Rehabilitation Sector Research Articles

Is the delivery of National Disability Insurance Scheme in Australia through quasi markets achieving the right outcomes in vision rehabilitation services? A qualitative study

Purpose Despite being a pioneering social initiative worldwide, Australia’s National Disability Insurance Scheme (NDIS) still presents unresolved issues for individuals with vision-related disability regarding its processes and outcomes. This study evaluates how well the NDIS markets are perceived to achieve efficiency, responsiveness, choice, quality, and equity within the vision rehabilitation sector, and identified factors facilitating or hindering desired outcomes. Materials and methods This qualitative study conducted 22 semi-structured interviews involving individuals with vision disability, service providers, peak-body and professional-body representatives, and an NDIS planner. Results Findings across stakeholder groups show minimal variation. The NDIS’s quasi-market approach has improved participants’ choices over ways to utilise and manage their funding and consequently provided them with a sense of control and empowerment. However, inefficiencies persist due to insufficient competition, workforce shortages, price caps, information asymmetry, high transaction costs, gaming behaviour, inadequate staff training, complex and lengthy processes, and eligibility concerns. Supportive factors include effective advocacy, pragmatic regulations to maintain quality, opportunities for innovation, and service providers’ motivation for cost-effectiveness. Conclusions While NDIS markets have made significant strides in enhancing participants’ choice and control, our findings underscore the need for continued refinement to achieve broader social objectives and long-term sustainability for individuals with vision-related disability.

The effect of patients' socioeconomic status in rehabilitation centers on the efficiency and performance.

Patients' socioeconomic status on hospitals' efficiency in controlling for clinical component characteristics may have a role that has few been studied in rehabilitation centers. Because of the national health insurance system, rehabilitation centers are free of charge. To answer whether a patient's socioeconomic status (SES) is associated with efficiency and performance, we use a counterfactual analysis to get the patient's SES effect "as if" the patient's case was identical to whatever hospital. We restrained the data to patients from public acute care units where the decision on rehabilitation sector admission is based on availability, limiting bias by confounding factors. Besides, an analysis of six pathologies led to the same results. An exhaustive, detailed administrative database on rehabilitation center stays in France. To define the patients' socioeconomic status, we use two sources of data: the information collected at the time of the patient's entry into rehabilitation care and the information collected during the patient's stay in acute care. This double information avoids possible loss of socio-economic details between the two admissions. Patients recruited were exhaustively admitted over the year 2018 for stroke, chronic obstructive pulmonary disease, heart failure, or total hip replacement in France in the acute care unit and then in a rehab center. Mainly the elderly population. Information on patients' demography, comorbidities, and SES are coded due to the reimbursement system. Different dimensions controlling for factors (hospital ownership, patient clinical characteristics, rehabilitation care specificities, medical staff detailed information, and patients' socioeconomic status), were progressively added to control for any differences in baseline data between the two groups. We assess rehabilitation centers' efficiency by combining selected outcome quality indicators (Physical score improvement, Cognitive score improvement, Mortality, Return-to-home). The specific Providers' Activity Index is used to get the performance index. The performance of healthcare institutions is correlated not only to the case mix of their patients but also to the socioeconomic status of the patients admitted. The performance needs to be seen in light of patients' socioeconomic status. The data reveals that patients' socioeconomic status affects rehabilitation care efficiency and performance. In controlling patients' socioeconomic status, for-profit rehabilitation hospitals seemed more efficient than public ones.

