ABSTRACT
ObjectiveTo construct a health intervention model for community-dwelling older adults with chronic diseases based on the International Classification of Diseases, Eleventh Revision (ICD-11) and the International Classification of Functioning, Disability and Health (ICF), and to analyze the health outcomes of three types of intervention models that integrate physical activity and chronic disease management. MethodsA scoping review was conducted by searching CNKI, Web of Science, PubMed and EBSCO databases for literature on community-based management of chronic diseases, physical activity, exercise rehabilitation, physical activity prescription intervention and related health outcomes up to May, 2023. ResultsEight studies from four countries were included, involving 568 randomized controlled trials and 4 359 participants aged 50 to 72. The studies were published mainly between 2017 and 2022. Community-based health intervention models for older adults with chronic diseases were categorized into three types: community health service models (chronic disease management and exercise rehabilitation), community physical activity models (prevention and health promotion) and mixed models (a combination of these two models). The community health service model focused on chronic disease management in the community, integrating community sports, and involving physical activity intervention, health education, dietary intervention, monitoring and motivation intervention, and care coordination, for six to 24 months, with the intervention attribute of rehabilitation and health promotion. The personnel involved doctors, nurses, dietitians, pharmacists, social workers and primary healthcare clinicians. The community physical activity model focused on design and implementation physical activity intervention for chronic disease in the community environment, providing relevant physical activity advice and guidance, and personalized reinforcement and support. The physical activities included walking, cycling, warm-up exercises, cardiopulmonary fitness, muscle strength and balance training, coordination and stretching exercises, Taijiquan, Yoga, Qigong, and water sports; ten to 150 minutes a time, low to vigorous, for eight to twelve months, with the intervention attribute of prevention and health promotion. The personnel involved clinical staff, primary healthcare staff, exercise intervention experts and consultants, doctors, nurses, social workers and certified exercise coaches. The mixed model involved a chronic disease prevention and management plan, including physical activity counseling, lifestyle intervention related to physical activity, personalized health guidance and exercise program design, for six to twelve months, with the intervention attribute of prevention, rehabilitation and health promotion. The personnel involved sports coaches and retired professional athletes, dietitians, nurses, personal trainers, general practitioners, occupational therapists and physiotherapists. The main health outcomes involved body function-related indicators, such as control of weight, blood pressure, waist circumference, systolic blood pressure, triglyceride and high-density lipoprotein cholesterol levels, to reduce cardiovascular risk; relief of arthritis and herpes zoster pain, improvement in cognitive function and depressive symptoms. In terms of activity-related outcomes, the physical fitness improved, involving agility and dynamic balance, flexibility, muscle strength, and aerobic endurance; while the amount of physical activity increased, as well as the time spent on mild, moderate and vigorous exercise or leisure activities; the risk of fall reduced, the level of daily physical activity improved, and the self-efficacy and level of social participation increased. ConclusionThe community-based physical activity and health services models for older adults with chronic diseases may be classified as community health service model, community physical activity model and mixed model. A comprehensive intervention integrating physical activity and community health services can improve the health status, control the symptoms of chronic diseases, improve physical and mental functions, and increase the level of physical activity and quality of life for older adults with chronic diseases. The mixed model is a hybrid model that incorporates physical activity into community health services, which can provide comprehensive health interventions to make better health and health-related benefits.
ABSTRACT
BACKGROUND@#Prior to developing a community-based rehabilitation program, there is a need to conduct a needs assessment to identify the factors that may affect the quality of life (QOL) in a community. However, after reviewing related literature, no community needs assessment tools were readily accessible and were directed toward the target population and research locale of this study. @*OBJECTIVE@#The study aims to develop and validate a questionnaire that assesses the needs of selected barangays in Binangonan, Rizal as part of the first phase of the PRECEDE-PROCEED model. @*METHODS@#A purposive sampling method will be utilized in recruiting via email a panel of experts, consisting of five content experts and five lay experts, to evaluate the researcher-developed questionnaire’s content validity. Content validity will be assessed through evaluation of the tool’s grammar, choice of words, question construction, and scoring of items. The data will then be analyzed by a statistician using content validity ratio (CVR) and content validity index (CVI) where questions may be retained, revised, or eliminated.@*EXPECTED RESULTS@#The study expects to produce a content-validated questionnaire in English consisting of four dimensions: social, epidemiological, educational, and administrative/policy. For an item to be considered valid, scores for CVR and CVI should be equal to or greater than the cut-off values. The information from the questionnaire may be utilized by healthcare professionals aiming to improve the QOL in the community.
