护理干预对全髋关节置换术病人功能康复及生活质量的影响

[目的]探讨护理干预对全髋关节置换术病人功能康复及生活质量的影响。[方法]将90例全髋关节置换术病人随机分为观察组和对照组各45例,对照组给予常规护理,观察组给予系统护理。记录病人术后关节引流量、离床活动时间、切口愈合时间评价临床疗效,应用髋Harris评分对病人髋关节功能评定病人功能康复情况,应用生活质量量表(SF-36)评定生活质量,比较两组病人的临床疗效及术后3个月及6个月Harris评分和SF-36评分。[结果]观察组病人术后关节引流量少于对照组,离床活动时间、切口愈合时间短于对照组(P0.05);观察组病人术后3个月Harris评分、SF-36评分优于对照组(P0.05)。[结论]全髋关节置换术病人加强系统护理干预可促进切口愈合,改善髋关节功能恢复,提高生活质量,效果优于常规护理。     

康复护理对股骨颈骨折患者全髋关节置换术后功能恢复的影响

目的探讨康复护理对行全髋关节置换术治疗的股骨颈骨折患者术后功能恢复的影响。方法选择100例行全髋关节置换术的股骨颈骨折患者,按随机数表法分为观察组和对照组各50例,对照组术后采用常规护理,观察组术后采用针对性早期康复护理,比较2组患者手术前后视觉模拟评分法(VAS)、生活质量(SF-36量表评分)、髋关节Harris评分以及临床疗效、并发症。结果 2组患者术后1周、1个月的VAS评分较手术前下降(P0.05),且观察组低于对照组(P0.05);手术1周、1个月后,2组患者SF-36量表评分较术前上升(P0.05),且观察组评分高于对照组(P0.05);术后1周、1个月、半年、1年时,2组Harris评分较术前升高(P0.05),且观察组高于对照组(P0.05);术后1年时,观察组疗效优良率92.00%高于对照组68.00%(P0.05);观察组术后并发症8.00%低于对照组28.00%(P0.05)。结论在股骨颈骨折患者全髋关节置换术后实施早期康复护理效果显著,可有效缓解疼痛,促进关节功能恢复,提高生活质量,临床应用价值高。     

阶梯式模拟居家康复训练在髋关节置换术后患者中的应用效果

目的 :评价阶梯式模拟居家康复训练在髋关节置换术(THA)患者中的应用效果。方法 :采用便利抽样法选择广州市某三级甲等医院首次行单侧全髋关节置换术患者共210例为研究对象,其中2019年4月至11月入组的105例患者设为对照组,采用常规护理及康复锻炼方法 ;2019年12月至2020年9月入组的105例患者设为观察组,在常规护理及康复锻炼基础上增加阶梯式模拟居家康复训练。随访并比较患者入院时、出院前、出院后1个月两组患者的髋关节功能评分量表(Harris Hip Score,简称Harris评分)、日常生活能力评定量表(Barthel指数)、生活质量调查表(SF-36)的评分。结果 :对照组患者入院时的Harris评分(P=0.108)、Barthel指数(P=0.055)及SF-36评分(P=0.161)和观察组比较,差异无统计学意义(P>0.05)。出院前及出院后1个月两个时间段,观察组患者的Harris评分、Barthel指数、SF-36评分均高于对照组(P<0.001)。结论 :阶梯式模拟居家康复训练能帮助患者有效掌握康复及日常生活能力训练的方法,促进关节功能恢复,...     

基于跨学科护理团队的快速康复护理对全髋关节置换患者术后康复、并发症及生活质量的影响

目的探究基于跨学科护理团队(INT)的快速康复护理(ERAS)对全髋关节置换术(THR)患者术后康复、并发症及生活质量的影响。方法选取2019年1月至2019年12月期间鄂东医疗集团黄石市中心医院骨科收治的80例THR患者为对象, 采用随机数字表法平均分为两组, 对照组40例患者在围术期进行常规护理干预, 试验组40例患者在围术期通过建立INT进行ERAS, 对比两组患者术后康复、并发症和生活质量的差异。结果干预前, 两组患者Harris评分(髋关节功能评分)和生活质量(SF-36)各维度评分对比组间差异无统计学意义(P>0.05);试验组患者术后并发症发生率明显低于对照组, 差异有统计学意义(P<0.05);试验组患者出院后3个月和6个月时的髋关节功能评分(Harris)评分均明显高于对照组, 差异有统计学意义(P<0.05);试验组患者出院后3个月生活质量各维度评分均明显高于对照组, 差异有统计学意义(P<0.05)。结论基于INT的ERAS可有效减少THR患者术后并发症发生率, 促进患者髋关节功能改善, 提升患者生活质量。     

