Rehabilitation: Assessing the Outcome

摘要

Rehabilitation may be defined as a planned program in which a patient progresses toward, or maintains, the highest possible level of physical and psychological function, with illness and disease taken into account. Patients with persistent pain commonly have biopsychosocial problems. Selection of outcome instruments and choice of treatment should therefore be based on multi-method assessment batteries (Rudy et al. 1990; Turk et al. 1993; Turk and Rudy 1994). Test data can be prescriptive of treatment and predictive of outcome. Data can also discriminate between different groups of subjects and evaluate outcome after treatment. Whether each test included within a testing array is equally useful for every purpose can be questioned. While all assessment tools should be reliable, valid, and feasible, outcome measures also should be sufficiently sensitive to discern important changes (Beattie and Maher 1997; Simmonds et al. 2000). Evaluation of the effectiveness of rehabilitation programs depends most often on outcome measures that are repeated before and after treatment (Deyo et al. 1991, 1994; Guyatt et al. 1987). Selected outcome measures must fit the patient, as well as the type and aim of treatment, and should address the following types of questions: Has treatment been clinically efficient and the program cost-effective? Which biopsychosocial dimensions are included?