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Moksnes HØ, Andelic N, Schäfer C, Anke A, Soberg HL, Røe C, Howe EI, Forslund MV, Røise O, Dahl HM, Becker F, Løvstad M, Perrin PB, Lu J, Sveen U, Hellstrøm T, Rasmussen MS. Unmet rehabilitation needs in the first 6 months post-injury in a trauma centre population with moderate-to-severe traumatic injuries. J Rehabil Med 2024; 56:jrm40078. [PMID: 38803207 DOI: 10.2340/jrm.v56.40078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/21/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE To describe the needs for subacute inpatient rehabilitation and community-based healthcare services, rehabilitation, and social support in patients with moderate-to-severe traumatic injury in the first 6 months post-injury. Further, to explore associations between sociodemographic and clinical characteristics and unmet needs. DESIGN Multicentre prospective cohort study. SUBJECTS Of 601 persons (75% males), mean (standard deviation) age 47 (21) years, admitted to trauma centres in 2020 with moderate-to-severe injury, 501 patients responded at the 6-month follow-up and thus were included in the analyses. METHODS Sociodemographic and injury-related characteristics were recorded at inclusion. Estimation of needs was assessed with the Rehabilitation Complexity Scale Extended-Trauma and the Needs and Provision Complexity Scale on hospital discharge. Provision of services was recorded 6 months post-injury. Multivariable logistic regressions explored associations between baseline variables and unmet inpatient rehabilitation and community-based service needs. RESULTS In total, 20% exhibited unmet needs for subacute inpatient rehabilitation, compared with 60% for community-based services. Predictors for unmet community-based service needs included residing in less central areas, profound injury severity, severe head injury, and rehabilitation referral before returning home. CONCLUSION Inadequate provision of healthcare and rehabilitation services, particularly in the municipalities, resulted in substantial unmet needs in the first 6 months following injury.
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Affiliation(s)
- Håkon Øgreid Moksnes
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christoph Schäfer
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway; Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Audny Anke
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway ; Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Helene Lundgaard Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway 2Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marit V Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Olav Røise
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Norwegian Trauma Registry, Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Hilde Margrete Dahl
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Frank Becker
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway; Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Paul B Perrin
- School of Data Science, University of Virginia, Charlottesville, VA, USA; Department of Psychology, University of Virginia, Charlottesville, VA, USA; Central Virginia Veterans Affairs Health Care System, Richmond, VA, USA
| | - Juan Lu
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Epidemiology, School of Population Health, Virginia Commonwealth University, Richmond, USA
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Mari S Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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O'Malley N, Coote S, Clifford AM. Outcomes of importance to people with multiple sclerosis, Parkinson's disease and stroke following a falls prevention intervention: a qualitative study to inform a core outcome set. Disabil Rehabil 2024; 46:1580-1592. [PMID: 37092355 DOI: 10.1080/09638288.2023.2201513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/06/2023] [Indexed: 04/25/2023]
Abstract
Purpose: Falls are a major issue for people with neurological conditions, and the evaluation of falls prevention interventions is of high priority. To date, the views of patient groups regarding outcomes of importance have been largely overlooked. The purpose of this study was to explore outcomes of interest among people with Multiple Sclerosis (MS), Parkinson's disease (PD) and stroke upon completion of falls prevention interventions to inform the development of a core outcome set (COS).Materials and methods: Five online focus groups and one semi-structured interview were conducted among people with PD (n = 10), MS (n = 7), and post-stroke (n = 3), one of whom also had PD. Transcripts were analysed using reflexive thematic analysis.Results: Four themes were developed; (1) Fall events are not homogeneous, (2) Exercise-based programmes are beneficial but falls services are not meeting user needs, (3) Programme success beyond the reduction in falls, and (4) Acquisition of skills to self-manage falls beyond the life of the programme.Conclusions: This study presents new perspectives across patient groups regarding important outcomes upon completion of falls prevention interventions. Taken together with the findings of a literature review, this data will inform the development of a COS.Implications for rehabilitationPeople with multiple sclerosis, Parkinson's disease and stroke consider the success of a falls prevention intervention to be dependent on improvements across a wide range of outcomes.The design and implementation of falls prevention interventions should align with patient preferences.Clinicians and researchers should consider the use of multidomain interventions to facilitate improvements in the desired outcomes of patients.
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Affiliation(s)
- Nicola O'Malley
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Susan Coote
- School of Allied Health, University of Limerick, Limerick, Ireland
- Centre of Physical Activity for Health, Health Research Institute, University of Limerick, Limerick, Ireland
- Multiple Sclerosis Society of Ireland, Limerick, Ireland
| | - Amanda M Clifford
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Jackson K, Newbury-Birch D. Patient reported experiences of community rehabilitation and/or support services for people with long term neurological conditions: a narrative review of quantitative studies. Disabil Rehabil 2023:1-18. [PMID: 37905706 DOI: 10.1080/09638288.2023.2266369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 09/24/2023] [Indexed: 11/02/2023]
Abstract
Objectives: 1. To identify validated quantitative Patient Reported Experience Measures (PREM's) being used in Community Rehabilitation and/or Support services for people with long term neurological conditions (PwLTNC). 2. To explore how data from quantitative PREM's adds to research on patient experiences of Community Rehabilitation and Support for PwLTNC.Method: Eight data bases were searched for peer reviewed studies (2005-2021) which met inclusion criteria. Data extraction and quality assessment for sixteen studies was performed by two reviewers. Narrative synthesis was conducted.Results: Eleven validated PREM's were identified which captured data for 15,831 PwLTNC. PREM scores indicated positive and negative experiences for people with Multiple Sclerosis (n = 13,123), Parkinson's Disease (n = 2215) and Acquired Brain Injury (n = 493). Negative experiences related to Picker Institute Principles: 1 (accessibility); 3 (coordination/continuity); 4 (involvement/support for family and carers); 5 (information provision), 6 (Involvement in decision making) and 7 (empathy and emotional support).Conclusion: Quantitative PREM's provide evidence of process quality and person-centred care within community rehabilitation and support services across large data sets of heterogeneous neurological conditions and geographical locations. Quality improvement initiatives for people with MS, PD and ABI should target processes relating to Picker Institute Principles 1,3,4,5,6, and 7.Implications for RehabilitationQuantitative validated Patient Reported Experience Measures can be used to evaluate process quality and person- centred care within community rehabilitation and support services for people with long term neurological conditions.Experiences of people with Multiple Sclerosis, Parkinson's Disease and Acquired Brain Injury indicate the need for quality improvement in community rehabilitation.Training in communication skills and person-centred care may enhance information provision and support for self-management for people with long term neurological conditions.
