Rehabilitation Services For People Research Articles

Cognitive Impairments in Parkinson’s Disease: Professional Support and Unmet Rehabilitation Needs in Patients with and without Self-Reported Cognitive Impairments—A Secondary Analysis

Parkinson’s disease (PD) is the second most common age-related neurodegenerative disease after Alzheimer’s disease. Cognitive impairments are frequent non-motor symptoms in PD and have a significant impact on everyday life and well-being. Still, rehabilitation services for people with PD predominantly target motor symptoms. Drawing on data from a national Danish survey, this study aimed to determine significant differences among people living with PD with or without perceived cognitive impairments regarding (1) contact with different healthcare professionals, and (2) unmet needs for rehabilitation services. Data were analyzed based on whether the person with PD perceived cognitive impairments or not. Statistically significant differences between results for PD patients with and without cognitive impairments were calculated. Data on 6711 individuals with PD were included in the study. Respondents’ mean age was 73.5 years, and 31% of them were experiencing cognitive impairments. Significantly more people with PD and cognitive impairments were in contact with almost all professionals compared to those without cognitive impairments. However, individuals experiencing cognitive impairments were less often in contact with the professions most experienced in cognitive rehabilitation.

Asian Americans’ Perceived Knowledge of State Vocational Rehabilitation Services for People With Mental Illness

Given the significant role of employment on independent living and well-being among individuals with disabilities, such as those with mental illness, it is important to examine the experiences of racially and ethnically diverse cultural groups, including Asian Americans. However, little research has focused on Asian Americans with disabilities in the rehabilitation counseling field. This study examined knowledge of state vocational rehabilitation (VR) services and the perceived importance and likeliness of receiving VR services in a sample of 315 Asian Americans. Survey questions were developed to ask participants’ perceived importance of receiving various VR services provided within state VR agencies and the likeliness of receiving or recommending each service if they or their family members had a mental illness. The results showed that most participants were not familiar with state VR services. Although slightly different patterns were identified in the participants’ importance and likeliness ratings, the top important and preferable service was diagnosis and treatment. The information gathered in this study has important implications for crafting culturally sensitive and effective outreach and marketing strategies in Asian American communities.

Assessing Human Motion During Exercise Using Machine Learning: A Literature Review

The World Health Organization promotes healthy living through regular physical activities, such as exercise and sports, as well as access to healthcare and rehabilitation services for people with motor dysfunctions. However, there is a lack of specialized personnel and increased costs associated with such activities. These have led to the increased use of machine learning for the analysis and evaluation of human motion during exercise. To study the latest advancements in this area, a systematic literature review focusing on publications from 2017 to 2021 was performed. As a result, 88 relevant publications were identified, which developed both shallow machine learning and deep learning algorithms. The results indicated that algorithms for human motion assessment should provide personalized and informative assessments, with explainable and interpretable outcomes, that can be computed in real-time or concurrently with the execution of an exercise. Furthermore, they should be easy to adapt based on the needs of applications and should be able to perform with different motion capture systems. This has been challenging because of the usually small amount of collected data, the lack of large open datasets, and the unique characteristics of exercise motions. Based on the above findings, guidelines for the development of such algorithms are proposed and discussed. They relate to the selection of the type of assessment, handling data imbalances, selecting of motion capture technologies, balancing between accuracy and speed, selecting the right algorithm, performing concurrent assessment during an exercise, personalization and scalability, and evaluation.

A quality indicator set for rehabilitation services for people with rheumatic and musculoskeletal diseases demonstrates adequate responsiveness in a pre\u2013post evaluation

