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1.
Adv Exp Med Biol ; 1251: 29-38, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31933146

RESUMO

A mutual link between somatic and visceral neural pathways is known in medicine. This study addresses therapeutic effectiveness of an integrated rehabilitative approach of thermal aquatic environment, combined with neuromuscular manual stimulation, on activation of afferent sensory visceral and somatic efferent neuronal motor pathways in different pathologies of neuromuscular motor and respiratory systems. The study included 63 patients subjected to a protocol consisting of hydroponic treatment, hydrokinesitherapy associated with ozonized vascular pathway, and mud therapy associated with cardiorespiratory treatment performed in aquatic environment and aided by neuromuscular manual therapy. The therapeutic protocol consisted of rehabilitation sessions 5 days a week for 2 months. The outcome measures were spirometry tests and the following evaluation instruments: Tinetti Gait and Balance assessment scale, Functional Independence Measurement, visual analogue scale, and the EQ-5D-5 L instrument. The tests were applied before and after the protocol completion. The findings demonstrate a general increase in patients' everyday living autonomy and quality of life, with a particular improvement in respiratory function tests. We conclude that the integrated thermal approach holds promise in therapeutic rehabilitation of disabilities.


Assuntos
Pessoas com Deficiência/reabilitação , Modalidades de Fisioterapia , Feminino , Marcha , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Testes de Função Respiratória , Resultado do Tratamento , Escala Visual Analógica
3.
Codas ; 32(2): e20190046, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31851217

RESUMO

PURPOSE: Describe the implementation process of the International Classification of Functioning, Disability and Health (ICF) in a Specialized Rehabilitation Center based on the biopsychosocial approach to health. METHODS: This is a descriptive, analytical, longitudinal study. The ICF implementation process in the healthcare center encompassed four stages: a) training on the use of the ICF; b) preparation of checklists by the team; c) collection of relevant data based on the checklist from the healthcare center users; and d) construction of a database. RESULTS: A checklist was constructed for each sector involved, and the database included user information and the ICF results during evaluation and reevaluation. The findings indicate higher problem-solving capacity in all sectors throughout the study period, and that training was crucial to operationalize the ICF. Preparation of the instruments based on the reality of the healthcare center was essential to meet local demands and those of each sector. CONCLUSION: The ICF enabled greater practice of the biopsychosocial approach based on the engagement of the professionals in its operationalization, with evidence of healthcare problem-solving capacity and visibility and organization of the work process.


Assuntos
Pessoas com Deficiência , Classificação Internacional de Funcionalidade, Incapacidade e Saúde/instrumentação , Fortalecimento Institucional , Lista de Checagem , Assistência à Saúde , Avaliação da Deficiência , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Estudos Longitudinais , Masculino , Centros de Reabilitação
5.
BMC Public Health ; 19(1): 1742, 2019 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-31881994

RESUMO

BACKGROUND: Worldwide, fifteen percent (15%) of the world's population or one (1) billion people live with some form of disability. In Uganda, 12.4% of the Uganda's population lives with some form of disability and Kawempe division accounts for (22.6%) of all persons with disabilities living in Kampala district. Rehabilitation services are provided within Kawempe division at Mulago hospital physiotherapy department and Katalemwa rehabilitation center in Kampala district, Uganda at a free and a subsidized cost to help to improve the function, independence, and quality of life of persons with physical disabilities. However, many people with physical disabilities do not utilize the services and the reasons are not clear. METHODS: The study design was a descriptive cross-sectional study employing quantitative methods of data collection. A total of 318 participants were included in the study. Simple random sampling was used to select the study participants. Ethical issues were maintained at all levels during data collection and dissemination of results. RESULTS: The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Kampala, Uganda. Factors that were significantly associated with utilization of rehabilitation services among people with physical disabilities at multivariable logistic regression analysis included; age (AOR: 0.30; 95% CI: 0.12-0.74), socioeconomic status (AOR: 2.13; 95% CI: 1.03-4.41), education level (AOR: 4.3; 95% CI: 1.34-13.91) and awareness of the participants about the rehabilitation services (AOR: 5.1; 95% CI: 2.74-9.54) at p value ≤0.05. CONCLUSION: The study revealed a prevalence of 26.4% of the utilization rehabilitation services among people with physical disabilities in Kawempe division, Uganda. Factors that were significantly associated with utilization of rehabilitation services included; age, socioeconomic status, education level and awareness of the participants about the services. Therefore, the government and other relevant stake holders should increase sensitization and awareness of rehabilitation services, their benefits and facilities providing such services to people with physical disabilities, healthcare professionals and the general public.


