How can cooperation between rehabilitation professionals in rehabilitation planning be improved? A qualitative study from the employer's perspective

Research shows that there are often problems with cooperation between rehabilitation professionals within vocational rehabilitation. The aim of this study was to describe employers' experiences of how cooperation between different rehabilitation professionals can be improved in a vocational rehabilitation planning process. Ten employers who had sent their employees to vocational rehabilitation at a rehabilitation centre in the north of Sweden during 2000 and 2001 participated in the study. Qualitative interviews were performed and analysed by thematic content analysis. The employers' cooperation with clients could be improved by a focus on clients' needs and participation in the rehabilitation process. The employers cooperation with Social Insurance companies could be improved by, 1) early prevention and intervention, 2) knowledge of each other's roles, responsibilities and opportunities and 3) priority making. The employers' cooperation with rehabilitation professionals could be improved by, 1) early identification of rehabilitation needs and goals and early rehabilitation and, 2) increased focus on own responsibilities from each part in the process.     

What is rehabilitation counseling?: A student's perspective on professional identity

This article (a) reviews changing perspectives about the roles and functions of the rehabilitation counselor and (b) summarizes the reflections of a graduate student in rehabilitation counseling regarding how these perspectives have influenced her emerging professional identity. A review of the literature indicates many different thoughts as to where the profession will stand in the 21st Century. These differing opinions make it challenging for students deciding what career direction to take in their course of study, as well as for practitioners who must stay abreast of new developments in the field to maintain job marketability.     

Assessing physical activity in inpatient rehabilitation—sensor-based validation of the PAIR

Increased physical activity is positively associated with better health in community-dwelling older persons. It is unclear whether physical activity also influences success of inpatient rehabilitation. For the assessment of physical activity in inpatient rehabilitation the Physical Activity in Inpatient Rehabilitation Assessment (PAIR), a short questionnaire based on five questions, was developed and preliminary validated. In this study, the PAIR was validated against a sensor-based physical activity measurement. Seventy functionally impaired and cognitively mostly intact patients of a German geriatric inpatient rehabilitation clinic who had undergone hip surgery (n?=?62 women, median age?=?83 years) participated. Physical activity was measured using the PAIR and a sensor-based activity monitor (Physilog ®; BioAGM, CH). Assessments were conducted at admission (T1) and 2 weeks later (T2) during the rehabilitation process. To assess concurrent and predictive validity, Spearman correlations and linear regression models were calculated using sensor-based walking activity and uptime activity (walking and standing time) as dependent variables. Criterion-related concurrent validity using physical activity sensors was weak to moderate. Correlations were slightly higher at T2 (r?=?0.45-0.53) than at T1 (r?=?0.44-0.46). The objectively measured variance of physical activity, explained by the PAIR, ranged from 25 to 43 %. PAIR activity scores and sensor-based walking or total activity increased in a dose-dependent manner, confirming the scoring system of the PAIR. The application time was usually less than 2 min. The validity of the PAIR is weak to moderate when compared to a sensor-based activity monitor and comparable to existing physical activity assessments for community-dwelling older adults.     

Serious games in prevention and rehabilitation—a new panacea for elderly people?

Digital games cannot only be used for fun and entertainment. The term “serious games” (SG) denotes digital games serving serious purposes like education, training, advertising, research and health. Recently, a new generation of games has emerged involving whole-body movements. Compared to traditional interventions, these games may help elderly people to improve their health by enhancing physical fitness and coordinative abilities by combining increased motivation, game experience like fun and game flow and training. Serious games, particularly adventure and shooter games, already play an important role in health education, prevention and rehabilitation, e.g. to enhance health-related physical activity, improve sensory–motor coordination, prevent asthma, change nutrition behaviour and alleviate diabetes and prevent smoking or HIV. In this paper, the impact of SG on prevention and rehabilitation is discussed. Three criteria are applied. Beyond effectivity and efficiency, the additional benefits of serious games can be described and explained by different models including social, psychological, physiological and sensory–motor factors. The quality of study serves as a third criterion. Despite first promising results, there are only few high-quality studies. Adequate content, game interfaces, sustainability and appropriate settings are critical factors for the success of SG. In this regard, (sport) science can help to develop and evaluate SG and test appropriate settings that ensure sustainable use of serious games.     

Juvenile offender rehabilitation in Estonia: interprofessional collaboration in written assessments and specialists’ perceptions

Qualitative and quantitative research methods were used to study an interprofessional assessment model in rehabilitation services and its implementation in Estonia based on (1) a sample of rehabilitation plans for 160 juvenile offenders aged 7–18 and (2) expert interviews with 10 members of an interprofessional assessment team. Each specialist’s role was compared with the assessments. While each team member is assigned a discrete role based on discipline, in practice, the disciplines’ work overlapped considerably during the assessment process. The overlap seems to occur because team members conduct their assessments individually, rather than following the collaborative best practice model for interprofessional teams described in the literature. The expert interviews indicate that rehabilitation specialists perceive the individual-level elements of interprofessional teamwork to be consistent with the ideals articulated in the Perception of Interprofessional Collaboration Model, while the substantial overlap in assessments that occurred in practice could be related to lack of interprofessional collaboration at group and organizational levels. Recommendations to improve the functioning of teams serving juvenile offenders include establishing an interprofessional education system, increasing the flexibility of the legal framework for service provision, and improving the interprofessional assessment instrument.     

What's the problem? A problem-based approach to the reform of the Norwegian drug rehabilitation sector

This article explores how the scope of solutions to complex problems is determined by the way in which the problem is formulated. We inquire into this by means of a theory-driven case study of the reform in the Norwegian drug rehabilitation sector and the Tyrili facility. We analyze divergent approaches to drug rehabilitation by means of a problem formulation framework, which distinguishes between (1) the value dimensions of given problems, and (2) the phases of problem solving activities. Based on this inquiry, we arrive at a set of propositions, in which we propose that the two approaches differ in their inclusion of various value dimensions. Moreover, we suggest that the reform pursued increased efficiency as a solution to a reductionist formulation of the problem, which challenged Tyrili's opportunity to solve the problem in the multidimensional manner they conceive of it. This is an argument against a one-dimensional maximization of efficiency as a pursuit of quality in social services.