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Magalhães JP, Faria-Fortini I, Menezes KK, Lara IA, Batista LR, Sant'anna R, Faria CD. Determinants of access to rehabilitation professionals by individuals with stroke in the first six months after hospital discharge in Brazil: a study based on the Andersen model. Top Stroke Rehabil 2024; 31:615-624. [PMID: 38319730 DOI: 10.1080/10749357.2024.2304969] [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: 10/24/2023] [Accepted: 12/29/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND determinants of access to rehabilitation professionals after stroke in middle-income countries, where the burden of this disease is higher, are little known. OBJECTIVES To identify the determinants of access to rehabilitation professionals by individuals with stroke at one, three, and six months after hospital discharge in Brazil and compare referral and access rates after discharge. METHODS Longitudinal and prospective study, with individuals with primary stroke, without previous disabilities. At hospital discharge, the number of rehabilitation professionals referred by the multidisciplinary team was recorded. The possible determinants of access, according to Andersen's model, were: a) predisposing factors: age, sex, education levels, and belief that they could improve with treatment; b) need factors: stroke severity, levels of disability; c) enabling factors: socioeconomic status, disposable income for health care, and quality of care provided by rehabilitation professionals. One, three, and six months after hospital discharge, individuals were contacted to identify which rehabilitation professionals were accessed. Multiple linear regression model and Wilcoxon tests were used (α=5%). RESULTS 201 individuals were included. Disability levels and stroke severity explained 31%, 34%, and 39% (p<0.01) of access at one, three, and six months after hospital discharge, respectively. In all periods, there was less access than that recommended at the time of hospital discharge (p<0.01). CONCLUSION Need factors (disability levels and stroke severity) were determinants of access in all assessed periods. In addition, in all periods, the comprehensiveness of care for individuals with stroke was compromised.
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Affiliation(s)
- Jordana P Magalhães
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Iza Faria-Fortini
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kênia Kp Menezes
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isadora A Lara
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ludmilla R Batista
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Romeu Sant'anna
- Department of Neurology, Hospital Risoleta Tolentino Neves, Belo Horizonte, Brazil
| | - Christina Dcm Faria
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Pratte G, Trottier N, Couture M, Beaudoin AJ, Camden C. Proposed framework and knowledge synthesis of services delivered by specialized professionals in childcare settings: A scoping review. Child Care Health Dev 2024; 50:e13282. [PMID: 38801207 DOI: 10.1111/cch.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/18/2023] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Services from specialized professionals in childcare settings contribute to support early childhood development. Little is known, however, about how services are delivered in this context. The aims of this scoping review were to propose a framework to describe services delivered by specialized professionals in childcare contexts and synthesize knowledge about those services. METHODS Documents published between 2000 and 2022 in APA PsychINFO, ERIC, CINAHL and MEDLINE were included. These documents described services delivered by a range of specialized professionals (e.g., speech-language pathologists, occupational therapists, physical therapists and early childhood special education teachers) in childcare contexts and whose aim was to support motor, cognitive, affective, language or social development of children. Deductive and inductive qualitative analyses and descriptive statistics were carried out. RESULTS The review included 47 documents. The Description of Services delivered by specialized Professionals in Early Childhood (D-SPEC) Framework emerged from qualitative analyses. The D-SPEC Framework included 11 dimensions: three actors and their context, specialized professionals involved, children served, purpose of service, type of service, service duration and intensity, mode of service delivery, mode of access to services and funding. Most services delivered by specialized professionals in childcare were provided by a single professional and targeted language. Two documents described multitiered service delivery models with a continuum of services ranging from general support for all children to individualized interventions for children with specific needs. In-context services were preferred to pull-out services in most documents reviewed. CONCLUSIONS The D-SPEC Framework may be a useful tool to assist researchers in documenting and comparing services delivered by specialized professionals. More importantly, this framework will facilitate the development of intersectoral and interdisciplinary services essential for supporting early childhood development. Multitiered service delivery models appeared to be a promising way to develop those services addressing the various needs encountered in childcare.
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Affiliation(s)
- Gabrielle Pratte
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
- Institut Universitaire de Première Ligne en Santé et Services Sociaux du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
- Centre de Recherche du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
| | - Nathalie Trottier
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
- Institut Universitaire de Première Ligne en Santé et Services Sociaux du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
- Centre de Recherche du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
| | - Mélanie Couture
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
- Centre de Recherche du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
- Institut Universitaire en Déficience Intellectuelle et Troubles du Spectre de L'autisme, Trois-Rivières, Canada
| | - Audrée Jeanne Beaudoin
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
- Institut Universitaire de Première Ligne en Santé et Services Sociaux du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
| | - Chantal Camden
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
- Institut Universitaire de Première Ligne en Santé et Services Sociaux du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
- Centre de Recherche du CIUSSS de l'Estrie-CHUS, Sherbrooke, Canada
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Seijas V, Maritz R, Fernandes P, Bernard RM, Lugo LH, Bickenbach J, Sabariego C. Rehabilitation delivery models to foster healthy ageing-a scoping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1307536. [PMID: 38660395 PMCID: PMC11041397 DOI: 10.3389/fresc.2024.1307536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/15/2024] [Indexed: 04/26/2024]
Abstract
Introduction Rehabilitation is essential to foster healthy ageing. Older adults have unique rehabilitation needs due to a higher prevalence of non-communicable diseases, higher susceptibility to infectious diseases, injuries, and mental health conditions. However, there is limited understanding of how rehabilitation is delivered to older adults. To address this gap, we conducted a scoping review to describe rehabilitation delivery models used to optimise older adults' functioning/functional ability and foster healthy ageing. Methods We searched Medline and Embase (January 2015 to May 2022) for primary studies published in English describing approaches to provide rehabilitation to older adults. Three authors screened records for eligibility and extracted data independently and in duplicate. Data synthesis included descriptive quantitative analysis of study and rehabilitation provision characteristics, and qualitative analysis to identify rehabilitation delivery models. Results Out of 6,933 identified records, 585 articles were assessed for eligibility, and 283 studies with 69,257 participants were included. We identified six rehabilitation delivery models: outpatient (24%), telerehabilitation (22%), home (18.5%), community (16.3%), inpatient (14.6%), and eldercare (4.7%). These models often involved multidisciplinary teams (31.5%) and follow integrated care principles (30.4%). Most studies used a disease-centred approach (59.0%), while studies addressing multimorbidity (6.0%) and prevalent health problems of older adults, such as pain, low hearing, and vision, or incontinence were scarce. The most frequently provided interventions were therapeutic exercises (54.1%), self-management education (40.1%), and assessment of person-centred goals (40%). Other interventions, such as assistive technology (8.1%) and environmental adaptations (7.4%) were infrequent. Conclusions Focusing on primary studies, this scoping review provides an overview of rehabilitation delivery models that are used to foster healthy ageing and highlights research gaps that require further attention, including a lack of systematic assessment of functioning/functional ability, a predominance of disease-centred rehabilitation, and a scarcity of programmes addressing prevalent issues like pain, hearing/vision loss, fall prevention, incontinence, and sexual dysfunctions. Our research can facilitate evidence-based decision-making and inspire further research and innovation in rehabilitation and healthy ageing. Limitations of our study include reliance on published research to infer practice and not assessing model effectiveness. Future research in the field is needed to expand and validate our findings.
