African Journal of Disability最新文献

Background: Prosthetic rehabilitation modifies functional limitations and psychological challenges caused by amputations, as it helps to restore mobility and body image. A physical rehabilitation centre in Juba, South Sudan, has been providing prosthetic rehabilitation since 2009 in this conflict torn part of the world.

Objectives: To determine the quality of life (QoL) of persons with unilateral transfemoral or transtibial amputations who have received prosthetic rehabilitation in Juba, South Sudan.

Method: A cross-sectional survey was conducted with 40 participants, identified through consecutive sampling. Data were collected through face-to-face interviews using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF)questionnaire. Descriptive analysis was conducted, and relationships between QoL and participants' demographic and medical information were explored through the t-test and analysis of variance (normally distributed data) and the Mann-Whitney U and Kruskal-Wallace tests (skewed data).

Results: Mean domain scores were physical (74.28%), psychological (72.59%), social (71.40%) and environmental (58.81%). Overall QoL and overall health satisfaction had mean scores of 4.1/5 and 3.975/5. Marital status (0.049) and occupation (0.022) played a significant role in psychological QoL. No other demographic or medical variable had a significant effect on overall or domain QoL scores. Women were significantly more satisfied with their health than men (0.046).

Conclusion: Overall, participants had high QoL scores. This might be because of prosthetic rehabilitation. Lower scores in the environmental domain might be because of poverty and the continuous danger of armed conflict.

Contribution: Even when using basic components, prosthetic rehabilitation can significantly improve QoL after lower limb amputation.

Background: Job satisfaction among people with disabilities (PWDs) is a significant concern because of its impact on productivity, job retention and well-being in the workplace.

Objectives: This study aimed to assess the job satisfaction of employees with disabilities in Ethiopia and to identify key factors influencing job satisfaction.

Method: A cross-sectional survey was conducted with 784 Ethiopian government employees with various disabilities. All interviews were conducted in 2021.The survey was designed to collect key socio-demographic information, and factors related to job satisfaction.

Results: The majority of respondents had motor difficulties (59%), followed by visual impairments (36.7%). The mean age was 33 years, and 67% were male. Over half of the study participants were first-degree holders, and 80.6% had experienced integrated education. The mean time to secure a job was 15.41 months, with over 18% unemployed for 6-12 months. Job dissatisfaction was influenced by factors such as low salary, gender, service years and lack of personal assistance. Vision impairment correlated with higher dissatisfaction. Overall, around 32.5% reported satisfaction in their job, 44.1% were neutral and 23.4% were dissatisfied. Dissatisfaction rose to 29% when measured using supplementary questions.

Conclusion: The study was the first to examine factors leading to job satisfaction of employees with disabilities in the Ethiopian public sector. Recommendations include social policy adjustments for better working conditions, considering central factors associated with dissatisfaction. The government should explore measures such as employment quotas or wage supplementation to address disparities and ensure reasonable accommodation. Inclusive research methods will assist in leading change.

Contribution: This research contributes nuanced insights into the factors affecting job satisfaction and its complexities among employees with disabilities in the Ethiopian context, emphasising the need for ongoing research to improve worker support structures and inclusive practices in job acquisition and employment.

Background: Ample evidence suggests that primary caregivers of children with cerebral palsy experience barriers relating to their caregiving role; however, these caregivers also reported encountering factors that facilitate their caregiving experience.

Objectives: This article aimed to explore factors that facilitate and support caregivers of children living with cerebral palsy in rural South Africa.

Method: An exploratory qualitative research design was employed. Purposive convenience and snowball sampling were used to select 10 primary caregivers of children living with cerebral palsy between the ages of 3 years and 18 years. A semi-structured interview was used to collect data. Data were analysed using thematic analysis.

Results: This research identified several factors for facilitating and supporting caregivers of children living with cerebral palsy. These include social support, caregivers' ability to understand and accept their children's disability, mental health support and caregivers' access to resources.

Conclusion: The study found that caregivers looking after children living with cerebral palsy in rural communities have access to certain support systems that aid their caregiving experiences; however, such systems of support need to be strengthened and sustained to reduce the burden of care.

Contribution: This article highlights the facilitators and supportive factors of caring for children living with cerebral palsy in rural communities of South Africa to inform stakeholders on possible intervention strategies for maternal mental health in the context of raising a child with limiting disabilities.

Background: Political rights are crucial for all individuals, especially marginalised groups such as people with disabilities (PWDs). The Constitution of Zimbabwe specifically reserves two seats in the Senate for PWDs. While this is commendable, the current political climate in Zimbabwe does not sufficiently address PWDs' political inclusion, necessitating further action.

