF-PSRP) that could enhance patients' community reintegration level.
Post-stroke patients who completed the ICF-PSRP participated in intake and pre-discharge individual face-to-face semi-structured interviews. In addition, case therapists were invited to a face-to-face semi-structured group interview. Clinician experts were invited to complete an interview with the same interview contents as case therapists but in an online format. All interview recordings were analyzed with the Framework analysis. Patients' treatment goals were mapped with the ICF Core Set for Stroke.
Out of 37 invited post-stroke patients, thirty-three of them completed the interview. Three case therapists and five clinicians completed the interviews. The goals set by the patients and their caregivers showed a broadening of their scope over the course of the program. The changes in scope ranged from the activities to the participation and environmental components. Increases in patient-therapist interactions played an essential role in the goal-setting process, which were integral to personalizing the treatment content. These characteristics were perceived by all parties who contributed to the program outcomes.
The application of ICF's principles and core components offers a useful framework for enhancing post-stroke patients' community reintegration level. Future studies should explore the way in which patient-therapist interaction, exposure to environmental factors, and personalized interventions maximize the benefits of applying this framework to the community integration of post-stroke patients.
身体功能与结构、活动及参与是《国际功能、残疾和健康分类》（ICF）中用于确定中风后患者健康状况的核心要素。明确健康状况可提高中风后康复的效果。
本研究旨在探讨基于ICF的中风后康复计划（ICF - PSRP）在提高患者社区重新融入水平方面的程度和过程。
完成ICF - PSRP的中风后患者参与了入院时和出院前的个人面对面半结构化访谈。此外，邀请个案治疗师参加面对面半结构化小组访谈。邀请临床专家以与个案治疗师相同的访谈内容进行在线访谈。所有访谈录音均采用框架分析法进行分析。患者的治疗目标根据中风的ICF核心集进行映射。
在37名受邀的中风后患者中，33人完成了访谈。3名个案治疗师和5名临床医生完成了访谈。患者及其照顾者设定的目标在计划过程中显示出范围的扩大。范围的变化从活动到参与和环境要素。患者与治疗师互动的增加在目标设定过程中起着至关重要的作用，这对于使治疗内容个性化不可或缺。所有对项目结果有贡献的各方都认识到了这些特点。
ICF原则和核心要素的应用为提高中风后患者的社区重新融入水平提供了一个有用的框架。未来的研究应探索患者与治疗师互动、接触环境因素以及个性化干预如何最大限度地发挥将该框架应用于中风后患者社区融入的益处。
