Centre for Disability and Rehabilitation Studies
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Browsing Centre for Disability and Rehabilitation Studies by browse.metadata.advisor "Geiger, Martha"
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- ItemAccessibility of advanced seating services in a Western Cape setting : a qualitative exploration of the experiences of carers of children with cerebral palsy(Stellenbosch : Stellenbosch University, 2019-12) North, Gwen-Lynn; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: It is important for health professionals to understand the experiences of carers of children with cerebral palsy (CP) when accessing health care. Understanding their experiences might help providers to make services more accessible. Aim of the study: To explore the experiences of carers of children with CP (GMFCS IV/V), around the accessibility of advanced seating services at a tertiary healthcare facility in the Western Cape. Methods: This study implemented an exploratory, qualitative research design. Of the study population consisting of 62 carers of children with severe CP, seven carers were purposively sampled and interviewed. Thematic analysis with an inductive reasoning process was used to analyse and generate themes from the semi-structured interviews that were conducted. Findings: Carers experienced a great deal of stress around accessing the tertiary healthcare facility for the seating appointment. Four themes were generated: (1) A strenuous experience, (2) Transport, (3) The child and the buggy, and (4) Facilitators to access. Conclusion: Carers encountered barriers, such as transport, that limited access to the tertiary healthcare facility to attend the advanced seating clinic. Service providers need to take cognisance of the challenges that posture support devices pose to using public transport when prescribing a posture support wheelchair. Service providers should consider decentralizing seating services. There is room for improvement of the current public transport systems to be more inclusive for carers, their children with CP and their posture support wheelchairs by enacting legislation in the Western Cape.
- ItemCardiovascular Disease : Exploring the barriers to lifestyle modification in a Cape Town setting(Stellenbosch : Stellenbosch University, 2021-12) Sawyer, Stephanie; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: Cardiovascular disease (CVD) is a growing problem worldwide and is the second highest cause of death in South Africa. It can be avoided by controlling modifiable risk factors such as blood pressure, food consumption and exercise. However, many people seem to struggle with modifying and maintaining a healthy lifestyle. Methods: The aim of this study was to explore the barriers to lifestyle modifications experienced by persons identified at moderate risk for CVD in the Blaauwberg suburb of Cape Town. One-on-one semi-structured telephonic interviews, guided by an interview schedule, were conducted with eleven participants. Thematic data analysis was performed. Findings: Individuals conveyed a vague understanding of heart disease. However, it was enough to encourage lifestyle modification. Modifiable risk factors revealed in this study included eating habits, physical activities, and smoking. Three themes emerged from the findings: CVD “You can prevent it”, Lifestyle modification “It just feels like an insurmountable task”, A better lifestyle “It’s all about self-awareness, self-love.” Information gathered on the barriers/facilitators for the risk factors (above) was further categorized into sub-headings including Health and quality of life, Physical environment, Sociocultural factors, Access to information and resources, and Psychological factors. Conclusion: Barriers that occur repeatedly include time, financial constraints, and support. Safety concerns when exercising, the availability of free exercise equipment in parks and free organised group physical activities are elements specific to SA.
- ItemA case study exploring community inclusion of adults with intellectual disabilities who participate in/attend protective workshops in Cape Town(Stellenbosch : Stellenbosch University, 2024-03) Pitt, Catherine; Geiger, Martha; Kahonde, Callista; Mji, Gubela; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Research shows that persons with intellectual disabilities (ID) are the most marginalized group among persons with disabilities in South Africa. Despite the progress in this country towards an inclusive and free country, persons with ID are not experiencing their full citizenship. Although South Africa signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) almost two decades ago, persons with ID still have limited access to services that can facilitate their inclusion into communities. Some progress has been made in education with children with ID, but little progress has been made towards the inclusion of adults with ID into employment and community activities. Furthermore, they are seldom included in research even when the research seeks to understand their day-to-day experiences. This study therefore set out to explore the community inclusion opportunities and aspirations of persons with ID attending a protective workshop in Cape Town. This study used a case study methodology within a constructivist paradigm to explore the participants’ aspirations and opportunities for community inclusion. Methods of data collection were carefully selected and planned to ensure meaningful inclusion of the participants in the data collection process. The methods included interviews, focus groups, community mapping and field notes, which were supported by tools like pictures, icons, games, community maps and repetition of the questions and discussions. An analysis of secondary data was also conducted to seek further understanding of the study context and confirm the findings from other sources of data. Twenty-eight adults with ID within the age range of 21 and 54 years, recruited from two protective workshops, participated in the study. The data was analysed using thematic analysis and four themes were generated, namely; what I do in my community, what I want from independence, the significance of relationships, and the importance of work. Their inclusion opportunities in their community ranged from assisting in their homes, and participating in community activities and hobbies and the importance of work in achieving their experience of independence and relationships was described. The participants aspired to be included in more activities independently, understanding the barriers that their impairment and the context presented. Possible supports were identified to overcome their barriers. The findings demonstrate that with appropriate support available, persons with ID are capable of contributing meaningfully to their communities. This disrupts the status quo of myths and stereotypes about persons with ID that marginalize them. The participants grappled with the conflict of their desire for independence versus their identified vulnerability. Further, they described the variety of relationships that they find to mitigate loneliness. Finally, work was described as a facilitator of inclusion. These findings can inform policy developers to effect changes to service provision to establish supports for persons with ID to be included in their communities. Emerging from these findings was a possible tool of community inclusion which aligns the environment with the supports of persons with ID to facilitate inclusion in the activities of their own choice.