Objectives: This study aimed to firstly describe diverging definitions of disability and highlight that persons with visual and hearing impairments are excluded from the media, thus affecting their political engagement. Secondly, to build upon this assertion and elucidate the necessity of enhancing media access for PWDs to improve their political engagement.

Method: A qualitative document-based methodology was utilised.

Results: People with visual and hearing impairments face considerable barriers in accessing media content during and following electoral processes, effectively constraining their political participation.

Conclusion: Political parties should ensure the inclusion of sign language interpreters during election campaigns and provide their manifestos in Braille to enhance media accessibility by people with visual and hearing impairments. Additionally, the integration of sign language and Braille into educational curricula may foster more effective political engagement through various media channels for PWDs. Furthermore, training journalists in sign language and Braille may improve their communication for people with visual and hearing impairments.

Contribution: This study reveals significant challenges encountered by PWDs in accessing media, which exposes barriers to their political participation. To address these obstacles to accessing media, practical solutions are proposed that may improve the representation of PWDs in political roles.

Background: Developmental disabilities (DDs) involve impairments affecting children's abilities, impacting development and necessitating specialised care. Many caregivers face challenges caring for these children, lacking access to supportive healthcare interventions. Addressing this issue aligns with United Nations (UN) goals for ensuring access to quality services for children with disabilities and their caregivers.

Objectives: This study aimed to systematically review and synthesise evidence on healthcare interventions enhancing caregiver capabilities for children with DDs, identifying intervention types, components and effectiveness.

Method: Our systematic review analysed peer-reviewed English-language studies from 2014 to 2024, focusing on interventions for caregivers of children with DDs. The review investigated healthcare interventions designed to enhance caregiver capabilities across diverse cultural contexts, examining international research to understand strategies supporting caregivers of children with DDs.

Results: We found significant improvements in caregiver well-being through five interventions. Parent education reduces stress and improves parenting. Peer support decreased isolation while counselling enhanced family functioning. Condition-specific interventions increased intervention adherence among minorities. Combined interventions showed strong positive effects, especially when tailored. Comprehensive programmes greatly improved caregiver quality of life. Further research is needed for underserved communities and culturally adaptive interventions.

Conclusion: Our review indicates potential positive parental impacts with limited evidence. Small samples warrant future research using larger studies, emphasising rigorous methods, cultural adaptation and diverse community representation.

Contribution: Our review identifies promising intervention types and highlights the need for further research to optimise caregiver support and promote access to quality services.

Introduction: Spinal cord injuries (SCIs), while relatively rare, profoundly alter the lives of those affected. Among the diverse causes of SCI, traumatic sporting injuries represent 8.7% of newly reported cases. Despite the life-altering consequences of SCI, physical activity (PA) can mitigate some of these impacts.

Patient presentation: This case study highlights the long-term benefits of sustained PA and its crucial role in fostering a cascade of positive outcomes post-SCI. We present the case of an elite South African athlete, 'Jim', who sustained a complete SCI at the C6 level at the age of 16 in 2012 following a fall during dismount in a gymnastics competition. Jim's rehabilitation journey began shortly after the injury, encompassing formal inpatient care, alternative therapies and ultimately a return to competitive sports. By 2015, Jim resumed athletic activities, beginning with shot put and discus before transitioning to wheelchair racing, which became a pivotal aspect of his recovery.

Management and outcome: The case emphasises how sustained PA led to Jim's significant physical and mental improvements, such as weight loss, enhanced self-esteem, increased mobility and greater independence in daily living. Moreover, sport provided Jim with a renewed sense of purpose and direction.

Conclusion: This case underscores the importance of creating ongoing opportunities for individuals with SCI to continue their recovery long after discharge from inpatient rehabilitation.

Contribution: This case study illustrates how sustained PA contributed to a cascade of positive outcomes in Jim's recovery following SCI, offering valuable insights from his lived experience.

Background: The World Health Organization (WHO) published 'Standards for Prosthetics and Orthotics' to improve these services globally. Research that compares services to the standards assists in developing a baseline against which future development can be measured and identifies areas needing improvement.

Objectives: This article aims to describe prosthetic services in Namibia and compare them to the 60 WHO standards.

Method: A mixed-methods exploratory design was employed. Qualitative data were collected through semi-structured interviews with purposively selected participants, including managers (n = 2), service providers (n = 9) and users (n = 16). The data were analysed using content analysis. In the quantitative phase, cross-sectional surveys were administered to managers (n = 2), service providers (n = 10) and users (n = 120). The data were analysed descriptively. Qualitative and quantitative data were triangulated to determine Namibia's adherence to the standards.

