（注：部分翻译已经修正，QU）

 

Occupational Therapy 作业治疗

OT on the Acquired Brain Injury Team at the GF Strong Rehabilitation Center
GF Strong复康中心后天性脑损伤作业治疗组
Vancouver, Canada
温哥华   加拿大
Erin Hartnett 2009

 

GF Strong Rehabilitation Center GF Strong复康中心
Inpatient and outpatient programs including:住院和门诊项目包括
Acquired brain injury  后天性脑损伤
Spine cord injury  脊髓损伤
Arthritis  关节炎
Neuromuscular Skeletal  神经肌肉骨骼
Adolescent and Young Adult  青少年
Acquired Brain Injury Program 后天性脑损伤项目
Inpatient Unit  住院单元
Average length of stay is 6 8 weeks but that can vary significantly  平均住院期6 8周, 不同情况会有不同
Primary diagnoses include: 初步诊断包括
stroke, traumatic brain injury, brain tumor, anoxic brain injury among others  中风, 脑外伤, 脑瘤, 缺氧性脑损伤
Multidisciplinary team including: 多学科小组包括
Social work, SLP(speech language pathology), PT, MD, Nursing, dietician and OT  社会工作，语言治疗， 物理治疗师，医师，护理，营养师和作业治疗师
Neuropsychologist, psychiatrist, music and recreational therapist, addictions specialist, vocational therapist 神经心理学家，精神病学家，音乐和休闲治疗师，癖嗜学专家，职业治疗师
The OT role on the ABI team 后天性脑损伤小组中作业治疗师的角色
As an occupational therapist, I help people with brain injuries to regain the skills needed for everyday living, such as dressing, eating, bathing, and shopping, as well as for tasks related to homemaking, school, work and leisure.  作为作业治疗师，我帮助脑损伤人士重新获得日常生活所需技能，例如穿衣，吃饭，沐浴，购物，以及家务，学校，工作，休闲相关的任务
Each patient has different goals for their rehabilitation program and these depend on what they will need to do when they leave the hospital. 每位病人都对自己的康复项目有不同 目标，取决于他们出院后需要做什么

What my work includes: 我的工作包括
Assessment and goal development 
   评估和目标发展
Treatment  治疗
Education  教育
Discharge Planning  出院后的计划
Typical goals may include: 典型目标可能包括
Becoming independent with activities of daily living  日常活动能够自理
bathing, grooming, toileting, dressing, feeding  沐浴，扫地，如厕，穿衣，吃饭
Becoming independent with instrumental activities of daily living  工具性日常生活能够自理
meal preparation, housekeeping, laundry, financial management, paying bills and using their cell phones 做饭，家务，洗衣，理财，打理账单，运用手机
Becoming independent with community living tasks  社区生活能够达到独立
transportation, time management, grocery shopping 交通，时间管理，购物

Other Functional Goals of GF Strong Patients: GF Strong病人的其他功能性目标
Returning to Work  回归工作
Returning to Driving  恢复驾驶
Returning to Leisure  恢复休闲活动
*** These are often different for each individual depending on their priorities and what they will need to do when they leave the hospital  这些通常根据个人的优先权以及出院后需要做什么而不同
Assessment 评估
First step is to assess a patient’s functional performance 第一步是评估病人的功能性行为
What tasks are they having difficulty with? 哪些任务执行起来有困难？
The next step is to assess the performance components/impairments 下一步是评估行为构成/损伤
Why are they having difficulty completing those tasks? 为什么完成这些任务有困难？
Assessing Functional Performance 功能性行为能力评估
Day 1 I assess the patient’s transfers and bed mobility with the PT and set up an appropriate wheelchair if needed. 第一天 同物理治疗师一起评估病人的床上/下移动情况，看需要是否提供合适的轮椅
Day 2 I see the patient on the ward in the morning to assess their ADL’s and set them up with an ADL training program as appropriate. 第二天 在病房内探望病人，评估自理能力，设定合适的自理能力培训项目
Day 3 I begin to assess the performance components that are impacting their ability to complete their ADLs independently 第三天 评估影响他们自理能力的行为构成

Performance Components 行为构成Why are they having difficulty completing their ADLs? 是什么造成他们不能自理？

Vision 视力
acuity, visual fields, scanning, tracking 敏锐程度，视野，扫描，跟踪
Perception 感知
neglect, figure ground, spatial orientation, body scheme, visual closure 忽略，层次感，距离感，身体认知，视觉遮盖
Cognition 认知
Orientation, attention, memory, executive functions (problem solving, planning, awareness, initiation and self monitoring) 定位，注意力，记忆力，实施能力（解决问题，计划，意识，主观能动性以及自测）
Physical 身体
PROM/AROM (passive/active range of motion), strength, coordination, sensation, postural control, balance 主动/被动活动度，力量，协调，感觉，姿势控制，平衡
Treatment Plan 治疗计划
The next step is to develop a plan to work on the person’s functional goals by targeting the impairments that are causing the task to be difficult!
   下一步是针对造成行为障碍的损伤，为病人制定一个功能性目标
My treatment plan often includes: 我的治疗计划通常包括
1:1 treatment sessions (for working on visual perceptual, cognitive or physical impairments)
    一对一的治疗（针对视觉感知，认知以及身体障碍）
Seating and equipment intervention 座位及设备干预
Self management training 自我管理培训
ADL training 自理能力培训
IADL and community training 二级自理和社区培训
Patient and family education 病人和家庭教育
Upper extremity programs 上肢项目

Patient and Family Education 病人和家庭教育
It is very important that education happens throughout the person’s stay because when the patient leaves the hospital, they need to be able to keep working on everything they learned in the hospital and their family will be the ones to support them!
    病人住院期间实行教育非常重要，因为病人出院后即需要应用和练习他们在医院学到的内容，他们的家人需要支持他们

Discharge Planning 出院后的计划
Includes: 包括
Home assessment 家庭评估
Organizing necessary equipment 确定必要的设备
Providing a home program 提供家庭项目
Identifying community resources 确定社区资源
Discharge planning is necessary to ensure that the patient and their family have the right tools to manage when they leave the hospital. We want them to be able to return to their life successfully, even if it is different then before!!
    出院后计划的必要性在于保证病人和家庭离院时具备正确的工具。我们希望确保病人成功的回归生活，即使不能完全像从前一样！！
 
Suggestions for Further Lectures 关于未来讲座的建议
ADL training in the hospital 自理能力在医院的培训
Seating and considerations for wheelchairs 座位和轮椅的考虑
Upper extremity management and minimizing shoulder pain 上肢管理以及减少肩痛
Visual perceptual impairments and how they impact ADLs
    视力缺陷及其如何影响自理能力
Cognitive impairments and how they impact ADLs
    认知缺陷及其如何影响自理能力
Discharge planning and preparing the families for taking home a person with a brain injury 出院后的计划，使病人家属准备好迎接脑损伤家人回家

 

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