ABSTRACT
BACKGROUND@#The emergence of Telerehabilitation in managing hypertension showed positive outcomes as an alternative approach to deliver healthcare services. With the ongoing COVID-19 pandemic which necessitates less physical contact, the study aims to determine the effectiveness of Telerehabilitation versus the usual care in hypertension management among adults in communities, especially in rural settings. @*METHODS@#A comprehensive electronic search was conducted in the following databases: ProQuest, EBSCOhost, AHA Journals, PubMed, Google Scholar, Scopus, HERDIN, Web of Science, JSTOR, and ScienceDirect in March 2022 and was updated in August 2022. Inclusion criteria are randomized controlled trial studies that involve participants aged ≥ 18 years old with hypertension or baseline blood pressure of >140/90 mmHg and the use of technologies and digital services to address hypertension versus non-Telerehabilitation approaches in rural communities or through community- based rehabilitation. Exclusion criteria are non-randomized controlled trials, qualitative studies, unfinished and article type records. The revised Cochrane Collaboration Risk of Bias tool will be used to evaluate the content for risk of bias, quality, and internal validity. An electronic data collection form and Raxter will be utilized to extract and to organize the following: demographics, objectives, design, settings, interventions, outcome measures, and significant findings. Review Manager (RevMan) version 5.4 will be used to perform quantitative synthesis of the pooled data if homogeneity is observed in the outcomes. @*EXPECTED RESULTS@#The study will determine the effectiveness of Telerehabilitation in managing hypertension and aiding in its implementation in response to the global trend of urbanization in rural areas.
Subject(s)
TelerehabilitationABSTRACT
ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.
ABSTRACT
The experience of leprosy clients undergoing treatment in community-based rehabilitation (CBR) needs to be identified more deeply to reduce, prevent transmission and the disability it causes because it will impact the social life of leprosy clients in the community. The non-fulfillment of the needs of leprosy clients in the community will impact the conditions of transmission and disability of leprosy clients. We explored the experiences of leprosy clients attending self-care groups during CBR for identifying their health needs. A descriptive phenomenology study was performed among leprosy clients, families, and healthcare providers. Our study included 16 leprosy clients and their families and six healthcare providers. A triangulation method was performed to compare the third source data. Thematic analysis was used to identify the phenomenon of leprosy during CBR for fulfilling their health needs. We have identified five themes, including leprosy prevention efforts, self-care process and client treatment for leprosy, the needs of clients with leprosy during self-care at CBR, medication, and therapy during the CBR family support during rehabilitation and treatment. Therefore, fulfilling the needs for self-care, medication, and therapy during the rehabilitation period for leprosy clients in the community needs to be facilitated and fulfilled to support recovery. Furthermore, CBR designs that prioritize self-care aspects and are integrated with family care need to be developed in the future. All these approaches should be developed, adapted and validated in different settings with specific needs
ABSTRACT
BACKGROUND@#Filipino speech-language pathologists (SLPs) can reach more persons with disabilities across 7,107 Philippine islands through telerehabilitation (also known as teletherapy, telepractice). This study described the feasibility of telerehabilitation for speech-language pathology in community-based rehabilitation in terms of appropriate information and communication technologies (ICT), stakeholder perspectives, and facilitators and barriers.@*METHODS@#A qualitative descriptive design was employed. Participants were purposely selected as telerehabilitation stakeholders. One metropolitan-based SLP conducted remote and synchronous therapy sessions to two persons with voice disorders (52 and 65 years old) in their homes, assisted by one primary caregiver each and one community-based rehabilitation worker (CBRW). ICT observations were logged as field notes. Stakeholder perspectives were obtained through participant journals and interviews, thematically analyzed using NVIVO, and validated by participants. Facilitators and barriers were derived from data triangulation of field notes, journals, and interviews.