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[PMID]:29298304
[Au] Autor:Hruby LA; Pittermann A; Sturma A; Aszmann OC
[Ad] Endereço:Christian Doppler Laboratory for Restoration of Extremity Function, Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
[Ti] Título:The Vienna psychosocial assessment procedure for bionic reconstruction in patients with global brachial plexus injuries.
[So] Source:PLoS One;13(1):e0189592, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Global brachial plexopathies cause major sensory and motor deficits in the affected arm and hand. Many patients report of psychosocial consequences including chronic pain, decreased self-sufficiency, and poor body image. Bionic reconstruction, which includes the amputation and prosthetic replacement of the functionless limb, has been shown to restore hand function in patients where classic reconstructions have failed. Patient selection and psychological evaluation before such a life-changing procedure are crucial for optimal functional outcomes. In this paper we describe a psychosocial assessment procedure for bionic reconstruction in patients with complete brachial plexopathies and present psychosocial outcome variables associated with bionic reconstruction. METHODS: Between 2013 and 2017 psychosocial assessments were performed in eight patients with global brachial plexopathies. We conducted semi-structured interviews exploring the psychosocial adjustment related to the accident, the overall psychosocial status, as well as motivational aspects related to an anticipated amputation and expectations of functional prosthetic outcome. During the interview patients were asked to respond freely. Their answers were transcribed verbatim by the interviewer and analyzed afterwards on the basis of a pre-defined item scoring system. The interview was augmented by quantitative evaluation of self-reported mental health and social functioning (SF-36 Health Survey), body image (FKB-20) and deafferentation pain (VAS). Additionally, psychosocial outcome variables were presented for seven patients before and after bionic reconstruction. RESULTS: Qualitative data revealed several psychological stressors with long-term negative effects on patients with complete brachial plexopathies. 88% of patients felt functionally limited to a great extent due to their disability, and all of them reported constant, debilitating pain in the deafferented hand. After bionic reconstruction the physical component summary scale increased from 30.80 ± 5.31 to 37.37 ± 8.41 (p-value = 0.028), the mental component summary scale improved from 43.19 ± 8.32 to 54.76 ± 6.78 (p-value = 0.018). VAS scores indicative of deafferentation pain improved from 7.8 to 5.6 after prosthetic hand replacement (p-value = 0.018). Negative body evaluation improved from 60.71 ± 12.12 to 53.29 ± 11.03 (p-value = 0.075). Vital body dynamics increased from 38.57 ± 13.44 to 44.43 ± 16.15 (p-value = 0.109). CONCLUSIONS: Bionic reconstruction provides hope for patients with complete brachial plexopathies who have lived without hand function for years or even decades. Critical patient selection is crucial and the psychosocial assessment procedure including a semi-structured interview helps identify unresolved psychological issues, which could preclude or delay bionic reconstruction. Bionic reconstruction improves overall quality of life, restores an intact self-image and reduces deafferentation pain.
[Mh] Termos MeSH primário: Biônica
Plexo Braquial/lesões
Reabilitação/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189592


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[PMID]:29045409
[Au] Autor:Roda F; Agosti M; Merlo A; Maini M; Lombardi F; Tedeschi C; Benedetti MG; Basaglia N; Contini M; Nicolotti D; Brianti R; GRECo
[Ad] Endereço:Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Parma, Italy.
[Ti] Título:Psychometric validation of the Italian Rehabilitation Complexity Scale-Extended version 13.
[So] Source:PLoS One;12(10):e0178453, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In Italy, at present, a well-known problem is inhomogeneous provision of rehabilitative services, as stressed by MoH, requiring appropriate criteria and parameters to plan rehabilitation actions. According to the Italian National Rehabilitation Plan, Comorbidity, Disability and Clinical Complexity should be assessed to define the patient's real needs. However, to date, clinical complexity is still difficult to measure with shared and validated tools. The study aims to psychometrically validate the Italian Rehabilitation Complexity Scale-Extended v13 (RCS-E v13), in order to meet the guidelines requirements. An observational multicentre prospective cohort study, involving 8 intensive rehabilitation facilities of the Emilia-Romagna Region and 1712 in-patients, [823 male (48%) and 889 female (52%), mean age 68.34 years (95% CI 67.69-69.00 years)] showing neurological, orthopaedic and cardiological problems, was carried out. The construct and concurrent validity of the RCS-E v13 was confirmed through its correlation to Barthel Index (disability) and Cumulative Illness Rating Scale (comorbidity) and appropriate admission criteria (not yet published), respectively. Furthermore, the factor analysis indicated two different components ("Basic Care or Risk-Equipment" and "Medical-Nursing Needs and Therapy Disciplines") of the RCS-E v13. In conclusion, the Italian RCS-E v13 appears to be a useful tool to assess clinical complexity in the Italian rehab scenario case-mix and its psychometric validation may have an important clinical rehabilitation impact allowing the assessment of the rehabilitation needs considering all three dimensions (disability, comorbidity and clinical complexity) as required by the Guidelines and the inhomogeneity could be reduced.
[Mh] Termos MeSH primário: Psicometria/métodos
Reabilitação
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Idoso
Demografia
Análise Fatorial
Feminino
Seres Humanos
Itália
Masculino
Análise de Componente Principal
Reprodutibilidade dos Testes
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178453


