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Preliminary experiences in acute occupational therapy for in-patients with coronavirus-19 (COVID-19): leveraging assistive technology in three case studies of male veterans

RICH, Tonya
HICKS, Brandon
DAHL, Abigail
SULLIVAN, Elle
BARRETT, Benjamin
BEDORE, Beau
2020

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Purpose:

Coronavirus 2019 (COVID-19) was first identified in December 2019 with millions of cases reported globally in the succeeding months. Initial hospitalisation strives to minimise multisystem organ failure and of those that survive, individuals can present with profound rehabilitation needs. The purpose of this case series is to describe occupational therapy (OT) and special technology considerations for three male Veteran patients hospitalised with suspected or confirmed COVID-19. 

 

Methods: 

This is a descriptive case series using a retrospective electronic health record review at a Veterans Administration hospital. The case series includes three male Veterans with confirmed or suspected COVID-19 (ages 69–78) who were referred to OT. The cases were selected to demonstrate the novel use of technology and strategies to reduce the risk of transmission. In two of three of our cases, we describe acute rehabilitation with a focus on activity tolerance, participation in occupations, and discharge planning. In all cases, we measured vital signs and activity tolerance as primary outcomes. 

 

Results and conclusions: 

The findings suggest that outcome measures focussing on activity tolerance to maintain stable vital signs during the recovery phase is central to the progression of activities. We observed in our cases that the Person-Environment-Occupation-Performance (PEOP) model can guide practice and complement the medical model in management of these patients. We utilised technology to engage family members in the rehabilitation care and minimise exposure risks.

Action on COVID-19 Evidence on the Response of Disabled People’s Organisations during Pandemic

ADD International
October 2020

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In June 2020, ADD International conducted structured interviews with leaders from ten Disabled People’s Organisations (DPOs) which are participating in the Inclusion Works programme in three districts in Bangladesh to understand impact of and response to Covid-19 among DPOs.

 

Evidence from these interviews suggest that the economic impact of Covid-19 on persons with disabilities has been acute, and DPOs are taking critical action. DPOs are engaging with power holders to make relief, livelihood support and information accessible to persons with disabilities. DPOs are in touch with their members, but they face barriers in doing their work during this time, and more could be done to reach the most excluded.

Measure It Super Simple (MISS) activity tracker: (re)design of a user-friendly interface and evaluation of experiences in daily life

UMMELS, Darcy
BRAUN, Susy
STEVENS, An
BEEKMAN, Emmylou
BEURSKENS, Anna
2020

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Purpose

The purposes of this study were, first, to (re)design the user-interface of the activity tracker known as the MOX with the help of input from elderly individuals living independently and, second, to assess the use of and experiences with the adapted Measure It Super Simple (MISS) activity tracker in daily life.

 

Methods

The double diamond method, which was used to (re)design the user-interface, consists of four phases: discover, define, develop, and deliver. As a departure point, this study used a list of general design requirements that facilitate the development of technology for the elderly. Usage and experiences were assessed through interviews after elderly individuals had used the activity tracker for 2 weeks.

 

Results

In co-creation with thirty-five elderly individuals (65 to 89-years-old) the design, feedback system, and application were further developed into a user-friendly interface: the Measure It Super Simple (MISS) activity. Twenty-eight elderly individuals (65 to 78-years-old) reported that they found the MISS activity easy to use, needed limited help when setting the tracker up, and required limited assistance when using it during their daily lives.

 

Conclusions

This study offers a generic structured methodology and a list of design requirements to adapt the interface of an existing activity tracker consistent with the skills and needs of the elderly. The MISS activity seemed to be successfully (re)designed, like the elderly who participated in this pilot study reported that anyone should be able to use it.

Final evaluation report project for ASEAN hometown improvement through disability-inclusive communities model

MEKONG INSTITUTE (MI)
May 2019

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This report covers the objectives, process, findings and recommendations of final evaluation on APCD Project for ASEAN Hometown Improvement through Disability‐Inclusive Communities Model. The project reached to the end of implementation in its second year and required a final evaluation to assess its achievements and non-achievements in against of its desired objectives from this project. The final evaluation has assessed the relevance, effectiveness, efficiency, impact and sustainability of the project. This report provides analysis of its findings from literature review and field visits during the evaluation and provides country-specific as well as overall recommendations for further implementation of this kind project in future. 

WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights

WORLD HEALTH ORGANISATION (WHO)
2019

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SELF-CARE is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health-care provider. 

The purpose of this guidance is to develop a peoplecentred, evidence-based normative guideline that will support individuals, communities and countries with quality health services and self-care interventions, based on PHC (Primary Health Care) strategies, comprehensive essential service packages and people-centredness. The specific objectives of this guideline are to provide:

• evidence-based recommendations on key public health self-care interventions, including for advancing sexual and reproductive health and rights (SRHR), with a focus on vulnerable populations and settings with limited capacity and resources in the health system

• good practice statements on key programmatic, operational and service-delivery issues that need to be addressed to promote and increase safe and equitable access, uptake and use of self-care interventions, including for advancing SRHR.

Developing inclusive practices through action learning: Inclusive education cross-country peer-review of Bangladesh (Hope project) and Indonesia (IDEAL project)

GRIMES, Peter
HEIJNEN-MAATHUIS, Els
April 2018

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The aim of the review was to create a capacity building and professional learning opportunity based on inclusive education experience and expertise in another context. The background, methodology, findings of the study are enclosed within the document. Specific objectives include: (1) to create focused peer-to-peer sharing and learning opportunities across countries, (2) record key strategies, opportunities, remaining challenges and achievements, (3) document lessons learned for targeted quality improvements during the last year of each project, and (4) use information collected for developing a responsible, phased exit strategy for 2018.

Cross-cutting Capacity Building Learning Review

LIPSON, Brenda
GARBUTT, Anne
March 2016

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This short report is based on an analysis of the individual case studies on capacity building in Cambodia and Bangladesh. The purpose of this cross-case report is to present the views of the two consultants with regard to the following:

  • Points arising from the experiences in the two countries which shed light on the ADD approach and working model of capacity building.
  • Recommendations for ADD to reflect upon in its work to strengthen the capacity building model and the overall monitoring, evaluation and learning on this work.

Participatory Monitoring of Community-Based Rehabilitation and other Disability- Inclusive Development Programmes: the Development of a Manual and Menu

Madden, Rosamond H
et al
2016

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Purpose: This paper describes a three-year research project leading to the development of the CBR Monitoring Manual and Menu (MM&M). The MM&M is a practical toolkit that meets the needs of CBR managers and stakeholders, and is consistent with the philosophy of CBR and community- based disability-inclusive development. It is designed to produce meaningful and locally useful information and data, based on international data standards where possible, to enable aggregation at regional, national and international levels.

 

Methods: Five complementary workstreams of research were carried out from 2011 to 2014: 1) literature review and analysis; 2) participatory action research with CBR stakeholders; 3) analysis and refinement of validity of concepts andstructures; 4) consultation and review; and 5) synthesis of results. This article documents the method and key results of each of the five workstreams, and the lessons learned along the way.

 

Results: The MM&M is now freely available on-line at thttp://sydney.edu. au/health-sciences/cdrp/projects/cbr-monitoring.shtml. Collaboration among members of the development team continues, chiefly via an on-line group to which new members have been welcomed.

 

Conclusion and Implications: At the time of writing, the MM&M is the only international monitoring product, known to the authors, that consciously sets out to reflect both a ‘bottom- up’ and ‘top-down’ perspective of monitoring information and data.To achieve this for a complex programme such as CBR, and to align with its principles, it was essential to use a multi-component and multi-stage strategy for tool development, involving a diverse multidisciplinary team including collaboration with CBR stakeholders.

NGO self-assessment through a SWOT exercise

NETWORKLEARNING.ORG
January 2016

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This short guide aims to guide non-governmental organisations (NGOs) through a four-step analysis of capacity. Known as a SWOT exercise, this tool has been found to be useful in many NGOs and stands for the "Strengths" and "Weaknesses" within your organisation; plus factors outside your organisation that offer "Opportunities" or pose "Threats."  The guide enables NGOs to lead themselves through the SWOT exercise and make, implement, evaluate and monitor the resulting strategic action plan

Towards a ‘mind map’ for evaluative thinking in Community Based Rehabilitation: reflections and learning