- ItemA description of recorded HIV status in persons with disabilities at Western Cape Rehabilitation Centre(Stellenbosch : Stellenbosch University, 2014-12) Nash, Megan Renee; Geiger, Martha; Bardien, Faeza; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences: Centre for Rehabilitation Studies.ENGLISH ABSTRACT: It is only recently that research on HIV and persons with disabilities has started to emerge. There still remains, however, a lack of research on the prevalence of HIV infection in persons with disabilities. The challenges facing HIV prevalence studies include that persons need to be tested for HIV to be able to be certain of HIV status. Issues related to disclosure and accessibility to health care further limit HIV prevalence studies, especially in the disabled population where stigmatisation and marginalisation, due to the disability, already exist. This research assignment aimed to yield some preliminary quantitative information on HIV disease in the population of persons with disabilities admitted to WCRC. It aimed to describe the HIV status information as recorded in the medical files of in-patients admitted to WCRC in a 6-month period. A cross-sectional design was applied in this exploratory study. Data was collected through an audit of 331 clients‟ clinical records. Variable information collected was type of disability, gender, population group, age, the source documents used to gather data, and recorded information regarding HIV status (i.e. positive, negative or unknown). The source documents used to gather information were medical records, laboratory results, pharmacy scripts and therapy notes. The recorded information in the medical records and therapy notes was, however, subject to client disclosure. The unknown subset in the sample included folders with HIV status recorded as unknown as well as folders lacking any HIV information, which constituted a major limitation of the study. 16.4% of females were recorded with an HIV positive status, compared to only 6.51% of males. Per population group, Black African clients had the highest number of recorded HIV positive status whereas Coloured clients had the highest recorded unknown HIV status. The recorded HIV positive status information of the study sample was 9.97%, which is comparable to the national estimate of 9.9%. The results indicate that a better understanding of the undercurrents driving HIV information recording and disclosure in the disabled population of WCRC is needed. According to the literature, various factors could contribute to disclosure or non-disclosure of HIV status, such as fear of stigmatisation, lack of access to testing and social marginalisation. This study aims to provide a first step in research, and specifically in hypothesis generating research, of HIV information recording and supports the need for HIV prevalence studies in the disabled population.
- ItemExperiences of persons with mobility impairment in using public transport in Knysna townships in the Western Cape Province(Stellenbosch : Stellenbosch University, 2020-03) Gudwana, Khangelani; Geiger, Martha; Visagie, Surona; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: For persons with mobility impairments, accessible public transport remains a major challenge in many areas such as Knysna townships in the Western Cape;, South Africa, with implications for their access to services such as health and their participation in economic and social activities. The aim of this study was to explore the experiences of persons with mobility impairment in accessing public transport in Knysna townships in the Western Cape Province. Method: An exploratory qualitative design was implemented. The townships in Knysna in the Western Cape Province, were chosen as the study setting because of its steep and rough terrain and its restricted public transport options. The study population consisted of all persons with mobility impairment, aged 18-35 using public transport in Knysna townships. Purposive and snowball sampling was used to select the participants. A final sample of six was determined by data saturation. Data were collected using in-depth interviews. With the permission of participants, interviews were audio-recorded, and field notes were used to supplement and verify the voice recording after interviews. Photos of the home environment were taken with consent of each participant. Manual data analysis was implemented using a six-step thematic data analysis guide. Ethical considerations: informed consent was obtained, and confidentiality was safeguarded. Rigour: All aspects of the study were carefully monitored against the criteria of trustworthiness such as credibility, transferability, dependability and confirmability. Findings: Six themes emerged, namely: Challenges related to lack of safety; challenges related to cost of transport for persons with mobility impairment; challenges related to accessibility to the taxi, the road and to the houses; attitudes contributing to exclusion, and finally; participant’s perceptions on ways to address the challenges. Conclusion: Participants concurred that challenges in accessing public transport cause them to suffer social / economic exclusion. The recommendations to diverse stakeholder audiences should be implemented sooner rather than later due to the ongoing negative impact on basic human rights and human dignity for persons with mobility impairment in Knysna townships.
