Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Reside...Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.展开更多
Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, rena...Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, renal and urogenital complications, needing lifelong healthcare provisions. The aim of this study was to analyze the reality experienced by children and adolescents with meningomyelocele and their families in the city of Belo Horizonte and its metropolitan area, Brazil. A descriptive and exploratory study was conducted via three home visits and a scripted interview with 16 children and adolescents with meningomyelocele and their families. It was observed that mean age of children and adolescents was 12 years old, most of them did not walk (n = 10), and depended on wheel chairs and parental care. Mothers represented the main caregivers and most (n = 12) had to leave their formal work outside of the home, compromising family income. It concluded that the families had socioeconomic levels aggravated by difficulties in purchasing materials needed for their children’s care. Some social challenges included barriers to education and the acquisition of medications and materials, demonstrating the need for planning public policies aimed at integrating different health services.展开更多
文摘Objective: To identify and understand facilitators and barriers to implementing an Outreach rehabilitation program designed to improve post-operative recovery following hip fracture in long-term care residents. Residents of nursing home facilities are at considerable risk of hip fracture and minimal recovery following a hip fracture. Methods: Data were gathered over June-August, 2012 through semi-structured interviews or focus groups. Fifteen persons (n = 15) who were members of the Outreach rehabilitation team (n = 8) or relevant nursing home staff (n = 7) were interviewed. Data analysis was guided by principles of grounded theory method. Findings: Three major themes that contributed to or hindered the Outreach rehabilitation program emerged, namely, 1) the division, the separate operation and delivery of rehabilitation services;2) building bridges, or negotiating ways to communicate and work together, and 3) strength in the structure, the acceptance of the program and the perceived benefits of the program. One main challenge to program implementation con- cerned coordinating additional rehabilitation with the rehabilitation provided within the nursing homes. Facility staff was largely unaware of the program and were unprepared to work with Outreach team members. As the program progressed, the facility staff and Outreach team were able to collaborate to overcome resident health issues impeding recovery such as cognitive impairment, language barriers and post-surgical pain control needs. Facilitators included the consistency of Outreach team members and accessible facility staff, which contributed to effective communication and trust between the Outreach team and facility staff. Facilitators also included support for the program by the Outreach team and facility staff, as well as the potential benefits of improved mobility and functional status among some program recipients. Conclusion: Although planning, implementation, and delivery of an Outreach rehabilitation program present some challenges, this study suggests that it is possible to deliver rehabilitation to older residents who fracture their hips in nursing homes.
文摘Meningomyelocele is a congenital defect involving the central nervous system which is one of the most common among those compatible with life. Children affected by this condition present neurological, orthopedic, renal and urogenital complications, needing lifelong healthcare provisions. The aim of this study was to analyze the reality experienced by children and adolescents with meningomyelocele and their families in the city of Belo Horizonte and its metropolitan area, Brazil. A descriptive and exploratory study was conducted via three home visits and a scripted interview with 16 children and adolescents with meningomyelocele and their families. It was observed that mean age of children and adolescents was 12 years old, most of them did not walk (n = 10), and depended on wheel chairs and parental care. Mothers represented the main caregivers and most (n = 12) had to leave their formal work outside of the home, compromising family income. It concluded that the families had socioeconomic levels aggravated by difficulties in purchasing materials needed for their children’s care. Some social challenges included barriers to education and the acquisition of medications and materials, demonstrating the need for planning public policies aimed at integrating different health services.
