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R - Community Participation

Community Participation | Participation VK Noonan, PT, PhD; SL Hitzig, PhD; G Linassi, MB, FRCPC; C Craven, MD; and the E-Scan Investigative Team Community participation is a broad construct defined by the World Health Organization (WHO) as involvement in life situations.1 Within the International Classification of Functioning, Disability and Health (ICF),1 a life situation encompasses several areas, including individuals’ ability to move around their home and community, bathe and dress themselves, engage in relationships with others, participate in social activities and civic life, in addition to employment, education, recreation and leisure activities. The ICF concept under the term community participation, has been adapted and defined as a return to, or participating in, life situations of importance to the individual living with spinal cord injury (SCI). This definition reflects the focus of transition from inpatient rehabilitation to living and participating in a community setting. Community participation intersects and informs other goals, within the rehabilitation framework (see the Employment/Vocation and the Informed Self-Management chapters, as examples). The introduction of the ICF, and related research, has highlighted the importance of personal factors and the environment in obtaining optimal community participation - where environment relates to external factors such as the role of products/technology, the natural environment, support and relationships, attitudes and social policies, services and systems1; and personal factors are intrinsic to the individual and include their age, gender, culture, social and religious values. When developing and implementing rehabilitation goals, it is vital to consider the individual’s personal goals and the environment in which he or she lives. The aim of rehabilitation service delivery is to ensure individuals living with SCI are healthy, able and empowered to participate fully in the life situations they deem important (Figure 1.0). This requires customizing goals for individuals during inpatient rehabilitation, and then continuing to support them as they return to the community. Increasingly, there has been a shift away from clinical disciplines providing independent follow-up, towards interprofessional models of care, tailored to meet an individual’s goals and needs. Linkages with community resources and service providers are vital to the provision of community participation services. Future service models should include adoption of ‘chronic disease models of care’, with strong community linkages and a focus on principles of self management2 (see Informed Self-management chapter). FIGURE 1.0 the comunity participation proces WHICH involves customi zed goal seting and interprofesional implementation over the time course, from inpatient rehabilitation to comunity living. Goal setting Developing a plan Education Engagement in life situations (e.g., leisure programs) Rehabilitation skills (e.g., mobility skills and equipment) Social Context Inpatient Rehab Community Discharge Community Living Discharge into the community Follow up as needed for: • Health issues • Emotional wellbeing • Equipment/housing • Recreation/leisure • Employment/vocation • Parenting • Transportation • Other areas Reassessment as needed Environment COMMNUITY PARTICIPATION | PARTICIPATION 185


R - Community Participation
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