A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil

The purposes of this study were twofold: (1) for traffic accident (TA) victims with severe disabilities, to identify access barriers to physical rehabilitation; and (2) to build a theoretical model that will offer guidance for the improvement of these services. The city of Natal in Northeast Brazil was the site for qualitative research carried out in the form of semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims), as identified from a database provided by the emergency hospital. Alceste software, version 4.9 was utilized to analyze the interviews. There were several main barriers present in the interviews, as shown by the results. These were, as follows: (1) related to services: bureaucratic administrative practices, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. A theoretical model was used to present the large number of access barriers, with causes that related to the following: (1) organizational structure; (2) processes of care; and (3) professionals and patients. In order to improve the quality of physical rehabilitation and to avoid unnecessary prolongation of the TA survivors' suffering and disability, this model must be tested by health policy-makers and managers. Overall, there were five main areas covered in this study, as follows: (1) There are several implications here for rehabilitation. (2) Traffic accidents (TAs) must be treated as a global health dilemma that requires integrated preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). As an issue of quality of care that results in preventable disabilities, this study lays the foundation for improving access to PR for TA survivors. (3) Often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care, the suffering of victims is revealed through interviews in the words of the patients. (4) The study team built a theoretical model of the causes of the problem of access to PR. Through the intervention of health policy-makers, managers, regulators and rehabilitation professionals, and by encouraging the participation of patients, the identified barriers are potentially preventable. (5) In order to address access barriers in a timely way, it is necessary to expand the supply of services and rehabilitation professionals, regulate and standardize referencing practices, and encourage the sharing of information with patients regarding their health needs and continuity of care.


  • English

Media Info

  • Media Type: Digital/other
  • Features: Figures; References; Tables;
  • Pagination: pp 568-577
  • Serial:

Subject/Index Terms

Filing Info

  • Accession Number: 01671734
  • Record Type: Publication
  • Files: TRIS
  • Created Date: Mar 16 2018 3:42PM