Factors associated with physiotherapy provision in a population of elderly nursing home residents; a cross sectional study.
Factors associated with physiotherapy provision in a population of elderly nursing home residents; a cross sectional study.
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DOI：
10.1186/1471-2318-7-7
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发表时间：
2007-04-04
期刊：
影响因子：
4.1
通讯作者：
Dekker, Joost
中科院分区：
文献类型：
--
作者：
Leemrijse, Chantal J;de Boer, Marike E;Dekker, Joost
背景：尽管物理治疗 (PT) 在改善日常生活活动（ADL 功能）和出院率方面发挥着重要作用，但尚不清楚有多少疗养院居民接受治疗。此外，缺乏对影响治疗决策的决定因素的深入了解。在这项研究中，我们调查了有多少疗养院居民接受了 PT。此外，我们还分析了导致疗养院之间和居民之间 PT 提供差异的因素。方法：从 15 家疗养院中随机抽取 600 名老年居民。居民必须入院进行康复或长期护理。数据是通过采访疗养院医生和物理治疗师收集的。使用多水平分析来定义 PT 提供的变化以及与居民是否接受 PT 问题相关的因素。此外还分析了提供的 PT 数量以及与之相关的因素。 结果：平均 69% 的居民接受了 PT。各个疗养院接受治疗的患者比例存在显着差异，尤其是可用的物理治疗师的数量，解释了疗养院之间的这种差异。入住躯体病房进行康复治疗的居民，以及一般男性居民，最有可能接受 PT。接受物理治疗师治疗的居民每周平均接受 55 分钟 (标准差 41) 的治疗。入院康复的居民每周接受更多的 PT，全髋关节置换术后状态的居民也是如此。 结论：PT 最有可能提供给躯体病房的居民，这些病房最近入院康复，疗养院拥有相对较多的物理治疗师。这表明对于有认知问题的长期居民来说，PT 的使用可能不足。建议物理治疗师重新考虑哪些居民可以从治疗中受益。这可能需要物理治疗师的重点从“康复和出院”转向“生活质量和福祉”。
BACKGROUND: Although physiotherapy (PT) plays an important role in improving activities of daily living (ADL functioning) and discharge rates, it is unclear how many nursing home residents receive treatment. Furthermore, there is a lack of insight into the determinants that influence the decision for treatment. In this study, we investigated how many nursing home residents receive PT. In addition, we analysed the factors that contribute to the variation in the provision of PT both between nursing homes and between residents.METHODS: A random sample of 600 elderly residents was taken from a random sample of 15 nursing homes. Residents had to be admitted for rehabilitation or for long-term care. Data were collected through interviews with the nursing home physician and the physiotherapist. Multilevel analysis was used to define the variation in the provision of PT and the factors that are associated with the question whether a resident receives PT or not. Furthermore the amount of PT provided was analysed and the factors that are associated with this.RESULTS: On average 69% of the residents received PT. The percentage of patients receiving treatment differed significantly across nursing homes, and especially the number of physiotherapists available, explained this difference between nursing homes. Residents admitted to a somatic ward for rehabilitation, and male residents in general, were most likely to receive PT. Residents who were treated by a physiotherapist received on average 55 minutes (sd 41) treatment a week. Residents admitted for rehabilitation received more PT a week, as were residents with a status after a total hip replacement.CONCLUSION: PT is most likely to be provided to residents on a somatic ward, recently admitted for rehabilitation to a nursing home, which has a relatively large number of physiotherapists. This suggests a potential under-use of PT for long-term residents with cognitive problems. It is recommended that physiotherapists reconsider which residents may benefit from treatment. This may require a shift in the focus of physiotherapists from 'recovery and discharge' to 'quality of life and well-being'.