Ramires I
Serviço de Medicina Física e Reabilitação, Hospital de S. José, Lisboa.
Acta Med Port. 1997 Aug-Sep;10(8-9):557-62.
The field of action for rehabilitation is that of making use of the patient's maximum functional capacity with the purpose of adapting to life in relation to the environment. Rehabilitation must commence immediately, although it may be in different forms from the acute phase to sequelae. It is considered appropriate to call the physiatrist as soon as the neurologic condition has stabilised. A list is made of the measures to be taken for rehabilitation in the acute phase and sequelae, and the composition of the rehabilitation team is described. In what concerns location, where to rehabilitate the patient? The group of ambulatory patients should have their rehabilitation as outpatients. Our experience with house calls is briefly described. The group of patients who cannot walk, those that present an eminently motor condition, with the possibility of being able to walk, should be with their families, with transport provided to health and rehabilitation centres. The second group, with the capacity of walking within a reasonable time, especially if with multiple associated problems such as impaired communication, should be hospitalised in a rehabilitation department. The third group consists of severely handicapped patients, for whom a solution must be found that provides life with a minimum of dignity in centres or homes. From among the measures to be introduced, we point out following: acquisition of transport for patients who must travel, as outpatients, to the department; providing family doctors with complete freedom to refer their patients to rehabilitation centres.
康复的作用领域在于利用患者的最大功能能力,以便使其适应与环境相关的生活。康复必须立即开始,尽管从急性期到后遗症期其形式可能有所不同。一旦神经状况稳定,就应尽快请物理治疗师会诊。列出了急性期和后遗症期康复所需采取的措施,并描述了康复团队的组成。关于康复地点,患者应在哪里接受康复治疗?能够走动的患者群体应作为门诊病人接受康复治疗。简要介绍了我们上门服务的经验。不能行走的患者群体,即那些存在明显运动障碍但有可能恢复行走能力的患者,应与家人在一起,并提供前往健康和康复中心的交通。第二类患者,即在合理时间内能够行走的患者,尤其是那些伴有多种相关问题(如沟通障碍)的患者,应住院在康复科接受治疗。第三类患者是重度残疾患者,必须为他们找到在康复中心或家中能让其有起码尊严生活的解决办法。在需要采取的措施中,我们指出以下几点:为必须作为门诊病人前往科室就诊的患者提供交通工具;给予家庭医生将患者转介至康复中心的完全自主权。