Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application ...of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation. These programs almost all include pediatric surgeons, pediatric gastroenterologists, specialized nurses, and dietitians; many also include a variety of other medical and allied medical specialists. Intestinal rehabilitation programs provide integrated interdisciplinary care, more discussion of patient management by involved specialists, continuity of care through various treatment interventions, close follow-up of outpatients, improved patient and family education, earlier treatment of complications, and learning from the accumulated patient databases. Quality assurance and research collaboration among centers are also goals of many of these programs. The combined and coordinated talents and skills of multiple types of health care practitioners have the potential to ameliorate the impact of intestinal failure and improve health outcomes and quality of life.
Background: Neurological early rehabilitation aims at regaining cooperativity and acquiring rehabilitation capability with brain-injured patients, most of whom are transferred from Intensive Care ...Units, most of whom still require intensive care and suffer from disorders of consciousness. In neurological early rehabilitation, therapeutic nursing is an integral part of the therapeutic team. Other than the specialized therapists, nurses are present on the ward 24/7, which gives them a closer perspective on the patient. The research question was how do nurses, physiotherapists, occupational therapists and speech therapists communicate and interact as teams in neurological rehabilitation wards. A literature review was conducted aiming at inter-professional communication and interaction with special regard to the role of these four professionals being the core team members in these settings.
Methods: A literature search was conducted in the period from August to October 2016 within the following electronic Databases: Medline, CINAHL, PSYNDEX, SpeechBITE, PEDro und OTseeker. Further searches were undertaken in the reference lists of obtained studies to locate other relevant material. The aim was to gather and evaluate the evidence about inter-professional teamwork in neurological early rehabilitation. The main inclusion criterion was the presence of the following professionals as participants in the study: Nurses, physiotherapists, occupational therapists and speech therapists. Twenty-seven studies were found relevant, of which 17 (12 qualitative and five quantitative) bore empirical results that related to the research questions. These 17 studies were qualitatively analysed for the grade of evidence, methods and the relevance for the conditions and processes in rehabilitation units. Out of 17 studies, four were performed in neurological rehabilitation settings, five in stroke units, six in general rehabilitation, one in short-term care rehabilitation and one in geriatric rehabilitation. Due to the scarcity of material, all these studies were analysed under the perspective of relevance for neurological early rehabilitation.
Results: The results of this exploratory literature review indicate that the efficiency and quality of cooperation in rehabilitation teams could be improved through a better patient-oriented inter-professional communication. This is achieved through cross-professional team organization, team supervision and by including team communication in vocational and on-the-job-training. Profession-specific terminologies and differences in understanding of roles could be barriers for collaboration in teams.
Conclusions: According to this literature review, successful inter-professional patient-orientated care is promoted by being informed about the various functions of team members from different disciplines, about the role each member plays within the team and communication styles. Means of improving communication are being outlined.
Implications for Rehabilitation
Inter-professional communication is promoted by cross-professional team organization.
Inter-professional communication should be included in vocational and on-the-job-training and supervision.
Barriers for communication in teams are different terminologies and differences in role perception.
Work stress (WS) is a set of harmful physical and emotional reactions that occur when the demands coming from work are not adequate to the skills, resources, or needs of the worker. This causes ...physical, mental, psychological, or social suffering and dysfunction, which can lead to burnout syndrome.
The aim of this study is to evaluate WS in the healthcare professions, evaluating the effectiveness of a professional stress prevention program to promote a reduction in WS.
Thirty-three healthcare professionals of the Multiple Sclerosis (MS) rehab ward of the IRCCS Neurolesi (Messina, Italy) were enrolled in this study. The professional stress prevention program was based on group support activities, as well as individual support.
At baseline, we found a high burnout risk in physiotherapists, physicians, and other healthcare professionals. At the end of the meetings, we found a normalization in WS, with a higher sense of personal realization in all of the health-professions, and a greater use of functional coping strategies.
The occupational stress-reducing intervention in healthcare teams can promote a reduction of stress and anxiety, encouraging more functional coping strategies to face work difficulties.