What Medical Specialties do ME/CFS Sufferers Consult? A Public Health Study on the need for Better Medical Education and Training

The disease ME/CFS is unknown to many doctors in Germany. Within the healthcare system, significant deficits in dealing with ME/CFS patients have been repeatedly revealed. Hence, the aim of the present study was to identify the specialties of the doctors consulted by ME/CFS patients and to find out whether information on the medical procedure in the context of the diagnosis process can be derived from this. As part of the APAV-ME/CFS survey, the quantitative responses of 674 adult ME/CFS sufferers (>20 y.; 554 ♀, 120 ♂) who already had a medical ME/CFS diagnosis were statistically examined. The sampling was done by self-activation and via the snowball principle. The data were primarily evaluated descriptively. An analysis of variance was carried out to consider possible relationships. Almost a quarter of the patients said they had suffered from ME/CFS for 6 to 10 years. Diagnosis was made within 10 years of disease onset in 62%. For 6.4% it took 21-40 years. 75% of the participants consulted 6 to 15 different doctors from a wide range of disciplines in the course of the disease, in particular from general medicine, neurology, internal medicine and psychosomatics/psychiatry. Diagnosis was made in particular by GPs and immunologists. On average, the test persons named 11 mostly neuroregulatory symptoms. The results suggest that in the context of finding a diagnosis in Germany for ME/CFS, referral behaviour to specialists based on single ME/CFS symptoms or rather arbitrary contacting of doctors from a wide variety of disciplines has prevailed so far. Therefore, training and further education measures on the subject of ME/CFS are urgently needed in all specialist disciplines in the resident, inpatient and rehabilitation sectors.

Successful treatment of Trypanoxyuris sp. infection in naturally infected southern brown-howlers (Alouatta guaribaclamitans)

Southern brown-howler monkeys (Alouatta guariba clamitans) may harbor Trypanoxyuris sp., a pinworm parasite with documented fatal consequences in this species. Despite this risk, effective treatment protocols remain unclear. Therefore, the present study aimed to evaluate the efficacy of two anthelmintic protocols against natural infections in two brown-howler monkeys received at the Wild Animal Care and Rehabilitation Sector (SARAS-CAV-UDESC). The protocols utilized pyrantel pamoate & praziquantel (600.0 mg, PO, single dose) and albendazole (20.0 mg, PO, daily for 5 days). Fecal egg counts were carried out daily at the Laboratory of Parasitology and Parasitic Diseases (LAPAR-CAV-UDESC) before and after drug administration. Both treatments successfully eliminated Trypanoxyuris sp. infections. The animal treated with pyrantel pamoate & praziquantel achieved egg clearance by day 6 (144 h), demonstrating effectiveness with a single administration. Albendazole cleared the infection within 2 days of treatment, indicating its potential as a fast-acting treatment. No adverse effect were observed in the treated monkeys. These findings contribute to the development of evidence-based treatment protocols for Trypanoxyuris sp. in primates, enhancing animal health and welfare of captive and wild populations.

A life span perspective on competencies for a healthy, physically active lifestyle: Findings of a data pooling initiative with over 7000 individuals.

Individuals are recommended to lead active lifestyles throughout the life course. The model of physical activity-related health competence (PAHCO) adopts a competence approach by integrating physical, cognitive, and motivational determinants for health-enhancing PA (movement competence, control competence, self-regulation competence). Drawing on a comprehensive dataset pooling, the goal of the present study was to model the idiosyncratic courses of 10 PAHCO indicators over the life span. We identified studies that empirically operationalized PAHCO, combining data of 7134 individuals (age range: 15-97years; 61% female) from 18 different populations (prevention and rehabilitation sectors). We applied a stepwise multilevel analysis approach with disjunct sub-samples (n=48) to examine linear and quadratic associations between age and PAHCO. Indicators of movement competence (i.e., manageability of endurance, strength, and balance demands; task-specific self-efficacy) congruently showed negative associations with age (0.054≤ ≤0.211). However, parameters of control competence remained stable across the life span (-0.066≤β≤0.028). The three indicators of self-regulation competence revealed an inconsistent relationship with age, though uncovering positive associations for self-control (β=0.106) and emotional attitude toward PA (β=0.088). The associations of some indicators varied significantly across sub-samples. The results suggest differential analyses for associations between PAHCO and age. While the physically determined PAHCO indicators (movement competence) probably decline across the life span, the ability to ensure regularity of PA (self-regulation competence) or align PAs with an individual's health (control competence) appear to remain constant or improve with increasing age. The findings reinforce a de-stigmatizing approach for PA promotion practices with considerable space for aligning activities with health also in the elderly.

