African Journal of Disability最新文献

Background: Individuals with lower-limb amputations (LLAs) face unique challenges that affect their leisure participation and overall quality of life (QoL).

Objectives: This study examines the relationships between leisure participation, leisure constraints and QoL among South Africans with LLAs (N = 50, mean age 46.2 ± 11.63 years).

Method: A cross-sectional quantitative design was used, collecting data via the Trinity Amputation and Prosthesis Experience Scale-Revised (TAPES-R), Constraints to Participation, the World Health Organization Quality of Life Brief (WHOQOL-BREF), and the World Health Organization Quality of Life Disability Module (WHOQOL-DIS) questionnaires.

Results: Weak to moderate relationships were found between leisure participation and constraints (interpersonal: τb = -0.01, p = 0.402; structural: τb = -0.21, p = 0.072). Moderate positive associations emerged between leisure participation and QoL in the disability module (τb = 0.21, p = 0.073), physical domain (τb = 0.20, p = 0.088) and environment domain (τb = 0.20, p = 0.091). Medium-negative correlations were observed between QoL and constraints in the physical domain (intrapersonal: r = -0.33, p = 0.021; interpersonal: r = -0.32, p = 0.021). Significant negative relationships were found between QoL (social domain) and both intrapersonal (r = -0.33, p = 0.020) and interpersonal constraints (r = -0.36, p = 0.010).

Conclusion: This is the first study to explore these relationships in South Africans with LLAs. Intrapersonal and interpersonal constraints significantly impact physical and social QoL. Addressing these barriers may improve overall QoL in this population.

Contribution: This study provides novel insights into the interplay between leisure participation, constraints, and QoL among South Africans with LLAs. By identifying the significant impact of intrapersonal and interpersonal constraints on physical and social QoL, these findings highlight the need for targeted interventions to reduce barriers and enhance leisure engagement.

Background: Kenya faces significant challenges in addressing the impact of various health conditions. Understanding the functioning problems associated with these conditions is crucial for informing targeted interventions and improving overall healthcare outcomes.

Objectives: This study aimed to determine the prevalence and types of functioning problems associated with health conditions contributing most to Years Lived with Disability in the adult Kenyan population and to identify the International Classification of Functioning, Disability, and Health (ICF) domains and categories most affected.

Method: A scoping review was conducted. Searches were performed across multiple databases using relevant keywords and inclusion criteria. Studies published between January 2006 and December 2023 were eligible. Data were extracted from 39 eligible studies using a web-based software application (Rehab4all).

Results: Major depressive disorder, human immunodeficiency virus, low back pain and fractures were identified as the leading conditions contributing to functioning problems in Kenya. The most prevalent problems included walking difficulties, paraesthesia, various forms of pain and depression. The most affected ICF domains were mobility (d4), sensory function and pain (b2) and mental (b1).

Conclusion: The comprehensive description of functioning problems associated with priority health conditions in Kenya can be used to develop targeted interventions to improve health outcomes across affected domains.

Contribution: This research enhances comprehension of disability burden guiding intervention development and policy formulation for improved rehabilitation and offers a platform for further evidence-based strategies to tackle the country's complex health challenges.

[This corrects the article DOI: 10.4102/ajod.v13i0.1399.].

Background: In this article, I reflect on my continuing journey of becoming an autism self-advocate and how this has extended to advocate for the broader neurodiverse community.

Objectives: I aimed to provide an academic analysis of the value of autism self-advocacy with special reference to building resilience to confront discrimination and advocating for equal opportunities, support and inclusion.

Method: My autoethnographic reflections are fused with those of my co-constructors to present critical incidents that defined my journey of becoming an internationally recognised advocate for autism.

Results: Education has been the transformative force that has changed my life, granting me opportunities to advocate for my broader neurodiverse community on various local and international platforms and guiding me to create an ecosystem of family and professionals who continuously support me and others who are neurodiverse. My advocacy, which aims at raising autism awareness, has changed the perceptions of the community of practice as well as others with an interest in supporting and including individuals living with autism in a significant way.

Conclusion: A network of care and support is required to sustain autism self-advocacy and to build on it to advocate for the broader neurodiverse community.

Contribution: This demonstrates the need for educating stakeholders to raise their expectations for autistic children and adults and for teachers and psychologists to continue supporting families and children with Autism Spectrum Disorder (ASD) to realise their full human potential.

Background: Person-centred care (PCC) is a fundamental aspect of healthcare, and its implementation is primarily based on clinicians' initiation and sustained efforts and the availability of resources. Recent PCC literature has primarily focused on high-income settings, raising concerns about the feasibility of PCC implementation in low- and middle-income countries.

Objectives: This study examined speech-language pathologists' (SLPs) and audiologists' (AUDs) perceptions of barriers and facilitators towards implementing PCC in the diverse South African context, particularly how their demographic factors influence these perceptions.

Method: A national cross-sectional e-survey pooled 103 clinicians who were providing speech-language pathology and audiological services in South Africa. The e-survey included questions on participants' demographics, working environment and a seven-point Likert scale rating 10 components that influence PCC.

Results: Clinicians scored personal factors (64.7%), followed by their relationships with different professionals (54.9%) as the most facilitating factors for achieving PCC. The most significant perceived barrier was resources, including time and finances (59.8%), followed by the client perspectives (53.9%). Significant associations were found between the components influencing PCC and clinicians' qualifications, work sectors and populations served.

Conclusion: The collective findings of this study highlighted the multifaceted nature of PCC implementation within a diverse healthcare context. Client perspectives need to be considered while leveraging clinician attributes and fostering supportive workplace environments for the successful adoption of PCC.

