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Objective:To investigate the care needs and influencing factors for caregivers of children with disabilities. Methods:From December, 2019 to January, 2020, and August to September, 2020, a total of 496 family caregivers of children with disabilities were surveyed in Shanghai. The Care Needs Assessment Tool for Children with Disabilities was used to measure the care needs rates and satisfaction, and multiple linear regression was performed to analyze the related factors. Results:The rate of total need was 71.8%, which was high in the information support (83.7%), spiritual support (75.9%) and financial support (74.1%), and was at an intermediate level in alternative service support (62.9%) and professional support (62.2%). The satisfaction of total need was 39.4%, which was at a intermediate level in the spiritual support (50.8%) and professional support (45.5%), and was at a low level in alternative service support (32.8%), financial support (32.3%) and information support (30.3%). The caregivers needed less support for thoses with higher public policy satisfaction (B = -3.252, 95%CI -5.370 to -1.134, P = 0.003) and the children with vision and speech disability, and undetermined disability (Bvision disability= -12.160, 95%CI -21.976 to -2.344, P = 0.015; Bspeech disability= -12.754, 95%CI -22.583 to -2.925, P = 0.011; Bundetermined disability= -16.553, 95%CI -24.714 to -8.392, P < 0.001), while mothers (B = 9.071, 95%CI 4.293 to 13.848, P < 0.001) needed more support than grandparents. The caregivers with higher public policy satisfaction (B = 7.392, 95%CI 5.523 to 9.262, P < 0.001), the children with vision disability, hearing disability and speech disability (Bvision disability= 8.612, 95%CI 0.081 to 17.144, P = 0.048; Bhearing disability= 8.686, 95%CI 1.920 to 15.451, P=0.012; Bspeech disability= 9.515, 95%CI 1.184 to 17.846, P = 0.025), lower barriers to social inclusion (B = 1.932, 95%CI 0.457 to 3.408, P = 0.010) and shorter average daily care hours (B = -4.123, 95%CI -6.247 to -1.999, P < 0.001) were more satisfactory for support. Conclusion:The care needs of children with disabilities are diverse, with the highest rate of need for information support and the lowest level of satisfaction. There is some variation in the care needs of children with different types of disabilities, family roles, average daily care hours and social environment characteristics.
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Teniendo en cuenta el insuficiente nivel de actualización del rehabilitador en salud en terapia ocupacional, lo cual atenta contra la atención a pacientes con discapacidades, se elaboró un sistema de procedimientos metodológicos que facilitarán la adquisición, ampliación y perfeccionamiento continuo de los conocimientos y habilidades necesarios para un mejor desempeño en la rehabilitación integral, a partir del carácter científico-tecnológico-asistencial en este proceso.
Keeping in mind the scarce updating level of the health rehabilitator in Occupational Therapy, which is against the care to patients with disabilities, a system of methodological procedures was elaborated that will facilitate the acquisition, amplification and continuous improvement of knowledge and necessary skills for a better acting in the comprehensive rehabilitation, starting from the scientific-technological-assistance character in this process.
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Occupational Therapy , Professional TrainingABSTRACT
Objective To explore the effect of comprehensive rehabilitation nursing on endothelial cell function and limb function in patients with cerebral infarction. Methods A total of 70 cerebral infarction patients with hemiplegia treated from February to August 2017 were divided into the observation group and the control group by random digits table method, 35 cases in each group. The control group was treated with conventional western medicine and rehabilitation training. The observation group was adopted the comprehensive rehabilitation nursing of traditional Chinese medicine on the basis of the control group. The clinical efficacy, nerve function and limb function of the two groups were compared, and the endothelium factor endothelin (ET), nitric oxide (NO) and serum calcitonin gene-related peptide (CGRP) of the patients were detected. Results The total effective rate in the observation group and the control group was 91.43％(32/35), 68.57％(24/35), and the difference was statistically significant (Z=5.887, P=0.041). The NO and CGRP in the observation group after intervention were (68.21±15.46) mg/L, (48.29± 9.04) mg/L and (56.23±12.35) mg/L, (39.86±10.75) mg/L in the control group, while ET was (56.25±9.71) mg/L in the observation group and (68.34 ± 11.84) mg/L in the control group, and the difference was statistically significant (t=3.582, 3.551, 4.771, P=0.000). The Nerve Function score in the observation group after intervention was (8.69 ± 1.66) points and (12.02 ± 1.97) points in the control group, and the strength of upper and lower limbs was (2.78±0.61), (3.42±0.63) grades, better than (2.26±0.45), (2.84± 0.62) grades in the control group, and the score of Fugl- Meyer score was (78.62 ± 10.33) points in the observation group and higher than (69.53±8.64) points in the control group, the difference was statistically significant(t=3.882- 7.647, all P=0.000). Conclusions Comprehensive rehabilitation nursing can significantly improve the clinical effect of cerebral infarction patients with hemiplegia, promote the recovery of limb function and nerve function, which may be related to the effect of improving the function of vascular endothelial cells.