@*RESULTS@# The best ICT comprised of fastest wireless internet available (7.2 Mbps), MacBook™ laptop, and FaceTime™ videoconferencing application. Stakeholders had varied yet positive perspectives. The SLP focused on ICT requirements and intervention conduct. The families saw telerehabilitation benefits of cost-effectiveness and intervention effectiveness. Both SLP and the families were satisfied as telerehabilitation providers and consumers. CBRW appreciated intervention effectivity. The only barrier to telerehabilitation was low internet bandwidth. Facilitators to telerehabilitation were stronger CBR policies and SLP capacity development.@*CONCLUSION@#Telerehabilitation is feasible in speech-language pathology within communitybased rehabilitation in the Philippines, given community-appropriate ICT and positive experiences of stakeholders. It can flourish with faster internet, stronger community health policies, and empowering stakeholders.
Subject(s)
TelerehabilitationABSTRACT
Objective:To investigate the current status of community rehabilitation services for the older adults and the related factors based on the framework of Anderson Health Model and World Health Organization Community-based Rehabilitation Guideline. Methods:Data from 2016 China Longitudinal Aging Social Survey were analyzed with multiple response to explore the needs of community rehabilitation services, analyzed with Logistic regression to explore the related factors. Results:The older adults needed somehow community rehabilitation services (11.07%). However, the ratio of actual utilization of rehabilitation services (0.94%) and the meeting of needs (6.75%) were very low. The demand of community rehabilitation services related with education among the propensity factors (OR = 1.299); income (OR = 1.245), pensions (OR = 1.337), financial support from children (OR = 1.236), community's health support services (OR > 1.547) and community participation (OR = 1.640) among the enabling factors; disability (OR = 2.336) and suffering some chronic diseases (diabetes, cerebrovascular diseases, cervical and lumbar diseases, and Alzheimer's disease, etc.) among the demand factors. Conclusion:There are structural differences between the demand and supply of community rehabilitation services for the older adults. Education, economic conditions, community's health support services, community participation and health status are the factors related with the needs of community rehabilitation services, in the framework of Community-based Rehabilitation Guideline.
ABSTRACT
Objective:To explore the effects of home-based telerehabilitation guidance on physical function and activities of daily living for stroke patients. Methods:From September, 2015 to March, 2018, 240 stroke recovering patients from three community health service centers in Fengtai District, Beijing for outpatient rehabilitation were randomly divided into control group (n = 120) and tele-rehab group (n = 120). Both groups accepted routine rehabilitation for six months, while the tele-rehab group received telerehabilitation guidance in addition. They were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and after treatment. Results:The scores of FMA and MBI improved after treatment in both groups (|t| > 14.536, P < 0.001), and improved more in the tele-rehab group than in the control group (|t| > 2.200, P < 0.05). Conclusion:Home-based telerehabilitation guidance may enhance the effect of community-based outpatient rehabilitation for stroke patients.
ABSTRACT
Objective:To investigate the rehabilitation resources of community health centers in Shanghai. Methods:December, 2018, all 247 community health centers in 16 districts of Shanghai were investigated with Health Institution Questionnaires, including the number of rehabilitation personnel (physiatrician, physical therapists) and the number of rehabilitation beds, etc. Results:There were 152 physiatrician and 597 physical therapists in community health centers in Shanghai. The numbers of physiatrician and physical therapists per 1000 registered population were 0.01 and 0.04, and were 0.03 and 0.12 for per 1000 registered elderly population. There were 17 484 beds in community health centers, in which the rehabilitation beds were 1425, accounting for 8.15%. Besides, the numbers of rehabilitation beds per 1000 registered population and registered elderly population in Shanghai were 0.10 and 0.30. Conclusion:The development of community-based rehabilitation in Shanghai is unbalanced. There is lack of community-based rehabilitation resources, the supply of service is insufficient, and there is gap between supply and demand. It is suggested to strengthen the support to community-based rehabilitation, and improve the supply of community-based rehabilitation resources.