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Affiliation(s)
- Katherine Jackson
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Laurie K, Foster MM, Borg DN, Gustafsson L. Perceived service adequacy and unmet need after discharge from brain injury rehabilitation. Disabil Rehabil 2023; 45:3252-3261. [PMID: 36111685 DOI: 10.1080/09638288.2022.2123054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 07/30/2022] [Accepted: 08/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The present study aimed to quantify the perceived needs and adequacy of realised access to post-acute services in a sample of people with acquired brain injury in the first 6-months after discharge from inpatient rehabilitation. A secondary focus was the influence of access to funding and specialist transitional rehabilitation on unmet needs. MATERIALS AND METHODS Participants were 51 adults with a median age of 50 (IQR 35-57) recruited from an inpatient rehabilitation unit in an Australian tertiary hospital. The sample was those who had an acquired brain injury, including 23 who sustained a traumatic injury and 28 who sustained a non-traumatic injury. Measures were collected via telephone at 3- and 6-months, in a prospective observational cohort design using the Needs and Provisions Complexity Scale. A series of logistic regression models were used to determine the effects of participation in a transitional rehabilitation program and funding pathway on adequacy and unmet needs. RESULTS Unmet needs for rehabilitation were most commonly reported (60%), followed by unmet needs in relation to health care (40%), social care (35%), personal care (32%) and environment-related (14%). Participants who attended transitional rehabilitation were more likely to indicate unmet health care needs (OR = 6.40, 95% CI = 1.40-29.24, p = 0.02). CONCLUSIONS The study highlights the need to look beyond functional impairment when conceptualising appropriate access. Additionally, the present research highlighted the need for greater work into an expectation of services.IMPLICATIONS FOR REHABILITATIONThe majority of people with an acquired brain injury report unmet needs at 6 months post discharge.Present findings support the utility of patient reported measures when considering treatment evaluation with people with ABI, where assessing the personal appraisal of individuals needs may prove to be a key indicator to facilitate optimal service access.There are specific services that needed and not provided including psychological, speech pathology, family carer needs and vocational rehabilitation, and therefore are a key target for ensuring appropriate support is provided.
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Affiliation(s)
- Kirstyn Laurie
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Michele M Foster
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - David N Borg
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
| | - Louise Gustafsson
- Division of Rehabilitation, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Geraghty TJ, Foster MM, Burridge LH. Moving from Interest to Engagement-Understanding the Research Capacity Building Needs of Rehabilitation Doctors. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:112-119. [PMID: 37493439 DOI: 10.1097/ceh.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Doctors working in rehabilitation settings have specialized clinical skills and experience, but research activity may be constrained by time pressures and inadequate current skills. This means missed opportunities to contribute to the evidence-base for better clinical practice and outcomes for people living with disabling, chronic complex conditions. This research aimed to understand rehabilitation doctors' research needs, experience, and aspirations to enable future training initiatives that are tailored to their practice context. METHODS This exploratory sequential mixed-method study comprised a survey followed by focus groups. Rehabilitation doctors from three health services in south-east Queensland, Australia completed an online survey incorporating the Research Spider to explore their research experience, confidence, interest, opportunity, and intent. Focus groups explored the survey results and participants' views regarding strategies to build research capacity. RESULTS The major findings were the gap between high research interest and low experience, confidence and opportunity; and fundamental research skills were identified as priority training topics. These findings support previous research. However, rehabilitation doctors may also have a self-expectation that, as competent clinicians, they should necessarily also be research-competent, and hold misperceptions regarding the shared nature of health services research. DISCUSSION Protected time and funding may enhance engagement with research to generate specialty-relevant evidence for practice. To this end, a research capacity building initiative in the form of a series of self-directed learning packages has been developed and implemented. A tailored workshop to strengthen rehabilitation doctors' research skills and engagement has also been developed for implementation.
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Affiliation(s)
- Timothy J Geraghty
- Prof. Geraghty: Co-Director, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and Medical Chair, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Brisbane, Australia. Prof. Foster: Adjunct Professor, Policy Innovation Hub, Griffith Business School, Griffith University, Nathan, Queensland, Australia, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and School of Health Sciences and Social Work, Griffith University, Brisbane, Australia. Dr. Burridge: Research Fellow, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Bohan JK, Nielsen M, Watter K, Kennedy A. "It gave her that soft landing": Consumer perspectives on a transitional rehabilitation service for adults with acquired brain injury. Neuropsychol Rehabil 2023; 33:1144-1173. [PMID: 35543026 DOI: 10.1080/09602011.2022.2070222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
Transitional rehabilitation service models for people with acquired brain injury (ABI) may address sub-optimal support for individuals returning home after hospitalization for ABI. This study investigated perspectives of people with ABI and close others who received transitional rehabilitation. A qualitative study involving semi-structured interviews with 10 individuals with ABI and 12 associated close others was conducted as part of a mixed-method evaluation of an Australian transitional rehabilitation service (TRS) pilot project. Thematic analysis based on the Framework method was conducted independently by two researchers. Three broad themes illustrated participants' experience of the TRS: (1) structure after hospital discharge; (2) a "soft landing"; and (3) equipped for community living. Findings suggest that home-based, interdisciplinary transitional rehabilitation after hospital discharge was perceived as an important stage of rehabilitation by participants. Valued features relate to post-hospital rehabilitation structure: a single point of contact to facilitate organization and information exchange, a known discharge destination, and consistent communication; support and therapy within a familiar home environment; and being equipped with relevant knowledge and strategies to manage ongoing challenges. Further research exploring the experiences of individuals with ABI without close family or social support, and research capturing longitudinal outcomes from transitional rehabilitation is recommended.
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Affiliation(s)
- Jaycie K Bohan
- Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation,Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Health and Rehabilitation Services, The University of Queensland, Brisbane, Australia
| | - Mandy Nielsen
- Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation,Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kerrin Watter
- Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation,Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Areti Kennedy
- Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation,Princess Alexandra Hospital, Metro South Health, Brisbane, Australia
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Laurie K, Foster M, Gustafsson L. Personal experiences of appropriate access to post-acute care services in acquired brain injury: a scoping review. BRAIN IMPAIR 2023; 24:1-26. [PMID: 38167584 DOI: 10.1017/brimp.2021.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
People with an acquired brain injury (ABI) experience substantial access inequalities and unmet health needs, with many experiencing insufficient access to appropriate rehabilitation in the community. To deepen our understanding of what appropriate access to post-acute care services is for this population, and to facilitate optimal recovery, there is a need to synthesise research from the service user perspective. A scoping review study was conducted to identify key characteristics of 'appropriate' access to post-acute care services, as defined by the personal experiences of adults with ABI. Electronic scientific databases Medline, PsycINFO, Proquest Central and CINAHL were searched for studies published between 2000 and 2020. The initial search identified 361 articles which, along with articles retrieved from reference list searches, resulted in 52 articles included in the final analysis. Results indicated that a majority of the studies sampled participants with an average of over 1 year post-injury, with some studies sampling participants ranging over 10 years in difference in time post-injury. A thematic synthesis was conducted and results indicated a number of dominant elements which relate to (1) the characteristics of services: provider expertise, interpersonal qualities, partnership and adaptability; (2) characteristics of the health system: navigable system, integrated care, adequacy, and opportunity. These findings provide some insight into what might be considered appropriate. However, rigorous research, focused on personalised access to post-acute care services, is recommended to verify and elaborate on these findings.