A study on the reliability and validity of the Japanese version of the Scenario Test for people with chronic stroke-induced aphasia: A cross-sectional study.

The Scenario Test is recognised for its effectiveness in assessing the interactive aspects of functional communication in people with post-stroke aphasia (PWA). To develop a Japanese version of the Scenario Test (Scenario Test-JP) and assess its reliability and validity. Among 66 participants, we selected 61 individuals: 34 PWA and 27 healthy controls (HCs). We modified the Scenario Test-JP based on the UK version and subsequently evaluated its reliability (internal consistency, test-retest and intra-rater and inter-rater reliabilities) and validity (convergent and discriminant) by comparing PWA and HCs. The Scenario Test-JP showed strong reliability with a Cronbach's α of 0.93, test-retest reliability with an intraclass correlation coefficient (ICC) of 0.97, intra-rater reliability with an ICC of 0.95-1.00, and inter-rater reliability with an ICC of 0.96. The validity of the test was confirmed with concurrent scores ranging from ρ = 0.37 to 0.76 (p < 0.05) and known-groups validity (p < 0.001, r = -0.56). The reliability and validity of the Scenario Test-JP align with those of the original Dutch version and the UK and Greek versions. Additionally, the assessment can now include extended alternative communication methods, such as digital devices, indicating the potential of the Scenario Test-JP for modern Japanese speech-language therapy. What is already known on the subject Interactive communication is a facet of functional communication and is crucial for evaluating engagement and participation of people with aphasia (PWA) in speech-language therapy. The Scenario Test provides valuable information for planning speech-language treatment strategies by assessing dialogic communication. What this study adds This study describes the development of the Scenario Test-JP for use with Japanese speakers and Japanese PWA, which is adapted from the Scenario Test UK version. This study evaluated the reliability and validity of this assessment tool and provided supporting evidence. What are the clinical implications of this work? The reliability and validity of the Scenario Test-JP were consistent with those of the Dutch, UK and Greek versions. The Scenario Test-JP contributes to speech-language therapy in Japan, where high-quality support for the activities and participation of PWA is required. Insights from the Scenario Test The Scenario Test plays a crucial role in evaluating the functional communication skills of people with post-stroke aphasia (PWA). Enhancing functional communication has been linked to improved social engagement among PWA, which in turn influences their overall quality of life (QOL). Issues addressed by the Scenario Test The Scenario Test aids in delineating rehabilitation objectives for activities and participation among PWA, particularly concerning functional communication. The test facilitates tailored support for PWAs' interactive communication and forms the foundation for appropriate speech-language therapy interventions. Transformation of speech-language therapy (SLT) in Japan through the introduction of the Scenario Test-JP The integration of the Scenario Test-JP could enhance the SLT services provided to PWA in Japan. With Japan experiencing an unprecedented ageing population, the prevalence of social isolation and diminished QOL resulting from communication disorders like stroke-induced aphasia is expected to rise. Consequently, the SLT rehabilitation sector in Japan is actively seeking effective interventions to support functional communication among PWA. Hence, the adoption of the Scenario Test-JP is anticipated to streamline the evaluation of functional communication, facilitating the judicious selection and timely provision of assistance to PWA in SLT, including guidance on communication partner support and communication skill training.

Enhancing the Diagnosis of Lateral Ankle Sprains: The Role of MSK Diagnostic Ultrasound in Evaluating ATFL and CFL.

