Evaluation of the rehabilitation program for persons with complete paraplegia at Netcare rehabilitation hospital

Thesis (MSc (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy))--University of Stellenbosch, 2009.ENGLISH ABSTRACT: Spinal cord injury is a devastating sudden cause of disability which renders a person paralyzed and dependent on care immediately after the incident. A person who has suffered a spinal cord injury requires an intensive rehabilitation program to achieve physical independence as well as reintegration into the community. The aim of this study was to evaluate the rehabilitation program for patients with complete paraplegia at the Netcare Rehabilitation Hospital, a 120 bed private rehabilitation facility in Johannesburg, where rehabilitation for patients with physical disabilities is offered by an interdisciplinary team. The rehabilitation program was evaluated in terms of effectiveness including the degree of physical independence the patients achieved and how well the program prepared patients for successful integration into the community. The Functional Independence Measure (FIM), a standardized outcome measure that measures certain physical and cognitive functions and the Needs Assessment Checklist (NAC), an instrument designed to assess if the rehabilitation program is geared towards the patients’ individual needs were used as outcome measure. FIM scores were determined on admission and discharge and NAC scores were determined at discharge. A convenient, consecutive sample of sixteen patients with complete paraplegia (ASIA A), with a neurological level between T1 and T12, formed the study population. Consistently high FIM and NAC scores in the area of physical functioning suggested that the rehabilitation program at Netcare Rehabilitation Hospital was effective in terms of providing patients with physical independence. However, NAC results showed that the patients were not completely ready to reintegrate back to their communities. Areas that were identified as particularly problematic were knowledge on follow up health care services in the community, readiness for work and accessibility of the home and work environments. Therefore it is recommended that the rehabilitation team re-evaluate the program and incorporate strategies with the aim to improve it’s effectiveness in terms of preparing patients for community reintegration. It is also recommended that further research is conducted to assess the current success rate with regards to community reintegration and determine challenges to re-integration in order to assist with program panning.AFRIKAANSE OPSOMMING: ‘n Spinaalkoordbesering is ‘n skielike oorsaak van gestremdheid wat die persoon verlam en afhanklik van sorg laat direk na die voorval. ‘n Persoon wat ‘n spinalkoordbesering opdoen benodig ‘n intensiewe rehabilitasie program om weer fisies onafhanklik te wees en ook om hom/haar voor te berei om weer by die gemeenskap in te skakel. Die doel van hierdie studie was om die rehabilitasie program by die Netcare Rehabilitasie Hospitaal, ‘n 120 bed private rehabilitasie fasiliteit in Johannesburg, waar rehabilitasie vir fisies gestremde persone deur ‘n interdissiplinere span aangebied word, te evalueer. Die program is geevalueer in terme van twee uitkomste naamlik, die graad van fisiese onafhanklikheid wat die pasiënte behaal en tot watter mate die program pasiente voorberei vir herintegrasie in die gemeenskap Die “Functional Independence Measure” (FIM), ‘n gestandaardiseerde uitkoms skaal wat sekere fisiese en kognitiewe funksies meet en die “Needs Assessment Checklist” (NAC), `n instrument wat ontwikkel is om te evalueer of rehabilitasie programme pasiente se spesifieke behoeftes aanspreek. Is gebruik om the rehabilitasie program te evalueer. Die FIM is met toelating en ontslag voltooi en die NAC is met ontslag voltooi. ‘n Steekproef van sestien pasiente met volledige spinaalkoordletsels (ASIA A) tussen T1 en T12 het die studie populasie gevorm. Deurgans hoë FIM en NAC tellings vir fisiese funksionering het daarop gedui dat die rehabilitasie program by die Netcare Rehabilitation Hospital effektief is in terme van fisiese onafhanklikheid van pasiente. Aan die ander kant het die NAC tellings daarop gedui dat die program minder suksesvol is wat betref die voorbereiding van pasiente vir gemeeskapsintegrasie. Spesifieke probleem areas sluit in kennis van waar om opvolg gesondheidssorg in die gemeenskap te bekom, gereedheid vir werk en toeganklikheid van die huis en werksomgewing. Daar word aanbeveel dat die rehabilitasie span by Netcare Rehabilitasie Hospitaal die program herevalueer om die effektiwiteit van die program in terme van die voorbereiding vir gemeenskaps herintegrasie te verbeter. Dit word ook aanbeveel dat ‘n opvolg studie gedoen word om die huidige sukses ten opsigte van gemeenskaps herintegrasie te evalueer en sruikelblokke te identifiseer ten einde die span the help met program beplanning

Promoting regional coherence and cohesion amidst multiple assistive technology initiatives in Africa

Background: Appropriate provision of assistive technology services (ATS) and products are a global health issue and essential for achieving the Sustainable Development Goals (SDGs). The Sixth African Network for Evidence-to-Action on Disability (AfriNEAD) conference included a workshop on collaboration, cohesion and coherence in ATS delivery in Africa. Objective: This article aimed to summarise the workshop proceedings and to provide some recommendations on how coherence and cohesion can be facilitated in assistive technology services in Africa. Method: A round table and small group discussions on assistive technology were facilitated in the virtual space of the AfriNEAD conference. Organisations and role players in ATS and products in Africa participated as keynote speakers, round table members and in small group discussions. Results: There was consensus amongst participants that cohesive collaboration must be facilitated. They further agreed that users must be central to future action. There are local, national and regional initiatives, but none of these have grown into an African assistive technology platform. World Health Organization (WHO) Africa can bring partners together and facilitate creation, officialisation and operationalising of a continental assistive technology platform, through building on the existing initiatives. The AfriNEAD disability research country working groups can act as in-country coordinating bodies for ATS and afford a possibility of a structured approach to assistive technology research. Conclusion: It is time to break away from Western institutionalised biomedical ways of providing ATS in Africa. Africans must develop coherent, cohesive ATS driven by empowered users who build on Africa's strengths and addresses the continents' unique needs

Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa

CITATION: Visagie, S. J., et al. 2018. Lessons from the pilot of a mobile application to map assistive technology suppliers in Africa. African Journal of Disability, 7:a422, doi:10.4102/ajod.v7i0.422.The original publication is available at https://ajod.orgA pilot project to develop and implement a mobile smartphone application (App) that tracks and maps assistive technology (AT) availability in southern Africa was launched in Botswana in 2016. The App was developed and tested through an iterative process. The concept of the App (AT-Info-Map) was well received by most stakeholders within the pilot country, and broader networks. Several technical and logistical obstacles were encountered. These included high data costs; difficulty in accessing AT information from the public healthcare sector, the largest supplier of AT; and the high human resource demand of collecting and keeping up-to-date device-level information within a complex and fragmented supply sector that spans private, public and civil society entities. The challenges were dealt with by keeping the data burden low and eliminating product-level tracking. The App design was expanded to include disability services, contextually specific AT categories and make navigation more intuitive. Long-term sustainability strategies like generating funding through advertisements on the App or supplier usage fees must be explored. Outreach and sensitisation programmes about both the App and AT in general must be intensified. The project team must continually strengthen partnerships with private and public stakeholders to ensure ongoing project engagement. The lessons learnt might be of value to others who wish to embark on initiatives in AT and/or implement Apps in health or disability in southern Africa and in low-resourced settings around the world.https://ajod.org/index.php/ajod/article/view/422Publisher's versio