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Novel Application of the World Health Organization Community-Based Rehabilitation Matrix to Understand Services'
Srijan S Raha1, Silas Yip, Chester Ho
1From the Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada (SSR, SY, CH, OO, AL-S); Cumming School of Medicine, University of Calgary, Calgary, Canada (SSR); Faculty of Science, University of British Columbia, Vancouver, Canada (SY); Alberta Health Services, Edmonton, Canada (CH, KKB, AL-S); Hospital General de México "Dr. Eduardo Liceaga," México City, Mexico (IP-B); Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada (AKR-M); Spinal Cord Injury Alberta, Edmonton, Canada (RM); Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH, RC); Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada (RH); School of Public Health, University of Alberta, Edmonton, Canada (KKB); Provincial Research Data Services, Alberta Health Services, Edmonton, Canada (JB); Alberta Health Services, Calgary, Canada (RC); Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (RC); and Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada (RK).
Purpose:
The aim of the study is to use the World Health Organization community-based rehabilitation matrix for understanding services' contributions to foster community participation for people with traumatic spinal cord injury.
Methods:
This study used a convergent mixed-methods design with a quantitative arm describing the frequency with which services contributed to 22 of the community-based rehabilitation-matrix elements and a qualitative arm involving document reviews and stakeholder interviews. Results were integrated following Onwuegbuzie and Teddlie's method (i.e., quan + QUAL).
Results:
Twenty of the 22 (91%) of the World Health Organization community-based rehabilitation elements were addressed by traumatic spinal cord injury services. Five types of services were identified. Integrated results showed that the strengths of traumatic spinal cord injury services were as follows: (1) comprehensiveness; (2) essential medical services publicly funded; (3) numerous social protections available; and (4) highly active community-based organizations. Identified opportunities to improve these services were as follows: (1) increase specificity for traumatic spinal cord injury and (2) increase communication and integration among services.
Conclusions:
Services available for people with traumatic spinal cord injury in the province studied address most of the elements of the World Health Organization community-based rehabilitation matrix. However, lack of cohesion between services could create gaps that hinder community participation. Addressing these gaps could improve the quality of life and outcomes of people with traumatic spinal cord injury.
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