Rapid Changes in the Provision of Rehabilitation Care in Post-Acute and Long-Term Care Settings During the COVID-19 Pandemic.
Rapid Changes in the Provision of Rehabilitation Care in Post-Acute and Long-Term Care Settings During the COVID-19 Pandemic.
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DOI：
10.1016/j.jamda.2021.08.022
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发表时间：
2021-11
影响因子：
7.6
通讯作者：
Baier RR
中科院分区：
文献类型：
--
作者：
Reddy A;Resnik L;Freburger J;Ciolek DE;Gifford DR;Whitten MJ;Baier RR
关于新冠肺炎大流行如何影响急性后和长期护理中的康复护理，人们知之甚少。作为评估研究优先事项的过程的一部分，我们对这些环境中的专业人员进行了调查，以评估大流行的影响和相关的研究需求。对开放式调查结果进行定性分析。30名在急诊后和长期护理中工作的临床和行政人员。从2020年6月24日至7月10日，我们使用专业关系向临床和管理人员的方便样本传播了一项电子调查。我们对数据进行了归纳主题分析。我们确定了4个主题，涉及(1)护理提供的快速变化，(2)对患者动机和身体功能的负面影响，(3)新的获取障碍和增加的成本，以及(4)在提供和支付方面持续变化的不确定性。快速变化：受访者描述了感染控制政策和做法如何将康复从小组会议和社区健身房转移到床边和远程保健。负面影响：受访者认为，患者的孤立，特别是在住院护理环境中，影响了他们康复的动机和身体功能。准入和成本：受访者对成本增加(例如，个人防护设备)和病人数量减少以及准入问题表示担忧。不确定性：与此同时，受访者描述了远程医疗和联邦医疗保险豁免如何实现与患者联系的新方式，并想知道公共卫生紧急情况后豁免是否会延长。调查结果突出表明，在新冠肺炎大流行高峰期，急诊后和长期护理方面的康复发生了迅速变化。由于工作人员疫苗覆盖率仍然很低，患者在住院护理环境中处于弱势地位，感染预防措施等变化可能会持续下去。未来的研究应该评估对护理、结果和成本的影响。
Little is known about how the COVID-19 pandemic has affected rehabilitation care in post-acute and long-term care. As part of a process to assess research priorities, we surveyed professionals in these settings to assess the impact of the pandemic and related research needs. Qualitative analysis of open-ended survey results. 30 clinical and administrative staff working in post-acute and long-term care. From June 24 through July 10, 2020, we used professional connections to disseminate an electronic survey to a convenience sample of clinical and administrative staff. We conducted an inductive thematic analysis of the data. We identified 4 themes, related to (1) rapid changes in care delivery, (2) negative impact on patients’ motivation and physical function, (3) new access barriers and increased costs, and (4) uncertainty about sustaining changes in delivery and payment. Rapid changes: Respondents described how infection control policies and practices shifted rehabilitation from group sessions and communal gyms to the bedside and telehealth. Negative impact: Respondents felt that patients’ isolation, particularly in residential care settings, affected their motivation for rehabilitation and their physical function. Access and costs: Respondents expressed concerns about increased costs (eg, for personal protective equipment) and decreased patient volume, as well as access issues. Uncertainty: At the same time, respondents described how telehealth and Medicare waivers enabled new ways to connect with patients and wondered whether waivers would be extended after the public health emergency. Survey results highlight rapid changes to rehabilitation in post-acute and long-term care during the height of the COVID-19 pandemic. Because staff vaccine coverage remains low and patients vulnerable in residential care settings, changes such as infection precautions are likely to persist. Future research should evaluate the impact on care, outcomes, and costs.
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影响因子：
7
作者：
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通讯作者：
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影响因子：
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影响因子：
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影响因子：
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作者：
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DOI：
10.1093/gerona/63.10.1076
发表时间：
2008-10-01
影响因子：
5.1
作者：
Kortebein, Patrick;Symons, T. Brock;Evans, William J.
通讯作者：
Evans, William J.