Die uitkomste wat fisies-gestremde kliënte bereik deur hul deelname aan rehabilitasie by ‘n gemeenskapsrehabilitasiesentrum in die Wes-Kaap

Kloppers, Maatje (2012-12)

Thesis (MOccTher)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Despite the existence of many guidelines for rehabilitation services both internationally and in South Africa, there is a need for a uniform format for the measurement and reporting of outcomes reached by clients utilising these services. Traditionally, statistics on client numbers fail to report actual outcomes attained by clients. Aim: This aim of the study was to describe the outcomes achieved by clients after participating in rehabilitation at the Bishop Lavis Rehabilitation Centre (BLRC) over a three month period. It was done by describing clients’ function according to the World Health Organisation’s International Classification of Function (ICF) model, and included both the environmental and personal factors impacting on an individual’s function. Method: The study employed a descriptive design and used six measuring instruments which exceeded acceptable test-retest requirements to gather data from within the framework of the ICF Model. A field worker was trained to administer the majority of instruments which were pilot-tested for pre and post-test purposes. A sample of 78 clients who met the inclusion criteria was selected from the five main diagnostic categories seen at the BLRC. All clients were evaluated on referral, and again after receiving rehabilitation services for three months. An open-ended questionnaire was also administered as part of the post-test to obtain clients’ personal perspective on outcomes reached, as well as their subjective opinion of the rehabilitation experience. Data on the impact of various demographic and environmental factors on function was also gathered and statistically analysed in conjunction with the qualitative data obtained from the interviews in order to identify the rehabilitation outcomes achieved by the clients included in this study. Results: Clients reported a statistically significant decrease in the impact of disability on their function, with ‘mobility’ emerging as the aspect of function which improved the most after rehabilitation. The effect of most demographic and environmental factors investigated were perceived as facilitating rather than debilitating to rehabilitative outcomes, with ‘faith’ reported to be most facilitating and ‘monthly income’ the most debilitating of all factors. Subjectively, clients perceived their participation in rehabilitation to be a contributing factor to the improvement in their function, and generally expressed a positive attitude toward the rehabilitation experience. Recommendations based on the results of this study are presented to inform governing bodies involved in rehabilitation in South Africa.

AFRIKAANSE OPSOMMING: Ten spyte van die bestaan van veelvuldige riglyne vir rehabilitasie dienste, beide internasionaal en in Suid-Afrika, is daar steeds ‘n behoefte vir uniforme riglyne vir die meting en rapportering van die uitkomste wat kliënte bereik met deelname aan hierdie dienste. Tradisionele statistiek rakende kliëntegetalle rapporteer nie die werklike uitkomste wat kliënte bereik het nie. Doel: Die doel van die studie was om die uitkomste te beskryf wat kliënte bereik na hul deelname aan rehabilitasie by Bishop Lavis Rehabilitasiesentrum (BLRS) oor ‘n drie maande periode. Dit is gedoen deur kliënte se funksionering te beskryf volgens die Wêreld Gesondheidsorganisasie se Internasionale Klassifikasie van Funksie (IKF) model, insluitend beide die omgewings- en persoonlike faktore wat ‘n impak op ‘n individu se funksionering kon hê. Metode: Die studie het gebruik gemaak van ‘n beskrywende studiestruktuur. Dit het ses meetinstrumente gebruik wat beter as aanvaarbare vereistes vir toets-hertoets-betroubaarheid getoon het om data binne die raamwerk van die IKF-model in te samel. ‘n Veldwerker is opgelei vir die administrasie van die meerderheid van die meetinstrumente wat vir voor- en na-toets doeleindes in ‘n loodstudie getoets is. ‘n Steekproef van 78 kliënte wat aan die insluitingskriteria voldoen het, is geselekteer uit die vyf hoof diagnostiese groepe gesien by BLRS. Alle kliënte is geevalueer met verwysing en weer na hulle drie maande se rehabilitasie dienste ontvang het. Administrasie van ‘n oop-einde vraelys is ook as deel van na-toetsing gedoen om kliënte se persoonlike perspektief van die uitkomste wat hulle bereik het in te samel, sowel as hulle subjektiewe opinie van die rehabilitasieproses. Data oor die impak wat verskeie demografiese en omgewingsfaktore op funksionering kon hê is ingesamel, statisties ontleed en gebruik saam met die kwalitatiewe data wat met onderhoudsvoering ingesamel is om sodoende die rehabilitasieuitkomste te identifiseer wat behaal is deur kliënte wat ingesluit was in die studie. Resultate: Kliënte rapporteer ‘n statisties beduidende vermindering in die impak van gestremdheid op hulle funksionering, met ‘mobiliteit’ wat uitstaan as die area van funksionering wat die meeste verbeter het na rehabilitasie. Die effek van die meeste demografiese en omgewingsfaktore wat ondersoek was, is as fassiliterend eerder as inhiberend tot rehabilitasieuitkomste ervaar, met ‘geloof’ gerapporteer as die mees fassiliterende en ‘maandelikse inkomste’ as die die mees inhiberende faktor. Op 'n subjektiewe vlak het kliënte hul deelname aan rehabilitasie as ‘n bydraende faktor tot hul verbetering in funksionering ervaar, en het hulle oor die algemeen ‘n positiewe houding teenoor rehabilitasie gerapporteer.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/71707
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