<p>According to the United Nations, more than half a billion people (about 650 million) worldwide are disabled. Disability can have a vast impact on both the individual and the family. Rehabilitation is therefore a fundamental need for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it is important to seek clients&rsquo / perspectives of the rehabilitation services and to incorporate these perspectives into the planning and delivery of rehabilitation services. In areas where rehabilitation services are available in South Africa, minimal research has been done to explore the clients&rsquo / experiences regarding provision of these services. The aim of this study&nbsp / therefore was to explore the persons with physical disabilities&rsquo / experiences of the rehabilitation services they received at community health centres (CHCs) in the Cape Town Metro Health&nbsp / District. Data was collected using a mixed methods design in the form of a sequential exploratory strategy. Qualitative data collection was done using in-depth interviews and this was followed&nbsp / by administration of an interview questionnaire. The questionnaire was developed using results from the in-depth interviews together with information from literature. Ten persons with physical&nbsp / isabilities, who had received rehabilitation services at participated in the in-depth interviews and 95 responded to the interview questionnaire. The interviews were tape-recorded and&nbsp / transcribed verbatim and they were analysed using predetermined themes. The SPSS version 16.0 was used to analyse the quantitative data which was presented in frequencies, medians, quartiles and percentages. The results&nbsp / of the study revealed that the participants experienced problems with getting transport to travel to the community health centres and getting adequate information from the service providers,&nbsp / &nbsp / particularly information regarding disability and support services available for them. Experiences regarding participants&rsquo / involvement in their rehabilitation were generally positive. Generally, the&nbsp / participants reported positive experiences regarding their interaction with service providers and family support and involvement and this study recommends the staff to maintain their standards&nbsp / &nbsp / regarding these two dimensions of rehabilitation. However most of the participants were not concerned about whether the service providers gave them an opportunity to express their preferences or not. The results indicate the need to improve transport services for persons with physical disabilities and to give them more information regarding support services. The service providers&nbsp / should also give the clients more opportunities to get involved in their rehabilitation and educate them about the benefits of them getting involved.</p>

Consumers with spinal cord injury (SCI) served by state vocational rehabilitation services programs receive a variety of services to help them achieve competitive employment and higher earning outcomes. The purpose of this study was twofold: (a) to determine whether there was a relationship between specific vocational rehabilitation (VR) services and vocational outcomes (i.e., competitive employment and weekly earnings) at closure and (b) to establish whether there was a relationship between specific demographic variables and vocational outcomes (i.e., competitive employment and weekly earnings) at closure. The RSA-911 data for fiscal year 2006 were analyzed. The analysis of specific VR service variables indicated job placement, maintenance, and rehabilitation technology were significantly related to competitive employment of consumers with SCI. However, rehabilitation technology was negatively related to competitive employment. Vocational rehabilitation counseling and guidance, college/university training, and rehabilitation technology were positively related to weekly earnings; whereas occupational/vocational training, on-the-job training, and job placement services were negatively related to weekly earnings. An analysis of demographic variables indicated that gender and age were not related to competitive employment. Level of education and race were related to competitive employment. Gender, age, educational level, and race were related to weekly earnings. Males, young consumers, consumers with most education, and Whites were more likely to earn higher salaries.