ABSTRACT
Objective:To analyze the status quo and development of the Hope Houses for individuals with spinal cord injury (SCI) in Shanghai. Methods:In June, 2018, the organizers and managers of Hope Houses from 16 districts in Shanghai were investigated with the self-designed questionnaires, which covered the personal characteristics, knowledge of related policy, development of projects and obstacles, and rehabilitation recognition. The descriptive analysis and correlational analyses were conducted. Results:Totally, eleven organizers and 16 managers were investigated. The knowledge of related policy for organizers was not good enough. Eight Hope Houses in 16 districts in Shanghai were operated by social organizations. The average implementation rate of projects in Hope Houses was 60.6%, and the highest was rehabilitation knowledge education (96.3%). There was insufficient provision in legal services, job skills training, rehabilitation nursing guidance, job referral, medical referral and education referral, etc. The main related factors limiting the development of the Hope Houses were lacks of budgets, social consensus and professionals. The rehabilitation cognition of organizers and managers was generally good, but the cognition of rehabilitation principles and rehabilitation value needed to be strengthened. Conclusion:The Hope Houses for individuals with SCI in Shanghai work well, and the rehabilitation cognition of organizers and managers is satisfactory. It should be strenghened in resource input, comprehensive rehabilitation and standard of management, to expand the service timely.
ABSTRACT
Objective:To explore the suggestion and key points of implementing community rehabilitation centered on peer education for patients with chronic obstructive pulmonary disease (COPD). Methods:From June, 2016 to June, 2017, 19 doctors, 15 nurses and 27 patients with COPD were selected for semi-structured interviews with the phenomenological research method, and the data were analyzed using the 7-step analysis method of Colaizzi. Results:The points were as follows: establishment and orientation of group leader education, hospital-community-family interaction mode, collective and individual intervention mode and effect and interaction monitoring. Conclusion:There is still lack of unified standards and teaching materials for the application of peer education in the rehabilitation of COPD patients. COPD community rehabilitation implementation strategies with peer education as the core are formulated to provide further reference for the rehabilitation of COPD patients.
ABSTRACT
@#Objective This paper studied the status of community-based rehabilitation of rural disabled people in the process of ac-curate poverty alleviation and aimed to provide reference and reflection for promoting the community-based re-habilitation and development of rural disabled people and realizing a comprehensive well-off society. Methods Through combining and summarizing the literature,this paper elaborated the intrinsic relationship between ac-curate poverty alleviation and community-based rehabilitation, and analyzed the effectiveness and problems of community-based rehabilitation of rural disabled people in the process of accurate poverty alleviation based on field research. Results Aiming at the existing problems of community-based rehabilitation of disabled people in rural areas,some sug-gestions were put forward such as strengthening the top-level design and management and training of accurate employment skills in the process of accurate poverty alleviation so as to better realize the community-based reha-bilitation of rural disabled people. Conclusion The development of community-based rehabilitation for disabled people in rural areas is closely related to the process of precise poverty alleviation.They have the same purpose and promote each other.Simultaneously, they are both sustainable and inclusive development strategies.
