Home-visit rehabilitation is an important form of home-based rehabilitation that supports the lives of, and provides care for, individuals who are unable to visit rehabilitation facilities. Home-visit rehabilitation enables elderly people to receive care at home, which helps them maintain their dignity and live independently1). Additionally, rehabilitation plays an important role in enabling independent living in many countries around the world2-5). In rural and remote areas, there is a lack of sufficient medical resources, and access to healthcare is affected by cost, distance to facilities, and information barriers, in addition to the limited availability of therapists6,7). Disaster evacuation and repopulation are known to be complex situations that affect access to various healthcare services, such as emergency medical services8). However, there is a lack of information regarding the provision of rehabilitation in limited-resource areas, the distance to the patient’s home, the number of staff available, and the frequency of rehabilitation activities. It is important that recovery areas provide rehabilitative care to community members returning to their homeland after a disaster evacuation.
In Fukushima Prefecture, Japan, residents of 12 municipalities within a 20 km radius were forced to evacuate due to the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident caused by the Great East Japan Earthquake of March 11, 20119). The FDNPP accident had a significant impact on the medical system in Hamadori, the coastal region of Fukushima Prefecture. Before the nuclear accident, there were 80 operational medical institutions in Hamadori’s Futaba County; however, by August 1, 2016, only 15, i.e., 18.75% of these institutions, were operational10).
Kawauchi Village, located 10-30 km from the FDNPP (Figure 1), was one of the first municipalities to be repopulated after the evacuation in April 2012. Before the disaster, Kawauchi Village had only one medical facility, the National Health Insurance Clinic11). Rehabilitation resources were limited by the closure of medical facilities in neighboring municipalities after the disaster.
In March 2016, the Healthcare Corporation Seireikai was started as a home-visit rehabilitation service in Kawauchi Village to provide access to rehabilitation care. However, contemporary reports on home-visit rehabilitation in repopulated villages after an evacuation following a nuclear accident have been scarce. Kawauchi Village is an important area to understand the feasibility of home-visit rehabilitation in the repopulated areas, and how rehabilitation care was conducted in a real-life situation.
Hence, this report describes a case study of home-visit rehabilitation in Kawauchi Village. The purpose of this study was to explore how the users of home-visit rehabilitation services in Kawauchi Village perceive home-visit rehabilitation and whether it has a positive impact on their daily life.
Fig. 1. Location of Kawauchi Village, Hirata Village, Hirata Central Hospital (HCH), and Fukushima Daiichi Nuclear Power Plant (FDNPP). This map was created using R version 3.5.0 (http://www.r-project.org) and R Package “jpndistrict” (https://cran.r-project.org/web/packages/jpndistrict/index.html), which derives its geographical plotting data from National Land Numerical Information (http://nlftp.mlit.go.jp/ksj-e/index.html).