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Mangiameli J, Hamiduzzaman M, Lim D, Pickles D, Isaac V. Rural disability workforce perspective on effective inter-disciplinary training-A qualitative pilot study. Aust J Rural Health 2021; 29:137-145. [PMID: 33811401 DOI: 10.1111/ajr.12719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Inter-professional education is a growing area of importance that enables training of health care professionals and students to develop skills in collaborative clinical practice, a critical aspect of disability care. However, research is limited on appropriate on-site inter-professional training for the rural and remote disability workforce. This paper aims to explore the features of an effective inter-professional training approach for rural disability workforce. SETTING Riverland, South Australia. PARTICIPANTS Clinical educators, allied health professionals, health and service providers and students. DESIGN A qualitative-explorative research design, involving focus group discussion and a thematic analysis method were employed in this study. Participants of the focus group discussion completed a capacity building training program centred on inter-professional education, cultural-safety and the National Disability Insurance Scheme. National Disability Services Social Impact Measurement Tool was used to evaluate and explore the features of effective inter-professional training program for existing and emerging disability workforce in rural regions. RESULTS Four themes emerged from data analysis: inter-professional education focus; structured inter-professional training; building collaborative learning environment; and culturally appropriate care practice. Inter-professional supervision was identified as a key enabler for capacity building in an area with limited health workforce. Inter-agency collaboration and professional network were identified as important elements to support disability health workforce retention and the transition from novice to practitioner. Prior knowledge about the needs of persons with disability and empathetic relationships influenced the quality of practice. CONCLUSION In situ training programs, which provide real-life rural practice context and harness inter-agency collaboration, improve effectiveness of rural disability workforce readiness for practice.
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Affiliation(s)
- Jacinta Mangiameli
- Flinders Rural Health SA, College of Medicine & Public Health, Flinders University, South Australia, Australia
| | | | - David Lim
- Postgraduate Health Sciences, University of Western Sydney, Sydney, NSW, Australia
| | - David Pickles
- College of Nursing & Health Sciences, Flinders University, Renmark, SA, Australia
| | - Vivian Isaac
- Flinders Rural Health SA, College of Medicine & Public Health, Flinders University, South Australia, Australia
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Cairns A, Geia L, Kris S, Armstrong E, O'Hara A, Rodda D, McDermott R, Barker R. Developing a community rehabilitation and lifestyle service for a remote indigenous community. Disabil Rehabil 2021; 44:4266-4274. [PMID: 33756085 DOI: 10.1080/09638288.2021.1900416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Community rehabilitation is an essential health service that is often not available to remote Australians. This paper describes the first cycle of a collaborative project, between local community members, allied health professionals and a university, to co-design a community rehabilitation and lifestyle service to support adults and older people to stay strong and age well in place. METHODS An action research framework was used to develop the service for adults in two remote communities, one being a discrete Aboriginal community. The first cycle involved planning for, and trialling of a service, with observations, reflections and feedback from clients, community members, university students and health service providers, to inform the subsequent service. RESULTS Over two years, stakeholders worked collaboratively to plan, trial, reflect and replan an allied health student-assisted community rehabilitation service. The trial identified the need for dedicated clinical and cultural supervision. During replanning, three key elements for culturally responsive care were embedded into the service: reciprocity and yarning; holistic community-wide service; and Aboriginal and Torres Strait Islander mentorship. CONCLUSIONS An action-research approach to co-design has led to the establishment of a unique community rehabilitation service to address disability and rehabilitation needs in two remote Australian communities.Implications for rehabilitationCo-design of community rehabilitation services between Aboriginal and Torres Strait Islander community members and the local allied health professionals can lead to development of an innovative service model for remote Aboriginal communities.Culturally responsive community rehabilitation services in Aboriginal and Torres Strait Islander communities requires holistic and community-wide perspectives of wellbeing.Incorporating Aboriginal and Torres Strait Islander ways of engaging and communicating, and leadership and mentorship for non-Indigenous allied health professionals and students are essential components for students-assisted culturally responsive services.
