A protocol for the methodological steps used to evaluate the alignment of rehabilitation services in the Western Cape, South Africa with the National Rehabilitation Policy

CITATION: Mji, G., et al. 2017. A protocol for the methodological steps used to evaluate the alignment of rehabilitation services in the Western Cape, South Africa with the National Rehabilitation Policy. BMC Health Services Research, 17:200, doi:10.1186/s12913-017-2141-3.The original publication is available at http://bmchealthservres.biomedcentral.comENGLISH SUMMARY : Background: Rehabilitation medicine plays an integral part in attainment of optimal functioning after injury or disease. The National Rehabilitation Policy of South Africa (NRP) (2000) highlights the need for access to professional health care services, redistribution and optimal utilisation of resources and research in the field of disability and rehabilitation. The government further ratified the Convention on the Rights of Persons with Disabilities (CRPD) (2007), which validate the urgency in advancing the agenda of persons with disabilities. This paper outlines the methodological plan for evaluating rehabilitation services in the Western Cape, South Africa against the aims and objectives of the NRP as well as its principles and concepts. The evaluation process further focused on specific articles in the CRPD that were aligned with disability, health and rehabilitation. Methods/Design: A mixed-method design was used to evaluate the alignment of rehabilitation services with the NRP in the Western Cape. Four rehabilitation study settings were selected to ensure that both inpatient and outpatient rehabilitation levels of care were covered at different contexts (rural and peri-urban). The sites were checked for the most prevalent rehabilitation-related conditions to ensure the identification of suitable instruments for measuring rehabilitation outcomes. Each study setting was linked to two researchers with one exploring the rehabilitation organizational structure of the sites and the other exploring the client outcomes after receiving rehabilitation services. Patients were evaluated at baseline and discharge, within seven days after admission and seven days prior to discharge. The evaluation was based on the rehabilitation organizational capacity to provide patient-oriented rehabilitation and the measurement of rehabilitation outcomes. Kaplan’s framework of organisational capacity was used in the context of each study setting. For the measurement of service users’ outcomes, the International Classification of Functioning, Disability and Health was used (ICF). Standardised outcome measures were adopted for the domains of impairment, activity and participation. The World Health Organisation Community-Based Rehabilitation guidelines were used as guiding principles and concepts as suggested in the NRP. Discussion: This is a groundbreaking methodological exploration that offers both study methods and instruments to measure rehabilitation services at both in-patient and out-patient rehabilitation services.South Africa Netherlands Research Programme on Alternative development (SANPAD) Project PO8/16:2009-2012http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2141-3Publisher's versio

Collaborative capacity development to complement stroke rehabilitation in Africa

This scholarly book focuses on stroke in Africa. Stroke is a leading cause of disability among adults of all ages, contributing significantly to health care costs related to long term implications, particularly if rehabilitation is sub-optimal. Given the burden of stroke in Africa, there is a need for a book that focuses on functioning African stroke survivors and the implications for rehabilitation within the African context. In addition, there is a need to progress with contextualised, person-centred, evidence-based guidance for the rehabilitation of people with stroke in Africa, thereby enabling them to lead socially and economically meaningful lives. The research incorporated in the book used a range of primary and secondary methodological approaches (scoping reviews, systematic reviews, meta-analyses, descriptive studies, surveys, health economics, and clinical practice guideline methodology) to shed new insights into African-centred issues and strategies to optimise function post-stroke

Current patch test results with the European baseline series and extensions to it from the 'European Surveillance System on Contact Allergy' network, 2007-2008

BACKGROUND: The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in consecutive patients in the years 2007 and 2008, and to discuss possible differences. METHODS: Data from the 39 departments in 11 European countries comprising the European Surveillance System on Contact Allergy network (www.essca-dc.org) in this period have been pooled and analysed according to common standards. RESULTS: Patch test results with the European baseline series, and country-specific or department-specific additions to it, obtained in 25 181 patients, showed marked international variation. Metals and fragrances are still the most frequent allergens across Europe. Some allergens tested nationally may be useful future additions to the European baseline series, for example methylisothiazolinone, whereas a few long-term components of the European baseline series, namely primin and clioquinol, no longer warrant routine testing. CONCLUSIONS: The present analysis points to 'excess' prevalences of specific contact sensitization in some countries, although interpretation must be cautious if only few, and possibly specialized, centres are representing one country. A comparison as presented may help to target in-depth research into possible causes of 'excess' exposure, and/or consideration of methodological issues, including modifications to the baseline series

Does a problem-based learning approach benefit students as they enter their clinical training years? : lecturers’ and students’ perceptions

