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Introduction In modern conditions, in the Republic of Belarus rehabilitation is the main instrument of the direction of social policy, which is designed to solve the problems of the socially vulnerable part of the population - the disabled. Therefore, its implementation includes directions for improving the quality of life of disabled people, creating the necessary conditions for achieving and maintaining maximum independency and autonomy, individual mobility, restoration of physical, social and professional abilities and their highest involvement in all spheres of life. Timely and well-grounded solution of the above tasks’ complex requires the formation of a coordinated system of rehabilitation, habilitation of disabled people, including the development of social service institutions that provide social services to disabled, rehabilitation and habilitation centers. Materials and methods The study of the direction and subjective structure of social rehabilitation, habilitation of the population with disabilities in the Republic of Belarus involves the use of not only general methodological approaches (systemic, statistical, sociological), but also a qualitative institutional analysis. The use of the last of the above approaches makes it possible to identify more fully the boundaries of the possibilities and limitations of all subjects, who are involved in the process of rehabilitation and habilitation of disabled people, in real practice. Analysis of legislative and regulatory legal documents in the field of rehabilitation makes it possible to identify areas and stages of social rehabilitation, habilitation of disabled people, as well as substantiate the requirements for managing this complex social process. Results and discussion ps2021s1.4htm00099.jpg In the national legal framework, social rehabilitation is defined as a set of measures aimed at improving the quality of life of people with disabilities by creating conditions for them to live independently and integrate into society 181. Achievement of the goal of social rehabilitation of disabled people is carried out through the implementation of social domestic and pedagogical rehabilitation measures; provision of psychological assistance; provision of social services, including the services of a personal assistant; development of creativity, physical culture and sports among the disabled. The directions of rehabilitation are formed under the influence of both the objective needs of the disabled, identified in the process of medical and social expertise, and taking into account the possibilities of their practical satisfaction within the framework of measures implemented by the state. Today, the bulk of services for social rehabilitation, habilitation of disabled people are provided by territorial centers of social services for the population (Table). The predominant part of social services (71%) provided by territorial centers of social services for the population is social domestic services, which are provided in the form of services at home for citizens with disabilities (namely, the ability to carry out self-service corresponding to FC3 - a pronounced violation (from 51% to 75%) and FC4 - a highly pronounced violation (from 76% to 100%)). In the terms of specific weight, the second place belongs to consulting, information, and social mediation services related to other types of social rehabilitation, habilitation of disabled people. These types of services are provided on the certain days of visits to institutions in the form of semi-stationary social services. In this form, people with disabilities are also provided with socio-pedagogical and socio-psychological rehabilitation services. In a complex form (10%) both in stationary and semi-stationary conditions and at home, cultural and leisure nature rehabilitation services are provided. Analysis of the activities of the state institutions of social services showed that social rehabilitation, habilitation of disabled people is a complex controlled dynamic process 182. Its complexity is determined by the object of management, the system for assessing changes in the object’s state in the process of rehabilitation, and by significant costs both for carrying out rehabilitation, habilitation measures and monitoring their effectiveness. Based on the present practice in the Republic of Belarus, the process of social rehabilitation, habilitation of disabled people on the basis of state institutions providing social services consists of the following stages: Stage 1. Determination of the basic needs of a disabled person in the measures of social rehabilitation, habilitation is based on: 1) the state of personal health, the severity of violations of the main criteria of life (the ability to self-service, independent movement, orientation, communication, control of behavior); 2) a comprehensive assessment of the abilities and capabilities of a disabled person, the social and living conditions of his residence, the psychological state and social attitudes of the potential recipient of services, i.e. not only the individual capabilities of a disabled person are taken into account, but also their compliance with social status. Stage 2. Selection of necessary measures and services for social rehabilitation, habilitation of a disabled person based on an analysis of the range of available measures for social domestic and psychological rehabilitation, social services, personal assistant services, measures for the development of creativity, physical culture and sports among disabled people. Stage 3. Drawing up an individual route for social rehabilitation, habilitation of a disabled person, which includes the formation of a section of social rehabilitation program within an individual rehabilitation, habilitation of a disabled person, as well as an assistance in obtaining services provided by employment services, services of public organizations and individual entrepreneurs, cultural institutions, sports, etc. Stage 4. In cases of objective and (or) subjective necessity, the individual route of social rehabilitation, habilitation of a disabled person is corrected. Stage 5. Implementation of the prescribed rehabilitation measures, monitoring of their implementation timing. At the same time, the state social service institutions are assigned with the function of coordinating the activities of the object and subjects of social rehabilitation, habilitation, and the rehabilitation process itself. Stage 6. Monitoring the effectiveness of the implementation of a specific section of social rehabilitation of an individual rehabilitation program, habilitation of a disabled person. The presented stages of