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Affiliation(s)
- Kirstyn Laurie
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Michele Foster
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute, Brisbane, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Queensland, Australia
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Lakhani A, Dema S, Hose J, Erdem N, Wollersheim D, Grimbeek P, Charlifue S. What happens post-lockdown for people with disability? Autonomy, quality of life, service access and health changes for people with spinal cord injury in Victoria, Australia after COVID-19 social distancing restrictions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5366-e5377. [PMID: 35924426 PMCID: PMC9538439 DOI: 10.1111/hsc.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/05/2022] [Accepted: 07/16/2022] [Indexed: 06/17/2023]
Abstract
Social distancing restrictions are undoubtedly important for controlling the spread of COVID-19 however, they are also adversely impacting population health and health service access. It is important that priority populations with a disability which may already have adverse health, access to health services, and autonomy and participation compared to those without disability, are able to receive preventative health and social care during periods of restriction. The impact of social distancing restrictions on people with disability is not uniform nor well-understood. Research has been cross-sectional and considered data gathered during social distancing restrictions, or longitudinal, considering data gathered during a pre-pandemic baseline. This longitudinal study investigated the impact of lifting social distancing restrictions on priority domains for people with disability including autonomy and participation, access to health services, health issues and quality of life. People with spinal cord injury in Victoria, Australia (n = 71) completed a survey towards the end of social-distancing restrictions (T1) and 6-months post social distancing restrictions (T2). Non-parametric tests for significant differences confirmed that 6-months post-lifting social distancing restrictions participants experienced a significant increase in health conditions, a significant decrease in the number of inaccessible health services, and a significantly lower level of limitations across participation and autonomy, outdoor autonomy and work and education domains. QOL improved 6-months post lifting restrictions, however not to a significant level. The adverse health experienced by people with spinal cord injury after lifting restrictions may in part result from limited health service access and reduced participation during the time of restrictions. Clear definitions of what constitutes as essential care may ensure that eligible and required care remains received during lockdown or instances when service provision is compromised. Health and social care providers should be equipped with the knowledge of priority populations so that their support can be targeted to those most in need.
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Affiliation(s)
- Ali Lakhani
- The School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
- The Hopkins Centre, Menzies Health Institute QueenslandGriffith UniversityMeadowbrookQueenslandAustralia
- Palliative Care DepartmentEastern HealthWantirnaVictoriaAustralia
| | - Salvatore Dema
- Austin Health ‐ Royal Talbot Rehabilitation CentreKewVictoriaAustralia
| | - Josh Hose
- AQA VictoriaHeidelbergVictoriaAustralia
| | | | - Dennis Wollersheim
- The School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
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Thwaites C, Nayyar R, Blennerhassett J, Egerton T, Tan J, Bower K. Is telehealth an effective and feasible option for improving falls-related outcomes in community-dwelling adults with neurological conditions? A systematic review and meta-analysis. Clin Rehabil 2022; 37:17-46. [PMID: 36263524 DOI: 10.1177/02692155221133468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the effectiveness of telehealth interventions in reducing community falls risk or rates compared to equivalent in-person interventions in adults with neurological conditions. DATA SOURCES Eight electronic databases, trial registries and search engines were searched for the concepts 'falls', 'neurological conditions', and 'telehealth', limited to English language, from inception until August 2022. REVIEW METHODS Search for original research where the intervention was delivered via synchronous videoconferencing with the aim of reducing falls and falls-related outcomes. Screening and risk of bias assessment were completed by two independent researchers. Outcome data included falls rates, falls-related outcomes, safety, feasibility, and acceptability. Risk of bias was assessed using the ROB-2 and ROBINS-I tools. Quality of evidence was rated with the grading of recommendations, assessment, development and evaluation (GRADE) approach. RESULTS Seventeen studies with 581 participants were included; six were randomised controlled trials. Risk of bias ranged from low to high. Only one study (n = 76) reported falls and did not find differences between telehealth and in-person physiotherapy. There was low-quality evidence that telehealth interventions improve balance outcomes more than face-to-face interventions (pooled between-group mean difference 2.48 Berg Balance Scale units, 95%CI 0.77 to 4.20). Fear of falling was not different between intervention delivery modes. CONCLUSION Findings suggest that telehealth delivered falls prevention interventions are safe, feasible and acceptable in community-dwelling adults with neurological conditions, however, data related to effectiveness in reducing falls is limited. Low-quality evidence suggests that telehealth may deliver similar or better outcomes for standing balance in this population.PROSPERO Registration: (CRD42021240167).
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Affiliation(s)
- Claire Thwaites
- Academic and Research Collaborative in Health (ARCH), La Trobe University, Melbourne, Australia.,The Victorian Rehabilitation Centre, Healthscope, Melbourne, Australia
| | - Rohini Nayyar
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Jannette Blennerhassett
- Physiotherapy Department and Health Independence Program, 3805Austin Health, Heidelberg, Australia
| | - Thorlene Egerton
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Jasmine Tan
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
| | - Kelly Bower
- Faculty of Medicine, Dentistry and Health Sciences, Department of Physiotherapy, 2281The University of Melbourne, Melbourne, Australia
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Leclair LL, Zawaly K, Korall AMB, Edwards J, Katz A, Sibley KM. Exploring the delivery of community rehabilitation services for older people in an urban Canadian setting: Perspectives of service providers, managers and health system administrators. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2245-e2254. [PMID: 34850489 DOI: 10.1111/hsc.13662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/26/2021] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
As the global population of older people increases, policies aimed at improving health care delivery for older people often include supports for ageing in place. Living in the community not only reduces institutionalisation but also improves quality of life and reduces health care costs. For older people, community rehabilitation offers the opportunity to preserve and maximise function while maintaining the ability to live in the community. However, limited research examines the delivery, coordination and integration of community rehabilitation services in health systems. Our case study explored the perspectives of service providers, managers and health system administrators on the strengths, limitations and gaps in community rehabilitation for older people in one Canadian urban health region. Using interpretive description and thematic analysis, we analysed interview data from: 16 service providers, eight managers and five health system administrators. Three themes were identified: (a) Limited Access to Programs and Services; (b) Need to Emphasise Promoting, Maintaining and Restoring Function; and (c) Lack of Flow Across the System. Participants highlighted that restrictive eligibility criteria limited access to services. Services were organised around health conditions that did not address the needs of older people. Long waitlists meant that services were delayed. Transportation costs limited participation of individuals from lower socioeconomic status (SES). Age restrictions did not reflect differences in the ageing process and the health inequities individuals from lower SES groups experienced. There was a lack of emphasis in community rehabilitation programs on maintaining or restoring function in older people, which is the primary focus of rehabilitation. Furthermore, key stakeholders stressed the need for strengthening the integration of service delivery across the continuum of care. The findings underscore the need to develop a conceptual framework for community rehabilitation to promote greater system integration, access and availability of services and to optimise functional outcomes for older people.
