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住院康复中的患者参与:措施及不断演变的概念的范围综述

Patient engagement in inpatient rehabilitation: A scoping review of measures and evolving conceptualizations.

作者信息

Sánchez González Mayra L, Nitsch Kristian, Carnahan Nicolette, Aaron Rachel V, Hosey Megan M, Schechter Nicole

机构信息

Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine.

Department of Psychology, Shepherd Center.

出版信息

Rehabil Psychol. 2025 Jul 3. doi: 10.1037/rep0000630.

Abstract

OBJECTIVE

This scoping review aims to describe measures of patient engagement in acute inpatient rehabilitation settings, measurement approaches, and conceptualizations of patient engagement.

METHOD

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and the Joanna Briggs Scoping Review Framework, we searched seven databases-PubMed, EMBASE, Cochrane Library, CINAHL Plus, Web of Science, Scopus, and PsycInfo-from inception to May 2024. Inclusion criteria included (a) participants aged 18 or older; (b) conducted in a hospital-based acute inpatient rehabilitation program irrespective of diagnosis; (c) measured patient engagement during rehabilitation; and (d) published in English. Major search concepts included patient engagement, measures, rehabilitation, and inpatient rehabilitation settings. Two independent reviewers assessed eligibility and extracted data, resolving conflicts through consultation with a third reviewer. The initial search identified 8,320 records.

RESULTS

Of the 384 studies that underwent full-text review, 37 met inclusion criteria and reported on 10 engagement measures. The Pittsburgh Rehabilitation Participation Scale was the most frequently used, followed by therapy dosage and the Hopkins Rehabilitation Engagement Rating Scale. Most studies used an observer-rated approach. Conceptualizations of engagement varied in depth and integration of theoretical models. Although motivation was a central theme, conceptualizations have evolved, recognizing multiple factors influencing engagement.

CONCLUSION

The lack of consensus on measuring and conceptualizing patient engagement limits efforts to advance research and clinical practices to improve engagement and, ultimately, outcomes in rehabilitation. Future research could explore the clinical utility of existing measures and establish patient-centered best practices for measurement. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

本综述旨在描述急性住院康复环境中患者参与度的测量方法、测量途径以及患者参与度的概念。

方法

遵循系统评价和Meta分析的首选报告项目扩展版的范围综述指南以及乔安娜·布里格斯范围综述框架,我们检索了7个数据库——PubMed、EMBASE、Cochrane图书馆、CINAHL Plus、科学网、Scopus和PsycInfo,检索时间从建库至2024年5月。纳入标准包括:(a)年龄在18岁及以上的参与者;(b)在基于医院的急性住院康复项目中进行,无论诊断如何;(c)测量康复期间的患者参与度;(d)以英文发表。主要检索概念包括患者参与度、测量方法、康复和住院康复环境。两名独立评审员评估了研究的合格性并提取了数据,通过与第三名评审员协商解决冲突。初步检索共识别出8320条记录。

结果

在384项接受全文审查的研究中,37项符合纳入标准,并报告了10种参与度测量方法。匹兹堡康复参与量表是使用最频繁的,其次是治疗剂量和霍普金斯康复参与评定量表。大多数研究采用观察者评分法。参与度的概念在理论模型的深度和整合方面各不相同。尽管动机是一个核心主题,但概念已经有所发展,认识到影响参与度的多种因素。

结论

在测量和概念化患者参与度方面缺乏共识,限制了推进研究和临床实践以提高参与度并最终改善康复结果的努力。未来的研究可以探索现有测量方法的临床效用,并建立以患者为中心的最佳测量实践。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)

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