Rehabilitation Coordinators Research Articles

Cardiac rehabilitation services in Ireland: the impact of a coordinated national development strategy

The national Cardiovascular Health Strategy including specific plans for cardiac rehabilitation was launched in Ireland in 1999. A survey of cardiac rehabilitation services was conducted in 2003 to evaluate progress on service provision. To establish levels of service provision, service formats and geographic distribution of cardiac rehabilitation services in 2003 and compare them with the status pre-Strategy (1998). All hospitals in Ireland (n = 39) admitting cardiac patients to a coronary or intensive care unit were surveyed by postal questionnaire. All hospitals provided information and all reported providing Phase I cardiac rehabilitation. Seventy-seven per cent (30 of 39) provided Phase III rehabilitation in 2003 (i.e. outpatient cardiac rehabilitation services) compared with 29% (12 of 41) in 1998. Of those hospitals currently without programmes, 78% (seven of nine) had plans in place for programme establishment. All programmes had trained cardiac rehabilitation coordinators, multidisciplinary teams and multiple components as recommended in the Strategy. In 82% of hospitals, intervention was provided at Phase II (immediate post-discharge period) while 26% of hospitals provided intervention at Phase IV (long-term maintenance period). There have been substantial achievements towards the Cardiovascular Health Strategy target of providing cardiac rehabilitation services for all relevant hospitals in Ireland over the past five years. Service provision of cardiac rehabilitation can benefit from collective efforts made across centres to encourage the prioritisation of cardiac rehabilitation in national health policy initiatives.

A Preliminary Exploration of Goal-setting in Community-based Rehabilitation for People with Brain Impairment

AbstractCommunity-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.

Patient characteristics and outcomes of cardiac rehabilitation.

To investigate changes in physical fitness and psychological characteristics of patients after cardiac rehabilitation, and to assess predictors of defaulting from the program. A prospective study of 1902 consecutive patients admitted to a community-based, hospital-linked cardiac rehabilitation program was conducted over a period of 6 years and 7 months. The cardiac rehabilitation program centered on a 2-to 6-month circuit training course with education, stress management, relaxation, and risk factor monitoring. Before and after the program, measures of physical fitness and of hospital anxiety and depression were performed. The course was completed by 1443 patients (76%), with 240 patients (13%) defaulting. For those who completed the course, peak oxygen consumption per minute increased by 3.2 mL/min/kg (95% confidence interval [CI], 3.1-3.4) or 19% (95% CI, 17.7%-20.3%). According to the hospital anxiety and depression scores, anxiety fell by 1.1 (95% CI, -1.3 to -0.98) and depression by 1.3 (95% CI, -1.4 to -1.2). The main predictors of defaulting were depression (patients with depression were twice as likely to default as nondepressed patients) and diagnosis (patients who had experienced angina or percutaneous transluminal coronary angioplasty were twice as likely to default as those who had experienced infarct or coronary artery bypass graft). The identification of depressed coronary patients known to be at increased risk should be a priority for cardiac rehabilitation coordinators. Every effort should be made to keep them in the cardiac rehabilitation program.

Training cardiac rehabilitation coordinators

Abstract Recent years have witnessed a dramatic growth in the provision of cardiac rehabilitation services throughout Ireland and the UK. However, this growth has not been matched by the development of formal training for cardiac rehabilitation coordinators. The present paper presents a model for cardiac rehabilitation coordinator training with reference to the key academic and practical points of such a programme. A multidisciplinary approach to training affords potential coordinators with the understanding necessary to coordinate a range of professionals, and thereby provide the recommended multifactorial programme to service users. Formalized training contributes to acceptable standards of both clinical practice and service delivery and advances expertise in audit and service representation. Such training may promote recognition of career specialization for cardiac rehabilitation coordinators.

The BACR database of cardiac rehabilitation units in the UK

Objectives : To identify: 1. All the cardiac rehabilitation units in the UK together with the names and addresses of their co-ordinators and the different health professionals involved. 2. The range of patient diagnoses treated. 3. The before and after assessment procedures used. 4. The provision of ongoing support for patients when they leave the programme. 5. Their arrangements for secondary prevention and knowledge of local protocols and arrangements for long-term care. Design : Questionnaire and telephone surveys. Main outcome measures : Names and addresses of all cardiac rehabilitation co-ordinators, the disciplines of their staff, the conditions which they treat, the treatments offered and the outcomes measured together with knowledge of and provision for long-term secondary prevention. Results : 300 centres were identified. Of the 294 who returned questionnaires, nearly all provided a mixture of exercise training, education and stress management. Age was an exclusion factor in 14%. Outcomes in the form of exercise tolerance was measured by 22%, psychological function by 60% and quality of life by 51%. Staffing included nurses, physiotherapists and dieticians in over 80% and doctors and pharmacists in over 60%. Psychologists and social workers were involved in less than 30%. The majority of co-ordinators were involved with or aware of secondary prevention initiatives in their area.

A Pilot Study of Client Satisfaction: An Occupational Therapy Duty System in an Occupational Therapy Bureau

The duty system is the telephone referral system for the Kent Occupational Therapy Bureau service for members of the public and health professionals. The duty rota is staffed by occupational therapists and rehabilitation coordinators. This evaluation aimed to determine the quality and equity of the service in relation to client satisfaction. Over a 2-week period, telephone interviews were conducted using a questionnaire. All members of the public who telephoned to make a referral and had had no prior contact with the bureau were eligible for the study. The duty system was shown to provide a consistently high level of service in all areas evaluated. However, those interviewed expressed dissatisfaction with the predicted time of wait for an assessment visit and the lack of accurate information regarding this wait. This pilot study demonstrates that an occupational therapist may not be needed to fulfil the role of duty officer. A trained duty officer with an occupational therapist available for consultation can provide the service, thereby freeing occupational therapists to undertake assessments and reduce waiting lists. More accurate information and regular contact from the bureau regarding the waiting time for an assessment is required to reduce dissatisfaction.