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Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, Parana, Brazil
| | | | - Luz Helena Lugo
- Rehabilitation in Health Research Group, University of Antioquia, Medellin, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
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Seijas V, Maritz R, Mishra S, Bernard RM, Fernandes P, Lorenz V, Machado B, Posada AM, Lugo-Agudelo LH, Bickenbach J, Sabariego C. Rehabilitation in primary care for an ageing population: a secondary analysis from a scoping review of rehabilitation delivery models. BMC Health Serv Res 2024; 24:123. [PMID: 38263183 PMCID: PMC10804573 DOI: 10.1186/s12913-023-10387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The world population is ageing rapidly. Rehabilitation is one of the most effective health strategies for improving the health and functioning of older persons. An understanding of the current provision of rehabilitation services in primary care (PC) is needed to optimise access to rehabilitation for an ageing population. The objectives of this scoping review are a) to describe how rehabilitation services are currently offered in PC to older persons, and b) to explore age-related differences in the type of rehabilitation services provided. METHODS We conducted a secondary analysis of a scoping review examining rehabilitation models for older persons, with a focus on PC. Medline and Embase (2015-2022) were searched to identify studies published in English on rehabilitation services for people aged 50 + . Two authors independently screened records and extracted data using the World Health Organization (WHO)'s operational framework, the Primary Health Care Systems (PRIMASYS) approach and the WHO paper on rehabilitation in PC. Data synthesis included quantitative and qualitative analysis. RESULTS We synthesised data from 96 studies, 88.6% conducted in high-income countries (HICs), with 31,956 participants and identified five models for delivering rehabilitation to older persons in PC: community, home, telerehabilitation, outpatient and eldercare. Nurses, physiotherapists, and occupational therapists were the most common providers, with task-shifting reported in 15.6% of studies. The most common interventions were assessment of functioning, rehabilitation coordination, therapeutic exercise, psychological interventions, and self-management education. Environmental adaptations and assistive technology were rarely reported. CONCLUSIONS We described how rehabilitation services are currently provided in PC and explored age-related differences in the type of rehabilitation services received. PC can play a key role in assessing functioning and coordinating the rehabilitation process and is also well-placed to deliver rehabilitation interventions. By understanding models of rehabilitation service delivery in PC, stakeholders can work towards developing more comprehensive and accessible services that meet the diverse needs of an ageing population. Our findings, which highlight the role of rehabilitation in healthy ageing, are a valuable resource for informing policy, practice and future research in the context of the United Nations Decade of Healthy Ageing, the Rehab2030 initiative and the recently adopted WHA resolution on strengthening rehabilitation in health systems, but the conclusions can only be applied to HICs and more studies are needed that reflect the reality in low- and middle-income countries.
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Affiliation(s)
- Vanessa Seijas
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland.
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland.
