Rehabilitation Experience Research Articles

Women offenders’ experiences of rehabilitation in a South African correctional centre

This study explored gendered rehabilitation of women in correctional spaces and the systems and structures that recreate inequities in women’s incarceration experiences. Eighteen black women completed in-depth interviews on their offender rehabilitation experiences. Their age ranged from 23 to 69 years old, and they were mostly incarcerated for violent offenses. Thematic analysis of the interview data yielded the following themes: lack of active participation in rehabilitation processes; exclusion through language and religion; and enforcement of domestication for incarcerated women. Social justice centred approaches that recognise the diversity (classification, socio-cultural background, and gender dynamics) of people inhabiting correctional centres would help reduce disparities in correctional rehabilitation that disadvantage women offenders.

Exploring the experiences of the cardiac rehabilitation journey among South Asian patients

Background/AimsIndividuals from South Asian backgrounds are at greater risk of developing coronary heart disease. Cardiac rehabilitation reduces the risk of future cardiac events, yet uptake is low among South Asian populations. This study explored South Asian patients' understanding and experiences of cardiac rehabilitation.MethodsThis qualitative, semi-structured study identified a purposeful sample of 36 eligible patients, of whom six participated in an interview that explored their experiences and perceptions of cardiac rehabilitation. Data were analysed using inductive analysis.ResultsThree themes were identified: starting the conversation; expectation vs reality; and meeting patient needs. Patients perceived cardiac rehabilitation as additional support rather than a fundamental part of care. Moreover, they considered the content of cardiac rehabilitation programmes to lack cultural sensitivity, which influenced both attendance and perceived relevance.Conclusions:Nurses must promote cardiac rehabilitation during the acute phase of recovery, while considering South Asian patients' beliefs, perceptions and cultural acceptance of cardiac rehabilitation. Invitations to attend and cardiac rehabilitation delivery must be personalised, accounting for cultural influences on lifestyle.

Cardiac Rehabilitation Program at CUHK Medical Centre

According to World Health Organization (WHO), heart disease remained the leading cause of death globally during 2000-2019[1]. In Hong Kong, heart diseases have been the third leading cause of mortality since 1960s[2]. According to the statistics on the number of hospital discharges and deaths by heart disease group in Hong Kong in 2019, 21578 cases were of heart failure, which accounted for 25% among all other heart diseases[3]. In order to improve the management for heart failure, cardiac rehabilitation is crucial to help patients to improve functional capacity and quality of life, and most importantly to reduce mortality[4]. Guideline for cardiac rehabilitation in CUHK Medical Centre (CUHKMC), the Hong Kong's first non-profit private teaching hospital, has been developed based on evidence-based practices and international guidelines[5]. The experience of cardiac rehabilitation by the CUHKMC physiotherapy team will be shared in this session. According to World Health Organization (WHO), heart disease remained the leading cause of death globally during 2000-2019[1]. In Hong Kong, heart diseases have been the third leading cause of mortality since 1960s[2]. According to the statistics on the number of hospital discharges and deaths by heart disease group in Hong Kong in 2019, 21578 cases were of heart failure, which accounted for 25% among all other heart diseases[3]. In order to improve the management for heart failure, cardiac rehabilitation is crucial to help patients to improve functional capacity and quality of life, and most importantly to reduce mortality[4]. Guideline for cardiac rehabilitation in CUHK Medical Centre (CUHKMC), the Hong Kong's first non-profit private teaching hospital, has been developed based on evidence-based practices and international guidelines[5]. The experience of cardiac rehabilitation by the CUHKMC physiotherapy team will be shared in this session.

Starting a DBS service for children: It's not the latitude but the attitude - Establishment of the paediatric DBS centre in Northern Finland.

