Application of ICF in occupational therapy: conceptual framework and approaches / 中国康复理论与实践

ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.

Implementation of Ethical Principles to Promote Development of Rehabilitation Services / 中国康复理论与实践

Objective:To analyze the ethical value of rehabilitation medicine and its influence on rehabilitation medicine services. Methods:The ethical value of rehabilitation medicine was studied with the literature review, investigation, and analysis method, integrating with the behavioral process of rehabilitation medicine, and relevant issues were proposed. Results:Rehabilitation medicine ethics was important for rehabilitation medicine services, and played a great role in improvement of qualities of services. Conclusion:The article proposes the significance and methods of how to practice medical ethical principles in rehabilitation medicine, and points out specific measures and practical countermeasures for implementing medical ethics.

Association between Socio-economic Status and Rehabilitation Service Utilization for Adults with Different Disabilities / 中国康复理论与实践

Objective:To analyze the relationship between socio-economic status and utilization of rehabilitation services for adults with different disabilities. Methods:Adults with single disability were selected from the Second China National Sample Survey on Disability. Their education level and per capita household income were used as socio-economic index, controlled with sex, age group, residence, disabled level and marriage. Results:The prevalence of rehabilitation service utilization was 2.98% to 15.97%, and it was more in urban people than in rural ones. Education level trended to be a positive factor to utilization of rehabilitation service, but different with the types of disabilities. Per capita household income was mixed for the utilization of rehabilitation service, which was positive for some disabilities, negative for some ones, and no significant for others. Conclusion:The utilization of rehabilitation services needs to improve for adults with disabilities. Policies can be made targeting to the people with different disabilities.

The rehabilitation services current situation and reference of developed countries in elderly patients with tumor / 中国实用护理杂志

The tumor is a kind of age-related chronic diseases. Nearly 60% tumors appear in 65 years or older.With the growth of elderly population and worsen of environment.There is an upward trend in elderly patients with tumor. Most of patients with tumor, their subsequent treatment, rehabilitation or end-stage care outside the hospital.Rely on the community′s long-term rehabilitation services at home. However,due to various factors,limit the elderly patients with physical and mental needs.Unmet effective needs. This paper is based on extensive researching and reading lots of literature, to summarize and analyze the rehabilitation services between the elderly patients with tumor at the present stage,in order to attract attention to community elderly patients with tumor at home,further improve the service system and quality of life for the elderly patient with tumor.

Investigation of Rehabilitation Medical Resources and Services in Shanghai / 中国康复理论与实践

@#Objective To investigate Shanghai rehabilitation resources and services, define the status and problems and provide suggestions for making Shanghai rehabilitation health care system planning. Methods Based on the "Structure-Process-Result" theoretical framework, the questionnaire survey and field investigation were conducted on medical institutions in term of the rehabilitation departments setting, manpower, beds, equipment, housing, income and expenditure, and referral services. Results There were 321 rehabilitation doctors, 860 rehabilitation therapists and 666 rehabilitation nurses, 2199 preparation beds and 2573 real beds in all kinds of rehabilitation medical institutions. The rates of carrying out rehabilitation services were 94.79% in general hospitals, 100.00% in rehabilitation hospitals, 75.56% in community health service centers, rehabilitation equipment rates were 50.79%, 71.15%, 17.77%, and 27.73 %, 30.00%, 13.21% of them provided outpatient rehabilitation services. Conclusion Shanghai tertiary rehabilitation medical services architecture has initially formed, however, there are still many problems in the rehabilitation function. The rehabilitation health care system planning should focus on rehabilitation services capacity, rehabilitation staff team, rehabilitation resources and services referrals.

Effect of Rehabilitation Medical Professional Training in Guangzhou, China / 中国康复理论与实践

@# Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were analyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.

Effect of Rehabilitation Medical Professional Training in Guangzhou, China / 中国康复理论与实践

Objective To investigate the effect of rehabilitation professional training. Methods Based on the 10 tertiary hospitals in Guangzhou, Guangdong, the professionals from communitiy hospitals were trained. The scores of knowledge and practice tests were ana-lyzed in 2 terms of training. Results The students performed better in the practice test (82.01±8.91) than knowledge (71.08±10.05) (P<0.01). The score of knowledge tests was better in the second term than the first (P<0.05), no difference between them in the score of practice test. Conclusion Rehabilitation professional training in Guangzhou can improve the ability of service of medical rehabilitation.

