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Post-acute care for stroke – a retrospective cohort study in Taiwan

机译:急性中风后护理–台湾一项回顾性队列研究

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Background: Stroke often causes functional decline in patients. Therefore, after the acute phase, many patients require post-acute care (PAC) to maximize their functional progress, reduce disability, and make it possible for them to return to their home and community. PAC can be provided in different settings. Taiwan’s National Health Insurance (NHI) proposed a PAC pilot program, effective since 2014, for stroke patients that allowed patients with the potential for functional improvement to receive PAC rehabilitation in regional or community hospitals. The purpose of this study was to explore the initial achievements and clinical impact of this program in Taiwan. Methods: This was a retrospective cohort study that mainly analyzed basic hospitalization data and scores for function and quality of life, as recorded immediately after admission and before discharge, for stroke patients in the PAC program in a hospital in Taiwan. Results: This study collected complete data from a total of 168 patients. After an average of 43.57?days in the program, patients showed significant improvement in the Modified Rankin Scale (MRS), the Barthel Activity Daily Living Index (B-ADL), the Lawton–Brody Instrumental Activity Daily Living Scale (LB-IADL), the Functional Oral Intake Scale (FOIS), and the Mini Nutrition Assessment (MNA), in mobility, self-care, and usual activity, as well as on anxiety/depression in the EuroQol Five Dimensions Questionnaire (EQ-5D) and in the Mini Mental State Examination (MMSE). After discharge, 76.8% of the patients could return to their home and community. Conclusion: This study showed that the pilot PAC program significantly promoted recovery of function in stroke patients and helped them to return to their home and community. Patients with the potential for functional recovery should consider receiving PAC service in a hospital after discharge from acute stroke care.
机译:背景:中风通常会导致患者功能下降。因此,在急性期后,许多患者需要进行急性后护理(PAC)以最大程度地发挥其功能,减少残疾,并使他们有可能返回家园和社区。 PAC可以提供不同的设置。台湾的国民健康保险(NHI)提出了一项针对中风患者的PAC试点计划,该计划自2014年起生效,该计划使具有功能改善潜力的患者能够在地区或社区医院接受PAC康复治疗。这项研究的目的是探讨该计划在台湾的初步成就和临床影响。方法:这是一项回顾性队列研究,主要分析了台湾医院PAC计划中风患者入院后和出院前记录的基本住院数据以及功能和生活质量得分。结果:本研究收集了总共168例患者的完整数据。经过平均43.57天的计划后,患者在改良Rankin量表(MRS),Barthel活动每日生活指数(B-ADL),Lawton-Brody工具活动每日生活量表(LB-IADL)方面均有显着改善,功能性口腔摄入量表(FOIS)和小型营养评估(MNA),包括在行动力,自我护理和日常活动中,以及在EuroQol五维问卷(EQ-5D)和迷你精神状态考试(MMSE)。出院后,有76.8%的患者可以返回家园和社区。结论:这项研究表明,PAC试点计划极大地促进了中风患者的功能恢复,并帮助他们返回家园和社区。可能恢复功能的患者在急性卒中治疗出院后,应考虑在医院接受PAC服务。

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