RESUMO
BACKGROUND: Rehabilitation services are an integral part of patient care, but in many developing countries, they are not prioritized and either unavailable or easily accessible to those who need them. Although the need for rehabilitation services is increasing in Honduras, rehabilitation workers are not included in the health care model that guides the care provided to communities, particularly in rural and remote areas. To understand the need for providing impactful rehabilitation services in disadvantaged communities, we explored the education and perception of the community relating to rehabilitation, investigated training available for rehabilitation workers, and examined the rehabilitation processes and practices in Northern Honduras from stakeholders' experiences. METHODS: We utilized a qualitative descriptive and interpretive approach grounded in case study methodology to understand rehabilitation education, process, and practice in Northern Honduras. Three rehabilitation centres were purposefully selected as the cases, and participants consisted of rehabilitation workers and managers from these centres. We collected data via interviews and focus group sessions. We analyzed the data via thematic analysis using NVivo version 12. RESULTS: In Northern Honduras, rehabilitation workers' limited training and continuing education, along with awareness about rehabilitation by community members and other health providers influence rehabilitation care. Although policies and initiatives to support people with disabilities and the broader community in need of rehabilitation exist, most policies are not applied in practice. The sustainability of rehabilitation services, which is rooted in charity, is challenged by the small range of funding opportunities strongly affecting rehabilitation care processes and clinical practices. The lack of trust and awareness from the medical profession towards rehabilitation workers sets a major barrier to referrals, interdisciplinary work, and quality of life for individuals in need of rehabilitation. CONCLUSION: This study advances knowledge of the need to increase understanding of rehabilitation care among community members and health providers, improve care processes and resources, and foster interprofessional practice, to enhance the quality of care and promote equitable care delivery, especially in rural and remote communities.
Assuntos
Pessoas com Deficiência , Qualidade de Vida , Humanos , Honduras , Atenção à Saúde , Educação ContinuadaRESUMO
Resumen Introducción: para la población en situación de discapacidad cognitiva, los procesos de lectura y escritura forman parte importante de su proyecto de vida; basados en las habilidades de comunicación y cognición, lo cual son ineludibles para fomentar la interrelación con el mundo, permitiendo desarrollar destrezas necesarias para los procesos de inclusión social, educativa y laboral. Objetivo: evaluar la efectividad de la intervención interdisciplinaria entre Equinoterapia y Fonoaudiologia para el desarrollo de lectoescritura en adolescentes y adultos jóvenes con discapacidad cognitiva. Materiales y métodos: se realizó un estudio Cuasiexperimental, evaluando 34 estudiantes con discapacidad cognitiva entre los 11 y 42 años pertenecientes a una institución educativa especial, a través de la evaluación la lectoescritura por medio del "Material para la investigación clínica del lenguaje de Martha Espeleta" en el antes y después de la intervención fonoaudiológica con apoyo de equinoterapia; el análisis estadístico en Stata v13 y el análisis descriptivo con medidas de frecuencia y tendencia central, el análisis bivariado se realizó utilizando el test de McNemar. Resultados: el 52,94% de los individuos eran mujeres, la mediana de edad fue de 22 años, con una edad mínima de 11 años y máxima de 42 años; la escritura espontánea con orientación y la escritura espontánea con apoyo sensoperceptual, fueron las habilidades que presentaron cambios estadísticamente significativos (p<0,05). Conclusiones: la intervención en los individuos es efectiva para mejorar algunas habilidades lectoescriturales pasando la lectura automática en el nivel de silabeo, a un nivel de silabeado con reintegración y en la escritura espontánea (redacción) de un nivel secundario de descripción enumerativa a esbozos de iniciación literaria.
Abstract Introduction: for people with cognitive disabilities, writing and reading processes are a vital part of their life Project. Based on communication and cognition abilities, which are unavoidable to promote interrelationships with the world, these allow to develop skills needed for social, education, and work inclusion processes. Objective: the objective of this study is to assess the effectiveness of an interdisciplinary intervention between equine-assisted therapy and speech-language pathology for writing and reading development in adolescents and adults with cognitive disabilities. Materials and methods: a quasi-experimental study was conducted to assess 34 cognitively disabled students between 11 and 42 years old from a special education institution using a literacy assessment instrument called "Material for clinical research on language by Martha Espeleta" before and after the speech-language intervention supported by equine-assisted therapy. Statistical analysis was made using Stata v13 and descriptive analysis using measures of central frequency and tendency. Bivariate analysis was made using McNemar's test. Results: 52,94 of individual were women. Average age was 22 years old, ranging from 11 to 42 years old. Both spontaneous-oriented writing and spontaneous sensoperceptive-supported writing abilities presented an important statistical change (p<0,05). Conclusions: individuals intervention is effective to improve certain literacy skills from an automatic reading at syllable level to a reintegrated syllable level. It also helps in spontaneous writing (composition) at a secondary level for enumerative description outlining a literary start.
Resumo Introdução: os processos de leitura e escritura fazem parte importante do projeto de vida das pessoas portadoras de deficiência cognitiva, sendo que estes processos baseados nas habilidades de comunicação e cognição são iniludíveis para promover a interrelação com o mundo, pois eles permitem desenvolver as habilidades necessárias aos processos de inclusão social, educacional e de trabalho. Objetivo: avaliar a efetividade da intervenção interdisciplinar entre Equoterapia e Fonoaudiologia para o desenvolvimento da leitura e escritura em adolescentes e adultos jovens portadores de deficiência cognitiva. Materiais e métodos: foi realizado um estudo quase-experimental, avaliando 34 estudantes portadores de deficiência cognitiva entre os 11 e 42 anos pertencentes a uma instituição educacional especial, através da avaliação da leitura e escritura a través do "Material para a pesquisa clínica da linguagem de Martha Espeleta" no antes e depois da intervenção fonoaudiológica com apoio de equoterapia; a análise estatística em Stata v13 e a análise descritiva com medidas de frequência e tendência central, a análise bivariada foi realizada utilizando o teste de McNemar. Resultados: 52,94% dos indivíduos eram mulheres, a mediana de idade foi de 22 anos, com uma idade mínima de 11 anos e uma idade máxima de 42 anos; a escritura espontânea com orientação e a escritura espontânea com apoio senso-perceptual, foram as habilidades que apresentaram mudanças estatisticamente significativas (p<0,05). Conclusões: a intervenção nos indivíduos é efetiva para melhorar algumas habilidades de leitura e escritura passando da leitura automática no nível silábico para um nível silábico com reintegração e na escritura espontânea (redação) de um nível secundário de descrição enumerativa para esboços de iniciação literária.