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Objective To explore the clinical effect of cognitive rehabilitation therapy combined with repetitive transcranial magnetic stimulation (rTMS) on diabetes mellitus patients complicated with early cognitive impairment.Methods Eighty patients with type 2 diabetes mellitus complicated with early cognitive impairment admitted to our hospital between February 2016 and February 2018 were randomly divided into a control group and an observation group.Patients in both groups were treated with conventional medications and comprehensive rehabilitation training,while the observation group was additionally treated with rTMS for 4 weeks.The fasting blood glucose (FBG) was detected before and after the treatment.The cognitive status,as well as the latency and amplitude of P300 were evaluated using Montreal cognitive assessment (MoCA),NTS-2000 Instrument for electromyography and evoked potentials before and after the treatment.Results After the treatment,significant decrease was observed within both groups in terms of FBG compared to before the treatment,but no significant differences between the two groups were revealed (P＞0.05).After the treatment,the sub-scores and total scores of the MoCA scale of the two groups were significantly higher than those before treatment,with those of the observation group significantly higher than the control group.After the treatment,the latency of P300 decreased significantly,while the amplitude of P300 increased significantly in both group,with significantly higher improvement in the observation group than the control group (P＜0.05).Conclusion rTMS,in addition to cognitive function rehabilitation,significantly improved cognitive function status in patients with type 2 diabetes mellitus complicated with early cognitive impairment.Such combination is worthy of clinical promotion with its safety,reliability and patient compliance.
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@#Objective To explore the effect of psychological intervention combined with comprehensive rehabilitation on depression after brain injury, and to analyze the psychological stressor.Methods A total of 62 patients with brain injury following depression included 21 cases for cerebral hemorrhage, 22 cases for cerebral infarction, and 19 cases for traumatic brain injury in our hospital from October, 2015 to December, 2017. The patients received comprehensive rehabilitation and psychological intervention for two weeks. They were assessed by the psychologist with Hamilton Rating Scale of Depression (HAMD) before and two weeks after intervention. The effect of all interventions was analyzed on the related psychological stressors on the base of ICF TBI coreset.Results The score of HAMD significantly decreased from (22.96±8.46) to (15.40±7.53) (t=11.709, P<0.001).Conclusion Psychological intervention combined with comprehensive rehabilitation can relieve the depression of brain injured patients.
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Objective To explore the application value of shenjindan capsule combined with comprehensive rehabilitation training on limb function recovery in patients with shoulder hand syndrome.MethodsA total of 90 patients with shoulder-hand syndrome who were treated in our hospital from January 2014 to June 2015 were enrolled in this study.All subjects were randomly divided into three groups using a randomized, 30 cases.Group A was treated only with oral Yanjin Dan capsule, group B was only integrated rehabilitation training, group C was treated with Yanjin Dan capsule and comprehensive rehabilitation training program.Comparison of limb function, life ability recovery and treatment efficiency.ResultsThe scores of FIM score (102.14±6.78) and ADL score (81.65±6.02) in group C were higher than those in group A[(89.32±6.78), (63.56±5.90)] and group B[90.22±6.49), (65.21±6.44)], the difference was significant (P<0.05).The total effective rate of group C was 90.00%, which was significantly better than that of group A (66.67%) and group B (63.33%), the difference was significant (P<0.05).ConclusionShenjindan capsule combined with comprehensive rehabilitation training can significantly improve the limb function of patients with shoulder hand syndrome and clinical treatment effect.
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Se realizó una investigación en sistemas y servicios de salud para evaluar la calidad de la atención brindada en el Servicio de Rehabilitación Integral de base comunitaria, perteneciente al Policlínico Docente "Armando García Aspurú" del municipio de Santiago de Cuba, durante el 2013. La muestra estuvo constituida por 15 profesionales y 180 pacientes, a los cuales se les aplicaron encuestas que fueron validadas a través del coeficiente alfa de Cronbach. Se analizó la dimensión proceso teniendo en cuenta 15 criterios, indicadores y estándares. Al finalizar la evaluación, 12 de estos criterios se consideraron adecuados (80,0 %); por tanto, se cumplió con el estándar establecido. Se concluyó que la atención ofrecida en el servicio antes citado fue adecuada.
