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- Takáč, P, et al.
(författare)
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Position paper on PRM and persons with long term disabilities
- 2014
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Ingår i: European journal of physical and rehabilitation medicine. - 1973-9095. ; 50:4, s. 453-64
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Tidskriftsartikel (refereegranskat)abstract
- In the current population we observe a rise of chronic health problems often with multiple characteristics. This results in a growing number of people who are experiencing long-term disabilities or difficulties in functioning because of disability. These conditions require a complex response over an extended period of time, that involves coordinated inputs from a wide range of health professionals. This paper argues the central role and benefit of rehabilitation and describes the rehabilitation as an integral component in the management of people with chronic disabilities. It also presents the most important related definitions: long-term care, rehabilitation for chronic disease and disability, the aim of physical and rehabilitation medicine (PRM). An interdisciplinary team is ideal for an effective implementation of rehabilitation for chronic disease and disability. However, the article mainly focuses on defining the role and contribution of the PRM physician in the rehabilitation of persons with long-term disabilities. The article includes: descriptions of his/her key role and competencies, particularly with regard to medical and functional status and prognosis, of the ability to comprehensively define the rehabilitation needs of the patient/person with respect to ICD-WHO classification domains, of the cooperation with other medical specialists and health professionals, of determining the rehabilitation potential, of developing the rehabilitation plan tailored to specific needs, as well as of the contribution of PRM physician in the follow-up care pathways.
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- Berzina, G., et al.
(författare)
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A comparison of stroke rehabilitation; data from two national cohorts
- 2016
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 134:4, s. 284-291
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesInpatient rehabilitation is a commonly used complex intervention to improve a person's independence after stroke. Evaluation and comparison of the effects of routine clinical practice could provide a contribution towards optimization of stroke care. The aim of this study is to describe results of inpatient rehabilitation as a complex intervention for persons after stroke and explore possible differences between two countries. MethodsData from 1055 Latvian and 1748 Swedish adult patients after stroke receiving inpatient rehabilitation, during 2011-2013, were used for this retrospective cohort study. Qualitative description of systems, as well as information on basic medical and sociodemographic information, and organizational aspects were reported. Change in the Functional Independence Measure during rehabilitation was investigated. In six domains of the instrument, the shifts for three levels of dependence were analysed using ordinal regression analysis. ResultsThe components of stroke care seem to be similar in Latvia and Sweden. However, the median time since stroke onset until the start of rehabilitation was 13 weeks in Latvia and 2 weeks in Sweden. The median length of rehabilitation was 12 and 49 days, respectively. The level of dependency at start, time since stroke onset and length of the period had an impact on the results of the rehabilitation. ConclusionsAlthough components of the rehabilitation are reported as being the same, characteristics and the outcome of the inpatient rehabilitation are different. Therefore, comparison of stroke rehabilitation between countries requires caution.
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| 4. |
- Berzina, G., et al.
(författare)
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Living in Latvia after stroke: the association between functional, social and personal factors and the level of self-perceived disability - a cross-sectional study
- 2016
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 6:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate how functional, social and personal factors are associated with self-perceived level of disability in the chronic phase of stroke in a Latvian stroke population. The consequences of stroke can vary greatly and often leads to long-term disability that, according to the WHO definitions, depends on the interaction between the person and his/her context. Setting Community-dwelling persons who received specialised in-patient rehabilitation after stroke in Latvia. Participants Of 600 persons after stroke who were identified through hospital register and selected for the study, 255 were included in the analysis. Primary and secondary outcome measures The medical information and discharge data of the Functional Independence Measure (FIM) was extracted from medical records. Participants filled out a questionnaire on sociodemographic information and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), either in Latvian or Russian, depending on their wish when contacted for their oral agreement to participate. Stepwise multiple regression analysis was conducted to find a model that best explains the variance in WHODAS 2.0 scores. Results The models explained 23-43.5% of variance in outcomes. The best explained WHODAS 2.0 domains were mobility' and self-care'. The significant factors were level of independence in self-care', locomotion' and communication' according to FIM, as well as working status, time since rehabilitation, age, gender, living alone or in family and preferred language. Conclusions Functional, social and personal factors are of similar importance when explaining self-perceived disability in the chronic phase of stroke. Some, but not all, of the factors are modifiable by the healthcare system. Therefore, a complex approach and involvement of medical, social and political systems is needed.
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