摘要
对早期康复(ER)中作业治疗(OT)和物理治疗(PT)的模式和趋势,以及美国的康复治疗师特别是作业治疗师(OTs)和物理治疗师(PTs)在ER中发挥的作用进行了全面综述。首先概述与卧床休养和制动不良后果相关的研究,OT和PT技术能够最大限度地减少不良后果并通过ER来优化功能;然后以作业为基础和以运动为重点探讨康复在减少再入院率和提高患者和家庭满意度方面的作用;最后分析中国传统OT和PT的常规治疗,以及其在ER中遇到的挑战和对临床疗效的影响。ER是在急性医疗过程中针对有康复、安全或社区支持需求的患者以快速的方式启动治疗服务。在患者遭受损伤、疾病后,ER可以改善患者的作业表现和提高其参与活动和运动的能力,防止其功能进一步丧失。在快速过渡的医疗环境中,OT和PT的目标是促进患者的功能恢复,从而改善其康复状况并防止残疾的加重和功能的丧失。在美国,联邦法规、医疗政策、财政限制以及住院时间缩短的规定都要求治疗师全面、高效地推进ER。同时,ER必须及时、高效地带来积极的变化,通过患者的参与来实现患者及其家属所确认的最必要治疗目标,并使患者成功地过渡到家庭或其他环境中。ER不仅改善患者的功能,而且还能够降低不良后果和意外风险。医院获得性疾病(HAC)是患者在住院期间发生的疾病,患者在卧床休养、制动或身体受到限制时发生HAC的风险会增加。患者长期处于危重疾病、外伤或手术状态下会导致其系统性机能减退,从而降低患者的功能能力、损害其认知能力、削弱其心理承受力并增加患者抑郁和焦虑症的发生率。通过ER中OT和PT康复干预措施能够最大限度地降低患者的不良健康状况、损伤和残疾的风险,同时促进其功能恢复。针对每个康复专业的角色和职责,美国的OTs可以提升患者的作业表现和对日常工作、角色�
This review article describes the patterns and trends of early rehabilitation(ER),occupational therapy(OT)and physical therapy(PT),and the specific roles of rehabilitation therapists,particularly occupational therapists(OTs)and physical therapists(PTs)in acute care hospitals in the United States(U.S.).First,a broad overview of the research literature related to the consequences of bed rest and immobility is presented along with the techniques used by OTs and PTs to minimize negative outcomes and optimize function through ER.Occupation-based and mobility-focused practices are then outlined to describe rehabilitation therapy's role in decreasing readmissions and improving patient and family satisfaction.Finally,traditional OT and PT practices in acute care settings in China,including the challenges of implementing ER and the implications for contemporary practice,are discussed.ER refers to the initiation of therapy services in an expedited manner for patients who have rehabilitative,safety,or community support needs in the acute care hospital.That is,after experiencing an injury,illness,or disease,patients'occupational performance and ability to participate in activities and mobility can be improved,or prevented from worsening,with ER.The goals of OT and PT in an accelerated and fast-past hospital environment are to facilitate a patient's functional performance and outcomes to improve function recovery and to prevent further disability and loss of function.Currently in U.S.,federal regulations,health care policies,financial constraints,and the demanded shortened hospital stays require therapists to be both comprehensive and efficient and to continue advancing ER practices.Early rehabilitation must be well-timed and intensive enough to bring about positive changes.Additionally,ensuring patients'active engagement and addressing therapy goals that patients and families identified as essential are imperative to achieve patients'successful transition to home or to another setting.Through ER,not only can a patient's func
出处
《康复学报》
CSCD
2020年第3期240-249,共10页
Rehabilitation Medicine
关键词
医院
康复
作业治疗
物理治疗
卧床休养
临床决策
hospitals rehabilitation
occupational therapy
physical therapy
bed rest
clinical decision-making
