An Inter-disciplinary approach to persons with aphasia

目的：分析影响失语症患者生活质量的因素，调查目前康复环境中采用的团队方法，并制定针对失语症患者的跨学科教育方案。方法：采用观察法和访谈法进行分析。医护人员对失语症患者的积极理解态度影响患者的生活质量。既往接触、接触频率和职业种类与患者的态度显著相关。目前的团队方法包括：1.团队成员之间患者数据的统一和电子临床记录的引入；2.通过团队会议，他们分享患者的目标，制定统一的治疗计划。3.小组成员共用一个工作地点和一个工作人员间。4.物理和职业治疗师在晚上和早上参加病人护理(ADL护理)。5.患者的服务和责任被共享，卫生专业人员的正常边界变得模糊，他们的身份冲突出现。5.语言治疗师可以根据患者在地板上的日常活动为其他成员提供适当的方法。结论：失语症患者面临的问题如此复杂，任何单一的学科都不可能有效地应对。在康复环境中，已经制定了一种称为跨学科方法的非典型战略，根据该战略，中心重点是改善病人护理，其中分担责任，模糊各种卫生专业人员的正常边界。这些发现表明，在护理教育中，跨学科/跨学科的健康教育将是未来的新需求

Objectives : This study aimed to analyze factors affecting the QOL of the aphasics, to investigate the team approach presently made in rehabilitation settings, and to develop an interdisciplinary educational program for the aphasics.Method : Analyses based on observation and interview.Results The attitudes of health professional toward the aphasics were very important. Health professional's positive and understanding attitudes toward the aphasics affected patient' QOL. Prior contacts, frequency of contact, and kind of occupation were significantly related to such attitudes.The team approach presently made involved the following : 1.Uniformity of patient's data among team members and introduction of electron clinical records 2.Through team meetings they shared the patient' goal and developed uniform treatment plan. 3.Team members shared a staff station and a staff room. 4.Physical and occupational therapists took part in patient care (care of ADL) in the evenings and mornings. 5.Patient's services and responsibilities were shared, normal boundaries of the health professionals blurred, and their identity conflicts arose. 5.Speech therapists could provide to other members appropriate methods based on patient's daily activities on the floor.Conclusions : Problems facing persons with aphasia are so complex that no single discipline can possibly respond to them effectively. In the rehabilitation settings an atypical strategy called trans-disciplinary approach has been developed, whereby the central focus is to improve patient care in which responsibilities are shared and normal boundaries of the various health professionals are blurred. These finding suggest that in nursing education inter/trans-^disciplinary health education will be new demands for the very future