Provision Of Rehabilitation Services Research Articles

Exploring Barriers to Implementing Telerehabilitation from experiences of managers, policymakers, and providers of rehabilitation services in Iran: A Qualitative Study.

Background:Telerehabilitation is an emerging technology that uses digital technologies to perform evaluation, counseling, treatment, and telemonitoring to provide rehabilitative care to patients in various locations such as homes, communities, health centers, and workplaces. This approach has advantages such as reducing costs and overcoming barriers of distance and time. Reducing patient-rehabilitator interaction, and being hard to teamwork and express thoughts and feelings are some disadvantages of this approach. TR services are provided by a variety of rehabilitation specialists. The aim of the study was to identify barriers in the way of implementing TR in Iran Methods:This study was conducted using a conventional content analysis method based on a qualitative approach. 26 people were selected as participants based on purposive sampling with maximum diversity. Data were collected through semi-structured interviews and managed using MAXQDA 10 software. Results:765 codes were extracted by conducting interviews and coding. The findings of this study are classified into seven main categories and 32 sub-categories. The main categories are insufficient infrastructure, legal, physical, and moral hazards, lack of priority and insufficient determination, insufficient support of the public and non-governmental organizations, poor knowledge in using equipment, Lack of knowledge and negative attitude, and low capacity in comparison with face-to-face rehabilitation. Conclusion:This study shows that based on the insights from the experiences of participants, inadequate infrastructure and poor knowledge of the use of equipment are the most important obstacles in the way of TR. This study reveals that the implementation of TR in Iran encounters several obstacles and eliminating them requires serious effort.

Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study

BackgroundDespite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury.MethodsPatients (n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale – Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury – Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles.ResultsOverall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL.ConclusionsPatients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach.Trial registrationClinicalTrials.gov NCT02210221.

The article is devoted to the study of the peculiarities of legal regulation of relations in the field of provision of rehabilitation services to participants in hostilities in connection with the full-scale invasion of the Russian Federation on the terri

The article is devoted to the study of the peculiarities of legal regulation of relations in the field of provision of rehabilitation services to participants in hostilities in connection with the full-scale invasion of the Russian Federation on the territory of Ukraine. It has been established that relations for the provision of rehabilitation services, focused on determining non-property goods - life and health, arise on the basis of a contract for the provision of rehabilitation services (a contract for medical care of the population), and therefore have a civil law nature. The author's definition of the concept of "civil relations in the field of provision of rehabilitation services to combatants" has been formulated.
 The division of civil relations for the provision of rehabilitation services to participants in hostilities was carried out on the basis of both general classification criteria, specific for the differentiation of civil-legal relations, and special criteria taking into account the peculiarities of the studied legal relations, including the specifics of their subject composition.
 The author established that the field of health care, in particular the segment of provision of rehabilitation services, is in a permanent state of transformation, and the implementation of medical reform in this field requires significant joint efforts on the part of the domestic legislator, as well as representatives of the legal scientific community. Attention is drawn to the fact that, despite the existence of a number of regulatory and legal documents in Ukraine, which determine the basic principles for creating legal, socio-economic, and organizational conditions in the field of implementation of rehabilitation measures, the normalization of relations related to the provision of rehabilitation services to combatants remains outside the attention of the legislator actions as a result of the military aggression of the Russian Federation against Ukraine. It has been established that the effective implementation of the right to health care by the specified subjects presupposes a primary need for proper legal regulation of civil legal relations in the field of rehabilitation services, and a modern approach to the rehabilitation of combatants should be based on both state support and scientific reasonable concept.

COVID-19 impact on the provision of psychosocial rehabilitation services in Latin America and the Caribbean

Health care services have been deeply affected worldwide by the COVID-19 pandemic. However, and despite its importance to psychiatric reforms, very little has been written on actual responses to the COVID-19 pandemic in community psychiatry and psychosocial rehabilitation settings. Fifty-two mental health professionals from thirteen countries in Latin America and the Caribbean were interviewed in May and June 2020 and shared their opinions on the state of psychosocial rehabilitation services and programs during the first one-hundred days of the COVID-19 pandemic. Simple quantitative measures were added to a thematic analysis of responses. The results indicated that the disruption of group activities deeply affected psychosocial rehabilitation services, non-core activities (e.g., food and medication supply) became the most relevant aspects of these programs, shifting to remote mode proved to be a significant hurdle for many psychosocial rehabilitation service users, and long-term effect on rehabilitation services is expected by almost 90% of interviewees.

