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Tytuł:
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Understanding the role of the physiatrist and how to improve the continuum of care for trauma patients: a qualitative study.
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Autorzy:
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Hitzig SL; St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.; Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.
Gotlib Conn L; Tory Trauma Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.; Department of Anthropology, Faculty of Arts and Science, University of Toronto, Toronto, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Guilcher SJT; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.; ICES, Toronto, Canada.; MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada.
Cimino SR; St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
Robinson LR; St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.; Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Canada.
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Źródło:
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Disability and rehabilitation [Disabil Rehabil] 2021 Oct; Vol. 43 (20), pp. 2846-2853. Date of Electronic Publication: 2020 Feb 04.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 2015- : Abingdon, Oxford : Taylor & Francis
Original Publication: London ; Washington, DC : Taylor & Francis, c1992-
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MeSH Terms:
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Physiatrists*
Physical and Rehabilitation Medicine*
Humans ; Patient Discharge ; Qualitative Research ; Rehabilitation Centers
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Contributed Indexing:
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Keywords: Wounds and injuries; continuity of patient care; physiatrists; physical and rehabilitation medicine; qualitative research
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Entry Date(s):
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Date Created: 20200205 Date Completed: 20211015 Latest Revision: 20211015
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Update Code:
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20240105
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DOI:
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10.1080/09638288.2020.1719215
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PMID:
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32017865
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Purpose: Transitions across care settings can be stressful for trauma patients, and when poorly executed, can lead to poor outcomes. Early physical medicine and rehabilitation (PM&R) consults in acute care settings can optimize the continuum of care for trauma patients, but there is a need for additional insight on its impact. This study aimed to better understand how early PM&R consults influence the continuum of care between acute and rehabilitation trauma settings.
Methods: Four focus groups were conducted with 21 trauma acute care and rehabilitation staff, and data were analyzed via content analysis.
Results: The main themes identified were: (1) patient-level considerations (i. readiness for rehab [mental health]; ii. patient education and expectations for rehab); (2) clinical-team considerations (i. physiatry role clarity and role limitations; ii. access and accuracy of information; iii. departmental silos); and (3) system-level considerations (i. occupancy and discharge pressures; ii. inter-facility coordination and patient flow).
Conclusions: Although both acute and rehabilitation care staff find early PM&R consults as being important to support the recovery of trauma patients, there is a need for greater role clarity of the physiatrist across settings and a more refined implementation approach to better meet the communication needs of clinical staff. Implications for RehabilitationEarly physical medicine and rehabilitation consults are seen by acute care and rehabilitation front-line staff as valuable for optimizing the continuum of trauma care.There is a lack of clarity on the role of physiatrists among acute care and rehabilitation clinical staff.The physiatrist plays an important role to help prepare trauma patients for rehabilitation. For patients with complex physical and/or mental health challenges, the physiatrist can also serve as an advocate for access to rehabilitation services.