並列タイトル等Quality Management Program of Stroke Rehabilitation Using Adherence to Guidelines : A Nationwide Initiative in Japan
学位博士(医学)
Doctor of Philosophy in Medical Science
一般注記博士論文全文, 最終試験結果の要旨, 論文審査の要旨
Background and AimIn recent years, interest in the quality of medical care has rapidly increased worldwide. However, quality indicators that contribute to establishing standard treatment in stroke medicine, especially rehabilitation, are not well-developed in Japan. Japan has established Kaifukuki (convalescent) rehabilitation wards, and the development of quality indicators for stroke rehabilitation in the convalescent phase is an urgent issue.MethodsWe first reviewed the literature regarding quality indicators for stroke rehabilitation. Next, we extracted candidate indicators from identified reports and guidelines and surveyed educational hospitals certified by the Japanese Association of Rehabilitation Medicine. On the basis of the survey results, we reevaluated the suitability of the proposed indicators in discussions with an expert panel.ResultsThe questionnaire survey highlighted several important items that revealed there is room for improvement in adherence. For stroke rehabilitation in the convalescent phase, we adopted 15 indicators that were feasible as indicators to be used for comparisons between facilities, based on scoring by and opinions of the expert panel. These indicators measured structure (2 indicators), process (5 indicators), and outcome (8 indicators).ConclusionThis is the first study to establish quality indicators to standardize stroke rehabilitation in Japan. We developed this set of 15 indicators using an evidence-based approach. However, many tasks remain for continuous quality improvement.Seiji Miura, Ryuji Miyata, Shuji Matsumoto, Takahiro Higashi, Yoshinobu Wakisaka, Tetsuro Ago, Takanari Kitazono, Koji Iihara, Megumi ShimodozonoQuality Management Program of Stroke Rehabilitation Using Adherence to Guidelines: A Nationwide Initiative in JapanJournal of Stroke and Cerebrovascular Diseases 28(9) p.2434-2441 2019https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.028
コレクション(個別)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
受理日(W3CDTF)2021-11-08T14:10:24+09:00
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