Introduction to Rehabilitation: Difference between revisions
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Revision as of 21:01, 4 July 2021
Original Editors - Joseph Ayotunde Aderonmu and Naomi O'Reilly
Top Contributors - Naomi O'Reilly, Kim Jackson, Vidya Acharya, Merinda Rodseth, Lucinda hampton, Tarina van der Stockt, Ashmita Patrao, Aminat Abolade, Oyemi Sillo, Candace Goh, Rucha Gadgil and Wanda van Niekerk
Introduction[edit | edit source]
Rehabilitation is a concept that is widely discussed globally. This is by no means unexpected since over a billion people live with a form of disability, accounting for over 15% of the world population. Furthermore, according to a recent report, 2.41 billion individuals worldwide live with conditions that impact on their function in daily life and would benefit from rehabilitation services, which equates to 1 in 3 individuals requiring rehabilitation services throughout the course of their illness or injury.[1]
The proportion of the worldwide population over 60 will double in the next 30 years, the majority of whom will live with chronic diseases, particularly noncommunicable diseases. These changing health and demographic trends are contributing to rapid global increases in the numbers of people experiencing decline in functioning, resulting in enormous unmet rehabilitation needs. Much of these unmet needs are concentrated amongst the poorest and most vulnerable populations in low- and middle-income countries and conflict-affected settings, which are often ill equipped to cope with these increasing needs for rehabilitation services.[2][3]
According to the WHO, rehabilitation is one of the essential components of Universal Health Coverage (UHC), which features alongside “promotion of good health, prevention of diseases, treatment and palliative care”.[2] Thus, rehabilitation focuses on achieving functional independence in activities of daily living (ADL), participation in work, recreation and also education with individuals being able to achieve meaningful roles in daily life.[2] Clearly, rehabilitation is pivotal in achieving not only individual health benefits, but an overall universal health goal that permits the building of a healthy and functional global population.
Definition[edit | edit source]
Fundamentally, rehabilitation is founded on the philosophy that every individual has the inherent tendency and right to be experts of their own health care.[5] This therefore marks the distinction between acute care and rehabilitation; where acute care is concerned with an individual’s survival, while rehabilitation is concerned with the education and training of individuals to be able to carry out activities of daily living by themselves, thus promoting self care and functional independence.[6] There is currently no universal understanding of rehabilitation, and it is portrayed in many ways depending on the context including a development issue, disability issue, health issue, human rights issue, substance abuse issue and security issue to name a few and have been differently defined by different authorities:
“Refers to services, and programmes designed to assist individuals who have experienced trauma or illness that results in an impairment that creates a loss of function (physical, psychological, social or vocational).” [7]
“Aims to restore, compensate, prevent or slow deterioration in functioning (sensory, physical, intellectual, mental, cognitive, or social) to help individuals to reach their optimal levels.” [1]
“A process to restore mental and/or physical abilities lost to injury or disease in order to function in a normal or near-normal way” [8]
Rehabilitation is one of the core health strategies of the World Health Organisation, along with promotion, prevention, treatment, and palliative care. WHO defines rehabilitation as
" a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.” [9]
Rehabilitation is then a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment. Health conditions can refer to disease (acute or chronic), injury or trauma, which may also include other circumstances such as pregnancy, ageing, stress, congenital anomaly, or genetic predisposition. It may be needed by anyone with a health condition who experiences some form of limitation in functioning, such as in mobility, vision or cognition and is characterized by interventions that address impairments, activity limitations and participation restrictions, as well as personal and environmental factors including assistive technology that have an impact on functioning.
Rehabilitation is an essential service offered across all levels of the health care system. Many people without long-term impairments will need rehabilitation services at some point in their lives. Similarly many people with long-term impairments are not in constant need of rehabilitation services e.g. a person with a spinal cord injury will need intensive rehabilitation in the months following their injury, but once they have received enough therapy to allow them to function to their maximum capabilities, and has been provided with the assistive devices they need to allow them to continue to function well in their community and home environment, then they may not need to access more rehabilitation services. Some people with long-term impairments may also need episodic rehabilitation services such as a person with depression or degenerative conditions.
Rehabilitation is a highly person-centred health strategy where treatment caters to the underlying health conditions as well as goals and preferences of the user. Information on functioning is essential to decision-making in rehabilitation at all levels of the health system since goal of rehabilitation is to optimize functioning in light of impairments, injuries, & acute or chronic diseases:
- At user level, information on functioning guides goal setting and outcome evaluation across the continuum of rehabilitation care (primary, secondary and tertiary) and in the treatment phases (acute care, post-acute care and long-term care).
- At facility or programme level, information on functioning from users can be aggregated to help monitor clinical outcomes and improve service planning and quality assurance.
- At policy level, aggregated clinical information on functioning gives policy-makers a source of evidence for planning health and rehabilitation services and monitoring their impact.
By restoring, preventing or slowing deterioration in functioning (sensorial, physical, intellectual, mental, cognitive, or social), rehabilitation places the person at the centre of the process and contributes to people reaching their full potential and participating in society. Its impact is therefore not only on the individuals, but also on their families, communities, and economies.
Misconceptions about Rehabilitation[edit | edit source]
Summary[edit | edit source]
Rehabilitation is without doubt a crucial aspect of health that is aimed at enhancing functionality and independence. As a field of health, it has evolved through different stages before arriving at its present model that incorporates different components of biological, societal and contextual factors that have effects on the health and functionality of individuals experiencing various health challenges. Regardless of who the beneficiary is, who delivers it, or the context in which rehabilitation is delivered, optimising functioning is the ultimate objective of rehabilitation and is instrumental to a patient's wellbeing, regardless of the underlying health condition. [10]
Resources[edit | edit source]
References [edit | edit source]
- ↑ 1.0 1.1 Duttine A, Battello J, Beaujolais A, Hailemariam M, Mac-Seing M, Mukangwije P, et al. Introduction to Rehabilitation Factsheet. Handicap International. 2016. Available from: https://humanity-inclusion.org.uk/sn_uploads/document/2017-02-factsheet-rehabilitation-introduction-web_1.pdf [Accessed on 8 January, 2020].
- ↑ 2.0 2.1 2.2 Shimizu Y. Rehabilitation. World Health Organization. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/rehabilitation. [Accessed on 8 January, 2020].
- ↑ Cieza, Alarcos. "Rehabilitation the health strategy of the 21st century, really?." Archives of physical medicine and rehabilitation 100.11 (2019): 2212-2214.
- ↑ World Health Organisation (WHO). Rehabilitation is about health and functioning in everyday life. Available from: https://youtu.be/uG_VdZe9VNU[last accessed 26/06/2021]
- ↑ Gender AR. Scope of rehabilitation and rehabilitation nursing. Chin P, Finocchiaro D. Rosebrough, A. Rehabilitation nursing practice. New york: McGraw-Hill,.1996.
- ↑ Mauk KL. Overview of rehabilitation. Rehabilitation Nursing: A Contemporary Approach to Practice. 2011.
- ↑ Lubkin IM, Larsen PD, editors. Chronic illness: Impact and interventions. Jones & Bartlett Learning; 2006.
- ↑ National Cancer Institute. Rehabilitation. 2007. Available at: https://www.cancer.gov/search/results?swKeyword=rehabilitation. [Accessed on 8 January, 2020].
- ↑ World Health Organization. World Report on Disability 2011. Geneva: World Health Organization, 2011. Rehabilitation.
- ↑ Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020 Dec 19;396(10267):2006-17.