Synchronized telerehabilitation care in rural zones supported by teleoperated technological aids: application to a Colombian case

Objective: This research work proposes and evaluates a model for the provision of physical rehabilitation services supported by teleoperated technological aids, using the Internet as a communication channel for the care of the rural population, and by taking as the study region, a western subregion of Colombia around the municipality of Santiago de Cali- Colombia. Methodology: From the dynamics generated by the interaction between the service system and the users, characterized by the occurrence of events, a formal model was built, using a Colored Petri Net. To do this, a modelling methodology based on a top-down approach was proposed. Results: A model of the care system was developed and evaluated using Petri nets, based on a case study consisting of the current care model offered by a typical health service provider in Cali called "La Ladera ESE Health Network". The weighted improvements through the proposed system were: greater objectivity of traceability, speed of communication, better quality of rehabilitation, as well as the ability of the new system to contribute to greater precision in the initial diagnosis and subsequent periodic evaluation of recovery. Conclusions: The proposed protocol based on the model made it possible to attend concurrently and accurately diagnose up to three patients, through the implementation of technological aids to improve diagnostic support and allow a subsequent periodic evaluation of the patient´s recovery.

Rehabilitation models of care for children and youth with traumatic brain and/or spinal cord injuries: A focus on service structure, service organization, and the barriers and facilitators of rehabilitation service provision

ABSTRACT To understand the systems underlying current rehabilitation models of care used with children and youth (0–21years) who sustain traumatic brain and/or spinal cord injuries. This study gathered qualitative data on service structures, service organization, and the barriers and facilitators of service provision in selected medical rehabilitation service(s) (MRS) and community-based rehabilitation service(s) (CBRS). Informants from 11 rehabilitation services were interviewed using a semi-structured interview guide. Interviews were analysed in NVivo using content analysis method. Experiences shared by the service representatives indicated that most services supported children and youth with brain injury, with a limited number also specializing in spinal cord injuries. MRS often delivered care in inpatient or outpatient settings, while CBRS offered home/community-based services. Care planning often started either prior to or shortly after admission from acute care settings, using either multidisciplinary or interdisciplinary teamwork models. Strengths of the services included innovation and provision of family-centred care; while challenges experienced included difficulty translating evidence into practice and poor team communication. Models of care were similar across services, with a focus on providing family-centred care. Several shared challenges were described, and service representatives expressed interest in forming partnerships and collaborations to address these challenges through innovative initiatives.

Pathways to recovery model of youth substance misuse in Assam, India.

There are global calls for better understanding of substance use disorder (SUD) to inform prevention, risk reductionand treatment of this relapse-prone disorder. Our aim in this article is to understand the pathways to recovery of youth in Assam, India who have suffered SUD. We recruited 15 participants (11 menand 4 women) via two rehabilitation facilities. All are addicts-in-recovery aged 19-24 years. Material was generated through photo-led interviews, analysed using an inductive variant of thematic analysisand the resulting model refined through expert and participant checks. We present a multiroute, multidirectional pathway to recovery model. It has three phases, Recreational Use, Addiction (Relaxed, Chaotic, Strategic)and Supported Recovery, each phase consisting of cycling between, or transitioning through, a series of stages. The model enhances psycho-socio-cultural insights into the experience of risk and recovery, and informs prevention and treatment for youth substance misuse in Assam. This is the first model of its kind and an important public health resource. We discuss the possible transferability of the model to a wider range of contexts. The model presented was generated through analysis of interviews with addicts-in-recovery. Four of these addicts-in-recovery, and two mental health and rehabilitation service providers, conducted participant and expert checks of the model leading to its improvement.

Pilot implementation of rural rehabilitation services, India.

