簡介：
《實證物理治療臨床應用指引》是一本研究方法的基礎知識和教導物理治療學生與臨床從業者如何將實證整合至臨床工作中，讓物理治療之流程易於理解。本書在每章開頭都設計有一個新的臨床情境來概述所提供的實證應用，且結合了物理治療師的臨床判斷和患者或客戶的偏好、價值觀和目標背景，書中亦更新物理治療師實證相關術語，並增入對「問題、介入、比較、結果」（PICO)方法的改編，以提供學生和從業者各種形式的證據，對學生或從業者本書絕對是您不容錯過的工具書。
序言：
《實證物理治療臨床應用指引》提供了研究方法的基礎知識，並教導物理治療學生和臨床人員如何將證據整合到臨床工作中。其目標是使實證物理治療(evidence-based physical therapist practice, EBPT) 的流程容易理解， 及讓進行研究的非研究者也能易於使用。
與之前的版本相同，本書仍是以美國物理治療學會Guide to Physical Therapist Practice 3.0 中的患者 / 客戶處理模式作為討論架構，而在實證物理治療對於病患照護方法之定義和標記的描述，是與世界衛生組織所提出的「功能、失能和健康國際分類（ICF ）」一致。以新的臨床情境來概述每章所提供之實證應用，並結合了物理治療師的臨床判斷及患者或客戶的偏好、價值觀和目標的背景，本書中也更新了文獻資料的當前範例，以提供學生和從業者各種形式的證據。
本版的結構(Organization of the This Edition)
此處描述了這些部分的結構和目標，已盡一切努力為物理治療學生和臨床執業者提供易於使用的結構。
第一部分：實證物理治療的原則
第一部分包括三個章節，為在患者 / 客戶治療中使用的證據奠定基礎。這是依據物理治療師執業的背景下，改編或引用自被公認為實證運動領導者的組織和個人作者的工具和資源。
第二部分：證據要素
第二部分的前五章描述了研究文章的不同組成，重點是提高或降低研究品質的特性。這些章節的目標沒有改變，它們旨在增加讀者對他們審查證據的理解和信心，而不是培訓新的研究人員。其餘章節回顧了與物理治療師實踐相關的統計方法及其在不同研究設計中的應用。
第三部分：評析證據
證據的評估仍維持其基本原則，實證物理治療在於要求學生和臨床者使用最好的可用證據，因通常證據的研究設計可能是薄弱的。儘管有所局限性，本部分中的章節幫助讀者自行判斷他們找到的證據是否有用。
第四部分：實踐證據
第四部分繼續關注證據在患者 / 客戶處理方面的應用。本書的一個基本原則是，必須考慮針對個體患者或客戶的證據。
本版的更新部分(Updates to the This Edition)
如前所述，每章開頭都包含了一個新的臨床情境介紹，它為在執業中使用證據提供了背景。此外，下面列出了選擇章節的關鍵更新。希望這些更新能夠幫助讀者有效地參與實證物理治療的實踐。
● 第1章，實證物理治療師實踐。物理治療師之患者/客戶處理模式和相關術語已更新，以反映美國物理治療學會Guide to Physical Therapist Practice 3.0中的更改。
● 第2章，什麼是證據？證據的層次結構已經擴大到包括對預先評估的證據模式的應用以及與質性研究設計一起使用的擬議模式。
● 第3章，尋找證據：入門。添加了對「問題、介入、比較、結果」(PICO) 方法的改編，用於開發可回答的臨床問題。更新了最常用的網路搜索引擎的特性和功能。並增加美國物理治療學會的 PTNow 門戶網站，以取代已停用的 Hooked on Evidence 門戶網站。該版本的新增內容是對將研究轉化為實踐 (TRIP) 數據庫和國家指引訊息交換數據庫的描述。
● 第17章，評估證據收集：系統評析和第 18 章，評估證據收集：臨床實踐指引。該內容最初合併為一章，現已分成單獨的章節，以促進對材料更好的理解，並允許擴展有關臨床實踐指引的內容。
● 第19章，評析質性研究。這是一個新的章節，提供了關於證據質量評估的指導，這些證據是從受試者和研究人員用來描述經驗、看法、觀點和觀察的詞語發展而來的。
● 第20章，患者或客戶的偏好和價值觀。本章重新編號以反映第17、18和19章的變化。
● 第21章，將它們放在一起。本章也重新編號。添加了一個新場景，說明了質性研究的搜索、評估和應用。
目錄：
序言 ··················xiii
致謝 ··················xv
中文版致謝 ·········xvi
審稿群 ···············ix
Part I 實證物理治療的原則 1
Chapter 1 實證物理治療 3
前言 ···········································4
什麼是實證？ ·····························6
實證物理治療 ·······························8
實證物理治療的聚焦領域 ············ 10
實證物理治療的流程 ·················· 12
總結 ········································· 14
練習 ········································· 15
參考文獻 ··································· 16
Chapter 2 證據是什麼？ 19
前言 ········································· 21
可取的證據特性··························· 21
證據的形式 ································ 23
研究設計：綜觀 ························ 23
研究設計：時間性 ····················· 25
研究設計：問題是什麼？ ············ 26
證據的層級 ································ 27
從言語中產生之證據的品質 ········· 32
證據分級結構的限制 ····················· 33
總結 ········································· 34
練習 ········································· 35
參考文獻 ··································· 35
Chapter 3 實證探索：入門 37
前言 ········································· 39
形成臨床問題 ····························· 39
背景問題 ································ 40
前景問題 ································ 40
關於診斷測試的問題 ·················· 41
關於臨床測量的問題 ·················· 43
關於預後因子的問題 ·················· 43
關於介入的問題 ························ 43
關於臨床預測準則的問題 ············ 44
關於成果與自評成果測量的問題 ···· 44
關於健康照護經驗意義的問題 ······· 44
證據查詢 ··································· 44
決定哪一個資料庫是最有效的 ······· 44
定義輸入資料庫的搜尋名詞 ········· 45
使用查詢配置選項來精簡流程 ······· 46
準備好修正問題 ························ 46
目的在於有用的最高品質證據 ······· 47
供實證物理治療實務的電子資料庫 ···· 47
美國國家圖書館醫學電子資料庫 ······ 47
醫學主題詞表 ··························· 48
一般關鍵字查詢 ························ 49
查詢過濾 ································ 49
查詢歷史 ································ 50
臨床查詢 ································ 51
相似文章 ································ 53
國家生物技術資訊中心 ··············· 55
美國國家圖書館醫學電子資料庫教學 ·· 55
護理和相關健康文獻累積索引 ········· 56
考科藍圖書館 ····························· 59
物理治療實證資料庫 ····················· 60
