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註釋Since September 11, 2001, the Department of Defense (DOD) has rehabilitated more than 2,000 service members and veterans who experienced one or more deployment-related amputation(s), with the number of new amputations peaking in 2011. As a consequence of lower deployment, the number of new amputations has shrunk in each subsequent year, bringing with it the risk that provider skills will atrophy. In order to prevent this and to capture best practices, knowledge, and skills that were developed by DOD during the conflicts in Iraq and Afghanistan, RAND Arroyo Center researchers interviewed providers working in military treatment facilities to identify a set of services that are integral to optimal amputation rehabilitation. These services are behavioral health, biomedical engineering, case management, diet/nutrition, occupational therapy, orthopaedic surgery, physical therapy, physical medicine and rehabilitation, and prosthetics and orthotics. For those nine services, the researchers defined and documented the core competencies that are needed by health care provides who offer those services, as well as behaviors that demonstrate that a provider has the competency. The competencies common to all nine services fall into the following categories: teamwork, patient and family education, military and other cultural awareness, patient-centered care, evidence-based practice, and ethical and professional behavior. Using technical expert surveys, researchers asked providers in each service area to discuss their use and understanding of the core competencies, along with means for evaluating them, and then developed recommendations for how to adopt and implement them in the military health setting.--