Magistrinio darbo tikslas yra įvertinti medicininės reabilitacijos sistemos reformos pagrindinius trūkumus ir privalumus, nustatyti pagrindinius tai įtakojančius veiksnius ir remiantis analizės duomenimis bei reabilitacijos sistemos kūrime dalyvaujančių ekspertų nuomone, pateikti pasiūlymus kaip gerinti reabilitacijos paslaugų teikimo kokybę ir prieinamumą Lietuvoje. Darbo teorinėje dalyje analizuojami reabilitacijos sistemos pokyčių teoriniai pagrindai. Nagrinėjami norminiai aktai, moksliniai darbai ir kiti literatūros šaltiniai , aprašantys reabilitacijos sistemos raidą, struktūrą, reabilitacijos etapus, paslaugų rūšis bei jų vietą Lietuvos Nacionalinėje sveikatos sistemoje. Praktinėje dalyje analizuojami reabilitacijos sistemos pokyčiai Lietuvoje nuo 1992 m. iki 2005 m. Analizę sudaro trys dalys. Pirmoje dalyje analizuojami teisės aktai turėję įtaką reabilitacijos sistemos pokyčiams, buvo įvertintas kiekvieno jų tiesioginis poveikis reabilitacijos paslaugų struktūrai bei sąsajos su Lietuvos reabilitacijos strategijoje įvardintais reabilitacijos sistemos kūrimo principais. Antroje dalyje buvo atlikta reabilitacijos efektyvumo statistinių rodiklių analizė. Analizuota reabilitacijos paslaugų struktūra jos rodiklių kitimai bei teisės aktų, įtaka šiems pokyčiams. Trečioje dalyje apibendrinami anketinės apklausos duomenys. Tam, kad įvertintume reabilitacijos sistemos paslaugų kitimą bei reabilitacijos sistemos reformos sėkmę Lietuvoje, atlikta ekspertų apklausa. Buvo... [to full text] / The purpose of the master paper is to evaluate the key advantages and drawbacks of the reform of the medical rehabilitation system, to establish its influencing factors and, based on the data of analysis and the opinion of the experts participating in the development of the rehabilitation system, to develop suggestions how to improve the quality and accessibility of the rehabilitation services in Lithuania. In the theory part of the paper the theoretical base of the changes in the rehabilitation system are analysed. Legal acts, scientific papers and other sources of literature dealing with the development, structure, steps of rehabilitation, types of services and their place in the National Health Care System in Lithuania. The practical part analysis the changes in the rehabilitation system in the period From 1992 to 2005. The analysis consists of three parts. The first part deals with the legal acts, which influenced the changes in the rehabilitation system, the direct impact of each of them on the structure of services and the correlation with the principles defined in the Lithuanian Rehabilitation System Development Strategy. The second part contains the analysis of the statistical data of the rehabilitation efficiency. The structure of the rehabilitation services, the changes in its indexes and the influence of the legal acts have been analysed. The third part summarise the data of the questionnaire. A survey among experts has been carried with the purpose to... [to full text]

<p>According to the United Nations, more than half a billion people (about 650 million) worldwide are disabled. Disability can have a vast impact on both the individual and the family. Rehabilitation is therefore a fundamental need for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it is important to seek clients&rsquo / perspectives of the rehabilitation services and to incorporate these perspectives into the planning and delivery of rehabilitation services. In areas where rehabilitation services are available in South Africa, minimal research has been done to explore the clients&rsquo / experiences regarding provision of these services. The aim of this study&nbsp / therefore was to explore the persons with physical disabilities&rsquo / experiences of the rehabilitation services they received at community health centres (CHCs) in the Cape Town Metro Health&nbsp / District. Data was collected using a mixed methods design in the form of a sequential exploratory strategy. Qualitative data collection was done using in-depth interviews and this was followed&nbsp / by administration of an interview questionnaire. The questionnaire was developed using results from the in-depth interviews together with information from literature. Ten persons with physical&nbsp / isabilities, who had received rehabilitation services at participated in the in-depth interviews and 95 responded to the interview questionnaire. The interviews were tape-recorded and&nbsp / transcribed verbatim and they were analysed using predetermined themes. The SPSS version 16.0 was used to analyse the quantitative data which was presented in frequencies, medians, quartiles and percentages. The results&nbsp / of the study revealed that the participants experienced problems with getting transport to travel to the community health centres and getting adequate information from the service providers,&nbsp / &nbsp / particularly information regarding disability and support services available for them. Experiences regarding participants&rsquo / involvement in their rehabilitation were generally positive. Generally, the&nbsp / participants reported positive experiences regarding their interaction with service providers and family support and involvement and this study recommends the staff to maintain their standards&nbsp / &nbsp / regarding these two dimensions of rehabilitation. However most of the participants were not concerned about whether the service providers gave them an opportunity to express their preferences or not. The results indicate the need to improve transport services for persons with physical disabilities and to give them more information regarding support services. The service providers&nbsp / should also give the clients more opportunities to get involved in their rehabilitation and educate them about the benefits of them getting involved.</p>