social rehabilitation, habilitation of disabled people reflect the integrity of the process. In such a way, the loss or omission of one or another stage (direction) of rehabilitation not only leads to a decrease in the quality of social functioning for an individual with disabilities, but also to ineffective, incomplete rehabilitation in those directions that were implemented. This is predetermined both by the integrity of the human personality, all sides and manifestations of which are interconnected, and by its integration into social life. At the same time, the existing socio-economic conditions burdened by the spread of coronavirus infection COVID-19 do not allow achieving continuity and comprehensiveness of social rehabilitation, habilitation of disabled people, which is primarily associated with: a) high risk of contracting a coronavirus infection, proceeding in a severe form and, as a result, the highest mortality rates among this population group; b) lack of access to medical and social expertise; c) strict regime of self-isolation, leading to the interruption of the provision of any rehabilitation services, including social ones. ps2021s1.4htm00101.jpg In these conditions, it is necessary to ensure the flexibility and inclusiveness of the management of social rehabilitation, the habilitation of people with disabilities, the ability of the system to respond to the current situation and cover a variety of categories of people with disabilities. The solution of this scientific and practical problem will be facilitated by the formalization of blocks of management of social rehabilitation, habilitation of disabled people on the basis of state institutions of social services for the population (Figure). Block «normative legal regulation of social rehabilitation, habilitation». The regulatory legal documents in force in the field of rehabilitation of disabled people in Republic of Belarus determine the procedure for planning, organizing, implementing and monitoring the implementation of rehabilitation measures. To implement the norms of national legislation, a number of by-laws have been adopted, which consist of normative legal acts of various ministries and departments. Block «entrance» includes resource provision and organizational tools for managing social rehabilitation, habilitation of disabled people. Personnel, financial and material-technical support of rehabilitation in institutions of social service of the population is defined as resource provision. The organization of specific measures for social rehabilitation, habilitation is carried out on the basis of a comprehensive assessment of the abilities, capabilities, social and living conditions, psychological state and social attitudes of a disabled person. The next input condition for the implementation of social rehabilitation, habilitation of disabled people is the formation of a section of social rehabilitation of an individual program of rehabilitation, habilitation of a disabled person (hereinafter - IPRD). The individual program of rehabilitation, habilitation of a disabled person contains rehabilitation measures provided free of charge in accordance with the legislation of the Republic of Belarus 183. IPRD is of a recommendatory nature for a disabled person, he or she has the right to refuse one or another type, form and volume of rehabilitation measures, as well as from the implementation of the program as a whole. Refusal of a disabled person (or a person representing his interests) from an individual rehabilitation program as a whole, or from the implementation of its individual parts, relieves the relevant state authorities, as well as other organizations and individual entrepreneurs, from responsibility for ensuring the implementation of relevant measures. The main principles for the formation of IPRD are: •individuality; •continuity; •sequence; •continuity; •complexity. The individuality of rehabilitation means the need to take into account the specific conditions for the onset, development and outcome of disability in a given person. Continuity presupposes organizational and methodological support for the continuity of a single process of implementing various rehabilitation measures. Otherwise, there is a sharp decrease in their effectiveness. At the same time, it is necessary to observe a certain sequence in carrying out rehabilitation, dictated by the peculiarities of the course of the illness of a disabled person, the possibilities of his social and environmental environment, and the organizational aspects of the rehabilitation process. The continuity of the stages of rehabilitation means taking into account the ultimate goal of the next stage when carrying out the activities of the previous one. When forming a program of social rehabilitation, habilitation, it is necessary to determine: •direction and content of rehabilitation measures; •form of rehabilitation (stationary, semi-stationary, in a day care unit, at home); •frequency of implementation of rehabilitation measures and deadlines (dates of the beginning and end of the rehabilitation measure); •performers (institutions); •predictable result (the possibility of compensating for disabilities, the possibility of forming the main criteria for life: achieving self-service, independent movement, orientation, communication, living, integration into society). If the section of social rehabilitation, habilitation is not fulfilled, there must be a record indicating the reason for the failure. The implementation of the IPRD can be carried out by institutions of any form of ownership with the right to engage in this type of activity. Control over the implementation of IPRD is carried out by social service institutions in the course of dynamic monitoring. IPRD in the rehabilitation process has a number of advantages that allow taking into account all the potential capabilities of a disabled person, achieving the greatest success with adequate measures. Block «technologies of social rehabilitation, habilitation». The methodological basis for the implementation of rehabilitation appointments for disabled people is the technology of social rehabilitation, habilitation. Social technologies mean a set of forms, methods and techniques of influence that must be applied to achieve the set goals in the process of social development of an individual, to solve one or another of his social problems. The technology of social rehabilitation can be defined as ways of implementing activities for social rehabilitation based on its rational division into procedures and operations with their subsequent coordination and the choice of optimal means, methods of their implementation. Taking into account the various types of functional