患者报告结局在脑卒中患者临床康复中应用: 范围综述

Application of patient-reported outcome in clinical rehabilitation of stroke patients: A scoping review

关键词:  脑卒中康复  患者报告结局  康复评定  范围综述

Key words:  stroke rehabilitation  patient reported outcome  rehabilitation assessment  scoping review

摘要:

目的 综述患者报告结局在脑卒中康复中应用现状的证据。方法 以“患者报告结局”“卒中”“康复”“Patient Reported Outcome”“Stroke”“Rehabilitation”为检索词，在中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science核心集、Embase、Cochrane Library 8个中英文数据库中系统检索和分析。检索时限为建库至2023年12月31日。 结果 共检索到830篇文献，本综述纳入14篇文献，有关康复评定采取量表的方式进行患者报告结局（patient reported outcome, PRO）的应用，其中1篇设计了基于PRO的干预方案。14篇文献介绍了10个评估工具，PROMIS-10是脑卒中患者康复评定中应用最多的工具。评估内容涉及总体健康状况、临床综合疗效、症状负担、生存质量以及吞咽功能改善情况、身体功能、疲劳、疼痛、社会参与满意度。 结论 PRO在脑卒中康复中应用不断增加，但评估工具亟待统一，效果有待全面验证。

Abstract:

Objective To review the current status of the application of patient-reported outcomes in stroke rehabilitation. Methods Using the terms “patient reported outcome,” “stroke,” and “rehabilitation,”, the relevant literature was searched in 8 Chinese and English databases from inception to December 31, 2023, including China Knowledge Network, Wanfang Database, Weipu Database, Chinese Biomedical Literature Database, PubMed, Web of Science Core Collection, Embase, and Cochrane Library. Results A total of 830 papers were retrieved and 14 studies were included in this review, in which the patient reported outcome(PRO) scales were used in rehabilitation assessment; including one study using a PRO-based intervention program. In 14 papers 10 assessment tools were introduced, with PROMIS-10 being the most frequently used in stroke patient rehabilitation assessments. The assessments focused on general health status, comprehensive clinical outcomes, symptom burden, quality of survival, and improvements in swallowing function, physical function, fatigue, pain, and social participation satisfaction. Conclusion The application of PRO in stroke rehabilitation is increasing; however, the assessment tools need to be unified, and their effectiveness should be fully validated.