Assuntos
Pessoas com Deficiência/reabilitação , Pessoas com Deficiência/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Centros de Reabilitação/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores Socioeconômicos , Uganda/epidemiologia , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-31683536

RESUMO

Mobile health and mobile rehabilitation (mHealth and mRehab) services and technologies have attracted considerable interest from healthcare providers, technology vendors, rehabilitation engineers, investors and policy makers in recent years. Successful adoption and use of mHealth/mRehab requires clinician support and engagement, including the ability to identify appropriate use cases and possible barriers to use for themselves and their patients, and acquire adequate knowledge and confidence using mHealth/mRehab interventions. This article reports results from a survey of rehabilitation clinicians in the United States on their attitudes, experience, expectations and concerns regarding mHealth/mRehab interventions and technologies. Over 500 clinicians in physical, occupational, speech, recreation and psychological therapy professions, among others, participated in the survey. Respondents reported that an overwhelming majority of their patients need additional therapy after discharge from inpatient environments, and over half of outpatients need additional therapy between visits. A large majority reported prescribing specific exercises and interventions for patients to work on outside of the clinic. However, only 51% reported being comfortable integrating mRehab technology into their practice; and only 23% feel knowledgeable about rehabilitation technology currently available. Technologies to support mRehab are maturing rapidly. Clinicians recognize the need for mRehab, but their knowledge and confidence prescribing mRehab represents a significant barrier to adoption.


Assuntos
Pessoas com Deficiência/psicologia , Pessoas com Deficiência/reabilitação , Conhecimentos, Atitudes e Prática em Saúde , Equipamentos de Autoajuda , Telemedicina , Instituições de Assistência Ambulatorial , Humanos , Inquéritos e Questionários , Estados Unidos
7.
BMC Public Health ; 19(1): 1502, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711455

RESUMO

BACKGROUND: Musculoskeletal impairments (MSI) are a major global contributor to disability. Evidence suggests entrenched cyclical links between disability and poverty, although few data are available on the link of poverty with MSI specifically. More data are needed on the association of MSI with functioning, socio-economic status and quality of life, particularly in resource-poor settings where MSI is common. METHODS: We undertook a case-control study of the association between MSI and poverty, time use and quality of life in post-conflict Myanmar. Cases were recruited from two physical rehabilitation service-centres, prior to the receipt of any services. One age- (+/- 5 years of case's age) and sex- matched control was recruited per case, from their home community. 108 cases and 104 controls were recruited between July - December 2015. Cases and controls underwent in-depth structured interviews and functional performance tests at multiple time points over a twelve-month period. The baseline characteristics of cases and controls are reported in this manuscript, using multivariate logistic regression analysis and various tests of association. RESULTS: 89% of cases were male, 93% were lower limb amputees, and the vast majority had acquired MSI in adulthood. 69% were not working compared with 6% of controls (Odds Ratio 27.4, 95% Confidence Interval 10.6-70.7). Overall income, expenditure and assets were similar between cases and controls, with three-quarters of both living below the international LMIC poverty line. However, cases' health expenditure was significantly higher than controls' and associated with catastrophic health expenditure and an income gap for one fifth and two thirds of cases respectively. Quality of life scores were lower for cases than controls overall and in each sub-category of quality of life, and cases were far less likely to have participated in productive work the previous day than controls. CONCLUSION: Adults with MSI in Myanmar who are not in receipt of rehabilitative services may be at increased risk of poverty and lower quality of life in relation to increased health needs and limited opportunities to participate in productive work. This study highlights the need for more comprehensive and appropriate support to persons with physical impairments in Myanmar.


Assuntos
Pessoas com Deficiência/reabilitação , Doenças Musculoesqueléticas/reabilitação , Qualidade de Vida , Ferimentos e Lesões/epidemiologia , Adulto , Estudos de Casos e Controles , Status Econômico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Mianmar , Razão de Chances , Modalidades de Fisioterapia/estatística & dados numéricos , Classe Social , Ferimentos e Lesões/reabilitação
8.
J Rehabil Med ; 51(11): 828-833, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31663597

RESUMO

The harmonization of staff education is a key element for ensuring the highest standard of rehabilitation care across Europe. With this aim, the European Union of Medical Specialists (UEMS) has created a Common Training Framework, which consists of a common set of knowledge, skills and competencies for postgraduate medical training. As a body linked to the Physical and Rehabilitation (PRM) Section of the UEMS, the European PRM Board is committed to promoting the harmonization of PRM physicians qualifications. The European PRM Board accomplishes this mission, not only by determining the theoretical knowledge necessary for the practice of the PRM specialty, and the core competencies (training outcomes) to be achieved at the end of training, but also by ascertaining that a standard level of education is achieved and maintained by PRM physicians, through a medically driven system of certification. This paper provides an overview of the methodology and outcomes of the European PRM Board examination, while showing how the approach to PRM education should be considered as a reference point by scientific societies, higher education institutions, health policymakers, patients associations, and all the other bodies caring for high-quality rehabilitation provision to disabled people, at the national and European level.


