在医疗危机期间维持神经康复质量的共识建议:利益相关者通知的混合方法研究
Perrine Ferré1,2, Diana Zidarov2,3,4, Claude Vincent5
1School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
概括
COVID-19大流行对神经康复质量产生了负面影响,减少了COVID阳性患者的功能独立性. 建议侧重于在危机期间平衡感染控制与康复需求.
科学领域:
- 神经科学与康复医学 神经科学与康复医学
- 公共卫生和医疗保健管理
- 传染病流行病学 传染病流行病学
背景情况:
- COVID-19大流行给医疗保健系统带来了前所未有的挑战,特别是神经康复服务.
- 住院康复设施 (IRF) 经历了重大干扰,需要审查危机应对和护理质量.
- 了解大流行对患者结果和操作策略的差异影响,对于未来的准备工作至关重要.
研究的目的:
- 评估COVID-19大流行对IRF神经康复护理质量的影响.
- 为了比较COVID阳性患者 (感染者入院前与康复期间) 与非COVID患者的结果.
- 在公共卫生危机期间制定基于证据的建议,以优化神经康复.
主要方法:
- 一种混合方法的方法,结合了定量医疗记录分析 (n=495) 和定性利益相关者咨询 (n=88).
- 多变量分析比较了大流行前,非COVID,COVID阳性预先入院和康复期间COVID阳性组的神经康复结果.
- 来自患者,工作人员和管理人员的定性数据为基于共识的建议提供了信息.
主要成果:
- 与非COVID患者相比,COVID阳性患者在出院时表现出功能独立性降低.
- 在康复期间感染的患者经历了更长的停留时间和更高的再入院率.
- 定性调查结果强调了心理社会,排放规划和资源管理方面的挑战,这些挑战因社会隔离而加剧.
结论:
- COVID-19感染的时间显著影响了患者的发展轨迹和神经康复中的资源利用.
- 有效的危机管理需要平衡严格的感染控制措施和质量康复的基本组成部分.
- 基于共识的建议强调环境适应,家庭参与,社会化和灵活管理,以提供弹性神经康复服务.
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