- ItemExploring CBR workers’ perceptions of their role in wheelchair provision in three areas of Uganda(Stellenbosch : Stellenbosch University, 2016-03) Seymour, Nikola; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.ENGLISH ABSTRACT:Background: Wheelchair provision and use in less resourced settings face significant challenges. Global efforts to affect change include the WHO Guidelines on provision of manual wheelchairs in less resourced settings and the WHO wheelchair training resources. Multiple stakeholders are required to collaborate to affect improvement, and in contexts where community-based rehabilitation (CBR) is implemented CBR workers have a role to play. Objectives: The objectives of the study were to determine what CBR workers in three areas of Uganda perceive as the challenges with wheelchair provision and use; the factors contributing to these challenges; the role they can play and what they need to achieve this. Method: This qualitative, participatory study in the transformative paradigm gathered perceptions of twenty one CBR workers through three focus group discussions, in the north, west and central regions of Uganda. Findings: Limited availability of appropriate products; financial constraints of people with disabilities (PWD) and wheelchair services; and historical and societal influences on beliefs are perceived by CBR workers to affect utilisation of wheelchair services and mobility of PWD. Participation is further influenced by inadequate skills in wheelchair use; limited durability of products and environmental factors including physical and attitudinal barriers. CBR workers suggested strategies which, if strengthened with training and closer partnership with wheelchair services, can positively impact the provision and use of wheelchairs in less-resourced settings. Findings also indicate the need to address issues related to the position and empowerment of CBR workers. Conclusion: Contextual challenges to wheelchair provision and use in less-resourced settings would benefit from involvement of CBR workers. However, further efforts are required to increase the availability of appropriate wheelchairs and services, and to ensure the financial resources necessary to enhance effectiveness of both wheelchair services and community-based rehabilitation.
- ItemExploring experiences of graduates of the workers’ compensation fund control board (WCFCB) return to work (RTW) programme in Zambia(Stellenbosch : Stellenbosch University, 2020-03) Chishimba, Rodgers; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Purpose of the study: The purpose of the study was to explore the experiences of graduates of the Workers’ Compensation Fund Control Board (WCFCB) return to work (RTW) programme in Zambia. Methods: A qualitative research design was used which helped to elicit in-depth data on the subject under study. The study was done in Zambia using a sample of six participants purposefully selected from a population of twenty-one WCFCB beneficiaries who had graduated from the WCFCB RTW programme. Data was collected through semi structured interviews and thematic analysis was used to analyse data. Findings: Four themes were identified i.e. `Loss due to occupational injury`, `Challenges experienced by graduates of the WCFCB RTW programme`, `Hope through the WCFCB RTW programme` and `Satisfaction with the WCFCB RTW programme`. Participants were despondent due to the loss of physical ability, income and career opportunities after the injury. The RTW programme brought hope back through the provision of a new career pathway. Although discrimination on account of disability hindered some graduates from returning to work, personal factors and external support helped participants to successfully RTW. The RTW scholarship provisions were sufficient and presented opportunities for income replacement, realisation of career dreams and professional growth. A need for improvements in areas of ration, education equipment allowance, career placements, timely processing of scholarship applications and RTW related payments as well as training of WCFCB staff on how to empathise with and provide professional support to injured workers on the RTW programme were identified. Conclusion: Being on the WCFCB RTW programme provided the opportunity for self-improvement, a new career and financial independence for injured workers. Satisfaction with the programme was high and participants called for its continuance. Recommendations for improvement of the programme and further study were made.
- ItemExploring the facilitators and barriers experienced by persons with disabilities employed by the City of Cape Town(Stellenbosch : Stellenbosch University, 2023-03) Morris, Selwyn; Luger, Rosemary; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Introduction: The City of Cape Town (CCT) is a municipality employing over 27000 people. They have reached the compulsory two percent (2%) target for employment of persons with disabilities in the public sector. Critical to this achievement is the retention of staff with disabilities. Aim of the study: To explore the facilitators and barriers experienced by persons with disabilities employed by the City of Cape Town. Methods: A qualitative exploration of the experiences of persons with disabilities employed by the City of Cape Town was conducted. Fifteen participants were purposively sampled. An interview guide was used during the semi-structured interviews. Thematic analysis was used to analyse the data. Findings: The study found that supportive attitudes in the organisation and inclusion, with an emphasis on affirmation of staff with disabilities, to be important facilitators. Equally, a negative office culture and anxiety or fear to speak up were found to be critical barriers experienced by staff with disabilities in the workplace. Covid-19 was found to be both a facilitator and barrier. Conclusion: The City of Cape Town has made great strides in creating a workplace free of discrimination. They have policies and a clear strategy in place. Relationships with colleagues and management, the perceptions which both the disabled and able-bodied have of each other and workplace rights for the disabled and how these are claimed and implemented are key factors to consider. Recommendations: Disability training for target groups should be introduced to mitigate some of the barriers experienced. Training should also focus on ensuring management buy-in and leadership. Updating of current policies on disability to ensure an inclusive and consistent approach will assist with greater cohesion on disability matters within the workplace.