BackgroundQuality of care is gaining increasing attention in research, clinical practice, and health care planning. Methods for quality assessment and monitoring, such as quality indicators (QIs), are needed to ensure health services in line with norms and recommendations. The aim of this study was to assess the responsiveness of a newly developed QI set for rehabiliation for people with rheumatic and musculoskeletal diseases (RMDs).MethodsWe used two yes/no questionnaires to measure quality from both the provider and patient perspectives, scored in a range of 0–100% (best score, 100%). We collected QI data from a multicenter stepped-wedge cluster-randomized controlled trial (the BRIDGE trial) that compared traditional rehabilitation with a new BRIDGE program designed to improve quality and continuity in rehabilitation. Assessment of the responsiveness was performed as a pre–post evaluation: Providers at rehabilitation centers in Norway completed the center-reported QIs (n = 19 structure indicators) before (T1) and 6–8 weeks after (T2) adding the BRIDGE intervention. The patient-reported QIs comprised 14 process and outcomes indicators, measuring quality in health services from the patient perspective. Pre-intervention patient-reported data were collected from patients participating in the traditional program (T1), and post-intervention data were collected from patients participating in the BRIDGE program (T2). The patient groups were comparable. We used a construct approach, with a priori hypotheses regarding the expected direction and magnitude of PR changes between T1 and T2. For acceptable responsivess, at least 75% of the hypotheses needed to be confirmed.ResultsAll eight participating centers and 82% of the patients (293/357) completed the QI questionnaires. Responsiveness was acceptable, with 44 of 53 hypotheses (83%) confirmed for single indicators and 3 of 4 hypotheses (75%) confirmed for the sum scores.ConclusionWe found this QI set for rehabilitation to be responsive when applied in rehabilitation services for adults with various RMD conditions. We recommend this QI set as a timely method for establishing quality-of-rehabilitation benchmarks, promoting important progress toward high-quality rehabilitation, and tracking trends over time.Trial registrationThe study is part of the larger BRIDGE trial, registered at ClinicalTrials.gov (Identifier: NCT03102814).

Study on legal foundation of vocational rehabilitation services for people with disabilities: Focused on Act on Welfare of Persons with Disabilities

Study on legal foundation of vocational rehabilitation services for people with disabilities: Focused on Act on Welfare of Persons with Disabilities

COVID-19 Modifications for Remote Teleassessment and Teletraining of a Complementary Alternative Medicine Intervention for People With Multiple Sclerosis: Protocol for a Randomized Controlled Trial.

BackgroundAccess to comprehensive exercise and rehabilitation services for people with multiple sclerosis (MS) remains a major challenge, especially in rural, low-income areas. Hence, the Tele-Exercise and Multiple Sclerosis (TEAMS) study aims to provide patient-centered, coordinated care by implementing a 12-week complementary and alternative medicine (CAM) intervention for adults with MS. However, due to the societal impact of coronavirus disease (COVID-19) in mid-March 2020, the University of Alabama at Birmingham announced a limited business model halting all nonessential research requiring on-site visits, which includes the TEAMS study.ObjectiveIn compliance with the shelter-in-place policy and quarantine guidance, a modified testing and training protocol was developed to allow participants to continue the study.MethodsThe modified protocol, which replaces on-site data collection and training procedures, includes a teleassessment package (computer tablet, blood pressure cuff, hand dynamometer, mini disc cone, measuring tape, an 8” step, and a large-print 8” × 11” paper with ruler metrics and wall-safe tape) and a virtual meeting platform for synchronous interactive training between the therapist and the participant. The teleassessment measures include resting blood pressure and heart rate, grip strength, Five Times Sit to Stand, Timed Up & Go, and the Berg Balance Scale. The teletraining component includes 20 sessions of synchronous training sessions of dual tasking, yoga, and Pilates exercises designed and customized for a range of functional levels. Teletraining lasts 12 weeks and participants are instructed to continue exercising for a posttraining period of 9 months.ResultsThe protocol modifications were supported with supplemental funding (from the Patient-Centered Outcomes Research Institute) and approved by the University Institutional Review Board for Human Use. At the time nonessential research visits were halted by the university, there were 759 people enrolled and baseline tested, accounting for 92.5% of our baseline testing completion target (N=820). Specifically, 325 participants completed the 12-week intervention and follow-up testing visits, and 289 participants needed to complete either the intervention or follow-up assessments. A modified analysis plan will include sensitivity analyses to ensure the robustness of the study results in the presence of uncertainty and protocol deviations. Study results are projected to be published in 2021.ConclusionsThis modified remote teleassessment/teletraining protocol will impact a large number of participants with MS who would otherwise have been discontinued from the study.Trial RegistrationClinicalTrials.gov NCT03117881; https://clinicaltrials.gov/ct2/show/NCT03117881International Registered Report Identifier (IRRID)DERR1-10.2196/18415

Are people in residential care entitled to receive rehabilitation services following hip fracture? Views of the public from a citizens\u2019 jury

