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在因肺炎住院且存在活动受限(包括移动和自我护理任务)的患者中确定了五个功能类别。

Five Functional Classes Identified Among Patients Hospitalized for Pneumonia Characterized by Activity Limitations With Mobility and Self-Care Tasks.

作者信息

Edelstein Jessica, Kinney Adam R, Hoffman Amanda, Graham James E, Malcolm Matthew P

机构信息

Department of Occupational Therapy, Colorado State University, Fort Collins, CO.

Veterns Affairs Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) for Suicide Prevention, Aurora, CO.

出版信息

Arch Rehabil Res Clin Transl. 2024 Jan 26;6(1):100323. doi: 10.1016/j.arrct.2024.100323. eCollection 2024 Mar.

Abstract

OBJECTIVE

Latent class analysis was used to identify functional classes among patients hospitalized for pneumonia. Then, we determined predictors of class membership and examined variation in distal outcomes among the functional classes.

DESIGN

An observational, cross-sectional study design was used with retrospectively collected data between 2014 and 2018.

SETTING

The study setting was a single health system including 5 acute care hospitals.

PARTICIPANTS

A total of 969 individuals hospitalized with the primary diagnosis of pneumonia and receipt of an occupational and/or physical therapy evaluation were included in the study.

INTERVENTIONS

Not applicable.

MAIN OUTCOMES

The following 5 distal outcomes were examined: (1) occupational therapy treatment use, (2) physical therapy treatment use, (3) discharge to home with no services, (4) discharge to home with home health, and (5) institutional discharge.

RESULTS

Five functional classes were identified and labeled as follows: and . Probability of occupational therapy treatment use (χ[4]=50.26, <.001) and physical therapy treatment use (χ[4]=50.86, <.001) varied significantly across classes. The class had the greatest probability of occupational therapy treatment use and physical therapy treatment use. Probability of discharging to home without services (yes/no; χ[4]=88.861, <.001), home with home health (yes/no; χ[4]=15.895, =.003), and an institution (yes/no; χ[4]=102.013, <.001) varied significantly across the 5 classes. The class had the greatest probability of discharging to home without services.

CONCLUSIONS

Five functional classes were identified among individuals hospitalized for pneumonia. Functional classes could be used by the multidisciplinary team in the hospital as a framework to organize the heterogeneity of functional deficits after pneumonia, improve efficiency of care processes, and help deliver targeted rehabilitation treatment.

摘要

目的

采用潜在类别分析确定因肺炎住院患者的功能类别。然后,我们确定了类别归属的预测因素,并研究了各功能类别中远期结局的差异。

设计

采用观察性横断面研究设计,回顾性收集2014年至2018年的数据。

设置

研究设置为一个包含5家急症护理医院的单一卫生系统。

参与者

共有969名以肺炎为主要诊断并接受职业和/或物理治疗评估的住院患者纳入研究。

干预措施

不适用。

主要结局

检查了以下5个远期结局:(1)职业治疗的使用情况,(2)物理治疗的使用情况,(3)无服务出院回家,(4)有家庭健康服务出院回家,(5)机构出院。

结果

确定了5个功能类别并标记如下: 和 。职业治疗使用概率(χ[4]=50.26,<.001)和物理治疗使用概率(χ[4]=50.86,<.001)在各类别间差异显著。 类别的职业治疗使用概率和物理治疗使用概率最高。无服务出院回家(是/否;χ[4]=88.861,<.001)、有家庭健康服务出院回家(是/否;χ[4]=15.895,=.003)以及机构出院(是/否;χ[4]=102.013,<.001)的概率在这5个类别间差异显著。 类别的无服务出院回家概率最高。

结论

在因肺炎住院的患者中确定了5个功能类别。医院的多学科团队可将功能类别作为一个框架,用于梳理肺炎后功能缺陷的异质性、提高护理流程效率并帮助提供有针对性的康复治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10928279/cf1b9ed8972a/gr1.jpg

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