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Affiliation(s)
- Leanne L Leclair
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathleen Zawaly
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alexandra M B Korall
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Alan Katz
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathryn M Sibley
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
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Witzig-Brändli V, Lange C, Gschwend S, Kohler M. "I would stress less if I knew that the nurse is taking care of it": Multiple Sclerosis inpatients' and health care professionals' views of their nursing-experience and nursing consultation in rehabilitation-a qualitative study. BMC Nurs 2022; 21:232. [PMID: 35999594 PMCID: PMC9396844 DOI: 10.1186/s12912-022-01013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses play a crucial role in the multidisciplinary team in the rehabilitation of multiple sclerosis (MS) patients. However, little is known about patients' and health care professionals' (HCP) experiences (physicians, therapists) with nurses in rehabilitation. The aim of this qualitative study is (i) to describe the rehabilitation nursing care from the perspective of MS patients and HCPs and their view of a nursing consultations (ii) to elaborate similarities and differences of patients' and HCP's views. METHODS We used a qualitative approach and selected the participants purposively. We conducted semi-structured individual MS patient (n = 15) and two focus groups interviews with HCPs (n = 8) in an inpatient rehabilitation clinic in Switzerland. We analysed the data using a structuring content analysis approach. First, we analysed patients' and HCPs' perspectives separately. Afterwards we elaborated similarities and differences descriptively. RESULTS Main categories of patients' perspectives were "need for nursing care" and "relationship between nurses and MS patient". MS patients have mentioned the following points according to a nursing consultation: (i) nurses as advocates, (ii) involvement of relatives (iii) peer groups (iv) contact person. "Nurses in their scope of practice", "nurses as a part of the multidisciplinary team" and "the specifications in the treatment of MS patients" were main categories of HCPs' perspective. MS patients and HCPs demonstrated similarly the importance to have a nurse as a contact person in the multidisciplinary team and the need to integrate a nurse-led peer group in a nursing consultation. While HCPs prefer that relative always be included in nursing consultations, patients provided reasons when inclusion was not desirable. CONCLUSION The results indicate that continuity in the nursing care for MS patients could contribute to a trusting nurse-patient relationship. This facilitates nurses to create a deeper understanding of MS patients and their needs in daily rehabilitation. The need for MS patients to share their concerns and receive scientifically proven knowledge from peers could addressed with a nurse-led peer group.
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Affiliation(s)
- Verena Witzig-Brändli
- Eastern Switzerland University of Applied Sciences, School of Health Sciences, Institute of Applied Nursing Science, Rosenbergstrasse 59, CH-9001, St. Gallen, Switzerland
| | - Cordula Lange
- Eastern Switzerland University of Applied Sciences, School of Health Sciences, Institute of Applied Nursing Science, Rosenbergstrasse 59, CH-9001, St. Gallen, Switzerland
| | - Sabine Gschwend
- Rehabilitation Centre Valens, Taminaplatz 1, CH-7317, Valens, St. Gallen, Switzerland
| | - Myrta Kohler
- Eastern Switzerland University of Applied Sciences, School of Health Sciences, Institute of Applied Nursing Science, Rosenbergstrasse 59, CH-9001, St. Gallen, Switzerland.
- Rehabilitation Centre Valens, Taminaplatz 1, CH-7317, Valens, St. Gallen, Switzerland.
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12
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Zhang S. Application Research of Public Art in the Design of Old People's Rehabilitation Space Based on Virtual Information Interaction Platform From the Perspective of Developing Economies. Front Public Health 2022; 10:917330. [PMID: 35712298 PMCID: PMC9197336 DOI: 10.3389/fpubh.2022.917330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
To solve the problem of the design of the old people's recuperation space, the virtual information interaction platform is used to study the public art application in the design of the old people's recuperation space. Firstly, the principles of interactive design are expounded, and secondly, the existing institutions for the old people are investigated. Under the premise of optimizing the functions of the facilities, the concepts of humanistic care, emotional care and humanization in public art are integrated into the design of the old people's rehabilitation space, to solve the long-term negative impression of the old people's repression and indifference to the old people's care institutions. The construction of the scene allows the old people to experience some operations with the help of the virtual information interaction platform. In the modern elderly rehabilitation space, the attention and application of public art design will inevitably bring spiritual and material help to the old people in their later years, and create a happy, peaceful, and comfortable elderly life for them. The survey results manifest that 65.3% of urban old people and 71.8% of rural old people feel that they cannot keep up with the pace of development. Through the analysis and discussion of the physiological and psychological characteristics of the old people, the whole survey denotes that the physiological functions of the old people are declining, which seriously affects their normal life. Therefore, the design of the rehabilitation space for the old people should not only meet the basic needs of life, but also analyze the space design from the perspective of humanization and emotion. An ecological, natural, and human settlement environment has been established. The recuperation space is designed for the needs of different old people, which helps the old people to eliminate loneliness, enhance their value of the old people, and make life full of joy and meaning for the old people.
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Affiliation(s)
- Shaoqing Zhang
- College of Landscape Architecture and Art, Henan Agricultural University, Zhengzhou, China
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13
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Loft MI, Poulsen I, Guldager R. Feeling all alone in the world - experiences of patients with a neurological disease during a COVID-19 visitor ban: An interview study. Nurs Open 2022; 10:61-69. [PMID: 35730124 PMCID: PMC9748115 DOI: 10.1002/nop2.1278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/12/2021] [Accepted: 05/20/2022] [Indexed: 01/04/2023] Open
Abstract
AIM The aim of this study was to explore how patients with neurological disease experienced a COVID-19 visitor ban and to identify ways of improving the quality of care. BACKGROUND In March 2020, a temporary visitor ban was introduced in Danish hospitals to reduce the spread of COVID-19. This led to changes in clinical practice, leaving patients without their loved ones beside them. Since neurological patients are already considered vulnerable due to physical, and sometimes cognitive impairment, we urgently wished to investigate these circumstances to facilitate appropriate support. DESIGN This study was conducted using a qualitative explorative design. METHODS Fourteen patients with neurological disease were interviewed using a semi-structured interview guide. Data were analysed through inductive thematic analysis. RESULTS For most patients, being hospitalized during the COVID-19 visitor ban was a painful experience with the potential to negatively influence both their mental and physical health.
