Ei dian otsikkoa

1
Svensk Neuropediatrisk Förening Vidareutbildnings
dagar 13-14, 2005 VÅRDPROGRAM EN RÄDDARE I
NÖDEN eller SLUTET PÅ INDIVIDUELL KLINISK
BEDÖMNING Lennart von Wendt Prof Barnneurologi,
Hfors Prof Neuropediatrisk rehabiliteriung,
ALB/KI, Sthlm
2
Skräckexempel på hur barn med neuropsykiatriska
svårigheter remitteras härs- och tvärs i
Helsingfors mellan primärvård och
specialsjukvården
3
Assessment of national clinical practice in the
treatment and rehabilitation of children with
cerebral palsy H. Anttila, I. Autti-Rämö, J.
Suoranta, A. Malmivaara, M. Mäkelä FinOHTA, The
National Research and Development Centre for
Welfare and Health (STAKES), Helsinki, Finland
4
Objectives 1) To survey the availability and use
of different therapies and drugs on children with
CP. 2) To identify what therapies and treatments
will be chosen for three varying severity of
diplegic CP.
5
Methods Structured questionnaires and video
recordings of three example cases with short
written summary.
Data collection in November-December 2003
of child neurological rehabilitation teams that
cover medical rehabilitation in Finland 5
university hospitals, 15 central district
hospitals, nongovernmental organisation and 3
schools for handicapped children. The teams
were asked to produce consensus answers.
6
RESULTS
Child 1 (age 2 years 9 months, ambulant,
no additional problems) o Amount of therapy
ranges from 60 to 112,5 hours per year. o
Botulinum toxin was recommended in
10/21, electrical stimulation in 9/21
and surgical intervention in 3/21 hospitals.
Child 2 (age 4 years 2 months, walks indoors
with an aid, additional visuomotor disorder
indicating specific learning disorder) o Amount
of therapy ranges from 100 to 200 hours per
year. o Botulinum toxin was recommended
12/21, electrical stimulation in 4/21
and surgical intervention in 7/21 hospitals.
7
RESULTS
Child 3 (age 3 years 5 months,
non-ambulant, visuomotor, additional perceptual
and oral motor control problems) o Amount of
therapy ranges from 116 to 225 hours per year. o
Botulinum toxin was chosen in 16/21, electrical
stimulation in 6/21 and surgical intervention in
4/21 hospitals.
8
KONKLUSION Så här kan det inte få se ut
! Vetenskap och beprövad erfarenhet ? eller
fritt fram för tyckeri och charlataner? Tyvärr
knappast ett isolerat finskt fenomen
9
Ett annat skräckexempel Hfors - utarbetande
(jobbigt) av vårdprogram vårdkedjor för en
rad olika tillstånd - särskild blankett ifylls
dels av primärvården dels av specialsjukvården,
undertecknas ( kontrakt!) - slutresultat
ytterligare ett papper i journalen som ingen
bryr sig om