An investigation in health systems and services to evaluate the health care quality given in the Comprehensive Rehabilitation Service with community base, belonging to "Armando García Aspurú" Teaching Polyclinic in Santiago de Cuba, was carried out during 2013. The sample had 15 professionals and 180 patients, in whom surveys that were validated through alpha Cronbach coefficient were applied. The process dimension was analyzed taking into account 15 approaches, indicators and standards. When concluding the evaluation, 12 of these approaches were considered appropriate (80.0%); therefore, established standard was fulfilled. It was concluded that the health care aboved mentioned was optimal.
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Primary Health Care , Rehabilitation ServicesABSTRACT
Objective To analyze the therapeutic effect of acute stroke dysphagia using rehabilitation therapy.Methods A total of 94 cases diagnosed with dysphagia after acute stroke were randomly selected from January 2012 to May 2013 in our hospital.The patients were equally divided into control group and research group.The control group received the conventional support treatment and the research group received comprehensive rehabilitation treatment.The results of swallowing dysfunction recovery of two groups were compared.Results After the treatment for 3 weeks,swallowing disorder degree score and swallowing function ratings were improved in both groups and the research group's scores were significantly higher than those of the control group (P ＜0.05) Conclusion Application of comprehensive rehabilitation treatment for dysphagia in patients with acute stroke has significant curative effect and is worth promoting.
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@#Objective To explore the effect of community comprehensive rehabilitation on quality of life in patients with stroke sequelae under the family medical service mode. Methods From October, 2013 to October, 2014, 51 patients with stroke sequelae received compre-hensive rehabilitation intervention for three months, including rehabilitation training, rehabilitation guidance, health education and psycho-logical counseling. They were assessed with modified Barthel index (MBI), WHO-Disability Assessment Schedule (WHO-DASⅡ), Short Form 36 Health Survey Questionnaire (SF-36), Brain Injury Community Rehabilitation Outcome Scales (BICRO-39), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) before and after intervention. Results The scores of physical functionning, role physical, general health, mental health, social functioning and the total score in SF-36 increased after intervention (t>2.072, P<0.05). The scores of so-cial contact, locomotivity, self handling transaction ability and the total score in BICRO-39 decreased after intervention (t>2.434, P<0.05), as well as the scores of getting along with people, housework and society and participation in WHO-DAS II (t>2.507, P<0.05). Conclusion In the community health service, comprehensive rehabilitation guided by multidisciplinary rehabilitation team can facilitate to improve the quality of life in patients with stroke sequela.
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Objective To analysis the effect of using comprehensive rehabilitation treatment for osteoporotic bulging disc combine diabetes otients.Methods Ninety cases osteoporotic bulging disc combine diabetes patients, who treated in Guanganmen Hospital of Chinese Academy of Traditional Chinese Medicine from January 2011 to January 2011, were randomly divided them into observation group and control group, 45 cases in each group, control group was given conventional treatment, the observation group was given comprehensive rehabilitation treatment, compare visual analogue scale (VAS) score and Oswetry functional disability index (ODI) changes in two groups after treatment, and compared the efficient of treatment.Results VAS scores after treatment for one course and 2 courses in observation group were respectively (2.05± 1.31) and (1.26± 1.03) points,ODI score was respectively (26.37±5.10) and (21.82±4.57) points, VAS score in the control group was (5.85±1.38) and (3.29±1.94) points,ODI score was respectively (37.29±6.32) and (28.33±5.30), all obviously improving than before treatment, but compared with control group, the observation group improved more apparent,the difference between groups was statistically significant(P＜0.05).Treatment effective rate in observation group was 95.56％ (43/45), the control group was 80.00％ (36/45), the difference between groups was statistically significant(x2=5.075 ,P＜0.05).Conclusion Comprehensive rehabilitation therapy applied in treatment for osteoporotic bulging disc combine diabetes patients can obviously improve the patient's pain symptomsand and the lumbar spine, obtain better treatment effect, worthy of clinical popularization and applications.
