Rehabilitation Treatment Specification System: Methodology to Identify and Describe Unique Targets and Ingredients.
Rehabilitation Treatment Specification System: Methodology to Identify and Describe Unique Targets and Ingredients.
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DOI：
10.1016/j.apmr.2020.09.383
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发表时间：
2021-03
影响因子：
4.3
通讯作者：
Tolejano CJ
中科院分区：
文献类型：
--
作者：
Van Stan JH;Whyte J;Duffy JR;Barkmeier-Kraemer JM;Doyle PB;Gherson S;Kelchner L;Muise J;Petty B;Roy N;Stemple J;Thibeault S;Tolejano CJ
尽管在衡量康复干预措施的结果方面取得了重大进展，但在衡量导致改善结果的治疗过程方面取得的进展相对较少。最近开发的一个名为康复治疗规范系统（RTSS）的框架有可能确定哪些临床医生的行动（即成分）积极改善患者的特定功能（即目标）。然而，RTSS没有提供标准识别特定独特靶点或成分的方法。如果没有一种方法来评估单个靶点或成分的独特性，就很难知道治疗描述中的变化是同义的（即不同的词描述同一治疗）还是有意义的不同（例如，不同的词描述不同的治疗或相同治疗的变化）。最近的一个项目使用声音康复成分和目标来创建基于rtss的独特的总体目标和成分类别列表，其中包含了描述这些类别中单个成分和目标如何变化的潜在维度。本文的主要目的是描述项目期间遇到的挑战，以及为解决这些挑战而开发的方法。由于该方法基于RTSS广泛适用的框架，因此它可以用于康复的所有领域，无论学科（言语语言病理学、物理治疗、职业治疗、心理学等）或损伤领域（语言、认知、行走、上肢训练等）。所得到的标准操作化目标和成分表具有较高的表面效度和内容效度。这些清单还可促进在研究、教育、跨学科交流和日常治疗方面实施RTSS。
Although significant advances have been made in measuring the outcomes of rehabilitation interventions, comparably less progress has been made in measuring the treatment processes that lead to improved outcomes. A recently developed framework called the Rehabilitation Treatment Specification System (RTSS) has potential to identify which clinician actions (ie, ingredients) actively improve specific patient functions (ie, targets). However, the RTSS does not provide methodology for standardly identifying specific unique targets or ingredients. Without a method to evaluate the uniqueness of an individual target or ingredient, it is difficult to know whether variations in treatment descriptions are synonymous (ie, different words describing the same treatment) or meaningfully different (eg, different words describing different treatments or variations of the same treatment). A recent project used vocal rehabilitation ingredients and targets to create RTSS-based lists of unique overarching target and ingredient categories with underlying dimensions describing how individual ingredients and targets vary within those categories. The primary purpose of this article is to describe the challenges encountered during the project and the methodology developed to address those challenges. Because the methodology was based on the RTSS’s broadly applicable framework, it can be used across all areas of rehabilitation regardless of the discipline (speech-language pathology, physical therapy, occupational therapy, psychology, etc) or impairment domain (language, cognition, ambulation, upper extremity training, etc). The resulting standard operationalized lists of targets and ingredients have high face and content validity. The lists may also facilitate implementation of the RTSS in research, education, interdisciplinary communication, and everyday treatment.
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