On the Quality of Providing Rehabilitation Care in Sanatorium and Health Resort and Health-Improving Institutions in Kyrgyzstan

The article is devoted to the analysis of the activity of rendering rehabilitation aid to the population of Kyrgyzstan in the sanatorium and resort conditions. In the course of work, the basic elements of management of the quality system of this service are covered.

The Organization of Diagnosis, Care and Funding for Specific Learning and Developmental Disorders (SLDD): A French Regional Experimental Protocol

Introduction: Access in France to early diagnosis and care for the most severe, but infrequent, Neurodevelopmental Disorders (NDD), autism spectrum disorder and global developmental delay, in children aged 0–7 was improved through measures implemented in 2019. However, there are no such measures for specific learning disorders (SLD), attention, motricity and language disorders (SLDD), despite their annual incidence of between 5 and 8%.Method: We describe the design of a new type of organization and financing of care for SLDD including evaluation procedure, as well as other factors, mainly at the prevention level that will contribute to local and national policy for this frequent health problem. This in response to a national call for projects, commonly called Article 51, targeted innovation in healthcare delivery and funding in the context of medium-term national reform. This provides project stakeholders with the opportunity to set up and implement “bottom-up” projects, mainly using local professionals. A joint initiative by the regional Health Authorities of the Occitanie region, the French Social Security system and a non-profit Association (Occitadys) proposed an experimental new structure of NDD care and funding.Discussion: We here discuss the design of this experiment that aims, over two to three years, to alleviate families' financial burden of care and establish a regional three-tier care system with respect to evaluation, re-education and rehabilitation care. Our approach may benefit SLDD health-care planning, and addresses the questions of prevention, early detection and care-design for families, taking local and socioeconomic disparities into account.

Rehabilitation Care at the Time of Coronavirus Disease-19 (COVID-19) Pandemic: A Scoping Review of Health System Recommendations

Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers.Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations’ websites were searched.Study Selection: We included articles and reports if they were focused on rehabilitation related recommendations for COVID-19 patients, treating providers, or the general population.Data Extraction: Pairs of team members used a pre-tested data abstraction form to extract data from included full-text articles. The strength and the quality of the extracted recommendations were evaluated by two reviewers using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.Results: We retrieved 6,468 citations, of which 2,086 were eligible for review, after duplicates were removed. We excluded 1,980 citations based on title and abstract screening. Of the screened full-text articles, we included all 106 studies. A summary of recommendations is presented. We assessed the overall evidence to be strong and of fair quality.Conclusion: The rehabilitation setting, and processes, logistics, and patient and healthcare provider precaution recommendations identified aim to reduce the spread of SARS-CoV-2 infection and ensure adequate and safe rehabilitation services, whether face-to-face or through teleservices. The COVID-19 pandemic is rapidly changing. Further updates will be needed over time in order to incorporate emerging best evidence into rehabilitation guidelines.

Possibilities of telemedical monitoring risk factors in patients with cardiovascular diseases: experience of using a patient-oriented model of remote rehabilitation care

Introduction. The modern system for the prevention of cardiovascular diseases and the creation of conditions for the formation and maintenance of a healthy lifestyle (coolant) includes activities in the development of monitoring systems for information on risk factors. Purpose: to assess the capabilities of telemedicine monitoring of cardiovascular risk factors in the structure of a patient-oriented model of distance rehabilitation care. Material and methods. The study included patients with coronary heart disease and/or arterial hypertension of the I-III degree, without cognitive dysfunction and contraindications to physical rehabilitation, with a mobile device with Internet access. The following groups were distinguished: remote cardiac rehabilitation, with the participation of patients in a 12-month program (28 patients, 86% of men, average age 55.2 ± 10.7 years), and traditional follow-up (30 patients, 80% of men, average age 64.7 ± 6.9 years). Remote cardiac rehabilitation model provided for office consulting using a decision support system, monitoring indicators based on digital recording devices, mobile applications and the electronic «Patient Diary» deferred telemedicine counselling. The effectiveness of the observation was evaluated by the trend of the modified risk factors; patient satisfaction with remote assistance - according to the «Client Satisfaction Questionnaire - CSQ-8» questionnaire. Results. After completion of the remote cardiac rehabilitation (RCR) program, a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and triglycerides were observed, and a tendency to increase physical activity. Upon completion of the RCR-program, a high level of satisfaction with telemedicine assistance was noted. Conclusion. The results of the pilot phase of the study, dedicated to the study of the possibilities of remote rehabilitation in the context of maximizing the benefits for cardiovascular prophylaxis, indicate the possibility of using a patient-oriented model of remote cardiac rehabilitation to monitor and modify risk factors in patients with cardiovascular diseases.

Intellectual disability – towards the modification of theoretical contexts

n this article, I deal with the contemporary contexts of the analysis of the intellectual disability phenomenon and the alternative proposals for theorizing presented by disability studies. I ask the question: what /who the dominant views and non-scientific alliances are for. I question the tendency to favour the medical approach in special pedagogy, which is the starting point as well as the reference point for the educational, rehabilitation, care and support practices it develops. I am not going to decide on the legitimacy of various approaches, I am aware of their historical and systemic conditions. However, I dare to ask a question about – as Miłosz Markiewicz (2017) described it – the limits of the definition of a Human. In view of the experienced diversity of human conditions, like the above-mentioned author, today I have a “problem with using the category of disability too easily” (Markiewicz, 2017, p. 23), and in particular, not often considered in relation to the methods of scientific analysis and theoretical contexts, the category of intellectual disability.