Statham, S.B., Inglis-Jassiem, G., Hanekom, S.D. 2014. Does a problem-based learning approach benefit students as they enter their clinical training years?: lecturers’ and students’ perceptions. AJHPE, 6(2):185-191. DOI:10.7196/AJHPE.529.Publication of this article was funded by the Stellenbosch University Open Access Fund.The original publication is available at http://www.ajhpe.org.zaENGLISH ABSTRACT: This paper presents the findings of a study completed to establish the differences between the lecturers’ and students’ perceptions of a hybrid problem-based learning (PBL) approach in successfully completing a PBL module in the third year of physiotherapy training at Stellenbosch University. Objectives. To assess the perception of the achievement of the PBL benefits, the module outcomes, the barriers to learning and positive aspects of the module. Methods. A theory-based evaluation approach using both qualitative and quantitative methods was used. All students and lecturers involved with the new module were invited to participate in the study. The participants consisted of 37 students and 11 lecturers. The data were collected using questionnaires and focus group discussions for both groups. The different components of the theory (PBL methods) were used as the guiding themes for the analysis of the qualitative data. The quantitative (ordinal) data are presented using descriptive statistics. Results. The results indicated that the module was enjoyed by both groups. The achievement of the generic outcomes for the module produced mixed results. Areas of agreement and areas of differences in perceptions relating to the achievement of the expected PBL benefits are discussed. Conclusion. PBL as a new methodology presents challenges for both groups; however, many of the benefits of PBL, in particular self-directed learning, were achieved. Some areas of shortfall are discussed.Publisher's versio

What does an enquiry-based approach offer undergraduate physiotherapy students in their final year of study?

CITATION: Inglis-Jassiem, G., Statham, S.B. & Hanekom, S.D. 2014. What does an enquiry-based approach offer undergraduate physiotherapy students in their final year of study?. African Journal of Health Professions Education, 6(2):192-197, doi:10.7196/ajhpe.532.The original publication is available at http://www.ajhpe.org.zaPublication of this article was funded by the Stellenbosch University Open Access Fund.Background. Physiotherapy students in their final year at Stellenbosch University (SU) complete a module that follows an enquiry-based learning (EBL) approach. This module exposes them to higher-order problem solving and was developed to facilitate independent self-directed learning and improved higher-order thinking skills. Objective. To describe the perceptions of undergraduate physiotherapy students on the impact of this EBL approach on their learning. Methods.A cross-sectional descriptive study was conducted with three consecutive cohorts of final-year undergraduate physiotherapy students. A questionnaire was used to obtain information related to the students’ perception of this module. Coding and identification of themes were done independently using an inductive approach. Initial themes were compared and discussed to achieve consensus regarding the final themes reported. Results.Students reported the development of skills such as the ability to source relevant information and problem-solving abilities. Students attributed improvements in their clinical reasoning and performance during clinical work to the skills they developed during this module. The main themes identified as barriers to learning during this module were availability of learning materials, quality assurance and time constraints. Group work was identified as both a facilitator and a barrier to their learning. Conclusion. Physiotherapy students at SU perceived the introduction of a module following an EBL approach positively. They developed skills such as sourcing information and problem-solving, which they perceived improved their clinical work. The main barriers to learning were time constraints and concerns regarding quality assurance of learning material. Group work was regarded as both facilitatory and a barrier to learning. Programmes considering the implementation of EBL should ensure sufficient resource material and that quality assurance mechanisms are in place to address students’ anxiety regarding learning material. Guidance and support to students during the initial implementation phase of an EBL approach are necessary to allay fears and frustrations.http://www.ajhpe.org.za/index.php/ajhpe/article/view/532Publisher's versio

Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

CITATION: Kumurenzi, A., et al. 2015. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province. African Journal of Disability, 4(1):1-7, doi:10.4102/ajod.v4i1.164.The original publication is available at http://www.ajod.orgBackground: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.http://www.ajod.org/index.php/ajod/article/view/164Publisher's versionAuthors retain copyrigh

Well-being and resilience in children with speech and language disorders

© 2018, American Speech-Language-Hearing Association. All rights reserved. Purpose: Children with speech and language disorders are at risk in relation to psychological and social well-being. The aim of this study was to understand the experiences of these children from their own perspectives focusing on risks to their well-being and protective indicators that may promote resilience. Method: Eleven 9- to 12-year-old children (4 boys and 7 girls) were recruited using purposeful sampling. One participant presented with a speech sound disorder, 1 presented with both a speech and language disorder, and 9 with language disorders. All were receiving additional educational supports. Narrative inquiry, a qualitative design, was employed. Data were generated in home and school settings using multiple semi-structured interviews with each child over a 6-month period. A total of 59 interviews were conducted. The data were analyzed to identify themes in relation to potential risk factors to well-being and protective strategies. Results: Potential risk factors in relation to well-being were communication impairment and disability, difficulties with relationships, and concern about academic achievement. Potential protective strategies were hope, agency, and positive relationships. Conclusion: This study highlights the importance of listening to children’s narratives so that those at risk in relation to well-being can be identified. Conceptualization of well-being and resilience within an ecological framework may enable identification of protective strategies at both individual and environmental levels that can be strengthened to mitigate negative experiences

Collaborative capacity development to complement stroke rehabilitation in Africa

This scholarly book focuses on stroke in Africa. Stroke is a leading cause of disability among adults of all ages, contributing significantly to health care costs related to long term implications, particularly if rehabilitation is sub-optimal. Given the burden of stroke in Africa, there is a need for a book that focuses on functioning African stroke survivors and the implications for rehabilitation within the African context. In addition, there is a need to progress with contextualised, person-centred, evidence-based guidance for the rehabilitation of people with stroke in Africa, thereby enabling them to lead socially and economically meaningful lives. The research incorporated in the book used a range of primary and secondary methodological approaches (scoping reviews, systematic reviews, meta-analyses, descriptive studies, surveys, health economics, and clinical practice guideline methodology) to shed new insights into African-centred issues and strategies to optimise function post-stroke