Pilots of building the medical rehabilitation service system and recommendations / 中华医院管理杂志

Analyzed in the paper is the present development of medical rehabilitation service system in Beijing,Changsha,and Urumqi,in an effort to identify key measures,and discover problems found with the policy environment and system building.Based on such findings,the authors proposed such measures as developing policies and regulations, optimizing resource allocation, strengthening training of rehabilitation personnel and greater publicity.

Fisioterapia en mastectomizadas con alteraciones físicas y funcionales en el hombro ipsolateral / Physiotherapy in mastectomized women with physical and functional disorders in the ipsilateral shoulder

Se efectuó un estudio descriptivo, longitudinal y prospectivo de 28 mujeres con mastectomía radical modificada, a fin de evaluar las principales alteraciones del hombro ipsolateral y su respuesta ante la atención fisioterapéutica brindada en el Servicio de Rehabilitación Integral del Policlínico Universitario "Julián Grimau García" de Santiago de Cuba, desde junio hasta noviembre del 2011. En la casuística, 3 pacientes abandonaron el tratamiento. La complicación más frecuente fue la omalgia (67,8 %), acompañada en muchos casos de limitación articular y disminución de la fuerza del miembro superior afectado. Entre los procederes terapéuticos empleados figuraron: tratamiento postural, cinesiterapia y masoterapia. La respuesta al tratamiento fue satisfactoria en 96,2 % de las afectadas, puesto que las técnicas y procederes fisioterápicos utilizados eran sencillos y con escasos recursos materiales.

A descriptive, longitudinal and prospective study was conducted in 28 women with modified radical mastectomy in order to assess the main ipsilateral shoulder disorders and their response to physiotherapy provided in Comprehensive Rehabilitation Service of "Julián Grimau García" University Polyclinic of Santiago de Cuba from June to November 2011. In the case series 3 patients discontinued treatment. The most frequent complication was the shoulder pain (67.8%), accompanied in many cases by joint limitation and decreased strength of the affected upper limb. Among the therapeutic procedures were postural treatment, kinesitherapy and massage therapy. The response to treatment was successful in 96.2% of patients, since the used techniques and therapeutic procedures were simple and with limited material resources.

Implications of World Report on Disability to Services of Rehabilitation for Persons with Disabilities in China / 中国康复理论与实践

@#World Report on Disability discussed the current situation of persons with disabilities, health care, rehabilitation, support and assistance, barrier-free environment, education, employment, and relevant policy recommendations, adhering to the spirit of Convention on the Rights of Persons with Disabilities, using the International Classification of Functioning, Disability and Health as its theoretical structure.Based on the report, this article discussed the revelations to services of rehabilitation for persons with disabilities and their problems,which were advocating new concepts of rehabilitation services, using multidisciplinary rehabilitation model, and strengthening construction of talents in services of rehabilitation.

Situation of Mental Disability and Rehabilitaion Needs in Hebei Province ZHAO Zhi-hang, FENG Chao / 中国康复理论与实践

@#Objective To investigate the situation of mental disability in Hebei province. Methods Based on the survey of the Second National Disabled Sample in Hebei province, the data of mental disability were analysed, including the morbidity, severity, causes, and the service and demand. Results The morbidity of mental disability was higher in the countryside than that in the city (χ2=364.24, P<0.01). The severity of the disabled was more in level 3 or 4 than in level 1 and 2 (χ2=221.16, P<0.01). The genetic disease and brain disease were the major causes to the mental disability. The service did not meet the demand. Conclusion The mental disability was more in the countryside than in the city, with severity of mild to moderate.

3 Models of Rehabilitation Service on Stroke Patients Following Hemiplegia in Community / 中国康复理论与实践

@#Objective To compare the effect of 3 models of rehabilitation service on stroke patients following hemiplegia in community.Methods 87 stroke patients were randomly divided into rehabilitation training group (n=29), intensive training group (n=30) and followed-up group (n=28). Fugl-Meyer Assessment (FMA) was used to evaluate the limbs motor function and Modified Barthel Index (MBI) was used to evaluate the activities of daily living before, 3 months and 6 months after intervention. Results There was no significantly difference in scores of FMA and MBI among the groups. Both the rehabilitation training group and the intensive training group improved in scores of FMA and MBI 3 months after intervention (P<0.01). The intensive training group and the rehabilitation training group improved further 6 months after intervention, while follow-up group had no improvement. Conclusion Stroke patients following hemiplegia can improvemotor function and activities of daily living through systematic, standard, and ongoing rehabilitation training from professionals in community.

