Using knowledge translation to establish a model of hospital-based early supported community reintegration for stroke patients in South Korea

Background In 2019, the South Korean government started designating rehabilitation medical institutions to facilitate the early return of patients with stroke (PWS) to their communities after discharge. However, a detailed operating model has not yet been suggested. We aimed to develop a hospital-based early supported community reintegration model for PWS that is suitable for South Korea based on knowledge translation in cooperation with clinical experts and PWS. Methods Clinical experts (n = 13) and PWS (n = 20) collaboratively participated in the process of developing the early supported community reintegration model at a national hospital in South Korea, using the following phases of the knowledge-to-action cycle: (1) identifying knowledge, (2) adapting the knowledge to the local situation, (3) assessing barriers and facilitators to local use of knowledge, and (4) tailoring and developing the program. Barriers and facilitators to local use of knowledge were assessed multidimensionally at the individual, interpersonal, organizational, and community level based on the social-ecological model. Literature reviews, workshops, individual and group interviews, and group meetings using nominal group technique were conducted in each phase of the knowledge-to-action cycle. Results Each phase of the knowledge-to-action cycle for developing the early supported community reintegration model and a newly developed model including the following components were reported: (1) revision of strategies of organizations related to community reintegration support, (2) establishment of a multidepartmental and multidisciplinary community reintegration support system, (3) standardization of patient-centered multidisciplinary goal setting, (4) multidimensional classification of community reintegration support areas, and (5) development of guidelines for a tailored community reintegration support program. Conclusions We designed a hospital-based multidimensional and multidisciplinary early supported community reintegration model that comprehensively included several elements of community rehabilitation in connection with hospitals and communities, taking into account the South Korean situation of lacking community rehabilitation infrastructure. In developing a guideline for a tailored community reintegration support program, we attempted to take into consideration various situations faced by PWS in South Korea, which is in a transitional stage for community rehabilitation. It is expected that this early supported community reintegration model can be referenced in other countries that are in a transitional stage of community rehabilitation.

Psychiatric well-being among men leaving prison reporting a history of injecting drug use: A longitudinal analysis

Background: Community reintegration from prison is typically stressful, with several health and social outcomes impacting psychiatric well-being during this time, often exacerbated among individuals with histories of drug use. Longitudinal data was used to assess change in psychiatric well-being over 2 years following release from prison among men who reported a recent history of injecting drug use. Methods: Data for this study come from the Prison and Transition Health cohort study of 400 men recruited in prison prior to release and followed up over three time points. Psychiatric well-being was assessed using the 12-item General Health Questionnaire. We calculated change in individual General Health Questionnaire scores between interviews and identified covariates associated with General Health Questionnaire score using linear mixed-effects regression. Results: Data from 690 follow-up interviews among 326 participants were included in analyses. There was considerable variation in individuals’ General Health Questionnaire scores. Moving accommodation frequently and frequent illicit drug injections were associated with an increase in General Health Questionnaire score (i.e. decline in psychiatric well-being). Two or more prior adult imprisonment episodes, social supports and past month primary healthcare attendance were associated with a decrease in General Health Questionnaire score. Conclusion: Our findings identify health, social and structural influences on psychiatric well-being after release from prison that can inform re-entry programmes to support community reintegration.

Community Reintegration of Long-Term Psychiatric Patients Through a Creative Arts Rehabilitation Therapy Group

After years of inpatient treatment in a locked facility, psychiatric patients who are preparing to transition to lower-security residential settings often benefit from bridging that continuum of care with supervised community excursions. In this study, facilitators and patients collaborated to identify and engage in a variety of arts-related experiences and settings in nearby cities and nature areas as a medium through which to help reconnect patients in a state psychiatric hospital with their surrounding community. Preliminary findings from data gathered included increased positive affect and quality of life, decreased feelings of isolation and institutionalization, more positive regard for treatment, and maintained or improved pace of patient progress toward discharge and community reintegration. Supervised therapeutic exposure to arts in the community appears to be an indicated clinical option to help motivate and prepare select psychiatric inpatients for community reintegration. As this is an information-sharing article regarding research-informed practice rather than the result of a research project, formal research is recommended as a next step to establish external validity and further the field’s knowledge of this topic.

Community Reintegration of Human-Trafficking Survivors: OT Perspective

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This study will provide knowledge for OTs in the United States about how OTs can potentially assist survivors to reintegrate into society as well as how OT can contribute to the prevention efforts in the antitrafficking movement. Increased understanding of OTs' role in providing services to human-trafficking survivors will contribute to the advancement of care provision to human-trafficking survivors overall. Primary Author and Speaker: Sarbinaz Bekmuratova Contributing Authors: Nicole Amato, Taran Pottebaum, Amanda Ruether, Madeline Smith, and Monica Williams