Cerebral palsy in children is an early impairment of the central nervous system that affects various areas of a child’s functioning – movement, speech, communication, cognitive functions, attention, ...behaviour, and emotions (Rosenbaum et al., 2007). Lack of independence poses a high risk of causing a child psychological and social difficulties, limits opportunities to participate in daily life, and makes the child dependent on others; these factors reduce a child’s self-confidence and their desire to act in a social space (Whittingham, Bodimeade, Lloyd, & Boyd, 2014). This article concerns global experiences of the application of music therapy in neurology, and presents the situation in Lithuania (Abramavičiūtė & Aleksienė, 2011). The concept of neurological music therapy is disclosed on the basis of theoretical research methods, and an overview of the range of options for the application of music therapy in rehabilitating children with CP is provided (Alves-Pinto & Turova, 2016; Rolvsjord, 2010; Thaut & Hoemberg, 2014). The therapeutic effects of music are increasingly being recognized in the field of rehabilitation medicine. More music therapists are being employed in physical medicine and rehabilitation centres, with the goal of using music therapy services to assist in the physical recovery and maintenance of the health of children with cerebral palsy. Music therapy and rehabilitation medicine are starting to find a common niche in working together with clients who have various neurological, orthopaedic, and paediatric conditions (Stanley & Ramsey, 2001). The therapeutic application of music in rehabilitation contributes to the quality of life of individuals with disabilities. Combined goals include improving strength, range of motion, balance, communication, and cognition (Nip, Arias, Morita, & Richardson, 2017; Rolvsjord, 2010). Continued research and efforts in clinical practice will build on the information already available to further define the possible applications of music therapy in rehabilitation, its outcome, and its benefits. Occupational therapists can use the therapeutic medium of music, and the services of the discipline of music therapy, in assisting clients to maximize their functional independence in their daily occupational roles. The research object of this paper is music therapy methods, focused on the individual special needs of children with CP. The aim of this article is to reveal the role of a music therapist in a team of rehabilitation specialists in the health maintenance of children with cerebral palsy. This will involve three tasks: 1) to review the results of music therapy research in children with CP, revealing the applied methods for the development of movement, emotion, and communication skills; 2) to present the assessment of specialists regarding children with CP (their strengths, weaknesses, achievements, and goals) from those working in the rehabilitation team – namely the speech therapist/special pedagogue, occupational therapist, and physiotherapist; and 3) to analyse the possibilities of the individual effects of music therapy on children with CP in order to achieve positive changes in psychosocial status. The research question asks: Which methods can a music therapist contribute to the rehabilitation programme of children with CP as an equal member of the team? The sample of this study was three children with cerebral palsy attending X social care day centre. Children were selected by convenient selection (all children attended the same institution) to analyse homogeneous cases according to CP diagnosis during music therapy sessions. The research ethics were ensured in a number of ways. Firstly, the participation of the day centre specialists in the interview survey was voluntary. In accordance with the principles of ethics, the researcher presented the topic of the work, the objectives of the research, and confirmed the anonymity of the received information and its use only for the purposes of the work. The parents of the study participants (children) were introduced to the objectives of the study and confirmed their consent in writing, as well as approving the use of the recordings of the MT sessions for scientific purposes. Finally, the children’s names were changed to preserve anonymity. The study possesses some limitations – primarily the fact that, due to the complexity of the disabilities of children with cerebral palsy and the nature of supportive rehabilitation, trends in therapeutic effects could not be confirmed over eight individual MT sessions. Music therapy should be an individual, long-term, and systematic process, as consolidating new abilities in a child with CP requires the consistency and continuity of activities. The research methods utilized include: theoretical analysis of scientific literature and research in rehabilitation and music therapy; structured interview with rehabilitation specialists – physiotherapist, occupational therapist, and speech therapist; and empirical research – an analysis of three cases identifying physical, emotional, and communication changes in the process of music therapy. Analysis of the video recordings of individual sessions of music therapy revealed positive changes in children with CP in the following areas of development: movement skills, emotions, and communication. The findings of the empirical research revealed that therapeutically created space – by properly choosing musical instruments – strengthened the child’s movement control, the musical environment increased motivation, and rhythmic music playing allowed the child to adjust the sequence of their movements and their range. Music was an alternative means of communication, helping to develop the child’s communication skills, social interaction, and the creation of a new communication experience for the child. The individualized selection of music therapy methods provided an opportunity to delve into the child’s emotional state, develop their self-awareness, strengthen self-confidence, reduce anxiety levels, and model appropriate behaviour.
