Rehabilitation of the 21st century is present in almost every field of medicine. Because Poland is a member state of the European Union, we are obliged to adapt to the recommendations applicable in other countries. Rehabilitation principles are included in the White Book on Physical and Rehabilitation Medicine in Europe. The contents of this book coincide with the model of the Polish Rehabilitation School adopted in 1970 by the WHO and recommended ever since. This model was based on four principles: the universality, early implementation, comprehensiveness and continuity of the rehabilitation process.
The World Health Organization (WHO) describes rehabilitation as „using all possible means to reduce the impact of disability and impairments and creating conditions aimed at achieving an optimal level of social integration of the disabled.”
The number of disabled people is increasing in Poland and in Europe. This is caused by aging and the prolongation of life expectancy of people with serious diseases and injuries. Therefore the number of people with complex functional problems is increasing. Also the level of social expectations concerning maintaining good health increases.
Comprehensive rehabilitation reduces the consequences of disability and allows the disabled to take part in social and professional life. Costs incurred due to rehabilitation are lower than health care and social costs incurred due to the lack of rehabilitation.
The access to rehabilitation is a basic human right, guaranteed in standards published in the United Nations Charter promulgated in 1993.
I would like to explain a few terms, so that you understand the organizational scheme of rehabilitation better.
Comprehensive rehabilitation consists of the following:
- Social rehabilitation, aiming at restoring social independence of the disabled
- Professional rehabilitation, aiming at restoring the ability of the disabled to professional activity (changing or adjusting the given job or vocational retraining)
- Medical rehabilitation (therapeutic rehabilitation) taking place in health care facilities.
In Poland medical rehabilitation is being conducted: in stationary rehabilitation departments (constitutional rehabilitation for adults and children, neurological, pulmonary, cardiac rehabilitation) in daily rehabilitation departments/centers (constitutional rehabilitation, rehabilitation of the hearing and speech organ, of the eye, cardiac, pulmonary rehabilitation, rehabilitation of children with neurodevelopmental disorders), in rehabilitation clinics, outpatient physiotherapy clinics and in form of home rehabilitation.
Medical rehabilitation should be carried out by a rehabilitation team, i.e. a group of medical and non-medical professionals, conducting the rehabilitation process under the guidance of a doctor being a specialist in rehabilitation.
The rehabilitation team consists of following people: a doctor being a specialist in medical rehabilitation managing and being responsible for the whole rehabilitation process, doctors of other medical specializations as consultants and (depending on the needs): a nurse, a physiotherapist, occupational therapist/ergo therapist, a psychologist/clinical psychologist/neuropsychologist, a speech therapist/a neuro-speech-therapist, a person adjusting/producing medical products of individual use/a prosthetist/a orthotist/an orthopedic technician, a massage technician, a social assistant, an educator/a special educator.
The doctor being a specialist in medical rehabilitation is conducting clinical and functional examination, diagnosing, establishing and supervising the rehabilitation program, determining the prognosis and evaluating the effectiveness of rehabilitation. He/she is also selecting the members of the rehabilitation team taking the need to ensure an effective implementation of the individual rehabilitation program into account. The members of the rehabilitation team are carrying out their tasks in accordance with the rehabilitation program for every patient within the scope of their competences.
The team of the national consultant in the field of rehabilitation developed standards for the medical rehabilitation treatment performed by different entities, which will be presented in January 2016 to the Health Minister for approval.
It is necessary to develop separate standards in various fields of medicine, based on own experience and the experience of other countries. Thanks to the support of the Management of the National Geriatrics, Rheumatology and Rehabilitation Institute, especially Director Piotr Bednarski the work on the standards will start soon.
National Consultant in the field of Medical Rehabilitation