Health Rehabilitation Services Research Articles

Treating Post-Stroke Aphasia: Psychological Wellness Approaches

One of the most difficult conditions to treat while dealing with post-stroke aphasia and depression is related. To help stroke survivors manage their depression symptoms, stroke medical professionals are essential. In light of stroke specialists' opinions about post-stroke aphasia, this study intends to investigate current methods of treating depression. In five semi-structured focus groups, thirty-nine stroke healthcare professionals from various phases of stroke therapy took part. A thorough transcript analysis of these focus group talks was conducted using the interpretive description approach. After the transcripts were analyzed, several themes emerged, including the difficulties associated with treating depression and aphasia at the same time in stroke rehabilitation, the undervaluing of mood disorders in clinical practice, the use of ad hoc methods for diagnosis and treatment, and the attempts of stroke doctors to fill in the gaps in psychological care. This study emphasizes how difficult it is for doctors to treat depression in patients who have had a stroke-related aphasia. For better patient care, evidence-based therapies are crucial, as is the inclusion of mental health services in stroke rehabilitation. Policies that promote mental health should be developed, leaders should take the lead in putting comprehensive treatment plans into practice, and healthcare professionals should get specialized training. These initiatives have a critical role in enhancing the results and standard of life for those coping with the co-occurring conditions of depression and aphasia after stroke.

Development of Mental Health and Social Rehabilitation Service Models for Psychosocial Disabilities

This study aims to determine the extent to which policies related to persons with disabilities and mental health can accommodate the rights of people with psychosocial disabilities, then the extent to which the model of mental health services and social rehabilitation for psychosocial disabilities contributes to mental health treatment in DIY. YAKKUM Rehabilitation Center through capital development of mental health services and post-recovery social rehabilitation that is accessible and community-resourced. This model is oriented towards improving the quality of life of people with psychosocial disabilities and the existence of communities that contribute proactively to community-based mental health efforts in DIY. The data mining method in this study uses a mixed method, namely discriptive studies, descriptive qualitative, participant as observer and participant non observer. Subjects in this study included people with psychosocial disabilities, caregivers, mental health cadres, village governments, puskesmas and related local organizations. The results of this study show that the service model developed by the YAKKUM rehabilitation center is able to encourage social recovery in people with psychosocial disabilities, strengthen their role in the community in community-based mental health, local mental health policies that accommodate the rights of people with psychosocial disabilities, the existence of a mental health service system that focuses on fulfilling the rights of psychosocial disabilities and social rehabilitation.

Community Based Rehabilitation in People With Lower Limb Amputation: A Systematic Review

The purpose of this paper is to identify the intervention components, key actors and models of social innovation that can contribute to the improvement of health rehabilitation services from a biopsychosocial perspective, aimed at people with lower limb amputation in a situation of disability. Likewise, it aims to analyze the ways in which Community Based Rehabilitation (CBR) facilitates the elimination of barriers in rehabilitation services and promotes a better quality of life for people with disabilities. A systematic review of scientific literature for the period 2001 to 2019 was carried out, starting with a bibliometric analysis of publications found in the Web of Science and Scopus databases; followed by content analysis with NVivo 12 software. Among the findings, it was identified that the optimization of health services for the population with disabilities in emerging countries requires investment and training. In addition, the success and deficiencies in CBR programs were analyzed, since according to the systematic review, these are limited to the care of people with lower limb amputation in contexts of armed conflict.

Hospital Efforts in Fulfilling Patients' Rights to Emergency Unit Health Services

A hospital is a health service facility that provides complete individual health services through promotive, preventive, curative, rehabilitative and/or palliative health services by providing inpatient, outpatient and emergency services. The Emergency Department (IGD) is a hospital unit that provides first care to patients. Emergency Services are medical actions required by Emergency Victims/Patients immediately to save lives and prevent disability. The current difficulty of society is expensive health financing. Not only because of the doctor, but to reach health facilities and infrastructure you also have to make a lot of effort. We can see in several cases of patient refusal in the ER at hospitals in several regions of Indonesia how difficult it is for people to get optimal health services. The method used is the Normative Juridical Method which aims to find legal regulations regarding hospitals in their efforts to treat emergency patients. The problem formulation that the author can put into this paper is how to implement and optimize hospital efforts to fulfill patients' rights to health services in the emergency unit. The results of the author's research are that in order to optimize the fulfillment of patient rights, hospitals are required to form internal hospital regulations and require hospitals to implement good corporate governance and good clinical governance.

