Rehabilitation

康复治疗

Rehabilitation: A combination of physical, occupational, and speech therapy; psychologic counseling; and social work directed toward helping patients maintain or recover physical capacities.

康复医学：集理疗、工疗、言语治疗、心理咨询和社会工作为一体，旨在帮助病人维持和恢复体能的医学。

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.

发生下列情况时常常需要进行康复治疗：髋部骨折、截肢、卒中、严重心脏病、或长期卧床休息造成全身状况不良、或关节炎辅助治疗、或其他造成不同程度功能丧失的疾病或损伤。通常，年轻病人的康复目的是完全自如地恢复功能；年老病人则是要尽可能多地恢复日常生活活动。年轻人往往恢复得快，老年人则进展缓慢。

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.

康复治疗可以在急诊保健医院进行，但那里鲜有系列性康复治疗方案。康复医院通常可以提供最广泛、深入的保健服务，有潜力、能参与剧烈项目的病人(如能耐受每天3小时及以上治疗的病人)可考虑进行康复医院治疗。.许多疗养院都有康复项目(一般为每天1小时，每周不超过5天)，因此更适合那些只需要一般性康复治疗的病人(如体弱或老年人病人)。一些种类较少、次数不多的康复项目也可以在门诊或病人家中进行，很多病人适合这种方式。

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.

开始正式康复治疗时，医生必须书面安排理疗师、治疗师或康复中心人员工作，明确说明治疗目的，且内容详细，包括相关信息和初始指令。虽然人们通常也接受一些模糊的指令(例如“理疗评估和治疗”)，但这样做并不恰当。治疗方案写作不熟练的医生应请教资深治疗师、理疗师或矫形医生。

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.医学.全在线www.med126.com

伤残病人易患抑郁症，并可能失去恢复功能和回归社会的积极性。心理保健专家可帮助这些病人摆脱这些不利情感状态，把注意力集中到功能恢复上。家人也须适应病人伤残情况，正确帮助病人。伤残也可能造成病人和家属经济困难，社会工作者应帮助其处理好。

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.

初始评估包括目标讨论，其重点一般是恢复日常生活能力，包括个人自理能力，如修饰行为、沐浴、穿衣、进食、如厕， 以及烹饪、清扫、购物、用药、管理钱财、使用电话和旅游等。安排治疗的医生和康复小组可以确定采用何种活动，确定何种活动对病人维持独立很有必要。