ABSTRACT
Objective To discuss the model and the effects of intervention treatment among patients with cerebral apoplexy during the recovery period in the primary and tertiary hospitals. Methods From Mar. 2015 to Feb. 2016, we selected 119 patients with cerebral apoplexy cured in our department and randomly divided them into two groups: 61 cases in the combined treatment group and 58 cases in the control group. After 6-month treatment, the effects were evaluated using FMA and BI index. Results FMA and BI indexes of patients with cerebral apoplexy improved significantly after the treatment (P ＜0.05). The effect of using the combined treatment is better than that of the control group (P＜0. 05). Conclusion The recovery model performed in the primary hospital together with the tertiary hospital is beneficial to the recovery of patients with cerebral apoplexy and worthy to generalize.
ABSTRACT
@#Objective To analyze the development of community-based sport and rehabilitation for people with disabilities with the policy of Healthy China 2030, and then make political recommendation. Methods Policies and theories related to Healthy China 2030 and community-based services had been discussed. The data of community-based rehabilitation from China Disabled Persons' Federation statistics from 2011 to 2017 were analyzed. Results The policies background for community-based sport for people with disabilities developed with the development and implementation of Healthy China 2030, National Fitness Program and other related work programs during the Thirteenth Five-Year Plan Period. More and more people with disabilities participated in the community-based exercise. The facilities of community-based physical activity for people with disabilities improved continuously. The fitness guidance for the people with disabilities became more standardized. Conclusion Community-based physical activity and sport for people with disabilities should be developed based on the framework of Healthy China 2030, with the implementation of National Fitness Program (2016-2020) and Plan for the Disabled Culture and Sports Work during Thirteenth Five-Year Plan Period and so on, and implement Community-Based Rehabilitation Guidelines. It is important not only to increase the enthusiasm and participation, but also to provide good physical guidances, facilities and environment. It is proposed to integrate community-based sport and community-based rehabilitation, and to build a public service system for people with disabilities within the community.
ABSTRACT
@#Objective To explore the effect of community rehabilitation collaborative service on stroke patients. Methods From January, 2016 to March, 2018, 200 stroke inpatients from ten community health service centers (CHSC) were divided into control group (n=100) and treatment group (n=100). The physicians, therapist and nurses of rehabilitation department were paired with CHSC personnels, to guide rehabilitation treatment and nursing, fieldly and through WeChat group. They were evaluated with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before treatment, three weeks after treatment, and two months afterwards. Results The FMA scores of upper and lower extremities and MBI scores improved after treatment and follow-up in the treatment group (t>2.710, P<0.01). For the control group, the FMA score of upper extremities improved after treatment (t=-2.195, P<0.05), but it was not significantly different from pre-treatment as follow-up (t=-1.394, P>0.05); the FMA score of lower extremities improved both post-treatment and follow-up (t>3.828, P<0.001); the MBI score did not improve after treatment and follow-up (t<1.774, P>0.05). The FMA score of upper and lower extremities and MBI score improved more in the treatment group than in the control group after treatment and follow-up (t>3.155, P<0.01).Conclusion The community rehabilitation collaborative service can improve the motor function and activity of daily living in stroke patients.
ABSTRACT
@#Objective To analyze the policies and theories, and built the theoretical framework and methods to provide policy support and service development for the development of community-based physical activity and rehabilitation for people with disabilities based on WHO Community-based Rehabilitation (CBR) Guidelines.Methods The relevant policies at home and abroad were analyzed using policy research and literature research methods, and the functions of community-based physical activity were systematically analyzed based on the framework of WHO CBR Guidelines.Results The community-based physical activity can empower people with disabilities in the fields of health, rehabilitation, education, life, and social integration.Conclusion Based on WHO CBR Guidelines, the theory and policy framework of community-based physical activity for people with disabilities has been developed. It is benefit to promote the implementation of the National "Healthy China 2030 Outline" and the "National Fitness Program" to develop community-based physical activity for PWDs, to strengthen guidance and support services for community-based physical activity and to integrate physical activity and rehabilitation at community level for people with disability. It is also to achieve inclusive community development.