Lateral ankle sprains, predominantly involving the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL), constitute a significant portion of sports-related injuries, with a notable rate of recurrence and progression to chronic instability. Precise diagnosis and effective treatment of the ATFL and CFL injuries are crucial in preventing long-term complications. Musculoskeletal (MSK) diagnostic ultrasound has emerged as a pivotal tool in the rehabilitation sector, particularly in assessing lateral ankle ligament injuries. This article will highlight its benefits over traditional diagnostic methods and the emerging role of MSK diagnostic ultrasound as a superior tool for accurate, cost-effective, and comprehensive assessment of these injuries. We discuss the technology's ability to provide objective, real-time imagery, facilitating accurate diagnosis, treatment planning, and injury monitoring emphasizing the need for a standardized approach to ultrasound evaluation to improve diagnostic accuracy and patient outcomes.

CHILD PROTECTION FROM THE PERSPECTIVE OF ISLAMIC LAW AND THE CONVENTION ON THE RIGHTS OF CHILDREN IN MEDAN CITY

&lt;p align="justify"&gt;In particular, handling children's problems is included in the social rehabilitation sector which is under the Social Rehabilitation Section for Children and the Elderly Outside of Homes and/or Institutions, although it is also related to other sections within the Medan City Social Service. The importance of this study is to carry out integration between the concept of human rights in the global context and human rights in Islam. It still needs to be reduced to an integrated child protection concept, so that it can be implemented in the form of policies in the local context, especially in the field of social welfare. To derive these two concepts, a systems approach is needed that can explain the position and role of the CRC and Islamic law in child protection and the role of the Medan City Government, especially within the Medan City Social Service, in implementing existing policies. This research uses a qualitative approach to describe and analyze how Islamic law and the Convention on the Rights of the Child (CRC) view child protection from their respective perspectives and will then be analyzed as a whole. The role of the Medan City Social Service relating to the field of child protection is carried out through the duties of the Social Rehabilitation Sector, in point (g) that "Guidance, development and control of social service efforts in the field of social rehabilitation services for street children, abandoned children, delinquent children and service provision for neglected elderly people and social rehabilitation of delinquent children.&lt;/p&gt;

A Comparative Analysis of Telerehabilitation and Telemedicine Utilization During the COVID-19 Pandemic in Poland: Trends, Patterns, and Implications.

The study aimed to examine the influence of COVID-19 on the adoption of teleservices in Poland, with a focus on contrasting patterns between rehabilitation and ambulatory care settings. We conducted a retrospective analysis of a national dataset to assess trends in telehealth use from 2020 to 2022. The use of teleservices peaked in April 2020 in both sectors. The share of the teleservices in the period of October 2020-December 2022 was much higher in the ambulatory (average 7,8%) than the rehabilitation sector (average 0,16%). Although, the analysis showed a moderate relationship between COVID-19 incidence and telehealth utilization (Spearman's rho from 0.39 and 0.52). Our findings demonstrate no statistically significant difference in Spearman's rho values between ambulatory care and rehabilitation, indicating a similar strength of response to the pandemic waves. Our findings underscore the importance of telehealth services in ensuring healthcare accessibility during times of crisis, emphasizing their role in facilitating continuity of care amidst pandemic-related disruptions. This study contributes to the understanding of telehealth utilization trends during the COVID-19 pandemic, offering insights into the adaptive responses of healthcare systems to unprecedented challenges. Further research is warranted to explore the long-term implications of telehealth use and to inform strategies for optimizing healthcare delivery in post-pandemic contexts.

Understanding the value of rehabilitation: Perspectives from South African Stakeholders.

