title: Stakeholders' perceptions of rehabilitation services for individuals living with disability: a survey study.
abstract: BACKGROUND
  The World Health Organization (WHO) was tasked with developing health system guidelines for the implementation of rehabilitation services. Stakeholders' perceptions are an essential factor to take into account in the guideline development process. The aim of this study was to assess stakeholders' perceived feasibility and acceptability of eighteen rehabilitation services and the values they attach to ten rehabilitation outcomes.
  
  
  METHODS
  We disseminated an online self-administered questionnaire through a number of international and regional organizations from the different WHO regions. Eligible individuals included persons with disability, caregivers of persons with disability, health professionals, administrators and policy makers. The answer options consisted of a 9-point Likert scale.
  
  
  RESULTS
  Two hundred fifty three stakeholders participated. The majority of participants were health professional (64 %). In terms of outcomes, 'Increasing access' and 'Optimizing utilization' were the top service outcomes rated as critical (i.e., 7, 8 or 9 on the Likert scale) by >70 % of respondents. 'Fewer hospital admissions', 'Decreased burden of care' and 'Increasing longevity' were the services rated as least critical (57 %, 63 % and 58 % respectively). In terms of services, 'Community based rehabilitation' and 'Home based rehabilitation' were found to be both definitely feasible and acceptable (75 % and 74 % respectively). 'Integrated and decentralized rehabilitation services' was found to be less feasible than acceptable according to stakeholders (61 % and 71 % respectively). As for 'Task shifting', most stakeholders did not appear to find task shifting as either definitely feasible or definitely acceptable (63 % and 64 % respectively).
  
  
  CONCLUSIONS
  The majority of stakeholder's perceived 'Increasing access' and 'Optimizing utilization' as most critical amongst rehabilitation outcomes. The feasibility of the 'Integrated and decentralized rehabilitation services' was perceived to be less than their acceptability. The majority of stakeholders found 'Task shifting' as neither feasible nor acceptable.
authors.affiliation: Department of Clinical Research Institute, American University of Beirut, Beirut, Lebanon. andreajdarzi@gmail.com.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Darzi
authors.affiliation: World Health Organization, Geneva, Switzerland. officera@who.int.
authors.forename: Alana
authors.initials: A
authors.lastname: Officer
authors.affiliation: University of East Anglia, Norwich, UK. ola_abualghaib@yahoo.com.
authors.forename: Ola
authors.initials: O
authors.lastname: Abualghaib
authors.affiliation: Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. ea32@aub.edu.lb.|Department of Internal Medicine, American University of Beirut, Beirut, Lebanon. ea32@aub.edu.lb.|Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. ea32@aub.edu.lb.|AUBMC Department of Internal Medicine, Riad-El-Solh Beirut, 1107 2020, P.O. Box: 11-0236, Beirut, Lebanon. ea32@aub.edu.lb.
authors.forename: Elie A
authors.initials: EA
authors.lastname: Akl
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D012047:Rehabilitation Centers / Q000592:standards*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014944:World Health Organization; D055815:Young Adult