Paediatric movement disorder patients can benefit from deep brain stimulation (DBS) treatment and it should be offered in a timely manner. In this paper we describe our experience establishing a DBS service for paediatric patients. We set out to establish a paediatric DBS (pDBS) procedure in Oulu University Hospital in northern Finland, where up to this point DBS treatment for movement disorders had been available for adult patients. Collaboration with experienced centres aided in the process. A multidisciplinary team was assembled and a systematic protocol for patient evaluation and treatment was created, with attention to special features of the regional health care system. All of our first paediatric patients had very severe movement disorders, which is typical for a new DBS centre. The patients benefitted from pDBS treatment despite variable aetiologies of movement disorders, which included cerebral palsy and rare genetic disorders with variants in PDE10A, TPK1 and ARX. We also present our high-quality paediatric MR-imaging protocol with tractography. Establishment of a pDBS centre requires expertise in classification of paediatric movement disorders, longstanding experience in adult DBS and a committed multidisciplinary team. Besides high-quality imaging and a skilled neurosurgery team, careful patient selection, realistic treatment goals and experience in rehabilitation are imperative in pDBS treatment.

Experience of remote rehabilitation for patients with multiple sclerosis

To evaluate the efficacy of remote rehabilitation for non-exacerbating patients with multiple sclerosis (MS). A total of 17 patients, including 12 (70.6%) women and 5 (29.4%) men, with the established diagnosis of MS according to the 2017 McDonald criteria were enrolled in the study. The age varied from 26 to 70 years, the median age was 47 [34; 53] years. Patients with mild or moderate atactic disorders, mildly or moderately manifested central paresis with gait function and fine motor skills impairment were included in the group, median EDSS in which was 4 [3; 5.5]. The patients underwent a course of remote neurorehabilitation on the «NeyroDom» website according to individualised training programmes. All patients underwent in-person examination before and after the course of rehabilitation using EDSS scoring, the Berg Balance Scale (BBS), the Dynamic Gait Index (DGI), the 25 foot walking test (25-FWT), the 9-Hole Peg Test (9-HPT) and the Hospital Anxiety and Depression Scale. The control over adherence to the technique of exercising and due amount of training was maintained via remote monitoring of the website and telemedical consultations one time per week. The average rehabilitation course duration was 28 days. After the course of remote rehabilitation, the statistically significant improvement in all main indices of BBS, DGI, 9HPT and 25FWT functional scales were noted, which indicates the improvement in gait, balance and fine motor skills functions. The positive influence of remote rehabilitation for patients with MS has been proved.

The Recovery Journey and the Rehabilitation Boat - A qualitative study to explore experiences of COVID-19 rehabilitation.

IntroductionThere are early data to suggest that a rehabilitation programme can help with on-going symptoms of COVID-19, including breathlessness, exercise limitation and fatigue. As yet, there are no published data to understand patients’ perceived acceptability of a rehabilitation programme for COVID-19.Methods2 focus groups (n = 9) and 4 one to one interviews were conducted with participants who attended a rehabilitation program following COVID-19. Interviews were analysed using reflexive thematic analysis with an inductive approach.ResultsTwo overarching themes were generated from the data. The first, The Recovery Journey is sub-divided into five sub-themes of Expectations, Individual and Varied Journeys, Mental and Physical Improvements, Self-values and The Journey Continues. The second overarching theme, The Rehabilitation boat contains five subthemes: Programme Delivery, Safe and Supportive, Validation and Assurance, Shared Reflections and Education.ConclusionA rehabilitation programme for post COVID-19 symptoms was considered to be acceptable and viewed positively in terms of improving physical and mental symptoms. The opportunity to share the experience with others in the same boat was highly valued in the context of an unexpected and potentially lonely COVID-19 recovery.

