共查询到20条相似文献,搜索用时 15 毫秒
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Riis V Jaglal S Boschen K Walker J Verrier M 《Physiotherapy Canada. Physiothérapie Canada》2011,63(3):324-333
Purpose: Rehabilitation costs for spinal-cord injury (SCI) are increasingly borne by Canada's private health system. Because of poor outcomes, payers are questioning the value of their expenditures, but there is a paucity of data informing analysis of rehabilitation costs and outcomes. This study evaluated the feasibility of using administrative claim file review to extract rehabilitation payment data and functional status for a sample of persons with work-related SCI.Methods: Researchers reviewed 28 administrative e-claim files for persons who sustained a work-related SCI between 1996 and 2000. Payment data were extracted for physical therapy (PT), occupational therapy (OT), and psychology services. Functional Independence Measure (FIM) scores were targeted as a surrogate measure for functional outcome. Feasibility was tested using an existing approach for evaluating health services data.Results: The process of administrative e-claim file review was not practical for extraction of the targeted data.Conclusions: While administrative claim files contain some rehabilitation payment and outcome data, in their present form the data are not suitable to inform rehabilitation services research. A new strategy to standardize collection, recording, and sharing of data in the rehabilitation industry should be explored as a means of promoting best practices. 相似文献
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《The Journal for Nurse Practitioners》2014,10(2):107-112
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) were created to provide a temporary safety net for people who become disabled to protect them from impoverishment. Currently, many people receive SSDI or SSI until they reach retirement age. This literature review explored the impact these programs have on people reaching their optimal level of health. Results show the number of people voluntarily returning to work is 0.2%, demonstrating that most people receiving disability benefits stay with the programs instead of returning to the workplace. 相似文献
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Vicki A. Freedman Judith D. Kasper Alan Jette 《Archives of physical medicine and rehabilitation》2018,99(8):1507-1513
Objective
To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home).Design
Longitudinal observational study.Setting
Participants' homes.Participants
Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview.Interventions
Not applicable.Main Outcome Measures
Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service.Results
Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels.Conclusions
Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans. 相似文献6.
INTRODUCTIONTOWCPTTheWorldConfederationforPhysicalTherapy(WCPT)isaninternational,non-governmentalorganization,establishedin1951.Itisaconfederationof83MemberOrganizationsrepresenting225,000physicaltherapistsworldwide.ItsMemberOrganizationsarethenationallyrecognisedprofes鄄sionalphysicaltherapyassociationsofcountriesfromaroundtheworld.WCPTisorganizedintofiveregions.Italsohasfiverecognizedphysicaltherapyspecificorganizationsasof鄄ficialsub-groupscoveringtheareasofacupuncture,manipu… 相似文献
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Nursing program graduates rarely choose mental health nursing as a career. A quasi-experimental study was conducted to examine attitudes of 310 nursing students towards persons with mental illness. Students completed surveys on the first and last days of their program's psychiatric mental health nursing course. The pre- and post-test survey analysis indicated that students improved their attitude, knowledge and preparedness to care for persons with mental illness. However, students maintained little interest in working as a mental health nurse. Modifications in mental health nursing courses could be made to improve students' interest in choosing a career in mental health nursing. 相似文献
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Sinead Hennessy 《Issues in mental health nursing》2013,34(8):700-706
Individuals with a severe mental illness have a gap in life expectancy of up to 20 years in comparison to the general population. Nurses who work in mental health services have been identified as best placed to improve the physical health outcomes of individuals with mental illness. The literature identifies a lack of nursing knowledge related to physical health care and the presence of metabolic syndrome which is impeding nurses in providing essential physical health care to patients. An integrated literature review was carried out due to the dearth of research evidence pertaining to the impact of targeted education specifically with psychiatric/mental health nurses in the provision of physical healthcare. A search for literature included the following databases: CINAHL, Medline, PsycINFO, Embase and Web of Science revealed nine studies: seven quantitative, one qualitative and one mixed method. Qualitative synthesis has shed light on the value of targeted education on improving knowledge and skills in providing physical health care that can then be translated into clinical practice. Targeted education in physical healthcare grows psychiatric/mental health nurse's confidence and develops the skills necessary to enable them to screen and monitor and offer range of physical health interventions to individuals with severe mental illness.Accessible summary ? The poor physical health outcomes and premature death of individuals with severe mental illness is of growing concern; a contributing factor is a lack of knowledge and confidence amongst psychiatric/mental health nurses to providing physical health screening and intervening in preventable diseases such as cardiovascular disease, stroke cancer, and type 2 diabetes mellitus. ? An integrated literature review was used to ascertain if targeted education on physical health care can improve the knowledge base of psychiatric/mental health nurses within physical health care. ? Nine studies were critically appraised, and the data reduced using a narrative synthesis that tells a story of the findings from these research studies. ? The review found that targeted education with psychiatric/mental health nurses does result in a statistical increase in knowledge This review finds that nurses have not been regularly supported with physical health education to alter existing practices. This lack of knowledge within physical healthcare is hindering psychiatric/mental health nurses to fully engaging in physical health care activities in practice. 相似文献