To implement rehabilitation services in a rural area of Raigad district, Maharashtra, India. We piloted a rehabilitation service delivery model through the Mahatma Gandhi Mission Institute of Health Sciences, in five villages. The institute performed participatory rural appraisal and focus group discussions with stakeholders to identify general issues in village life that could affect delivery. To integrate rehabilitation service delivery into the existing primary care system, a team from the institute developed a strategic plan through multidisciplinary clinical meetings. A rehabilitation team conducted a door-to-door survey and referred people needing rehabilitation services to the outreach visits the team was making to the primary health centre twice a week. If needed, patients could be referred to a university teaching hospital for tertiary-level care. The rural appraisal identified lack of awareness, inadequate workforce and infrastructure as key issues for rehabilitation services delivery. In response, we conducted awareness campaigns and formed a rehabilitation team consisting of personnel and students from the institute. Between 2018 and 2021, the team provided care to 1800 patients, of which half (900 patients) had musculoskeletal disorders. After rehabilitation, 360 (40%) of these 900 patients performed daily-living activities and continued to work with reduced pain within 2-3days after rehabilitation. The team provided antenatal care to 1629 pregnant women with musculoskeletal pain or stress urinary incontinence. Provision of rehabilitation services built awareness about physiotherapy, developed a rehabilitation care pathway and established a need for regular services. Using existing resources of the institute and involving students rendered the model sustainable.

Unmet needs in long-term outpatient rehabilitative care: a qualitative and multi-perspective study in Japan

Purpose This study explores the experiences and unmet needs related to post-discharge long-term rehabilitation from triadic perspective of male patients with stroke, caregivers, and rehabilitation professionals. Methods This is an exploratory qualitative study using in-depth interviews conducted in two outpatient rehabilitation facilities in Japan. Nine male patients with stroke, ten caregivers, and five rehabilitation professionals participated in this study. The data were coded, followed by thematic analysis. Results Patients who did not achieve further physical recovery regardless of their efforts experienced a loss of motivation and lost sight of their goals. Moreover, caregivers regarded such patients as lazy and reported feeling frustrated with them. Furthermore, patients and caregivers had unmet needs regarding communication with professionals and psychological and emotional care. In contrast, professionals perceived time constraints on outpatient rehabilitation service provision and sometimes narrowed the scope of the care approach to physical function aspects for providing services efficiently. They also expressed difficulties in identifying patients’ needs, values, and meaningful goals. Conclusions These findings suggest that in Japanese post-stroke outpatient rehabilitation, there is a need to adopt a comprehensive care approach, enhance the quality of communication, and involve caregivers in the rehabilitation process in limited-resource situations. IMPLICATIONS FOR REHABILITATION In long-term outpatient rehabilitation services in the community, stroke patients and their caregivers often face a physical recovery plateau. A comprehensive approach such as enhancing the quality of communication and providing psychological and emotional care —other than physical rehabilitation— is needed, particularly once the patient physical recovery stagnates. Involving caregivers in the rehabilitation process may be helpful for rehabilitation professionals to understand a potential problem that the patient cannot express but the caregiver can. It can be crucial to develop strategies that enable the rehabilitation professionals to provide a comprehensive care approach and prevent too much reliance on physical rehabilitation under the time-constraint situation in outpatient rehabilitation services.

Improve Autism Rehabilitation Services by Providing Solutions Based on the Perception and Experience of Parents and Providers: A Qualitative Study

