African Journal of Disability最新文献

Background: Dysphagia, a swallowing impairment, has left people in need of assistance and care. Therefore, the lives of caregivers to those individuals with dysphagia change drastically. There is scarce research about the difficulties experienced by caregivers in caring for their loved ones with dysphagia, a phenomenon known as third-party disability (TPD).

Objectives: This study explored Speech Language Therapists' (SLTs') experiences with caregivers when managing adult patients living with dysphagia in South Africa.

Method: This study made use of a qualitative approach through an online survey with an optional follow-up interview using an adapted framework of the International Classification of Functioning, Disability and Health (ICF) model. Thirteen participants took part in the survey and two completed the follow-up online interview. Data were analysed using a top-down thematic analysis approach.

Results: Third-party caregivers receive counselling at various times with different content because of the lack of a standardised counselling protocol. Furthermore, using the ICF framework, the article identified that environmental, and contextual factors contribute to TPD. However, not all ICF components were applicable, and additional relevant factors were not captured.

Conclusion: Understanding SLTs' experiences in managing TPD in the adult dysphagia population was achieved.

Contribution: The study contributes to literature regarding TPD of adult patients living with dysphagia and has captured the role of the SLT in managing TPD in diverse settings across South Africa.

Background: In Zimbabwe, disability is defined and explained from a cultural, African indigenous religion and spirituality. These perspectives are sources of exclusion of persons with disabilities (PWD) from important social positions, economic empowerment, rites of passage and ceremonies.

Objectives: This study explores the politics of disability and belonging in Zimbabwe.

Method: Using Marco Antonsich's conceptualisation of place-belongingness and the politics of belonging, data are collected through qualitative desktop methodology, which explores how people with disabilities in Zimbabwe make emotional connections with communal spaces while being excluded from them.

Results: The study findings show the struggles for PWD to belong to religious or spiritual practices and cultural and economic spaces in Zimbabwe. The conventional concept of Ubuntu, which calls for interconnection of humans, provides hope to include PWD as part of the community. Disability in Zimbabwe is not one thing; the experiences of PWD are influenced by overlapping identities (such as gender, class and religion). The legacy of colonialism is visible in the spatial exclusion of the PWD, especially in the urban informal settlements, which sustain the pre-existing trends of exclusion.

Conclusion: The study concludes that belonging and belongingness of PWD should be within the grassroots movements and Ubuntu ethics, which encourage humaneness.

Contribution: The study contributes to policy changes informed by decolonised disability justice, participatory governance and the integration of Ubuntu principles to create a more inclusive citizenship and a stronger communal belonging for people with disabilities in Zimbabwe.

Background: The intricate process of ensuring equitable access to opportunities, resources and connections through social inclusion promotes social interaction. Resilience is frequently associated with these variances, and the ability to bounce back from setbacks is one of the most crucial components of athletic success. Episodic future thinking (EFT) is the capacity to visualise oneself in the future, establishing a link between one's present and future selves, promoting resilience and social integration.

Objectives: To evaluate the impact of EFT on sports mental resilience and social inclusion among wheelchair tennis players. To assess the social inclusion and mental resilience of wheelchair tennis players.

Method: This was a randomised controlled trial and employed a convenience sampling technique to recruit 36 wheelchair tennis players. It was divided into two groups: the Experimental group: EFT combined with strengthening exercises and the conventional group: Counselling combined with strengthening exercises. This study was formally registered in the Thai Clinical Trial Registry (TCTR) under the registration number TCTR20250310008.

Results: A total of 36 wheelchair tennis players with findings on Social Inclusion and Sports Mental Resilience were included, with 18 in the experimental group and 18 in the conventional group. Both groups were comparable in post-mean values. The experimental group showed statistically significant results compared to the conventional group (p < 0.05).

Conclusion: This study concludes that while both EFT and conventional training improve sports' mental resilience and social inclusion.

Contribution: The combination of EFT with strengthening exercises is slightly more effective than conventional training.

Background: Stigma poses significant challenges to the overall quality of life of people living with epilepsy (PLWE) in Nigeria; yet, there remains a limited understanding of the stigmatisation of PLWE.

Objectives: Guided by critical theory, the purpose of this systematic review is to synthesise evidence on the nature, impact, and socio-cultural drivers of epilepsy-related stigma in Nigeria. This review attempts to provide insights that could be useful for informing interventions to empower PLWE, reduce their burdens, improve their outcomes, and foster their inclusion in the Nigerian society.