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Poulsen AA Ziviani JM 《Canadian journal of occupational therapy. Revue canadienne d'ergothérapie》2004,71(2):100-107
BACKGROUND: Children with developmental coordination disorders (DCD) are less physically active and have significantly different patterns of social and physical play than their well-coordinated peers. FACTORS: The impact of motor incoordination on physical activity engagements throughout life is influenced by a multitude of factors. External factors such as the social, cultural and physical environment may act as either supports or barriers to active physical involvement. Individual characteristics including the unique physical and psychological attributes of the child with motor coordination difficulties also impact on engagement in physically active occupations. RESULT: A model is proposed that conceptualizes the multiple dimensions which impinge on the decisions to select, engage and persist in physical activities for children with developmental coordination disorders. PRACTICE IMPLICATIONS: The occupational therapist's role in promoting a balanced and physically active lifestyle is explored. Interventions to increase physical activity participation for children with DCD are dependent on a full understanding of the complex, multi-dimensional correlates of occupational engagement. 相似文献
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[Purpose] This study aimed at evaluating PT interns’ performance from the perspectives
of clinical and academic physical therapists (PTs). [Methods] An online questionnaire
based on a modified version of the Clinical Internship Evaluation Tool (CIET) was used to
evaluate PT interns’ performance in patient management skills. Assessors comprised
clinical and academic PTs from Saudi Arabia. The survey aimed at assessing the competency
of interns in 25 patient management skills comprising four major domains: clinical
examination, patient evaluation, diagnosis and prognosis, and intervention. Assessors were
also asked to rank the importance of possessing each skill and evaluating the internship
programs at their facilities. A multivariate logistic regression analysis assessed whether
the demographic variables between the two groups influenced their views. [Results] A total
of 148 participants (112 clinical PTs and 36 academic PTs) responded to the survey. The
majority of the participants agreed that interns were competent in all 25 skills.
Differences between the two groups of assessors were observed for five out of the 25
skills. Interestingly, skills with the highest means were perceived as the most important
skills by both groups of assessors. There was no association between sociodemographic
variables and evaluation scores. [Conclusion] There were no differences observed between
clinical and academic PTs in their evaluation of PT interns in 20 of the 25 clinical
skills. There were indications of a need for further improvement in certain competencies
and skills such as clinical examination, evaluation, diagnosis and prognosis, and
intervention.Key words: Clinical internship, Physical therapy education, Clinical education 相似文献
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The Safety of Aggressive Statin Therapy: How Much Can Low-Density Lipoprotein Cholesterol Be Lowered? 总被引:1,自引:0,他引:1
Jacobson TA 《Mayo Clinic proceedings. Mayo Clinic》2006,81(9):1225-1231
Recent clinical trials have consistently demonstrated that reducing low-density lipoprotein cholesterol to very low levels will substantially reduce cardiovascular morbidity and mortality. The lipid-lowering agents of choice are the statins, which are generally considered safe and effective. Of the various agents available, atorvastatin and rosuvastatin are the most powerful, followed by simvastatin. Serious adverse effects with statin therapy are uncommon and primarily involve effects on the liver and skeletal muscle. The risk increases with the statin dose and coadministration with other drugs metabolized by the same metabolic pathway, such as the cytochrome P-450 system. For patients who do not achieve adequate reduction in low-density lipoprotein cholesterol levels with statin therapy of moderate potency, the clinician can up-titrate the dose of the initial statin, institute combination therapy and carefully monitor for adverse effects, or switch to a lower dose of a more potent statin. The strategy chosen depends on the degree of lipid lowering required and on safety, cost, and compliance issues. This article reviews evidence concerning the benefits of reducing low-density lipoprotein cholesterol levels below currently established targets and addresses the question of whether Intensive statin therapy is likely to Increase the risk of adverse events or concomitant comorbidity. 相似文献
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《Archives of physical medicine and rehabilitation》2022,103(11):2197-2208
ObjectiveThis systematic review analyzed the effects of physical exercise programs in patients with cancer undergoing chemotherapy on chemotherapy-induced peripheral neuropathy (CIPN) prevention.Data SourcesPubMed, Web of Science, Scopus, and Cochrane Library were searched for relevant studies published before December 2020. Additional references were identified by manual screening of the reference lists.Study SelectionBased on the Population, Intervention, Comparator, Outcomes, and Study Designs strategy, randomized controlled trials in which physical exercise was applied before or during chemotherapy to prevent or ameliorate CIPN were included.Data ExtractionTwo reviewers blinded and independent screened the articles, scored methodologic quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Sensitivity and precision analysis databases was included. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools.Data SynthesisOf 229 potentially relevant studies, 8 randomized controlled trials were included and scored. They comprise a total of 618 patients with cancer. MEDLINE and Scopus databases recorded the highest sensitivity. None of the studies achieved a “low” overall risk of bias. Four studies were included in meta-analysis for quality of life, and a significance standardized mean difference was found between groups from baseline of 14.62; 95% CI, 6.03-3.20, with a large effect size g=0.83; 95% CI, 0.48-1.18) in favor of physical exercise program compared with usual care.ConclusionsPhysical exercise at the onset of chemotherapy has shown promising effects on the prevention of CIPN, specially improving quality of life. 相似文献
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