An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education

ABSTRACT

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals’ agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents’ confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals’ clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

KEYWORDS:

• Interprofessional communication
• interprofessional education
• interprofessional practice
• rehabilitation
• stroke
• survey

Acknowledgments

We would like to acknowledge Dr. Joseph Zunt, MD; Dr. Angela Carbone, MD; Demetrios Terezakis, MOT; Orli Shulein, SLP; and Cyndi Robinson, PhD, PT for their contribution to the content and successful completion of the training. We would also like to thank Christian Gutierrez and Daniela Quesada for their help with survey data entry.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this paper.

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Additional information

Funding

Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health (Award Number D43 TW009137). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.