An exploration of the experiences and perceptions of primary caregivers of children with cerebral palsy living in rural communities in Ghana

Background Cerebral palsy has been identified as the most common, chronic childhood disability that causes appreciable motor deficit. Building the capacity of caregivers and improving children’s functional capacities through rehabilitation programs could reduce the physical and psychological burden imposed by the caregiving process. There is paucity of information about the experiences of caregivers of children with cerebral palsy in Ghana especially those who are not receiving any form of care. The purpose of this study was to explore the experiences and perception of caregivers living in rural communities. Methodology A descriptive phenomenological approach as proposed by Husserl was used to explore the experiences of 12 caregivers of children with cerebral palsy aged between 2 years 9 months to 14 years. The caregivers’ interviews were analysed using Colaizzi’s phenomenological method of data analysis framework. Findings Two main themes emerged from the narratives of the caregivers. The first theme ‘Developing personal beliefs to support the caregiving role’ revealed that caregivers developed religious and spiritual beliefs to interpret their children’s condition, perceive the standard of care and negatively their beliefs caused feeling of despair and sorrow. The second main theme ‘Demands that shaped the experience of caring’ revealed the demands included physical, financial and social demands. The essential structure of the phenomenon demonstrated the complex interaction of personal and environmental factors in harmony with the actual demands to influence the experiences of caregivers positively or negatively. Positively caregivers achieve coping, committed to caring, hope for the future and acceptance of the condition of their children. However negatively caregivers described the triggering factors of feeling of despair and sorrow as frustration, lack of understanding of the condition, felt stigmatised and perceived that the child was going through pain and suffering. Conclusion Caregivers derived strength from their religious and spiritual beliefs to balance the demands of caregiving. The new findings could be used as a basis for developing interventions to support caregivers, inform new strategies for rehabilitation care delivery and sensitisation of community members about inclusion of children with disabilities in the futur

Patterns of ethical issues and decision-making challenges in clinical practice among Ghanaian physiotherapists

Objectives: To determine the patterns of ethical issues and decision-making challenges encountered by practicing physiotherapists in Ghana.Design: This is a cross-sectional study in which the stratified sampling technique was adopted to sample the participants.Setting: The study involved physiotherapists at the private healthcare setting and from different levels of public healthcare facilities.Participants: Eighty-two duly registered physiotherapists who were practising in Ghana participated in the study.Interventions: Participants completed a 30-item questionnaire related to ethical issues and challenges encountered in making ethical decisions. Data analysis was premised on the frequency of occurrence of ethical tensions and difficulty in decision making which were dichotomized as 'high' and 'low' issues, and 'extreme' and 'low' difficult decisions, respectively.Results: The age range of the participants was 21-49 years (mean 31.5 ± 1.4years). 18 (22%), 31 (37.8%) and 33 (40.2%) physiotherapists practice in the primary, secondary and tertiary healthcare settings respectively. 56 (68.3%) and 43 (52.4%) of the participants affirmed that 'establishing priorities for patient's treatment amidst limited time resources' was the most frequently encountered and the most extremely difficult ethical issue to make a decision on respectively. Whereas, limiting physical therapy services for personal or organizational gains sub-theme was the least occurred issue which was also the least difficult to make a decision on as indicated by the respective 16 (19.5%) and 18 (22.0%) physiotherapists.Conclusion: A wide range of primary and secondary ethical issues were reported by the sampled physiotherapists, which tend to pose difficulty during the decision-making process in practice.Keywords: Ethical issues; code of ethics; decision making; physiotherapy practice, ethical judgementFunding: The research work was self-funded by the authors

Overcoming the Barriers for Participation by the Disabled: An appraisal and global view of community-based rehabilitation in community development

The discipline of rehabilitation developed after the Second World War. Some disabled people were reintegrated into the society due to advances in technical aids, appliances and assistive technology. The transfer of these aids and technology to developing countries was facilitated by the United Nations Organization (UNO). The results, however, did not get to the rural communities. The number of people with disability worldwide, and particularly in the developing countries, is increasing due to wars, conflicts, vehicular accidents, chronic diseases, mental impairment, birth defects and malnutrition. Many of these people face participation-restriction in activities of life. This paper appraises the emergence and the global view of community-based rehabilitation (CBR). The review and remodelling of CBR in developing countries, and its inclusion in community development will enhance the reintegration of the disabled individuals into the society. KEY WORDS: disabled, community based rehabilitation, reintegration, community developmen

