Speech-Language and Hearing Therapy

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Browsing Speech-Language and Hearing Therapy by browse.metadata.advisor "Gcaza, Siphokazi"

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    Description and evaluation of the rehabilitation programme for persons with lower limb amputations at Elangeni, Paarl, South Africa
    (Stellenbosch : Stellenbosch University, 2012-03) Fredericks, Jerome P.; Visagie, Surona; Gcaza, Siphokazi; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy. Centre for Rehabilitation Studies.
    ENGLISH ABSTRACT: Lower limb amputations cause multiple physical, psychological, environmental and socioeconomic barriers. Individuals who have suffered a lower limb amputation require comprehensive rehabilitation to ensure social integration and economic self-sufficiency. In addition, constant monitoring and evaluation is an essential part of human service delivery programmes. However, the amputation rehabilitation programme offered at Elangeni an outpatient rehabilitation centre for clients with physical disabilities in Paarl, Western Cape, South Africa is not monitored, and has not been evaluated since its inception in 2000. Thus, the current study evolved to describe and evaluate the rehabilitation programme for persons with lower limb amputations at Elangeni. A mixed method descriptive design was implemented. All persons who received rehabilitation, after a major lower limb amputation at Elangeni, between 2000 to 2011, were included in the study population. In addition, the physiotherapist and occupational therapist that provided amputation rehabilitation at Elangeni, at the time of the study, were interviewed. Thirty participants who met the study inclusion criteria were identified. Quantitative data was collected using a researcher designed, structured demographic questionnaire, an International Classification of Function checklist based questionnaire and a participant rehabilitation folder audit form. Two interview schedules one for clients and one for therapists were used for guidance during semi structured interviews. Quantitative data was entered onto a spread sheet and analysed by a statistician using Statistica, version 8. Qualitative data was thematically analysed according to predetermined themes. No programme vision, mission or objectives could be identified for the amputation rehabilitation programme. Poor record keeping practices and a lack of statistics were found. Rehabilitation was impairment focused with no attention given to social integration. Clients who received prosthetic rehabilitation showed improved functional ability with regard to picking up objects from the floor (p = 0.031) getting up from the floor (p = 0.00069), getting out of the house (p = 0.023), going up and down stairs with a handrail (p = 0.037) and moving around in the yard (p = 0.0069), climbing stairs without a handrail (p = 0.037), going up and down a kerb (p = 0.0082) walking or propelling a wheelchair more than 1km (0.0089) and walking in inclement weather (0.017). A lack of indoor mobility training had a statistically significant negative impact on the participants’ ability to lift and carry objects (p 0.011), standing up from sitting (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016), going up and down stairs with a handrail (p = 0.019), moving around in the yard (0.0013), going up and down stairs with-out a hand-rail (p = 0.019), getting up and down a kerb (p = 0.0022), walking or wheeling 1km or more (p = 0.0032) and using transport (p = 0.0034). Failure to address community mobility during rehabilitation had a statistically significant negative impact on all aspects of community mobility scores except doing transfers and driving. In conclusion, for the study participants, Elangeni failed to provide rehabilitation according to the social model of disability and Community Based Rehabilitation principles. It is recommended that managers, service providers, and clients re-consider the purpose of Elangeni and develop a vision and objectives for that service. In addition, management should take an active role in service monitoring and evaluation and provide guidance and mentorship to therapists.
