ISBN: 978-80-2712-434-3 | ISBN online: 978-80-2712-434-3 | DOI: 10.32725/zsf.2020_124343

Sociální práce v systému koordinované rehabilitace

u klientů po získaném poškození mozku (zejména CMP) se zvláštním zřetelem na intervenci z hlediska sociální práce, fyzioterapie, ergoterapie a dalších vybraných profesí

Jitka Vacková a kolektiv

According to estimates by the World Bank and the World Health Organization approximately one billion people (about 15% of the
population) live with some form of disability, with the highest incidences seen in developing countries. In Europe, by the end of 2020,
it is estimated that people with disabilities will represent up to one-fifth of the population. Stroke (CVA), as a subset of acquired brain
injury (ABI), is referred to as a silent epidemic. It is, therefore, clear that caring for people after a CVA is one of the key issues for many
health professions. The abovementioned estimates, and in conjunction with the current situation in the Czech Republic concerning the
implementation of a coordinated rehabilitation program using a interdisciplinary team approach (in particular the absence of suitable
legislation), led to the submission of a unique project funded by the University of South Bohemia in České Budějovice called “Coordinated
rehabilitation in patients with brain injuries” (project number GAJU 138/2016/S, solution time: 2016–2018).
The aim of the research project was to map (using a qualitative research strategy) and partially measure (using quantitative methods
and techniques) the outcomes of coordinated rehabilitation of ABI clients in their home environments – and at the same time using social
work, physiotherapy, occupational therapy, medicine, speech therapy, and psychotherapy to improve quality of life (QoL) and help clients
start to regain their independence (despite the limitations caused by the disease).
The formulation of the objectives included the use of mixed research strategies. The qualitative part took place in the client’s home
environment and focused on providing a thorough description of the social and health issues faced by clients after a stroke. Data collection
took the form of structured interviews and observations of the home environment (e.g., assessment of the home to determine what
modifications were needed to make it wheelchair accessible). Standardized functional tests such as the Functional Independence Measure
(FIM), the WHO Disability Assessment Schedule 2.0, as well as additional questionnaires specific for physiotherapists and social workers
were used in the evaluation process. The results were statistically processed in Microsoft Excel 2010. Interview records were processed
using the ATLAS.ti program. Basic descriptor statistics were used to evaluate the project’s quantitative results.
To meet the research goals of the project, two target groups were assessed (1) clients after a stroke together with their family members
(total number of clients = 21), and (2) social workers directly responsible for providing social services (all organizations in České Budějovice
that provide services to clients after an CVA were approached – a total of 20 were approached, and 12 agreed to be interviewed). At first
glance, this might seem to be an insignificant group, but it is important to note that since each client received roughly 56 visits (44 visits
for physiotherapists, 6 visits for occupational therapists, and 6 visits for the social worker) the amount of data collected was significant.
Clients were monitored for 9 months after discharge from the hospital and received on average 2,201 hours of direct care during the
project (about 2 hours per visit to clients and their families).

1. vydání. edition, Published: 2020, online: 2020, publisher: Grada Publishing, a. s., Praha