OP-090 : Holistic rehabilitation care for disabled children: A lesson from Thai community hospital

Author(s): 
EKARAT CHANWANPEN, Thailand
Text: 
The aim of improvement program was to develop the physical, mental, emotional and social skills of children with disabilities and to educate families about the needs of children with disabilities and special needs.

Sichon Hospital had launched a program for disabled children since 2007. Developing accessibility of care for disabled children was one of the hospital policies for improving quality of life. Health care team including physical therapists, occupational therapist, medical staffs and nursing staffs were working together as multidisciplinary team. According to the current data, there were about 40 families with disabled children in the district. Most of them were lack of adequate rehabilitation program. Children with disabilities, focus of children with cerebral palsy were our target group. We developed holistic rehabilitation program by empowerment the parents of these children and assist children with disabilities and their families through the process of rehabilitation and working to become as self-sufficient as possible. In the past, most of the children with disabilities especially children with cerebral palsy did not receive proper rehabilitation that caused many health problems such as child development, muscle dystrophy and spasticity. The multidisciplinary team led by physical therapist and family physician had been implementing a program aimed at strengthening of day care structures. The program methodology included every Friday, the physical therapist and occupational therapist provides activities for examples Thai massage and musical therapy. All activities could be useful for training disabilities child to create an enjoyable atmosphere between parents and disabilities child. The activities could take place outside hospital area. For example, swimming pool and camping at the beaches.

This program had been accomplished by organizing persons according to their disability and then bringing them into the appropriate rehabilitation group. Families were encouraged to develop and maintain parent support groups and used the training they had received at the clinic. In overall, the children developments were improved and decreased complication of morbidity mostly in cerebral palsy cases. As a result, this rehabilitation program was strengthened, the quality of care improved through trainings for health care staffs. The involved parents were supported in organization of self-help groups. Parents’ knowledge about children’s disabilities was improved through thematic workshops and published materials. Patient parents’ satisfaction rates were increasing from 83.50 % to 95.00 % during these two years.

Establishing services to cover target population, which was not being sufficiently reached mostly for rural locations and broadening development opportunities for children with disabilities. In the future, we plan to enable special needs children to be self-sufficient and integrated into society rather than spend a life in an institutional setting. Take a stakeholder approach, bringing together families, community members, and local administrative organization to apply concept of community-based rehabilitation for the disabled children.