International Experience of Implementing Cognitive Remediation for People With Psychotic Disorders.

Cognitive remediation (CR) is an effective therapy for the cognitive impact of mental illness, especially schizophrenia. Global efforts are being made to implement CR into routine mental health services with the aim of improving functional outcomes for the population of people recovering from mental illness. Implementation and dissemination of CR in heterogeneous settings require knowledge gleaned from formal implementation research and pragmatic experiential learning. This article describes cross-cultural approaches to CR implementation, focusing on initiatives in France, the United States, Australia, and Japan. Key leaders in the implementation of CR in France, the United States, Australia, and Japan were asked to describe the implementation and dissemination process in their settings with respect to the categories of context, implementation, outcomes, facilitators, and barriers. All 4 sites noted the role of collaboration to leverage the implementation of CR into mental health rehabilitation services. In France, high-level, government organizational backing enhanced the dissemination of CR. Academic and clinical service partnerships in the United States facilitated the dissemination of programs. The advocacy from service users, families, and carers can aid implementation. The support from international experts in the field can assist in initiating programs but maintenance and dissemination require ongoing training and supervision of staff. CR is an effective intervention for the cognitive impact of schizophrenia. Programs can be implemented in diverse settings globally. Adaptations of CR centering upon the core components of effective CR therapy enhance outcomes and enable programs to integrate into diverse settings.

Efektivitas Pelayanan Kesehatan di Puskesmas Akle Kabupaten Kupang Ditinjau dari Undang-Undang Nomor 36 Tahun 2009 Tentang Kesehatan

The Akle Health Center of Kupang Regency always strives to serve the community well.well in all care needs including curative services(treatment), preventive (prevention efforts), promotive (health improvement)and rehabilitation (health restoration) with the hope that patients who obtain health services feel satisfied with the services provided.The purpose of this study is to determine the effectiveness of health services at the Akle Health Center, Kupang Regency, and to find out the inhibiting factors for the effectiveness of health services at the Akle Health Center, Kupang Regency. The type of research conducted is empirical juridical research. The types and sources of data used are primary and secondary data. Primary data is data obtained directly from the research location through direct interviews with respondents and based on researcher observations.Secondary data is data obtained from literature studies.Data analyzed descriptively qualitative. The results of this study indicate that: (1) The Effectiveness of Health Services at Puskesmas Akle Kupang Regency are: (a) Implementation of Health Services at Puskesmas Akle Kupang Regency, (b) Implementation of Preventive Health Services, (c) Implementation of Promotive Health Services, (d) Implementation of Curative Health Services, (e) Implementation of Rehabilitative Health Services. (2) Factors inhibiting the effectiveness of health services at the Akle Health Center, Kupang Regency are: (a) Human Resources, (b) Infrastructure Facilities, (c) System factors, Procedures and Regulations, (d) Skills.

Exploring women’s experiences of an inpatient mental health rehabilitation service

Exploring women’s experiences of an inpatient mental health rehabilitation service

Paving the way for COVID survivors' psychosocial rehabilitation: Mining topics, sentiments, and their trajectories over time from Reddit.

Objective: This study examined major themes and sentiments and their trajectories and interactions over time using subcategories of Reddit data. The aim was to facilitate decision-making for psychosocial rehabilitation. Materials and Methods: We utilized natural language processing techniques, including topic modeling and sentiment analysis, on a dataset consisting of more than 38,000 topics, comments, and posts collected from a subreddit dedicated to the experiences of people who tested positive for COVID-19. In this longitudinal exploratory analysis, we studied the dynamics between the most dominant topics and subjects' emotional states over an 18-month period. Results: Our findings highlight the evolution of the textual and sentimental status of major topics discussed by COVID survivors over an extended period of time during the pandemic. We particularly studied pre- and post-vaccination eras as a turning point in the timeline of the pandemic. The results show that not only does the relevance of topics change over time, but the emotions attached to them also vary. Major social events, such as the administration of vaccines or enforcement of nationwide policies, are also reflected through the discussions and inquiries of social media users. In particular, the emotional state (i.e., sentiments and polarity of their feelings) of those who have experienced COVID personally. Discussion: Cumulative societal knowledge regarding the COVID-19 pandemic impacts the patterns with which people discuss their experiences, concerns, and opinions. The subjects' emotional state with respect to different topics was also impacted by extraneous factors and events, such as vaccination. Conclusion: By mining major topics, sentiments, and trajectories demonstrated in COVID-19 survivors' interactions on Reddit, this study contributes to the emerging body of scholarship on COVID-19 survivors' mental health outcomes, providing insights into the design of mental health support and rehabilitation services for COVID-19 survivors.