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Affiliation(s)
- Mia Ingerslev Loft
- Department of NeurologyRigshospitaletCopenhagenDenmark,Health, Department of Public Health, Research Unit for Nursing and HealthcareAarhus UniversityAarhusDenmark
| | - Ingrid Poulsen
- Health, Department of Public Health, Research Unit for Nursing and HealthcareAarhus UniversityAarhusDenmark,Department of Neurorehabilitation, TBI UnitRigshospitaletHvidovreDenmark
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14
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Saumur TM, Gregor S, Xiong Y, Unger J. Quantifying the amount of physical rehabilitation received by individuals living with neurological conditions in the community: a scoping review. BMC Health Serv Res 2022; 22:349. [PMID: 35296315 PMCID: PMC8925183 DOI: 10.1186/s12913-022-07754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Physical rehabilitation is often prescribed immediately following a neurological event or a neurological diagnosis. However, many individuals require physical rehabilitation after hospital discharge. The purpose of this scoping review was to determine the amount of physical rehabilitation that individuals living in the community with neurological conditions receive to understand current global practices and assess gaps in research and service use. Methods This scoping review included observational studies that 1) involved adults living with a neurological condition, and 2) quantified the amount of rehabilitation being received in the community or outpatient hospital setting. Only literature published in English was considered. MEDLINE, EMBASE, AMED, CINAHL, Cochrane Library, and PEDro databases were searched from inception. Two independent reviewers screened titles and abstracts, followed by full texts, and data extraction. Mean annual hours of rehabilitation was estimated based on the amount of rehabilitation reported in the included studies. Results Overall, 18 studies were included after screen 14,698 articles. The estimated mean annual hours of rehabilitation varied greatly (4.9 to 155.1 h), with individuals with spinal cord injury and stroke receiving the greatest number of hours. Participants typically received more physical therapy than occupational therapy (difference range: 1 to 22 h/year). Lastly, only one study included individuals with progressive neurological conditions, highlighting a research gap. Discussion The amount of rehabilitation received by individuals with neurological conditions living in the community varies greatly. With such a wide range of time spent in rehabilitation, it is likely that the amount of rehabilitation being received by most individuals in the community is insufficient to improve function and quality of life. Future work should identify the barriers to accessing rehabilitation resources in the community and how much rehabilitation is needed to observe functional improvements. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07754-4.
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Affiliation(s)
- Tyler M Saumur
- Rehabilitation Sciences Institute, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada
| | - Sarah Gregor
- Rehabilitation Sciences Institute, University of Toronto, 160-500 University Ave, Toronto, ON, M5G 1V7, Canada
| | - Yijun Xiong
- School of Physical Therapy, Western University, London, ON, N6G 1H1, Canada
| | - Janelle Unger
- School of Physical Therapy, Western University, London, ON, N6G 1H1, Canada.
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15
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Spiess AAF, Skempes D, Bickenbach J, Stucki G. Exploration of current challenges in rehabilitation from the perspective of healthcare professionals: Switzerland as a case in point. Health Policy 2021; 126:173-182. [PMID: 34625281 DOI: 10.1016/j.healthpol.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 12/11/2022]
Abstract
Rehabilitation is a health strategy with the potential to mitigate the negative health consequences of population ageing and the rise of noncommunicable diseases. Literature indicates that even in high-income countries rehabilitation services can be improved. The purpose of this study is to engage rehabilitation professionals in Switzerland in identifying and prioritizing current challenges in the development and delivery of rehabilitation services. We conducted a qualitative study consisting of interviews with key informants and a stakeholder consultation. Thirteen interviews were conducted and analysed using inductive thematic analysis. Identified challenges were refined, extended, and prioritized through multi-voting in a workshop attended by a wide range of rehabilitation professional organizations. Final results were subject to further analysis and member checking. We identified nineteen challenges, of which eight were viewed as highly important. Results suggest the need to revise the financing system for rehabilitation services, highlighted a poor integration of rehabilitation in primary care, a lack of academic rehabilitation training, and insufficient funding for research. Finally, we identified a perceived lack of awareness for rehabilitation among policy-makers and the public. This study provides a unique perspective on challenges in rehabilitation practice and policy and offers an opportunity for professionals, policy-makers, and other stakeholders, to influence and guide the rehabilitation service agenda both in Switzerland and in terms of mutual learning also in other countries.
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Affiliation(s)
- Adrian Andrea Flavio Spiess
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland.
| | - Dimitrios Skempes
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
| | - Jerome Bickenbach
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
| | - Gerold Stucki
- Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland; Swiss Paraplegic Research (SPF), Guido A. Zaech Strasse 4, 6207 Nottwil, Switzerland..
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16
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Right people, right time? a qualitative study of service access experiences of adults with acquired brain injury following discharge from inpatient rehabilitation. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractPurpose:The intention of this paper is to develop the personal concept of appropriate access. We report on the service access experiences and opportunities of adults with an acquired brain injury after leaving inpatient rehabilitation. The benefits of appropriate access underpin standards in early and long-term recovery, though users’ access needs are highly personal.Methods:The study used a qualitative design involving 16 semi-structured interviews with Australian adults with an acquired brain injury after discharge from inpatient brain rehabilitation. Data were thematically analysed.Results:Three main themes were derived from the analysis. Theme 1 shows that participants valued being steered to services that providers thought appropriate for them early after discharge from inpatient rehabilitation. Theme 2 highlights the tensions between timing and personal recovery and perceived needs. Theme 3 captures participants’ insights into the challenges of gaining access vis-a-vis what the system offers and the enablers of actualising appropriate access.Conclusion:The positive experiences of being directed to specialist services early after discharge suggest that continuity of care constitutes appropriateness of access for participants in this study. However, it is also clear that continuity should not displace flexibility in the timing of services, to accord with individuals’ perceived needs. This, in addition to enablement of access opportunities, through funding and transport, are important in maintaining a personalised approach.