Contribution: This study contributes to literature of PCC implementation and has captured how the perceptions of speech-language therapists (SLPs) and AUDs call for tailored approaches in diverse healthcare contexts.

Background: Within lower- to middle-income countries, mothers of children with disabilities often bear the burden of caregiving for their children, and experience various familial, systemic, structural and sociocultural challenges to the fulfilment of this role.

Objectives: This article discusses the barriers and enablers to caregiving experienced by mothers of children with disabilities living in a peri-urban setting in South Africa.

Method: A qualitative study using in-depth interviews was implemented with six mothers of children with disabilities, recruited through total population sampling. Interviews were conducted in three South African languages - English, isiXhosa and Afrikaans. The interviews were translated, transcribed and analysed thematically.

Results: Key challenges experienced in care giving include poverty, a sense of abandonment and communal stigma. Despite the challenges, the mothers identify spirituality and empathetic healthcare workers as a support for caregiving.

Conclusion: Mothers of children with disabilities experience isolation and stigmatisation, are often alienated from accessing community structures on an equal basis with others, creating a barrier to caregiving for these mothers. An inclusive and targeted approach is needed to raise awareness and create peer support groups for mothers of children with disabilities.

Contribution: A sense of isolation, financial challenges and familial abandonment are significant challenges for mothers of children with disabilities, but they find strength in spirituality. Spiritual belief systems and collaboration with community and spiritual leaders are advocated for ongoing communal support for mothers of children with disabilities. An inclusive, authentic intersectoral collaboration is needed to enhance caregiving capacity for mothers of children with disabilities.

Background: People with disabilities on average experience health care barriers, poorer health and higher mortality.

Objectives: This study aims to review and synthesise life expectancy (LE) and years of life lost (YLL) comparing people with disabilities to those without in low and middle-income countries (LMICs).

Method: A systematic review was conducted across six databases. Longitudinal studies with a comparator group that measured LE in or YLL between people with and without disabilities in LMICs were eligible for inclusion. Two reviewers independently assessed study eligibility, extracted data and assessed the risk of bias. Meta-analyses were undertaken using R 4.3.3. The study assessed heterogeneity with I² and publication bias with a funnel plot. Sub-group and meta-regression analyses were performed, and the risk of bias was evaluated.

Results: Twelve full-text articles were included in this meta-analysis. The pooled mean LE was lower in people with disabilities (57.98 years; 95% confidence intervals [CI]: 53.40-62.95) compared with people without disabilities (70.86 years; 95% CI: 64.06-78.38). The overall weighted years of YLL in people with disabilities was 15.84 years (95% CI: 11.1-22.61). There was no significant difference in YLL between men (16.33 years; 95% CI: 11.49-23.21) and women (13.7 years; 95% CI: 8.45-22.22).

Conclusion: The average LE in people with disabilities was substantially lower compared to those without disabilities in LMICs. This inequity highlights that health systems and public health efforts are failing to meet the needs of people with disabilities and must be improved to become more inclusive.

Contribution: The study emphasises the need for inclusive policies and robust research in the health system to address health disparities.

Background: In Ethiopia, children with disabilities face significant barriers to education, which are exacerbated for those living in remote villages and areas affected by conflict and insecurity. Several studies have highlighted the important role that sustained multistakeholder collaborations could play in removing barriers to inclusive education, supporting students with disabilities and helping countries like Ethiopia achieve inclusion.

Objectives: This study explored stakeholders' strategies and the programmes and support they provide to schools or students with disabilities (K-12) to promote inclusive education in the central Gondar zone, Ethiopia.

Method: This study used key informant interviews to collect detailed information on education stakeholders' collaborations to support the inclusion of children with disabilities. The interviewees include experts, administrators and policymakers from purposively selected governmental and civil society organisations and schools.

Results: This study found that collaboration focused on promoting accessibility, students enrolment and retention, financial, material and medical support, capacity-building, and institutional accountability.

Conclusion: This study concluded that persistent instability and conflict hindered stakeholders' collaborative efforts in the region. It also argued that structured or semi-structured collaborations are more effective for promoting inclusive education.

Contribution: This article presents research findings on collaboration among educational stakeholders to promote inclusive schools and support students with disabilities. Its holistic approach identifies ecological and institutional factors that affect collaborations for inclusion, as well as the support and services that could be further explored in future research. Additionally, it highlights the lessons that education programmes could use to enhance community and stakeholder participation in school inclusivity.

Background: The growing reliance on digital learning in South Africa, partly because of the emergence of the coronavirus disease 2019 (COVID-19) and 4IR technologies, risks excluding students with disabilities (SwDs) if measures to adequately support them are not in place.

Objectives: The study aims to identify gaps in knowledge, policies, practices and resources, which could impede the full engagement of SwDs. This article utilises the conceptual framework for inclusive digital learning, which comprises three categories of concepts related to inclusive digital learning: (1) defining attributes, (2) antecedents (necessary conditions) and (3) consequences (results). The framework is applied to synthesise the literature, determine the framework's efficacy, feasibility, and suitability, and demonstrate its value and utility in the actual implementation of inclusive and high-quality higher education for SwDs in South Africa during this era of digital learning.

Method: This study reviewed 22 articles (2020-2023) on disabilities, higher education, and digital learning identified through Google Scholar using Boolean operators.

Results: The study reveals significant gaps in South African higher education research on institutional policies related to digital access, capacity development, and disability inclusion in teaching and curriculum design.

Conclusion: The challenges facing SwDs and the existing research gaps imply that most higher education institutions lack the theoretical knowledge, policies, resources, infrastructure and staff capacity to support SwDs.

Contribution: This study exposes gaps in the literature and recommends further research on higher education policies and to establish the potential for policy reform to better support SwDs in the current era of digital learning.