| | - Roxanne Maritz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Satish Mishra
- Disability, Rehabilitation, Palliative and Long-Term Care, Health Workforce and Service Delivery Unit, Division of Country Health Policies and Systems, WHO Regional Office for Europe, UN City, Marmorvej 51, Copenhagen, 2100, Denmark
| | - Renaldo M Bernard
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Patricia Fernandes
- Department of Clinical Medicine, Federal University of Parana, R. XV de Novembro, 1299 - Centro, Curitiba, PR, 80060-000, Brasil
| | - Viola Lorenz
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Barbara Machado
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Ana María Posada
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Luz Helena Lugo-Agudelo
- Rehabilitation in Health Research Group, Sede de Investigación Universitaria, University of Antioquia, Cl. 62 # 52-59, Medellín, Colombia
| | - Jerome Bickenbach
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
| | - Carla Sabariego
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Rehabilitation in Global Health Systems (WHO Collaborating Center), Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Ageing, Functioning Epidemiology and Implementation, Swiss Paraplegic Research, Nottwil, Switzerland
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Lampart P, Häusler F, Langewitz W, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury: A pilot qualitative interview study. J Spinal Cord Med 2023; 46:837-847. [PMID: 35867389 PMCID: PMC10446827 DOI: 10.1080/10790268.2022.2095496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To explore patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/disorder (SCI/D). DESIGN Qualitative design with semi-structured interviews and purposively sampled participants. Interviews were transcribed verbatim. Transcripts were analyzed for qualitative content analysis using the Mayring method. SETTING Specialized acute care and rehabilitation center for SCI/D-patients. PARTICIPANTS Patients in initial rehabilitation after a newly acquired SCI/D. INTERVENTIONS n.a. OUTCOME MEASURES n.a. RESULTS Ten participants were interviewed in the post-acute phase after a newly acquired SCI/D. Participants described individual patient characteristics as well as organizational elements influencing their experience with goal setting. Organizational elements comprised structural elements (e.g. ward rounds, rehabilitation meetings, etc.) and interaction with and among the interprofessional teams. Perspectives from various health care professionals (HCPs) were perceived as increasing adequate goal setting and motivation. Furthermore, the participants described their own involvement and motivation as crucial for goal achievement. The main point of the critique was the standardization of the goal setting process. Interviewees would have preferred individualized goal setting embedded in a clearly foreseeable rehabilitation plan. CONCLUSION Organization and collaboration with and among the HCPs should be geared towards identifying specific patient needs during the course of rehabilitation and deriving individually tailored goals from them. Communication plays an important role in the individual goal setting.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Florin Häusler
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Magalhães JP, Faria-Fortini I, Dutra TM, Sant'Anna R, Soares CLA, Teixeira-Salmela LF, Faria CD. Access to rehabilitation professionals by individuals with stroke one month after hospital discharge from a stroke unit in Brazil is insufficient regardless of the pandemic. J Stroke Cerebrovasc Dis 2023; 32:107186. [PMID: 37295173 PMCID: PMC10246573 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE To compare access to rehabilitation professionals by individuals with stroke one month after hospital discharge from a stroke unit in Brazil, before and during the COVID-19 pandemic. MATERIALS AND METHODS This longitudinal and prospective study included individuals aged 20 years or older without previous disabilities admitted into a stroke unit due to a first stroke. Individuals were divided into two groups: before (G1) and during (G2) the COVID-19 pandemic. Groups were matched for age, sex, education level, socioeconomic status, and stroke severity. One month after hospital discharge, individuals were contacted via telephone to collect data regarding their access to rehabilitation services based on the number of referred rehabilitation professionals. Then, between-group comparisons were conducted (α = 5%). RESULTS The access to rehabilitation professionals was similar between groups. Rehabilitation professionals accessed included medical doctors, occupational therapists, physical therapists, and speech therapists. The first consultation after hospital discharge was mainly provided by public services. Despite the pandemic, telehealth was not frequent in any period evaluated. In both groups, the number of accessed professionals (G1 = 110 and G2 = 90) was significantly lower than the number of referrals (G1 = 212 and G2 = 194; p < 0.001). CONCLUSIONS Access to rehabilitation professionals was similar between groups. However, the number of accessed rehabilitation professionals was lower than that of referred ones during both periods. This finding indicates a compromised comprehensiveness of care for individuals with stroke, regardless of the pandemic.
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Affiliation(s)
- Jordana P Magalhães
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Iza Faria-Fortini
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Tamires Mfv Dutra
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Romeu Sant'Anna
- Department of Neurology, Hospital Risoleta Tolentino Neves, Belo Horizonte, MG, Brazil
| | - Carolina LA Soares
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luci F Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Christina Dcm Faria
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Gutenbrunner C, Nugraha B, Meyer T. Prevention Aiming at Functioning-Describing Prevention in the Context of Rehabilitation: A Discussion Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5399. [PMID: 37048012 PMCID: PMC10094495 DOI: 10.3390/ijerph20075399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual description of prevention aimed at functioning on the basis of the ICF model. Starting from the ICF-based conceptual descriptions of rehabilitation as a health strategy, a conceptual description of functioning prevention has been developed. Prevention aiming at functioning is the health strategy that applies approaches to avoid or reduce risks of impairing bodily functions and structures, activity limitations and participation restrictions; to strengthen the resources of the person; to optimize capacity and performance; to prevent impairments of bodily functions and structures; to prevent activity limitations and participation restrictions; to reduce contextual risk factors and barriers, including personal and environmental factors; to promote and strengthen contextual facilitators, with the goal of enabling people with impairments and people at risk of disability; and to maintain or improve the level of functioning in interactions with the environment. The proposed concept widens the scope of prevention to all aspects of functioning, including contextual factors.
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Affiliation(s)
- Christoph Gutenbrunner
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Boya Nugraha
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Thorsten Meyer
- Institute for Rehabilitation Medicine, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany
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Meyer T, Kleineke V, Stamer M. Cooperative leadership as a condition for patient-reported rehabilitation success. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1114666. [PMID: 37009399 PMCID: PMC10056212 DOI: 10.3389/fresc.2023.1114666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/31/2023] [Indexed: 03/17/2023]
Abstract
IntroductionRehabilitation is a complex intervention that takes place in a complex setting. The MeeR project (characteristics of successful rehabilitation facilities) aims to identify complex conditions of successful rehabilitation outcomes.MethodsA project with a sequential mixed-methods study design with a quantitative prestudy and a qualitative main study was applied. In the quantitative study, quality assurance data of the German Pension Insurance was used to (1) develop and compute a multifacet z-standardized outcome index based on patient-reported outcome data, (2) rank k = 273 orthopedic rehabilitation facilities comprising n = 112,895 patients and k = 86 cardiac rehabilitation institutions comprising n = 30,299 patients based on their outcome index score by means of a league table, and (3) adjust the ranking by basic patient characteristics (age, gender, diagnosis, weeks out of work prior to rehabilitation, application for pension). In the qualitative main study, k = 6 rehabilitation facilities (orthopedic and cardiac rehabilitation centers) were recruited based on the results of the quantitative analysis: three facilities that ranked top 10% and three facilities that ranked lowest 10% of the adjusted league table. All six rehabilitation facilities were visited each for 1 week by two researchers. We conducted participant observations, expert interviews with medical and administrative leaders, group discussions with rehab team members, and group discussions with patients. Subsequently, a systematic comparison of the results of the upper and lower 10% facilities was conducted to identify those characteristics that distinguished those institutions from one another.ResultsOne of the three clusters of characteristics that distinguished the above and below 10% facilities related to teamwork or interdisciplinary cooperation: among others, the extent of interdisciplinary cooperation was higher in the rehabilitation facilities with a higher degree of success, the leading medical doctors were less dominant in these institutions, and there was also a more comprehensive representation of the team within team meetings, i.e., the quality and amount of interdisciplinary cooperation were higher in these institutions compared to rehabilitation facilities with a lower level of success.DiscussionThis project provided qualitative evidence for the role of interdisciplinary cooperation and collaborative leadership and its different facets for patient-related successful rehabilitation in orthopedic and cardiac rehabilitation. It provides valuable insights into the fabric and structure of a rehabilitation institution and a variety of target points for team development and group-leading interventions.