The need for rehabilitation in South Africa has doubled between 1990 and 2017 and is expected to increase in the coming years. However, the rehabilitation needs of South Africans (and globally) remain largely unmet. Establishing a common understanding of the value of rehabilitation can inform clinical practice and policymaking to achieve Universal Health Coverage (UHC). This study aims to explore the value of rehabilitation services in South Africa's public healthcare sector by gathering perspectives from stakeholders. The goal is to inform policy decisions related to the implementation of National Health Insurance (NHI) in South Africa. The study used a phenomenological approach and interpretivist paradigm. Semi-structured interviews were conducted face-to-face, online, or telephonically with 12 stakeholders from various rehabilitation sectors. The value of rehabilitation was analysed and categorised into five main categories: context, service delivery, patient outcomes, economic and financial components, and collaboration within and between sectors. The value of rehabilitation was found to be multifaceted, because of the varying health, economic, and social challenges faced by many South Africans. The study identified components of value-based rehabilitation that should be prioritised in the proposed NHI of South Africa. Future research should explore all stakeholder perspectives, including patients, and provide empirical evidence of rehabilitation's economic and societal value. We highlight priority areas that are central to the value of rehabilitation in South Africa and other low- and middle-income countries (LMICs). Tailoring rehabilitation services to patient and community needs is crucial for achieving value-based care. Given South Africa's commitment to the United Nations Convention on the Rights of Persons with Disabilities, prioritising rehabilitation remains essential.

One the development of a professional mandate by social workers in medical rehabilitation- key results from the SWIMMER Project.

Social work in the German rehabilitation sector is practiced with great variation and its interventions lack research evidence. The SWIMMER project aims to develop a program theory of social work in rehabilitation to explain this variation and to discuss possible conditions. The dealing with ethical dilemmas by social workers is one possible influence and the focus of this paper. The social workers' practice was analyzed using the triple mandate, a German-Swiss concept that describes three possible, sometimes simultaneous directives without a concrete call to action from society, the client or the profession. This qualitative, case-comparative research project collected data from interviews with social workers and managers, participant observation and counseling sessions in ten German rehabilitation facilities. Social workers were confronted with all three mandates. They prioritized either the societal mandate or the client mandate. A consequence for social work practice was the limitation of options under social law (mandate by society). Social workers relied on their professional experience to reflect on the mandates. They used a variety of strategies when faced with conflicting mandates. The research project has succeeded in systematizing the orientations of social workers in goal conflicts. Further investigation on this topic on a broader basis would be beneficial.

INTERPERSONAL COMMUNICATION IN THE RECOVERY EFFORTS OF MENTALLY ILL STUDENTS AT THE BOARDING SCHOOL CONDROMOWO 2 NGAWI DISTRICT

The purpose of this article is to find out the form of interpersonal communication in the recovery efforts of mentally ill students at Condromowo 2 Islamic Boarding School and the supporting and inhibiting factors in the recovery process of mentally ill students. The method used in this article is descriptive qualitative method with data collection through interviews, observation, documentation, and literature research. The results of this analysis show that there are five forms of interpersonal communication in the recovery efforts of mentally ill students, namely dialogue, sharing, interviews, counseling, and spiritual therapy. In the process of dialoguing with students, there is one-way communication, two-way communication, the use of verbal language, and the use of non-verbal language. Sharing occurs when students already have trust in the rehabilitation sector administrators. The interview occurs when the santri are not clear about their problems, thus encouraging the administrators to ask deeper questions. Counseling is done by providing solutions to the problems experienced by students. As for spiritual therapy using alternative wirid, reciting the Koran, reading sholawat, and praying in congregation five times. The supporting factors contained in the interpersonal communication process between rehabilitation administrators and mentally ill students can be divided into three, namely supporting factors from the communicator's angle, supporting factors from the communicator's angle, and supporting factors from the message angle. The obstacles that occur during the recovery process of mentally ill students are process, semantic, and psychological obstacles.

‚Interlocking practice, science and teaching‘

The Willy Robert Pitzer Institute for Health Services Research and Rehabilitation was founded in 2022 with the establishment of the endowed professorship for Health Services Research and Rehabilitation at the Faculty of Health at the Technical University of Central Hesse (THM) in Giessen. The director of the institute is Prof Dr Susanne Hanefeld. In addition to filling the endowed professorship, she is also responsible for the Master‘s degree programme in Public Health, which focuses on the areas of healthcare research and rehabilitation. The founding father of the non-profit foundation is Willy Robert Pitzer, a pioneer in the German rehabilitation sector. The Willy Robert Pitzer Foundation, which is one of the largest foundations in the state of Hesse, has a strong scientific and medical focus.