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    Key factors impacting on the development of physically disabled athletes in Limpopo province
    (Stellenbosch : University Stellenbosch, 2009-12) Sellschop, Ingrid; Gcaza, Siphokazi; Melling-Williams, Natalie; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH ABSTRACT: For physically disabled learners to achieve successful participation in sport requires the synergistic interaction of many diverse factors. The Limpopo province of South Africa produces fewer physically disabled athletes at the junior, senior and elite levels than any other province in South Africa. This study identifies and examines the key aspects that affected the development of physically disabled athletes in the Limpopo province in 2006/2007. Factors that both facilitate or inhibit the development of physically disabled athletes in the province are identified and discussed. This highlights aspects that need to be addressed in seeking to bridge the gap between current deficiencies and an optimised future for participants in disabled sport in Limpopo province. The study is descriptive, using a case-study design as part of a situational analysis. Physically disabled athletes from one school were selected using a convenience sample and key informants were selected through purposive sampling. Questionnaires were completed by ten physically disabled athletes as well as by staff involved in their athletic development. Interviews were also conducted among key informants from the sport and education sectors. The questionnaires were analysed quantitatively and the interviews underwent qualitative content analysis. The findings indicated that there are seven critical areas/key factors influencing the development of physically disabled athletes in Limpopo province. These are: 1. Support systems; 2. Sports participation; 3. Attitudinal facilitators and barriers; 4. Environmental accessibility; 5. Resources; 6. Education and training; 7. Politics. The above elements impacting on the development of physically disabled athletes in Limpopo province are compared with the five key areas of the International Paralympic Committee (IPC) Development Model. It was found that numerous challenges exist in Limpopo, namely: a lack of sufficient humanresource capacity, funding, sponsorships and the necessary financial resources for adequate infrastructure sustainability and support services. Therefore, in order for physically disabled athletes in Limpopo province to be successfully developed within the framework of the IPC Development Model, the challenges and key factors/critical areas identified by this study need to be addressed. The following recommendations were made following the outcomes of the study: 1. Establish a discussion forum for all stakeholders; 2. Take steps to elevate the status of sport for physically disabled athletes in Limpopo province; 3. Improve the co-operation between sports federations, government departments and disabled people’s organisations Limpopo province; 4. Educate stakeholders; 5. Improve coaching expertise and knowledge; 6. Have specialist rehabilitation expertise in the LSEN schools; 7. Monitor and evaluate sports programmes.
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    Mainstreaming disability into the poverty reduction processes in Uganda : the role of the human rights - based approach to the National Development Plan
    (Stellenbosch : University of Stellenbosch, 2011-03) Mulumba, Moses; Chataika, Tsitsi; Gcaza, Siphokazi; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH ABSTRACT: Research evidence suggesting the link between disability and poverty has been increasing at an alarming rate in recent years. Despite this, there has been very little attention to ensuring representation and inclusion of people with disabilities in poverty reduction processes. However, disability movements and their partners have been increasing pressure to ensure that people with disabilities effectively participate in the development of national development plans targeting poverty reduction. The aim of this qualitative study was to analyze the extent to which the human rights-based approach can be used as an advocacy tool for mainstreaming disability in the national development processes targeting poverty reduction in Uganda. The study was conducted in Kampala and Kiboga districts, and data were gathered between August and October 2009. Key informant interviews and focus group discussions were used for data collection. Eleven participants were purposively selected to participate in key informant interviews. Using these key informants, the snowballing technique was used to identify twenty people that participated in the two focus group discussions, with each having ten participants. A thematic content analysis was used to analyze data, and this involved coding and cataloguing data into emerging themes and subthemes. The study established that despite several legal frameworks in Uganda, disability mainstreaming is still far from being achieved. Translation of policies into practice was identified as a major challenge, making it difficult for people with disabilities to be meaningfully involved in poverty reduction processes. Negative attitudes and misconception of disability by both policy makers and civil society, were also seen to be contributing to the exclusion of people with disabilities in poverty reduction processes and programmes. Lack of capacity and meaningful political representation of disabled people seem to negatively impact on effective participation, monitoring and evaluation of the poverty-reduction processes in Uganda. The study recommends the need to strengthen capacity and advocacy work among people with disabilities and their promoters to ensure their effective participation and inclusion of disability in the national development agenda. It further recommends the need to adopt the human rights-based approach in any development initiative, ensuring disability mainstreaming in policies and the national development plan, in order to effectively address poverty reduction in Uganda. The researcher also challenges disability and development researchers to engage in more wider-scale studies in order to establish more evidence on the need to adopt the human rights-based approach to national development.
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    Participants’ experience of the Bishop Lavis Rehabilitation Centre stroke group
    (Stellenbosch : University of Stellenbosch, 2007-03) De la Cornillere, Wendy-Lynne; Visagie, Surona; Gcaza, Siphokazi; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy. Centre for Rehabilitation Studies.