Background: Children with autism spectrum disorder (ASD) need a variety of services. One of the most essential needs of these children with ASD is the use of rehabilitation services. However, these services pose many challenges for these individuals. Providing strategies to solve these barriers is essential. Objectives: The purpose of this study was to identify strategies to overcome barriers to using rehabilitation services and improve them based on the perceptions and experiences of rehabilitation service providers and parents of children with ASD. Methods: This study was conducted with a conventional qualitative approach. Twenty-seven participants were selected from rehabilitation service providers and parents of children with ASD based on purposive sampling with maximum diversity. Data were collected through semi-structured face-to-face interviews. The interviews lasted from July to December 2020 for 20 to 60 minutes and continued until the data was saturated. Data were analyzed with MAXQDA 10 software. Results: After the interviews, 1057 initial codes were extracted by deleting similar codes. Strategies for using rehabilitation services for these children with ASD were classified into 5 main categories and 20 subcategories, which are: Improving the level of knowledge and attitude, creating and strengthening a systematic support system, systematic rehabilitation policies, developing a comprehensive autism rehabilitation management program and facilitating access. Conclusions: In previous studies, many challenges have been identified for all services for children with ASD. The findings of this study showed that considering facilitators to solve the existing challenges in order to use of rehabilitation services for these children with ASD and their families. Therefore, policy makers, service providers and managers need to be aware of the strategies collected and pay special attention to these issues. To achieve a more favorable situation, they should adopt and implement the necessary mechanism in the field of policy and planning, so that finally lead to fundamental steps to improve the rehabilitation services needed by children with ASD.

Age-Based Trends in Cognitive-Communication Management for Adults in Subacute Rehabilitation Following New Onset Traumatic Brain Injury.

Although traumatic brain injury (TBI) has a disproportionate impact on older adults, there has been limited inclusion of these individuals in post-TBI cognitive-communication research. This study was undertaken to compare demographic and injury characteristics, speech-language pathology input, and broad outcomes for younger and older adults admitted to inpatient rehabilitation following TBI. A retrospective audit of first occasion adult TBI admissions in 2019 to inpatient rehabilitation in an Australian metropolitan subacute hospital was conducted via medical record data. Admissions were located using International Statistical Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM) coding that aligned with TBI. Comparisons were made for younger (18-54 years) and older (≥ 55 years) adults. A total of 114 admissions (51.75% older adults) were included. Patient age ranged between 18 and 90 years. Falls caused TBI in the majority of older adults, whereas transport-related accidents were the most common cause for younger adults. Age-based trends for intracranial injury were observed. Cognitive-communication difficulties were the most common speech-language pathology diagnosis with no significant difference in prevalence between younger and older adults. Age group was not significantly associated with length of stay or discharge home. The implications of injury-related trends for older adults on post-TBI cognitive-communication are poorly understood. This lack of information is problematic given the frequency of cognitive-communication difficulties in this population. Research into cognitive-communication following new onset TBI in older adults is crucial to support rehabilitation service provision and improve outcomes for older adults.

Environmental impact of telerehabilitation visits in an urban setting

• Travel cost and time burden are reduced using telehealth. • Telehealth positively impacted the environment by eliminating travel related gas emissions. • Patients and providers report high satisfaction with care delivered by SVV. Climate change has been described as the largest public health concern of the 21st century. In response to climate change over 50 countries have pledged to go carbon neutral in the provision of health care services and telemedicine can be an integral part of decreasing emissions related travel associated with health care. While telemedicine rapidly expanded to increase access to care during the Covid-19 pandemic, the impact of telerehabilitation on climate change as part of the provision of physical rehabilitation services has not been assessed. This study focuses on physical medicine and rehabilitation physicians in an urban physical medicine and rehabilitation (PM&R) department and assesses patient satisfaction with synchronous video visits (SVVs) as well as the estimated value of SVVs in travel savings and carbon emissions. We conducted a retrospective chart review, implemented a patient survey, and conducted a commuter analysis to report our experience using SVVs to provide follow-up care across multiple rehabilitation sub-specialties A total of 154 SVVs were conducted before the pandemic over an 18-month period. The most commonly addressed issues during the SVVs were rehabilitation and medication management, followed by equipment, lab and imaging results. About one-third of the patients (31%) were non-ambulatory at the time of their SVV. On average, SVVs reduced travel distance (95 miles), travel time (2.23 h), travel cost ($15) and carbon emissions. The use of telerehabilitation should be an integral part of decreasing the carbon footprint of provision of physical medicine and rehabilitation services.