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Affiliation(s)
- Thorsten Meyer
- Institute for Rehabilitation Medicine, Medical School, Martin-Luther-University Halle-Wittenberg Halle (Saale), Germany
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Correspondence: Thorsten Meyer
| | | | - Maren Stamer
- Alice Salomon Hochschule Berlin, University of Applied Sciences, Berlin, Germany
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Velez M, Lugo-Agudelo LH, Patiño Lugo DF, Glenton C, Posada AM, Mesa Franco LF, Negrini S, Kiekens C, Spir Brunal MA, Roberg ASB, Cruz Sarmiento KM. Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 2:CD014823. [PMID: 36780267 PMCID: PMC9918343 DOI: 10.1002/14651858.cd014823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND To increase people's access to rehabilitation services, particularly in the context of the COVID-19 pandemic, we need to explore how the delivery of these services can be adapted. This includes the use of home-based rehabilitation and telerehabilitation. Home-based rehabilitation services may become frequently used options in the recovery process of patients, not only as a solution to accessibility barriers, but as a complement to the usual in-person inpatient rehabilitation provision. Telerehabilitation is also becoming more viable as the usability and availability of communication technologies improve. OBJECTIVES To identify factors that influence the organisation and delivery of in-person home-based rehabilitation and home-based telerehabilitation for people needing rehabilitation. SEARCH METHODS We searched PubMed, Global Health, the VHL Regional Portal, Epistemonikos, Health Systems Evidence, and EBM Reviews as well as preprints, regional repositories, and rehabilitation organisations websites for eligible studies, from database inception to search date in June 2022. SELECTION CRITERIA: We included studies that used qualitative methods for data collection and analysis; and that explored patients, caregivers, healthcare providers and other stakeholders' experiences, perceptions and behaviours about the provision of in-person home-based rehabilitation and home-based telerehabilitation services responding to patients' needs in different phases of their health conditions. DATA COLLECTION AND ANALYSIS: We used a purposive sampling approach and applied maximum variation sampling in a four-step sampling frame. We conducted a framework thematic analysis using the CFIR (Consolidated Framework for Implementation Research) framework as our starting point. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. MAIN RESULTS: We included 223 studies in the review and sampled 53 of these for our analysis. Forty-five studies were conducted in high-income countries, and eight in low-and middle-income countries. Twenty studies addressed in-person home-based rehabilitation, 28 studies addressed home-based telerehabilitation services, and five studies addressed both modes of delivery. The studies mainly explored the perspectives of healthcare providers, patients with a range of different health conditions, and their informal caregivers and family members. Based on our GRADE-CERQual assessments, we had high confidence in eight of the findings, and moderate confidence in five, indicating that it is highly likely or likely respectively that these findings are a reasonable representation of the phenomenon of interest. There were two findings with low confidence. High and moderate confidence findings Home-based rehabilitation services delivered in-person or through telerehabilitation Patients experience home-based services as convenient and less disruptive of their everyday activities. Patients and providers also suggest that these services can encourage patients' self-management and can make them feel empowered about the rehabilitation process. But patients, family members, and providers describe privacy and confidentiality issues when services are provided at home. These include the increased privacy of being able to exercise at home but also the loss of privacy when one's home life is visible to others. Patients and providers also describe other factors that can affect the success of home-based rehabilitation services. These include support from providers and family members, good communication with providers, the requirements made of patients and their surroundings, and the transition from hospital to home-based services. Telerehabilitation specifically Patients, family members and providers see telerehabilitation as an opportunity to make services more available. But providers point to practical problems when assessing whether patients are performing their exercises correctly. Providers and patients also describe interruptions from family members. In addition, providers complain of a lack of equipment, infrastructure and maintenance and patients refer to usability issues and frustration with digital technology. Providers have different opinions about whether telerehabilitation is cost-efficient for them. But many patients see telerehabilitation as affordable and cost-saving if the equipment and infrastructure have been provided. Patients and providers suggest that telerehabilitation can change the nature of their relationship. For instance, some patients describe how telerehabilitation leads to easier and more relaxed communication. Other patients describe feeling abandoned when receiving telerehabilitation services. Patients, family members and providers call for easy-to-use technologies and more training and support. They also suggest that at least some in-person sessions with the provider are necessary. They feel that telerehabilitation services alone can make it difficult to make meaningful connections. They also explain that some services need the provider's hands. Providers highlight the importance of personalising the services to each person's needs and circumstances. AUTHORS' CONCLUSIONS This synthesis identified several factors that can influence the successful implementation of in-person home-based rehabilitation and telerehabilitation services. These included factors that facilitate implementation, but also factors that can challenge this process. Healthcare providers, program planners and policymakers might benefit from considering these factors when designing and implementing programmes.
