The Rehabilitation Complexity Scale - extended version: detection of patients with highly complex needs
The Rehabilitation Complexity Scale - extended version: detection of patients with highly complex needs
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DOI：
10.3109/09638288.2011.615880
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发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Siegert, Richard
中科院分区：
文献类型：
--
作者：
Turner-Stokes, Lynne;Scott, Harriet;Siegert, Richard
目的：描述扩展的康复复杂性量表（RCS-E）及其因子结构，并确定其是否在RCS-version 2上提供附加值，以识别具有高度复杂康复需求的患者。方法：一项队列分析，前瞻性收集了331例在英国三级专科神经康复单位接受住院康复治疗的复杂神经系统残疾患者的常规临床数据。多学科团队（MDT）每两周平行记录一次RCS-E和RCS-v2评分，同时记录Northwick Park护理（NPDS）和治疗（NPTDA）依赖量表，以工作人员小时/周为单位记录护理和治疗干预。结果如下：RCS-v2总分与RCS-E评分（rho = 0.954）、RCS-E“护理和护理”子量表与护理/护理小时/周（rho = 0.838，p < 0.001）以及RCS-E“治疗”子量表与总治疗小时/周（p = 0.697，p < 0.001）之间存在非常强的相关性。RCS-E对复杂治疗需求的区分度优于RCS-v2，但对复杂护理/护理需求的区分度不高。RCS-E因子结构与RCS-v2相似，总体上具有中度内部一致性，分为两个不同的维度（“护理/医疗护理+设备”和“治疗”）。结论：RCS-E提供了与RCS-v2等同的复杂性测量，但在识别具有高度复杂治疗和设备需求的患者方面提供了附加价值。
Purpose: To describe the extended Rehabilitation Complexity Scale (RCS-E) and its factor structure, and to determine whether it provides added value over the RCS-version 2 to identify patients with highly complex rehabilitation needs. Method: A cohort analysis of prospectively-collected routine clinical data from 331 patients with complex neurological disabilities undergoing inpatient rehabilitation in a tertiary specialist neurorehabilitation unit in the UK. RCS-E and RCS-v2 scores were recorded in parallel by the multi-disciplinary team (MDT) at fortnightly intervals, alongside the Northwick Park nursing (NPDS) and therapy (NPTDA) dependency scales, capturing nursing care and therapy interventions in staff hours/week. Results: Very strong correlations were found between total RCS-v2 and RCS-E scores (rho = 0.954); the RCS-E "Care & nursing" subscale and care/nursing hours/week (rho = 0.838, p < 0.001); and the RCS-E "Therapy" subscale and total therapy hours/week (p = 0.697, p < 0.001). The RCS-E showed better discrimination for complex therapy needs than the RCS-v2, but not for complex care/nursing needs. The RCS-E factor structure was similar to the RCS-v2, with moderate internal consistency overall, separating into two distinct dimensions ("Nursing/medical care + Equipment" and "Therapy"). Conclusion: The RCS-E provides an equivalent measure of complexity to the RCS-v2, but offers added value in identifying patients with highly complex therapy and equipment needs.