Parenting children with autism spectrum disorder in the United Arab Emirates: Exploring perceptions towards using the picture exchange communication system to enhance the development of children with autism spectrum disorder

BackgroundAutism spectrum disorder (ASD) is an interplay between biological, social and environmental factors that impact the development of individuals. However, core characteristics are social, communication and behaviour challenges that restrict children’s participation in society. Consequently, there are discussions regarding the need for society to develop interventions that are geared towards promoting the participation of children with ASD in societies. While the Picture Exchange Communication System (PECS) helps lessen the biological characteristics of children with ASD, its impact has rarely been explored in non-western societies, such as the United Arab Emirates (UAE).ObjectivesThe instant study’s purpose was to explore parents’ perceptions of the effectiveness of the PECS on the communicative, social and academic developments of children with ASD in UAE.MethodThe Perception Towards Picture Exchange Communication Scale (PTPECS) was developed to collect data from the participants. The newly developed tool was piloted and validated before being implemented. The participants included 73 caregivers of children with ASD in the UAE.ResultsThe following non-parametric tests were conducted: Mann-Whitney U test, Kruskal-Wallis test, and spearman rho. The results revealed that the parents were generally positive about employing the PECS to support the development of their children with ASD. There was also a positive association between using the PECS and improving communication, learning and social skills in children with ASD.ConclusionIt is imperative that educators and policymakers envisage parents as equal partners in providing rehabilitation services to children with ASD. Various implications, such as the need for continual engagement and empowering parents of children with ASD, are discussed.

Do patients with and survivors of COVID-19 benefit from telerehabilitation? A meta-analysis of randomized controlled trials.

BackgroundCoronavirus disease 2019 (COVID-19) significantly impacts physical, psychological, and social functioning and reduces quality of life, which may persist for at least 6 months. Given the fact that COVID-19 is a highly infectious disease and therefore healthcare facilities may be sources of contagion, new methods avoiding face-to-face contact between healthcare workers and patients are urgently needed. Telerehabilitation is the provision of rehabilitation services to patients at a distance via information and communication technologies. However, high-quality evidence of the efficacy of telerehabilitation for COVID-19 is still lacking. This meta-analysis aimed to investigate the efficacy of telerehabilitation for patients with and survivors of COVID-19.MethodsWe searched the Cochrane Library, EMBASE, Medline (via PubMed), PEDro, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from January 1st, 2020 to April 30th, 2022 for randomized controlled trials published in English, which aimed to evaluate the efficacy of telerehabilitation vs. face-to-face rehabilitation, usual care, or no treatment for COVID-19. Methodological quality and overall evidence quality of the included studies were assessed. The statistical reliability of the data was quantified using the trial sequential analysis.ResultsSeven randomized controlled trials with eight comparisons were included and all of them were used for meta-analysis. The meta-analyses of absolute values showed the superiority of telerehabilitation over no treatment or usual care for dyspnea (Borg scale: mean difference = −1.88, −2.37 to −1.39; Multidimensional dyspnea-12: mean difference = −3.70, −5.93 to −1.48), limb muscle strength (mean difference = 3.29; 2.12 to 4.47), ambulation capacity (standardized mean difference = 0.88; 0.62 to 1.14), and depression (mean difference = −5.68; −8.62 to −2.74). Significant improvement in these variables persisted in the meta-analyses of change scores. No significant difference was found in anxiety and quality of life. No severe adverse events were reported in any of the included studies.ConclusionsModerate- to very low-quality evidence demonstrates that telerehabilitation may be an effective and safe solution for patients with and survivors of COVID-19 in dyspnea, lower limb muscle strength, ambulation capacity, and depression. Further well-designed studies are required to evaluate the long-term effects, cost-effectiveness, and satisfaction in larger samples.