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Affiliation(s)
- Marcela Velez
- Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | | | | | - Claire Glenton
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Ana M Posada
- Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University La Statale , Milano, Italy
- Laboratory of Evidence Based Rehabilitation, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Abedi A, Biering-Sørensen F, Chhabra HS, D’Andréa Greve JM, Khan NM, Koskinen E, Kwan KYH, Liu N, Middleton JW, Moslavac S, Rahimi-Movaghar V, O’Connell C, Previnaire JG, Patel A, Scivoletto G, Sharwood LN, Townson A, Urquhart S, Vainionpää A, Zaman AU, Noonan VK, Cheng CL. An international survey of the structure and process of care for traumatic spinal cord injury in acute and rehabilitation facilities: lessons learned from a pilot study. BMC Health Serv Res 2022; 22:1565. [PMID: 36544168 PMCID: PMC9768992 DOI: 10.1186/s12913-022-08847-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To describe the key findings and lessons learned from an international pilot study that surveyed spinal cord injury programs in acute and rehabilitation facilities to understand the status of spinal cord injury care. METHODS An online survey with two questionnaires, a 74-item for acute care and a 51-item for rehabilitation, was used. A subset of survey items relevant to the themes of specialized care, timeliness, patient-centeredness, and evidence-based care were operationalized as structure or process indicators. Percentages of facilities reporting the structure or process to be present, and percentages of indicators met by each facility were calculated and reported separately for facilities from high-income countries (HIC) and from low and middle-income countries (LMIC) to identify "hard to meet" indicators defined as those met by less than two-thirds of facilities and to describe performance level. RESULTS A total of 26 acute and 26 rehabilitation facilities from 25 countries participated in the study. The comparison of the facilities based on the country income level revealed three general observations: 1) some indicators were met equally well by both HIC and LMIC, such as 24-hour access to CT scanners in acute care and out-patient services at rehabilitation facilities; 2) some indicators were hard to meet for LMIC but not for HIC, such as having a multidisciplinary team for both acute and rehabilitation settings; and 3) some indicators were hard to meet by both HIC and LMIC, including having peer counselling programs. Variability was also observed for the same indicator between acute and rehabilitation facilities, and a wide range in the total number of indicators met among HIC facilities (acute 59-100%; rehabilitation 36-100%) and among LMIC facilities (acute: 41-82%; rehabilitation: 36-93%) was reported. CONCLUSIONS Results from this international pilot study found that the participating acute and rehabilitation facilities on average adhered to 74% of the selected indicators, suggesting that the structure and processes to provide ideal traumatic spinal cord injury care were broadly available. Recruiting a representative sample of SCI facilities and incorporating regional attributes in future surveys will be helpful to examine factors affecting adherence to indicators.
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Affiliation(s)
- Aidin Abedi
- grid.42505.360000 0001 2156 6853Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Fin Biering-Sørensen
- grid.5254.60000 0001 0674 042XDepartment for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Nasser M. Khan
- grid.413542.50000 0004 0637 437XOrthopedic Surgery Department, Hamad General Hospital, Doha, Qatar
| | - Eerika Koskinen
- grid.412330.70000 0004 0628 2985Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland
| | - Kenny Yat Hong Kwan
- grid.194645.b0000000121742757Department of Orthopaedics & Traumatology, Faculty of Medicine, University of Hong Kong, Hong Kong, SAR China
| | - Nan Liu
- grid.411642.40000 0004 0605 3760Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - James W. Middleton
- grid.1013.30000 0004 1936 834XJohn Walsh Centre for Rehabilitation Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Sasa Moslavac
- Post-acute and Palliative Care Department Novi Marof, General Hospital Varaždin, Varaždin, Croatia
| | - Vafa Rahimi-Movaghar
- grid.411705.60000 0001 0166 0922Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Colleen O’Connell
- grid.55602.340000 0004 1936 8200Physical Medicine & Rehabilitation, Dalhousie University Faculty of Medicine, Fredericton, NB Canada
| | | | - Alpesh Patel
- grid.415534.20000 0004 0372 0644Middlemore Hospital, Auckland, New Zealand
| | - Giorgio Scivoletto
- grid.417778.a0000 0001 0692 3437Spinal Unit and Spinal Rehabilitation (SpiRe) Lab, IRCCS Fondazione S. Lucia, Rome, Italy
| | - Lisa N. Sharwood
- grid.1013.30000 0004 1936 834XUniversity of Sydney, Sydney, NSW Australia
| | - Andrea Townson
- grid.17091.3e0000 0001 2288 9830Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Susan Urquhart
- Spinal Injuries Unit, Queensland Spinal Cord Injuries Services, Brisbane, QLD Australia
| | - Aki Vainionpää
- grid.412326.00000 0004 4685 4917Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland
| | - Atiq Uz Zaman
- Lahore Medical and Dental College, Ghurki Trust Teaching Hospital, Lahore, Pakistan
| | - Vanessa K. Noonan
- grid.429086.10000 0004 5907 4485Praxis Spinal Cord Institute, Vancouver, BC Canada
| | - Christiana L. Cheng
- grid.429086.10000 0004 5907 4485Praxis Spinal Cord Institute, Vancouver, BC Canada
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11
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Lampart P, Schäppi L, Langewitz WA, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Health care professionals’ experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/ disorder – a qualitative focus group study. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:982321. [PMID: 36189066 PMCID: PMC9397958 DOI: 10.3389/fresc.2022.982321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022]
Abstract
IntroductionGoal setting (GS) is an important aspect of initial spinal cord injury/ disorder (SCI/D) rehabilitation. However, because expected outcomes are individual and often difficult to determine, GS is not straightforward. The aim of this study was to explore the health care professionals' (HCP's) experiences with and perspectives on the goal-setting process (GSP) during initial SCI/D rehabilitation.MethodFive semi-structured focus groups (FG) (22 purposively sampled HCP, mostly in leadership positions, six different professions). The FG were transcribed verbatim. We analyzed the transcripts for qualitative content analysis following Braun and Clarke (2013).ResultsHCP described GS-influencing aspects at the macro, meso and micro levels. At the macro level, participants spoke about restrictions imposed by health insurers or difficulties in planning the post-inpatient setting. Regarding the meso level, HCP spoke of institutional structures and culture that facilitated the GSP. At the micro level, knowledge of the diagnosis, expected outcomes, and individual patient characteristics were mentioned as important to the rehabilitation process. It was important for HCP to be patient and empathetic, to endure negative emotions, to accept that patients need time to adjust to their new situation, and to ensure that they do not lose hope. Open communication and interprofessional collaboration helped overcome barriers in the GSP.DiscussionThis paper shows the complex relationship between external (e.g., health insurers), emotional, and communication aspects. It calls for a comprehensive approach to optimizing the GSP, so that patients' experiences can be fully considered as a basis to identify the most appropriate care pathway.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Livia Schäppi