Darbo tikslas. Įvertinti pacientų nuomonę ir lūkesčius apie UAB“Sk Impeks Medicinos Diagnostikos Centre“ teikiamas reabilitacijos paslaugas. Darbo uždaviniai.: 1. Įvertinti pacientų pasiskirstymą UAB ,,SK Impeks Medicinos diagnostikos centre” teikiamoms reabilitacijos paslaugoms. 2. Nustatyti pacientų vertinimus teikiamoms reabilitacijos paslaugoms pasirinktoje sveikatos priežiūros įstaigoje. 3. Įvertinti sveikatos priežiūros paslaugų kokybę ir prieinamumą, lojalumą pasirinktai sveikatos priežiūros įstaigai Tyrimo metodika. 2011 metais UAB“Sk Impeks Medicinos Diagnostikos Centre“ atlikta anoniminė 381 pacientų apklausa. Tyrimas atliktas 2011 metų lapkričio, gruodžio ir 2012 metų sausio mėnesiais. Pacientų apklausai sudaryta 36 klausimų anoniminė anketa. Tyrimo duomenų analizė atlikta naudojant statistinį duomenų analizės paketą SPSS 20.0. Rezultatai. Atliktame tyrime dalyvavo 338 pacientai: (31,9 proc.) (n =108 ) - vyrų, (68,0 proc.) (n =230 ) – moterų. Įvertinus apklaustųjų amžių nustatyta, jog skaitlingiausios buvo 25 – 44 metų (42,0 proc.) ir 19 – 24 metų (32,3 proc.) amžiaus grupės. 65 – 74 metų ir vyresnių, daugiau negu 75 metų amžiaus grupėse respondentų skaičius buvo beveik vienodas (6,4 proc.) ir (5,8 proc.) Pastebėta tendencija, kad vyrams buvo labai svarbi aukštesnė personalo kvalifikacija (30,5 proc.) ir tobulesnė įranga ir medžiagos (13,0 proc.) negu moterims. Moterų pasirinkime dominavo: malonesnis personalo bendravimas (28,6 proc.), pacientui skiriama... [toliau žr. visą tekstą] / Research objective. Assess patients opinions and expectations about „SK Impeks Medicinos Diagnostikos Centre“ provided rehabilitation services. Research tasks. 1) to analyze,,SK Impeks Medicinos Diagnostikos Centre“ provided rehabilitation services; 2) to assess health status of patients visiting ,,SK Impeks Medicinos Diagnostikos Centre“ according to their gender, age; 3) to assess patients‘ opinions and expectations regarding provision of rehabilitation services. Research methodology. During 2011 an anonymous survey of 381 patients from “SK Impeks Medicinos Diagnostikos Centre“ were conducted. Research has been conducted during November and December of 2011 as well as January of 2012. For patients‘ survey an anonymous questionnaire with 36 questions were used. Research data analysis was performed using statistical analisys package SPSS 20.0. Results. There were 338 patients participating in the study: (31,9 proc.) (n =108) – men, (68,0 proc.) (n =230) – women. Assesing the age of respondents the most were 25 – 44 years old (42,0 proc.) and 19 – 24 years old (32,3 proc.), age groups 65 – 74 years and 75 years and older were similar (6,4 proc.) and (5,8 proc.). It was noticed that for men compared to women high quality of personnel was very important (30,5 proc.) and better equipment and materials (13,0 proc.). Women mostly choose: stuff communication (28,6 proc.), time given to patients (7,0 proc.) and shorter visits waiting time (7,4 proc.). Assesing reposndents... [to full text]