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17
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Ambrosio L, Rodriguez-Blazquez C, Ayala A, Forjaz MJ. Rasch analysis of the living with chronic illness scale in Parkinson's disease. BMC Neurol 2020; 20:346. [PMID: 32933508 PMCID: PMC7493322 DOI: 10.1186/s12883-020-01926-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Neurologists play an essential role in facilitating the patient’s process of living with Parkinson’s disease (PD). The Living with Chronic Illness Scale-PD (LW-CI-PD) is a unique available clinical tool that evaluates how the patient is living with PD. The objective of the study was to analyse the LW-CI-PD properties according to the Rasch model. Methods An open, international, cross-sectional study was carried out in 324 patients with Parkinson’s disease from four Latin American countries and Spain. Psychometric properties of the LW-CI-PD were tested using Rasch analysis: fit to the Rasch model, item local independency, unidimensionality, reliability, and differential item functioning by age and gender. Results Original LW-CI-PD do not fit Rasch model. Modifications emerged included simplifying the response scale and deleting misfit items, the dimensions Acceptance, Coping and Integration showed a satisfactory fit to the Rasch model, with reliability indices greater than 0.70. The dimensions Self-management and Adjustment to the disease did not reach fit to the Rasch model. Conclusion Suggestions for improving the LW-CI-PD include a multidimensional and shorter scale with 12 items grouped in three subscales with a simpler response scheme. The final LW-CI-PD Scale version is a reliable scale, with good internal construct validity, that provides Rasch transformed results on linear metric scale.
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Affiliation(s)
- Leire Ambrosio
- Faculty of Nursing, University of Navarre, Campus Universitario s/n, 31009, Pamplona, Navarre, Spain.
| | | | - Alba Ayala
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
| | - Maria João Forjaz
- National School of Public Health, Institute of Health Carlos III and REDISSEC, Madrid, Spain
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18
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Borg DN, Nielsen M, Kennedy A, Drovandi C, Beadle E, Bohan JK, Watter K, Foster MM, Fleming J. The effect of access to a designated interdisciplinary post-acute rehabilitation service on participant outcomes after brain injury. Brain Inj 2020; 34:1358-1366. [PMID: 32780595 DOI: 10.1080/02699052.2020.1802660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to determine the influence of participation in a designated acquired brain injury (ABI) transitional rehabilitation service (ABI TRS) on outcome, in the context of a historical comparison group (HIST). Design: A cohort study, with retrospective comparison. Participants: 187 persons with ABI. Measures: The Depression, Anxiety and Stress Scale (DASS-21), Mayo-Portland Adaptability Index (MPAI-4) and Sydney Psychosocial and Reintegration Scale (SPRS) were completed at discharge and 3 months after discharge. Participation in the ABI TRS involved interdisciplinary rehabilitation, 2-4 times per week, for 3 months after hospital discharge. Results: There was evidence that at 3 months, participants with ABI TRS showed stabilized psychological wellbeing, and improvements in MPAI-4 ability and participation scores; in addition to improvements in SPRS occupational activity and living skills scores. Conclusion: A designated ABI TRS may improve the transition from hospital to home, and could form an important part of the brain injury rehabilitation continuum, between the inpatient and community setting.
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Affiliation(s)
- David N Borg
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Mandy Nielsen
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Areti Kennedy
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Christopher Drovandi
- Australian Research Council Centre of Excellence for Mathematical and Statistical Frontiers , Brisbane, Australia.,School of Mathematical Sciences, Queensland University of Technology , Brisbane, Australia
| | - Elizabeth Beadle
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Jaycie K Bohan
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, Australia
| | - Kerrin Watter
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Michele M Foster
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University , Brisbane, Australia.,Acquired Brain Injury Transitional Rehabilitation Service, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health , Brisbane, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, Australia
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19
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Jesus TS, Hoenig H, Landry MD. Development of the Rehabilitation Health Policy, Systems, and Services Research field: Quantitative Analyses of Publications over Time (1990-2017) and across Country Type. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E965. [PMID: 32033180 PMCID: PMC7036950 DOI: 10.3390/ijerph17030965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Health policy, systems and services research (HPSSR) is increasingly needed to enable better access to, and value of, rehabilitation services worldwide. We aim to quantify the growth of Rehabilitation HPSSR publications since 1990, compared to that of overall rehabilitation research and overall HPSSR. METHODS Quantitative, comparative analysis of publication trends using the PubMed database and its indexation system. Comprehensive search filters, based on Medical Subject Headings (MeSH), were built and calibrated to locate research articles with content on HPSSR and rehabilitation of physical impairments. Additional filters were used for locating research publications declaring funding support, publications in rehabilitation journals, and finally publications focused on high-income (HICs) or low- and middle-income countries (LMICs). The same approach was used for retrieving data on comparator fields-overall HPSSR and overall rehabilitation research. Linear regressions, with ANOVA, were used for analyzing yearly publication growths over the 28-year time frame. RESULTS Rehabilitation HPSSR publications in PubMed have grown significantly from 1990 to 2017 in the percentage of all rehabilitation research (from 11% to 18%) and all HPSSR (from 2.8% to 3.9%; both p < 0.001). The rate of Rehabilitation HPSSR published in rehabilitation journals did not change significantly over time (p = 0.47). The rates of publications with declared funding support increased significantly, but such growth did not differ significantly from that of the comparator fields. Finally, LMICs accounted for 9.3% of the country-focused rehabilitation HPSSR since 1990, but this percentage value increased significantly (p < 0.001) from 6% in 1990 to 13% in 2017. CONCLUSION Rehabilitation HPSSR publications, i.e., those indexed in PubMed with related MeSH terms, have grown in both absolute and relative values. Rehabilitation HPSSR publications focused on LMICs also grew significantly since 1990, but still remained a tiny portion of the Rehabilitation HPSSR publications with country-specific MeSH terms.
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Affiliation(s)
- Tiago S. Jesus
- Global Health and Tropical Medicine & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, 1349-008 Lisbon, Portugal
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC 27705, USA;
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
| | - Michel D. Landry
- School of Medicine, Duke University, Durham, NC 27710, USA;
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
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20
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Legg M, Foster M, Parekh S, Nielsen M, Jones R, Kendall E, Fleming J, Geraghty T. Trajectories of Rehabilitation across Complex Environments (TRaCE): design and baseline characteristics for a prospective cohort study on spinal cord injury and acquired brain injury. BMC Health Serv Res 2019; 19:700. [PMID: 31615532 PMCID: PMC6794776 DOI: 10.1186/s12913-019-4564-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/26/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Trajectories of Rehabilitation across Complex Environments (TRaCE), a consented prospective cohort study, addresses a critical need to better understand access to the healthcare system after acute treatment and specialist inpatient rehabilitation for acquired disability. It is expected that this study will produce new knowledge on access to healthcare through the linkage of administrative, survey, and spatial datasets on the one cohort. This paper outlines the study design and baseline characteristics of the cohort. METHODS The TRaCE cohort is comprised of 165 inpatients who are currently being followed up for 12 months after discharge from specialist rehabilitation for acquired brain injury (ABI) and spinal cord injury (SCI). This project combines a data linkage framework on health service use with a prospective survey on psychosocial wellbeing, geographical information systems to examine spatial accessibility to services, and qualitative interviews with a sub-cohort on experiences of service access. CONCLUSION Ultimately, TRaCE will have strong translational impact on strategies for more targeted interventions to improve the healthcare system and support individuals with acquired disabilities in the long-term.