PENERAPAN PERATURAN KEJAKSAAN NOMOR 18 TAHUN 2021 TERKAIT REHABILITASI NARKOTIKA BERDASARKAN KEADILAN RESTORATIF

Restorative Justice is utilized as an approach to resolve criminal cases involving offenders, victims, families, and relevant parties to seek a fair resolution, prioritizing rehabilitation over retribution. The Guidelines for Narcotics Rehabilitation based on Restorative Justice guide Prosecutors in the stages of pre-prosecution, prosecution, and rehabilitation supervision. In practice, there are differences in the interpretation and application of the dominus litis principle by Prosecutors in handling narcotics cases with a restorative justice approach. The limitations in understanding and applying the dominus litis principle can affect the consistency and uniformity of rehabilitation policies provided by the Prosecutor's Office in narcotics criminal cases. Moreover, this issue can also lead to inconsistent treatment of narcotics defendants in need of rehabilitation. The issue concerning the authority of the prosecutor's office in implementing rehabilitation policies in narcotics criminal cases with a restorative justice approach and enforcing the law in narcotics criminal cases with a restorative justice approach. This research method employed a normative juridical research type using legislative and conceptual approaches as the basis for analysis in addressing the issues. The conceptual approach used includes the concept of narcotics rehabilitation by the Indonesian Prosecutor's Office based on theories of authority and law enforcement, serving as analytical tools in addressing the issue of prosecutor's authority in law enforcement rehabilitation in narcotics criminal cases. In conclusion, the Prosecutor's Office has the juridical authority to conduct rehabilitation in narcotics criminal cases with a restorative justice approach. This is regulated in the Indonesian Prosecutor's Regulation Number 18 of 2021. Prosecutors play a central role in controlling cases, from investigation to court judgment execution, based on the dominus litis principle. Public prosecutors have a significant role in ensuring that medical and social rehabilitation efforts are carried out appropriately by designated rehabilitation institutions or health services, as well as in issuing warnings and taking further action if suspects fail to comply with the prescribed rehabilitation process. Law enforcement in cases of narcotics abuse requires a thorough understanding and strict application of the requirements based on the Indonesian Prosecutor's Regulation Number 18 of 2021

Cross-sectoral collaborations between nonprofit organizations and businesses: implications for organizations providing mental health rehabilitation services

ABSTRACT This article presents a case study of a community garden in Israel, the product of a collaboration between a Social Service Nonprofit Organization (SSNO) providing mental health rehabilitation services and a real-estate business firm. The study examines the inter-organizational dynamics of this collaboration, as well as its benefits and challenges for the SSNO and its service users, based on interviews with key figures, onsite observations, and document analysis. The results indicate that collaboration with business can offer SSNOs benefits in terms of financial resources and volunteers, but at the same time involves difficulties, which are intensified in the context of mental health SSNOs.

Assessing the clinical and cost-effectiveness of inpatient mental health rehabilitation services provided by the NHS and independent sector (ACER): protocol

BackgroundMental health rehabilitation services provide specialist treatment to people with particularly severe and complex problems. In 2018, the Care Quality Commission reported that over half the 4,400 mental health inpatient rehabilitation beds in England were provided by the independent sector. They raised concerns that the length of stay and cost of independent sector care was double that of the NHS and that their services tended to be provided much further from people’s homes. However, there has been no research comparing the two sectors and we therefore do not know if these concerns are justified. The ACER Study (Assessing the Clinical and cost-Effectiveness of inpatient mental health Rehabilitation services provided by the NHS and independent sector) is a national programme of research in England, funded from 2021 to 2026, that aims to investigate differences in inpatient mental health rehabilitation provided by the NHS and independent sector in terms of: patient characteristics; service quality; patient, carer and staff experiences; clinical and cost effectiveness.MethodsACER comprises a:1) detailed survey of NHS and independent sector inpatient mental health rehabilitation services across England; 2) qualitative investigation of patient, family, staff and commissioners’ experiences of the two sectors; 3) cohort study comparing clinical outcomes in the two sectors over 18 months; 4) comprehensive national comparison of inpatient service use in the two sectors, using instrumental variable analysis of routinely collected healthcare data over 18 months; 5) health economic evaluation of the relative cost-effectiveness of the two sectors. In Components 3 and 4, our primary outcome is ‘successful rehabilitation’ defined as a) being discharged from the inpatient rehabilitation unit without readmission and b) inpatient service use over the 18 months.DiscussionThe ACER study will deliver the first empirical comparison of the clinical and cost-effectiveness of NHS and independent sector inpatient mental health rehabilitation services.Trial registrationISRCTN17381762 retrospectively registered.