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2013-05-28T19:02:59Z No. of bitstreams: 1 Diss Fabiane Costa Santos. 2013.pdf: 2025697 bytes, checksum: 32d1940f46251b1cee721713af55a8bb (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-28T19:05:14Z (GMT) No. of bitstreams: 1 Diss Fabiane Costa Santos. 2013.pdf: 2025697 bytes, checksum: 32d1940f46251b1cee721713af55a8bb (MD5) / Made available in DSpace on 2013-05-28T19:05:14Z (GMT). No. of bitstreams: 1 Diss Fabiane Costa Santos. 2013.pdf: 2025697 bytes, checksum: 32d1940f46251b1cee721713af55a8bb (MD5) Previous issue date: 2013 / Segundo o Relatório Mundial sobre a Deficiência, mais de um bilhão de pessoas são acometidas pelo problema e destas, 200 milhões enfrentam alterações de funcionalidade que comprometem suas atividades de vida diária. No Brasil, o envelhecimento populacional, o aumento da incidência de acidentes e violências e ainda outros agravos - que conferem ao indivíduo algum grau de deficiência - representam um desafio para o SUS, pautado na organização da assistência à saúde, dos cuidados básicos à reabilitação. Os serviços de reabilitação física encontram-se entre os principais problemas do sistema e apesar das políticas que normatizam a criação destas unidades, poucas conquistas foram evidenciadas, faltando implantar os planos desenvolvidos. Precariedade da oferta de atendimento multiprofissional e domiciliar, carência de dispensação de órteses e próteses e dificuldade de acesso foram problemas dos serviços de cinco capitais estudadas, e despertaram curiosidade em relação à situação de Salvador. Realizou-se um diagnóstico de doze serviços, com utilização de dados secundários do CNES e entrevistas com gerentes dos serviços e técnico da SESAB. O diagnóstico administrativo e o momento explicativo do planejamento situacional foram as referências teórico-metodológicas adotadas. Os resultados apontaram para insuficiência de unidades e infraestrutura, inexistência de serviço da rede própria municipal, problemas de gestão, organização e prestação de serviços, e divergência entre dados do CNES e a realidade dos estabelecimentos. O propósito de mudança da situação evidenciada exige a formação de sujeitos transformadores, visando impulsionar um movimento que resulte na concretização de ações de melhoria da assistência em reabilitação física em Salvador, Bahia. / Salvador

The phenomenon being explored in this study was the understanding of minority clients' perceptions in relation to their rehabilitation counselors' cultural competence. A descriptive qualitative research methodology consisting of eight participants was used. Hycner's (1985) phenomenological analysis was used to investigate the in-depth interviews. The investigation revealed seven different themes that comprised of the essence of the phenomenon. The themes include: clients' understanding of the term cultural competence, self, attitudes, advocacy, understanding culture is important, role of culture, and expectations from the agency. The invariant structure that was consistent through all the above mentioned themes was the representation and manifestations of culture in the lives of the clients that continually challenged rehabilitation counselors' cultural competence through different phases of the vocational rehabilitation counseling experiences. The essence behind cultural competence was - perceiving the phenomenon as an experiential relationship based concept, where the client and the rehabilitation counselor educate one another about the all inclusive nature of the term culture and its role in the vocational rehabilitation process.

Masters of Science - Msc (Physiotherapy) / People with disabilities face many challenges. Some are made to feel inferior by others because of their physical or mental disabilities. Primary healthcare described by the Alma Ata Declaration as "health for all", is a process of care which encompasses a comprehensive approach to meet the basic healthcare needs of all, including people with disabilities. The main focus of the primary healthcare approach is to put people at the centre of healthcare. Primary healthcare utilises rehabilitation as a service. Rehabilitation services worldwide are set to improve the standard that the United Nations Convention of the Rights of People with Disabilities and National Committee of Rights People with Disabilities aims to achieve. There are however, gaps in the delivery of healthcare services at a primary level, as identified by the Western Cape Department of Health in South Africa. The 2030 healthcare plan was developed to fill the gaps at this level of service. The plan builds on the comprehensive service plan of healthcare 2010 which aimed to strengthen community-based services, primary healthcare and district hospitals. The plan also looks at how the Department of Health will operate using this platform. The framework was established to focus on changes inclusive of threats in the environment such as technological advances and the availability of resources, building on lessons learned in the Comprehensive Service Plan 2010 as well as a reimagined future to improve healthcare services for all. Key stakeholders in the Western Cape aim to improve these health services by providing patientcentred care, moving towards a goal orientated outcome, improving services at a district health level, improvement of equity, affordable health services and establishing premeditated partnerships.