ABSTRACT
This paper reviewed the key periods in 30 years'development of community-based rehabilitation(CBR)for persons with dis-abilities in China.The measures for CBR development were discussed forward,including to implement the Regulations of Disability Preven-tion and Rehabilitation for Persons with Disabilities for pushing the legal development of CBR, to explore ways of multi-supplying for CBR sustainable development, to integrate CBR into general situations for realizing rehabilitation for all persons with disabilities, to strengthen institutions building and talents training for improving CBR capabilities,to standard the CBR actions for providing safe,effective and precise rehabilitation services,to promote the gaining sense of persons with disabilities from CBR services through balanced develop-ment of CBR in urban and rural areas.
ABSTRACT
Objective This paper summarized the practice and experience of community rehabilitation project based on the model of In-ternational Classification of Functioning, Disability and Health (ICF) and whole-person development, in order to promote the well-off pro-cess of people with disabilities. Methods They worked under the guidance of double track, strength perspective and whole-person develop-ment for people with disabilities;developed and integrated the community resources and provided personalized accurate service;brought the affairs of people with disabilities into various departments;adjusted measures to local conditions and innovated working methods;and creat-ed a good social atmosphere. Results Three years after project implementation, it improved in health, education, making a living and other aspects. The benefited people with disabilities returned to society in various degrees. Conclusion The project combined the concept of inter-national community rehabilitation with the actual situation of the project area effectively. Throughwhole-person developmenttraining and practice, it promoted the social way of functioning, disability, and changed the way of work and the development of thedual-track model, fully promoted the service level of rehabilitation workers at the grass-roots level, as well as the ability construction of local disabled persons' federation.
ABSTRACT
El quehacer fonoaudiológico actualmente se encuentra influenciado por perspectivas de atención en salud que promueven una atención basada en el modelo biopsicosocial, el cual propende a la inclusión social de personas en situación de discapacidad. En este contexto, la presente investigación pretende caracterizar el quehacer profesional de fonoaudiólogos/as insertos en Centros Comunitarios de Rehabilitación (CCR) que utilizan una estrategia comunitaria (Rehabilitación Basada en la Comunidad, RBC) para llevar a cabo sus procesos de evaluación, diagnóstico y rehabilitación. Este estudio cualitativo se enmarca en un enfoque microsociológico relacionado con la exploración de las prácticas profesionales en contextos de salud. La recolección de datos se realizó mediante la técnica de entrevistas en profundidad y observación no participante de las prácticas de dos fonoaudiólogos que fueron registradas en bitácoras. La información obtenida fue procesada mediante análisis de contenido. Los profesionales fonoaudiólogos definieron su rol por medio de diferentes acciones que promueven su incorporación a un equipo multidisciplinario de atención y la participación activa, tanto del usuario como de la familia, en el proceso de rehabilitación. Se discute la suficiencia de las acciones fonoaudiológicas para explicar aspectos específicos del rol y diferencias en las formas de llevar a cabo las prácticas basadas en esta estrategia comunitaria de rehabilitación. Finalmente, la expresión de esta estrategia es parcial y constituye aún un desafío para el/la fonoaudiólogo/a basar la totalidad de su práctica diaria en dicha estrategia.
The speech therapists task is currently influenced by prospects of health care based on biopsychosocial model; which tends to social inclusion of people with disabilities. In this text, this article aims to characterize professional work of speech therapists inserts in Communitarian Rehabilitation Centers (CRC) using community strategy (Community based rehabilitation, RBC) to carry out assessment, diagnosis and rehabilitation processes. This qualitative research is part of a micro sociological approach which explores professional practices in health contexts. Data collection was performed using in-depth interview and nonparticipating technique in observation of two speech therapists practice that were recorded in logbooks. The information obtained was analyzed through content analysis. Speech therapists defined their role through actions that promoted their incorporation to a multidisciplinary health team, and the active participation of both the user/patient and the family in the rehabilitation process. The adequacy of actions to explain role specific aspects and carry out ways differences of speech therapists practice based on this communitarian rehabilitation strategy. Finally, expression of this strategy is partial and is still a challenge for speech therapists to base their daily practice on this strategy.