Zusammenfassung
Fragestellung: Es sollte die funktionelle Gesundheit und die häufigsten Einschränkungen von Patienten der fachübergreifenden Frührehabilitation mithilfe der Internationalen Klassifikation für Funktionsfähigkeit, Behinderung und Gesundheit (ICF) beschrieben werden. Material und Methode: Querschnittstudie einer Stichprobe von Patienten der indikationsübergreifenden Frührehabilitation. Die Kategorien der zweiten Ebene der ICF wurden zur Datenerhebung eingesetzt. Es wurden absolute und relative Häufigkeiten der Einschränkungen in den Kategorien der Komponenten Körperfunktionen, Körperstrukturen und Aktivität und Partizipation und der positiven und negativen Faktoren (Förderfaktoren und Barrieren) der Kategorien der Komponente Umweltfaktoren berichtet. Ergebnisse: Die 174 Patienten waren im Mittel 59,8 Jahre alt. 37 % waren Frauen. 85 Kategorien (35 %) hatten eine Prävalenz von 30 % oder darüber. Davon stammten 25 Kategorien (32 %) aus der Komponente Körperfunktionen, 10 Kategorien (33 %) aus Körperstrukturen, 30 Kategorien (41 %) aus Aktivitäten und Partizipation und 20 Kategorien (39 %) aus Umweltfaktoren. Am häufigsten waren Kategorien der Kapitel Neuromuskuloskeletale und bewegungsbezogene Funktionen und Mobilität. Schlussfolgerung: Diese Studie ist eine erste Grundlage für die Entwicklung von ICF Core Sets für Patienten der fachübergreifenden Frührehabilitation.
Abstract
Purpose: To describe functioning and health of patients in early post-acute rehabilitation facilities and to identify the most common problems using the International Classification of Functioning, Disability and Health (ICF). Material and method: Cross-sectional survey in a convenience sample of patients requiring rehabilitation in early post-acute rehabilitation facilities. The second level categories of the ICF were used to collect information on patients' problems. For the ICF components Body Functions, Body Structures and Activities and Participation absolute and relative frequencies of impairments or limitations in the study population were reported. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. Results: The mean age in the sample of 174 patients was 59.8 years. 37 % of the patients were female. 85 categories (35 %) had a prevalence of 30 % and above. The 85 categories included 25 categories (32 %) of Body Functions, 10 categories (33 %) of Body Structures, 30 categories (41 %) of Activities and Participation and 20 (39 %) categories of Environmental Factors. The most common categories belonged to the chapters Movement related functions and Mobility. Conclusion: This study is a first step towards the development of ICF Core Sets for patients in early post-acute rehabilitation facilities.
Schlüsselwörter
Rehabilitation - fachübergreifende Frührehabilitation - ICF - ICF Core Sets
Key words
Rehabilitation - outcome assessment - cross sectional studies - post-acute rehabilitation - ICF - ICF Core Set
References
1 Stucki G, Stier-Jarmer M, Grill E, Melvin J. Rationale and principles of early rehabilitation care provision after an acute injury or illness. Disabil Rehabil 2005; in press
2
Stucki G, Stier-Jarmer M, Berleth B, Gadomski M.
Indikationsübergreifende Frührehabilitation.
Phys Med Rehab Kuror.
2002;
12
146-156
3
Stucki G, Ewert T, Cieza A.
Value and application of the ICF in rehabilitation medicine.
Disabil Rehabil.
2002;
24 (17)
932-938
4
Grimes D A, Schulz K F.
An overview of clinical research: the lay of the land.
Lancet.
2002;
359
57-61
5
Kelly-Hayes M, Robertson J T, Broderick J P, Duncan P W, Hershey L A, Roth E J. et al .
The american heart association stroke outcome classification.
Stroke.
1998;
29
1274-1280
6
Collin C, Wade D T, Davies S, Horne V.
The Barthel ADL index: a reliability study.
Int Disabil Stud.
1988;
10 (2)
61-63
7
Loewen S C, Anderson B A.
Predictors of stroke outcome using objective measurement scales.
Stroke.
1990;
21
78-81
8
Gresham G, Philips T F, Labi M L.
ADL status in stroke: relative merits of three standard indexes.
Arch Phys Med Rehabil.
1980;
61
355-358
9
Roy C W, Togneri J, Hay E, Pentland B.
An inter-rater reliability study of the Barthel index.
Int J Rehabil Res.
1988;
11
67-70
10
Prosiegel M, Böttger S, Schenk T, König N, Marolf M, Vaney C. et al .
Der Erweiterte Barthel-Index (EBI) - eine neue Skala zur Erfassung von Fähigkeitsstörungen bei neurologischen Patienten.
Neurol Rehabil.
1996;
1
7-13
11
Lawrence E S, Coshall C, Dundas R. et al .
Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population.
Stroke.
2001;
32
1279-1284
12
Mukand J A, Blackinton D D, Crincoli M G, Lee J J, Santos B B.
Incidence of Neurologic Deficits and Rehabilitation of Patients with Brain Tumors.
Am J Phys Med Rehabil.
2001;
80
346-350
13
Ragnarsson K T.
Results of the NIH consensus conference on „Rehabilitation of Persons with Traumatic Brain Injury”.
Restor Neurol Neurosci.
2002;
20 (3 - 4)
103-108
14
Pashkow P, Ades P, Emery C, Frid D, Miller N, Peske G. et al .
Outcome Measurement in Cardiac and Pulmonary Rehabilitation by the AACVPR Outcome Committee.
J Cardiopul Rehabil.
1995;
15 (6)
394-405
15
ACCP/AACVPR Pulmonary Rehabilitation Guidelines Panel .
Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Guidelines.
Journal of Cardiopulmonary Rehabilitation.
1997;
17 (6)
371-405
16
Marsh N V, Kersel D A, Havill J H, Sleigh J W.
Caregiver burden during the year following severe traumatic brain injury.
J Clin Exp Neuropsychol.
2002;
24
434-437
17
Mant J, Carter J, Wade D T, Winner S.
Family support for stroke: a randomised controlled trial.
Lancet.
2000;
356
808-813
18
Kärner A M, Dahlgren M A, Bergdahl B.
Rehabilitation after coronary heart disease: spouses' view of support.
J Adv Nurs.
2003;
46
204-211
19
Grissom S P, Dunagan L.
Improved satisfaction during inpatient rehabilitation after hip and knee athrosplasty: a retrospective analysis.
Am J Phys Med Rehabil.
2001;
80 (11)
798-803
20 Boldt C, Brach M, Grill E, Berthou A, Meister K, Scheuringer M. et al .The ICF categories identified in nursing interventions administered to neurological patients with post-acute rehabilitation needs. Disabil Rehabil 2005; in press
21 Grill E, Hermes R, Swoboda W, Uzarewicz C, Kostanjsek N, Stucki G. ICF Core Set for geriatric patients in early post-acute rehabilitation facilities. Disabil Rehabil 2005; in press
22 Stier-Jarmer M, Grill E, Ewert T, Bartholomeyczik S, Finger M, Mokrusch T. et al .ICF Core Set for patients with neurological conditions in early post-acute rehabilitation facilities. Disabil Rehabil 2005; in press
Gerold StuckiMD, MS, Professor and Chairman
Department of Physical Medicine and Rehabilitation · University of Munich
Marchioninistraße 15
81377 Munich · Germany
Phone: 0049/89/7095-4050
Fax: 0049/89/7095-8836
Email: gerold.stucki@med.uni-muenchen.de