Impact of community-based rehabilitation on quality of life and self-esteem of persons with physical disabilities and their family members

Abstract

Objective

Community-based rehabilitation (CBR) is a strategy by which persons living with disability (PWDs) access comprehensive rehabilitation services with limited evidence regarding its impact on the quality of life (QOL) and self-esteem (SE) of PWDs and their family members. This study compared the QOL and SE of Nigerian PWDs in communities with and without a CBR programme (CBR and non-CBR respectively), and the family quality of life (FQOL) of their family members.

Methods

Cross-sectional study involving 2 604 PWDs (1 302 in CBR and 1 302 in non-CBR); 5 208 family members of PWDs (2 604 in CBR and 2 604 non-CBR), recruited from four randomly selected geo-political zones in Nigeria, purposive/consecutive selection of eight CBR programmes, PWDs and their family members (CBR and non-CBR). Outcomes assessed using Rosenberg Self-Esteem Scale (RSES), World Health Organization Quality of Life Instrument- short form (WHOQOL-BREF) and Beach Centre Family Quality of Life Instrument (BCFQOL). Mann-Whitney U test and Spearman's rank order correlation were used to analyse data at P < 0.05.

Results

PWDs in CBR scored higher in all domains of WHOQOL-BREF (P < 0.0001 in all cases) and RSES than non-CBR group (P < 0.0001). The CBR families scored significantly higher than non-CBR families in all domains (P < 0.05) except Emotional Well-Being of the BCFQOL. The CBR group scores on Psychological and Social Health domains of the WHOQOL-BREF showed significant positive correlation with CBR families’ Family Interaction (P = 0.06) and Parenting (P = 0.07) domains and total FQOL (P = 0.07).

Conclusion

Community-based rehabilitation positively impacted on SE and QOL of PWDs and their family members.