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基于社区的初级医疗保健中风康复训练计划的评估

Evaluation of a stroke rehabilitation training programme for community-based primary healthcare.

作者信息

Scheffler Elsje, Mash Robert

机构信息

Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Centre for Disability and Rehabilitation Studies, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

Afr J Disabil. 2023 Sep 8;12:1137. doi: 10.4102/ajod.v12i0.1137. eCollection 2023.

Abstract

BACKGROUND

Family caregiver training is an integral part of stroke rehabilitation programmes and is associated with improved caregiver and stroke survivor outcomes. In the Cape Winelands District, a low-resourced rural community-based setting in South Africa, stroke survivors and family caregivers mostly rely on assistance from community health workers (CHWs), despite their lack of stroke-specific rehabilitation training.

OBJECTIVES

To evaluate the implementation and immediate effects of a bespoke, 16 session, 21 h stroke rehabilitation training programme for CHWs to better support family caregivers.

METHODS

Two cooperative inquiry groups participated in participatory action research to design and develop the programme. This article reports on the implementation of this programme. Inquiry group members directly observed the training, obtained written and verbal feedback, interviewed CHWs and observed them in the community. Consensus on their learning was achieved after reflection on their experience and observations.

RESULTS

Learning of the cooperative inquiry groups was categorised into the effect on community-based care, the training programme's design and development, how training was delivered and implications for service delivery. Community health workers empowered caregivers and stroke survivors and enabled access to care, continuity, coordination and person-centredness. The need for experiential learning and a spiral curriculum was confirmed. Therapists needed a different set of skills to deliver training. A systems approach and effective leadership were needed to enable community health workers to use their new skills.

CONCLUSION

The stroke rehabilitation training programme demonstrated potential for integration into service delivery and equipping CHWs to support family caregivers and stroke survivors. Further evaluation of the programme's effectiveness and scale-up is needed.

CONTRIBUTION

Evidence of an intervention to train CHWs to support stroke survivors and family caregivers.

摘要

背景

家庭照顾者培训是中风康复计划的一个组成部分,与改善照顾者和中风幸存者的结局相关。在南非资源匮乏的农村社区温嫩堡地区,中风幸存者和家庭照顾者大多依赖社区卫生工作者(CHW)的帮助,尽管这些社区卫生工作者缺乏针对中风的康复培训。

目的

评估一项为社区卫生工作者量身定制的、为期16节、共21小时的中风康复培训计划的实施情况及即时效果,以更好地支持家庭照顾者。

方法

两个合作探究小组参与了参与式行动研究,以设计和开发该计划。本文报告该计划的实施情况。探究小组成员直接观察培训过程,获取书面和口头反馈,采访社区卫生工作者并在社区中观察他们。在反思他们的经验和观察结果后,就他们的学习达成了共识。

结果

合作探究小组的学习被归类为对社区护理的影响、培训计划的设计与开发、培训的交付方式以及对服务提供的影响。社区卫生工作者增强了照顾者和中风幸存者的能力,并使他们能够获得护理、连续性、协调性和以患者为中心的服务。证实了体验式学习和螺旋式课程的必要性。治疗师需要一套不同的技能来进行培训。需要采用系统方法和有效的领导,以使社区卫生工作者能够运用他们的新技能。

结论

中风康复培训计划显示出整合到服务提供中并使社区卫生工作者有能力支持家庭照顾者和中风幸存者的潜力。需要对该计划的有效性进行进一步评估并扩大规模。

贡献

关于培训社区卫生工作者以支持中风幸存者和家庭照顾者的干预措施的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcf4/10546249/3d6e6ba75226/AJOD-12-1137-g001.jpg

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