其他資料庫與服務 ························ 62
總結 ········································· 64
練習 ········································· 66
參考文獻 ··································· 67
PART II 實證的要素 69
Chapter 4 問題、理論與假說 71
前言 ········································· 72
研究問題 ··································· 73
背景 ········································· 75
文獻回顧 ································ 75
流行病學資料的引用 ·················· 76
理論、概念和架構 ························ 76
假說 ········································· 80
總結 ········································· 81
練習 ········································· 82
參考文獻 ··································· 82
Chapter 5 研究設計 85
前言 ········································· 88
研究設計的一般特徵 ····················· 89
研究計畫 ································ 89
研究模型：量性研究 ·················· 89
研究模型：質性研究 ·················· 90
組別數 ··································· 91
資料型態 ······························· 91
時間要素 ································ 92
控制的程度 ····························· 92
研究問題 ································ 93
關於診斷性測試和臨床測量問題的研究設計 93
臨床測試的方法學研究 ··············· 95
預後因素問題的研究設計 ··············· 95
世代研究 ································ 96
病例對照設計 ··························· 97
預後指標的其他設計 ·················· 97
介入問題的研究設計 ····················· 97
實驗性研究 ····························· 98
準實驗性研究 ··························100
單一系統設計 ··························101
臨床預測準則的研究設計 ··············103
成效研究的研究設計 ····················103
自評成效測量的方法學研究 ···········104
次級資料分析 ····························106
系統性回顧 ····························107
統合分析 ·······························107
質性研究 ··································108
總結 ········································ 108
練習 ········································ 109
參考文獻 ·································· 110
Chapter 6 研究受試者 113
前言 ········································115
受試者識別 ·······························116
受試者選擇 ·······························118
機率抽樣法 ···························· 118
非機率抽樣法 ··························121
研究中的受試者管理 ····················122
隨機分派法 ····························122
非隨機分派法 ··························124
其他受試者管理議題 ·················124
樣本數 ·····································124
總結 ········································ 125
練習 ········································ 125
參考文獻 ·································· 126
Chapter 7 變項及其測量 127
前言 ········································130
變項 ········································131
自變項 ··································131
依變項 ··································132
外在變項 ·······························133
變項相關的其他名稱 ·················133
測量 ········································133
測量尺度 ·······························133
測量參照標準 ··························137
測量信度 ··································137
工具的信度：再現性或再測信度 ···137
工具的信度：內部一致性 ···········139
工具的信度：複本信度 ··············139
工具的信度：折半信度 ··············139
施測者信度 ····························139
測量效度 ··································139
表面效度 ·······························140
內容效度 ·······························141
建構效度 ·······························141
聚斂效度 ·······························142
區辨效度 ·······························142
效標效度 ·······························142
同時效度 ·······························142
預測效度 ·······························143
改變的反應性 ····························143
地板效應與天花板效應 ··············144
變化的解釋 ·······························144
總結 ········································ 144
練習 ········································ 145
參考文獻 ·································· 146
Chapter 8 研究設計的效度 147
前言 ········································149
「可相信性」：量性研究 ··············151
研究效度的威脅 ·······················151
介入型研究之研究效度的威脅 ········151
「受試者」相關之研究效度的威脅 152
研究者相關之研究效度的威脅 ······155
研究邏輯相關之研究效度的威脅 ···156
