Biomedical Engineering Reference
In-Depth Information
For instance, limiting the points of access onto and off the unit often deters patients from
wandering into unsafe areas. In addition, low stimulation settings help decrease agitation
and irritability. All of these aspects of management facilitate recovery and help minimize
the use of medications and their side effects.
Clinical information, the results of laboratory testing as well as imaging, all aid in the
determination of disability. The evaluations done by occupational and physical therapists,
speech-language pathologists, psychologists, and so on are equally important. Information
from a variety of standardized assessments and tests are used to help determine and guide
treatment planning from acute care to community (re)integration.
Outcome measures used to determine the effectiveness of medical interventions
and rehabilitation continue to focus primarily on changes over time in body functions
and structures and when quality of life is addressed, it is apt to be limited to health-
related quality of life (e.g., Maas et al. 2010). A recent study reported, however, that
health-related quality-of-life measures are predominantly measures of function that
results “in a bias against people with long-standing functional limitations not related
to current health” (Hall et al. 2011, p. 98).
As stated by Wilson (2006), improved ways of evaluating rehabilitation are needed
that relinquish the dependence on traditional outcome measures that frequently fail to
apprehend the real needs of patients and families. It remains the case, however, that too
little attention is given to:
• The preferences and goals of individuals with disability and their family members,
• A person's predisposition to beneit from some interventions over others,
• The match of expectations of beneit with realization of beneit from the chosen
interventions, and
• Social and environmental factors impacting beneit.
True to a biopsychosocial approach , rehabilitation needs to begin with an understanding of
the current physical, cognitive, emotional/behavioral, and psychosocial functioning of the
individual. This requires a rehabilitation team composed of individuals from the diverse
areas of specialty, including neuropsychology, rehabilitation psychology, psychiatry, occup-
ational therapy, speech-language pathology, social work, and vocational rehabilitation
counseling. Specialists in sensory loss, such as audiologists and optometrists, may also
be included. A key member of the team to include at the outset is the assistive technology
specialist. Personal assistance and support from technologies, as well as environmental
restructuring and the use of cognitive and behavioral strategies, are important resources.
Case managers and disability advocacy organizations can help obtain further appropriate
services for those in the community such as transportation, financial management, and
housing assistance.
Presentation of the Chapters of Section II
The structure, level of intensity, and services available for rehabilitation vary widely
from one area to another, whether comparing facilities, cities, states, and countries. As
 
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