Community-Based Rehabilitation (CBR) in primary care centers in Chile

Abstract

OBJECTIVE: To describe the implementation status of the Community-Based Rehabilitation in Chile. METHODS: Quantitative, transversal and descriptive study. The scope was constituted by the 66 community-based rehabilitation centers in the Chilean Metropolitan Region that implemented Community-Based Rehabilitation until December 2016. The sampling was based on a census method, so all the community centers were contacted. A self-administered questionnaire designed based on the Community-Based Rehabilitation matrix defined by the World Health Organization was applied. The questionnaire was answered on-line by the coordinators of the strategy in their respective centers. The data analysis was performed using descriptive statistics. RESULTS: A heterogeneous level of implementation of Community-Based Rehabilitation was identified, specifically in terms of the components of the matrix described by the World Health Organization. The most implemented component was Health; the Social, Livelihood and Empowerment components were moderately implemented; and the Education component was the least implemented. CONCLUSION: The implementation of Community-Based Rehabilitation is mainly based on the Health component. The level implementation of the other components of the matrix needs to be increased, as well as interdisciplinary and intersectoral strategies to achieve greater social inclusion of people with disabilities.

Clinical Effects of Rehabilitation on Balance in People With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

“…In addition, our meta-analysis only included balance assessment by clinical testing in the outpatient setting, excluding studies that incorporated instrumental assessment or evaluations in the inpatient setting. Therefore, our results could be extrapolated to a primary health care context, where communitybased rehabilitation appears as a possibility for constant treatment that allows permanent control, and at the same time, promotes the autonomy of individuals concerning their pathology (35).…”

Experiencias de fonoaudiólogos/as en hospitales y Centros Comunitarios de Rehabilitación: ¿se modifica la práctica de atención?

“…Otro aspecto que emerge del trabajo de los/las participantes que son funcionarios/as de CCR, es la relación que tendría el/la usuario/a con el/la terapeuta, donde todos/as los/las entrevistados/as enfatizan un rol activo, lo que es coherente con la estrategia RBC (Instituto Nacional de Rehabilitación Pedro Aguirre Cerda, 2005). Ello implica un abordaje que fomenta la educación y la participación de los/las usuarios, de sus familias y de la comunidad (Besoain-Saldaña et al, 2020). Sin embrago, es importante señalar que no es suficiente la "participación activa" de los/las usuarios/as para lograr inclusión, sino que se requiere de un trabajo real en el contexto de la persona, las redes de apoyo y la intervención coordinada con otras instituciones, lo que representa un desafío aún mayor para la Fonoaudiología.…”

“…Para la Organización Panamericana de la Salud (OPS) y la OMS el enfoque biopsicosocial contempla la interacción entre la persona en situación de discapacidad (PeSD) y su entorno familiar, comunitario y social, siendo una función de los CCR favorecer esta participación e inclusión comunitaria (Besoain-Saldaña et al, 2020). En las entrevistas todos/as resaltaron la importancia del contexto y de la comunidad en la rehabilitación.…”

People with disabilities family: highlighting an ancestral knowledge to guarantee food security

“…Health: refers to intersectoral work for health promotion, disease prevention and comprehensive rehabilitation for people with disabilities. 7,8 In this sense, this project sought the articulation of health system with children with disabilities through growth and development controls, together with the delivery of food packages.…”

“…Education: refers to the articulated work of school, family and community, so that, through universal access to learning, people achieve the full development of potentialities to be subjects of rights. 7,8 Trainings on nutrition, breastfeeding and disability prevention given to families exemplify this guideline.…”