- ItemExploring the lived experiences of students with disclosed epilepsy in accessing support services at a teachers’ college in Zimbabwe(Stellenbosch : Stellenbosch University, 2021-12) Chimedza, Margaret; Ohajunwa, Chioma; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : There is a marked increase in students with disabilities accessing higher education. A significant proportion of these students constitute students with chronic conditions such as epilepsy. The purpose of this study was to gain an insight into the lived experiences of students with disclosed epilepsy in accessing support services at a Teachers’ College in Zimbabwe. The main objectives were to identify the provisions that are available in the institution and the accessibility barriers students with epilepsy encounter in their learning. The study also intended to provide guidelines to stakeholders on how to assist students with epilepsy in accessing higher education based on their experiences. The study employed a qualitative approach to answer the main research question. Four former students with disclosed epilepsy, recruited through snowballing, participated in the research. Data was gathered by responding to telephonic interviews and analysed through thematic analysis. Three themes were derived from the data which included facilitators to inclusion, accessibility barriers and reasonable adjustments that the participants suggested would improve their access to higher education. Findings from the study indicated that the lack of mandatory disability policies, negative attitudes from the college community, inappropriate training of members of staff and lack of information acted as obstacles to accessing support services in the institution. The participants recommended that institutions draw up policies that guide their operations. They expressed the need for appropriate training for academic staff, psychosocial support, the need for disability awareness campaigns and self-representation at the college. The study outcomes recognized the need for institutions to adopt a Multi-dimensional support framework that values human rights and creates an inclusive and accessible learning environment. Findings from this study may add to the information base about the support services appropriate for students with epilepsy in accessing higher education.
- ItemFactors facilitating completion of mainstream education in an ordinary school : reflections of young adults with cerebral palsy(Stellenbosch : Stellenbosch University, 2016-03) Luger, Rosemary Jean; Geiger, Martha; Lyner-Cleophas, Marcia; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.ENGLISH ABSTRACT: Inclusive education is supported internationally and nationally, but most children with physical disabilities are still excluded from ordinary schools in South Africa. The purpose of this paper is to add to the body of knowledge about factors that facilitate the inclusion of learners with cerebral palsy. This will complement the more widely known barriers to education, from the perspectives of teachers and/or parents and in other countries. The research question was: What were facilitating factors within the lived experience of young adult participants with cerebral palsy, which allowed them to access mainstream education and achieve a Grade 12 pass in an ordinary school in Cape Town, South Africa? Two in-depth interviews were conducted with each of the three participants in English. Interpretative Phenomenological Analysis (IPA) led to the identification of three superordinate themes: “Treat me the same, but treat me differently”, “Good communication is vital” and “Ons gee om” [We care], each of which comprised two subordinate themes. The facilitating factors identified are discussed within the framework of the International Classification of Functioning, Disability and Health (ICF). Practical implications and recommendations are proposed.
- ItemFactors which facilitate a State-Owned Enterprise in the Western Cape, to recruit persons with disabilities to meet employment equity targets(Stellenbosch : Stellenbosch University, 2021-12) Maclean, Natasha Suzanne; Ned, Lieketseng; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: Gaining employment is an important life activity for everyone. However, employment statistics for persons with disabilities remain poor despite numerous policies and guidelines for employers being available. Disability in the workplace can present complexities that are difficult to encapsulate using only policy documents or guidelines. The achievement of employment equity targets in the disability category is an indicator that a company has successfully recruited and employed persons with disabilities. This study explores how a State-Owned Enterprise in the Western Cape has managed to navigate these challenges successfully. Aim of the study: To explore and identify factors which enable a State-Owned Enterprise in the Western Cape, to meet their employment equity targets for recruiting persons with disabilities. Methods: A qualitative single, embedded case study was conducted that is exploratory in nature. Data collection methods included document review and semi-structured interviews. Interview participants, including Human Resources Employees (HRE) and Employees with Disabilities (EWD) based at the Western Cape branch of the State-Owned Entity were purposively sampled. An interview schedule was used to guide in-depth, semi-structured interviews. A total of seven participants, including three HRE and four EWD, willingly participated in the study. Thematic analysis was used to analyse data. Results: The core value of diversity is embraced and embedded in the leadership of this company. Robust mechanisms have been put in place to monitor, report and be accountable for achieving Employment Equity Targets. Disability is a separate category within the Employment Equity Targets. An inclusive environment is created for PWD, in consultation with PWD. The company executes disability awareness and sensitivity training continuously, provides reasonable accommodation for PWD and creates a safe place for disclosure of disability. Talent acquisition takes place in a manner that is attractive and accessible