Carey R G, Posavac E J
Arch Phys Med Rehabil. 1978 Jul;59(7):330-7.
Rehabilitation units must meet the increasing demand for empirical documentation of the quality of care patients receive. Hospitals wanting to do program evaluations will find few published materials providing norms by which to judge the adequacy of the functional outcomes achieved by their rehabilitation patients. The purpose of this research was to develop an approach to program evaluation that would serve the accreditation needs and would be relatively inexpensive to implement. Sixty-nine consecutive admissions for cerebral vascular accidents (CVA) were assessed on activities of daily living (ADL) and cognition using a behaviorally defined procedure called the "Level of Rehabilitation Scale" that was developed for program evaluation purposes. Nurses and spouses of patients were interviewed to obtain the observations that were rated. Further ratings on ADL and cognition were made at discharge. Those at home 6 weeks and 4 1/2 months after discharge were assessed on the same scales and on home-relevant activities. Experience with the instrument showed that ratings of function can be made in a reliable and valid fashion. The research provides the beginning of the accumulation of improvement norms for CVA inpatients and documents maintenance of improvement 4 1/2 months after discharge. Hospitals and rehabilitation units can utilize these norms and this method of program evaluation economically using nonclinically trained staff.
康复科室必须满足对患者所接受护理质量进行实证记录的日益增长的需求。想要进行项目评估的医院会发现，几乎没有已发表的资料提供规范，用以判断其康复患者所取得的功能结果是否充分。本研究的目的是开发一种项目评估方法，该方法既能满足认证需求，实施成本又相对较低。使用一种为项目评估目的而开发的名为“康复水平量表”的行为定义程序，对69例连续收治的脑血管意外（CVA）患者的日常生活活动（ADL）和认知能力进行了评估。对患者的护士和配偶进行了访谈，以获取被评分的观察结果。出院时对ADL和认知能力进行了进一步评分。在出院后6周和4个半月在家中的患者，使用相同的量表以及与家庭相关的活动进行了评估。使用该工具的经验表明，可以以可靠且有效的方式进行功能评分。该研究为CVA住院患者积累改善规范提供了开端，并记录了出院后4个半月的改善维持情况。医院和康复科室可以利用这些规范以及这种项目评估方法，让未经临床培训的工作人员经济高效地开展工作。