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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12
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Zampolini M, Selb M, Boldrini P, Branco CA, Golyk V, Hu X, Kiekens C, Negrini S, Nulle A, Oral A, Sgantzos M, Shmonin A, Treger I, Stucki G. The Individual Rehabilitation Project as the core of person-centered rehabilitation: the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists Framework for Rehabilitation in Europe. Eur J Phys Rehabil Med 2022; 58:503-510. [PMID: 35148044 PMCID: PMC9980560 DOI: 10.23736/s1973-9087.22.07402-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To facilitate the interaction between the health professional and the patient, a framework to guide the rehabilitation process is needed. This framework would encompass three interwoven aspects: the rehabilitation management plan, Individual Rehabilitation Project (IRP), and rehabilitation cycle(s). All three framework aspects focus on the patient and on the aim of rehabilitation, i.e. to optimize a person's functioning across the continuum of care. An IRP is a multi-element, person-centered rehabilitation management scheme, in which rehabilitation is generally provided by a multiprofessional team under the leadership of a physical and rehabilitation medicine (PRM) physician, working in an interdisciplinary manner and together with the patient (or proxy). A reference system for operationalizing functioning and standardizing the process is the International Classification of Functioning, Disability and Health (ICF) - for assessing functioning needs, defining rehabilitation goals and outcomes. The objective of this paper is to present the IRP as a framework for rehabilitation in Europe (EUR-IRP). The specific aims are: 1) to introduce the IRP; and 2) to describe the framework components, elements and variables of the IRP. Demonstration projects (case studies) using the EUR-IRP will be conducted. The present paper presents the efforts to date for developing the EUR-IRP, a key part of the action plan of the PRM Section and Board of the European Union of Medical Specialists to implement the ICF systemwide across the care continuum. This paper serves as another step to bring together practice, science and governance in calling for contribution from rehabilitation clinicians and researchers and professional societies in PRM and beyond.
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Affiliation(s)
| | - Melissa Selb
- ICF Research Branch, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Paolo Boldrini
- Italian Society of Physical and Rehabilitation Medicine (SIMFER), Treviso, Italy
| | - Catarina A Branco
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | - Volodymyr Golyk
- Department of Physical and Rehabilitation Medicine and Sports Medicine, Shupyk National University of Healthcare of Ukraine, Kyiv, Ukraine.,Department of Physical and Rehabilitation Medicine, City Municipal Teaching Hospital N.4, Dnipro, Ukraine
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, Università "La Statale, " Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Anda Nulle
- National Rehabilitation Center "Vaivari, " Jurmala, Latvia
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Markos Sgantzos
- School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Aleksei Shmonin
- First Saint-Petersburg I.P. Pavlov State Medical University, Saint-Petersburg, Russia
| | - Iuly Treger
- Department of Rehabilitation, Soroka University Medical Center, Beer-Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Gerold Stucki
- ICF Research Branch, Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland.,Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, Switzerland
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Røe C, Bautz-Holter E, Andelic N, Søberg HL, Nugraha B, Gutenbrunner C, Boekel A, Kirkevold M, Engen G, Lu J. Organization of rehabilitation services in randomized controlled trials - which factors influence functional outcome? A systematic review. Arch Rehabil Res Clin Transl 2022; 4:100197. [PMID: 35756983 PMCID: PMC9214333 DOI: 10.1016/j.arrct.2022.100197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To identify factors related to the organization of rehabilitation services that may influence patients’ functional outcome and make recommendations for categories to be used in the reporting of rehabilitation interventions. Data Sources A systematic review based on a search in MEDLINE indexed journals (MEDLINE [OVID], Cumulative Index of Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials) until June 2019. Study Selection In total 8587 candidate randomized controlled trials reporting on organizational factors of multidisciplinary rehabilitation interventions and their associations with functional outcome. An additional 1534 trials were identified from June 2019 to March 2021. Data Extraction: Quality evaluation was conducted by 2 independent researchers. The organizational factors were classified according to the International Classification for Service Organization in Health-related Rehabilitation 2.0. Data Synthesis In total 80 articles fulfilled the inclusion criteria. There was a great heterogeneity in the terminology and reporting of service organization across all studies. Aspects of Settings including the Mode of Service Delivery was the most explicitly analyzed organizational category (44 studies). The importance of the integration of rehabilitation in the inpatient services was supported. Furthermore, several studies documented a lack of difference in outcome between outpatient vs inpatient service delivery. Patient Centeredness, Integration of Care, and Time and Intensity factors were also analyzed, but heterogeneity of interventions in these studies prohibited aggregation of results. Conclusions Settings and in particular the way the services were delivered to the users influenced functional outcome. Hence, it should be compulsory to include a standardized reporting of aspects of service delivery in clinical trials. We would also advise further standardization in the description of organizational factors in rehabilitation interventions to build knowledge of effective service organization.