Method: Literature search was conducted using six electronic databases - APA PsycINFO, Google Scholar, JSTOR, MEDLINE, PubMed, and Scopus - to identify relevant studies published between 2011 and 2024. Qualitative and quantitative studies were included. A total of 10 studies met the inclusion criteria and were analysed using thematic and narrative syntheses.

Results: The findings revealed that stigma is a multi-dimensional issue encompassing perceived, enacted, and internalised forms. Cultural misconceptions such as beliefs associating epilepsy with witchcraft, curses, and contagion were found to be the primary drivers of stigma. Economic barriers, gender-specific vulnerabilities, and social exclusion further perpetuate discrimination and healthcare disparities. Stigma is associated with social determinants of health, such as education, employment, and gender, to limit opportunities and quality of life for PLWE.

Conclusion: This study highlights that stigma adversely affects PLWE, perpetuating marginalisation, social isolation, and healthcare inequalities.

Contribution: Urgent action is required to implement culturally sensitive interventions, enhance healthcare policies, and increase awareness to address stigmatisation, ensuring equitable treatment and access.

Background: As supervisors, we often find ourselves giving a specific student more attention and leeway than others. Have you ever wondered why some students struggle more than others, even when receiving additional assistance?

Objectives: This article aimed to examine the depth of supervisory knowledge and awareness in supporting students with hidden disabilities to enhance academic guidance and foster student success.

Method: This article employed a systematic literature review (SLR) and thematic analysis to investigate the supervisory challenges and support mechanisms faced by students with hidden disability. The article sought to answer the research question: How does the existing literature critically address the supervision of students with hidden disabilities in higher education in supporting their academic success?

Results: Students with hidden disabilities often avoid disclosing their conditions because of stigma, emotional burden and fear of being perceived as less capable. Findings revealed a significant gap in supervisory preparedness and institutional support. Supervisors, lacking adequate training and awareness, are often ill-equipped to respond effectively, leaving students feeling isolated and invalidated, and many struggle with whether their condition is 'valid enough' and not seen as an excuse.

Conclusion: This article explored the multifaceted dimensions of supervising students with hidden disabilities, demonstrating a significant gap in supervisory preparedness, knowledge, training and awareness. The findings showed a need for targeted strategies and training programmes to equip supervisors with the necessary skills to support students with hidden disabilities and provide an inclusive supervisory environment that promotes their well-being and success.

Contribution: The article offers insights into supervisory approaches for students with hidden disabilities, providing the groundwork for future empirical research and empathetic supervisory support structures.

Background: Intellectual disability is a significant concern to both mothers and healthcare professionals. This is because of the support and care needed by these children. Healthcare professionals face various challenges while providing support to mothers of children with intellectual disabilities.

Objectives: The study focused on exploring the views of healthcare professionals regarding the healthcare of children with intellectual disabilities in the Vhembe district, Limpopo Province.

Method: A qualitative, explorative and descriptive design was used to explore the views of 15 participants who were selected purposively. In-depth individual interviews were used to collect data from the healthcare professionals who were working in paediatric wards. The data were analysed using Tesch's eight steps. Measures to ensure trustworthiness were adhered to throughout the study.

Results: This study revealed that a shortage of healthcare professionals, especially nurses, doctors, physiotherapists and occupational therapists, had a negative impact when providing healthcare for a child with intellectual disability. Moreover, a lack of experienced personnel to care for these children and a lack of training were found to be challenges faced by healthcare professionals.

Conclusion: Increasing the number of healthcare staff and providing training to them in intellectual disability care to enhance knowledge, competency, and skills were found to be effective strategies that help provide the needed emotional, psychological, and social support for children with intellectual disabilities and their mothers.

Contribution: This study adds to the literature by highlighting the vital role played by nurses, doctors, physiotherapists and occupational therapists in supporting children with intellectual disabilities and their mothers.

Background: Social communication disorder (SCD) issues within inclusive primary school classrooms present significant challenges for teachers, affecting the overall teaching and learning atmosphere. Recognition of learner diversity is the cornerstone of inclusive education, whereby all learners are expected to participate equally, actively and meaningfully.

Objectives: This study aimed to explore effective mediation strategies for addressing SCD in inclusive primary classrooms and how this learning disability impacts teacher professional development.

Method: This study adopted a qualitative research methodology, utilising a case study design focused on four inclusive primary schools. Data were collected through in-depth, semi-structured interviews to determine individual participants' opinions and perceptions. Thematic qualitative data analysis was used to analyse the data inductively. Twelve teachers from four inclusive primary schools were purposively selected to participate in the study.

Results: The study identified several contributing factors to SCD, which can arise from various underlying causes, often related to neurological, developmental, genetic or environmental factors. Nevertheless, teachers firmly supported including learners with SCDs in inclusive classroom settings to ensure their full and equal participation alongside their peers.

