Dawes Erinn, Hewitt Lyndel, Bliokas Vida, Wilson Val
School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.
Illawarra Shoalhaven Local health District, Illawarra Transitional Aged Care Service, Block E Port Kembla Hospital, Warrawong, NSW 2502, Australia.
J Clin Med. 2024 Dec 4;13(23):7378. doi: 10.3390/jcm13237378.
: Cognition plays a major role in prosthetic rehabilitation success. The ability to identify patients who may have difficulty understanding and adapting to the rehabilitation process is beneficial for clinicians and patients to allow for targeted and appropriate therapy. The research aim was to codesign a process that facilitates routine cognitive screening into the amputee inpatient journey. : A convenience sample of sixteen medical and allied health practitioners from one local health district undertook a codesign process over 10 months from March to November 2023. A combination of virtual and face-to-face data collection occurred. Each of the codesign meetings was audio recorded, following which transcription occurred. Transcripts were reviewed using thematic analysis-based techniques to capture themes and consensus within the group. : Two pathways were established for use within one local health district, allowing clinicians to measure the cognition of patients in both inpatient and outpatient settings either before or after they underwent amputation. The newly established pathways provide step-by-step guidance for clinicians, such as how to address contraindicators for testing and providing guidance for subsequent neuropsychological testing. The Montreal Cognitive Assessment (MoCA), both paper based and electronic based, was selected as the cognitive screening tool for implementation. : Utilizing codesign as a method for generating a cognitive screening pathway for amputees was successful. The pathways generated should be reviewed for suitability for application in other health settings.
认知在假肢康复成功中起着重要作用。识别可能在理解和适应康复过程中存在困难的患者的能力,对临床医生和患者都有益,有助于进行有针对性的适当治疗。本研究的目的是共同设计一个流程,以便在截肢患者住院期间方便地进行常规认知筛查。
来自一个当地卫生区的16名医学和相关健康从业者组成的便利样本,在2023年3月至11月的10个月内进行了共同设计流程。采用了虚拟和面对面数据收集相结合的方式。每次共同设计会议都进行了录音,随后进行了转录。使用基于主题分析的技术对转录本进行审查,以捕捉小组内的主题和共识。
在一个当地卫生区建立了两条路径,使临床医生能够在患者截肢前后的住院和门诊环境中测量其认知能力。新建立的路径为临床医生提供了逐步指导,例如如何处理测试的禁忌证以及为后续神经心理学测试提供指导。蒙特利尔认知评估量表(MoCA),包括纸质版和电子版,被选为实施的认知筛查工具。
利用共同设计作为为截肢者生成认知筛查路径的方法是成功的。应审查生成的路径在其他卫生环境中的适用性。