WEBER, Joerg
GRECH, Shaun
POLACK, Sarah
2016

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Calls for evaluations in Community Based Rehabilitation (CBR), in particular those of a participatory nature have stepped up in recent years. Much of this shifting discourse has emerged in response to the fact that evaluations overall remain scarce. Furthermore, very little is known about the impacts of CBR in practice and if/how it benefits persons with disabilities and their families on the ground. Nevertheless, and despite the calls for participatory approaches, the few existing efforts are too often targeted at creating standardised evaluations frequently at the expense of voice, participation and flexibility. This paper reports on a series of critical workshops held in Jamaica with CBR workers and other stakeholders, the objectives of which included discussions and reflections on emerging issues in localised, locally driven and responsive participatory evaluation frameworks. The findings highlight how participants favoured a flexible, adaptive and iterative approach that was not rigid, structured or per-determined by outsiders. Instead, they favoured an approach that created a safe space for sharing and learning, prioritised their narratives, and that was directly linked to and that fed directly into action on the ground. The paper concludes with the call for critical, engaged and bottom-up approaches that move away from control-oriented approaches in CBR towards more experimental and adaptive problem and process-oriented approaches, that embrace complexity and that are consistently responsive to an ever changing context.

 

Disability & the Global South (DGS), 2016, Vol. 3 No. 2

Developing human rights based indicators to support country monitoring of rehabilitation services and programmes for people with disabilities : a study protocol

SKEMPES, Dimitrios
BICKENBACH, Jerome
September 2015

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This paper seeks to develop a study protocol that can assess and improve the provision of rehabilitation services for people with disabilities across the world. The research targets a knowledge gap that exists whereby there are no indicators to reliable identify the performance of rehabilitation systems and monitoring technologies. The paper provides a detailed analysis of the issue before outlining and justifying a choice of methods for data collection and analysis, and the likely impact and use of the study results

BMC International Health and Human Rights, 15:25

Mental health recommendations included in Sendai framework for disaster risk reduction

UNITED NATIONS UNIVERSITY
March 2015

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“The expert group was formed to address this challenge, bringing together UN experts to review evidence on mental well-being and disability related to disasters, share lessons learned and best practices, and develop recommendations for mainstreaming these issues in Disaster Risk Education.” This UN University report illustrates how disability and mental health should be highlighted as a priority in disaster risk reduction planning and execution. In addition, the group responsible for the report suggest that disability and mental health be integrated into any future discussions related to security and human rights. Finally, the group recommended that a United Nations working group be established to explore the ways in which policies and action effect or how these individuals can affect policy within the United Nations. 

Capturing the difference we make : community-based rehabilitation indicators manual

WORLD HEALTH ORGANIZATION (WHO)
2015

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This manual presents indicators that "capture the difference (Community-Based Rehabilitation) CBR makes in the lives of people with disabilities in the communities where it is implemented. This manual presents these (base and supplementary) indicators and provides simple guidance on collecting the data needed to inform them. The indicators have been developed to show the difference between people living with a disability and their families and those without disabilities in relation to the information reported in the indicators. This comparability provides valuable information to CBR managers, donors and government agencies alike, which can be used to guide decision-making, support advocacy and improve accountability. Further, the ability of the indicators to provide a comparison of the populations of persons with disability to persons without disability aligns with the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which states that persons with disability have equal rights to those without disabilities...this manual serves to standardize the monitoring of differences made by in the lives of people with disabilities and their families, making it possible to compare the difference CBR makes across areas and countries. This manual aligns with the WHO Global Disability Action Plan 2014–2021, and may also be used to monitor other development plans in an easy and efficient way”

Human Rights

www.macao-tz.org
December 2014

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Malezi AIDS Care Awareness Organization (MACAO) is a non-profit organization reaching out to neglected Indigenous people in Ngorongoro District, Arusha Region of Northern Tanzania.  Macao founded in 2003, Macao is a humanitarian organization that provides assistance to approximately 200,000 Indigenous Maasai community in Ngorongoro district for addressing needs of water and sanitation, food security, health Care Research, Education, Research environment, Maasai Traditional Research, Human Rights and sustainable economic development by strengthening their livelihoods.  In addition to responding to major relief situations, MACAO focuses on long-term community development through over 4 Area Development Project. We welcome the donors and volunteers to join us in this programs, we are wolking in ruro villages.

