ABSTRACT
PURPOSE: To understand the postoperative acute-care physiotherapy course for First Nations people returning after total hip replacement (THR) to remote communities with limited rehabilitation services and to evaluate length of stay and attainment of functional milestones after THR to determine to what extent an urban-based clinical pathway is transferrable to and effective for First Nations patients in a rural setting. METHODS: Data were collected retrospectively by reviewing charts of patients who underwent THR in the Northwest Ontario catchment area from 2007 through 2012. RESULTS: For the 36 patient charts reviewed, median length of stay (LOS) at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) was 7.5 days (range 2-335); median LOS from time of surgery at the regional hospital (Thunder Bay Regional Health Centre) to discharge from SLMHC was 13.5 days; and median time for mobilizing and stairs was 9 days (range 1-93). CONCLUSION: Commonly accepted urban clinical pathways are not a good fit for smaller rural hospitals from which First Nations patients return to remote communities without rehabilitation services. LOS in a rural acute-care facility is similar to LOS in an urban rehabilitation facility.
Objet: Comprendre le parcours de soins de physiothérapie postopératoires de courte durée pour les membres des Premières Nations qui retournent dans des collectivités éloignées offrant des services de réadaptation limités après une arthroplastie totale de la hanche (ATH); évaluer la durée du séjour et l'atteinte des jalons fonctionnels à la suite d'une ATH afin de déterminer dans quelle mesure et avec quelle efficacité le cheminement clinique de patients des Premières Nations effectué en milieu urbain peut être transféré en milieu rural. Méthodes: Les données ont été recueillies de façon rétrospective en examinant les dossiers de patients qui ont subi une arthroplastie totale de la hanche dans la circonscription hospitalière du nord-ouest de l'Ontario entre 2007 et 2012. Constatations: Pour les 36 dossiers de patient examinés, la durée du séjour (DDS) médiane au centre de santé Meno Ya Win de Sioux Lookout était de 7,5 jours (étendue: de 2 à 335); la DDS médiane à compter du moment de l'intervention chirurgicale à l'hôpital régional (Centre régional des sciences de la santé de Thunder Bay) jusqu'au départ du centre de santé Meno Ya Win de Sioux Lookout était de 13,5 jours; et le temps médian de recouvrement de la capacité à marcher et à monter des escaliers était de 9 jours (étendue: de 1 à 93). Conclusion: Les cheminements cliniques en milieu urbain généralement reconnus ne conviennent pas aux petits hôpitaux ruraux à partir desquels les patients des Premières Nations retournent dans des collectivités éloignées qui n'offrent pas de services de réadaptation. La DDS dans un centre de soins actifs en milieu rural est semblable à la DDS dans un centre de réadaptation en milieu urbain.
ABSTRACT
PURPOSE: The objectives of this study were to describe perceptions of disability among South Asian immigrant mothers of children with disabilities in a large multicultural urban centre in Ontario, Canada, and to explore how these perceptions influence rehabilitation services. The study was built on our previous work conducted with mothers in South Asia. METHODS: A descriptive qualitative research design was employed. Semi-structured interviews were conducted with five mothers who had immigrated to Canada from South Asia in the last decade, and whose children were receiving outpatient rehabilitation services. RESULTS: Three primary themes were identified: (1) perceptions of disability reflected a mix of traditional and western beliefs; (2) mothers experienced physical, emotional and social suffering related to socio-cultural and material barriers and (3) mothers' primary goal for their children was the achievement of independent walking, which was linked to notions of achieving a ?normal? life and the desire for more rehabilitation interventions. CONCLUSIONS: South Asian immigrant mothers' perceptions of their children's disabilities had important similarities and differences to mothers living in South Asia. Healthcare professionals can assist families in managing and coping with their child's disabilities by exploring their unique values and beliefs and identifying achievable outcomes together.
