Author/Editor		Fefer, Neža; Šuc, Lea; Novak, Primož; Prosič, Zdenka
Title		Proces delovno-terapevtske obravnave pri bolniku s sindromom Guillain-Barré
Translated title		Treatment for patient with Guillain Barre syndrome
Type		članek
Vol. and No.		Letnik 20, št. 2
Publication year		2021
Volume		str. 78-85
ISSN		1580-9315 - Rehabilitacija
Language		slv
Abstract		Izhodišča: Sindrom Guillain-Barré (GBS) je vnetna bolezen perifernega živčevja, ki povzroči hude okvare številnih telesnih funkcij in zgradb ter omejitve pri opravljanju dnevnih aktivnosti ali dejavnosti. Večina bolnikov v nekaj mesecih popolnoma okreva, pri nekaterih pa lahko ostanejo trajne posledice na različnih področjih. Vloga delovnega terapevta pri obravnavi oseb z GBS je vzdrževanje ali izboljšanje spretnosti in funkcij, potrebnih za izvedbo aktivnosti ter priprava na vrnitev v domače okolje. Metode: V študiji primera je sodeloval 33-letni bolnik z GBS. Rehabilitacija je potekala na Oddelku za rehabilitacijo pacientov po poškodbah, s perifernimi živčnimi okvarami in revmatološkimi obolenji na Univerzitetnem rehabilitacijskem inštitutu RS ‐ Soča (URI ‐ Soča). Delovno-terapevtska obravnava je potekala znotraj Ameriškega okvira prakse (AOTA), ki zajema tri faze: ocena/vrednotenje, obravnava in izidi. Učinkovitost delovno-terapevtske obravnave smo ocenili s standardiziranimi instrumenti. Za področje funkcij in zgradb smo uporabili Southamptonski test za ocenjevanje roke (angl. Southampton hand assesment procedure, SHAP), za področje dejavnosti pa Lestvico funkcionalne neodvisnosti (angl. Functional Independent Measure, FIM), Kanadski test izvedbe dejavnosti (angl. Canadian Occupational Performance Measure, COPM) in Lestvico doseganja ciljev (angl. Goal attainment scale, GAS). Rezultati: Ob zaključku obravnave so rezultati COPM pokazali izboljšanje bolnikovega dojemanja izvedbe in zadovoljstva z izvedbo zanj pomembnih dejavnosti; povprečna sprememba znaša 5,2 točke. Preiskovanec je dosegel večjo stopnjo samostojnosti na področju funkcionalne mobilnosti in skrbi zase, izboljšale so se zmožnosti gibanja, spretnosti in funkcije roke. Ob vrnitvi v domače okolje so preiskovancu največ težav predstavljale aktivnosti s področja produktivnosti. Pri spremljanju preiskovanca tako v institucionalnem kot tudi v domačem okolju smo opazili negativne in pozitivne vplive posameznega okolja. Zaključek: Spremljanje napredka je pokazalo izboljšanje vseh merjenih parametrov. Preiskovanec je bil uspešen pri doseganju zastavljenih ciljev. Po končani rehabilitaciji se je vrnil v domače okolje. Živel je skupaj s starši, ki so mu nudili pomoč in podporo.Background: Guillain-Barré syndrome (GBS) is an inflammatory disease of the peripheral nervous system that causes impairment of several bodily functions and skills and limits individuals in performing their daily activities or occupations. Most patients recover completely within a few months, but some lasting consequences may remain. The role of the occupational therapist in treating people with GBS is to maintain or increase the skills and functional needs, essential for performing the activities and to prepare patients for returning to their domestic environment. Methods: A 33-year-old patient with GBS was included in the case study. Rehabilitation took place at the Department for rehabilitation of patients after injuries, with peripheral nervous disorders and rheumatoid disease at the University Rehabilitation Institute of the RS ‐ Soča (URI ‐ Soča). The process of occupational therapy treatment was based on the American framework of practice (AOTA), including three phases of the process: evaluation, treatment and outcomes. The effectiveness of the occupational therapy treatment was assessed using standardised tools in the field of functions (Southampton Hand Assessment Procedure ‐ SHAP) and activities (Functional Independent Measure ‐ FIM, Canadian Occupational Performance Measure ‐ COPM, Goal Attainment Scaling - GAS). Results: After the treatment concluded, the results of COPM showed the improvement in the patient’s self-perception of the performance and his own satisfaction at performing the activities that are relevant and important to him. The average change was 5.2 points. The patient achieved a higher level of independence in the field of functional mobility and self-care. In addition, his moving abilities, skills and hand functions improved as well. Upon return to his domestic environment, he faced the most difficulties in the field of productivity activities. While following the patient both in the institutional and domestic environments, we noticed negative as well as positive effects of each type of environment. Conclusions: The monitoring of the progress showed improvement in all of the observed parameters. The patient has been successful in achieving the goals set. In the end of rehabilitation, he returned to his domestic environment to live with his parents, who gave him support and help.
Descriptors		Occupational Therapy Guillain-Barre Syndrome rehabilitation
Keywords		polinevropatija delovno-terapevtska obravnava dnevne aktivnosti funkcija roke ocenjevanje polyneuropathy occupational therapy treatment activities of daily-living hand function assessment