to PWD. Support structures for PWD and partnerships with disability organisations facilitate the recruitment and sustained employment of PWD. Conclusion: This study explored and identified the factors which facilitate the successful recruitment and employment of PWD. It also explored how barriers that have been encountered were overcome. Diversity as a core value is embedded into the leadership and brand of this company, which is attractive to PWD. Leadership implements strategies to ensure that policies are put to practice. To be successful in recruiting and employing PWD, inclusivity is designed within the company and the necessary support structures are put in place. The same type of leadership is called for in government to ensure policies are implemented to uphold the rights of PWD in broader society. This would further facilitate the workforce participation of PWD. Recommendations: Provision of accessible transport for PWD should be prioritised at a governmental level. Increased tertiary education and skills development opportunities should be made available to PWD. Improved benchmarking should be implemented to ensure universally accessible public buildings, spaces and workplaces. Self-efficacy is a skill that all PWD should acquire to improve their employment prospects. It would also be beneficial for PWD looking for employment to register with specialised recruitment agencies, disability organisations and NGOs
- ItemHigh-impact chronic pain : barriers and facilitators identified by Western Cape primary healthcare physiotherapists(Stellenbosch : Stellenbosch University, 2023-03) Mason, Brett James Nairn; Geiger, Martha; Parker, Romy; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY: Purpose of the study: The barriers and facilitators to the provision of effective care for individuals with high-impact chronic pain (HICP) identified by physiotherapists working in the Western Cape primary healthcare (PHC) setting were described to inform the development of curricula, policy, and practise of physiotherapists within the South African PHC system. Methods: A qualitative descriptive study was conducted utilising semi-structured interviews of eight purposively selected physiotherapists from Western Cape PHC facilities. Inductive thematic analysis was implemented to interpret the data. Findings: HICP is a complex and disabling condition that adds to physiotherapists’ burden in PHC. Participants identified that patient-centred approaches and collaborative strategies were facilitators to care, while time, patient, systemic, environmental, and physiotherapist factors were barriers. Participant’s identified needs can be summarised as relating to issues of time, knowledge, and support. Conclusion: HICP is a complex and disabling condition that increases the burden on physiotherapists in PHC. Participants recognised that a patient-centred and collaborative approach allows them to better treat these individuals. Multifaceted barriers to offering effective care could be overcome by providing resources such as more physiotherapists, rehabilitation-proficient managers, and pain-specific training in the PHC setting alongside facilitating physiotherapist skills such as innovative practice and networking with existing support structures.
- ItemHome-and community-based care services: identifying consumers and needs in a rural Western Cape Province setting(Stellenbosch : Stellenbosch University, 2016-12) Mackenzie, Valenzia; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: Person-centredness is an aim of the Home- and Community-Based Care service, where users’ needs always take priority. Identifying users and their needs is vital to quality services. Objectives: The dual aims of the study were to determine who the Home and Community Based Carers in the study setting view as the consumers of their services, and to identify the needs of these consumers. Method: An explorative, qualitative study was done. Home and Community-Based Carers (n=5), patients (n=9) and family caregivers (n=5) providing or using the Home- and Community-Based Care service in Caledon (Western Cape, South Africa) participated in the study. Convenient sampling was done. Data was collected through a focus group discussion with the carers and semi-structured interviews with the users and family caregivers. Thematic analysis of data was done. All relevant information related to the study was explained to the participants and informed consent was obtained. The anonymity and confidentiality of all participants was protected throughout the study. Findings: The Home- and Community-Based Carers viewed the community as the users of their service. The community refers to the residents of Caledon as any resident could benefit from the service. Family involvement, privacy and relationship-building are crucial to Home- and Community-Based Care service in Caledon. Themes from user interviews included: user experience of the service; impact of the service; services received; communication breakdown and suggestions for improvement. Users were mostly satisfied with the service and found it acceptable. Their needs were being met, but they expressed a need for further training and guidance related to the management of specific health conditions. Findings indicated challenges with referral to other levels of health care. Users had recommendations on how the service could improve, for example longer working hours, employing male caregivers, consistency of service delivery and increasing the stipend that the carers are currently earning. Conclusion: The Home- and Community-Based Carers provided a valuable service to the entire community of Caledon. The needs of the users were mostly met and most users had a positive experience of the service. The study identified gaps related to further education, interaction with family carers and referral to other services. Recommendations: Recommendations include: the development of a contact platform with clinic staff; education of Home- and Community-Based Carers on referral pathways and sources of support; developing or use of scope of practice guidelines; training on specific health conditions and practical suggestions that might improve working conditions.