BackgroundAccess to rehabilitation services for people living in residential care facilities is frequently limited. A randomised trial of a hospital outreach hip fracture rehabilitation program in residential care facilities has demonstrated improvements in mobility at four weeks and quality of life at 12 months but was not considered cost-effective by standard health economic metrics. The current study aimed to explore the general public’s views on issues involved in the allocation of rehabilitation resources for residents of care facilities.MethodsA citizens’ jury comprising 13 purposively sampled members of the general public, representative of the South Australian age, gender and household income profile. The jury considered the questions “Should there be an investment of physical rehabilitation services in residential care for older people following a hip fracture? If so, what is the best way of providing this service (considering funding, models of service delivery and equity)?” Deliberations were in the context of a state-wide health reform program. The jury was conducted over two days with an experienced independent facilitator, addressing questions developed by a steering group of research academics and clinicians.ResultsThe mean age of the citizens’ jury members was 43 (range 26 to 61). Eleven members voted for investment in outreach hospital rehabilitation services in residential aged care. All jurors agreed a number of strategies in addition to investment should be implemented, including health care planning and decision making, increased emphasis on hip fracture prevention, training of aged care staff in rehabilitation and routine provision of hospital discharge summaries to families. The jury further advocated for an increased focus on rehabilitation in residential care, potentially through accreditation criteria, increasing health literacy of residents and families, implementation of age friendly environment strategies and improving connections of care facilities with community, hospital and tertiary services.ConclusionsThis citizens’ jury representative of the general public recommends that regardless of dementia and frailty, people who live in residential care and are walking and fracture their hips should have access to hospital outreach rehabilitation and recovery services.

Experiences accessing and using rehabilitation services for people with physical disabilities in Sierra Leone

Purpose To explore the experiences of persons with physical disabilities accessing and using rehabilitation services in Sierra Leone. Materials and methods Interviews of 38 individuals with differing physical disabilities in three locations across Sierra Leone. An inductive approach was applied, and qualitative content analysis used. Results Participants faced several barriers to accessing and using rehabilitation services. Six themes emerged: The initial and ongoing need for rehabilitation throughout life; challenges with the cost of rehabilitation and transportation to reach rehabilitation services; varied experiences with rehabilitation staff; coming to terms with disability and encountering stigma; the struggles without and opportunities with rehabilitation services; and limited knowledge and availability of rehabilitation services. Conclusions There is a continued need to address the barriers associated with the affordability of rehabilitation through the financing of rehabilitation and transportation and exploring low-cost care delivery models. Rehabilitation services, assistive devices, and materials need to be available in existing rehabilitation centres. A national priority list is recommended to improve the availability and coordination of rehabilitation services. Improved knowledge about disability and rehabilitation services in the wider community is needed. Addressing discriminatory health beliefs and the stigma affecting people with disabilities through community interventions and health promotion is recommended. Implications for Rehabilitation Financing for rehabilitation, transportation to services and low-cost delivery models of care areneeded to reduce financial barriers and increase affordability of access and use. Community interventions and health promotion can provide information about the utility and availability of rehabilitation services, while addressing health beliefs and stigma towards persons with disabilities. The availability of both rehabilitation services and information, that is relevant and accessible is required to facilitate improved access and use of rehabilitation services.

A Vocational Rehabilitation Intervention Framework for People With Rheumatoid Arthritis

This article presents the Illinois Work and Well-Being Model (IW2M) as a framework that can be applied to facilitate vocational rehabilitation interventions for people with rheumatoid arthritis (RA). The model encompasses the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A discussion of the model's implications regarding vocational rehabilitation service and research is offered, with the overall goal of reinforcing career development as the foundation of vocational rehabilitation services for people with RA and other emerging age-related disabling conditions.

Designing a Client and Family Empowerment Model to Promote Constructive Life Recovery Among Persons with Spinal Cord Injury: A Qualitative Study

