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Table 3 Main themes and sub-themes related to access to comprehensive rehabilitation and summary of experiences, by type of participant

From: Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach

ThemesSub-ThemesPWDsCaregiversRehabilitation ProvidersOther stakeholders
Meaning of rehabilitation Inclusive of physical and psychological therapy, sports, and educationIncludes therapies and assistive technologyStrategy to promote independence, both in the PWD and their caregiversA process that “frees” the PWD and their family
It is necessary to overcome fear of leaving the house and improve quality of lifeNecessary so PWD can do things without help and reduce their care burdenShould be tailored to individual needs with a multidisciplinary/multilevel
approach
Beyond health and includes sports, recreation, education, employment, peer mentoring, and services for caregivers
Value of rehabilitation seen through peers who have had a successful outcomeRehabilitation as a tool for acceptanceA path to independence, to be able to decide on your ownRequires articulation between PWD, their families, and providers
Challenges to access comprehensive rehabilitation servicesBarriers for personal mobilityHomes of PWDs are inaccessible PWDs lack ability to navigate accessibility barriers with assistive technologyPWDs lack ability to navigate physical barriers with assistive technology
Built-environment barriers in public placesPublic places with lots of stairs, no ramps or elevatorsBuilt-environment barriers in public placesAccessibility challenges in public spaces
Lack of accessible, reliable, and affordable public transportationLack of accessible and affordable public transportationLack of accessible, reliable, and affordable public transportationLack of funding to afford transportation
Perceptions and knowledge about disabilityAttend talks, seminars as a tool to learn more about ones conditionNeed more training on how to care for PWD and themselvesMany providers lack appropriate training in disabilityPeople that design the city need to be aware of universal design
Some professionals, including health and rehabilitation, lack of appropriate knowledge on disability and accessibilitySome rehabilitation providers do not have the training to appropriately work with PWDRehabilitation is not seen as inclusive by policy and decision makersPWD and their families lack interest in learning
Mistrust in medical personnelMistrust in medical systemMany PWD and caregivers do not adhere to the programs because lack of interestPWD need training in rights and self-advocacy
  PWD and their families only identify as right-holders and not duty-bearersAwareness on appropriate assistive technology is needed
Navigating the systemServices constantly denied requiring legal appealLegal appeal required in many instances to access rehabilitation servicesDisability is not a priority for policy makersLegal appeal required to access services
Pathways to access services are not clearServices are insufficientLack of continuity in public programs and strategiesLack of coordination between programs
 Pathways to access services are not clearLack of public funding for sport, art, and recreationNon-existent care pathway
Participation in the community Leisure and recreation participation most mentionedLeisure and recreation participation most mentionedLack of interest and commitment from PWD and their families limit their community participationEmployment necessary to improve the quality of life of PWD and their families
Education and employment important to social participation and to raise awareness on disability  Education is key to improve participation
   Sports as tools that teach independence, responsibility, and commitment
   Need for PWDs to take leadership roles