针对性早期康复护理对全髋关节置换术患者术后恢复情况和生活质量影响研究

目的探讨针对性早期康复护理对全髋关节置换术患者术后恢复情况和生活质量影响。方法选取该院2017年5月至2018年9月行全髋关节置换术患者172例,并随机分为两组,对照组采用常规护理干预,观察组采用针对性早期康复护理治疗,比较两组患者护理后的护理效果Harris评分、日常生活能力Barthel指数评分、生活质量WHOQOL-BREF评分和并发症发生率。结果护理后,观察组的Harris评分,Barthel指数评分和WHOQOL-BREF评分均显著高于对照组,差异有统计学意义(均P<0.05),观察组并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论全髋关节置换术患者采用针对性早期康复护理可显著改善术后恢复情况,提高生活质量,减少并发症的发生,具有较高的临床护理价值。     

对人工髋关节置换术后患者实施多学科团队家庭康复指导的效果评价

目的 探讨对人工髋关节置换术后患者实施多学科团队家庭康复指导的临床效果.方法 选取行人工髋关节置换的患者80例,随机分为对照组和观察组,每组40例.对照组于患者出院时进行常规指导;观察组在对照组基础上实施多学科团队家庭康复指导.术后6个月对患者的生活质量进行评估,采用Harris髋关节评分表评价髋关节功能并评价患者及家属对护理的满意度.结果 两组患者术后6个月Harris评分与术前相比均明显升高(P＜0.05);观察组患者术后不同时间Harris评分均明显高于对照组(P＜0.05),观察组患者及家属对护理的满意度明显优于对照组(P＜0.05).结论 人工髋关节置换术后对患者实施多学科团队家庭康复指导,能够对患者的康复起到积极的作用.     

早期康复护理对老年髋关节置换术患者髋关节功能及睡眠质量的影响

目的:探究早期康复护理对老年髋关节置换术患者髋关节功能及睡眠质量的影响。方法:选取2016年8月至2019年9月厦门莲花医院收治的老年髋关节置换术患者97例作为研究对象,随机分为对照组(n=48)和观察组(n=49)。对照组进行常规护理,观察组进行早期康复护理。比较2组护理前后的睡眠质量[匹兹堡睡眠质量指数(PSQI)]、疼痛[视觉模拟评分(VAS)]、髋关节功能[Harris髋关节评分(Harris)]及生活能力[日常生活能力量表(Barthel指数)]。结果:护理后观察组的PSQI评分及VAS评分显著低于对照组,Harris评分及Barthel指数评分显著高于对照组,差异有统计学意义(P 0.05)。结论:早期康复护理干预可显著提升老年髋关节置换术患者的睡眠质量及生命质量,减轻患者疼痛,促进髋关节功能的恢复。     

精细化护理干预对股骨颈骨折行人工髋关节置换术患者的影响

目的:探讨精细化护理干预对股骨颈骨折行人工髋关节置换术患者的影响。方法:将60例股骨颈骨折行人工髋关节置换术患者根据术后护理干预方式不同分为对照组和研究组各30例,对照组给予常规护理,研究组给予精细化护理干预,比较两组护理效果。结果:研究组术后下肢深静脉血栓形成(DVT)发生率低于对照组(P0.05),髋关节疼痛情况较对照组轻(P0.05),术后1、3个月髋关节功能Harris评分高于对照组(P0.05)。两组护理后健康状况调查简表(SF-36)评分高于护理前(P0.05),研究组护理后SF-36评分高于对照组(P0.05)。结论:对股骨颈骨折行人工髋关节置换术患者实施精细化护理干预措施效果较好,可有效减轻患者关节疼痛,加速髋关节功能恢复,降低术后DVT发生风险,改善生活质量。     