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Affiliation(s)
- Alice Cairns
- Centre for Rural and Remote Health, James Cook University, Weipa, Australia
| | - Lynore Geia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Sylvia Kris
- Community Research Partner, Napranum, Australia
| | - Elizabeth Armstrong
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Amy O'Hara
- Centre for Rural and Remote Health, James Cook University, Weipa, Australia.,Torres and Cape Hospital and Health Service, Weipa, Australia
| | - Danielle Rodda
- Centre for Rural and Remote Health, James Cook University, Weipa, Australia
| | | | - Ruth Barker
- College of Healthcare Sciences, James Cook University, Cairns, Australia
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Jesus TS, Landry MD, Dussault G, Fronteira I. Classifying and Measuring Human Resources for Health and Rehabilitation: Concept Design of a Practices- and Competency-Based International Classification. Phys Ther 2019; 99:396-405. [PMID: 30561749 DOI: 10.1093/ptj/pzy154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/28/2018] [Indexed: 02/09/2023]
Abstract
The burden of physical impairments and disabilities is growing across high-, middle-, and low-income countries, but populations across the globe continue to lack access to basic physical rehabilitation. Global shortages, uneven distributions, and insufficient skill mix of human resources for health and rehabilitation (HRH&R) contribute to such inequitable access. However, there are no international standards to classify HRH&R and to promote their global monitoring and development. In this article, we conceptually develop an international classification of HRH&R based on the concept of monitoring HRH&R through their stock of practices and competencies, and not simply counting rehabilitation professionals such as physical or occupational therapists. This concept accounts for the varying HRH&R configurations as well as the different training, competencies, or practice regulations across locations, even within the same profession. Our perspective specifically develops the concept of a proposed classification, its structure, and possible applications. Among the benefits, stakeholders using the classification would be able to: (1) collect locally valid and internationally comparable data on HRH&R; (2) account for the rehabilitation practices and competencies among nonspecialized rehabilitation workers (eg, in less resourced/specialized contexts); (3) track competency upgrades or practice extensions over time; (4) implement competency-based human resources management practices, such as linking remuneration to competency levels rather than to professional categories; and (5) inform the development of (inter-)professional education, practice regulation, or even task-shifting processes for the whole of HRH&R. The proposed classification standard, still in a concept-development stage, could help drive policies to achieve the "right" stock of HRH&R, in terms of practices and competencies.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine, WHO Collaborating Center on Health Workforce Policy and Planning, and Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Rua da Junqueira 100, Lisbon 1349-008, Portugal
| | - Michel D Landry
- Duke Doctor of Physical Therapy Division, Duke University Medical Center, and Duke Global Health Institute, Duke University, Durham, North Carolina, United States
| | - Gilles Dussault
- Global Health and Tropical Medicine, WHO Collaborating Center on Health Workforce Policy and Planning, and Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon
| | - Inês Fronteira
- Global Health and Tropical Medicine, WHO Collaborating Center on Health Workforce Policy and Planning, and Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon
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Jesus TS, Landry MD, Dussault G, Fronteira I. Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century. HUMAN RESOURCES FOR HEALTH 2017; 15:8. [PMID: 28114960 PMCID: PMC5259954 DOI: 10.1186/s12960-017-0182-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/12/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the 'challenges and opportunities' for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce. METHODS The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome. RESULTS The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas. DISCUSSION Based on the results, we have prioritized the following 'Six Rehab-Workforce Challenges': (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and tele-service; (5) adapt policy options to different contexts (e.g. rural vs urban), even within a country; and (6) develop international solutions, within an interdependent world. CONCLUSIONS Concrete examples of feasible local, global and research action toward meeting the Six Rehab-Workforce Challenges are provided. Altogether, these may help advance a policy and research agenda for ensuring that an adequate rehabilitation workforce can meet the current and future rehabilitation health needs.
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Affiliation(s)
- Tiago S. Jesus
- Portuguese Ministry of Education, Aggregation of Schools of Escariz, 4540-320 Escariz, Portugal
| | - Michel D. Landry
- Doctor of Physical Therapy Division, Duke University Medical Center, Duke University, Box 104002, 27710 Durham, NC United States of America
- Duke Global Health Institute, Duke University, Durham, NC United States of America
| | - Gilles Dussault
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Inês Fronteira
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal
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Siegert RJ, Jackson DM, Playford ED, Fleminger S, Turner-Stokes L. A longitudinal, multicentre, cohort study of community rehabilitation service delivery in long-term neurological conditions. BMJ Open 2014; 4:e004231. [PMID: 24583762 PMCID: PMC3939653 DOI: 10.1136/bmjopen-2013-004231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/10/2014] [Accepted: 01/24/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Part A: To pilot the use of a register to identify and monitor patients with complex needs arising from long-term neurological conditions. Part B: To determine the extent to which patients' needs for health and social services are met following discharge to the community after inpatient rehabilitation; to identify which factors predict unmet needs and to explore the relationship between service provision and outcomes at 12 months. DESIGN A multicentre, prospective, cohort study surveying participants at 1, 6 and 12 months using postal/online questionnaires and telephone interview. SETTING Consecutive discharges to the community from all nine tertiary, specialist, inpatient neurorehabilitation services in London over 18 months in 2010-2011. PARTICIPANTS Of 576 admissions 428 patients were recruited at discharge: 256 responded at 4 weeks, 212 at 6 months and 190 at 12 months. MEASURES Neurological Impairment Scale, The Needs and Provision Complexity Scale, The Northwick Park Dependency Scale, Community Integration Questionnaire, Zarit Burden Inventory. RESULTS n=322 (75%) expressed willingness to be registered, but in practice less than half responded to questionnaires at 6 and 12 months (49% and 44%, respectively), despite extensive efforts to contact them, with no significant differences between responders and non-responders. Significant unmet needs were identified within the first year following discharge, particularly in rehabilitation, social work support and provision of specialist equipment. Dependency for basic care and motor and cognitive impairment predicted services received, together accounting for 40% of the variance. Contra to expectation, patients whose rehabilitation needs were met were more dependent and less well integrated at 12 months post discharge than those with unmet needs. CONCLUSIONS Registration is acceptable to most patients, but questionnaires/telephone interviews may not be the most efficient way to reach them. When community resources are limited, service provision tends to be focused on the most dependent patients. REGISTRATION The study was registered with the NIHR Comprehensive Local Research Network: ID number 7503.
