Journal of Rehabilitation Medicine: Special Issue 50-4bokBW | Page 67

Disability and rehabilitation in low- and middle-income countries
field of PM&R in various plenary and interactive panel
sessions, which included: basic principles of rehabilita-
tion, evidence-based practice and research methods,
disability care planning, capacity building, leadership
skills development, role of OT and speech pathologist
for different neurological conditions, rehabilitation nur-
sing; symptomatic management (spasticity, pain, wound
care, etc.) and others. The lead medical team members
from the “host” institutions provided information about
the local health service and system, including specific
challenges faced by the PM&R professionals. During
these workshops, participants were divided into 3 panels
to ensure that various specialist skill-base was as evenly
distributed as possible, and each panel focused on one
of the GDAP objectives. These panels were further
divided into subgroups based on the specific content of
the key GDAP objectives. All subgroups recorded their
responses on a form with an overview of the GDAP.
Participants in each panel, based on their experience and
issues faced in service delivery, discussed their views
and perspectives of various challenges and recorded
specific barriers/problems and potential facilitators in
line with the GDAP. At all times the GDAP was used
as a blueprint for discussion and allowed the authors to
educate the audience, many of whom were not familiar
with the GDAP document (mainly junior doctors, nurses
and some allied health professionals).
A modified Delphi-consensus method was used
for the collective participant opinion. This involved
a presentation by one speaker from each group, who
presented on behalf of their designated panel, followed
by a face-to-face large group discussion providing the
opportunity to brainstorm additional and emerging is-
sues, and to avoid the dominance of some participants
that can occur in nominal group consensus methods. At
the end, a formal iterative decision-making and consen-
sus process (with ≥ 80% of participants agreeing) was
conducted tabulating potential challenges/barriers and
facilitators/enablers in implementation of the GDAP.
Data collection and analysis
During the workshop, participants submitted their
responses in writing for each GDAP objective. They
were encouraged to document any emerging issues and
present these in the large group interactive session. All
information was supplemented with audio-recorded
data and video-tape during the workshops. The author-
facilitators recorded additional information, com