Experience in medical rehabilitation of patients who have undergone COVID-19 in the health resorts of the North Caucasian health resort complex of the Russian Ministry of Defense

Experience in medical rehabilitation of patients who have undergone COVID-19 in the health resorts of the North Caucasian health resort complex of the Russian Ministry of Defense

Telerehabilitation of hearing-impaired children during COVID-19 pandemic

To evaluate advantages and effectiveness of remote rehabilitation services for hearing-impaired children at Center of Pediatric Audiology during COVID-19 pandemic. 181 children with different types and degrees of permanent hearing loss, their parents and 10 hearing care professionals (audiologists, speech-language therapists) were included in the study. 2115 rehabilitation services were provided during 3 months: video- and text consultations, video lessons with child, sending homework to parents, etc. The results of questionnaires showed that, on specialists' and parents' opinion, remote rehabilitation care is effective tool for hearing impaired children during emergency situations. TeleCare allowed to improve parents' abilities to manage with children by themselves, their understanding goals and methods of rehabilitation, improving child's hearing and speech skills. 95% of parents were satisfied by remote rehabilitation. Advantages and problems of remote hearing rehabilitation were analyzed from the sides of professionals and parents. The most challenging activities for professionals during TeleCare were: evaluation of HA/CI effectiveness, diagnosis and developing of hearing and speech. The experience of remote hearing rehabilitation in emergency situation allows to conclude that this type of care could be useful in clinical practice after pandemic for parents consulting and for children with motor problems.

Barriers and Enablers to Pulmonary Rehabilitation in Low- and Middle-Income Countries: A Qualitative Study of Healthcare Professionals.

IntroductionLow- and middle-income countries bear a disproportionately high burden of global morbidity and mortality caused by chronic respiratory diseases. Pulmonary rehabilitation is recommended as a core intervention in the management of people with chronic respiratory diseases. However, the intervention remains poorly accessed/utilised globally, especially in low- and middle-income countries.AimThis qualitative study explored barriers and enablers to pulmonary rehabilitation in low- and middle-income countries from the perspective of healthcare professionals with pulmonary rehabilitation experience in these settings.MethodsOnline-based semi-structured in-depth interviews with healthcare professionals were undertaken to data saturation, exploring lived barriers and enablers to pulmonary rehabilitation in their low- or middle-income country. Anonymised interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis.ResultsA total of seven healthcare professionals from seven low- and middle-income countries representing Africa, Asia, and South America were interviewed. They included five physiotherapists (four females), one family physician (male), and one pulmonologist (female). Themes for barriers to pulmonary rehabilitation included limited resources, low awareness, coronavirus disease 2019, and patient access-related costs. Themes for enablers included local adaptation, motivated patients, coronavirus disease 2019 (which spanned both enablers and barriers), better awareness/recognition, provision of PR training, and resource support.ConclusionBarriers to pulmonary rehabilitation in low- and middle-income countries include limited resources, low awareness, coronavirus disease 2019, and patient access-related costs. Enablers include local adaptation, motivated patients, coronavirus disease 2019 (which spanned both enablers and barriers), better awareness/recognition, provision of PR training, and resource support. Successful implementation of these enablers will require engagement with multiple stakeholders. The findings of this study are a necessary step towards developing strategies that can overcome the existing pulmonary rehabilitation evidence-practice gap in low- and middle-income countries and alleviating the burden of chronic respiratory diseases in these countries.

Application Experience of Exercise Rehabilitation Nursing in Nursing Care of Patients with Coronary Heart Disease and Chronic Heart Failure

Application Experience of Exercise Rehabilitation Nursing in Nursing Care of Patients with Coronary Heart Disease and Chronic Heart Failure

The Persian Version of “Meaningful Activity Participation Assessment” Questionnaire: Evaluation of Its Face and Content Validity in Elderly

Background and Objectives: “Meaningful Activity Participation Assessment” (MAPA) questionnaire is a suitable tool for examining the frequency and meaningfulness of 28 activities. The aim of this study was to assess the face and content validity of the Persian version of MAPA for older adults. Methods: The face validity was assessed qualitatively using interviews and quantitively using the item impact method (IIM) with 15 elderly aged 65-90 years old and MMSE≥21. They measured the suitability simplicity and comprehensibility of the items. To assess the content validity using CVR and CVI, 15 occupational therapists (eight PhD. Candidates, seven masters) who had more than five years of experience in geriatric rehabilitation and aged>30 years old took part. Results: All items of MAPA using IIM were more than 1.5. The CVR scores for each item were 0.6-1 (the cut-off base on Lawshe table 0.49). The average CVR value of MAPA was 0.84. The I-CVI of the Persian version of MAPA ranged from 0.86-1. All items scored higher than 0.79. The S-CVI/UA was 0.58 and the S-CVI/Ave was 0.96. Conclusion: The Persian version of MAPA has acceptable content and face validity in the elderly. Investigation of test-retest and internal consistency reliability and construct validity (convergent, divergent, and factor analysis) is suggested.

