Browsing by Author "Fredericks, Jerome P."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- ItemDescription 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.
- ItemThe rehabilitation programme and functional outcomes of persons with lower limb amputations at a primary level rehabilitation centre(Occupational Therapy Association of South Africa, 2013-12) Fredericks, Jerome P.; Visagie, SuronaThe study aimed to evaluate the amputation rehabilitation programme offered at an out-patient rehabilitation centre. Amputations have a severe physical, psychological and socio- economic impact. Effective rehabilitation can assist the individual in dealing with these. A quantitative, descriptive design was implemented. Thirty amputees who received rehabilitation and the therapists working at the centre participated in the study. An International classification of Function, Disability and Health based questionnaire, folder audit form and interview schedules were used for data collection. No programme vision, mission or objectives could be identified. Rehabilitation focused on impairment. The impact of prosthetic rehabilitation on in and outdoor activities requiring mobility was statistically significant, with p values ranging from 0.00069 to 0.037.`No indoor mobility training` had a negative impact on lifting and carrying objects (p 0.011), standing up (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) and moving around in the yard (0.0013). `Failure to address community mobility` had a statistically significant negative impact on all aspects of community mobility scores except transfers and driving. Recommendations include that a service vision and objectives be developed. In addition services should be evaluated and monitored on an ongoing basis and mentorship provided to therapists.