Department of Medicine, Rehabilitation Teaching and Research Unit, University of Otago, Mein St, Newtown, PO Box 7343, Wellington, 6242, New Zealand.
Department of Rehabilitation Medicine PNS Shifa Hospital DHA-II, Karachi, Pakistan.
BMC Health Serv Res. 2021 Apr 29;21(1):399. doi: 10.1186/s12913-021-06293-8.
Demand for stroke rehabilitation is expected to grow dramatically; with the estimated prevalence of stroke survivors rising to 70 million worldwide by 2030. The World Health Organization's (WHO) report - Rehabilitation 2030: A call for action - has introduced the objective of 'upscaling' rehabilitation globally to meet demand. This research explored what upscaling stroke rehabilitation might mean for health professionals from countries at different stages of economic development.
Qualitative descriptive study design using semi-structured interviews was employed. Purposively sampled, clinical leaders in stroke rehabilitation were recruited for interviews from low through to high-income countries.
Twelve rehabilitation professionals (medicine, physical therapy, occupational therapy, and speech and language therapy) from high (United States of America, Germany, United Kingdom, United Arab Emirates, New Zealand), upper-middle (Colombia and Turkey), lower-middle (Vietnam, Pakistan, Ghana), and low-income countries (Nepal and Sierra Leone) were interviewed. Upscaling was seen as a necessity. Successful scaling up will require initiatives addressing: political governance and managerial leadership, increasing knowledge and awareness of the value of rehabilitation, financial support, workforce developments, physical space and infrastructure, and the development of community services and reintegration.
Although there have been many gains within the development of stroke rehabilitation internationally, further investment is required to ensure that this patient population group continues to receive the best quality services. For the WHO to be successful in implementing their objective to upscale rehabilitation, specific attention will need to be paid to political, professional, economic, and sociocultural issues at global and local levels.
预计对中风康复的需求将大幅增长；到 2030 年，全球中风幸存者的估计患病率将上升至 7000 万。世界卫生组织（世卫组织）的报告——《康复 2030：行动呼吁》提出了在全球范围内“扩大”康复规模以满足需求的目标。这项研究探讨了对来自不同经济发展阶段国家的卫生专业人员来说，扩大中风康复规模可能意味着什么。
采用半结构式访谈的定性描述性研究设计。从高收入到低收入国家，有针对性地招募中风康复临床领导者进行访谈。
来自高收入国家（美国、德国、英国、阿拉伯联合酋长国、新西兰）、中上收入国家（哥伦比亚和土耳其）、中下收入国家（越南、巴基斯坦、加纳）和低收入国家（尼泊尔和塞拉利昂）的 12 名康复专业人员（医学、物理治疗、职业治疗和言语和语言治疗）接受了采访。扩大规模被视为必要。成功扩大规模需要采取措施解决：政治治理和管理领导力、提高对康复价值的认识和了解、财政支持、劳动力发展、物理空间和基础设施，以及发展社区服务和重新融入。
尽管在国际中风康复发展方面已经取得了许多进展，但仍需要进一步投资，以确保这一患者群体继续获得最佳质量的服务。为了世卫组织成功实施其扩大康复规模的目标，需要特别关注全球和地方各级的政治、专业、经济和社会文化问题。