Results: The triangulated data showed adherence to 14 standards, partial adherence to 24 and non-adherence to 22 standards. As per the standards' requirements, the government directed the provision of prosthetic services, and a range of prosthetic products was provided free of charge at all levels of care. Funding challenges, no national prosthetics committee, and no databases as well as lacklustre support of providers' careers and professional development, indicated areas of non-adherence.

Conclusion: A systems-based approach, utilising a people-centred conceptual framework, can aid Namibia and similar countries in implementing the standards.

Contribution: This study is the first to provide information on implementing WHO prosthetic standards in an African setting.

Background: Western mental health models prioritise biomedical explanations and interventions at the expense of indigenous non-Western belief systems that offer culturally relevant understandings of mental health. In Zimbabwe, Ngozi [reconciliatory and restorative spirits] play a significant role in shaping mental health experiences and perceptions. This article introduces the Dandemutande [Spiderweb] approach, an innovative framework that responds to the limitations of solely relying on the Western-based mental health conceptualisation by considering a multidimensional approach that acknowledges and respects cultural and spiritual dimensions alongside Western-based medical interventions to address mental health challenges in non-Western contexts.

Objectives: This study aimed to explore the relationship between mental health challenges and Ngozi, and how Ngozi influences the understanding and management of mental health challenges in Zimbabwe.

Method: A multi-layered, autoethnographic methodology integrating personal reflections, narrative accounts, the literature, and media analysis was employed to investigate how Ngozi is believed to affect mental health outcomes.

Results: This article identifies Ngozi as a significant and influential factor within Zimbabwean cultures, which contributes to mental health issues.

Conclusion: The findings introduce the Dandemutande approach to mental healthcare, which integrates cultural and spiritual dimensions with Western-based medical interventions to address mental health challenges.

Contribution: This article highlights the importance of inclusive mental health practices that incorporate indigenous belief systems, for example, reparation and healing initiatives such as compensation. The proposed framework has the potential to positively contribute to mental healthcare in other non-Western contexts where mental health has cultural and spiritual dimensions.

Background: Road traffic accidents (RTAs) are a global and public health concern affecting a third of the world's population mainly in low- to middle-income countries, particularly affecting young people. Returning to work (RTW) following an RTA is essential for better health and financial outcomes. The motor vehicle accident (MVA) Fund Botswana assists loss-of-income (LOI) claimants with medical assistance, compensates for loss, advocates and facilitates RTW.

Objectives: The study aims to identify barriers to and facilitators of RTW for LOI claimants as experienced by health care workers (HCWs).

Method: A qualitative explorative design included six healthcare workers who had worked with the MVA Fund on RTW for at least 5 years through purposive sampling. Data collection was done using a focus group discussion. Thematic analysis was conducted using Atlas.ti, with data interpretation guided by the ecological case management model.

Results: The main themes were healthcare systems, legislation and insurance systems, personal and workplace systems, which were further classified into eight subthemes relating to barriers and facilitators.Barriers included ineffective case management and how claimants perceived work. Facilitators included clear insurance RTW guidelines and workplace support and education level.

Conclusion: Successful RTW can be achieved through multidisciplinary collaboration of HCWs. While legal and healthcare systems play vital roles in RTW, personal factors and workplace systems cannot be ignored.

Contribution: Understanding the barriers to and facilitators of RTW will assist in implementing RTW interventions to improve patient outcomes, health, livelihoods, quality of life and guide RTW operations to ensure a coordinated process in the insurance industry in Africa.

Background: Vision impairment (VI) services aim to mitigate the effect of VI and provide opportunities for visually impaired individuals to actively participate in their daily activities.

Objectives: To determine optometrists' perceptions regarding VI services in public hospitals within Limpopo province, South Africa.

Method: A descriptive, quantitative, cross-sectional study was conducted between January and August 2023 across 37 public hospitals, using a structured questionnaire. Data obtained from the participants' responses were analysed to describe the level of VI services.

Results: The study sample included 65 optometrists with 71% female, yielding a response rate of 83%. Over 90% of the participants were aware of the World Health Organization definition of VI. The majority of participants (54%) reported referring patients with VI to a hospital multidisciplinary team, while less than 50% provided optimal spectacle correction. The main barriers to providing VI services were: the lack of assistive devices (97%), and equipment (95%), poor access (80%), insufficient space (66%), and the lack of training (66%). The primary barriers to the uptake of VI services were the lack of awareness (86%) and the cost of VI services (80%).

Conclusion: The provision of VI services in Limpopo province is currently limited. The factors contributing to the limited VI services are avoidable; therefore, efforts to enhance the availability of equipment, access and provision of comprehensive VI services are crucial to improving the quality of life for affected individuals utilising public hospitals in Limpopo province.

Contribution: The study describes the optometrists' perceptions of VI services in public hospitals.