在因肺炎住院的患者中确定了五个功能分级,其特点是活动能力和自理能力受限

IF 1.9 Q2 REHABILITATION
Jessica Edelstein PhD, OTR , Adam R. Kinney PhD, OTR/L , Amanda Hoffman MS, OTR/L, BCPR , James E. Graham PhD , Matthew P. Malcolm PhD, OTR
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引用次数: 0

摘要

目标通过惯性分类分析确定肺炎住院患者的功能分级。然后,我们确定了类别成员资格的预测因素,并检查了功能类别之间远端结果的差异。设计采用观察性横断面研究设计,回顾性收集了 2014 年至 2018 年期间的数据。研究环境研究环境为单一医疗系统,包括 5 家急症护理医院。参与者研究共纳入了 969 名主要诊断为肺炎并接受职业和/或物理治疗评估的住院患者。干预措施不适用。主要结果研究了以下 5 个远端结果:(1) 职业疗法治疗使用情况;(2) 物理疗法治疗使用情况;(3) 无服务出院回家情况;(4) 有家庭医疗服务出院回家情况;(5) 出院回家情况:结果确定了五个功能分级,并标注如下:全面受损、低水平自理能力独立、低水平移动能力独立、自理能力独立和独立。使用职业疗法治疗的概率(χ2[4]=50.26,P<.001)和使用物理疗法治疗的概率(χ2[4]=50.86,P<.001)在不同等级之间存在显著差异。低水平自理班的独立患者使用作业疗法治疗和物理疗法治疗的概率最大。出院后回到没有服务的家庭(是/否;χ2[4]=88.861,P<.001)、有家庭医疗的家庭(是/否;χ2[4]=15.895,P=.003)和机构(是/否;χ2[4]=102.013,P<.001)的概率在 5 个等级中差异显著。结论在因肺炎住院的患者中确定了五个功能分级。医院的多学科团队可将功能分级作为一个框架,用于组织肺炎后功能障碍的异质性,提高护理流程的效率,并帮助提供有针对性的康复治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Five Functional Classes Identified Among Patients Hospitalized for Pneumonia Characterized by Activity Limitations With Mobility and Self-Care Tasks

Objective

Latent class analysis was used to identify functional classes among patients hospitalized for pneumonia. Then, we determined predictors of class membership and examined variation in distal outcomes among the functional classes.

Design

An observational, cross-sectional study design was used with retrospectively collected data between 2014 and 2018.

Setting

The study setting was a single health system including 5 acute care hospitals.

Participants

A total of 969 individuals hospitalized with the primary diagnosis of pneumonia and receipt of an occupational and/or physical therapy evaluation were included in the study.

Interventions

Not applicable.

Main Outcomes

The following 5 distal outcomes were examined: (1) occupational therapy treatment use, (2) physical therapy treatment use, (3) discharge to home with no services, (4) discharge to home with home health, and (5) institutional discharge.

Results

Five functional classes were identified and labeled as follows: Globally impaired, Independent with low-level self-care, Independent low-level mobility, Independent self-care, and Independent. Probability of occupational therapy treatment use (χ2[4]=50.26, P<.001) and physical therapy treatment use (χ2[4]=50.86, P<.001) varied significantly across classes. The Independent with low-level self-care class had the greatest probability of occupational therapy treatment use and physical therapy treatment use. Probability of discharging to home without services (yes/no; χ2[4]=88.861, P<.001), home with home health (yes/no; χ2[4]=15.895, P=.003), and an institution (yes/no; χ2[4]=102.013, P<.001) varied significantly across the 5 classes. The Independent class had the greatest probability of discharging to home without services.

Conclusions

Five functional classes were identified among individuals hospitalized for pneumonia. Functional classes could be used by the multidisciplinary team in the hospital as a framework to organize the heterogeneity of functional deficits after pneumonia, improve efficiency of care processes, and help deliver targeted rehabilitation treatment.

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