Conclusion: This study argues that negative teacher perceptions in schools might negatively affect the teaching and learning environment, causing long-term consequences for learners who display SCDs and their capacity to meet academic objectives.

Contribution: The study may shed light on strategies to effectively curb SCDs posed by learners in inclusive primary classrooms. School Management Teams (SMTs), teachers, parents, and other relevant key players will benefit from the study's outcomes to improve their knowledge and skills to support learners with SCDs. This study recommends integrating inclusive policy and legislation into the implementation of mediation strategies for addressing SCD in primary classrooms.

Background: To reduce stigma, there is a need to understand where stigma exists, how it affects different populations, and what interventions have proven effective in reducing stigma.

Objectives: To synthesise evidence on intervention effectiveness in reducing disability-related stigma in sub-Saharan Africa.

Method: We conducted a comprehensive search of nine databases, supplemented by grey literature, references and expert consultations. Two authors screened, extracted and appraised studies. Interventions were categorised according to the Behaviour Change Wheel framework, and synthesised narratively from those with a low and medium risk of bias.

Results: Out of 15 studies, eight studies (four each with low and medium risk of bias) reported positive effects, seven found education and training effective, either alone or with other interventions. One study observed positive effects from combining education with communication, enablement and persuasion. Of the five studies with mixed effects (medium risk of bias), four employed education and training alongside other interventions, and one combined education with modelling, persuasion, enablement and communication. Two studies (low risk of bias) reported null effects when combining education, training and service provision with other interventions.

Conclusion: High-quality research on the impact of stigma interventions in sub-Saharan Africa is limited. Challenges include defining stigma, proving intervention effectiveness, and the varied target groups, settings, intervention types and metrics used to measure stigma change.

Contribution: This study highlights the need for and provides the rationale for increased methodological rigour and theoretical grounding in the evaluation of stigma-reduction interventions, and full and transparent reporting of all results.

Background: Experiences of pregnancy and motherhood needs among women with disabilities are not often discussed by families, communities, and even within healthcare facilities, resulting in their reproductive health needs being overlooked and inadequately supported.

Objectives: This study aimed to explore experiences of pregnancy and motherhood among women with disabilities within Nkangala District, Mpumalanga province.

Method: A qualitative, exploratory descriptive design was used among a sample of 10 women with disabilities who met the inclusion criteria. Snowball sampling method was used to recruit participants, and the sample size was determined by data saturation. One-on-one in-depth interviews using an unstructured interview guide were used to collect data.

Results: Analysis revealed seven major themes reflecting women's experiences: unplanned pregnancy; mixed emotions including relief; decisions around pregnancy termination; support received during pregnancy and postpartum; attitudes of community members and healthcare professionals; difficulties in fulfilling motherly roles; and challenges of raising a child while with a disability. Women who received consistent maternal care and strong family support were able to nurture and care effectively for their children.

Conclusion: The healthcare sector needs to improve policies related to the reproductive health of women with disabilities, how they are treated to reduce the stigma and the negative comments that healthcare workers make to this population group during pregnancy and motherhood.

Contribution: The study contributes to a deeper understanding of disability, promotes inclusion and challenges harmful conceptions. This knowledge can eventually improve maternal care, improve the results for mothers and children, and increase the social integration for women with disabilities.

Background: People with neurological conditions resulting in disabilities face a multitude of challenges in their journey of care. Existing evidence recommends exploring region-specific care pathways to understand the multi-faceted factors that influence the health outcomes of people with neurological conditions.

Objectives: To explore the care pathway for neurological conditions in a specialised rehabilitation hospital in Gauteng, South Africa.

Method: This study used an explorative qualitative design. Semi-structured interviews were conducted with a purposeful sample of patients with neurological conditions and health professionals. All interviews were transcribed verbatim, and a framework analysis was used for data processing and interpretation.

Results: Two overarching themes emerged: the lack of an integrated care pathway and the key role players along the care pathway. Components in the care pathway continuum included the onset and emergency management, admission into an acute facility, waiting for admission into the rehabilitation hospital, inpatient and outpatient specialised rehabilitation care and community care. Participants described role players in the care pathway.

Conclusion: This study describes a detailed care pathway for people with neurological conditions in the healthcare system. Evidence suggests the lack of an integrated pathway for people with neurological conditions, especially in acute and community care settings. Multiple key components and role players are recommended for an integrated care pathway.

Contribution: There is a need to develop an integrated care pathway for neurological conditions to minimise clinical risk and improve patient outcomes.