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The Comprehensive Rehabilitation on Combining Medical Treatments with Education (CRCMTE) has become hot in the field of special education and rehabilitation medicine. The research of CRCMTE is deepening, the formulation of CRCMTE was drawn on a special background, and the content of CRCMTE involves extensive range of service. The research in the future will focus on some fields, such as personnel training, establishing institution, the school-based rehabilitation, and the reform of children's hospital rehabilitation depart-ment (center).
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@#The Comprehensive Rehabilitation on Combining Medical Treatments with Education (CRCMTE) has become hot in the field of special education and rehabilitation medicine. The research of CRCMTE is deepening, the formulation of CRCMTE was drawn on a special background, and the content of CRCMTE involves extensive range of service. The research in the future will focus on some fields, such as personnel training, establishing institution, the school-based rehabilitation, and the reform of children's hospital rehabilitation department (center).
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Se efectuó un estudio descriptivo, longitudinal y prospectivo de 28 mujeres con mastectomía radical modificada, a fin de evaluar las principales alteraciones del hombro ipsolateral y su respuesta ante la atención fisioterapéutica brindada en el Servicio de Rehabilitación Integral del Policlínico Universitario "Julián Grimau García" de Santiago de Cuba, desde junio hasta noviembre del 2011. En la casuística, 3 pacientes abandonaron el tratamiento. La complicación más frecuente fue la omalgia (67,8 %), acompañada en muchos casos de limitación articular y disminución de la fuerza del miembro superior afectado. Entre los procederes terapéuticos empleados figuraron: tratamiento postural, cinesiterapia y masoterapia. La respuesta al tratamiento fue satisfactoria en 96,2 % de las afectadas, puesto que las técnicas y procederes fisioterápicos utilizados eran sencillos y con escasos recursos materiales.
A descriptive, longitudinal and prospective study was conducted in 28 women with modified radical mastectomy in order to assess the main ipsilateral shoulder disorders and their response to physiotherapy provided in Comprehensive Rehabilitation Service of "Julián Grimau García" University Polyclinic of Santiago de Cuba from June to November 2011. In the case series 3 patients discontinued treatment. The most frequent complication was the shoulder pain (67.8%), accompanied in many cases by joint limitation and decreased strength of the affected upper limb. Among the therapeutic procedures were postural treatment, kinesitherapy and massage therapy. The response to treatment was successful in 96.2% of patients, since the used techniques and therapeutic procedures were simple and with limited material resources.
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Objective To study the efficacy of simple Chinese medicine steam spray and comprehensive rehabilitation nursing after facial burn deep Ⅱ degree.Methods 80 patients were randomized into the treatment group (40 cases) and the control group (40 cases).The treatment group was given the treatment of Chinese medicine steam spray.The control group was given the treatment of Chinese medicine steam spray,pressure therapy,physical therapy,rehabilitation training and psychotherapy.The clinical efficacy of two groups was evaluated respectively after 3 months.Results After 3 months,the skins of most of patients in the treatment group were nearly normal with no pigmentation and scar hyperplasia.The cure rate was 72.5 ％,the obvious effective rate was 12.5 ％,and the effective rate was 7.5 ％.Some patients in the control group were lightly and inconspicuously pigmented,but the pigmentation area was reduced.The colour of their skins was not different from that of the normal skin.The cure rate was 42.5 ％,the obvious effective rate was 12.5 ％,and the effective rate was 25.0 ％.The effects of the two groups were significant differences (P＜0.05).Conclusions Comprehensive rehabilitation nursing after the facial burn can reduce the pigmentation and scar hyperplasia and improve the quality of life.
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@#Objective To evaluate the effects of comprehensive rehabilitation training on the patients with schizophrenia by Meta-analysis.Methods Articles were searched form PubMed (2001 to 2011), EMCC(1995 to 2011), CNKI(1989 to 2011), VIP(1989 to 2011), and CBM(1989 to 2011), which were randomized controlled trials (RCTs) or controlled clinical trials (CCTs) about comprehensive rehabilitation training for schizophrenia. Quality of included articles was assessed with Jadad Scale, and the available data were analyzed with RevMan 5.0 software. Results 596 related articles were identified, but only 16 eligible articles were included. All the trials were of low quality. Meta-analysis showed that compared comprehensive rehabilitation training could improve the scores of Positive and Negative Syndrome Scale (PANSS) [Weighted Mean Difference (WMD) =-9.21, 95% CI(-10.83, -7.59), Z=11.6, P<0.00001], activites of daily living (ADL) [WMD=-5.84, 95% CI(-8.74, -2.94), Z=3.94, P<0.0001], Nurses' Observation Scale for Inpatient Evaluation (NOSIE) total score [WMD=27.50, 95%CI(16.18,38.81), Z=4.76, P<0.00001] and total score of negative factors [WMD=-13.60, 95%CI(-22.41, -4.80),Z=3.03, P=0.002], compared with those in routine care/management group. There was no significant difference between both groups in Social Disability Screening Schedule (SDSS) [WMD=-2.50, 95% CI(-5.33, 0.33), Z=1.73, P=0.08] and NOSIE total positive factor score [WMD=15.00, 95%CI(-2.06, 32.06), Z=1.72, P=0.08]. Conclusion Comprehensive rehabilitation training can reduce the positive and negative symptoms, improving the ability of daily living and quality of life.