    Current emphasis for rehabilitation in South Africa remains on individual intervention within the move towards primary health care. Primary health care is the strategy that has been adopted by the South African department of health to bring access and equity in health care services. Even so, the burden of providing effective rehabilitative services with limited resources requires innovative strategies, such as the use of therapeutic groups, to address certain aspects of rehabilitation. These strategies must be proven effective. There is a paucity of literature detailing the uses of group therapy in physical rehabilitation, and particularly the use of interdisciplinary group work in stroke rehabilitation. Furthermore, evidence shows that stroke survivors feel ill equipped to return to their communities despite rehabilitation. Stroke is a major cause of death and disability in South Africa, and is a condition shown to benefit from rehabilitation. These factors led to the selection of the Bishop Lavis Rehabilitation Centre stroke group as the setting for this study, which aims to describe the range of experiences relating to attendance or non-attendance of those referred to this programme. This descriptive study, employing quantitative means (to describe the demographic details of the participants) and qualitative means (to describe the experiences of participants), was conducted with twenty participants. Data was collected by means of an administered questionnaire. Following that, a focus group discussion involving six participants was used to gather in-depth information. Quantitative data was analysed with the assistance of a statistician, utilising the computer program, Statistica. The Chi-Squared, Kruskal-Wallis and ANOVA tests were used, with p>0.05 showing statistical significance. Qualitative data was thematically analysed, whereby data was categorised by means of an inductive approach. The study population consisted of 20 participants, with an average age of 59 years, of whom 15 were female and five male. The stroke group provided meaning to participants on two levels. On a psychosocial level, the phenomena of universality (identifying with others in a similar position), development of socialising techniques, imparting information and cohesiveness emerged strongly. On the level of meaning related to stroke recovery, improvement in ability to execute activities of daily living, mobility and strength were most frequently mentioned. Transportation issues were most commonly mentioned as factors negatively influencing attendance. Staff attitude and activities of the programme were most often cited as positive factors. Given the positive response of study participants, and the programme’s ability to sustain intervention with limited resources, it was concluded that this programme has a valid place within stroke rehabilitation in Bishop Lavis. Recommendations in terms of the group programme included investigating methods of providing transportation, providing childcare facilities and expanding the content of educational sessions. Further recommendations were to maintain the positive attitude of staff and the current activities of the programme. Frequency of group outings should also be increased and compensatory strategies for inclement weather must be explored.
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    The role of disability rights movements in the Ethiopian Development Agenda
    (Stellenbosch : University of Stellenbosch, 2011-03) Wakene, Dagnachew Bogale; Wazakili, Margaret; Gcaza, Siphokazi; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH ABSTRACT: Despite the ever increasing number of persons with disabilities (PWDs) in Ethiopia and the resulting conditions of abject poverty, efforts made to curb the existing situation, thereby improving the lives and citizenry contributions of PWDs, has been minimal. Consequently, poverty and insufficient participation of PWDs continue to be the distinctive features characterizing the disability sector and movement in Ethiopia. This research was aimed at investigating the role, involvement and impact of PWDs and the Disability Rights Movement (DRM) in Ethiopia in realizing the effective inclusion of disability in the country‟s development agenda, with a specific focus on Poverty Reduction Strategy Papers (PRSPs). A qualitative research paradigm, using a case study design, was employed as a research method in this study. Data were collected using two data collection methods; namely, key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling and snowballing techniques were used to select 44 people who participated in ten key informant interviews and three focus group discussions (each FGD attended by 8 to 10 participants). The researcher was flexible enough to conduct additional KIIs and FGDs until the data saturation point was reached. Semi-Structured Interview Guides were employed as data collection tools. A thematic content analysis was conducted following a systematic process of coding data and grouping codes into categories and emerging themes. The study was conducted in Addis Ababa, the capital of Ethiopia, in collaboration with the Federation of Ethiopian National Associations for People with Disabilities (FENAPD) – the umbrella Disabled People Organization (DPO) in Ethiopia. The results of the study revealed that the disability movement in Ethiopia has not been active enough in ensuring the involvement of PWDs in the country‟s development endeavours. It was also reiterated that, even if the Ethiopian government was one of the first signatories of the UN Convention on the Rights of Persons with Disabilities (CRPD), the practical recognition that it has so far conferred to disability and PWDs in its development plans has been less than satisfactory. The study also underlined the fact that some recent progresses, such as the mentioning of disability in the currently under-review third PRSP document of Ethiopia, should be strengthened in order to pave the way for a more comprehensive inclusion of disability. Imminent challenges and opportunities facing the Ethiopian disability movement have also been explored in the study. It is hoped that the results of this study will provide the pertinent disability stakeholders in Ethiopia, including the government, with useful, timely and concrete research evidence, especially as Ethiopia is now engaged in a process of launching its latest PRSP documents.