Empowering pelvic floor rehabilitation: Unveiling technological innovations in the pelvic floor muscle chair; insights and hurdles in the pakistani context

Owing to the expeditious advancement of research and technology, the Physical therapy and rehabilitation sciences have made a remarkable pace in recent years. This blooming enhancement has metamorphosed pelvic floor dysfunction treatment and has a great impression on the medical and allied health sciences field. In this article, technological advancements in pelvic floor muscles are explored. It also overviews Pakistan- specific challenges and considerations[1]. Intending to help and manage patients with pelvic floor dysfunction, biofeedback training uses sensors to put forward real-time feedback on pelvic floor muscle activity. It has illustrated Potential enhancement in pelvic floor muscle functioning and curtailing symptoms of pelvic floor muscle dysfunction[2]. The pelvic floor muscles are stimulated using low-intensity electrical currents, resulting in solid muscle contraction, and strengthening. It is promising in improving pelvic floor muscle dysfunction and urine incontinence[3]. Behavioral therapy aims to modify the routines and behavior open to pelvic floor dysfunction. It necessitates lifestyle modifications, bladder retraining, and pelvic floor muscle exercises. It has victoriously improved pelvic floor muscle weakness and urinary incontinence as well[4]. Manual treatment methods that include physical manipulation of the pelvic floor muscles and associated tissues include trigger point release and myofascial release. These methods reduce muscular stress, enhance blood flow, and increase muscle function[5]. While developed nations have successfully incorporated modern technology into rehabilitation practices, the Pakistani context presents unique insights and challenges. The lack of updated curriculum, limited training opportunities, and budgetary constraints hinder the adoption of the latest technological advancements in pelvic floor rehabilitation in Pakistan. To overcome these hurdles, the following steps are recommended; Curriculum Update: Rehabilitation degree programs should revise their curricula to align with global advancements in technology. The inclusion of courses focusing on pelvic floor rehabilitation and modern technological interventions would better equip future professionals. Continuous Professional Development: Continuous professional development programs should be designed to upskill already graduated professionals in the field of pelvic floor rehabilitation technology. These programs will ensure that healthcare practitioners stay updated with the latest innovations and can effectively incorporate them into their practice. Increased Budget Allocation: Allocating a higher budget to the rehabilitation sector, specifically for technological advancements, is crucial. Adequate financial resources would enable the acquisition of state-of-the-art equipment, infrastructure development, and research initiatives, thereby facilitating the integration of technological innovations in pelvic floor rehabilitation. Finally, technological innovations have transformed the landscape of pelvic floor rehabilitation, offering new possibilities for improved outcomes. In the Pakistani context, addressing the insights and hurdles specific to the country is vital for empowering pelvic floor rehabilitation and ensuring that individuals with pelvic floor disorders receive the benefits of modern technology.

Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories.

