Medical and social parameters as predictors of satisfaction with rehabilitation services for mentally disabled children

Authors:

Bolod Svetlana Olegovna – deputy head for expert work of the Main Bureau of Medical and Social Expertise in Moscow Region, 6 Kokkinaki Street, 125319 Moscow, Russian Federation; e-mail: bolod_so@msemo.ru; https://orcid.org/0000-0002-5765-7690.

Karasaeva Lyudmila Alekseevna – Grand PhD in Medical sciences (Dr. Med. Sci.), Professor, Head of the Department of Health Care Organization and Medical and Social Expertise, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ludkaras@yandex.ru; http://orcid.org/0000-0001-5621-0240.

Sokurov Andrei Vladimirovich – Grand PhD in Medical sciences (Dr. Med. Sci.), Associate Professor, Director of the Institute of Additional Professional Education, Albrecht Federal Scientific and Educational Centre of Medical and Social Expertise and Rehabilitation, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: ansokurov@yandex.ru; https://orcid.org/0000-0002-3736-2895.

Mechtanova Yulia Viktorovna – head of the organizational and methodological department of the Main Bureau of Medical and Social Expertise in Moscow Region, 6 Kokkinaki Street, 125319 Moscow, Russian Federation; e-mail: mechtanov22@mail.ru; https://orcid.org/0000-0002-8293-3642.

Annotation:

Introduction. The need to improve the system of rehabilitation services for children with mental disorders living in social institutions is becoming increasingly evident. The actual problems faced by these children in inpatient institutions require an integrated approach and the introduction of modern methods of support that meet international standards. Understanding the needs of disabled children with mental illness is a key aspect for improving the quality of services provided. It is necessary to research the factors that determine the need and influence the level of satisfaction with rehabilitation services.

Aim. The aim is to assess the satisfaction with rehabilitation services provided to children with mental illnesses living in residential institutions and in the family. In the process of achieving the aim of the study, the following tasks were solved: the indicators of satisfaction with rehabilitation services provided to children with mental illnesses living in residential institutions and in the family were analysed; The perception of disabled children by types of rehabilitation services was studied; The impact of service provision on the functioning of social service institutions was examined.

Materials and methods. Materials: children with mental disabilities, 40 people living in residential homes and 40 people living in families. The method of questionnaire and survey on satisfaction with services was used, thematic analysis was carried out during interviews. Research bases: branches of the Main Bureau of Medical and Social Expertise in Moscow Region; orphanages in the Moscow Region.
The analysis of hypothesis testing of medical and social variables and satisfaction with rehabilitation services was carried out using factor analysis, which allowed us to identify latent variables important for the characterisation of medical and social parameters affecting satisfaction with the quality of rehabilitation services. Data processing was carried out in MS Excel, SSPS Statistics 27.

Results. Differences in medical and social parameters in analysing satisfaction with the quality of rehabilitation services provided, between children with disabilities receiving these services, living in residential institutions and in the family, were identified. Qualitative research was conducted using a purposive sample of participants attending rehabilitation. The research participants expressed general satisfaction with the experience of receiving rehabilitation services in terms of effective communication, accessibility of information and active involvement of the disabled person to achieve positive results.

Discussion. As a result of comparative analysis, it was found that satisfaction with rehabilitation services among children with disabilities with mental disorders depends on their place of residence. Residential institutions demonstrate higher satisfaction rates compared to the family, which highlights the importance of systemic support in specialised institutions. However, identified problems, such as lack of necessary information about rehabilitation services and uncertain rehabilitation goals, act as serious barriers to improving the quality of life of children with disabilities. In order to optimise rehabilitation programmes, it is critical to take into account the needs and expectations of all participants in the process.

Summary. This study demonstrates the importance of an integrated approach to the rehabilitation of children with mental disorders. The established medical and social parameters of satisfaction with services allow a clear understanding of the needs and requirements of this contingent. The findings are key to the development of organisational strategies to improve the quality of rehabilitation services. The identified factors affecting the level of access and participation of children with disabilities in rehabilitation programmes require the development of optimisation mechanisms for their provision.

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