How to include and empower the vulnerable in disaster risk reduction

OVERSEAS DEVELOPMENT INSTITUTE (ODI)
November 2014

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 “This event is one of a new event series Rethinking International Policy for Reducing Disaster Risk hosted by the Overseas Development Institute (ODI) and Climate and Development Knowledge Network (CDKN). The series examines some of the more thorny issues involved in renegotiating the Hyogo Framework for Action, including public private partnerships, use of risk assessments, fragile states and conflict and effective governance for DRR, amongst others”

ODI seminar “How to include and empower the vulnerable in disaster risk reduction”

London, UK

25 November 2014

Children with Disability in Nepal: New Hope Through CBR?

MOL, Tanja Ingeborg
BRAKEL, Wim Van
SCHREURS, Merel
2014

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Purpose: This study assesses the impact of a community-based rehabilitation (CBR) programme on the quality of life (QoL) of children with disability and their families.

 

Methods: A qualitative approach was applied, using two techniques - a ranking line and semi-structured interviews. Nineteen children (ranging from 4 –18 years of age) were interviewed in their homes located in three villages - Chapakhori, Bokraha and Madesha - in Nepal.

 

Results: Children with disability and their families ranked physical health, psychological health, empowerment and level of independence as the most important factors for their QoL. Of the 19 children, 13 had experienced positive changes in their life and 1 child reported a negative change. The positive changes related mainly to their physical health and functioning. The impact of these changes was felt in the ‘social’, ‘level of independence’ and ‘empowerment’ outcome categories. The children mentioned that they had more friends, experienced less stigma, could go to school and were more hopeful about the future.

 

Conclusions: This CBR programme has brought about changes in the QoL of all children with disability and their families. The majority of them reported a positive impact.

 

 

Guidelines of disaster risk reduction : disability and disaster

GLOBAL ALLIANCE ON ACESSIBLE TECHNOLOGIES AND ENVIRONMENTS (GAATES)
ASIA DISASTER PREPAREDNESS CENTER (ADPC)
ASIA PACIFIC BROADCASTING UNION (ABU)
2014

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This report aims to raise awareness about inclusive policies, practices and disaster risk reduction strategies that address the accessibility of communication, shelter, transportation and early warning systems. The guidelines also hope to foster collaboration between disaster preparedness organizations, broadcasters and organizations of persons with disabilities to mainstreaming disability issues in disaster risk reduction strategies. These goals are achieved through discussion of the Convention on the Rights of Persons with Disabilities, inclusive disaster risk reduction, and concern for the inclusive nature of evacuation protocols for older people and people with disabilities, access to services, disaster risk reduction, and communication strategies

Community-based rehabilitation programme evaluations : lessons learned in the field

GRANDISSON, Marie
2014

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This article highlights some lessons about  the strategy of community-based inclusive education, drawn  from  in different programmes in Latin America. Having worked in the region for several years as a CBR advisor and special education teacher, the author provides insights into the progress that has been made. Early detection of disability followed by early education, with support from within the community, helps children with disability to participate in mainstream schools. Sensitisation of the public can overcome discrimination and exclusion. Teachers have to be trained to adapt teaching methods for the benefit of those with special needs. The author concludes that communities ought to initiate these strategies in their local schools as inclusive education is good for all children.

 

Disability, CBR and Inclusive Development, Vol. 25, No. 1

Lessons learned on inclusion of people with disability in the ICCO Gaibandha food security project for ultra poor women, 2009-2013

BRUIJN, Paulien
October 2013

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The Gaibandha Food Security Program is one of the first programs that mainstreams disability on a large scale, and the Food Security Project in Gaibandha was implemented in order to improve the food security situation of 40.000 women headed households. In April 2013 an internal evaluation took place on the disability mainstreaming process within the FSUP Gaibandha project. This report reflects related lessons learned about disability mainstreaming

The key informant child disability project in Bangladesh and Pakistan

MACTAGGART, Islay
MURTHY, GVS
2013

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The Key Informant Method (KIM) has previously been tested by CBM, LSHTM and others, and found to be a valid method for the identification of children with severe visual impairment and blindness in Bangladesh, using community volunteers in the place of a door-to-door survey. This report outlines a study that set out to expand this and test whether voluntary, community-level Key Informants (KIs) could be trained to effectively identify children with moderate or severe physical impairments, sensory impairments (visual and hearing) or epilepsy in Bangadesh and Pakistan, and if so whether this process could be used to assess prevalence and plan appropriate referral services for children meeting these criteria

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