量性研究中關於個案處理模式之其他元素的研究效度威脅 159
研究者偏差 ····························160
威脅研究效度的其他解決方法 ······163
建構效度的威脅 ·······················163
「可相信性」：質性研究 ··············164
研究的關聯性 ····························166
總結 ········································ 165
練習 ········································ 166
參考文獻 ·································· 167
Chapter 9 解開統計的奧秘：描述 169
前言 ········································171
描述性統計 ·······························171
資料的分布 ····························172
受試者的特徵 ··························174
效應值 ·····································178
總結 ········································ 178
練習 ········································ 183
參考文獻 ·································· 184
Chapter 10 解開統計的奧秘：推論 185
前言 ········································188
母數統計 ··································188
檢驗相關性的母數檢定 ··············188
檢驗差異的母數檢定 ·················192
無母數統計檢定··························193
實證治療實作中的其他統計檢定 ·····193
統計上的重要性··························200
p值 ······································200
信賴區間 ·······························200
檢力 ·····································201
臨床相關性 ·······························201
總結 ········································ 202
練習 ········································ 202
參考文獻 ·································· 206
PART III 評析證據 207
Chapter 11 診斷測試及臨床測量的實證評析 209
前言 ········································212
診斷測試 ··································212
研究的可信任性··························213
其他的考量 ····························216
研究結果 ··································216
可信度 ··································216
效度 ·····································217
敏感性 ··································218
特異性 ··································219
接收者操作特徵曲線 ·················220
陽性預測值 ····························222
陰性預測值 ····························222
概似比 ··································223
列線圖 ··································223
評估一個診斷測試︰依據研究結果的計算 ··226
概似比的實際操作 ····················227
研究結果的統計重要性 ·················228
關於物理治療診斷的觀念 ··············228
臨床測量 ··································229
研究的可信任性··························230
研究結果 ··································231
研究結果的統計重要性 ·················231
實證與病患或客戶 ·······················231
實證評析工具 ··························232
總結 ········································ 238
練習 ········································ 238
參考文獻 ·································· 239
Chapter 12 預後（危險）因子的 實證評析 241
前言 ········································242
未來不良事件的風險 ·················243
最終的結果 ····························243
物理治療介入的結果 ·················244
預後的元素 ·······························244
研究的可信任性··························246
其他的考量 ····························248
研究結果 ··································249
研究結果的統計重要性 ·················252
實證與病患或客戶 ·······················252
實證評價工具 ··························253
總結 ········································ 255
練習 ········································ 255
參考文獻 ·································· 256
Chapter 13 介入的實證評析 257
前言 ········································260
研究可信度 ·······························260
附加注意事項 ··························265
介入研究中與研究設計相關的議題 265
研究結果 ··································266
治療效果強度：連續性數據 ········267
治療效果強度：二分法數據 ········268
研究結果的統計重要性 ··············271
實證與病患或客戶 ·······················272
最小臨床重要差異 ····················272
需治療人數 ····························272
實務應用的注意事項 ·················273
實證評析工具 ··························273
總結 ········································ 278
練習 ········································ 278
參考文獻 ·································· 279
Chapter 14 評析臨床預測規則的 證據 281
前言 ········································283
研究的可信任性··························284
臨床預測規則的推導 ·················284
臨床預測規則驗證 ····················288