快速康复护理联合康复训练卡在老年髋关节置换术后患者中的应用

目的:探讨快速康复护理联合康复训练卡在老年髋关节置换术后患者中的应用效果。方法:将2017年1月1日～2020年6月30日收治的80例行髋关节置换术的老年患者随机分为对照组和观察组各40例。对照组实施常规术后康复护理及指导,研究组在对照组基础上实施快速康复护理联合康复训练卡干预。比较两组睡眠质量[采用匹兹堡睡眠质量指数(PSQI)]、疼痛情况[采用视觉模拟评分法(VAS)]、髋关节功能恢复情况[采用Harris髋关节评分]、生活自理能力[采用Barthel指数评定量表]及并发症发生情况。结果:观察组术后PSQI、VAS评分低于对照组(P0.05);干预后观察组Harris、Barthel指数评分高于对照组(P0.05);观察组术后并发症总发生率低于对照组(P0.05)。结论:对老年髋关节置换术后患者采用快速康复护理联合康复训练卡干预,可促进其关节功能恢复,缩短康复周期,预防相关并发症的发生,改善预后。     

早期康复护理在全髋关节置换术后患者中的应用

目的:研究早期康复护理在全髋关节置换术后患者的的临床效果。方法:将2006年6月~2008年6月全髋关节置换术后30例患者作为对照组,术后按常规护理;将2008年7月~2009年12月全髋关节置换术后患者38例作为观察组,术后早期实施功能康复锻炼、心理护理、出院指导。采用Harris评分系统对两组患者髋关节评估。结果:术前1周和术后第2周的Harris评分两组间差异无显著性意义;术后第3个月和第6个月时观察组的Harris评分及Barthel指数评分高于对照组(P<0.05)。结论:全髋关节置换术后患者的早期康复护理可保证髋关节功能恢复良好,从而提高患者的生活质量。     

A comparison of a hospital-based and two home-based rehabilitation programmes

Purpose.?This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH).

Method.?Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers.

Results.?The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment.

Conclusions.?Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.     

A comparison of a hospital-based and two home-based rehabilitation programmes

Purpose. This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH).

Method. Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers.

Results. The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled individualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment.

Conclusions. Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.     

From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences

The development of rehabilitation has traditionally focused on measurements of motor disorders and measurements of the improvements produced during the therapeutic process; however, physical rehabilitation sciences have not focused on understanding the philosophical and scientific principles in clinical intervention and how they are interrelated. The main aim of this paper is to explain the foundation stones of the disciplines of physical therapy, occupational therapy, and speech/language therapy in recovery from motor disorder. To reach our goals, the mechanistic view and how it is integrated into physical rehabilitation will first be explained. Next, a classification into mechanistic therapy based on an old version (automaton model) and a technological version (cyborg model) will be shown. Then, it will be shown how physical rehabilitation sciences found a new perspective in motor recovery, which is based on functionalism, during the cognitive revolution in the 1960s. Through this cognitive theory, physical rehabilitation incorporated into motor recovery of those therapeutic strategies that solicit the activation of the brain and/or symbolic processing; aspects that were not taken into account in mechanistic therapy. In addition, a classification into functionalist rehabilitation based on a computational therapy and a brain therapy will be shown. At the end of the article, the methodological principles in physical rehabilitation sciences will be explained. It will allow us to go deeper into the differences and similarities between therapeutic mechanism and therapeutic functionalism.     

上海市康复医疗资源调查报告

目的:上海对本地区现有的康复医疗资源现状进行调研,为卫生行政部门启动康复医疗服务体系的试点工作提供科学循证的决策依据.方法:采用问卷和实地走访的方式调研,各单位在完成《上海市康复医疗资源调查表》填写后需加盖单位公章确认.结果:上海市共有463家医疗机构,其中180家(38.88％)设有康复医学科,31家(6.7％)设有康复病床,康复医师585人,康复治疗师754人.康复医师具有研究生及以上学历者占26.32％,康复治疗师具有研究生及以上学历者占3.71％.结论:目前上海康复从业人员数量和专业质量都未达到卫生部对康复医学科设置的基本标准,尤其康复人才匮乏凸显.多种形式多种渠道,规范培养康复人员非常紧迫.     

Rehabilitation in the home versus the hospital: The importance of context

Purpose: Stroke rehabilitation has received increased attention in the past decade. Recent trials with new alternatives such as home-based rehabilitation services are being conducted. The purpose of the study was to explore differences between a therapy session with a stroke patient in two different contexts, i.e. in the patient's home and in the hospital.