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[PMID]:28805358
[Au] Autor:Centers for Medicare & Medicaid Services (CMS), HHS
[Ti] Título:Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2018. Final rule.
[So] Source:Fed Regist;82(148):36238-305, 2017 Aug 03.
[Is] ISSN:0097-6326
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Social Security Act (the Act), this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2018. This final rule also revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the "60 percent rule," removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions, removes the voluntary swallowing status item (Item 27) from the IRF-PAI, summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS, provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists, adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and revises and updates measures and reporting requirements under the IRF quality reporting program (QRP).
[Mh] Termos MeSH primário: Medicare/economia
Sistema de Pagamento Prospectivo/economia
Sistema de Pagamento Prospectivo/legislação & jurisprudência
Centros de Reabilitação/economia
Centros de Reabilitação/legislação & jurisprudência
Reabilitação/economia
Reabilitação/legislação & jurisprudência
[Mh] Termos MeSH secundário: Seres Humanos
Pacientes Internados
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:T
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE


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[PMID]:28704377
[Au] Autor:Körner M; Luzay L; Plewnia A; Becker S; Rundel M; Zimmermann L; Müller C
[Ad] Endereço:Medical Psychology and Medical Sociology, Medical Faculty, Albert-Ludwigs-University, Freiburg, Germany.
[Ti] Título:A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams.
[So] Source:PLoS One;12(7):e0180171, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. METHOD: A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. RESULTS: In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. CONCLUSION: The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.
[Mh] Termos MeSH primário: Tutoria/métodos
Assistência Centrada no Paciente/métodos
Reabilitação/organização & administração
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Análise por Conglomerados
Comportamento Cooperativo
Alemanha
Seres Humanos
Equipe de Assistência ao Paciente/organização & administração
Distribuição Aleatória
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180171


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[PMID]:28628009
[Au] Autor:Sepiashvili R
[Ad] Endereço:Peoples Friendship University of Russia, Moscow; National Institute of Allergology, Asthma and Clinical Immunology of Georgian Academy of Sciences, Tskhaltubo, Georgia; Institute of Immunology, Moscow, Russia.
[Ti] Título:[IMMUNOREHABILITOLOGY: A LOOK FROM THE SOURCES TO THE FUTURE. FROM IMMUNOTHERAPY TO PERSONALIZED TARGETED IMMUNOREHABLITATION].
[So] Source:Georgian Med News;(266):7-19, 2017 May.
[Is] ISSN:1512-0112
[Cp] País de publicação:Georgia (Republic)
[La] Idioma:rus
[Ab] Resumo:Development and introduction of modern clinical diagnostic tests (that allow to evaluate the functional system of immune homeostasis) into medical practice, a huge body of evidence on the leading role of the immune system in pathogenesis most acute and chronic diseases and even identification of specific nosological forms of immune-mediated diseases forced the scientists to search and develop new tools and techniques that have therapeutic effects on the impaired immune homeostasis and restore it to the normal state. The introduction of a new concept - immunorehabilitation - was an impetus for the accumulation of new knowledge and a catalyst for research in clinical immunology. It was Revaz Sepiashvili who breathed life into the concept of immunorehabilitation. He was lucky to be at its origi. He became not only the founder of the brand new scientific field - immunorehabilitation, but also the founder of a new medical science - immunorehablitology. In this paper, the author returns to the roots and recalls the way that medical science has gone before coming to understand immunorehablitology and tells readers about current successes and its development prospects.
[Mh] Termos MeSH primário: Fatores Imunológicos/história
Reabilitação/história
[Mh] Termos MeSH secundário: Estâncias para Tratamento de Saúde/história
História do Século XX
História do Século XXI
Seres Humanos
Doenças do Sistema Imune/história
Doenças do Sistema Imune/imunologia
Doenças do Sistema Imune/reabilitação
Fatores Imunológicos/uso terapêutico
Imunomodulação
Reabilitação/métodos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunologic Factors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE


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[PMID]:28593246
[Au] Autor:Abbasi J
[Ti] Título:Socially Assistive Robots Help Patients Make Behavioral Changes.
[So] Source:JAMA;317(24):2472-2474, 2017 Jun 27.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Reabilitação/instrumentação
Robótica/instrumentação
Equipamentos de Autoajuda
[Mh] Termos MeSH secundário: Transtorno Autístico/reabilitação
Desenho de Equipamento
Seres Humanos
Motivação
Reabilitação/psicologia
Reabilitação do Acidente Vascular Cerebral/instrumentação
[Pt] Tipo de publicação:INTERVIEW; NEWS
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.5682


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[PMID]:28575102
[Au] Autor:Mason C; Weber J; Atasoy S; Sabariego C; Cieza A
[Ad] Endereço:Department of Medical Informatics, Biometry and Epidemiology - IBE, Public Health and Health Services Research, Ludwig-Maximilians-University (LMU), Munich, Germany.
[Ti] Título:Development of indicators for monitoring Community-Based Rehabilitation.
[So] Source:PLoS One;12(6):e0178418, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Community-Based Rehabilitation (CBR) is a multi-sectoral approach working to equalize opportunities and include people with disability in all aspects of community life. Reliable and internationally comparable data needed to monitor and evaluate CBR are scarce, partially due to the absence of standardized indicators. The objective of this manuscript is to describe the collaborative development process which led to the World Health Organization's (WHO) recently launched set of standardized CBR outcome indicators. METHODS: The WHO's CBR Guidelines recognize CBR as a comprehensive and multi-sectoral strategy, and were therefore used as the starting point for the development of the indicators, in a consensus process involving WHO and International Disability and Development Consortium. Pilot implementations in Guatemala, Egypt and China using a specifically developed mobile phone application to collect data, and an online expert survey were completed to assess validity and feasibility of the indicators and their corresponding questions. RESULTS: The indicator set includes 13 Base Indicators which are broad enough to capture the situation of people with disability in settings where CBR is carried out, independently of the specific CBR activities carried out in a community; and 27 Supplementary Indicators that provide more specific coverage and can be selected based on the specific goals of a CBR program. CONCLUSION: The indicators were suitable to assess differences in health, education, social life, livelihood and empowerment between people with disability and other community members. This comparability provides valuable information to CBR managers, donors and government agencies, to guide decision making, support advocacy and improve accountability. The CBR indicators will support WHO and its member states in their efforts towards strengthening CBR, by generating evidence on its effectiveness.
[Mh] Termos MeSH primário: Serviços de Saúde Comunitária/normas
Reabilitação/métodos
[Mh] Termos MeSH secundário: Pessoas com Deficiência/reabilitação
Seres Humanos
Organização Mundial da Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178418


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[PMID]:28574985
[Au] Autor:Vos-Vromans D; Evers S; Huijnen I; Köke A; Hitters M; Rijnders N; Pont M; Knottnerus A; Smeets R
[Ad] Endereço:Revant Rehabilitation Centres, Breda, The Netherlands.
[Ti] Título:Economic evaluation of multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: A randomized controlled trial.
[So] Source:PLoS One;12(6):e0177260, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A multi-centre RCT has shown that multidisciplinary rehabilitation treatment (MRT) is more effective in reducing fatigue over the long-term in comparison with cognitive behavioural therapy (CBT) for patients with chronic fatigue syndrome (CFS), but evidence on its cost-effectiveness is lacking. AIM: To compare the cost-effectiveness of MRT versus CBT for patients with CFS from a societal perspective. METHODS: A multi-centre randomized controlled trial comparing MRT with CBT was conducted among 122 patients with CFS diagnosed using the 1994 criteria of the Centers for Disease Control and Prevention and aged between 18 and 60 years. The societal costs (healthcare costs, patient and family costs, and costs for loss of productivity), fatigue severity, quality of life, quality-adjusted life-year (QALY), and cost-effectiveness ratios (ICERs) were measured over a follow-up period of one year. The main outcome of the cost-effectiveness analysis was fatigue measured by the Checklist Individual Strength (CIS). The main outcome of the cost-utility analysis was the QALY based on the EuroQol-5D-3L utilities. Sensitivity analyses were performed, and uncertainty was calculated using the cost-effectiveness acceptability curves and cost-effectiveness planes. RESULTS: The data of 109 patients (57 MRT and 52 CBT) were analyzed. MRT was significantly more effective in reducing fatigue at 52 weeks. The mean difference in QALY between the treatments was not significant (0.09, 95% CI: -0.02 to 0.19). The total societal costs were significantly higher for patients allocated to MRT (a difference of €5,389, 95% CI: 2,488 to 8,091). MRT has a high probability of being the most cost effective, using fatigue as the primary outcome. The ICER is €856 per unit of the CIS fatigue subscale. The results of the cost-utility analysis, using the QALY, indicate that the CBT had a higher likelihood of being more cost-effective. CONCLUSIONS: The probability of being more cost-effective is higher for MRT when using fatigue as primary outcome variable. Using QALY as the primary outcome, CBT has the highest probability of being more cost-effective. TRIAL REGISTRATION: ISRCTN77567702.
[Mh] Termos MeSH primário: Terapia Cognitiva/economia
Síndrome de Fadiga Crônica/reabilitação
Custos de Cuidados de Saúde
[Mh] Termos MeSH secundário: Análise Custo-Benefício
Síndrome de Fadiga Crônica/psicologia
Seres Humanos
Reabilitação/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0177260