In the primary and secondary medical health sector, patient reported outcome measures (PROMs) are widely used to assess a patient's disease-related functional health state. However, the World Health Organization (WHO), in its recently adopted resolution on "strengthening rehabilitation in all health systems", encourages that all health sectors, not only the rehabilitation sector, classify a patient's functioning and health state according to the International Classification of Functioning, Disability and Health (ICF). This research sought to optimize machine learning (ML) methods that fully and automatically link information collected from PROMs in persons with unspecific chronic low back pain (cLBP) to limitations in activities and restrictions in participation that are listed in the WHO core set categories for LBP. The study also aimed to identify the minimal set of PROMs necessary for linking without compromising performance. A total of 806 patients with cLBP completed a comprehensive set of validated PROMs and were interviewed by clinical psychologists who assessed patients' performance in activity limitations and restrictions in participation according to the ICF brief core set for low back pain (LBP). The information collected was then utilized to further develop random forest (RF) methods that classified the presence or absence of a problem within each of the activity participation ICF categories of the ICF core set for LBP. Further analyses identified those PROM items relevant to the linking process and validated the respective linking performance that utilized a minimal subset of items. Compared to a recently developed ML linking method, receiver operating characteristic curve (ROC-AUC) values for the novel RF methods showed overall improved performance, with AUC values ranging from 0.73 for the ICF category d850 to 0.81 for the ICF category d540. Variable importance measurements revealed that minimal subsets of either 24 or 15 important PROM variables (out of 80 items included in full set of PROMs) would show similar linking performance. Findings suggest that our optimized ML based methods more accurately predict the presence or absence of limitations and restrictions listed in ICF core categories for cLBP. In addition, this accurate performance would not suffer if the list of PROM items was reduced to a minimum of 15 out of 80 items assessed.

Community-Based Intervention: A Case Study of Pantoloan Boya Village Community Through the Rehabilitation Field Program of National Narcotics Agency, Palu City

Drug abuse is becoming more of a threat and garnering global attention, particularly in parts of Southeast Asia. The drug issue in Indonesia is urgent and multifaceted. In 2019, Central Sulawesi ranked fourth in Indonesia for the highest rate of drug abuse, with 3.30% of the population, or the equivalent of 61,857 drug users. According to research, Palu City has the highest rate of drug abuse in Central Sulawesi province. The purpose of this research was to find out how the Community-Based Intervention (CBI) Program is being implemented in the Rehabilitation Sector of BNN Kota Palu in Pantoloan Boya Village. The method used in this study was qualitative. This study used a purposive sample strategy to select 7 informants. The results showed that the mapping was carried out by RW (Hamlet)/RT (Neighbourhood)-based Recovery Agents (RA) with minimal Human Resources (HR) and clients who participated in limited interventions. Outreach is the delivery of information and approaches to the community, families, and drug users. This study's recommendations include mapping to expand HR capacity, in this case, RAs and clients, so that the program works more efficiently. Increase client compliance in group and individual meetings as part of outreach. Recovery services are being provided by pushing for the continuation of CBI's activities in Pantoloan Boya Village

“Otherwise … he will be a beggar”: a focus group study to understand the Perspectives of physiotherapists about measuring rehabilitation outcomes and impact in low-resource and conflict-affected settings

Purpose Rehabilitation outcomes are important for patients, professionals and policy makers. Most outcome measures (OMs) were developed for “Western” contexts and may be inadequate for low-resource and conflict settings, where the ability to demonstrate impact would be critical to strengthening the sector. This study aims to understand perspectives of physiotherapists from challenging environments regarding current practices, value, barriers, and facilitators of measuring rehabilitation outcomes. Materials & methods Focus group discussions were held in English with 35 physiotherapists from 18 countries. Audio recordings were transcribed verbatim, anonymised, and analysed using reflexive thematic analysis. Results Four themes emerged illustrating the levels at which outcomes and measures were discussed: User (patients, families), provider (physiotherapists, rehabilitation workers), application (OMs), and structure (management, health system). Participants discussed diversity in current practices and patient populations, utility of OMs and a neglected rehabilitation sector lacking investment. Barriers to progressing outcome measurement included lacking patient health literacy, rehabilitation provider training, valid OMs, and leadership. Participants suggested improved patient involvement, routine outcome measurement by using, developing, or adapting simple, context- and stakeholder-relevant OMs, and support from management. Conclusions These insights illustrate the need of and provide robust recommendations for context-adapted development of rehabilitation outcome measurement in various challenging contexts.

Technologies in home-based Digital Rehabilitation: A scoping review.