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Affiliation(s)
- Melissa Legg
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Michele Foster
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Sanjoti Parekh
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Mandy Nielsen
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Rachel Jones
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Elizabeth Kendall
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Timothy Geraghty
- The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University and the Division of Rehabilitation, Metro South Health Hospital and Health Service, 199 Ipswich Road, Woolloongabba, Brisbane, Queensland 4102 Australia
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21
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Smith M, Neibling B, Williams G, Birks M, Barker R. A qualitative study of active participation in sport and exercise for individuals with multiple sclerosis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1776. [DOI: 10.1002/pri.1776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/19/2019] [Accepted: 03/17/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Moira Smith
- College of Healthcare SciencesJames Cook University Townsville Queensland Australia
| | - Bridee Neibling
- College of Healthcare SciencesJames Cook University Townsville Queensland Australia
| | - Gavin Williams
- Faculty of Medicine, Dentistry and Health SciencesUniversity of Melbourne Melbourne Victoria Australia
| | - Melanie Birks
- College of Healthcare SciencesJames Cook University Townsville Queensland Australia
| | - Ruth Barker
- College of Healthcare SciencesJames Cook University Townsville Queensland Australia
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22
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“Time's Up”: The Experience of Entering Residential Aged Care for Young People with Acquired Neurological Disorders and Their Families. BRAIN IMPAIR 2018. [DOI: 10.1017/brimp.2018.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and aims: Previous research has highlighted that living in residential aged care (RAC) is associated with a range of negative outcomes for adults with acquired neurological disorders. This study sought to understand the lived experience of entering RAC for young people and their family members and characterise their needs during this process.Method: Data included 64 written and verbal submissions to the 2015 Senate Inquiry into the Adequacy of existing residential care arrangements available for young people with severe physical, mental or intellectual disabilities in Australia. In line with hermeneutic tradition, text was analysed using thematic analysis.Results: Entry to RAC was experienced as a complex process that coalesced around three key events: an unexpected health crisis, a directive that time's up and the individual is required to leave the healthcare setting, with a subsequent decision to move into RAC. This decision was made in the absence of time, knowledge of options or adequate support.Conclusions: Findings suggest that there are both immediate practice changes and longer term policy responses that can support the health and disability systems to uphold the rights of people with acquired disability to choose where and how they will live their lives.
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Jackson K, Hamilton S, Jones S, Barr S. Patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition: a qualitative systematic review and meta-aggregation. Disabil Rehabil 2018; 41:2731-2749. [PMID: 29911901 DOI: 10.1080/09638288.2018.1473508] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life.Methods: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers. One hundred and one findings were extracted. Meta-aggregation was used to synthesize findings.Findings: Seven 'synthesized findings' [SF] were produced: Interactions with some professionals provide active participation, choice, confidence and autonomy [SF1]; Interactions with some professionals are disempowering and depersonalized [SF2]; Effective communication, specialist knowledge and an individualized approach to information provision is needed [SF3]; Indicators of success vary and may not be clear [SF4]; Informal support from family/friends is valued [SF5]; Opportunities for peer support/social interaction is valued [SF6]; Coordination required to ensure continuity during transition to community [SF7].Conclusion: Patient reported experiences identified common factors associated with process quality (respect, choice, autonomy, information provision, communication) and activities of patient centered care (personalized care, shared decision-making, self-management support) despite heterogeneity of neurological conditions, service configurations, and geographical location. These factors impact quality of life.Implications for RehabilitationPatient reported experiences provide useful information about courtesy, respect, choice, autonomy, information provision, and communication.Outcomes of self-efficacy and self-management are important for people with stable and progressive long-term neurological conditions.Interactions with individual professionals influence engagement, self-efficacy, and self-management for people with long-term neurological conditions.Training for health and social care professionals should develop the advanced communication skills and behavior required to facilitate self-efficacy and self-management.
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Affiliation(s)
- Katherine Jackson
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Sharon Hamilton
- School of Health and Social Care, Teesside University, Middlesbrough, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, Teesside University, Middlesbrough, UK
| | - Susan Jones
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Steven Barr
- School of Health and Social Care, Teesside University, Middlesbrough, UK
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Steel EJ. Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines. Assist Technol 2018; 32:74-78. [PMID: 29883264 DOI: 10.1080/10400435.2018.1485780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. METHODS Policy documents were analyzed iteratively with a set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. RESULTS AND DISCUSSION The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent with contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. CONCLUSION The policies frame rehabilitation in a medical model that separates assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.
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Affiliation(s)
- Emily J Steel
- School of Health and Wellbeing, The University of Southern Queensland, Ipswich, Australia.,TC Beirne School of Law, The University of Queensland, St Lucia, Australia
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25
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Gao F, Foster M, Liu Y. Disability concentration and access to rehabilitation services: a pilot spatial assessment applying geographic information system analysis. Disabil Rehabil 2018; 41:2468-2476. [PMID: 29726287 DOI: 10.1080/09638288.2018.1468931] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Due to geographical disparities, many people with profound or severe disabilities experience considerable delays in rehabilitation treatment, resulting in threats to quality of life. This pilot study aims to identify areas in Greater Brisbane, Australia, with a higher concentration of people with profound or severe disabilities and to evaluate access to rehabilitation services in these areas. Methods: Data came from the 2016 Australian Census of Population and Housing and the National Health Services Directory. Four frequently used rehabilitation services by individuals with profound or severe disabilities (i.e., occupational therapy, physiotherapy, speech pathology and psychology) were the focus of the analysis. The data were analyzed using geospatial analysis methods (e.g., spatial scan statistic and network analysis). Results: A higher concentration of rehabilitation services was found in the regions with lower disability prevalence and lower potential demand for rehabilitation services. In contrast, the regions with higher disability prevalence and higher potential demand for rehabilitation services experienced poorer access to rehabilitation services. Conclusion: The findings are expected to inform policy decisions about the prioritization of rehabilitation resources and derive evidence for planning more responsive service delivery. Implications for rehabilitation The current study has demonstrated the utilization of geographic information system methods to facilitate rehabilitation service planning. Identification of disability concentration may inform locally responsive rehabilitation service delivery. Spatial assessment of mismatch between supply and potential demand may assist policy makers and service providers in the prioritization of rehabilitation resources. The current study contributes to the World Health Organization's call for action to ensure adequate access to rehabilitation services by people with profound or severe disabilities.
