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환자중심 목표설정이 아급성기 뇌졸중 환자의 재활치료 성과에 미치는 영향

The Effect of Patient-Centered Goal Setting on Rehabilitation Outcomes in Patients With Subacute Stroke

  • 원종임 (전주대학교 의과학대학 물리치료학과) ;
  • 안창만 (전북대학교병원 물리치료실) ;
  • 박민희 ((주)호연메디컬 임상교육팀)
  • Won, Jong-im (Department of Physical Therapy, College of Medical Science, Jeonju University) ;
  • An, Chang-man (Department of Physical Therapy, Chonbuk National University Hospital) ;
  • Park, Min-hee (Department of Clinical Education, Hoyeon Medical Corporation)
  • 투고 : 2017.11.12
  • 심사 : 2018.01.02
  • 발행 : 2018.02.19

초록

Background: Patient-centered care has recently become highly recommended, because it can improve health outcomes more effectively than problem-oriented care. The goal attainment scale (GAS) is one of the methods used for patient-centered care. It was originally developed as an outcome measurement tool, but it can also be used as a therapeutic intervention when setting quantifiable patient-centered goals. Objects: We sought to identify the effect of setting patient-centered goals on rehabilitation outcomes in patients with subacute stoke using GAS. Methods: Overall, 46 subjects with subacute stroke were divided into experimental ($n_1=23$) and control ($n_2=23$) groups. Subjects in both groups attended physical therapy sessions five times a week for four weeks. Those in the experimental group set goals using goal-attainment scaling. The mobility of each subject was evaluated using the Rivermead mobility index (RMI); daily-living activities, using the K-modified Barthel index (K-MBI); participation, using the Hopkins rehabilitation-engagement rating scale (HRERS); satisfaction, using the patient-satisfaction scale (PSS). Results: Subjects in the experimental group experienced more significant increases in RMI, HRERS, and PSS than those in the control group (p<.05, p<.05 and p<.01, respectively). After four weeks, GAS scores of the experimental group had increased more significantly than those of baseline (p<.01). Conclusion: Setting patient-centered goals is effective in improving the mobility and satisfaction of patients with subacute stoke. Setting patient-centered goals needs to be performed more frequently in clinical settings.

키워드

참고문헌

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