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[PMID]:28499004
[Au] Autor:Frontera WR; Bean JF; Damiano D; Ehrlich-Jones L; Fried-Oken M; Jette A; Jung R; Lieber RL; Malec JF; Mueller MJ; Ottenbacher KJ; Tansey KE; Thompson A
[Ti] Título:Rehabilitation Research at the National Institutes of Health:: Moving the Field Forward (Executive Summary).
[So] Source:Phys Ther;97(4):393-403, 2017 Apr 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Approximately 53 million Americans live with a disability. For decades, the National Institutes of Health (NIH) has been conducting and supporting research to discover new ways to minimize disability and enhance the quality of life of people with disabilities. After the passage of the American With Disabilities Act, the NIH established the National Center for Medical Rehabilitation Research with the goal of developing and implementing a rehabilitation research agenda. Currently, a total of 17 institutes and centers at NIH invest more than $500 million per year in rehabilitation research. Recently, the director of NIH, Dr Francis Collins, appointed a Blue Ribbon Panel to evaluate the status of rehabilitation research across institutes and centers. As a follow-up to the work of that panel, NIH recently organized a conference under the title "Rehabilitation Research at NIH: Moving the Field Forward." This report is a summary of the discussions and proposals that will help guide rehabilitation research at NIH in the near future.This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: Frontera WR, Bean JF, Damiano D, et al. Am J Phys Med Rehabil. 2017;97(4):393-403.
[Mh] Termos MeSH primário: Pesquisa de Reabilitação
Reabilitação/organização & administração
[Mh] Termos MeSH secundário: Tecnologia Biomédica
Cuidadores
Medicina Baseada em Evidências
Seres Humanos
Informática Médica
National Institutes of Health (U.S.)
Próteses e Implantes
Equipamentos de Autoajuda
Determinantes Sociais da Saúde
Estados Unidos
[Pt] Tipo de publicação:CONGRESSES
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170513
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx027


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[PMID]:28395374
[Au] Autor:Jürgensen M; Großmann N; Thyen U
[Ad] Endereço:Klinik für Kinder und Jugendmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck.
[Ti] Título:["I would not even think of applying!" - Barriers to Claiming Benefits for Rehabilitation Services for Children and Adolescents from Families' Perspectives].
[Ti] Título:"Das würde ich gar nicht erst beantragen!" ­ Barrieren der Inanspruchnahme einer Kinder- und Jugend-Rehabilitations-Maßnahme aus Sicht der Familien..
[So] Source:Rehabilitation (Stuttg);56(2):109-118, 2017 Apr.
[Is] ISSN:1439-1309
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Medical rehabilitation is recognized as an effective health care service to promote and protect health and social participation of children and adolescents. Although the number of children and adolescents with chronic conditions is growing, applications for rehabilitation have declined substantially since 2008. The aim of the study is to identify barriers that prevent families from claiming benefits for rehabilitation services and to give recommendations for actions. In this explorative study, guided qualitative interviews with families with children and adolescents eligible for benefits were conducted. The analysis of the transcribed interviews followed the iterative process of content analysis (deductive and inductive development of main and sub-categories). 14 families (with 16 index-children) participated in the study. The results showed high levels of psychosocial burden of families and yet barriers to access services on a structural, disease-specific, and individual level. We identified three main topics in which families recommended modifications: (a) information policy, (b) family centeredness perspectives and flexibility, and (c) cross-sectoral collaboration/health care management. Results indicate that families perceive the current pediatric rehabilitation services to lack fitting and flexibility. In general, a new approach of information and counselling, a more family centered perspective and integration of rehabilitation services in a comprehensive and coordinated health care structure are needed.
[Mh] Termos MeSH primário: Serviços de Saúde do Adolescente/utilização
Serviços de Saúde da Criança/utilização
Família
Acesso aos Serviços de Saúde/estatística & dados numéricos
Benefícios do Seguro/estatística & dados numéricos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Reabilitação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Serviços de Saúde do Adolescente/economia
Criança
Serviços de Saúde da Criança/economia
Pré-Escolar
Efeitos Psicossociais da Doença
Feminino
Alemanha
Acesso aos Serviços de Saúde/economia
Seres Humanos
Lactente
Recém-Nascido
Benefícios do Seguro/economia
Masculino
Reabilitação/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-103063



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde