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Disability inclusion in African health systems’ responses during COVID-19: A scoping review 在 COVID-19 期间,将残疾问题纳入非洲卫生系统的应对措施:范围审查
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-21 DOI: 10.4102/ajod.v12i0.1284
Madri Engelbrecht, Y. Ngqangashe, Luphiwo Mduzana, Kate Sherry, Lieketseng Ned
Background: People with disabilities often experience poorer access to healthcare because of multiple barriers even in non-crisis times, especially more so in low- and middle-income countries. The coronavirus disease 2019 (COVID-19) pandemic significantly constrained health systems, thus exacerbating access barriers. African health system responses to, and considerations made for people with disabilities during the pandemic have not been adequately examined to inform future inclusive practices during emergent and non-emergent periods.Objectives: This review aimed to explore disability considerations and accommodations included by African governments in their health systems’ responses during the COVID-19 pandemic.Method: A scoping review was carried out of peer-reviewed published articles on the Web of Science, Academic Search Premier, MEDLINE, Africa-Wide Info, and CINAHL databases. A desktop search of African government websites for COVID-19 country plans and reports was also conducted. Deductive thematic analysis of included texts was performed to identify disability inclusiveness in the health responses.Results: Ten peer-reviewed articles and three COVID-19 country plans or reports were included in the review. Data reflected a general finding that included countries that failed to effectively consider and include the healthcare needs of persons with disabilities during the pandemic.Conclusion: Poor inclusion of persons with disabilities was effected in healthcare systems’ responses during COVID-19 in Africa.Contribution: This article contributed insights about gaps in healthcare systems’ responses and highlighted development foci that could improve systems towards greater inclusivity of persons with disabilities’ health needs in low- and middle-income countries.
背景:即使在非危机时期,残疾人也会因多重障碍而难以获得医疗保健服务,在中低收入国家尤其如此。2019 年冠状病毒病(COVID-19)大流行严重制约了医疗系统,从而加剧了就医障碍。非洲卫生系统在大流行期间对残疾人的应对措施和考虑尚未得到充分研究,因此无法为今后在紧急和非紧急时期的包容性做法提供参考:本综述旨在探讨在 COVID-19 大流行期间,非洲各国政府在其卫生系统的应对措施中对残疾问题的考虑和提供的便利:方法:我们在 Web of Science、Academic Search Premier、MEDLINE、Africa-Wide Info 和 CINAHL 数据库中对经过同行评审的已发表文章进行了范围审查。此外,还对非洲政府网站上的 COVID-19 国家计划和报告进行了桌面搜索。对收录的文章进行了演绎式主题分析,以确定卫生对策中的残疾包容性:结果:10 篇经同行评审的文章和 3 份 COVID-19 国家计划或报告被纳入审查范围。数据反映了一个普遍的发现,即一些国家在大流行期间未能有效地考虑和纳入残疾人的医疗保健需求:结论:在 COVID-19 期间,非洲的医疗保健系统在应对措施中没有充分考虑到残疾人的需求:这篇文章有助于深入了解医疗保健系统在应对措施方面存在的差距,并强调了一些发展重点,这些重点可以改善中低收入国家的医疗保健系统,从而在更大程度上满足残疾人的医疗保健需求。
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引用次数: 0
Universal design of instruction to enhance learning for university students with visual disabilities 通用教学设计以提高视力残疾大学生的学习效果
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-20 DOI: 10.4102/ajod.v12i0.1156
Jayshree Singh, Sachin Suknunan
Background: There has been a steady increase in the number of students with disabilities (SWD) in Higher Education Institutions (HEIs) in South Africa, with a significant number of students having visual disabilities. Equal access remains a key challenge in the classroom setting, thus emphasising a significant gap.Objectives: This paper capitalised on the significance of this gap and examined the potential of Universal Design of Instruction (UDI) to promote equal access for students with visual disabilities (SWVDs) in the classroom within a university setting in order to maximise learning outcomes.Method: The study was conducted at the University of KwaZulu-Natal (UKZN), which had approximately 204 SWVDs. This paper draws primarily on the quantitative component of the study. Data collection entailed distributing a questionnaire to all SWVDs. Analysis was conducted using SPSS 21, which produced descriptive and inferential statistics. The theoretical framework of Sen’s Capability Approach in line with the Social Model of Disability was applied.Results: Findings indicated a lack of UDI in the classroom with very little compliance to all principles, resulting in increased challenges in teaching and learning for SWVDs. The incorporation of UDI in the classroom does have a positive correlation with learning outcomes.Conclusion: The incorporation of UDI principles can offer a potential design for easier access to teaching and learning to enhance and maximise learning outcomes; alleviate access challenges in the classroom; and address the negative experiences thereof for SWVDs.Contribution: The study adds value to the scarce body of knowledge on UDI in the classroom for university SWVDs from a learning enhancement perspective.
背景:南非高等教育机构(HEIs)中的残疾学生(SWD)人数稳步增长,其中有相当数量的学生患有视力残疾。在课堂教学中,平等机会仍然是一个主要挑战,因此凸显了一个巨大的差距:本文从这一差距的重要性出发,研究了通用教学设计(UDI)在促进视力残疾学生(SWVDs)平等进入大学课堂方面的潜力,以最大限度地提高学习效果:研究在夸祖鲁-纳塔尔大学(UKZN)进行,该校约有 204 名视力残疾学生。本文主要借鉴了研究的定量部分。数据收集工作包括向所有社工估价师发放调查问卷。使用 SPSS 21 进行了分析,得出了描述性和推论性统计结果。研究采用了与残疾社会模式相一致的森能力方法理论框架:研究结果表明,课堂教学中缺乏 "统一设计",很少遵守所有原则,导致社会福利残疾人士在教与学方面面临更多挑战。将 UDI 纳入课堂确实与学习效果呈正相关:结论:纳入 UDI 原则可提供一种潜在的设计,使教学和学习更容易获得,以提高和最大限度地提高学习成果;减轻课堂上的学习挑战;并解决社会福利和残疾人士的负面体验:贡献:本研究从提高学习效果的角度出发,为有关在课堂上为大学中的社会弱势群体提供无障碍通道的稀缺知识体系增添了价值。
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引用次数: 0
Journeying with developmental coordination disorder: The family experience 与发育协调障碍同行:家庭经历
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-19 DOI: 10.4102/ajod.v12i0.1210
Nicola L. O’Kelly, Jean V. Fourie
Background: Developmental coordination disorder (DCD) is a neurodevelopmental disorder impacting 5% – 6% of children and continues into adulthood for 50% – 70% of cases. Despite the multidomain and lifelong influence of this disorder, little consideration has been given to the experiences of the family. Post-diagnostic support has been recommended however, the specific areas requiring support remain vague.Objectives: This study described the familial experiences of living with a member diagnosed with DCD.Method: A qualitative descriptive study using a phenomenological approach allowed insight into the lived experiences of families journeying with DCD. Forty-four participants representing 8 countries participated in an online questionnaire with 12 participating in an online semi-structured interview.Results: Themes generated reveal that obtaining a diagnosis and navigating the healthcare and education systems can be troublesome. Upon diagnosis, families tend to experience positive emotions such as relief. However, the daily challenges soon result in dominant negative emotional responses. DCD places significant financial burdens on families and impacts marital, parental and sibling relationships. Families often feel isolated from their communities as DCD is poorly understood.Conclusion: DCD places families at risk as daily struggles require support which targets identified motor, cognitive, academic and emotional challenges. Creating awareness in society, education and healthcare would alleviate continual frustrations.Contribution: This study provides insight into the wide-ranging impact that DCD has on families so that individualised support can be tailored, and general awareness raised.
背景:发育协调障碍(DCD)是一种神经发育障碍,影响 5%-6%的儿童,50%-70%的病例会持续到成年。尽管这种障碍会对多个领域和终生产生影响,但很少有人考虑到家庭的经历。诊断后的支持已被推荐,但需要支持的具体领域仍然模糊不清:本研究描述了与被诊断患有 DCD 的成员共同生活的家庭经历:方法:采用现象学方法进行定性描述研究,深入了解患有 DCD 的家庭的生活经历。来自 8 个国家的 44 名参与者参与了在线问卷调查,其中 12 人参与了在线半结构化访谈:结果:所产生的主题显示,获得诊断以及在医疗保健和教育系统中游刃有余可能是件麻烦事。确诊后,患者家属往往会产生如释重负的积极情绪。然而,日常的挑战很快就会导致主要的负面情绪反应。DCD 给家庭带来沉重的经济负担,并影响婚姻、父母和兄弟姐妹的关系。由于人们对 DCD 的了解甚少,这些家庭常常感到与社区隔绝:DCD 给家庭带来风险,因为日常的挣扎需要针对运动、认知、学业和情感方面的挑战提供支持。提高社会、教育和医疗保健领域的认识将缓解持续的挫折感:本研究有助于深入了解 DCD 对家庭造成的广泛影响,从而提供量身定制的支持,并提高人们的普遍认识。
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引用次数: 0
Leisure education to leadership: Youth with physical disabilities' experiences in South Africa. 从休闲教育到领导力:南非身体残疾青年的经验。
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-30 eCollection Date: 2023-01-01 DOI: 10.4102/ajod.v12i0.1234
Makhaya J Malema, Marie E M Young, Lisa Wegner

Introduction: Young people with physical disabilities frequently lack opportunities to develop their leadership potential. These include their ability to make decisions and be able to take charge of their leisure programmes. An argument is made that developing leadership skills for youth with physical disabilities can be facilitated by participating in leisure education programmes.

Objectives: The objective of this study was to explore youth with physical disabilities' perceptions of how leisure education can be used as a tool to develop their leadership.

Method: This study used a descriptive qualitative research design to collect data using the purposive sampling method from 10 youths with physical disabilities aged 18 to 34 years in the Western Cape, South Africa. One-on-one interviews with semi-structured and open-ended questions were used to collect data for this study.

Results: The findings of this study include 4 main themes and 11 sub-themes. This study's findings showed that participants' perceptions and experiences were evidence of leisure education being used to build their capacity as leaders within their society. Furthermore, their understanding of how they apply leadership opportunities is an encouraging moment for their development.

Conclusion: Leisure education should be considered as a means to promote leadership in youth with physical disabilities in South Africa.

Contribution: Knowledge and experience about youth with physical disabilities, their leisure education experiences and skills development during activities.

身体残疾的年轻人往往缺乏发展领导潜力的机会。这包括他们做决定的能力和负责自己的休闲计划的能力。有一种观点认为,通过参加休闲教育项目,可以促进身体残疾青年的领导技能的发展。目的:本研究的目的是探讨身体残疾青少年对如何利用休闲教育作为发展其领导能力的工具的看法。方法:本研究采用描述性定性研究设计,采用有目的抽样的方法,对南非西开普省10名年龄在18 - 34岁的身体残疾青年进行数据收集。本研究采用半结构化和开放式问题的一对一访谈来收集数据。结果:本研究结果包括4个主要主题和11个次要主题。这项研究的结果表明,参与者的看法和经历证明了休闲教育被用来培养他们作为社会领导者的能力。此外,他们对如何运用领导机会的理解对他们的发展是一个鼓舞人心的时刻。结论:休闲教育应被视为促进南非身体残疾青年领导能力的一种手段。贡献:有关残疾青少年的知识和经验、他们的休闲教育经验和在活动中发展的技能。
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引用次数: 0
Disability inclusion in malaria services in western Tanzania: A rapid barrier analysis. 坦桑尼亚西部疟疾服务将残疾人纳入:快速障碍分析。
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-28 eCollection Date: 2023-01-01 DOI: 10.4102/ajod.v12i0.1270
Elias C Nyanza, Anthony Kapesa, Theresia Maduka, Monica T Madullu

Background: Persons with disabilities generally face greater challenges in accessing healthcare and interventions compared with the general population. Malaria is one of the diseases that can seriously affect individuals with disabilities, as it requires early diagnosis and prompt treatment.

Objective: This study explores the extent to which locally available malaria services and interventions are inclusive of persons with disabilities and identifies associated access barriers.

Method: A qualitative case study focusing on social, cultural and health system factors associated with the inclusion of persons with disabilities in malaria services was conducted in Kigoma Region, western Tanzania. Thematic analysis of emerging themes identified barriers affecting access to locally available malaria services and interventions.

Results: Inclusion of persons with disabilities in planning, implementation and reporting of health issues in different malaria programmes was reported to be limited. Persons with disabilities were unable to access malaria services because of different barriers such as the distance of the service provision sites, communication and information issues and a lack of financial resources.

Conclusion: Persons with disabilities are widely excluded from malaria care provision across the entire health services paradigm, impacting access and utilisation to this vulnerable population. Barriers to malaria service access among persons with disabilities were physical, attitudinal, financial and informational.

Contribution: The findings of this study identify that malaria intervention stakeholders need to take a holistic approach and fully involve individuals with disabilities at all levels and scope of malaria service planning and provision.

背景:与一般人群相比,残疾人在获得医疗保健和干预措施方面通常面临更大的挑战。疟疾是可能严重影响残疾人的疾病之一,因为它需要早期诊断和及时治疗。目的:本研究探讨了当地可获得的疟疾服务和干预措施在多大程度上包括残疾人,并确定了相关的获取障碍。方法:在坦桑尼亚西部的基戈马地区进行了一项定性案例研究,重点关注与将残疾人纳入疟疾服务相关的社会、文化和卫生系统因素。对新出现主题的专题分析确定了影响获得当地疟疾服务和干预措施的障碍。结果:据报告,在规划、执行和报告不同疟疾方案的健康问题时,将残疾人纳入其中的情况有限。由于不同的障碍,如服务提供地点的距离、通信和信息问题以及缺乏财政资源,残疾人无法获得疟疾服务。结论:在整个卫生服务模式中,残疾人普遍被排除在疟疾护理服务之外,影响了这一弱势群体的获取和利用。残疾人获得疟疾服务的障碍包括身体、态度、经济和信息方面的障碍。贡献:本研究的结果表明,疟疾干预利益攸关方需要采取整体方法,在疟疾服务规划和提供的各个层面和范围内充分让残疾人参与进来。
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引用次数: 0
South African single mothers' experiences of raising a child with a disability. 南非单身母亲抚养残疾孩子的经历。
IF 1.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-17 eCollection Date: 2023-01-01 DOI: 10.4102/ajod.v12i0.1321
Siya Mbanjwa, Clare Harvey

Background: Historically, in South Africa (SA), single motherhood has been part of the landscape and continues to increase. Disability in children is also increasing, yet it remains under-researched. Mothers are often left to raise their children with a disability alone, yet their voiced maternal experiences continue to largely be unheard, particularly in SA.

Objectives: This study aimed to explore the lived experiences of single mothers raising a child with a disability in SA. Furthermore, the aim was to explore how these mothers navigate their complex realities and practice of mothering, and to amplify the voices of mothers. Finally, the study sought to shed light on the particular contextual factors that affect single maternal experiences in caring for a child with a disability.

Method: Twelve South African single mothers raising a child with a disability between the ages of 7 years and 18 years were individually interviewed in this exploratory interpretivist study. Thematic analysis was utilised on the data.

Results: The four themes highlight the complex, multi-level strain of raising a child with a disability, which has had a significant impact on the social, financial and emotional facets of single mothers' lives.

Conclusion and contribution: The findings of the study are important for developing a thorough understanding of the needs of single mothers in this specific context as well as their daily experiences as mothers of children with disabilities. These needs include the necessity of psychosocial support and equipping single mothers with accurate knowledge about their child's disability so that they can make better accommodations for themselves and their child.

背景:历史上,在南非(SA),单身母亲一直是景观的一部分,并继续增加。儿童的残疾也在增加,但仍未得到充分研究。母亲经常独自抚养残疾儿童,但她们的母性经历在很大程度上仍未被听到,尤其是在南非。目的:本研究旨在探讨单身母亲抚养残疾儿童的生活经历。此外,其目的是探讨这些母亲如何应对其复杂的现实和育儿实践,并扩大母亲的声音。最后,该研究试图阐明影响单亲母亲照顾残疾儿童经历的特定背景因素。方法:在这项探索性解释主义研究中,对12位抚养7至18岁残疾儿童的南非单身母亲进行了单独访谈。对数据进行了专题分析。结果:这四个主题突出了抚养残疾儿童的复杂、多层次的压力,这对单身母亲生活的社会、经济和情感方面产生了重大影响。结论和贡献:这项研究的结果对于深入了解单身母亲在这种特殊情况下的需求以及她们作为残疾儿童母亲的日常经历非常重要。这些需求包括社会心理支持的必要性,以及让单身母亲准确了解自己孩子的残疾情况,以便为自己和孩子做出更好的安排。
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引用次数: 0
A (mis)guidance of disabled youth: Post-secondary schooling transition experiences in South Africa 残疾青年的(错误)指导:南非中学后教育过渡经验
Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-14 DOI: 10.4102/ajod.v12i0.1293
Armand Bam, Samantha Kriger, Zelda Cottle
Background: Globally, there is a disparity that exists between equal employment opportunities for people with disabilities post-schooling. While South Africa has aimed at the inclusion of people with disabilities, there has not been sufficient evidence of a successful transition from school to work environments.Objectives: This study documents the experiences and barriers that influence the preparation of high school students with disabilities for post-secondary education and work opportunities.Method: A qualitative research methodology employing multiple case study design was used where semi-structured in-depth interviews were conducted with youth between the ages of 18 years and 36 years who were currently employed. The participants were identified through purposeful sampling. Data were analysed by thematic analysis.Results: The findings indicate two overarching themes indicating that the career choices of participants, firstly, were significantly influenced by teacher and guidance counsellor expectations and, secondly, experiences of discouragement where personal agency and autonomy were limited.Conclusion: This study illuminates the need to enhance the decisions around careers for people with disabilities which should debunk the expectations of society.Contribution: This study will make teachers, mentors and counsellors more aware of their contribution, influence and support to youth with disabilities as they transition into the workplace.
背景:在全球范围内,残障人士毕业后的平等就业机会存在差距。虽然南非的目标是包容残疾人,但没有足够的证据表明从学校环境成功过渡到工作环境。目的:本研究记录了影响高中残疾学生准备接受高等教育和工作机会的经历和障碍。方法:采用多案例研究设计的质性研究方法,对18岁至36岁的在职青年进行半结构化深度访谈。参与者是通过有目的的抽样确定的。数据采用专题分析方法进行分析。结果:研究结果表明,参与者的职业选择首先受到教师和辅导员期望的显著影响,其次受到个人能动性和自主性有限的挫折经历的显著影响。结论:这项研究表明,需要加强残疾人的职业决策,这应该打破社会的期望。贡献:这项研究将使教师、导师和辅导员更加意识到他们对残疾青年过渡到工作场所的贡献、影响和支持。
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引用次数: 0
Factors affecting occupational therapy services for patients with traumatic brain injury 影响创伤性脑损伤患者职业治疗服务的因素
Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-07 DOI: 10.4102/ajod.v12i0.1203
Melanie C.J.S. Leyder, Fiona Breytenbach
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引用次数: 0
Supporting a Tsonga learner living with Bardet-Biedl syndrome, a rare complex disability 支持一名患有baret - biedl综合症的特松加学习者,这是一种罕见的复杂残疾
Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-06 DOI: 10.4102/ajod.v12i0.1181
Mfungana M. Shikwambana, Jean V. Fourie
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引用次数: 0
Feeding children with autism in South Africa: The teachers’ perspectives 在南非喂养自闭症儿童:教师的观点
Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-11-02 DOI: 10.4102/ajod.v12i0.1252
Skye N. Adams, Nthabiseng Matsimela
Background: Over 80% of children diagnosed with autism spectrum disorders (autism) exhibit disruptive behaviours during mealtimes, highlighting the need for personalised care. In South Africa, teachers often take on the responsibility of feeding due to resource constraints and the time children spend at school. Moreover, children with autism have unique and individualised feeding requirements, which many teachers may not have the necessary training or skills to address adequately.Objectives: To explore the ways in which teachers of autistic children manage feeding difficulties in the classroom.Method: A qualitative research design was employed using semi-structured interviews. Eight teachers were interviewed on feeding autistic children between the ages of 3 years - 9 years in Johannesburg, South Africa. Data were transcribed and analysed using thematic analysis.Results: The findings revealed that teachers encountered distinct challenges when it came to feeding autistic children in the classroom, particularly concerning the management of associated feeding difficulties. Teachers employed several strategies to encourage eating in the classroom setting including: (1) bolus modification, (2) behaviour modelling, (3) positive reinforcement and (4) offering choices and alternatives.Conclusion: The study concludes the need for specialised support and training for teachers to address the individualised feeding needs of children with autism. Implementing targeted interventions and providing resources for teachers could enhance their abilities to effectively support children with autism during mealtimes and promote a more inclusive classroom environment.Contribution: This study highlighted the importance of including the teacher in the multidisciplinary team when managing the feeding challenges in children with autism.
背景:超过80%被诊断为自闭症谱系障碍(自闭症)的儿童在用餐时间表现出破坏性行为,突出了个性化护理的必要性。在南非,由于资源限制和儿童在学校的时间,教师往往承担喂养的责任。此外,自闭症儿童有独特和个性化的喂养需求,许多教师可能没有必要的培训或技能来充分解决这一问题。目的:探讨自闭症儿童教师处理课堂喂养困难的方法。方法:采用半结构化访谈的定性研究设计。在南非的约翰内斯堡,八位老师接受了关于喂养3 - 9岁的自闭症儿童的采访。使用专题分析对数据进行转录和分析。结果:研究结果表明,教师在课堂上喂养自闭症儿童时遇到了明显的挑战,特别是在管理相关的喂养困难方面。老师们采用了几种策略来鼓励在课堂上吃东西,包括:(1)药丸修改,(2)行为建模,(3)积极强化,(4)提供选择和替代方案。结论:该研究得出结论,需要为教师提供专门的支持和培训,以解决自闭症儿童的个性化喂养需求。实施有针对性的干预措施并为教师提供资源,可以提高他们在用餐时间有效支持自闭症儿童的能力,并促进更具包容性的课堂环境。贡献:本研究强调了在管理自闭症儿童的喂养挑战时,将教师纳入多学科团队的重要性。
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引用次数: 0
期刊
African Journal of Disability
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