disorders (impaired sensory functions, impaired staged dynamic functions, etc.), leading to limitations in life, the following types of programs for social rehabilitation, habilitation of disabled people should be distinguished: 1) programs of social rehabilitation, habilitation of disabled people with impaired functions of the musculoskeletal system; 2) programs of social rehabilitation, habilitation of disabled people with hearing impairments; 3) programs of social rehabilitation, habilitation of disabled people with visual impairments; 4) programs of social rehabilitation, habilitation of people with mental and intellectual disabilities. Each of the types of programs presented is a complex system of measures for social rehabilitation, habilitation of disabled people, various measures to ensure their life and integration into society. The content of the program of social rehabilitation, habilitation of disabled people in social service institutions includes the following components: 1) initial consultation with a specialist in social work; 2) social and environmental education; 3) solving psychological problems of a disabled person; 4) social and cultural rehabilitation; 5) occupational therapy; 6) provision of legal assistance, social services, support. Block «normative legal regulation of social rehabilitation, habilitation». The regulatory legal documents in force in the field of rehabilitation of disabled people in Republic of Belarus determine the procedure for organizing, implementing and monitoring the implementation of rehabilitation measures. To implement the norms of national legislation, a number of by-laws have been adopted, which consist of normative legal acts of various ministries and departments. Block “subjects (performers) of regulation of social rehabilitation, habilitation”. The implementation of measures (provision of services) of social rehabilitation, habilitation can be carried out by: •state organizations subordinate to republican government bodies, other state organizations subordinate to the Government of the Republic of Belarus, whose competence includes the implementation of measures aimed at improving the quality of life of disabled people; •stationary social service institutions; •centers of medico-social and (or) social rehabilitation; •centers for correctional and developmental education and rehabilitation; •territorial centers of social services for the population; •organizations whose property is owned by public associations of disabled people; •organizations engaged in artistic creation; •organizations of physical culture and sports; •individual entrepreneurs involved in the rehabilitation of disabled people in the manner prescribed by the legislation of the Republic of Belarus. The typology of rehabilitation institutions is based on the criterion of scale and scope of activity. The main tasks of rehabilitation institutions are: 1) detailing and concretizing individual rehabilitation programs for the disabled, developed by the institutions of the state service of medical and social expertise; 2) development of plans and programs (routes) for the rehabilitation of disabled people in a specific institution; 3) rehabilitation, habilitation of disabled people in various areas; 4) dynamic control over the rehabilitation process; 5) provision of advisory and methodological assistance on the rehabilitation of disabled people to public, state and other organizations. “Exit” block. Social rehabilitation, habilitation of disabled people should have social and economic effects. The result of the implementation of measures of medical, vocational and labor, and social rehabilitation, habilitation of disabled people is the restoration (compensation) of fully or partially impaired functions of the human body, elimination of the causes leading to disabilities. The social effect of rehabilitation is achieved by leveling the limitations of life and expanding the scope of the physical, psychological, social independence of an individual. These changes make it possible to integrate (reintegrate) persons with disabilities into the main spheres of life. In addition, an important aspect of social rehabilitation and habilitation is the achievement of an economic result, which consists in expanding the possibilities of returning to professional activity, realizing the labor potential of disabled people, as well as releasing a part of the working-age population from guardianship and trusteeship over this category of the population. It should be noted that in this case there is not only preservation, but also development and increase in the country's labor potential. In our opinion, the described blocks make it possible to ensure the flexibility and inclusiveness of the management of social rehabilitation, habilitation of disabled people in dynamic conditions, burdened by the spread of coronavirus infection COVID-19. The latter, in turn, should reflect the nature of modern social policy towards citizens with disabilities in Republic of Belarus. Output Social rehabilitation, habilitation of disabled people is a heterogeneous, complex in the composition of elements and tasks to be solved, a controlled dynamic process aimed at achieving self-service for disabled people, ensuring their individual socio-economic mobility with the highest possible degree of independence, creating conditions for independent living. The system of social rehabilitation, habilitation of disabled people includes the following structural components: social and domestic rehabilitation; social services, including the services of a personal assistant; social and psychological rehabilitation; social and cultural rehabilitation, including the development of creativity, physical culture and sports among the disabled. The research provides proposals for detailing the stages of social rehabilitation, habilitation of disabled people on the basis of state institutions of social services for the population, as well as generalization and formalization of the algorithm for managing the rehabilitation process, which ensures a more complete use of the resource base (social and legal) up to monitoring the implementation of individual rehabilitation programs, habilitation of disabled people. With functional integrity and complexity, these proposals allow to substantiate the further directions for improvement of the national rehabilitation system. Источник финансирования. Исследование не имело спонсорской поддержки. Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Об авторах

Г. А. Примачонак

Белорусский государственный университет

О. А. Лабейко

Барановичский государственный университет

Email: olgalabeyko@bk.ru

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