Design and Construction of a Broadloom Capable of Weaving Compound Weaves

Handloom weaving in Ghana is relevant to the growth and development of the textile industry as well as the economy of the country. Handloom weaving in Ghana has taken a new dimension due to the dawn of modern techniques and equipment. Students, lecturers and researchers are making substantial efforts to improve efficiency and to solve problems associated with handlooms in Ghana. This research was carried out to address the problem of weaving compound structures on the broadloom, which is normally produced on the indigenous handloom in narrow width. The aim of the research is to design and construct an “improved broadloom” capable of weaving compound weave structures. The processes and methods used to achieve the compound structures have been vividly expatiated with highly detailed diagrams. The testing of the loom and results are clearly stated for easy analysis and criticisms. However, the proper use of this loom, without any controversy would go a long way in improving on the weave structures produced on handlooms in Ghana and beyond. Keywords: Design, Broadloom, Weaving, Weave structures, Compound weave

Evaluating Performance Contracting as a Tool for Evaluating State-Owned Enterprises in Two Developing Countries: A Look at the Performance Dimensions

This paper is concerned about the performance evaluation aspect of performance contracting (PC), particularly, the performance dimensions used in performance contract system for evaluating the performance of State-Owned Enterprises (SOEs). The paper draws on evidence from the Ghanaian and Kenyan SOE sectors. The performance indicators under each broad performance dimension of the performance contract system were reviewed. This was achieved using data collected from multiple secondary sources including policy documents, government reports and publications. The findings of the paper revealed a number of insights into the evaluation of performance contracting as a tool for evaluating SOEs. Keywords: performance evaluation system, performance contracting, State-owned enterprises, performance dimensions, Ghana, Keny

Sex differences in physical activity among Ghanaian patients with sickle cell disease

Introduction: musculoskeletal pain and functional limitations experienced by patients with Sickle Cell Disease (SCD) impact their physical activity and social behaviour. Yet, we know little about physical activity behaviour in patients with SCD. The aim of this study was to investigate gender differences in physical activity, sedentary time and measures of fitness among Ghanaian adults with SCD. The study also determined the association between outcome variables in this population. Methods: patients with SCD attending a sickle cell clinic in a tertiary hospital in Accra, Ghana participated in this cross-sectional study. Physical activity, sedentary time, body composition, flexibility and cardiovascular endurance were assessed. Demographic data were also collected by self-report. Results: fifty three participants enrolled in the study. Of these, more than half were females (60.4%) and the average age of the participants was (M: 26.8, SD: 8.5 years). The total physical activity reported by the participants was different between males and females (t = 2.610, p = 0.012). However, there were no gender differences in sedentary time, body composition, flexibility and cardiovascular endurance. A moderately significant association was found between sedentary time and cardiovascular endurance (r = 0.437, p = 0.001). Conclusion: the findings suggest that gender differences in physical activity are apparent in patients with SCD. Investigations into the mechanisms underpinning these differences are warranted. Additionally, longitudinal observations of objectively measured physical activity may be useful to validate these results in a larger sample

Single nucleotide polymorphisms and the etiology of basal-like and luminal A breast cancer: a pathway-based approach

Genetic models suggest that there are breast cancer-associated genetic variants that remain uncharacterized. Heterogeneity among breast tumors may increase the difficulty of identifying these variants. The intrinsic molecular subtypes of breast cancer are associated with distinct risk factors and survival. Genetic risk factors may also differ by subtype. 312 potentially functional and tag SNPs in candidate genes related to hormone synthesis and signaling (CYP19A1, ESR1, HSD17B2, HSD3B1, PGR, SHBG) and central adiposity (ADIPOQ, LEP, LEPR, IL6, TNF) were genotyped in the Carolina Breast Cancer Study, a population-based study of African-American and white women. Genotype data was available for 1776 of 2022 controls and 1972 of 2311 cases (200 basal-like, 679 luminal A). Data from 144 ancestry informative markers was used to estimate ancestry and adjust for residual population stratification. Odds ratios (ORs) and 95% confidence intervals (CIs) for the association between genotypes and breast cancer were estimated using logistic regression. Haplotype ORs and 95% CIs were estimated using HAPSTAT. Genotypes in LEP, LEPR, TNF, CYP19A1, ESR1, HSD3B1, HSD17B2, and PGR were associated with breast cancer overall. Genotypes in ADIPOQ, IL6, LEP, LEPR, ESR1, HSD17B2, HSD3B1, PGR, and SHBG were associated with the luminal A or basal-like subtype. Many associations were stronger when cases were stratified by subtype compared to associations for breast cancer overall. In some cases, such as with the strongest associations in ESR1 and HSD17B2, associations were strong overall and by subtype. Haplotypes in IL6, LEP, LEPR, CYP19A1, ESR1, and PGR were associated with breast cancer overall and by subtype. Waist-hip ratio (WHR) and combined parity and lactation were evaluated as potential effect measure modifiers. Among genotypes and haplotypes displaying evidence of multiplicative or additive interaction, genotype/haplotype associations were weaker among women with higher WHR compared to those with lower WHR. There were no clear patterns of interaction between SNPs and parity and lactation. These results suggest that, for a subset of SNPs, SNP-breast cancer associations differ by intrinsic molecular subtype. Analyzing subtypes as distinct outcomes can increase the likelihood of identifying subtype-specific associations that may have been masked in analyses of breast cancer overall