It takes two to tango: The therapeutic alliance in community brain injury rehabilitation

AbstractObjective:A positive therapeutic (or working) alliance has been associated with better outcomes for clients in the psychotherapeutic and traumatic brain injury (TBI) rehabilitation literature. The aim of this pilot study was to gain an understanding of the therapeutic alliance in community rehabilitation from the perspectives of adults with TBI and their close others who have completed a community rehabilitation programme.Method:This study used a constructivist, qualitative methodology which applied grounded theory analysis techniques. Using purposeful sampling, three pairs of participants (adults with TBI and close others) who had finished a community rehabilitation programme completed separate in-depth interviews which were transcribed verbatim and progressively analysed using a process of constant comparison.Results:A preliminary framework illustrating participants’ experience of a therapeutic alliance was generated, comprising three interconnected themes: being recognised as an individual, working together and feeling personally connected. All participants viewed being able to work together as important in their experience of community rehabilitation and described features that helped and hindered the alliance.Conclusion:These pilot study results demonstrate the importance of the therapeutic alliance to the rehabilitation experience of individuals with TBI and those close to them.

Integrated Pedal System for Data Driven Rehabilitation.

We present a system capable of providing visual feedback for ergometer training, allowing detailed analysis and gamification. The presented solution can easily upgrade any existing ergometer device. The system consists of a set of pedals with embedded sensors, readout electronics and wireless communication modules and a tablet device for interaction with the users, which can be mounted on any ergometer, transforming it into a full analytical assessment tool with interactive training capabilities. The methods to capture the forces and moments applied to the pedal, as well as the pedal’s angular position, were validated using reference sensors and high-speed video capture systems. The mean-absolute error (MAE) for load is found to be 18.82 N, 25.35 N, 0.153 Nm for , and respectively and the MAE for the pedal angle is 13.2°. A fully gamified experience of ergometer training has been demonstrated with the presented system to enhance the rehabilitation experience with audio visual feedback, based on measured cycling parameters.

Research trauma in incarcerated spaces: Listening to incarcerated women's narratives

This paper discusses researcher emotional experiences evoked while conducting narrative interviews in a research project that explored the rehabilitation experiences of 18 incarcerated women. I highlight the significance of listening as a methodology in spaces of incarceration. The importance of retrospective reflexivity in locating experiences of trauma encountered during the research process is discussed. The paper also brings to the fore the transformative power of stories for listeners as I share how my prejudices and attitudes regarding incarcerated women, as people who are framed as dangerous, were challenged. Experiences with interviewing and connecting with the incarcerated women further emphasised the importance of proactive self-care for researchers, with the significance of reflexivity as a self-care tool when doing qualitative research with vulnerable populations.