Patient-report and caregiver-report measures of rehabilitation service use following acquired brain injury: a systematic review

ObjectiveTo review patient-report/caregiver-report measures of rehabilitation service use following acquired brain injury (ABI).Data sourcesMedline, APA PsycINFO, Embase and CINAHL were searched on November 2021 and November 2022. Authors were contacted...

Rehabilitation in children with home invasive mechanical ventilation.

Children with home invasive mechanical ventilation need special health care and rehabilitation services due to complications caused by both the pulmonary system and physical inactivity. Children who are dependent on invasive mechanical ventilators due to breathing difficulties and lung problems can benefit from rehabilitation programs. Rehabilitation requires a close relationship between the child, parents and/or caregivers, and healthcare professionals. The main goal of rehabilitation is to improve breathing, lung function and overall quality of life. In this review, although full standard approaches have not been determined yet, rehabilitation approaches for children dependent on home-type invasive mechanical ventilator will be discussed.

Rehabilitation and Recovery-Oriented Mental Health Services in the Northern Part of India: Initiatives and Way Forward

Rehabilitation and Recovery-Oriented Mental Health Services in the Northern Part of India: Initiatives and Way Forward

Coverage of Child Disability Detection, Management, and Rehabilitation Health Services in Central Uganda.

Child disability is a significant public health concern which impacts 1 in 20 children. Children with disabilities (CwDs) encounter deprivation of rights, biases in society, and a lack of access to necessary services, all of which are exacerbated by structural obstacles. This study assessed the coverage of child disability prevention, management and rehabilitation services in four districts of Central Uganda after two years of interventions to improve these services. The Lot Quality Assurance Sampling (LQAS) rapid health facility assessment method was employed to assess coverage of services based on sixteen indicators. The indicators were set based on constructs of: provision of disability-related services to CwDs; use of rehabilitation services; readiness of the health facilities (HFs) to provide basic disability management and rehabilitation services; community structures for linkage to disability management and rehabilitation services; psychosocial support provision; and upholding and protecting the rights of CwDs. A district-level decision rule was set based on 80% coverage target. Despite the interventions, the services have yet to provide the desired level of benefit to CwDs and their caregivers. Out of the sixteen indicators for healthcare service coverage for CwDs, only three attained the 80% coverage target. The findings suggest that greater focus by health service planners and project implementers is still needed, especially at the community and health facility levels to enhance the prevention, management and rehabilitation of CwDs. Psychosocial health services for caregivers of CwDs need special attention in order to achieve better service approaches.

Impact of Frailty on Gait Speed Improvements in Home Health after Hospital Discharge: Secondary Analysis of Two Randomized Controlled Trials.

More than half of older adults are frail or prefrail in the United States, and hospital-associated deconditioning likely increases this risk. However, the impact of frailty on potential functional improvements after hospital discharge is poorly understood. We sought to identify the influence of baseline frailty on gait speed change in older adults receiving home health physical therapy (PT) after hospital discharge. The severity of frailty was assessed using Cardiovascular Health Study frailty criteria (weakness, slowness, weight loss, physical inactivity, and exhaustion). Gait speed was measured at baseline and 60-days post-hospital discharge. Upon admission to home health rehabilitation services, half of older adults (total N=250) were considered frail, with slowness (90%) and weakness (75%) being the most common characteristics. Older adults, whether pre-frail or frail, demonstrated similar and clinically meaningful improvements in gait speed after receiving home health rehabilitation for 60 days following hospital discharge. These results suggest that clinicians caring for older adults in the hospital can counsel both pre-frail and frail patients that, with home health rehabilitation, clinically significant improvements in function can be expected over the 2 months following discharge. Furthermore, we observed encouraging gait speed improvement with physical therapy following hospitalization in older adults. Results can inform anticipatory guidance on hospital discharge.

Access to health care for Afghan immigrants and refugees: an ethico-legal analysis based on the Iranian health law system.