Current Status of Special Rehabilitation Service Needs of People with Disability at Zhabei District in Shanghai / 中国康复理论与实践

@#Objective To understand the status of special rehabilitation service demands of people with disability at Zhabei District in Shanghai and to provide the basis for the policy development.Methods Screen rate (SR) was used to indicate the level of demand of rehabilitation service, the data were analyzed with SPSS 13.0 statistical software.Results There were 4 349 persons with disability who demanded the special rehabilitation service; the SR of “on-site rehabilitation service” demands was the highest among the whole persons with disability; the SR of “personalized allotment of supplies and appliances” demands of the intellectual disability and mental disability was lower than the other types; the SR of special rehabilitation service demands of the female, the elderly, the low cultural level, the unemployed and the people with severe disability were relatively higher.Conclusion The form of “on-site rehabilitation services” needs to improve based on the demand of the disabilities; “personalized supplies and appliances” for the intellectual disability and mental disability needs to further develop; the rehabilitation services targeted to the female, the elderly, the low cultural level, the unemployed and the people with severe disability need to improve.

Survey of Information Management of Rehabilitation Service in Shanghai / 中国康复理论与实践

@#Objective To investigate and assess the current situations on information management of rehabilitation service in Shanghai. Methods The information management in 6 districts in Shanghai were assessed in field, the fulfilling of the first- and second-degree index and the standard-reaching rate of the third-degree index were calculated separately according to the first-degree index- information management of the Evaluation Index System of Rehabilitation Service for All Disabled in Shanghai. Results The average fulfilling degree of the first-degree index was 73.1%. There were only 2 districts reached the standard of Registration of Rehabilitation. The average fulfilling degrees of the Development and Dynamic Maintenance of Rehabilitation Service Information Database were 50.0% and 66.7%, respectively. The standard-reaching rate of the Disabled Children First-diagnose Report System, Effectual Providing Referral Rehabilitation Service Across-the-board, Suspicious Disabled Persons Report System in Community were 16.7%, 16.7% and 50%, respectively. Conclusion The development and supervision of rehabilitation service information should be reinforced and the referral rehabilitation service should be improved.

Desire for Rehabilitation Services of Stroke Patients Admitted in Post-acute Rehabilitation Facilities

OBJECTIVE: To determine whether the rehabilitation desire of stroke patients in post-acute rehabilitation facilities was suitable to objective parameters, and to figure out the discharge plan after post-acute rehabilitation facilities. METHOD: 107 stroke patients in post-acute rehabilitation facilities were included. In order to identify rehabilitation desire, interviews were conducted among patients or their family members in a direct line. Discharge plans of patients after post-acute rehabilitation facilities were surveyed. All participants completed demographic measures, Mini Mental Status Examination (MMSE), Korean Modified Barthel Index (K-MBI) and International Classification of Functioning, Disability and Health (ICF) core set for patients with neurological problems in post-acute rehabilitation facilities to determine the influences on rehabilitation desire. RESULTS: Most (81.3%) of the patients desired more intensive rehabilitation service and 65 patients (60.7%) purposed to get physical therapy focused on motor recovery. Only 24 patients (22.4%) planned home discharge, most (67.3%) of them did re-admission. CONCLUSION: The desire of patients in post-acute rehabilitation facilities would have a tendency of hospital staying for motor recovery in large percentage of patients. Rehabilitation desire and goal were not affected by the affected side and onset duration. Social support and extended educational program for rehabilitation for the patients and their relatives should be performed to overcome these problems.

Factors of influencing supply and utilization of rehabilitation service in five grade A hospitals in Beijing / 中国康复理论与实践

@#ObjectiveTo make sure the factors of influencing supply and utilization rehabilitation service of hospitals in Beijing.MethodsFive grade A hospitals in different districts in Beijing were surveyed to realize the condition and factors of influencing supply and utilization of rehabilitation service in polyclinics in Beijing and make sure the developing situation of departments of rehabilitation medicine, and its restriction factors in their hospitals.ResultsThe departments of rehabilitation medicine in the five hospitals had not reached to requirement of administer criterion to comprehensive hospitals, issued by Ministry of Health. The factors of influencing supply and utilization of rehabilitation service in polyclinics in Beijing included: discordant cooperation between rehabilitation section and other sections in hospitals; leaders of hospitals and clinical personnel not understanding the importance of rehabilitation early intervention much; patients and their family not understanding the special curative effect to prevent and treat disability of rehabilitation; the application for reimbursement limitation to the fee for patients to accept rehabilitation treatment and/or stay in rehabilitation section in hospitalization insurance and plan as a whole, and so on.ConclusionThe factors above limit the further development of rehabilitation service of polyclinics in Beijing. Effective measures should be taken and correlative policies should be established in order to promote the rehabilitation service in Beijing.