67 A BLENDED MODEL OF CARE USED IN THE ROLLOUT OF AN EARLY SUPPORTED DISCHARGE FOR STROKE SERVICE DURING COVID-19

BackgroundThe Health and Social Care Professionals budget was augmented to develop rehabilitation services that facilitated hospital discharges. Early Supported discharge (ESD) for stroke is a proven model of best care for stroke patients with mild to moderate disability (Langhorne et al., 2005). A pilot was implemented with the team consisting of an Occupational Therapist, Speech and Language Therapist, Physiotherapist and Medical Social Worker.MethodsThe service facilitated an early discharge from the hospital with the delivery of specialist stroke rehabilitation in the home. Therapy is provided with the same intensity and expertise that would be received in hospital and is available for up to 8 weeks, it was provided using a blended model of domiciliary care and the introduction of telehealth in response to COVID 19.Data was recorded for 100 service users using an excel spreadsheet. Data was recorded to measure number of new referrals, length of stay, bed days released back into the hospital system, mode of service delivery and functional outcomes. A cost analysis was completed. Service user experience was captured using questionnaires.ResultsFrom September 2020 to July 2021, 100 patients accessed ESD with a reduction of 7.2 days in hospital stay per patient. Improvements in pre- and post- rehabilitation scores on the FIM/FAM were evident. Very positive feedback regarding the rehabilitation experience was captured within the patient satisfaction questionnaire. Therapy delivery was 60% face to face, 37% via telehealth and 3% outpatient appointments. Telehealth received good compliance but with varying reports of experience in comparison to face to face.ConclusionESD provided in the home environment facilitated earlier discharge from hospital with positive outcomes for the hospital and service users. Telehealth ensured that rehabilitation was maintained throughout the pandemic. Telehealth increased access for patients residing outside of the catchment area. However service user preference remains face to face.

The experience of comprehensive rehabilitation of a patient after a stroke with moya-moya disease. Case report

The article describes a clinical case of neurorehabilitation with a multimodal approach of a young patient with repeated ischemic strokes against the background of a rare chronic progressive cerebrovascular disease moya-moya disease. The multimodal approach consisted in the use of high-tech complexes with biofeedback, such as a stabilometric platform for visual and support reactions, cognitive training using computer technologies, as well as mirror therapy, physiotherapy procedures and physical therapy, including physiotherapy exercises and individual targeted training with paretic limbs. In accordance with the clinical scales used, convincing data were obtained on the effectiveness of the selected complex of rehabilitation measures.

Experience of Outpatient Rehabilitation of Patients after Pneumonia Associated with the New Coronavirus Infection COVID-19

The revealed functional disorders in patients who have suffered pneumonia associated with the new coronavirus infection COVID-19 require long-term rehabilitation, in particular in outpatient environment. Aim. To evaluate the effectiveness of outpatient rehabilitation of patients who have suffered pneumonia associated with the new coronavirus infection COVID-19. Material and methods. The study included 72 patients after mild to moderate pneumonia associated with the new coronavirus infection COVID-19. The main group included 37 patients who underwent comprehensive rehabilitation, including physical therapy, massage, magnetic therapy, speleotherapy, cognitive behavioral therapy, and drug therapy. The comparison group (35 patients) received physical therapy, magnetic therapy and drug therapy. The effectiveness of therapy was assessed on the basis of standardized questionnaires and scales: Asthenia scale (MFI-20), Anxiety and Depression scale (HADS), mMRC and Borg dyspnea scales, clinical and laboratory examination data. The quality of life of patients in the dynamics of rehabilitation was assessed by the quality of life questionnaire (EQ-5D). Results and discussion. In the main group of patients, the effectiveness of rehabilitation was higher relative to the decrease in the severity of dyspnea, asthenia, normalization of lymphocyte levels. In this group, the quality of life improved more significantly on the scales of anxiety/depression and psychoemotional status. Conclusion. The rehabilitation program, which additionally included chest massage, speleotherapy, transcranial electrical stimulation (TES), showed an advantage in improving clinical and laboratory parameters and quality of life in patients who have suffered pneumonia associated with the new coronavirus infection COVID-19.

Unmet needs among Danish women with breast cancer in the transition from diagnosis into the early treatment phase

This study investigates the supportive needs of women diagnosed with breast cancer in the early treatment phase. The aim of this study was to identify unmet supportive care needs in the early treatment phase of women treated for breast cancer. This study employed a quantitative longitudinal design with baseline questionnaire (Time 1) and a six-month follow-up questionnaire (Time 2) that explored a variety of characteristics using both standardized scales and more explorative questions about employment situation, needs, rehabilitation, psychological, physical and social experiences. Eighty-five percent of the invited potential women agreed to participate, and 100 participants completed the baseline questionnaire. The analysis identified results concerning employment situation, depressive symptoms, unmet needs, distress, sexual life, social constraints and cancer-related quality of life. The study concludes that health professionals must embrace the challenges faced by the women and provide strategies to support women achieving meaningful lives.