Due to growing pressure on the healthcare system, a shift in rehabilitation to the home setting is essential. However, efficient support in home-based rehabilitation is still lacking. The COVID-19 pandemic has further exacerbated these challenges, and affected individuals and healthcare professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet the clients' needs and ease the growing pressure on the healthcare system it is necessary to give an overview of existing, relevant and future solutions shaping the constantly evolving market of technologies for home-based DR. This scoping review identifies digital technologies for home-based DR, predicts new/emerging DR trends and reports the influences of the COVID-19 pandemic on Digital Rehabilitation. The scoping review followed the framework of Arksey and O'Malley with the improvements of Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Cochrane library. The search spanned from January 2015 to January 2022. A bibliometric analysis was performed to give an overview of the included references and a co-occurrence analysis identified the technologies for home-based DR. A full-text-analysis of all included reviews filtered the trends for home-based DR. A grey literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic regarding the development of DR. 2.437 records were included in the bibliometric analysis, 95 for full-text-analysis and 40 as a result of the grey literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital/mobile applications are already used in home-based DR, but AI/machine learning, exoskeletons, and digital/mobile applications represent new/emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches, but has not led to the development of new technologies. Multiple tools are available and implemented for home-based DR, but some technologies face limitations in the application of home-based rehabilitation. However, AI and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the healthcare system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions even regardless of exceptional situations such as the COVID-19 pandemic.

Patient motivation, satisfaction and attitudes towards involvement in inter-professional collaborative practice: A cross-sectional study

During hospital-based long-term rehabilitation programmes, particularly for patients with spinal cord injuries, healthcare providers must make sure those patients are motivated, satisfied, and have positive views towards inter-professional collaboration among the team members. If they do this, patients will have a higher chance of sticking to their treatment plan, completing prescribed drugs, and getting better health results will have a higher chance of adhering to their treatment plan, taking the therapy recommended, and getting better health results if they comply with this. In a developing nation like Bangladesh, there is still much to learn about how patients feel about their care, what motivates them, and how they see the team that works with them. The purpose of the study was to investigate the level of motivation, attitudes, and satisfaction of people with spinal cord injury towards interprofessional collaborative practice. Quantitative research was applied to achieve the objectives. The overall motivation and satisfaction level of the patient with SCI towards interdisciplinary teamwork was high, 83.35% and 84.2%. Similarly, the patient attitude toward the team was just above average. The study findings could improve the rehabilitation sector's collaboration level by addressing strengths and weaknesses.

The Experience of Involved Individuals From the Implementing Challenges of Community-Based Rehabilitation in Iran: A Qualitative Study

Objectives: One of the prominent vital needs for implementing a community-based rehabilitation (CBR) program is correct perception and we know that CBR is linked to several challenges. The current study was performed to identify the challenges of implementing a CBR program in Iran based on the perceptions of the stakeholders. Methods: This study was qualitative conventional content analysis. In total, 25 participants who were staff of the Welfare Organization at different levels, managers, and experts working in the CBR project and non-governmental organizations (NGOs) were selected according to purposive sampling. Data gathering was performed by semi-structured and in-depth interviews and continued until saturation. The interviews were performed in 2020. To test the trustworthiness of data, the Guba and Lincoln criteria (credibility, dependability, confirmability, and transferability) and MAXQDA were used for data analysis. Results: The challenges of implementing a CBR program were identified. Eight novel categories and 39 subcategories were generated as follows: neglecting the local conditions and role of provinces, poor policymaking, and planning, deviation from the main goals, lack of a comprehensive evaluation system, inefficient resource management, weakness in facilitation, ineffective communication, and the inefficiency of NGOs). Discussion: Policymakers, service providers, and managers must understand the challenges of implementing a CBR program. Also, they are expected to address to this issue. This paper showed evidence for all stakeholders. Paying attention to these challenges can lead to the program’s tremendous success and ultimately, improved service provision and quality of life for people with disabilities and their families. The results support the need for policymakers and managers in the rehabilitation sector to change their vision and address the CBR as an essential part of the rehabilitation system. Also, the collected data could help to reinforce the CBR services.