Effect of Rehabilitation Team Meeting on the Patient’s Disability in the Department of Physical Medicine and Rehabilitation (PMR) in a Tertiary Care Hospital in Dhaka

Abstract

Background: Teamwork is one of the most fundamental factors in rehabilitation medicine. Although isolated physicians and therapists are working with rehabilitation services in Bangladesh, there is limited data for understanding the effects of a team effort. Objective: To evaluate the effect of rehabilitation team meeting on the patients’ disability in the Department of Physical Medicine and Rehabilitation (PMR) in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Methods: This was a randomized controlled trial conducted in the Department of Physical Medicine and Rehabilitation (PMR) in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2018 to October 2019. Two hundred and thirty nine patients attending the PMR department for comprehensive management of disability (such as disability in mobility, speech, self-care, sphincter control etc.) were purposively selected for the study. Patients were randomly allocated by lottery in two groupsgroup A (received Rehabilitation Team Meeting service) and group B (received conventional Rehabilitation treatment). The meeting comprised physiotherapist, occupational therapist, rehabilitation nurse, speech and language therapists, social worker, nutritionist, psychologists under the team leader guidance by physiatrist. Respondents of both groups were assessed to see the effects of treatment at 6th weeks, 12th weeks and 24th weeks. Among 239 patients, 77 patients in group A and 71 patients in group B had completed 24th week follow up. Outcomes were measured by FIM (Functional independence Measure) scores. Results: The mean age of the patients in group A and B were 42.2 (±17.5) years and 45.7 (±14.6) years respectively. In both groups, majority of the patents were male and came from urban areas. Main cause of disability was stroke while others had traumatic brain injury, spinal cord injury, spinal cord compression, rheumatoid disease and others. At baseline and after 6th week of treatment, there were no significant statistical differences between the two groups (p>0.05) regarding FIM scores. In 12th week, FIM significantly increased in group A (p=0.009) compared to group B which persisted till 24th week (p<0.001). Conclusion: Rehabilitation team meeting significantly reduce disability of the patient. It needs to work continuously to build up the rehabilitation team to improve physical rehabilitation in Bangladesh to ensure total care of the disabled. Bangladesh Med Res Counc Bull 2020; 46(3): 228-232

Social accountability challenges and recommendations by community service rehabilitation therapists

“…Studies have highlighted that the lack of management support has resulted in inadequate departmental funding, poor work monitoring and developmental feedback, overburdened rehabilitation therapists and a scarcity of senior rehabilitation therapists in many developing countries, which negatively impact service delivery at the district and community levels. 43 , 44 …”

“Leadership in Rehabilitation Teamwork: Challenges for Developing Countries”

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