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@# Unlike other vulnerable groups, rehabilitation is the most urgent problem to be resolved for the disabled. Good working onrehabilitation for the disabled is the foundation to improve the basic living condition and enhance the ability to participate in the society, andcommunity-based rehabilitation is the key to achieve "Rehabilitation for All" for the disabled. The goal "Rehabilitation for All" can beachieved only if "rehabilitation in community and service in family" be reached.
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Cardiac rehabilitation (CR) offers a highly effective causative treatment of atherosclerotic coronary and peripheral disease. The life style and risk factor modifications achieved by CR have been shown to halt disease progression, and to reduce cardiovascular mortality and the rate of non-fatal myocardial infarction in patients with coronary artery disease. CR programs consist of exercise training, medical counseling, cardiovascular disease education, and psychosocial support. This comprehensive approach has significant benefits on exercise capacity, coronary risk factors, and health-related quality of life. In addition, CR reduces all-cause mortality as well as cardiovascular events. In general, CR programs consist of 3 stages : acute stage (phase I), convalescent stage (phase II), and chronic stage (phase III). In addition to this preventive approach, exercise-based intervention programs are also effectively used for chronic heart failure (CHF). Since exercise intolerance in CHF is primarily related to the degree of peripheral changes (such as muscle atrophy, reduced peripheral perfusion due to endothelial dysfunction, abnormalities in ventilation), regular aerobic training in CHF has been shown to improve peak oxygen uptake, to reduce peripheral vascular resistance, to retard or reverse muscle wasting, and to reduce morbidity. Despite its documented clinical effectiveness, rehabilitation and a preventive approach are still widely underutilized in Japan. However, it becomes increasingly clear that the use of interventional and surgical procedures is suboptimal therapy in the absence of simultaneous lifestyle modifications, including regular physical exercise and controlling cardiovascular risk factors.
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@#Objective To explore the comprehensive rehabilitation on motor function after stroke. Methods 60 stroke patients were dividedinto 2 groups (n=30) who respectively accepted normal neurodevelopment therapy (control group) and comprehensive rehabilitation(experimental group) for 3 months. They were assessed with Fugl-Meyer Assessment (FMA) before and 3 months after the treatment. ResultsThere was significant improvement in both groups after treatments (P<0.01), and it was more in the experimental group than in the controlgroup (P<0.05). Conclusion Comprehensive rehabilitation can improve the motor function after stroke.
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@#ObjectiveTo observe the effect of comprehensive rehabilitation on chronic obstructive pulmonary disease(COPD).Methods10 patients with COPD received COPD training program. Relapse and ability of life were assessed 6 months after intervention.ResultsRe-admission and stay in hospital were 2-5 times and averaged 15 days respectively before intervention while re-admission and stay in hospital were 1-3 times and averaged 9 days respectively after intervention. Ability of life showed self-care, 0 case; partly self-care, 2 cases; no self-care, 8 cases before intervention while self-care, 5 case; partly self-care, 1 case; no self-care, 4 cases.ConclusionComprehensive rehabilitation can improve the quality of life of patients with COPD.
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@# ObjectiveTo investigate the needs and services of rehabilitation for persons with disabilities. MethodsThe questionnaires were issued through the journal Disability in China and collected the posted questionnaire to be analyze. ResultsPersons with disabilities have urgently needed rehabilitation, education, employment and barrier free environment reconstruction, yet short of services were supplied. ConclusionBased on the urgent comprehensive rehabilitation needs of persons with disabilities, the rehab-protective system and rehab-service system should be established and perfected in order to improve service quality constantly.