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Affiliation(s)
- Richard J Siegert
- School of Public Health and Psychosocial Studies and School of Rehabilitation and Occupational Studies, AUT University, Auckland, New Zealand
| | - Diana M Jackson
- Department of Palliative Care, Policy and Rehabilitation, School of Medicine, King's College London, London, UK
| | | | | | - Lynne Turner-Stokes
- Department of Palliative Care, Policy and Rehabilitation, School of Medicine, King's College London, London, UK
- Regional Rehabilitation Unit, Northwick Park Hospital, London, UK
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The Establishment of Core Competencies for Canadian Genetic Counsellors: Validation of Practice Based Competencies. J Genet Couns 2013; 22:690-706. [DOI: 10.1007/s10897-013-9651-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 08/14/2013] [Indexed: 11/26/2022]
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Steihaug S, Lippestad JW, Isaksen H, Werner A. Development of a model for organisation of and cooperation on home-based rehabilitation - an action research project. Disabil Rehabil 2013; 36:608-16. [PMID: 23758348 DOI: 10.3109/09638288.2013.800595] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To use general policy guidelines and staff experience of rehabilitation work in two boroughs in Oslo to develop a model for organisation and cooperation in home-based rehabilitation. METHOD The project was conducted as a collaboration between researchers and employees in the two boroughs. It was a practice-oriented study designed as an action research project combining knowledge generation and improvement of practice. Data were collected at seven meetings, and individual, qualitative interviews with a total of 24 persons were conducted in the period February 2010 to June 2011. RESULTS Home-based rehabilitation occurred rarely in the boroughs, and this field received little attention. However, this project provided a broad discussion of rehabilitation involving all parts of the organisation of both boroughs. In the course of the project, researchers and borough staff together developed a model for the organisation of and cooperation on rehabilitation including a coordinating unit assigned the paramount responsibility for the rehabilitation and an interdisciplinary team organising the collaboration on the practical level. CONCLUSIONS When implementing a model like this in primary health services, we recommend involving several levels and service locations of the borough staff in order to legitimise the model in the organisation. IMPLICATIONS FOR REHABILITATION An increasing number of older people with chronic diseases in the Western world have caused increasing emphasis on rehabilitation in primary health care in patients' homes. This study has elucidated challenging framework conditions for rehabilitation work in two Norwegian boroughs. To reduce municipal challenges we propose a rehabilitation model with a coordinating unit with the paramount responsibility for rehabilitation, and an interdisciplinary team constituting a suitable structure for collaboration.
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Jones R, Bhanbhro SM, Grant R, Hood R. The definition and deployment of differential core professional competencies and characteristics in multiprofessional health and social care teams. HEALTH & SOCIAL CARE IN THE COMMUNITY 2013; 21:47-58. [PMID: 22913320 DOI: 10.1111/j.1365-2524.2012.01086.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
There has been an increasing focus on delivering health and social care services through multiprofessional and inter-agency teams. This study, undertaken in 2011, explores how different professionals within multiprofessional teams define their own and other professions' core professional competencies, characteristics and contributions. It then compares these definitions with how different professionals deploy their time and what tasks they undertake. Sixty-four workers in four multiprofessional teams in England, within four different health and local authority areas, participated in the study. Using role repertory grids to generate constructs, which were then converted into Likert scales, and with diaries recording activities undertaken, the study compares the deployment of time and task with the views about the differential core competencies and characteristics of each profession. The study highlights important issues for consideration by multidisciplinary teams, the managers and commissioners of these teams, and by professional associations.
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Affiliation(s)
- Ray Jones
- Faculty of Health and Social Care Science, Kingston University and St George's, University of London, UK.
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