The Roles, Functions and Effectiveness of Treating Doctors in the Management of Occupational Injury: Perceptions of Key Stakeholders

Key stakeholders' perceptions of the role of the treating doctor, including treating doctors themselves, in the management of workplace injury and in occupational rehabilitation of injured workers was assessed via in-depth semi-structured interviews of doctors and via interviews and surveys of other stakeholders (injured workers, employers, rehabilitation co-ordinators, rehabilitation providers and insurers) in the post-injury period. A number of difficulties were identified by both doctors themselves and by other stakeholders in the treating doctors' management of compensable work injury clients. It was argued that these problems were a function of the conflict of interest that arises for various service providers within the current workers' compensation system and the polarised and adversarial nature of relationships between providers. The discussion of the underlying structural and policy problems inherent in the current workers' compensation system at various levels of practice which this study has highlighted provides a first step in attempts to resolve these difficulties in individual practitioner-client relationships.

Case Management in Occupational Rehabilitation: Would the Real Case Manager Please Stand Up?

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

Rehabilitation after injury and the need for coordination

The outcome of treatment after injury can be measured using the general terms of mortality and morbidity. Mortality is an all-or-none phenomenon, but morbidity is a graded response to injury and its medical treatment, varying from complete return to normality at one end of the scale to total dependence on other people requiring residence in an institution at the other end. The words disability (the individual's response) and handicap (society's reaction) specify the morbidity. Rehabilitation affects these two outcomes of disability and handicap and is a complex process involving the patient, carers and a team of specialists. The rehabilitation team is comprised of professionals each with specialist skills who aim to rehabilitate the individual as far as possible back to his former health and independence. All aspects of an individual's life are treated, including the physical, functional, psychological and social. The team operates in a number of ways according to the setting and treatment approaches used. The rehabilitation process should remain consistent throughout and focus on the patient's strengths and deficits. The key to effective rehabilitation is good organization with a comprehensive team approach working towards common goals and aims. Whether the patient is located in an acute hospital, rehabilitation unit, nursing home or in his own house, rehabilitation must be continuous. It is a mistake to believe that the rehabilitation process can only exist in a special centre; it must start in the acute hospital and be maintained even when at home, although its intensity may vary at different stages. It is suggested that coordination of this continuous process should be done by a rehabilitation coordinator, who must commence work early in the acute phase after the initial injury. Monitoring the amount of disability and the effectiveness of the rehabilitation process is essential and is best performed using the Functional Independence Measure. This simple scale can help to assess progress by nurses, doctors, therapists, and carers. It must be made part of the therapeutic process and utilized to fix goals. It can also act as the outcome measure to assess the cost effectiveness of rehabilitation after injury.

Evaluating a rehabilitation co-ordinator service for personal injury claimants.

Forty-eight British personal injury claimants received 12 months of assistance in using vocational rehabilitation services or 6 months' help after a 6-month deferment. There was no significant difference in number working at 6 months, but more were working at 12 months compared with 6 months. Interviews revealed that subjects were satisfied with the service. Language: en

Preventing amputation

Area Rehabilitation Coordinator Medicine and Rehabilitation Specialists Norwood, Massachusetts Program in Gerontology University of Massachusetts Doctoral Candidate Co-Director Maternal and Child Health Center Cambridge Physical Therapy Cambridge, Massachusetts Women's Physical Therapy Center Weymouth, Massachusetts

A rehabilitation coordinator service for personal injury claimants

P. Cornes, Ph. D., rehabiliration Studies Unit. Canaan Park. Astley Ainslie Hospital. 133 Grange Loan. M. Barth, Psychologisches Insiitut der Universitäi Freiburg. Abt. Rehahilitationspsychologie. Belfonsir. 16, D-7800 Freiburg. Fed. Rep. of Germany.

Accountability for the sexual awareness of the spinal cord injured patient.

Ann M. Latimer, RN, BSN, has been rehabilitation coordinator at Cathedral Rehabilitation Center, Jacksonville, FL, for the past two years. This article is an expanded version of a talk given at the Sixth Annual ARN Educational Conference in Seattle, WA, October 18, 1980.

In-home support for recovering alcoholic mothers and their families; the family rehabilitation coordinator project.

A program is described for training paraprofessional workers to aid recovering alcoholic mothers and their families to improve household organization and communication and to use community services.

Boy Scout Merit Badges and Vocational Counseling

Vocational Guidance QuarterlyVolume 11, Issue 1 p. 31-34 Boy Scout Merit Badges and Vocational Counseling JOHN L. BRIGGS, JOHN L. BRIGGS John L. Briggs is Vocational Rehabilitation Coordinator, Kalamazoo, Michigan. He formerly was Boy Scout Executive and Employment Service Selective Placement Interviewer.Search for more papers by this author JOHN L. BRIGGS, JOHN L. BRIGGS John L. Briggs is Vocational Rehabilitation Coordinator, Kalamazoo, Michigan. He formerly was Boy Scout Executive and Employment Service Selective Placement Interviewer.Search for more papers by this author First published: Autumn 1962 https://doi.org/10.1002/j.2164-585X.1962.tb00162.x AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume11, Issue1Autumn 1962Pages 31-34 RelatedInformation