其他注意事項 ··························289
研究結果 ··································290
研究結果的統計重要性 ·················290
證據和患者或客戶 ·······················290
證據評析工具 ··························291
總結 ········································ 294
練習 ········································ 294
參考文獻 ·································· 294
Chapter 15 評析成果研究 297
前言 ········································299
成果研究 ··································300
研究可信度 ·······························301
其他注意事項 ··························305
研究結果 ··································306
研究結果的統計重要性 ·················306
實證與病患或客戶 ·······················306
實證評析工具 ··························307
總結 ········································ 309
練習 ········································ 310
參考文獻 ·································· 310
Chapter 16 評價自我評估量測工具 313
前言 ········································315
重要的心理計量特性 ····················316
其他情況 ·······························320
研究結果 ··································320
初步問卷開發 ··························320
信度 ·····································320
效度 ·····································321
反應性 ··································321
可解釋性 ·······························322
研究結果的統計重要性 ·················322
實證和病患或客戶 ·······················322
實證評估工具 ··························322
總結 ········································ 326
練習 ········································ 327
參考文獻 ·································· 328
Chapter 17 評價系統性回顧 329
前言 ········································331
系統性回顧 ·······························332
研究可信性 ·······························336
研究結果 ··································339
報告格式 ·······························340
研究結果的意義··························344
臨床重要性 ····························346
實證和病患或客戶 ·······················348
證據評價工具 ··························348
總結 ········································ 348
練習 ········································ 351
參考文獻 ·································· 351
Chapter 18 評定實證的彙整： 臨床實務指引 355
前言 ········································356
臨床執行指引 ····························357
指引是否有效？··························359
指引是否適用？··························362
總結 ········································364
練習 ········································364
參考文獻 ··································364
Chapter 19 評定質性研究 367
前言 ········································369
研究可信度 ·······························370
其他考量 ·······························374
研究結果 ··································374
證據和病患或客戶 ·······················375
證據評估工具 ··························375
總結 ········································ 376
練習 ········································ 377
參考文獻 ·································· 377
PART IV 臨床實務的實證 379
Chapter 20 病患或客戶的偏好及 價值觀 381
前言 ········································382
以病患為中心的照護 ····················384
倫理考量 ·······························385
知情同意和醫病共享決策 ···········385
偏好、期望和價值觀 ····················388
偏好和價值觀的評估 ·················389
關於偏好、期望和價值觀的量性證據 ··391
總結 ········································ 393
練習 ········································ 394
參考文獻 ·································· 394
Chapter 21 整合在一起 397
前言 ········································397
第一節：使用實證於臨床個案的例子 398
第二節：使用生理學研究作為實證 ···433
第1篇文獻 ······························437
第2篇文獻 ······························438
第3篇文獻 ······························438
物理治療師的決策 ····················439
結論 ········································ 439
參考文獻 ·································· 439
Appendlx A
信賴區間的計算 441
Appendlx B
網站上提供的其他實證評析工具 445
Appendlx C
物理治療實證需要的其他計算式 446
診斷測試有關的計算 ····················446
預後因子有關的計算 ····················447
介入相關的計算··························447
英文索引 ···································· 449
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