The right to health is an internationally recognized and established human right with a long history of appreciation, indicating that governments should guarantee the highest possible level of access to health and provide health-care serivces with no discrimination based on nationality, race, gender, language or religion. The present study explored this topic using an analytic-descriptive approach. We reviewed related laws, policies and other available documents with the aim to investigate the ethico-legal aspects of Afghan refugees' and immigrants' access to health care and the challenges in in this regard within the Iranian health law system. According to the results of this study, the Iranian health law could be interpreted to include all Afghan immigrants in the country's public health system as a legal commitment. In addition, while basic and primary health coverage is available for all Afghan immigrants in Iran, provision of other medical and rehabilitative health services to documented and undocumented immigrants follow different methods. In order to alleviate the current situation, we recommend strategies such as supporting policy changes intended to register undocumented immigrants, which naturally results in an increase in their access to health care.

Minimal important difference of the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in persons with chronic low back pain

BackgroundThe World Health Organization Disability Assessment Schedule 2.0 12-item survey (WHODAS-12) is a questionnaire developed by the WHO to measure functioning across health conditions, cultures, and settings. WHODAS-12 consists of a subset of the 36 items of WHODAS-2.0 36-item questionnaire. Little is known about the minimal important difference (MID) of WHODAS-12 in persons with chronic low back pain (LBP), which would be useful to determine whether rehabilitation improves functioning to an extent that is meaningful for people experiencing the condition. Our objective was to estimate an anchor-based MID for WHODAS-12 questionnaire in persons with chronic LBP.MethodsWe analyzed data from two cohort studies (identified in our previous systematic review) conducted in Europe that measured functioning using the WHODAS-36 in adults with chronic LBP. Eligible participants were adults with chronic LBP with scores on another measure as an anchor to indicate participants with small but important changes in functioning over time [Short-form-36 Physical Functioning (SF36-PF) or Oswestry Disability Index (ODI)] at baseline and follow-up (study 1: 3-months post-treatment; study 2: 1-month post-discharge from hospital). WHODAS-12 scores were constructed as sums of the 12 items (scored 0–4), with possible scores ranging from 0 to 48. We calculated the mean WHODAS-12 score in participants who achieved a small but meaningful improvement on SF36-PF or ODI at follow-up. A meaningful improvement was an MID of 4–16 on ODI or 5–16 on SF36-PF.ResultsOf 70 eligible participants in study 1 (mean age = 54.1 years, SD = 14.7; 69% female), 18 achieved a small meaningful improvement based on SF-36 PF. Corresponding mean WHODAS-12 change score was − 3.22/48 (95% CI -4.79 to -1.64). Of 89 eligible participants in study 2 (mean age = 65.5 years, SD = 11.5; 61% female), 50 achieved a small meaningful improvement based on ODI. Corresponding mean WHODAS-12 change score was − 5.99/48 (95% CI − 7.20 to -4.79).ConclusionsUsing an anchor-based approach, the MID of WHODAS-12 is estimated at -3.22 (95% CI -4.79 to -1.64) or -5.99 (95% CI − 7.20 to -4.79) in adults with chronic LBP. These MID values inform the utility of WHODAS-12 in measuring functioning to determine whether rehabilitation or other health services achieve a minimal difference that is meaningful to patients with chronic LBP.

The growing evidence for mental health rehabilitation services and directions for future research.

The growing evidence for mental health rehabilitation services and directions for future research.

Level of Evidence of Telehealth Rehabilitation and Behavioral Health Services for Traumatic Brain Injury: A Scoping Review.

Traumatic brain injury (TBI) can result in significant impairments in functioning associated with partial or permanent disabilities. Examining the evidence for domain-specific telehealth interventions is necessary to guide the development of effective clinical and research programs for this population. The present scoping review characterizes the level of evidence across a range of TBI-related disabilities and impairments. A literature search was performed across comprehensive databases using search terms related to TBI, rehabilitation, telehealth, and outcome. A total of 19 publications from 17 studies met inclusion criteria. Articles focused on telehealth interventions to improve global, cognitive, emotional, and physical functioning post-TBI. Levels of evidence ranged from 1 to 4 across domains, with predominantly experimental designs (level 1). Outcomes demonstrating improvement or benefit from telehealth treatments were reported across all functional domains (50-80% of studies). Results highlight the potential of telehealth interventions across the span of comprehensive interdisciplinary rehabilitation care. Expanded research is needed on remote treatment options for physical symptoms, for subgroups within TBI populations (i.e., mild TBI, military populations), as well as on remote and hybrid comprehensive rehabilitation programs.