Magister Scientiae (Physiotherapy) - MSc(Physio) / According to the United Nations, more than half a billion people (about 650 million) worldwide are disabled. Disability can have a vast impact on both the individual and the family. Rehabilitation is therefore a fundamental need for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it is important to seek clients perspectives of the rehabilitation services and to incorporate these perspectives into the planning and delivery of rehabilitation services. In areas where rehabilitation services are available in South Africa, minimal research has been done to explore the clients experiences regarding provision of these services. The aim of this study therefore was to explore the persons with physical disabilities experiences of the rehabilitation services they received at community health centres (CHCs) in the Cape Town Metro Health District. Data was collected using a mixed methods design in the form of a sequential exploratory strategy. Qualitative data collection was done using in-depth interviews and this was followed by administration of an interview questionnaire. The questionnaire was developed using results from the in-depth interviews together with information from literature. Ten persons with physical isabilities, who had received rehabilitation services at participated in the in-depth interviews and 95 responded to the interview questionnaire. The interviews were tape-recorded and transcribed verbatim and they were analysed using predetermined themes. The SPSS version 16.0 was used to analyse the quantitative data which was presented in frequencies, medians, quartiles and percentages. The results of the study revealed that the participants experienced problems with getting transport to travel to the community health centres and getting adequate information from the service providers particularly information regarding disability and support services available for them. Experiences regarding participants involvement in their rehabilitation were generally positive. Generally, the participants reported positive experiences regarding their interaction with service providers and family support and involvement and this study recommends the staff to maintain their standards regarding these two dimensions of rehabilitation. However most of the participants were not concerned about whether the service providers gave them an opportunity to express their preferences or not. The results indicate the need to improve transport services for persons with physical disabilities and to give them more information regarding support services. The service providers should also give the clients more opportunities to get involved in their rehabilitation and educate them about the benefits of them getting involved. / South Africa

Home and community participation is measured by a multitude of determinant factors based within the context of a health system. Three studies were completed to understand relationships between environment and personal factors with service utilization and outcomes of participation among children with disabilities. In the first study, a scoping review was completed to identify factors that influenced rehabilitation service utilization among Canadian children with disabilities. Key findings of this review indicated higher rates of service utilization are associated to younger age, males and those with lower cognitive or motor functioning. Occupational therapists, physiotherapists and speech-language pathologists were the most commonly utilized disciplines. Higher perceptions of service satisfaction related to increased presence of family-centered practices. Areas requiring further research include family needs, barriers, personal health practices and participation outcomes. Based on the findings of this review, a survey was created to administer to parents using a large children’s rehabilitation treatment centre in Ontario. Findings from the survey conducted with 279 parents are reported in the second study by providing a descriptive profile of families and children using geographically-based rehabilitation services. Families using the centre typically have younger aged children, with more boys than girls, and a large proportion use the centre for speech services. Complexity scores correlated significantly and positively with service need and service utilization, indicating children with lower functioning desired and received more rehabilitation services. Age, sex, and diagnosis did not predict total time in therapy, but complexity was a significant predictor of total time in therapy. Participation frequency scores showed weaker relationships to complexity in comparison to participation involvement scores. The final study explored the relationship between environmental and personal factors of service utilization and participation using structural equation modeling. Predictors of participation include child’s age, environmental barriers, complexity, and mother’s participation. Findings support that exploring children’s complexity and promoting mother’s participation by removing environmental barriers and modifying inaccessible structures are important to examine from a young age. / Dissertation / Doctor of Philosophy (PhD) / This study examines the relationship between factors of service utilization and participation outcomes for children with disabilities. Currently, there is little knowledge pertaining to the characteristics of children receiving rehabilitation services and the influence of these services on health outcomes. Such information is vital to understand how health conditions, service utilization, service planning, and service satisfaction differ across children with disabilities. Use of health services (type and number of rehabilitation services used, duration of services), environmental barriers, maternal leisure practices, and socioeconomic factors are examined with consideration to the child’s diagnosis and complexity in relation to scores of participation. This is the only study in Canada so far to comprehensively explore relationships between rehabilitation utilization and participation. The study informs health care providers and researchers about patterns and variations in children’s needs that can be utilized to improve service quality and plan services, as well as to understand participation patterns.