ACTIVITIES THAT PROMOTE INTERPROFESSIONAL PRACTICE IN THE REHABILITATION SECTOR OF A PRIMARY HEALTH CARE FACILITY TO MEET CONTEXTUAL CHALLENGES

L. Africa¹, J. Frantz², N. Mlenzana¹

¹University of the Western Cape, Department of Physiotherapy, Bellville, South Africa, ²University of the Western Cape, Department of Research and Innovation, Bellville, South Africa

Background: The integration of rehabilitation into primary healthcare (PHC) has been met with various challenges. In response to these challenges, a rehabilitation model was developed for this level of care. However, as we move towards interprofessional practice (IPP), the model lacks the skills needed to execute the phases of the model in an interprofessional manner. The incorporation of activities that promote IPP into the rehabilitation model can be used as a guideline for the successful implementation of the model at PHC level.

Purpose: This study aimed to identify activities that promote IPP to address challenges at a PHC facility in the Western Cape Province, South Africa. To achieve the aim, the researcher needed to identify the challenges at the selected PHC facility, determine the appropriateness of the rehabilitation model’s objectives, and identify how the activities that promote IPP might be employed to achieve the model’s phases.

Methods: The logical framework (logframe) approach was used by triangulating data. In this aspect of the study, the analysis stage of the logframe approach was used to achieve the study aim. Contributing to the logframe data were transcripts from focus group discussions (FGDs) and the analysis of systematic review focusing on the activities that promote IPP at PHC level. The data were analysed using the READ approach.
The transcripts of the FGDs were analyzed to determine the contextual challenges at the PHC facility, as well as the appropriateness of the objectives to address the challenges. The systematic review's document analysis sought to highlight how IPP-promoting strategies can be incorporated into healthcare practices to achieve the rehabilitation model's goals.

Results: The researchers rephrased the rehabilitation model’s objectives as problems for the problem analysis. Different healthcare processes in the facility, a medical model of care, a poor continuum of care, no patient education and health promotion, and the roles and responsibilities of staff were the five predetermined themes for the document analysis of the FGD transcripts. The re-created problems correspond to the contextual challenges identified during the document review. The highlighted strategies from the systematic review were examined to determine the intended outcome. These outcomes corresponded to the phases of the rehabilitation model.

Conclusions: The congruence between the problems determined from the rehabilitation model and the challenges of the PHC facility suggests that the objectives were acceptable for addressing the contextual concerns at the aforementioned PHC facility. In addition, because the identified strategies may be linked with the stages of the rehabilitation model, they can be incorporated into the rehabilitation model as the actions required to effectively complete each step of the rehabilitation model. This procedure can be used to other PHC facilities to ensure that activities are matched to context-specific problems.

Implications: Given IPP’s benefits for employees and patients, its use is being expanded. We must ensure that physiotherapists who work outside of rehabilitation maintain access to these benefits. IPP can be implemented in all PHC sectors by analysing focus group discussions with staff from a given sector of PHC, and matching them with sector-specific conceptual models.

Funding acknowledgements: The South African Medical Research Council through its Division of Research Capacity Development (Bongani Mayosi National Health Scholars Programme)

Keywords:
Primary health care
Rehabilitation
Logical framework

Topics:
Primary health care
Disability & rehabilitation
Community based rehabilitation

Did this work require ethics approval? Yes

Institution: University of the Western Cape

Committee: BioMedical Research Ethics Committee

Ethics number: BM19/1/38