To date, the introduction of the International Classification of Functioning, Disability and Health (ICF) into the practical work of rehabilitation institutions and units of different levels and ...different profiles is a key moment in the organization of the rehabilitation process in accordance with a new legislative framework and a new model of the medical rehabilitation system being created in Russia. Namely, the ICF is the basis for the rehabilitation diagnosis formulation as well as rehabilitation goals and the development of the rehabilitation strategy for each individual patient, and the practical ICF use presents the greatest difficulties for members of the multidisciplinary rehabilitation team (MDRT), since it requires to restructure their thinking stereotypes and behavior « from dysfunction – to limitation of activity», «from correction of disorders to restoration of activity». In this regard, the ICF usage issues in the process of rehabilitation of patients who underwent arthroplasty of large joints, presented in this article, are very relevant.
Aim. To describe the most frequent ICF domains used in the formulation of a rehabilitation diagnosis in patients who have undergone the lower limb joints replacement.
Conclusion. Identification of key problems based on ICF in patients undergoing total knee and hip arthroplasty allows a more focused and specialized approach to the rehabilitation process for this category of patients, correct formulation of rehabilitation goals and drawing up a plan of rehabilitation measures. In patients who have yet to undergo joint replacement, the use of classification allows to clarify the indications for surgical intervention.
Introduction: Cooperation among rehabilitation team members is essential in the home-based rehabilitation setting. Q-methodology that can quantitatively analyze the subjectivity of members of the ...rehabilitation team was used to explore the role of occupational therapists (OTs) in home-based rehabilitation. Methods: The Q-methodology process was implemented in five steps: Step 1 - Representative statements about the role of OTs were collected through in-depth interviews, open questionnaires, and literature reviews (Q-sample); Step 2 - A total of 34 rehabilitation team members (physical therapists, OTs, social workers, nutritionists) were recruited (P-sample); Step 3 - The statements were classified according to their subjective perspective (Q-sort); Step 4 - Factor analysis was performed based on the correlation among the responses from the participants (Q-factor analysis); Step 5 - The awareness factor for roles was interpreted (Interpretation of awareness factors). Results: The roles of OTs perceived by members of the home-based rehabilitation team were formed into five factors (A) Adaptation within home environments; (B) Professional development; (C) Reliable service execution; (D) Client needs resolution; and (E) Focus on activity participation. In all factors, perspectives on the role of OTs in helping clients participate in their roles and activities at home were included. These factors included issues and directions addressed in prior literature on the development of occupational therapy. Conclusions: In home-based rehabilitation, OTs must play a professional role in ensuring clients live fully at home, and cooperate with team members for an effective rehabilitation approach.
To develop a team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) in clinical evaluation.
A Delphi study.
Experts from ...rehabilitation institutions in China including physicians, nurses, physiotherapists and occupational therapists.
A 2-round Delphi survey and expert panel discussion were used to generate the team approach. Firstly, the candidate types of professionals for team rating were chosen through expert panel discussion. A carefully selected group of participants was then asked to score the suitability of physicians, nurses, or other candidate therapists for each category's rat-ing, applying the International Classification of Functioning, Disability and Health Rehabilitation Set in clinical evaluation. After initial assignment of cate-gory to types of professionals, a second round Delphi survey was conducted to quantify the professionals' agreement with the category assignments and generate a final team evaluation approach.
Thirty of the category assignments achiev-ed consensus. The final team evaluation approach assigned 6 categories to physicians to evaluate, 7 categories to nurses, 9 categories to physiotherapists, and 8 to occupational therapists.
Such a team evaluation approach could facilitate implementation of the ICF-RS in clinical settings and provide a more convenient assessment tool for professionals.
Physical rehabilitation medicine is a diverse specialty; its main objective is to provide comprehensive rehabilitation involving multiple health care professionals to optimize function and improve ...the quality of life for people with disabilities. There is an increase in the number of people with disabilities, and people with disabilities in lower income countries do not receive the required rehabilitation. Rehabilitation intervention includes functional assessment, rehabilitation goal setting, composition of the focused team and coordination of the team works, all of which require a highly skilled team leader. No single professional is likely to have all the necessary skills to achieve optimal results alone. There is a knowledge gap between the theory, existing situation, and practice in rehabilitation team functioning. In this short communication challenges for quality rehabilitation services were highlighted, including the importance of the leadership role of team functioning.
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