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Affiliation(s)
- Cecilie Røe
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Corresponding author Cecilie Røe, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway, P.O. Box 1089, Blidern, 0319 Oslo, Norway.
| | - Erik Bautz-Holter
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Helene Lundgaard Søberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | | | - Andrea Boekel
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | - Marit Kirkevold
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet University, Oslo, Norway
| | - Grace Engen
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Juan Lu
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, Virginia
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14
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Camden C, Mulligan H, Nugraha B, Berbari J, Gauvin C, Cinar E, Gutenbrunner C. Scope and Practices of Physical Therapists Working With Children: Results From an International Online Survey. Pediatr Phys Ther 2021; 33:251-258. [PMID: 34417425 DOI: 10.1097/pep.0000000000000816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the scope of practice of physical therapists (PTs) working with children worldwide. METHODS PTs working with children in any context and country were invited via social media and email campaigns to complete an online survey containing 42 questions about work context and service delivery. Descriptive statistics were computed. RESULTS Of the 1133 participants from 77 countries, most worked with children full-time (51.8%), and in government-funded work settings (57.5%). Modalities of access to services varied across countries, work settings, and children's conditions, yet 46.7% of PTs reported that most children had direct access to services. PTs provided services to children with a variety of conditions, with cerebral palsy being most reported (83.3%). Interventions focused primarily on improving body function (42.0%) and on providing face-to-face individual treatment (96.6%). CONCLUSIONS This study provides an international portrait of pediatric PT practice and illustrates the diversity of services in pediatric PT.
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Affiliation(s)
- Chantal Camden
- School of Rehabilitation (Drs Camden and Cinar and Ms Gauvin), Sherbrooke University, Sherbrooke, Quebec, Canada; Research Centre of the Sherbrooke University Hospital Centre (Drs Camden and Cinar and Mr Berbari), Sherbrooke, Quebec, Canada; School of Physiotherapy (Dr Mulligan), Otago University, Christchurch, New Zealand; Department of Rehabilitation Medicine (Drs Nugraha and Gutenbrunner), Hannover Medical School, Hannover, Germany
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15
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Zhang Y. WITHDRAWN: The health management status of medical and health service institutions and its correlation with residents' health risk. Work 2021:WOR210263. [PMID: 34308895 DOI: 10.3233/wor-210263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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16
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Houben-Wilke S, Delbressine JM, Vaes AW, Goërtz YMJ, Meys R, Machado FVC, Van Herck M, Burtin C, Posthuma R, Franssen FME, van Loon NHP, Hajian B, Vijlbrief H, Spies Y, van ’t Hul A, Janssen DJA, Spruit MA. Understanding and Being Understood: Information and Care Needs of 2113 Patients With Confirmed or Suspected COVID-19. J Patient Exp 2021; 8:2374373521997222. [PMID: 34179387 PMCID: PMC8205416 DOI: 10.1177/2374373521997222] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To become a proactive and informed partner in postacute coronavirus disease 2019 (COVID-19) management, patients need to have the knowledge, skills, and confidence to self-manage COVID-19-related health challenges. Due to several restrictions and consequently social isolation, online platforms and forums where people can share information and experiences became more popular and influential. Therefore, this study aimed to identify perceived information needs and care needs of members of 2 Facebook groups for patients with COVID-19 and persistent complaints in the Netherlands and Belgium and patients with COVID-19 who registered at a website of the Lung Foundation Netherlands. Besides demographics and clinical characteristics, the degree of satisfaction with care during and after the infection as well as satisfaction with available information were assessed. Open text fields revealed specific information needs which were summarized. Patients with confirmed or suspected COVID-19 perceive various unmet needs varying from specific information needs (eg, information about permanent lung damage) to general needs (eg, being heard and understood). These data lead to several recommendations to improve care for patients with COVID-19 and justify further development of online platforms specifically addressing these unmet needs.
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Affiliation(s)
| | | | - Anouk W Vaes
- Department of Research and Development, Ciro, Horn, the Netherlands
| | - Yvonne MJ Goërtz
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Roy Meys
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Felipe VC Machado
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Maarten Van Herck
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Chris Burtin
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Rein Posthuma
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Frits ME Franssen
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Nicole HP van Loon
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | - Bita Hajian
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
| | | | - Yvonne Spies
- Lung Foundation Netherlands, Amersfoort, the Netherlands
| | - Alex van ’t Hul
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Daisy JA Janssen
- Department of Research and Development, Ciro, Horn, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands
- Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Benavides-Córdoba V, Guerrero-Jaramillo D, Betancourt-Peña J. Pulmonary Rehabilitation in COVID-19: The Contribution of other Chronic Lung Syndromes for the Intervention of a Novel Disease. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1573398x17666210129124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract::
COVID-19 has spread throughout the world causing a significant number of cases of
pneumonia and SARS. Patients with COVID-19 may also have other cardiovascular, respiratory,
and neuromuscular disorders. These multisystemic complications present the need for comprehensive
interventions focused on improving symptoms, functional capacity, and quality of life. Pulmonary
rehabilitation has the potential to offer some of these benefits. However, the evidence related
to specific aspects of pulmonary rehabilitation evaluation and intervention in COVID19 is limited.
We have learned from experiences with other types of chronic lung diseases that have used pulmonary
rehabilitation successfully. While the evidence of rehabilitation emerges in COVID-19, it is
necessary to establish some initial recommendations, prepared according to the sequelae found until
now.
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Affiliation(s)
- Vicente Benavides-Córdoba
- Facultad de Salud Universidad del Valle, Facultad de Salud y Rehabilitación Institucion Universitaria Escuela Nacional del Deporte, Cali, Colombia
| | - Diana Guerrero-Jaramillo
- Secretaría de Salud Publica Municipal, Facultad de Salud, Universidad Santiago de Cali, Colombia
| | - Jhonatan Betancourt-Peña
- Facultad de Salud y Rehabilitacion Institucion Universitaria Escuela Nacional del Deporte, Facultad de Salud Universidad del Valle, Cali, Colombia
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Nugraha B, Tani K, Gutenbrunner C. Rehabilitation Service Assessment and Workforce Capacity Building in Albania-A Civil Society Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197300. [PMID: 33036266 PMCID: PMC7579078 DOI: 10.3390/ijerph17197300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/16/2020] [Accepted: 09/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Rehabilitation is an important health strategy. Due to the lack of rehabilitation professionals (e.g., no physical and rehabilitation medicine, occupational therapist, and others) and lack of rehabilitation services (e.g., no multi-profession rehabilitation services in hospital, no post-acute rehabilitation services, no community-based rehabilitation services), the need to strengthen rehabilitation in Albania was pronounced. Therefore, this project aimed at rehabilitation service assessment and workforce capacity building in Albania. METHODS The World Health Organization's Template for Rehabilitation Information Collection was used to collect available data related to rehabilitation services. Additionally, two site visits to different rehabilitation centers including interviews with relevant stakeholders were performed. A stakeholders' workshop to prioritize recommendations was also performed before finalizing the report. RESULTS In Albania, rehabilitation service delivery, rehabilitation workforces, and financing in rehabilitation need to be strengthened. CONCLUSIONS The project achieved the intended objectives. Additionally progress has been occurring in the development and implementation of the Physical and Rehabilitation Medicine specialization at the University of Medicine, Tirana.
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Affiliation(s)
- Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, 30625 Hannover, Germany;
- Correspondence: ; Tel.: +49-511-532-9197
| | - Klejda Tani
- Faculty of Technical Medical Sciences, University of Medicine Tirana, AL1005 Tiranë, Albania;
| | - Christoph Gutenbrunner
- Department of Rehabilitation Medicine, Hannover Medical School, 30625 Hannover, Germany;
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19
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Meyer T, Kiekens C, Selb M, Posthumus E, Negrini S. Toward a new definition of rehabilitation for research purposes: a comparative analysis of current definitions. Eur J Phys Rehabil Med 2020; 56:672-681. [PMID: 32990687 DOI: 10.23736/s1973-9087.20.06610-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is a need for a common, shared definition of rehabilitation to conduct systematic reviews and identify relevant systematic reviews for knowledge translation purposes, which is an important task of Cochrane Rehabilitation. The present paper aimed to introduce and compare existing health-related definitions of rehabilitation and to propose core aspects that should characterize a new and workable definition of rehabilitation that is able to serve both as the basis for internal communication and identity work and for external communication. We have conducted a PubMed literature search on current definitions that have been published since the launch of WHO's ICF in 2001. Definitions were analyzed by framing questions to which the definitions provide answers. Nine definitions were included in the analysis. Rehabilitation has been defined as a process, as a set or bundle of interventions, and as a health strategy. The main beneficiaries were mainly related to the presence of disability, however, no specific means or interventions in rehabilitation could be identified. The definitions provided varying answers to the questions "by whom…," "where…," and "when…" and additionally identified certain conditions for rehabilitation. The present analysis can serve as a valuable source of information for developing a Cochrane Rehabilitation definition of rehabilitation.
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Affiliation(s)
- Thorsten Meyer
- School of Public Health, Bielefeld University, Bielefeld, Germany -
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy
| | - Melissa Selb
- Swiss Paraplegic Research, Nottwil, Switzerland.,ICF Research Branch, Nottwil, Switzerland
| | - Elain Posthumus
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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20
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Pedersen SG, Friborg O, Heiberg GA, Arntzen C, Stabel HH, Thrane G, Nielsen JF, Anke A. Stroke-Specific Quality of Life one-year post-stroke in two Scandinavian country-regions with different organisation of rehabilitation services: a prospective study. Disabil Rehabil 2020; 43:3810-3820. [PMID: 32356473 DOI: 10.1080/09638288.2020.1753830] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose: To compare stroke-specific health related quality of life in two country-regions with organisational differences in subacute rehabilitation services, and to reveal whether organisational factors or individual factors impact outcome.Materials and methods: A prospective multicentre study with one-year follow-up of 369 first-ever stroke survivors with ischaemic or haemorrhagic stroke, recruited from stroke units in North Norway (n = 208) and Central Denmark (n = 161). The 12-domain Stroke-Specific Quality of Life scale was the primary outcome-measure.Results: The Norwegian participants were older than the Danish (Mage= 69.8 vs. 66.7 years, respectively), had higher initial stroke severity, and longer stroke unit stays. Both cohorts reported more problems with cognitive, social, and emotional functioning compared to physical functioning. Two scale components were revealed. Between-country differences in the cognitive-social-mental component showed slightly better function in the Norwegian participants. Depression, anxiety, pre-stroke dependency, initial stroke severity, and older age were substantially associated to scale scores.Conclusions: Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as pre-stroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services.IMPLICATIONS FOR REHABILITATIONThe stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clinically important information for the rehabilitation services.The cognitive-social-mental component and the physical health component, indicate specific functional problems which may vary across and within countries and regions with different organisation of rehabilitation services.For persons with mild to moderate stroke, longer-term functional improvements may be better optimised if the rehabilitation services particularly address cognitive, emotional, and social functioning.
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Affiliation(s)
- Synne Garder Pedersen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Guri Anita Heiberg
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Henriette Holm Stabel
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Denmark, Denmark
| | - Gyrd Thrane
- Department of Health and Care Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Jørgen Feldbæk Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Denmark, Denmark
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), University of Oslo, Oslo, Norway
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