Browsing by Author "Gretschel, Dietlind"
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- ItemCommunity integration of adults with disabilities post discharge from an in-patient rehabilitation unit in the Western Cape(AOSIS Publishing, 2017) Gretschel, Dietlind; Visagie, Surona; Inglis, GakeemahIntroduction: Community integration is an important outcome of rehabilitation, because the ultimate focus of rehabilitation is to enable people to participate in their life roles. Aim: To determine community integration scores achieved by adults with disabilities post discharge from an in-patient rehabilitation centre in the Western Cape Province. Method: Fifty-nine individuals participated in this cross-sectional study. Community integration was determined using the Reintegration to Normal Living Index (RNLI). Descriptive analysis of age, gender, medical diagnosis and RNLI scores was performed. Kruskal–Wallis test and t-tests were used to determine whether there exists any relationship between age, gender, medical diagnosis and RNLI scores (p < 0.05). Results: Participants’ mean age was 45 (± 15.9) years. Of the study participants, 54% were women. The most common diagnosis was stroke (41%), followed by spinal cord injury (30%). The mean overall RNLI score was 66.3 (± 25.5). Persons with brain trauma (stroke or head injury) had a mean of 60.9 (±20.3); those with spinal cord injury had a mean of 75.2 (± 25.8) and those with peripheral impairments had a mean of 65.5 (± 30.5). The RNLI domains ‘personal relationships’ 73.45 (± 31.6) and ‘presentation of self’ 72.13 (± 35.4) recorded the highest mean scores. The domain ‘work or meaningful activities’ had the lowest mean score 52.54 (± 35.3). ‘Community mobility’ (59.9; ± 34.6) and ‘recreation’ (57.3; ± 37.2) also had mean scores below 60. No statistically significant relationships were found between age, gender and medical diagnosis and RNLI scores. Conclusion: The relatively low mean scores indicate that participants achieved poor community reintegration.
- ItemLevels of community integration achieved by adults with disabilities post discharge from a specialised in-patient rehabilitation unit in the Western Cape(Stellenbosch : Stellenbosch University, 2016-03) Gretschel, Dietlind; Visagie, Surona; Inglis, Gakeemah; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.ENGLISH ABSTRACT: Background: Community integration is one of the most important outcomes of rehabilitation. Rehabilitation services should strive to optimise community integration of persons with disabilities through the processes of functional restoration, prevention of secondary complications, provision of assistive devices and/or environmental modification. Studies conducted in South Africa show that rehabilitation services in the country often do not achieve community integration of persons with disabilities. The need to quantify the levels of community integration of persons with disabilities who received in-patient rehabilitation was identified. Aim: To determine the levels of community integration of adults with disabilities post discharge from a specialised in-patient rehabilitation unit in the Western Cape Province. Methods: A quantitative, cross-sectional, descriptive study design was used. Individuals discharged from the rehabilitation centre between 1 September 2012 and 30 November 2012, who met the inclusion criteria, made up the study sample. Fifty-nine individuals participated in the study. A demographic and medical data sheet was used to gather information from the participants’ medical folders. Levels of community integration were determined with the Reintegration to Normal Living Index (RNLI). Descriptive statistics on the variables age, gender and medical diagnosis as well as scores of the various RNLI domains, subscales and the overall RNLI score are presented in graphs and tables. To determine if a relationship existed between the variables age, gender and medical diagnosis and levels of community integration, interferential tests (t-test and Kraskal-Wallis tests) were applied. A P-value of <0.05 was observed as statistically significant. Results: Fifty-four percent of study participants were women. Participant’s median age was 43 with an interquartile range of 35 to 57. The most common diagnosis was stroke (41%) and spinal cord injury (30%). The median overall RNLI score for the study population was 71.30 with an interquartile range of 53.24 and 87.50. The RNLI items personal relationships and presentation of selfrecorded the highest median scores (88.89). The RNLI items work and related activities scored the lowest median score of 55.56. Home mobility, community mobility, travel out of town and recreational activities also had median scores below 70. No statistically significant differences could be found when examining the relationships between the variables age, gender and medical diagnosis and the domains, subscales and the overall RNLI scores. Conclusion: The results of this study show that persons with disabilities, who received inpatient rehabilitation and were discharged into their home and community environments, achieve lower overall RNLI scores than persons with disabilities living in well-resourced countries such as the United States of America (USA) and Canada. Rehabilitation professionals may need to adjust rehabilitation programmes offered to improve community integration outcomes of clients. Low levels of integration in areas such as community mobility, and participation in social and meaningful work activities might be an indication that persons with disabilities still face many barriers in the communities. Persons who suffered a traumatic brain injury or a cerebrovascular accident (CVA) achieved lower levels of community integration in comparison to persons who suffered a SCI or have an impairment of the peripheral neural/muscular system(s).