Rehabilitation | 康復醫(yī)學 |
Rehabilitation: A combination of physical, occupational, and speech therapy; psychologic counseling; and social work directed toward helping patients maintain or recover physical capacities. | 康復醫(yī)學:集體療、工療、語言訓練、心理咨詢和社會工作為一體,旨在幫助病人維持和恢復體能的醫(yī)學?!?/td> |
Rehabilitation is often needed after hip fracture, amputation, stroke, serious cardiac events, or prolonged bed rest that results in deconditioning or as part of the treatment of arthritis or various other illnesses or injuries causing varying degrees of functional loss. Usually, for younger patients, the goal is to achieve full, unrestricted function and, for older patients, to restore the ability to perform as many activities of daily living as possible. Recovery is often rapid for younger patients, but progress may be slow for elderly patients. | 發(fā)生下列情況時常常需要進行康復治療:髖部骨折、截肢、卒中、嚴重心臟病、或長期臥床休息造成全身狀況不良、或關(guān)節(jié)炎輔助治療、或其他疾病造成程度不同的功能喪失等。通常,年輕病人的康復治療目的是完全恢復功能,并不受限制;年老病人則是要盡可能多地恢復日常生活活動能力。年輕人往往恢復得快,老年人則進展緩慢。 |
Rehabilitation may begin in an acute care hospital, but organized rehabilitation programs rarely exist there. Rehabilitation hospitals usually provide the most extensive and intensive care and should be considered for patients who have the most potential and who can participate in aggressive intervention (eg, patients must be able to tolerate therapy for >= 3 h/day). Many nursing homes have programs that are less intensive (generally 1 h/day, < 5 days/wk) and, thus, are better suited to those who need more gentle rehabilitation (eg, frail or elderly patients). Rehabilitation programs with less variety and frequency of services may be offered in outpatient settings or at home and are appropriate for many patients. | 康復治療可以在急診護理醫(yī)院進行,但那里鮮有系列性康復治療方案。康復醫(yī)院通??梢蕴峁V泛深入的保健服務,有潛力、能參與劇烈項目的病人(如能耐受每天3小時及以上治療的病人)可考試進康復醫(yī)院治療。.許多療養(yǎng)院也有一般性康復項目(一般為每天1小時,每周不超過5天),因此更適合那些只需要一般性康復治療的病人(如體弱或老年人病人)。一些種類較少、次數(shù)不多的康復項目也可以在門診或病人家中進行,很多病人適合這種方式。 |
To initiate formal rehabilitation therapy, a physician must write a referral to a physiatrist, therapist, or rehabilitation center. The referral should establish the goal of therapy and, therefore, should be detailed, including relevant information and initial instructions. Although vague instructions (eg, "physical therapy to evaluate and treat") are often accepted, they are not adequate. Physicians unfamiliar with writing referrals should consult with a senior therapist, physiatrist, or orthopedic surgeon. | 開始正式康復治療時,醫(yī)生必須給理療師、治療師或康復中心提供一份治療方案,明確說明治療目的,且內(nèi)容詳細,包括相關(guān)信息和初始指令。雖然人們通常也接受一些模糊的指令(例如“理療評估和治療”),但這樣做并不恰當。治療方案寫作不熟練的醫(yī)生應請教資深治療師、理療師或矯形醫(yī)生。 |
Disabled patients tend to be depressed and may lose motivation for restoring lost function and returning to the community. Mental health specialists may help the patient overcome these adverse emotional states and focus on functional recovery. The family may have to adjust to the patient's disability and appropriately assist the patient. Disability may cause financial hardship to the patient and family. A social worker helps the patient and family adjust. | 傷殘病人易患抑郁癥,并可能失去恢復功能和回歸社會的積極性。心理保健專家可幫助這些病人擺脫這些不利情感狀態(tài),把注意力集中到功能恢復上。家人也須適應病人傷殘情況,正確幫助病人。傷殘也可能造成病人和家屬經(jīng)濟困難,社會工作者應幫助其處理好?!?/td> |
Initial evaluation includes discussions on objectives, which generally focus on restoring function for activities of daily living (ADLs). ADLs include personal care such as grooming, bathing, dressing, feeding, and toileting as well as cooking, cleaning, shopping, managing medications, managing finances, using the telephone, and traveling. The referring physician and rehabilitation team can determine which of these activities are achievable and which are essential for the patient to remain independent. | 初始評估包括目標討論,其重點一般是恢復日常生活能力,包括個人自理能力,如修飾行為、沐浴、穿衣、進食、如廁, 以及烹飪、清掃、購物、用藥、管理錢財、使用電話和旅游等。安排治療的醫(yī)生和康復小組可以確定采用何種活動,確定何種活動對病人維持獨立很有必要?!?/td> |