Methods: The research design was a qualitative case study. Three data collection methods were used; participant observations of therapy sessions in two different contexts, semi-structured interviews and documents.

Results: The data were examined and coded for common categories. Analysis of the data looking for similarities and differences in behaviour of two therapists and their patients during therapy sessions in the hospital and in the home was performed. The observations revealed that there was clearly a difference in behaviour; a different role-set used by the two therapists when working in the patient's home versus in the hospital. The major difference in patient behaviour was that the patient, observed in his home, took the initiative and expressed his goals, which was not the case with the patients observed in the hospital. The findings were confirmed in the interviews and the documents.

Conclusion: It is suggested that the context is a key component to be considered in the rehabilitation process of stroke patients.     

An introduction to the Korean Employment Promotion Agency for the Disabled

Purpose. The main aim of this article is to provide an introduction to the Korean Employment Promotion Agency for the Disabled (KEPAD), and to provide comparative thought regarding government-based vocational rehabilitation service delivery between South Korea and the USA.

Method. Relevant literature is considered, and current issues and comparative discussion in practice are highlighted.

Results. Introductory information in terms of organization, eligibility, services and programmes are presented. In addition, practical problems associated with the KEPAD system and a cross-cultural analysis is elaborated, comparing the USA and South Korean vocational rehabilitation systems.

Conclusion. KEPAD has successfully derived public support and acknowledgement of its national responsibility in ensuring vocational rehabilitation services for persons with disabilities. The KEPAD system demonstrates a unique approach in implementing vocational rehabilitation services by providing various benefits for both employers and persons with disabilities. However, considerable cautiousness in terms of cross-cultural analyses is required for international application. Furthermore, successive research of rehabilitation infrastructure is warranted.     

家庭康复结合机构康复对脑性瘫痪患儿早期康复疗效的影响

目的:观察和探讨家庭康复结合机构康复对脑瘫患儿的早期康复疗效。方法:将本中心2014年10月—2016年3月所有在训的42例6—45个月龄脑瘫患儿随机分为试验组和对照组,进行为期6个月的康复训练。对照组只进行机构康复,试验组除机构康复训练外,增加家庭康复,需进行家长康复指导和家庭康复记录、家长康复课程培训、家长心理辅导。采用儿童残疾量表(PEDI)、粗大运动功能测试量表(GMFM-66项)和Peabody精细运动评定量表(PDMS-FM)对两组患儿进行自理能力、移动、社交、粗大和精细运动功能的评定。结果:试验组PEDI各项评分均较前有显著提高(P0.01),对照组在PEDI功能技巧自我照顾(P0.01)和照顾者辅助下的自我照顾(P0.05)方面较前有显著提高,在功能技巧和照顾者辅助下的活动和社交方面均无显著提高(P0.05),且试验组较对照组各项分值提高更显著(P0.05)。试验组和对照组PDMS-FM抓握和视觉运动、GMFM-66项得分均较前提高显著(P0.05),且试验组较对照组各项分值提高更显著(P0.05)。结论:脑瘫患儿早期家庭康复结合机构康复使其在运动功能、生活自理能力、移动能力、社会功能的康复效果更显著。专业人员需制定方案,有效督导家庭康复的实施,并给予家长心理支持,才可使脑瘫患儿得到更有效的康复。     

An introduction to the Korean Employment Promotion Agency for the Disabled

Purpose. The main aim of this article is to provide an introduction to the Korean Employment Promotion Agency for the Disabled (KEPAD), and to provide comparative thought regarding government-based vocational rehabilitation service delivery between South Korea and the USA.

Method. Relevant literature is considered, and current issues and comparative discussion in practice are highlighted.

Results. Introductory information in terms of organization, eligibility, services and programmes are presented. In addition, practical problems associated with the KEPAD system and a cross-cultural analysis is elaborated, comparing the USA and South Korean vocational rehabilitation systems.

Conclusion. KEPAD has successfully derived public support and acknowledgement of its national responsibility in ensuring vocational rehabilitation services for persons with disabilities. The KEPAD system demonstrates a unique approach in implementing vocational rehabilitation services by providing various benefits for both employers and persons with disabilities. However, considerable cautiousness in terms of cross-cultural analyses is required for international application. Furthermore, successive research of rehabilitation infrastructure is warranted.