- ItemKnowledge, attitudes and adapted behaviours of adults with Type 2 Diabetes Mellitus, attending a private clinic in the Western Cape: A mixed-method study.(Stellenbosch : Stellenbosch University, 2020-02-24) Winton, Loreen; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: Diabetes is a worldwide epidemic. It is one of the top ten causes of death globally. Insulin resistance and deficiency are the main causes of type 2 Diabetes Mellitus (T2DM). Without proper control of blood glucose levels, tissue damage takes place within the body, causing diabetesrelated complications. These include possible loss of vision, renal failure, peripheral and autonomic neuropathy, sexual dysfunction, cardiovascular disease, and symptoms of hypertension and lipoprotein abnormalities. Studies done in South Africa have demonstrated relatively poor knowledge, attitudes and practices of individuals with T2DM. Most of these studies have been conducted in state hospitals or rural areas in Southern Africa. The current study aimed to describe the diabetes-related knowledge, attitudes and self-reported adapted behaviours of persons diagnosed for at least one year with T2DM, and attending a private clinic in Cape Town, South Africa. Methods: A mixed method design was applied using a phased approach; quantitative data were collected using a structured questionnaire, followed by qualitative interviews. Sixty-seven consecutively sampled participants, attending the Diabetes Life Clinic, formed the study population and completed the questionnaire. Six participants were interviewed via telephone for the qualitative phase. Descriptive statistics have been used for quantitative data, as well as basic inferential statistics, with P<0.05 considered statistically significant. Thematic analysis was applied to qualitative data. Results: A knowledge score of 60.6% was found. A significant correlation was found between less favourable attitude and behaviour. The behaviour scores of female participants was significantly lower than that of males (p=.16). There was a positive significant association between behaviour and higher levels of education (p=.049), and a significant association between depression (p=<.001) and stress/anxiety (p=.026) and quality of life. Qualitative data elicited three themes; 'Where it all started - How the diagnosis changed my life'; 'The diabetes journey – A daily choice'; 'It takes a village…support is key!’ Conclusion: Despite a reasonable knowledge score, this study sample demonstrated less than favourable behaviour and attitudes. The qualitative findings illustrated the stress and difficulty of managing diabetes daily. Recommendations were for healthcare professionals and their role in collaborating in empowering-partnerships with patients, NGO’s and their role in support groups and programmes, patients and their families, and the need to assume ownership of their DM.
- ItemKnowledge, attitudes and practices of academic and admission staff on the inclusion of students with physical disabilities in the School of Health Care Sciences at Sefako Makgatho Health Sciences University : An exploratory, qualitative descriptive study.(Stellenbosch : Stellenbosch University, 2020-03) Mphohoni, Mashudu Ronald; Geiger, Martha; Visagie, Surona; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Introduction: Inclusive higher education incorporates and welcomes all students, irrespective of their disability; in the higher education institutions (HEI) so that all are able to participate in educational opportunities. Disability is an umbrella term for physical, sensory, mental or other impairments resulting in activity limitations and participation restrictions due to a person’s contextual factors. The focus of this study was on students with physical disabilities (SWPD) that affects mobility and/or dexterity. To maintain this focus, other physically determined sensory impairments like visual and hearing disabilities were excluded. Knowledge and attitudes regarding inclusion affect the successful implementation of inclusive higher education (practice). Therefore, the aim of the study was to explore the self-reported knowledge, attitudes and practices of academic and admission staff on the inclusion of SWPD in the School of Health Care Sciences (SHCS) at Sefako Makgatho Health Sciences University (SMU). Methods: A qualitative descriptive study design was used in this exploratory study. The setting was the SHCS at SMU, and the study population comprised of academic and admission staff. A purposive sampling strategy was used, and the final sample consisted of 12 participants (10 academic staff and 2 admission staff). The researcher used a qualitative, semi-structured interview to collect data. Findings: The topic areas of knowledge, attitudes and practices were predetermined by the objectives of the study. Themes under each topic were generated by reflexive thematic analysis In addition, the effects of environmental factors on participants’ attitudes, were identified by inductive analysis. Conclusion: All academic staff demonstrated some knowledge of inclusive higher education while the admission staff demonstrated no knowledge. The lack of knowledge of the admission staff may imply that applications from the SWPD may not be processed in an equitable manner. Most participants’ attitudes were positive and welcomed the possibility of accommodating SWPD, but with some apprehension. This might be due to the effect of the environmental factors on inclusion as discussed. This may also imply that the inclusion of SWPD would be enhanced as more staff become positive, embrace inclusion and the environmental factors are addressed. In terms of practices, all participants noted the absence of students with physical disabilities, disability inclusion policy and Disability Unit at SMU. It may thus be concluded that SMU is currently not inclusive in terms of the recommended higher education practices.