Background: Spinal cord injury (SCI) causes financial, social, and psycho-emotional problems for both the person afflicted with SCI and the family. Family as an important source of care plays an important role in patients’ rehabilitation and complication reduction. Objectives: The present study aimed at designing a client and family empowerment model for SCI patients. Methods: This was a qualitative study with the grounded theory approach conducted in 2017. Unstructured interviews were used as the main method of data collection. Saturation was achieved with 43 participants, including people with SCI, family caregivers, and people involved in providing health care and rehabilitation services for people with SCI. Data analysis was performed on the basis of continuous comparative analysis of Strauss and Corbin (1998). In the second stage, the findings of the grounded theory study were used for designing the prescriptive model based on Walker and Avant (2005) three-step method. Results: The main concern of people with SCI and their families was the loss of physical ability, financial and physical independence, and lack of constructive life. Ultimately, a “client and family empowerment model to promote constructive life recovery for individuals with SCI” was developed based on the findings of the grounded theory study. This model includes four main concepts: correction of environment, educational empowerment of the clients and families, modification of the method of providing rehabilitation services, and recovery of a constructive life. Conclusions: There were several barriers to the client and family empowerment of people with SCI. In this study, a client and family empowerment model was developed to promote constructive life recovery and strategies were identified to remove the barriers. Hence, this model can help people with SCI to return their effective lives.

Characteristics and outcomes of patients with intellectual disability admitted to a specialist inpatient rehabilitation service.

Rehabilitation services for people with mental illnesses have been extensively researched. However, services with similar aims and specifications for patients with intellectual disabilities (IDs) have had little focus. This study describes the characteristics and outcomes of 21 patients admitted to a specialist ID rehabilitation service over an 8-year time frame. Rather that solely accepting 'step-down' referrals, some patients were referred from community settings. During the study, 20 patients were discharged, 80% to lower levels of service restriction, while 14.3% to higher levels. The study suggested that rehabilitation services have an important role within the wider service model for people with ID. Within the service studied, patients were referred from both higher and lower levels of restriction, suggesting the rehabilitation service 'bridged the gap' between inpatient and community settings, supporting the aim of caring for patients in the least restrictive setting for their needs.

Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services

BackgroundIn low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community.MethodsA qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability.ResultsOne hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors – including the Western healthcare, religious, and traditional sectors.ConclusionsUnderstanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.

A prospective cohort study of community functioning among psychiatric outpatients

The present study analyzed the community functioning among Chinese people with common mental disorders and their relationships with different factors under the framework of Model of Human Occupation. The research team followed up a stratified random sample of 238 patients in three public psychiatric specialist outpatient clinics in Hong Kong in one year. The patients completed assessments at baseline and 12-month follow-up in four areas of community functioning (i.e., self-care, independent living skills, social skills, and work skills), self-esteem, self-efficacy, physical functioning, behavioral regulation, mental states, family expressed emotion, and perceived social stigma. The data showed that after 12 months, the patients had positive changes in self-care, work skills, and behavioral regulation. Those patients who had higher levels of self-esteem at baseline and reduced their negative reactions to stigma were more likely to improve social skills, while those patients who perceived less discrimination at baseline and enhanced their self-esteem would have a higher likelihood of making improvement in work skills. The findings implied that the rehabilitation services for people with common mental disorders might target on the enhancement of self-esteem and reduction of discrimination experience to facilitate their improvement in social skills and work skills.

Benefits and challenges of role-emerging placements of student occupational therapists in HIV service organisations

Background and aims: Recognising the importance of occupational therapy for people with Human Immunodeficiency Virus (HIV) has led to the possibility of promoting and integrating services in HIV service organisations through role-emerging placements for student occupational therapists. The objective of this study was to investigate the benefits and challenges of role-emerging placements of student occupational therapists in HIV service organisations. Methods: This study employed qualitative methods to understand the perspectives of student occupational therapists, HIV service organisation staff, an occupational therapy preceptor, and people with HIV following 8-week role-emerging placements of student occupational therapists in HIV service organisations. Transcribed interviews were analysed using content analysis to identify themes. Findings: Results highlighted the following benefits: 1) Reinforcing professional skills; 2) Developing competency in providing rehabilitation services for people with HIV; 3) Shining a light on the role of occupational therapy; and 4) Empowering HIV service organisations. Challenges included: 1) Starting the groundwork; and 2) Building relationships. Conclusion: The placements of student occupational therapists in HIV service organisations can foster the integration of occupational therapy services in these organisations to maintain the optimum community responses. Findings also demonstrated the value that role-emerging placements have in increasing the competencies of the student occupational therapists as future rehabilitation professionals.

Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia

Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

Understanding illness perception as a barrier to cardiac rehabilitation uptake

This is an exploration of some of the evidence that supports the notion that negative illness perceptions are a barrier to accessing cardiac rehabilitation services for people with heart disease. The evidence that exists and potential strategies to improve the issue will be explored. It is hoped that ideas for future service development can be recommended. Cardiac rehabilitation is a cost-effective service that offers people with heart disease a structured programme of care. Given the evidence that shows the effectiveness of cardiac rehabilitation, health professionals need to be aware of the barriers that exist so that services can be improved for patients, ensuring that they are tailor made, menu-based and patient driven.

Unmet health and rehabilitation needs of people with long-term neurological conditions in Queensland, Australia.

The survival and life expectancy rates of people with traumatic and degenerative neurological conditions are increasing, sometimes up to several decades. Yet compared to the general population, people with a disability continue to experience poorer health and are at greater risk of developing secondary health problems and facing barriers to services they require. These trends have significant implications for provision of health and rehabilitation services. In this study, the adequacy of health and rehabilitation services provided to people with long-term neurological conditions and their unmet needs were explored from the perspectives of individual users, their nominated family members and key service providers. A qualitative research design with maximum variation sampling was used. Data were collected from semi-structured interviews with 65 participants comprising 25 long-term care service users, nominated family members or friends (n = 22) and care service providers (n = 18) in Queensland, Australia. All service users needed assistance with usual daily activities, and 22 were wheelchair dependent. The hours of funded personal care ranged from 2 to 201 hours per week. Data were analysed using framework analysis. Participants generally perceived that specialist medical and hospital services were adequate and satisfactory. They valued supportive health and rehabilitation professionals and receiving client-centred physical rehabilitation. However, the majority of participants (n = 17) had perceived unmet needs for physical rehabilitation (n = 14), other health or rehabilitation services (n = 10) or counselling (n = 6). Community-based physical maintenance rehabilitation was often perceived as inadequate, costly or inconveniently located. Participants highlighted the importance of personal and family counselling and information provision at time points such as diagnosis. The findings contribute to the limited international evidence on the gaps in health and rehabilitation services for people with neurological conditions receiving lifetime care services in the community. A continuum of integrated rehabilitation services to minimise avoidable impairments, optimise independence and functioning, and sustain quality of life is warranted.

Long-term mental health care for people with severe mental disorders – the importance of workplace rehabilitation

SummaryWork and meaningful activity have historically played a key role in rehabilitation services for people with severe mental health problems and continues to do so today. People with long-term and severe mental disorders have low rates of employment. In the last 30 years the increasing emphasis on raising the sights of mental health services to focus on personal recovery and the importance given to social justice and to combating social exclusion has led to a focus on gaining open employment. Individual Placement and Support (IPS) has emerged as an important and evidence-based scheme for getting people with severe mental health problems into open employment. Despite the strong and consistent evidence for the effectiveness of IPS, these schemes are not widely implemented. This paper summarises the background to, and research on, IPS and possible barriers to its wider implementation.

NEĮGALIŲJŲ PROFESINIS ORIENTAVIMAS KAIP PROFESINĖS REABILITACIJOS PASLAUGA

docentė socialinių mokslų (psichologija) daktarėVilniaus universiteto Klinikinės ir organizacinės psichologijos katedraUniversiteto g. 9/1, LT-01513 VilniusTel. (8-5) 266 7605El. paštas: ruta.sargautyte@fsf.vu.ltValakupių reabilitacijos centrasVyr. psichologėVaidilutės g. 69, LT-10100 VilniusTel. (8-5) 247 7545El. paštas: daiva.juozapaviciene@reabilitacija.ltValakupių reabilitacijos centrasDirektorėVaidilutės g. 69, LT-10100 VilniusTel. (8-5) 247 7544El. paštas: edita.satiene@reabilitacija.ltVykdant neįgaliųjų socialinės integracijos politiką, 2005 m. Lietuvoje pradėta teikti kompleksinė profesinės reabilitacijos paslauga, apimanti neįgaliųjų profesinį orientavimą. Paslaugų kokybei užtikrinti Valakupių reabilitacijos centras, turintis metodinio centro statusą, rengia ir diegia profesinio orientavimo ir konsultavimo metodiką, skirtingą turintiems negalią asmenims. Straipsnyje pateikiamas Valakupių reabilitacijos centre sukurtos ir išbandytos profesinio orientavimo paslaugos turinys ir metodika, taip pat 109 profesinės reabilitacijos programoje dalyvavusių klientų profesinio orientavimo efektyvumo analizė.

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?