382 Essential Skills for Future Equine Sports Rehabilitation Careers

Abstract The field of equine sports medicine and rehabilitation is rapidly expanding with increasing career opportunities for individuals (non-veterinarians) in equine rehabilitation facilities. However, throughout the United States, there are limited educational opportunities for undergraduate students to prepare for this career. The objective of this study was to determine what practical skills and theoretical knowledge are deemed most useful for employment by professionals in this industry. To meet this objective, an Qualtrics survey was distributed through email and social media to veterinarians, veterinary professionals, rehabilitation service providers, and horse owners. In addition to demographics, the survey asked respondents to list practical skills and theoretical knowledge that are essential for professionals in the equine rehabilitation industry. The majority of the 117 respondents (84%) were located in the United States, with the remainder from Canada (5%), the United Kingdom (5%) and several other countries. Eighteen percent of respondents were veterinarians, 26% owned or managed rehabilitation facilities, 8.5% were veterinary technicians, and the remainder were horse owners, rehabilitation service providers, and others. Horse handling skills (19%) and communication skills (18%) were the most commonly listed practical skills deemed essential for rehabilitation professionals. Of the theoretical skills, evaluation of lameness (29.5%), anatomy (31%), and fundamentals of equine reconditioning programs (32%) were deemed similarly important for rehabilitation professionals. Together, these data indicate that an educational program in equine sports rehabilitation should include fundamental knowledge in lameness evaluation and rehabilitation methods as well as significant hands-on opportunities with rehabilitating horses and communicating about rehabilitation methods and progress with clients.

플랫폼 기반의 정신장애인 직업재활서비스 가능성 탐색

This study aims to explore the possibility of expanding vocational rehabilitation services by examining the experience of applying general qualitative research to the experience of attempting vocational rehabilitation services. Focus group interviews were implemented for four vocational rehabilitation service providers. As a result of the study, 6 main themes and 21 sub-themes were derived. Major topics are‘Agonizing over social change and the limitations of vocational rehabilitation services and recognizing the need for new services development’, ‘Gradually attempting platform-based vocational rehabilitation services from the traditional method’, ‘Developing a support method suitable for platform environment’, ‘Providing various options to respond to the needs of the mentally disabled’, ‘Witnessing the mentally disabled people creating new identities through platform work’, ‘Giving tasks to expand vocational rehabilitation services using the platform’. Based on this, the implications and suggestions of vocational rehabilitation services using the platform were presented.

Provision and use of physical rehabilitation services for adults with disabilities in Rwanda: A descriptive study.

BackgroundPhysical rehabilitation interventions address functional deficits caused by impairments that affect someone’s performance. Whilst rehabilitation is important, it is assumed that these services are either minimal or nonexistent in low-resource settings. Our data expand on the data from the Situation Assessment of Rehabilitation in the Republic of Rwanda report to describe rehabilitation services and who access them at public and semiprivate facilities (primarily funded by the private sector).ObjectivesThis article describes the use of the outpatient physical rehabilitation services across nine health facilities, the characteristics of adults attending these health facilities and some of the facilitators and barriers they encounter when attending rehabilitation.MethodData were collected between September and December 2018 from the heads of departments and adult patients attending outpatient rehabilitation services funded by the government, international nongovernmental organisations or faith-based organisations.ResultsTwo hundred and thirteen adults were recruited from nine facilities. There is a sixfold difference in the number of rehabilitation personnel between public and semiprivate hospitals in these facilities’ catchment areas. However, most participants were recruited at public facilities (186 [87%]), primarily with physical disorders. Patients reported that family support (94%) was the most crucial facilitator for attending rehabilitation, whilst transportation cost (96%) was a significant barrier.ConclusionRehabilitation service availability for Rwandan adults with disabilities is limited. Whilst family support helps patients attend rehabilitation, transportation costs remain a significant barrier to people attending rehabilitation. Strategies to address these issues include developing triage protocols, training community health workers and families.ContributionData on rehabilitation service provision in Rwanda and most African countries are either non-existent or very limited. These data contain important information regarding the services provided and the people who used them across different health facilities (public versus private) and urban versus rural settings). To improve rehabilitation service provision, we first need to understand the current situation. These data are an important step to better understanding rehabilitation in Rwanda.