Assuntos
Competência Clínica/normas , Pessoas com Deficiência/reabilitação , Medicina Física e Reabilitação/educação , Medicina Física e Reabilitação/normas , União Europeia , Humanos
9.
J Rehabil Med ; 51(11): 847-853, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31663599

RESUMO

OBJECTIVE: Rehabilitation services play an important role in optimizing functional ability and societal integration for people with disabilities. The Madagascar Rehabilitation Programme (2011-2013) resulted from a global training partnership and led to 8 doctors achieving a university diploma in rehabilitation medicine. This paper describes a 2014 evaluation of the programme methods, results and learning points. METHODS: A combination of qualitative methods was used for the evaluation, based on a Theory of Change model, with informants from Madagascar and the UK. RESULTS: Malagasy trainees and UK volunteers gained new theoretical knowledge and practical skills. For Madagascar, it led to changes in working practice and the formation of a national rehabilitation association. Key to its success was the strong collaboration between Malagasy and UK professionals, with support from the University and Ministry of Health in Madagascar, and the UK partners. Having a clear common vision ensured the programme met the needs of the Malagasy clinicians. CONCLUSION: Rehabilitation is increasingly recognized as an important focus for international development. Successful rehabilitation training programmes can be achieved at modest costs with global health partnerships. The combination of factors that enabled this programme to be a success is reproducible in other contexts.


Assuntos
Pessoas com Deficiência/educação , Pessoas com Deficiência/reabilitação , Saúde Global/normas , Reabilitação/métodos , Humanos , Madagáscar
10.
Psychiatr Danub ; 31(Suppl 3): 462-466, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488773

RESUMO

Individuals with multiple disabilities can have a wide range of characteristics depending on the combination and severity of the disabilities, such as intellectual disability, mobility issues, sensorial impairment, language issues and brain injury. New technologies can help therapists find an alternative way to engage and interact with clients by opening a communication window and starting to build the therapeutic relationship. The need to use more customized technological tools led us to develop the Painteraction system, an intuitive tool based on Augmented Reality that allows clients to be immersed in their own images. Just by moving their bodies individuals are able to make drawings and receive visual feedback, both from themselves and their therapists, as it appears on the screen. The pilot testing of Painteraction was performed on 21 inpatients at Istituto Serafico (Assisi, Italy) with severe/multiple disabilities in order to explore and assess reaction and responsiveness in a semi-structured art therapy setting. The sample was formed by 14 males and 7 females (N=21) between the ages of 7 and 35. All participants attended three twenty-minute individual art therapy sessions which were approximately one week apart. Through direct and indirect (video recordings) observation of the sessions, it appeared that the specific Augmented Reality tool introduced in the art therapy setting was easily accepted by most of the clients involved and generally allowed the development of an interpersonal therapist-client relationship. The present study therefore gave us the opportunity to test new digital tools in the challenging setting of severe/multiple disabilities and observe the huge potential of new media to empower clients to express themselves and their creativity, and ultimately overcome mental and physical barriers. We propose that Augmented Reality tools are particularly well-suited to art therapy and create an equally suitable therapeutic environment to address specific client needs.


Assuntos
Terapia pela Arte/métodos , Pessoas com Deficiência/reabilitação , Deficiência Intelectual/reabilitação , Adolescente , Adulto , Criança , Feminino , Humanos , Pacientes Internados , Itália , Masculino , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31387320

RESUMO

The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4.2% of its operational range for WORQ and 8.5% for WORQ-BRIEF. Consequently, the French version of WORQ can be considered a good measure of work-related functioning in musculoskeletal conditions. WORQ can be used in rehabilitation practice to comprehensively identify the disability and guide clinical decision making and intervention planning. Further studies are needed to evaluate the psychometric properties of WORQ in other health conditions.


