玉树地震1年后上肢骨折伤员功能恢复的影响因素:加拿大作业活动测量表分析
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摘要
背景:全面测评地震后骨折伤员在作业活动中的真正需求,实施以伤员为中心的作业治疗模式,能提高康复治疗效果。目的:分析玉树地区地震后上肢骨骨折的功能恢复情况与各影响因素之间的关系,阐明伤后控制各影响因素的重要性。方法:以调查问卷的方式对玉树地区地震中上肢骨骨折已愈合的伤员74例进行随访。运用加拿大作业活动测量表(COPM)确认伤员亟待解决的作业活动问题,评测其治疗前后的作业活动表现和满意度。对可能影响上肢骨折伤员功能恢复的因素,行多元线性逐步回归分析。结果与结论:多元线性逐步回归分析结果显示,上肢骨骨折伤员作业活动表现与居住环境、社交活动、社区活动、语言、家务活动呈正相关(P<0.05),与居住地与康复点的距离呈负相关(P<0.05)。因此,培养藏族康复治疗师、改善居住环境、减少群居环境的依赖性、缩短居住地和康复点的距离以及增强自理、生产、休闲3个方面能力,有助于患者的功能恢复。
BACKGROUND:Comprehensive evaluation of the real needs of fracture patients in work activities after earthquake and the occupational therapy centered by the survivors can improve the rehabilitation effect.OBLECTIVE:To analyze the relationship between the various factors and functional recovery after upper limbs fracture of earthquake survivors in Yushu district.METHODS:Seventy-four victims with upper limb fracture were invested by on-site survey.The performance and satisfaction of work activities before and after therapy was evaluated by Canadian Occupational Performance Measure (COPM) in order to confirm the occupational issues under resolving of patients.The uniariate analysis and multiple linear regression analysis were employed.RESULTS AND CONCLUSION:The multiple linear regression analysis showed that the performance of work activities was positive correlated with the living conditions,the social interaction activities,the community activities,dialect and housework (P<0.05),while negatively with the distance between the inhabitation and the rehabilitation points (P<0.05).This may provide evidence for future strategy making for developing local therapists of rehabilitation,improving living conditions,reducing the dependence on living conditions,shortening the distance between the inhabitation and the rehabilitation points and enhancing the self-care ability,producing and leisure.
BACKGROUND:Comprehensive evaluation of the real needs of fracture patients in work activities after earthquake and the occupational therapy centered by the survivors can improve the rehabilitation effect.OBLECTIVE:To analyze the relationship between the various factors and functional recovery after upper limbs fracture of earthquake survivors in Yushu district.METHODS:Seventy-four victims with upper limb fracture were invested by on-site survey.The performance and satisfaction of work activities before and after therapy was evaluated by Canadian Occupational Performance Measure (COPM) in order to confirm the occupational issues under resolving of patients.The uniariate analysis and multiple linear regression analysis were employed.RESULTS AND CONCLUSION:The multiple linear regression analysis showed that the performance of work activities was positive correlated with the living conditions,the social interaction activities,the community activities,dialect and housework (P<0.05),while negatively with the distance between the inhabitation and the rehabilitation points (P<0.05).This may provide evidence for future strategy making for developing local therapists of rehabilitation,improving living conditions,reducing the dependence on living conditions,shortening the distance between the inhabitation and the rehabilitation points and enhancing the self-care ability,producing and leisure.
引文
[1]Shi YK,Zheng SW,Deng SL.Zhongguo Xunzheng Yixue Zazhi.2010;10(4):373-375.石应康,郑尚维,邓少林.从汶川经验到玉树医疗救援[J].中国循征医学杂志,2010,10(4):373-375.
[2]Zhang X,Bian R,Li JA.Zhongguo Kangfu Yixue Zazhi.2009;24(1):5-8.张霞,卞荣,励建安,等.四川江油地震伤员康复状况分析[J].中国康复医学杂志,2009,24(1):5-8.
[3]Hui XP,Packer TL,Ouyang DL,et al.Zhongguo Kangfu Lilun yu Shijian.1995;1(1):15-19.恽晓平,Packer TL,欧阳多利,等.从113例不同疾病患者的活动障碍分析看作业治疗的必要性[J].中国康复理论与实践,1995,1(1):15-19.
[4]Dedding C,Cardol M,Eyssen IC,et al.Validity of the Canadian Occupational Performance Measure:a client-centred outcome measurement.Clin Rehabil.2004;18(6):660-667.
[5]Law M,Baptiste S,Carswell A,et al.COPM-Canadian Ocupational Performance Measure[EB/OL].http://www.caot.ca/copm/index.htm[2005-05].
