Role of Physiotherapy in Ugandan Neurosurgical Transitional Care (2022-2023)

Background

Neurotrauma related to road traffic injury is a leading cause of admission to Ugandan hospitals. These patients often experience physical and cognitive impairments that require incorporating rehabilitation after hospital discharge – a crucial practice to reduce disability, improve functional mobility and reduce readmission rates. Thus, careful coordination of rehabilitation services during the hospital to community transition is crucial to quality patient care. Transitional care utilizes discharge practice to serve this connection.

A transitional care model must fit a society’s culture and resources. In Uganda, rehabilitation is an emerging healthcare service. The accessibility of rehabilitation services after the transition to community represents a knowledge gap. The extent of availability and accommodation of outpatient rehabilitation as well as the patient barriers to seeking, reaching and engaging in these services is unknown.

An international approach to determine rehabilitation’s role in discharge planning for neurosurgical patients will inform the development of transitional care models in emerging health systems. Further, cultural tailoring will improve Ugandan patient outcomes and contribute to strengthening the national rehabilitation sector.

Project Description

This project team aims to examine current and emerging post-hospital rehabilitation resources for traumatic brain injury (TBI) or new spinal cord injury (SCI) patients from stakeholder groups and identify patient/caregiver barriers and facilitators to accessing these resources. Long-term, this project contributes to a multiyear goal to develop a culturally appropriate protocol for rehabilitation involvement in hospital discharge planning of TBI and SCI patients, to be adopted as recommended practice by key national stakeholders in Uganda.

Conducting a situational analysis, team members will synthesize information from peer-reviewed literature and public data that maps post-hospital rehabilitation resources. The team will complete key stakeholder interviews to further identify emerging resources. Team members will collaborate on cultural adaptation of tools, tailoring research plans and methods to resource availability, and explore the effect of variations in health care systems on research implementation. 

Through qualitative design, the team will select a methodology for engaging with TBI/SCI patients and caregiver populations. 

All team members will engage with international collaborators and take part in the development of an international research team. 

Anticipated Outputs

Data for developing/testing and further research; referral protocol from hospital to post-hospital rehabilitation resources; abstract for submission to conferences; manuscript for submission to relevant global health and physiotherapy journals

Timing

Summer 2022 – Summer 2023

  • Summer 2022 (optional): Preparation meetings for subteam leaders and new members
  • Fall 2022: Workshop on team charter and norms creation; didactic lecture series; review of previous data analysis; data synthesis of post-hospital resources; project design
  • Spring 2023: IRB application; mock data collection and analysis
  • Summer 2023 (optional): Project implementation and evaluation; initial manuscript development

This Team in the News

Meet Some of the Teams at the Bass Connections Showcase

Bass Connections Teams Share Research Highlights at 2023 Showcase

See earlier related team, Role of Physiotherapy in Ugandan Neurosurgical Transitional Care (2021-2022).

 

Image: Traffic in Kampala, by flöschen, licensed under CC BY 2.0

Traffic in Kampala.

Team Leaders

  • Kira Battle, School of Medicine-Neurosurgery
  • Anthony Fuller, School of Medicine-Neurosurgery
  • Damascene Niyonsenga, Mbarara University of Science and Technology (MUST)

/undergraduate Team Members

  • Elizabeth Davidson, Biology (BS)
  • Julia Davis, Neuroscience (BS)
  • Amy Fulton
  • Emilie Lijesen, Neuroscience (BS)
  • Vignesh Pirapaharan

/yfaculty/staff Team Members

  • Jeffrey Hoder, School of Medicine-Family Medicine and Community Health: Doctor of Physical Therapy
  • Kearsley Stewart, Duke Global Health Institute

/zcommunity Team Members

  • Wilfred Arubaku, Mbarara University of Science and Technology (MUST)
  • Mbarara Regional Referral Hospital (MRRH)
  • Mbarara University of Science and Technology (MUST)
  • Mulago Referral Hospital
  • Ahurira Felix, Mbarara University of Science and Technology (MUST)
  • Ricky Kasaija, Mbarara University of Science and Technology (MUST)
  • Richard Kasiita, Mulago National Referral Hospital (MNRH)
  • Herman Kazibwe, Mbarara University of Science and Technology (MUST)
  • Catherine Kemirembe, Mbarara University of Science and Technology (MUST)
  • Florence Namirimu, Mbarara University of Science and Technology (MUST)