- ItemLived experiences with regards to social participation for persons with disabilities living in a residential facility in Cape Town(Stellenbosch : Stellenbosch University, 2021-12) Hairwadzi, Francisca; Geiger, Martha; Tshabalala, Khaya; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Disability and Rehabilitation Studies.ENGLISH SUMMARY : The aim of this study was to explore the lived experiences with regards to social participation of persons with disabilities living in a residential facility in Cape Town. Objectives: The challenges experienced regarding social participation and facilitators of social participation experienced by the participants were identified using a qualitative research method. Method: The methodology was phenomenological where the eight (8) participants with disabilities, represented themselves in the exploration of their lived experiences in the residential facilities from a subjective paradigm. Telephone interviews were used in lieu of face-to-face interviews which were not possible due to COVID-19 related restrictions. Thematic analysis was implemented. Findings: Outcomes from this study showed how limitations in executing daily activities affected their social participation leading to passive leisure like reading, watching television and listening to music. Residential homes have proven to be a reality for persons with disabilities due to lack of finances and inaccessible family home environments. Being wheelchair-dependent, with less mobility and facing the COVID-19 pandemic restrictions, social media and online communication filled in the gaps of isolation for some residents. Environments can limit the independence of persons with disabilities but with assistive products designed for wheelchair users, residents living in residential homes can live more fulfilling lives and engage more socially. Conclusion: While acknowledging limitation of findings from this “2 residences” focused study, conclusions drawn from its findings indicate that; inaccessibility of family homes and need for full time care and support make residential homes a practical alternative for persons with disabilities. The move from family home environment to the residential facility tends to limit participation of persons with disabilities in their families and community at large. Further investigation involving more residential institutions is needed to investigate social participation of persons with disabilities in order to establish relevant ways in which government, professionals and non-government organizations can work together with persons with disabilities in residential homes to promote social participation.
- ItemParental experiences on the role of wheelchairs in the lives of children with mobility impairments : a qualitative exploration in Dubai(Stellenbosch : Stellenbosch University, 2018-12) Liebenberg, Anjanet Wanda; Visagie, Surona; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Purpose: To explore parental experiences on the role of wheelchairs in the lives of children with mobility impairments in Dubai. Methods: Seven participants were recruited through purposive sampling and their experiences were explored by conducting semi-structured interviews. The audio recordings were transcribed and thematically analysed. Results: The findings showed that wheelchairs were an essential part of the children`s lives, which enabled their participation in the home, the school and the community. Procurement processes were difficult owing to a lack of assessment and prescription as well as insurance companies providing little assistance with payment. Participants described Dubai as a wheelchair friendly city, and two overarching themes emerged, firstly, Wheelchair: “It is her life”, and, secondly, Participation: Isolation versus inclusion Conclusion: The study is the first of its kind in Dubai and revealed that the wheelchair played an important role in the child’s life and allowed participation in life roles that brought joy and fulfilment. Without wheelchairs, children would be isolated and frustrated. However, some of the participants were not satisfied with their child’s current wheelchair and felt the chair was not appropriate. It is recommended that the Government of the Dubai develop policies to guide wheelchair service provision in the country. In addition, insurance providers should collaborate with the government to adhere to the policy to ensure healthy lives and promote well-being for all.
- ItemPerceptions of carers of persons with paraplegia, regarding the caregiver training(Stellenbosch : Stellenbosch University, 2021-12-) Mahlangu, Dineo Precious; Kahonde, Callista K.; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Background: In South Africa, the Integrated National Disability Strategy and the National Rehabilitation Strategy of 2000 emphasise that the rehabilitation of persons with disability is crucial. There are currently 16 recognized rehabilitation facilities in the whole country. The rehabilitation process leads to re-integration of the person who has acquired disability back into their homes and communities, where caregivers become important role players. Therefore, with the limitation of facilities to provide sufficient rehabilitation services, services empowering caregivers become necessary to ensure continuation of care and promotion of independence. Formal or informal caregivers that are identified will need to be trained well so that the specific needs of the caregivers can be prioritized. Aims: To understand the perceptions of caregivers of persons with paraplegia regarding the caregiver training programme offered at a neuro-rehabilitation facility in Mangaung, Free State Province in South Africa. Objectives: a) To explore and describe the perceptions of caregivers of persons with paraplegia regarding the caregiver training programme; b) To identify the gaps and the strengths of the caregiver training programme. Methods: This study used an exploratory-descriptive study design with qualitative methods of data collection. Participants were primary caregivers of persons with paraplegia who had received rehabilitation and got discharged from the neuro-rehabilitation facility. Semi-structured in-depth telephonic interviews were conducted with eight participants. The data was analysed using thematic analysis. Findings: The findings of this study highlighted aspects of the caregiver training programme that the participants appreciated and felt were beneficial and also several gaps that the programme is not addressing. Four themes were generated from the data. These were; 1) components of the caregiver training process, 2) duration and frequency, 3) unmet caregiver expectations and 4) caregiver support. Participants expressed both positive and negative perceptions on their experience of the training programme. Conclusions: The rehabilitation practitioners at Mangaung neuro-rehabilitation facility need to address the gaps within the caregiver training programme that were highlighted by the participants for example, caregiver preparation, increasing the time of training, providing opportunities for hands-on practice, providing follow up services and addressing the caregivers’ individualised support needs. This is important to ensure that the components of the training process address the needs of the caregiver and the person with paraplegia, to promote caregiver competency, good quality of care and quality of life. Currently, the caregiver training seems to be focused on what the rehabilitation practitioners think is important for caregiving and no so much on meeting the real needs of the caregivers.