The nature and prevalence of disability in a Ghanaian community as measured by the Language Independent Functional Evaluation

Introduction: The current study uses the Language Independent Functional Evaluation (L.I.F.E.) to evaluate disability in a smaller Ghanaian coastal town to characterize the extent and nature of disability. The L.I.F.E. is a video animated, language free equivalent of the standard 10-item verbal/written Barthel Index functional assessment. Methods: Over a four-month period, the L.I.F.E. survey was given to members of the village of Anomabo in a preliminary survey which consisted of recruitment in an un-controlled manner, followed by a systematic, comprehensive survey of three neighborhood clusters. Basic demographics were also collected, along with the observer’s assessment of disability. Results: 541 inhabitants (264 in the preliminary survey and 277 in systematic survey) completed the L.I.F.E. Participants ranged from 7-100 years old (mean age 32.88, s.d. 20.64) and were 55.9% female. In the systematic study, 16.6% of participants had a less than perfect score on the L.I.F.E., indicating some degree of impairment. Significant differences were found between age groups, but not between sexes, the preliminary and systematic survey, and study location (α=.05). Conclusion: The L.I.F.E. and this study methodology can be used to measure the prevalence of disability in African communities. Disability in this community was higher than the frequently cited estimate of 10%. African policymakers can use the L.I.F.E. to measure disability and thus more rationally allocate resources for medical rehabilitation.Pan African Medical Journal 2013; 14: 10

The impact of rehabilitation on the community life of stroke survivors in Accra, Ghana

DATA AVAILABILITY : The data of the study are available on request from the corresponding author, T.M.BACKGROUND : Return to pre-stroke life is of great importance to stroke survivors, their families and communities as stroke affects their ability to perform activities of daily living. It is therefore important to understand the impact of stroke rehabilitation on the community life of stroke survivors in Ghana as there are limited data. OBJECTIVES : Our study aimed to explore and describe the views of stroke survivors on the impact of stroke rehabilitation on their community life. METHOD : A descriptive qualitative study was conducted among 15 stroke survivors recruited from three selected hospitals in the Greater Accra Region of Ghana. Individual in-depth interviews were conducted using a semi-structured interview guide. Interview transcripts were analysed using thematic analysis and this gave rise to several themes. RESULTS : The authors found that stroke left most of the survivors with functional limitations and they required various degrees of assistance to perform their activities of daily living. As the stroke survivors received rehabilitation, most of them mentioned improvements in function. However, most participants were still unable to return to work and enjoy social or leisure activities. CONCLUSION : Our study shows that attention needs to be given to the occupational and social management in rehabilitation as much as it is given to the physical management, to improve community integration post-stroke. CLINICAL IMPLICATIONS : Our study highlights the need to take into consideration the occupational and social aspects of life as part of the rehabilitation process for stroke survivors.http://www.sajp.co.zaam2024PhysiotherapySDG-03:Good heatlh and well-bein

The structure, processes, and outcomes of stroke rehabilitation in Ghana: A study protocol

Conventional and complementary treatments are often used in rehabilitation for persons with stroke. The conventional treatment makes use of medications, physiotherapy, occupational, speech, and diet therapies, while the complementary treatment makes use of homeopathy, naturopathy, massage, and acupuncture. The structure, process, and outcomes of stroke rehabilitation using conventional or complementary treatments have not been empirically investigated in Ghana. This study aims to investigate the structure, process, and outcomes of stroke rehabilitation at the Korle Bu Teaching Hospital (KBTH) in Accra and Kwayisi Christian Herbal Clinic (KCHC) in Nankese-Ayisaa, Ghana, and to explore the experiences of persons with stroke