Report on Cardiovascular Health and Diseases in China 2021: An Updated Summary

In 2019, cardiovascular disease (CVD) accounted for 46.74% and 44.26% of all deaths in rural and urban areas, respectively. Two out of every five deaths were due to CVD. It is estimated that about 330 million patients suffer from CVD in China. The number of patients suffering from stroke, coronary heart disease, heart failure, pulmonary heart disease, atrial fibrillation, rheumatic heart disease, congenital heart disease, lower extremity artery disease and hypertension are 13.00 million, 11.39 million, 8.90 million, 5.00 million, 4.87 million, 2.50 million, 2.00 million, 45.30 million, and 245.00 million, respectively. Given that China is challenged by the dual pressures of population aging and steady rise in the prevalence of metabolic risk factors, the burden caused by CVD will continue to increase, which has set new requirements for CVD prevention and treatment and the allocation of medical resources in China. It is important to reduce the prevalence through primary prevention, increase the allocation of medical resources for CVD emergency and critical care, and provide rehabilitation services and secondary prevention to reduce the risk of recurrence, re-hospitalization and disability in CVD survivors. The number of people suffering from hypertension, dyslipidemia and diabetes in China has reached hundreds of millions. Since blood pressure, blood lipids, and blood glucose levels rise mostly insidiously, vascular disease or even serious events such as myocardial infarction and stroke often already occured at the time of detection in this population. Hence, more strategies and tasks should be taken to prevent risk factors such as hypertension, dyslipidemia, diabetes, obesity, and smoking, and more efforts should be made in the assessment of cardiovascular health status and the prevention, treatment, and research of early pathological changes.

Measurement of family-centered services: Validation of the Korean translation of the measure of processes of care for service providers

The Measure of Processes of Care for Service Providers (MPOC-SP) is a valid and reliable instrument to measure the professionals' perception of the extent to which they apply the principles of family-centered services in care for children with disabilities. This study aimed to evaluate the validity and reliability of the Korean translation of the MPOC-SP (Korean MPOC-SP). The Korean MPOC-SP was completed by 132 rehabilitation service providers in 5 provinces in South Korea. Analyses for internal consistency, construct validity, and test-retest reliability were performed. The estimates of internal consistency (Cronbach's alpha) of the four scales of the Korean MPOC-SP ranged from 0.67 to 0.92. All the scales correlated highly with the other scales (r ranging from 0.61 to 0.77). In addition, all the items exhibited high item-total correlations (rs ranging from 0.40 to 0.83). Three scales had moderate to good reliability with ICCs ranging from 0.57 to 0.78; the 'providing general information (PGI)' scale showed low reliability (ICC 0.22). The Korean MPOC-SP can be considered a valid instrument for group-level research purposes with acceptable internal consistency, but caution is warranted regarding the low test-retest reliability of the PGI scale.

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background.

IntroductionSpinal cord injury (SCI) causes significant and permanent disability affecting motor, sensory and autonomic functions. We conducted a survey on the priorities of functional recovery and preferences for community rehabilitation services in a cohort of Chinese individuals with SCI as well as the primary caregivers. The study also investigated their views on advanced technology and research.MethodsAn online platform with a self-administered questionnaire was used to collect the opinions of clients that received services from an SCI follow-up clinic, a self-help association, or a non-government organization from 1 September−31 December 2021.ResultsEighty-seven subjects (74 individuals with SCI−48 tetraplegic, 26 paraplegic, and 13 caregivers) responded to the survey. Recovery of arm/hand function was given the highest priority among tetraplegics, followed by upper trunk/body strength and balance, and bladder/bowel function. Sexual function had a significant lower ranking than all priority areas except normal sensation (p < 0.05). Paraplegics viewed bladder/bowel function as the most important area of functional recovery, followed by walking movement, upper trunk/body strength and balance, elimination of chronic pain, and regaining normal sensation. There was no statistically significant difference among the top priority areas (p > 0.05). In contrast to previous studies done in Western populations, the study revealed that sexual function was ranked as the lowest by all 3 groups of respondents (tetraplegics, paraplegics, and caregivers). The majority of participants thought community rehabilitation services were inadequate. Most of the respondents were interested to try advanced technology which would facilitate their daily life and rehabilitation. About half of the individuals with SCI thought advance in technology and research could bring significant improvement in their quality of life in the coming 10 years.ConclusionThis survey is the first study specifically looking into the recovery and rehabilitation priorities of a Chinese population of individuals with SCI. This is also the first study to investigate the priorities of the primary caregivers of SCI individuals. The findings are useful as a reference for planning of future research and provision of rehabilitation services for the SCI community locally and in other parts of China.