Pathways through rehabilitation for traumatic brain injury: preliminary results from an Irish study

Abstract Background Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In Ireland, little data exists on the number of TBI survivors or the availability of brain injury rehabilitation services. To address this, we examined nationally representative data to estimate the number of moderate to severe TBI survivors and to learn of their rehabilitation experiences. Methods A two-year mixed-methods, observational, cohort study was used to investigate the rehabilitation pathways of moderate to severe TBI survivors (N = 120). Participants were surveyed on two occasions six months apart using a range of standardised instruments (EQ-5D-3L, WHOQOL BREF and EBIQ). Preliminary findings from first surveys are reported. Results Fifty percent of participants reported having received some rehabilitation during their initial hospitalization. Following discharge, inpatient rehabilitation was recommended in 55.8% of cases (N = 67); 62.5% (N = 75) in an outpatient setting and 52.1% (N = 62) in a specialised brain injury community-based setting. Rehabilitation was not recommended in 9.2% (N = 11) of cases. Univariant analyses showed statistically significant differences between the experiences of males (N = 87) and females (N = 33) in three main elements; Isolation: males (M), mean 1.88, SD .488, females (F) mean 1.64, SD .476, (p = .015); Communication: M mean 1.85, SD .565, F mean 1.57, SD .469 (p = .012); Cognitive difficulties: M mean 1.81, SD .456, F mean 1.59, SD .426 (p = .020). Discussion Referrals to rehabilitation services varied substantially in this cohort of TBI survivors with evidence to suggest that, overall, males experience greater impacts on quality of life than do females. These findings support the need to, a) increase political priority and resource allocation for rehabilitation services for TBI survivors in Ireland and b) further study gender differences in TBI survivor outcome. Key messages Survivors of moderate to severe brain injury in Ireland have very divergent, and often inadequate experiences of rehabilitation. There is some evidence that male survivors of moderate to severe traumatic brain injury face more challenges than do female survivors.

The Influential Factors of Adherence to Physical Activity and Exercise among Community-Dwelling Stroke Survivors: A Path Analysis.

To investigate the status of physical activity and exercise (PAE) adherence and identify its influential factors among community-dwelling stroke survivors. Regular PAE after stroke is essential for recovery and secondary prevention, while adherence to PAE and its influential factors are rarely studied. A cross-sectional descriptive study. In total, 208stroke survivors (70.25±9.08years) were randomly selected from three communities. The influential factors of PAE adherence and associations between these variables were explored using multiple linear regression and path analyses. This study adhered to the EQUATOR checklist, STROBE. The mean adherence rate was moderate (62.00%), and stroke survivors tended to be more adherent to PAE than monitoring and seeking advice (70.30%>53.50%>48.30%). The regression results revealed that seven factors were significantly associated with PAE adherence, including knowledge, attitude, self-efficacy, social support, self-care ability, community rehabilitation experience and times since stroke. Furthermore, the path analysis showed that knowledge had a significant indirect positive influence on adherence with self-efficacy as a mediator, while attitude and social support impacted both directly and indirectly with self-efficacy as the mediator. Moreover, self-efficacy had the most substantial direct effect on community-dwelling stroke survivors' PAE adherence. These four variables accounted for a total of 67.00% of the variance in PAE adherence among community-dwelling stroke survivors. The PAE adherence of community stroke survivors needs to be improved. Healthcare professionals should develop more effective interventions to promote PAE adherence through enhancing self-efficacy among this population. Adherence to the recommended regimen is the most challenging dimension of stroke physical activity and exercise. This study contributes to exploring status and influential factors of PAE adherence, and self-efficacy was found to be a significant determinant. The results could be used to inspire future community-based intervention programs for stroke survivors.