- ItemPrimary caregivers' perceptions of why their school-aged children with physical disabilities are not attending formal schools in Mabvuku, a high- density location in Harare(Stellenbosch : Stellenbosch University, 2021-12) Kambasha, Stephanie Kambasha; Kahonde, Callista K.; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : Aim of the study - Children with disabilities face barriers to accessing education and there is a gap in literature reporting the perceptions of caregivers regarding the reasons for these children not getting access to education on par with their age mates. This study aimed to explore and describe the perceptions of primary caregivers of children with physical disabilities residing in Mabvuku, a high-density area in Harare, on why these children are not attending formal school. Method - This was a descriptive phenomenological study that subjectively explored the perceptions of five mothers of children with disabilities who lived in Mabvuku. Face-to-face in-depth interviews were used for data collection and thematic data analysis was used to analyse the data. Findings - The findings revealed that financial challenges were the main reason these mothers were not sending their children with disabilities to formal schools. The fact that the schools are physically located far from Mabvuku was also reported as a barrier as travelling with the child to school using public transport posed financial and access challenges. Physical access to the formal schools was also a factor hindering the children from attending school as the infrastructure was not easily accessible to children with disabilities and there is also a limited number of special schools that can accommodate these children. Lastly, the child’s disability was also presented as a challenge by the mothers because of the limitations of the impairment and the fact that some were not comfortable leaving their child in the care of someone else, especially with the negative attitudes they experienced from the community. Conclusion - The study gave an insight into the challenges faced by the mothers which resulted in them not sending their children with disabilities to school. The mothers live with their children with disabilities in poverty. They require support from the government and other relevant stakeholders to improve their circumstances which will impact positively on their children’s chances to attend school. Recommendations were made for policy makers and disability practitioners in Zimbabwe.
- ItemPrimary caregivers’ experiences of changes in their children during the course of Early Childhood Development also known as grade RR at a school for learners with Autism Spectrum Disorder (ASD) in Cape Town(Stellenbosch : Stellenbosch University, 2021-12) Mufutamari, Faith; Ohajunwa, Chioma; Geiger, Martha; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.ENGLISH SUMMARY : The aim of this study was to explore primary caregivers’ experiences of changes in their children during the course of Early Childhood Development also known as grade RR at a school for learners with Autism Spectrum Disorder (ASD) in Cape Town. A qualitative, descriptive phenomenological methodology was used for this study to bring into consciousness the lived experiences of participants and elicit narratives based on participants’ experiences and frame of reference. The six stages of thematic analysis were most suitable for this study because it assisted with the identification of recurring patterns and interconnections of data (Braun & Clarke, 2013). Findings in this study indicate that children with ASD enrolled for grade RR at a school for learners with ASD only, demonstrated potential to learn and develop on their milestones during the first year they started school. The outcomes of the study indicated positive outcomes for the children with autism. Parents stated that their children improved in their self-help skills, developing social, speech and academic skills. Most importantly, primary caregivers felt that their children grew in confidence, enjoying the special school setting and the expert attention they received from their teachers. An additional outcome that came out is the tri-factor approach. Parents explained that there are certain factors that support this successful and positive experience of grade RR for their children. These three factors are: School preparedness (Factors within the school); child’s preparedness (factors within the child); and parent preparedness (Parental influence). These outcomes are expected to provide valuable feedback to special educators working with children with ASD as well as to influence policy makers to create policies that speak to the reality on the ground especially within inclusive education. This study was limited for academic purposes and was restricted to participants residing only in Cape Town. Being a qualitative study, the outcomes cannot be generalized to the larger population. The study was also limited to only the primary caregivers of children with ASD. In that case, parents or other family members who are not primary caregivers were not invited to participate. Recommendations to different stakeholders were made as well as recommendations for future studies.