Assuntos
Avaliação da Deficiência , Pessoas com Deficiência/reabilitação , Reabilitação Vocacional , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
12.
IEEE Int Conf Rehabil Robot ; 2019: 46-52, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374605

RESUMO

This paper presents a voice control interface prototype for assistive robots aiming to help people living with upper limb disabilities to perform daily activities autonomously. Assistive robotic devices can be used to help people with upper-body disabilities gain more autonomy in their daily life. However, it is very difficult or even impossible for certain users to control the robot with conventional control systems (e.g. joystick, sip-and-puff). This paper presents the design and preliminary evaluation of a voice command system prototype for the control of assistive robotic arms' movements. This work aims at making the control of assistive robots more intuitive and fluid, and to perform various tasks in less time and with a lesser effort. The prototype of the voice command interface developed is first presented, followed by two experiments with five able-bodied subjects in order to assess the system's performance and guide future development.


Assuntos
Pessoas com Deficiência/reabilitação , Robótica/instrumentação , Atividades Cotidianas , Algoritmos , Desenho de Equipamento , Humanos , Equipamentos de Autoajuda , Extremidade Superior , Interface Usuário-Computador
13.
IEEE Int Conf Rehabil Robot ; 2019: 77-82, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374610

RESUMO

Autonomy and social inclusion can reveal themselves everyday challenges for people experiencing mobility impairments. These people can benefit from technical aids such as power wheelchairs to access mobility and overcome social exclusion. However, power wheelchair driving is a challenging task which requires good visual, cognitive and visuo-spatial abilities. Besides, a power wheelchair can cause material damage or represent a danger of injury for others or oneself if not operated safely. Therefore, training and repeated practice are mandatory to acquire safe driving skills to obtain power wheelchair prescription from therapists. However, conventional training programs may reveal themselves insufficient for some people with severe impairments. In this context, Virtual Reality offers the opportunity to design innovative learning and training programs while providing realistic wheelchair driving experience within a virtual environment. In line with this, we propose a user-centered design of a multisensory power wheelchair simulator. This simulator addresses classical virtual experience drawbacks such as cybersickness and sense of presence by combining 3D visual rendering, haptic feedback and motion cues. It relies on a modular and versatile workflow enabling not only easy interfacing with any virtual display, but also with any user interface such as wheelchair controllers or feedback devices. This paper presents the design of the first implementation as well as its first commissioning through pretests. The first setup achieves consistent and realistic behavior.


Assuntos
Pessoas com Deficiência/reabilitação , Navegação Espacial/fisiologia , Terapia de Exposição à Realidade Virtual/instrumentação , Simulação por Computador , Desenho de Equipamento , Humanos , Interface Usuário-Computador , Cadeiras de Rodas
14.
IEEE Int Conf Rehabil Robot ; 2019: 95-100, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374613

RESUMO

There has been a growth in the design and use of power assist devices for manual wheelchairs (MWCs) to alleviate the physical load of MWC use. A pushrim-activated power-assisted wheel (PAPAW) is an example of a power assist device that replaces the conventional wheel of a MWC. Although the use of PAPAWs provides some benefits to MWC users, it can also cause difficulties in maneuvering the wheelchair. In this research, we examined the characteristics of wheelchair propulsion when using manual and powered wheels. We used the left and right wheels' angular velocity to calculate the linear and angular velocity of the wheelchair. Results of this analysis revealed that the powered wheel's controller is not optimally designed to reflect the intentions of a wheelchair user. To address some of the challenges with coordinating the pushes on PAPAWs, we proposed the design of a user-intention detection framework. We used the kinematic data of MWC experiments and tested six supervised learning algorithms to classify one of four movements: "not moving", "moving straight forward", "turning left", and "turning right". We found that all the classification algorithms determined the type of movement with high accuracy and low computation time. The proposed intention detection framework can be used in the design of learning-based controllers for PAPAWs that take into account the individualized characteristics of wheelchair users. Such a system may improve the experience of PAPAW users.


Assuntos
Pessoas com Deficiência/reabilitação , Cadeiras de Rodas/classificação , Fenômenos Biomecânicos , Desenho de Equipamento , Humanos , Masculino , Aprendizado de Máquina Supervisionado , Interface Usuário-Computador
15.
IEEE Int Conf Rehabil Robot ; 2019: 1043-1048, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31374767

RESUMO

Assistive robotic arms have shown the potential to improve the quality of life of people with severe disabilities. However, a high performance and intuitive control interface for robots with 6-7 DOFs is still missing for these individuals. An inductive tongue computer interface (ITCI) was recently tested for control of robots and the study illustrated potential in this field. The paper describes the investigation of the possibility of developing a high performance tongue-based joystick-like controller for robots through two studies. The first compared different methods for mapping the 18 sensor signals to a 2D coordinate, as a touchpad. The second evaluated the performance of a novel approach for emulating an analog joystick by the ITCI based on the ISO9241-411 standard. Two subjects performed a multi-directional tapping test using a standard analog joystick, the ITCI system held in hand and operated by the other hand, and finally by tongue when mounted inside the mouth. Throughput was measured as the evaluation parameter. The results show that the contact on the touchpads can be localized by almost 1 mm accuracy. The effective throughput of ITCI system for the multi-directional tapping test was 2.03 bps while keeping it in the hand and 1.31 bps when using it inside the mouth.


