Background
A brief background and synopsis of the National rehabilitation policy (NRP)
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To improve accessibility of rehabilitation services
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To establish mechanisms for intersectoral collaboration in order to implement a comprehensive rehabilitation programme.
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To facilitate appropriate allocation of resources, and encourage their optimal utilisation.
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To facilitate human resource development that takes into account the needs of both the service providers and the consumers.
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To encourage the development and implementation of monitoring and evaluation strategies for rehabilitation programmes.
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To ensure participation of persons with disabilities in planning, implementation and monitoring of rehabilitation programmes.
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To encourage research initiatives in rehabilitation and related areas (1; p.2).
CBR principles | Definition |
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Participation | Active contribution of people with disabilities in CBR practice and monitoring. |
Inclusion | Placing people with disabilities and their issues in the mainstream. |
Sustainability | Benefits of the programme must be lasting beyond life of programme. |
Self-advocacy | Consistent involvement of service users in terms of defining practice and indicators. |
Article no. | Topic area |
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9 | Accessibility |
19 | Living independently and being included in the community |
20 | Personal mobility |
25 | Health |
26 | Habilitation and Rehabilitation |
The development of a collaborative research group
The development of the hypotheses for the study
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Firstly, we wanted to evaluate whether the NRP with its seven objectives is aligned with the rehabilitation services at the four sites in the Western Cape.
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Secondly, we wanted to measure whether rehabilitation services as an organizational structure in the four sites can deliver comprehensive rehabilitation services.
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Thirdly, we wanted to measure, using rehabilitation outcome measures, whether the patients that enter the four study settings do receive comprehensive rehabilitation.
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Lastly we wanted to align our findings with the 7 objectives of the NRP and do a gap analysis with regard to whether the NRP has lived to its promises.
Methods
The selection of the four rehabilitation research sites
Health conditions | WCRCa
| Gugulethu CHCa
| Bishop Lavis | Elangeni CHCa
|
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Spinal Cord Injury | X | |||
Stroke | X | X | X | X |
Amputations | X | |||
Head Injuries | X | |||
Peripheral Neuropathy | X | |||
Back and neck pain | X | X | X | |
Upper limb injuries | X | X | X | |
Lower limb injuries | X | X | X | |
Arthritis | X |
The development of the conceptual framework for the methodological steps used to evaluate rehabilitation services in four sites in the Western Cape
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The capacity of the four sites as organizational structures to deliver rehabilitation services
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And the rehabilitation outcomes of the patients receiving the services as well as client satisfaction.
The use of Kaplan’s framework for organizational capacity as a method of evaluating the capacity of the four sites to deliver rehabilitation services
The evaluation of the capacity of the four sites to deliver rehabilitation services (organizational capacity – underpinned by Kaplan framework)
The use of the International Classification of Function, Disability and Health (ICF) to determine the rehabilitation outcomes
The use of outcome measures to evaluate recipients of rehabilitation interventions in the four sites
Process followed
ICF | ||||||
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Instruments | Domains | Personal factors | Environmental factors | Body function | Activity | Participation |
Self-developed questionnaire | ||||||
Personal characteristics | - Age | X | ||||
- Gender | X | |||||
- Marital status | X | |||||
- Educational level | X | |||||
- Ethnicity | X | |||||
Health status | - Time since health event | X | ||||
- Recurrence of health event | X | |||||
- Co-morbidity | X | |||||
- Assistive gait devices | X | |||||
-Living conditions and basic needs | X | |||||
Environmental factors questionnaire | - Access to health facility -Environmental hazards -Satisfaction of care | X X | ||||
Self-report questionnaires | ||||||
Impairment data gathering sheet | - Severity of health event -Documented impairments | X | ||||
Activity measure, | - Functional ability | X | ||||
Zambian questionnaire | - Functional abilities and participation | X | X | |||
EQ-5D (Quality of life) | - Health-related quality of life | X |