Rehabilitation in HIV/AIDS: Development of an Expanded Conceptual Framework

Abstract

In industrialized countries where HIV infection is becoming a chronic, episodic condition, rehabilitation services have the potential to play an expanded role for people living with HIV/AIDS (PLHAs). However, little is known about rehabilitation in the context of HIV. This paper documents the development of an enhanced, multidisciplinary conceptual framework of rehabilitation in the context of HIV, using the perceptions of PLHAs and rehabilitation professionals. Rehabilitation, broadly defined, is a dynamic process that includes all prevention and/or treatment activities and/or services that address body impairments, activity limitations and participation restrictions for an individual. The framework was developed through broad consultation and interviews with thirteen key informants. Themes that emerged from analysis of interviews related to concepts of rehabilitation in the context of HIV, rehabilitation professionals' roles in the context of HIV, and barriers to access and delivery of rehabilitation services. While there was some variation, key informants generally viewed rehabilitation as a goal-oriented and client-centered process with the potential to impact a range of life domains. Themes were presented to members of a national advisory committee (including PLHAs and health care providers), who produced the foundation of the HIV rehabilitation framework. The framework uses the perspective of the person living with HIV/AIDS, and includes individual life domains that may be affected by HIV, drawing and expanding upon the World Health Organization's (WHO's) International Classification of Functioning, Disability and Health.

HIV/AIDS in Physiotherapy Education – Mainstreaming Using UN Principles

“…These investigations have shown positive clinical effects, how ever, most studies are still challenged by small sample sizes, difficulties with blinding, standardisation and poor iso lation of treatment, due to the nature of treating HIV. (Fulk et al, 2004;Galantino et al, 1999;Posner et al, 2004;Shor Posner et al, 2004;Worthington et al, 2005). Incorporation into teaching should therefore take cognisance of the levels of evidence.…”

“…Verbruggens (2004) proposes the use of frameworks to locate and contextualise the specific place for HIV in any area of work. For physiotherapists, Worthington's (2005) rehabilitation approach which under scores a multisectoral approach, and the ICF approach, (Anandan et al, 2006, Hwang & Nochajski, 2003 can be used as they account for disability in different life domains. Using ICF would include individual needs in physical, functional, psychological, spiritual, social and vocational aspects.…”

Increasing Capacity in Rehabilitation in the Management of HIV: A Case-based Email Intervention

“…People living longer with HIV often experience disability in the form of symptoms and impairments, difficulties with day-to-day activities, challenges to social inclusion, and 2 uncertainty . Rehabilitation may be broadly defined as interventions that address physical, emotional, social and professional challenges, and has an important role in managing disability and increasing quality of life for People living with HIV/AIDS (PHAs; Worthington et al, 2005). Despite increasing evidence of the role of rehabilitation in the management of PHAs (e.g., O'Brien et al, 2010) few rehabilitation professionals work in HIV care (Worthington et al, 2008).…”

Scoping the Field: Identifying Key Research Priorities in HIV and Rehabilitation

“…The ways in which disablement manifests may be unpredictable and episodic in nature (O'Brien et al 2008a). As a result, there is a need for health care communities to respond to the changing needs of people living with HIV and specifically the increasing role for rehabilitation (Worthington et al 2005).…”