[6]Ministary of Health of the People’s Republic of China,China Disabled Persons’Federation.Zhongguo Kangfu Yixue Zazhi.2008;23(7):577.卫生部,中国残联.地震伤员康复指导规范[J].中国康复医学杂志,2008,23(7):577.
[7](COPM)Canadian Association of occupational therapist.Guidelines for the client-centered practice of occuptiona therpy[M].Toronto:CAOT Publications ACE.1991.
[8]Law M,Baptiste S,McColl M,et al.The Canadian occupational performance measure:an outcome measure for occupational therapy.Can J Occup Ther.1990;57(2):82-87.
[9]Esnouf JE,Taylor PN,Mann GE,et al.Impact on activities of daily living using a functional electrical stimulation device to improve dropped foot in people with multiple sclerosis,measured by the Canadian Occupational Performance Measure.Mult Scler.2010;16(9):1141-1147.
[10]Colquhoun H,Letts L,Law M,et al.Routine administration of the Canadian Occupational Performance Measure:effect on functional outcome.Aust Occup Ther J.2010;57(2):111-117.
[11]Ostensj S,Oien I,Fallang B.Goal-oriented rehabilitation of preschoolers with cerebral palsy--a multi-case study of combined use of the Canadian Occupational Performance Measure(COPM)and the Goal Attainment Scaling(GAS).Dev Neurorehabil.2008;11(4):252-259.
[12]Jenkinson N,Ownsworth T,Shum D.Utility of the Canadian Occupational Performance Measure in community-based brain injury rehabilitation.Brain Inj.2007;21(12):1283-1294.
[13]Cusick A,Lannin NA,Lowe K.Adapting the Canadian Occupational Performance Measure for use in a paediatric clinical trial.Disabil Rehabil.2007;29(10):761-766.
[14]Kirsh B,Cockburn L.The Canadian Occupational Performance Measure:a tool for recovery-based practice.Psychiatr Rehabil J.2009;32(3):171-176.
[2]Zhang X,Bian R,Li JA.Zhongguo Kangfu Yixue Zazhi.2009;24(1):5-8.张霞,卞荣,励建安,等.四川江油地震伤员康复状况分析[J].中国康复医学杂志,2009,24(1):5-8.
[3]Hui XP,Packer TL,Ouyang DL,et al.Zhongguo Kangfu Lilun yu Shijian.1995;1(1):15-19.恽晓平,Packer TL,欧阳多利,等.从113例不同疾病患者的活动障碍分析看作业治疗的必要性[J].中国康复理论与实践,1995,1(1):15-19.
[4]Dedding C,Cardol M,Eyssen IC,et al.Validity of the Canadian Occupational Performance Measure:a client-centred outcome measurement.Clin Rehabil.2004;18(6):660-667.
[5]Law M,Baptiste S,Carswell A,et al.COPM-Canadian Ocupational Performance Measure[EB/OL].http://www.caot.ca/copm/index.htm[2005-05].
[6]Ministary of Health of the People’s Republic of China,China Disabled Persons’Federation.Zhongguo Kangfu Yixue Zazhi.2008;23(7):577.卫生部,中国残联.地震伤员康复指导规范[J].中国康复医学杂志,2008,23(7):577.
[7](COPM)Canadian Association of occupational therapist.Guidelines for the client-centered practice of occuptiona therpy[M].Toronto:CAOT Publications ACE.1991.
[8]Law M,Baptiste S,McColl M,et al.The Canadian occupational performance measure:an outcome measure for occupational therapy.Can J Occup Ther.1990;57(2):82-87.
[9]Esnouf JE,Taylor PN,Mann GE,et al.Impact on activities of daily living using a functional electrical stimulation device to improve dropped foot in people with multiple sclerosis,measured by the Canadian Occupational Performance Measure.Mult Scler.2010;16(9):1141-1147.
[10]Colquhoun H,Letts L,Law M,et al.Routine administration of the Canadian Occupational Performance Measure:effect on functional outcome.Aust Occup Ther J.2010;57(2):111-117.
[11]Ostensj S,Oien I,Fallang B.Goal-oriented rehabilitation of preschoolers with cerebral palsy--a multi-case study of combined use of the Canadian Occupational Performance Measure(COPM)and the Goal Attainment Scaling(GAS).Dev Neurorehabil.2008;11(4):252-259.
[12]Jenkinson N,Ownsworth T,Shum D.Utility of the Canadian Occupational Performance Measure in community-based brain injury rehabilitation.Brain Inj.2007;21(12):1283-1294.
[13]Cusick A,Lannin NA,Lowe K.Adapting the Canadian Occupational Performance Measure for use in a paediatric clinical trial.Disabil Rehabil.2007;29(10):761-766.
[14]Kirsh B,Cockburn L.The Canadian Occupational Performance Measure:a tool for recovery-based practice.Psychiatr Rehabil J.2009;32(3):171-176.
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