Toward a Theory-Driven Classification of Rehabilitation Treatments
Toward a Theory-Driven Classification of Rehabilitation Treatments
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DOI：
10.1016/j.apmr.2013.05.032
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发表时间：
2014-01-01
影响因子：
4.3
通讯作者：
Dijkers, Marcel P.
中科院分区：
文献类型：
--
作者：
Hart, Tessa;Tsaousides, Theodore;Dijkers, Marcel P.
康复需要一个有组织的系统或分类法来对治疗进行分类，以帮助研究，实践，培训和跨学科交流。在这篇文章中，我们描述了一个正在进行的工作，以创建一个康复治疗分类（RTT）的基本治疗理论，解释他们的效果分类康复干预。在RTT中，治疗根据其目标或其旨在改变的功能的可测量方面;成分或负责影响变化的可测量临床医生决策和行为;以及成分转化为目标变化的假设作用机制而分组在一起。提出了四种治疗分组：结构组织特性、器官功能、熟练表现和认知/情感表现，它们在所针对的目标类型、所使用的成分和导致变化的作用机制方面相似。与这些分组中的每一个相关的临床治疗的典型成分和例子进行了探讨，并进一步细分的挑战进行了讨论。虽然在RTT工作开始时设想了Linnaean分层树结构，但进一步开发可能需要分类组之间边界不那么严格的模型，和/或用于沿着选定连续统组织活性成分的矩阵状结构，以允许对治疗效果重要的定性和定量变化。(C)2014年美国康复医学大会
Rehabilitation is in need of an organized system or taxonomy for classifying treatments to aid in research, practice, training, and interdisciplinary communication. In this article, we describe a work-in-progress effort to create a rehabilitation treatment taxonomy (RTT) for classifying rehabilitation interventions by the underlying treatment theories that explain their effects. In the RTT, treatments are grouped together according to their targets, or measurable aspects of functioning they are intended to change; ingredients, or measurable clinician decisions and behaviors responsible for effecting changes; and the hypothesized mechanisms of action by which ingredients are transformed into changes in the target. Four treatment groupings are proposed: structural tissue properties, organ functions, skilled performances, and cognitive/affective representations, which are similar in the types of targets addressed, ingredients used, and mechanisms of action that account for change. The typical ingredients and examples of clinical treatments associated with each of these groupings are explored, and the challenges of further subdivision are discussed. Although a Linnaean hierarchical tree structure was envisioned at the outset of work on the RTT, further development may necessitate a model with less rigid boundaries between classification groups, and/or a matrix-like structure for organizing active ingredients along selected continua, to allow for both qualitative and quantitative variations of importance to treatment effects. (C) 2014 by the American Congress of Rehabilitation Medicine