Lehmann J F, DeLisa J A, Warren C G, deLateur B J, Bryant P L, Nicholson C G
Arch Phys Med Rehabil. 1978 Sep;59(9):410-9.
A sample of 805 cancer patients, comparable to but not identical with a national study, was screened to identify: rehabilitation problems encountered at different cancer sites; the need for rehabilitation services; and gaps in the delivery of rehabilitation care. Significant numbers of rehabilitation problems were found that could be improved by rehabilitation care. Psychologic problems were commonly encountered and seemed more severe in patients with physical disabilities; these patients have to make adjustments to both life-threatening disease and to a disabling condition. The findings suggest a need for psychosocial support services on any oncology service; where cancer is associated with significant physical disability, a comprehensive rehabilitation team with psychologic management capability is often needed. Primary barriers to optimal delivery of rehabilitation care are the lack of identification of patient problems and/or lack of appropriate referral by physicians unfamiliar with the concept of rehabilitation. Health care financial support for the patients in the sample came primarily from private insurance, Medicare and Medicaid; financial support from the patient's family held up well even in the advanced stages of the disease. A model of rehabilitation care delivery was established and implemented, with the result being that gaps and barriers to rehabilitation service delivery disappeared rapidly.
对805名癌症患者进行了抽样筛查，该样本与一项全国性研究具有可比性但不完全相同，旨在确定：不同癌症部位所遇到的康复问题；对康复服务的需求；以及康复护理提供方面的差距。发现了大量可通过康复护理改善的康复问题。心理问题普遍存在，且在身体残疾患者中似乎更为严重；这些患者既要应对危及生命的疾病，又要适应残疾状况。研究结果表明，任何肿瘤治疗服务都需要心理社会支持服务；在癌症伴有严重身体残疾的情况下，通常需要一个具备心理管理能力的综合康复团队。康复护理最佳提供的主要障碍是缺乏对患者问题的识别和/或不熟悉康复概念的医生缺乏适当转诊。样本中患者的医疗保健资金支持主要来自私人保险、医疗保险和医疗补助；即使在疾病晚期，患者家庭的经济支持也保持良好。建立并实施了一种康复护理提供模式，结果是康复服务提供方面的差距和障碍迅速消失。