Care for capabilities: Implementing the capability approach in rehabilitation of patients with neuromuscular diseases. Study protocol of the controlled before-after ReCap-NMD study

Background High quality care of patients with neuromuscular diseases requires a personalised approach that focuses on achieving and maintaining a level of functioning that enables them to be in a state of well-being. The capability approach states that well-being should be understood in terms of capabilities, the substantial opportunities that people have to be and do things they have reasons to value. In this Rehabilitation and Capability care for patients with Neuromuscular diseases (ReCap-NMD) study, we want to investigate whether providing care based on the capability approach (capability care) has an added value in the rehabilitation of patients with neuromuscular diseases (NMD). Methods Two groups of 30 adult patients with facioscapulohumeral muscular dystrophy or myotonic dystrophy type 1 will be included. The first group will receive rehabilitation care as usual with a follow-up period of 6 months. Then, based on theory, and experiences of patients and healthcare professionals, capability care will be developed. During the following 3 months, the multidisciplinary outpatient rehabilitation care team will be trained in providing this newly developed capability care. Subsequently, the second group will receive capability care, with a follow-up period of 6 months. A mixed methods approach is used with both qualitative and quantitative outcome measures to evaluate the effect of capability care and to perform a process evaluation. The primary outcome measure will be the Canadian Occupational Performance Measure. Discussion The ReCap-NMD study is the first study to design and implement a healthcare intervention based on the capability approach. The results of this study will expand our knowledge on how the capability approach can be applied in delivering and evaluating healthcare, and will show whether implementing such an intervention leads to a higher well-being for patients with NMD. Trial registration Registered at Trialregister.nl (Trial NL8946) on 12th of October, 2020.

Key Success Factors for Medical Service Quality of Early Treatment and Rehabilitation for Children in Taiwan

Early treatment and rehabilitation medical service is one of the important items in rehabilitation medicine. The service quality is critical for developing organizational sustainability. Therefore, the key success factors for the quality of such services are worthy of study. The main focus of this study is to explore the key success factors of the quality of early treatment and rehabilitation medical service in Taiwan. This study adopted an expert questionnaire for professional therapists related to rehabilitation care in Taiwan, and developed a total of 5 evaluation dimensions and 17 key success factors according to the concept of SERVQUAL. The analytic hierarchy process (AHP) method was used to analyze the expert questionnaires. The research results show that reliability is the most important dimension to construct quality early treatment and rehabilitation medical services. The seven key success factors affecting the quality of early treatment and rehabilitation medical services are in the order of “Professional treatment meets the needs of the case”, “Therapists have professional knowledge and skills”, “Professionalism gives parents and the case confidence”, “Professional advice can be understood by parents”, “The treatment equipment is consistent with the treatment provided by the therapists”, “Provide professional treatment in a timely and appropriate manner”, and “Therapists are enthusiastic and professional in handling case problems”. The practical implications of the research findings are also discussed in the study.

Mental health among students with neurodevelopment disorders: case of dyslexic children and adolescents

ABSTRACT Several research studies have been devoted to study the links between emotional disorders and learning disabilities. However, very minimal of this research has focused on dyslexic students. Objective: The objectives of this study were as follows: (1) to assess self-esteem, anxiety, and depression in dyslexic Arabic-speaking children and adolescents and (2) to describe psychiatric comorbidities in these subjects by comparing them to their non-dyslexic peers. Methods: In total, 205 students (56 dyslexics and 149 good readers), pursuing their education in ordinary schools in the Beni Mellal-Khenifra region of Morocco responded to Taylor’s Self-Assessment Scale of Anxiety, Beck’s Depression Questionnaire, and the Coopersmith Self-Esteem Inventory (SEI). Results: Overall, dyslexics were more anxious, more depressed, and had disturbed self-esteem compared to their non-dyslexic peers. The percentage of psychiatric comorbidity was higher in the dyslexic group. Conclusions: The results of this study highlight the need for a multidisciplinary approach that integrates emotional needs assessment into the rehabilitation care of dyslexic children and adolescents.

Rehabilitation care planning on a digital communication platform for patients with a work disability: protocol for the RehaPro-SERVE feasibility study

Background Long-term disability to work is a risk factor for a permanent reduction in income. Rehabilitation care can support people to return to work. In Germany, rehabilitation care to return to work is mostly provided in specialised clinics. The aim of the Rehapro-SERVE study is to reduce work disability days by facilitating rehabilitation care planning using a digital communication platform. To investigate the feasibility, we will test the implementation of the digital platform and evaluate the study procedures. The Rehapro-SERVE study is funded by the German Federal Ministry of Labour and Social Affairs (BMAS) (grant number: 661R0053K1). Method The feasibility study includes a two-armed unblinded block randomised controlled study (RCT) without follow-up assessments as well as an interview study. Participants for the RCT (n = 16) are primary care patients with a minimum of 4 weeks of absence from work due to musculoskeletal, oncological or psychological conditions and at high risk of early retirement. Eligibility criteria are age 40 to 60 years; minimum of 4 weeks continuous sick leave before recruitment due to musculoskeletal, mental health or oncological conditions; and being at high risk of early retirement. Patients will be recruited from 8 primary care practices in urban and rural areas in Hesse, Germany. Following baseline assessments, patients will be randomised to either digitalised care planning (treatment) or a control group. The digitalised care planning platform will include the patients’ primary care physicians, jobcentres and public health physicians to decide on a tailored return-to-work programme. The collaboration will be supported by a case administrator and, if considered beneficial, a social worker for the patient. An interview study will evaluate the acceptability of the study procedures and the intervention. Discussion The use of a digital communication platform enables stakeholders to exchange information and discuss rehabilitation care planning in a timely fashion. The results of the feasibility study will lead to the adaptation of study procedures for the main study. The results will support the design and conduct of similar studies including digital applications in primary care or across different healthcare settings. Trial registration DRKS- German Clinical Trials Register, DRKS00024207. Registered on 22 March 2021