Bradley Gemma, Baker Katherine, Bailey Catherine
Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
Br J Occup Ther. 2022 Mar;85(3):199-207. doi: 10.1177/03080226211011386. Epub 2021 May 5.
Evaluations of rehabilitation potential are an everyday occurrence, yet the concept is poorly understood and there is a lack of understanding about the reasoning process. This study aimed to explore how occupational therapists and physiotherapists evaluated the rehabilitation potential of older people following an acute hospital admission.
Focused ethnography was utilised, primarily using observation, interviewing and review of records within one acute medical ward in a general hospital in the United Kingdom. Five patient participants gave consent for their episode of care to be studied, for interactions with professionals to be observed and for their clinical records to be reviewed. Three occupational therapists and two physiotherapists then participated in individual interviews.
Thematic analysis of data led to the identification of a four-stage reasoning process. The four stages are as follows: gathering baseline information; provision of curative and supportive interventions; provision and monitoring of rehabilitative interventions; the evaluation of rehabilitation potential and decision about the subsequent pathway.
The reasoning process illustrates the professional reasoning of occupational therapists and physiotherapists when evaluating rehabilitation potential for older adults in acute care. However, it also highlights vulnerabilities to professional reasoning which may contribute to subjectivity, inconsistency or risk to patients.
对康复潜力的评估是日常工作，但这一概念却鲜为人知，人们对其推理过程也缺乏了解。本研究旨在探讨职业治疗师和物理治疗师如何评估老年患者急性入院后的康复潜力。
采用聚焦人种志研究方法，主要通过观察、访谈以及查阅英国一家综合医院一个急性内科病房的病历记录。五名患者同意对其治疗过程进行研究，观察他们与专业人员的互动，并查阅其临床记录。随后，三名职业治疗师和两名物理治疗师参与了个人访谈。
对数据进行主题分析后，确定了一个四阶段推理过程。这四个阶段如下：收集基线信息；提供治疗性和支持性干预措施；提供并监测康复干预措施；评估康复潜力并决定后续治疗途径。
该推理过程展示了职业治疗师和物理治疗师在评估急性护理中老年患者康复潜力时的专业推理。然而，它也凸显了专业推理中可能导致主观性、不一致性或给患者带来风险的薄弱环节。