Assuntos
Pessoas com Deficiência/reabilitação , Robótica , Língua , Algoritmos , Desenho de Equipamento , Feminino , Humanos , Masculino , Qualidade de Vida , Equipamentos de Autoajuda , Interface Usuário-Computador
16.
Surg Clin North Am ; 99(5): 977-989, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446922

RESUMO

This article provides a road map for discharge planning of adult patients with serious life-limiting illnesses. The need for early and guided conversations with specific prompts is offered to assist in the transition of care process. Transparent, patient-centered interactions are emphasized throughout with an acknowledgment that this type of direct, interpersonal communication may challenge a clinical team's typical mode of operation. Nevertheless, when done well, this approach can lead to better outcomes for everyone involved. This framework for discharge planning has led to greater patient and family satisfaction, lower mortality, reduced societal costs, and fewer instances of hospital readmission.


Assuntos
Pessoas com Deficiência/reabilitação , Alta do Paciente , Cuidados Pós-Operatórios/métodos , Adulto , Feminino , Humanos , Cuidados Paliativos/métodos , Assistência Centrada no Paciente , Sobreviventes
18.
Neonatal Netw ; 38(2): 113-115, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31470376

RESUMO

An expected complex outcome of a premature infant need not be assumed completely life limiting. Take Erik Zimmerman, an adult born early 40+ years ago that did end up with cerebral palsy. Yet he chose the gifts that the diagnosis provides and proves many people wrong in terms of what he can and cannot do. The result is a wonderful interview with an inspiring individual and tips for neonatal nurses that will inform them in the NICU as they carry forward wisdom to new families facing the same challenges.


Assuntos
Paralisia Cerebral , Erros de Diagnóstico/prevenção & controle , Pessoas com Deficiência , Enfermagem Neonatal , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/psicologia , Erros de Diagnóstico/psicologia , Pessoas com Deficiência/psicologia , Pessoas com Deficiência/reabilitação , Diagnóstico Precoce , Inteligência Emocional , Humanos , Unidades de Terapia Intensiva Neonatal , Enfermagem Neonatal/métodos , Enfermagem Neonatal/normas , Competência Profissional
19.
Med Pr ; 70(4): 459-473, 2019 Jul 16.
Artigo em Polonês | MEDLINE | ID: mdl-31293279

RESUMO

BACKGROUND: The increasing number of people receiving benefits due to incapacity for work is a heavy burden for the state budget. In order to reduce the scale of this phenomenon, the Social Insurance Institution (ZUS) carries out a rehabilitation program as part of disability pension prevention. MATERIAL AND METHODS: The study was based on the analysis of medical documentation of 607 patients rehabilitated at the Saint Queen Jadwiga's Regional Clinical Hospital No. 2 in Rzeszow, as part of the ZUS prevention of disability pension program in 2011-2013. Medical documentation included the medical history and results of the Functional Test recommended by ZUS. Two years after the completion of rehabilitation, a telephone check was conducted among 118 rehabilitated patients to assess their occupational status. RESULTS: The analysis of the Functional Test documentation showed that in all groups of wykorzystujapatients included in the rehabilitation program, as well as those among whom the control was carried out, the majority were people with post-exercise pain, full physical fitness, slight mobility limitation, full efficiency in everyday activities, correct strength of muscles and moving abilities, as well as normal psychosocial efficiency. The vast majority of them received a recommendation regarding work in a properly-adjusted position. It was shown that in the 2-year observation period, the percentage of professionally active people increased from 56% to 61.02%. CONCLUSIONS: The most important factors determining the return to work include psychosocial efficiency and the level of pain. Med Pr. 2019;70(4):459-73.


Assuntos
Emprego , Doenças Musculoesqueléticas/reabilitação , Retorno ao Trabalho , Avaliação da Capacidade de Trabalho , Adulto , Idoso , Doença Crônica/reabilitação , Pessoas com Deficiência/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Previdência Social
20.
Artigo em Inglês | MEDLINE | ID: mdl-31284620

RESUMO

Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.


Assuntos
Ambiente Construído , Pessoas com Deficiência/reabilitação , Serviços de Assistência Domiciliar , Feminino , Humanos , Masculino , Assistência Centrada no Paciente , Inquéritos e Questionários
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