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Affiliation(s)
- Fengsong Gao
- a The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | - Michele Foster
- a The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | - Yan Liu
- b School of Earth and Environmental Sciences , The University of Queensland , Brisbane , Australia.,c Queensland Centre for Population Research , The University of Queensland , Brisbane , Australia
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Narayan SW, Jamieson HA, Nishtala PS. Evaluation of the National Minimum Data Set for Neurological Conditions in Older Adults. J Geriatr Psychiatry Neurol 2017; 30:331-336. [PMID: 28950742 DOI: 10.1177/0891988717732154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM To evaluate the National Minimum Data Set (NMDS) against the International Resident Assessment Instrument-Home Care (interRAI-HC) in diagnosing dementia or Parkinson disease (PD). METHOD The NMDS data were matched with interRAI-HC for all older individuals in New Zealand. Dementia or PD was compared within 90 and 180 days and 1 to 4 years preceding and subsequent to the date of diagnosis in interRAI-HC. Consistency was measured through sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), weighted kappa (κ), and McNemar test. RESULTS For a diagnosis within 90 days, dementia showed 60.77% sensitivity, 95.33% specificity, 68.46% PPV, and 93.58% NPV. The PD showed 65.74% sensitivity, 99.52% specificity, 80.43% PPV, and 98.98% NPV. κ for dementia (κ = 0.59), PD (κ = 0.720), and McNemar test was significant ( P < .001) for all lengths of follow-up. CONCLUSION Substantial agreement between multiple sources of health data can be a valuable resource for decision-making in older people with neurological conditions.
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Affiliation(s)
| | - Hamish A Jamieson
- 2 Department of Medicine, University of Otago, Christchurch, New Zealand
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Navarta-Sánchez MV, Caparrós N, Riverol Fernández M, Díaz De Cerio Ayesa S, Ursúa Sesma ME, Portillo MC. Core elements to understand and improve coping with Parkinson's disease in patients and family carers: A focus group study. J Adv Nurs 2017; 73:2609-2621. [PMID: 28494098 DOI: 10.1111/jan.13335] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study were: (1) To explore the meaning that coping with Parkinson's disease has for patients and family carers; (2) To suggest the components of an intervention focused on enhancing their coping with the disease. BACKGROUND Adapting to Parkinson's disease involves going through many difficult changes; however, it may improve quality of life in patients and family carers. One of the key aspects for facilitating the psychosocial adjustment to Parkinson's disease is the strengthening of coping skills. DESIGN A sequential explanatory mixed methods study was carried out. Findings from the qualitative phase are presented. METHODS Data were collected in May 2014 through three focus groups: one of people with Parkinson's disease (n = 9), one of family carers (n = 7) and one of healthcare professionals (n = 5). All focus groups were digitally recorded and transcribed verbatim and content analysis was independently carried out by two researchers. FINDINGS The participants coincided in highlighting that coping with Parkinson's disease helped the patient and the family carer in their search for balance; and it implied a transformation in their lives. To aid the process of coping with Parkinson's disease, a multifaceted intervention is proposed. CONCLUSION Coping with Parkinson's disease is a complex process for both patients and family carers and it should therefore be considered a standard service in healthcare policies aimed at this group. The proposed intervention constitutes a nursing tool which has great potential to improve the quality of life in Parkinson's disease and in other long-term conditions.
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Affiliation(s)
| | - Neus Caparrós
- Faculty of Law and Social Sciences, University of La Rioja, Logroño, La Rioja, Spain
| | | | | | - M Eugenia Ursúa Sesma
- San Juan Primary Health Centre, Navarre Service of Health-Osasunbidea, Pamplona, Navarre, Spain
| | - Mari Carmen Portillo
- NIHR CLAHRC WESSEX, Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, UK
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Coffey NT, Weinstein AA, Cai C, Cassese J, Jones R, Shaewitz D, Garfinkel S. Identifying and Understanding the Health Information Experiences and Preferences of Individuals With TBI, SCI, and Burn Injuries. J Patient Exp 2016; 3:88-95. [PMID: 28725843 PMCID: PMC5513647 DOI: 10.1177/2374373516667007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction: Traumatic brain injury, spinal cord injury, and burn injury can cause lifelong disability and changes in quality of life. In order to meet the challenges of postinjury life, various types of health information are needed. We sought to identify preferred sources of health information and services for persons with these injuries and discover how accessibility could be improved. Methods: Thirty-three persons with injury participated in semistructured interviews. Responses to interview questions were coded using NVivo. Results: Participants’ difficulties accessing health information varied by injury type and individually. The majority of respondents found information via the Internet and advocated its use when asked to describe their ideal health information system. Nearly all participants supported the development of a comprehensive care website. When searching for health information, participants sought doctor and support group networks, long-term health outcomes, and treatments specific to their injury. Conclusion: To optimize the quality of health information resources, Internet-based health-care platforms should add or highlight access points to connect patients to medical professionals and support networks while aggregating specialized, injury-specific research and treatment information.
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Affiliation(s)
- Nathan T Coffey
- Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Ali A Weinstein
- Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Cindy Cai
- American Institutes for Research, Washington, DC, USA
| | - Jimmy Cassese
- Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Rebecca Jones
- Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, USA
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Barker RN, Sealey CJ, Polley ML, Mervin MC, Comans T. Impact of a person-centred community rehabilitation service on outcomes for individuals with a neurological condition. Disabil Rehabil 2016; 39:1136-1142. [DOI: 10.1080/09638288.2016.1185803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ruth N. Barker
- College of Healthcare Sciences, James Cook University, Townsville and Cairns, QLD, Australia
- Community Rehabilitation Northern Queensland, Northern Australia Primary Health Ltd., Townsville, QLD, Australia
| | - Cindy J. Sealey
- College of Healthcare Sciences, James Cook University, Townsville and Cairns, QLD, Australia
- Community Rehabilitation Northern Queensland, Northern Australia Primary Health Ltd., Townsville, QLD, Australia
| | - Michelle L. Polley
- Community Rehabilitation Northern Queensland, Northern Australia Primary Health Ltd., Townsville, QLD, Australia
| | - Merehau C. Mervin
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Tracy Comans
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Metro North Hospital and Health Service District, Brisbane, QLD, Australia
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