Mathye D1, Eksteen CA1
1University of Pretoria, Physiotherapy, Pretoria, South Africa
Background: The rehabilitation of children with disabilities (CWDs) in a rural area is difficult because of the multiple challenges associated with under-resourced regions. These challenges include amongst others accessibility of healthcare facilities, shortage of experienced rehabilitation professionals and limited rehabilitation models to direct the rehabilitation of CWDs should be conducted within a rural South African context.
Purpose: The purpose of the study was to develop a model for the rehabilitation of CWDs in the rural community of Giyani in South Africa.
Methods: A qualitative, theory-generating, exploratory, descriptive, contextual approach was used.Data collection comprised phases 1 and 2 conducted and facilitated by the first author.
In Phase 1, data were collected through individual face-to-face interviews with ten (n=10) caregivers of CWDs, eight (n=8) rehabilitation professionals, and two (n=2) community-rehabilitation workers (CRWs) to develop concepts.
In Phase 2, concepts were further expanded through focus group discussions (FGDs) with ten (n=10) caregivers of CWDs who participated in three groups, and six (n=6) rehabilitation professionals who participated in one group. Data were transcribed verbatim, translated and analysed using an inductive approach.
Results: Sixteen concepts and non-relational statements were developed:
Cause of childhood disability;
Available services;
Role of caregivers;
Caregivers' sources of support / coping strategy/ level of satisfaction/expectations;
Role of rehabilitation professionals;
Professionals' competencies;
Factors affecting professionals' work ethic;
Professionals plan of action; Role of CRWs;
Role of municipality towards CWDs;
Role of schools for the disabled;
Challenges experienced by CWDs and Societal perception of CWDs.
Seven relational statements were developed:
(1) causes of childhood disability,
(2) available services and roles,
(3) expectations and satisfaction of caregivers with available services,
(4) challenges experienced by caregivers and societal perception/attitude of CWDs,
(5) role of caregivers, sources of support and coping strategies,
(6) rehabilitation professionals' work ethic and competencies and
(7) rehabilitation professionals' plan of action and challenges experienced by caregivers were developed.
The seven relational statements were rearranged and reorganised using the available literature to show:
(1) causes of childhood disability clearly,
(2) available services for CWDs in Giyani,
(3) goal of rehabilitation from the WHO's perspective,
(4) challenges experienced by CWDs and caregivers,
(5) role of rehabilitation professionals,
(6) role of CRWs,
(7) role of family/caregivers,
(8) role of local municipality and
(9) role of the education sector.
Conclusion(s): The rehabilitation model was developed based on the relationship between the
(1) roles of rehabilitation professionals, CRWs, the local municipality and education sector;
(2) challenges experienced by CWDs and caregivers, and
(3) caregivers/family's ability to support CWDs and ensure continuity of care or treatment.
Implications: The model implies that professionals and CRWs have a responsibility to reduce child-related, family-caregiver related, and health-care related challenges. In addition, the local municipality and the education sector have a duty to mitigate community-related problems. The model assumes that a reduction in child-related, family-caregiver related, health-care related, and community-related difficulties are likely to improve the caregivers' ability to support the CWD and ensure that there is continuity of care or treatment.
Keywords: Rehabilitation model, children with disability, rural community
Funding acknowledgements: South African National Research Foundation (NRF)
Purpose: The purpose of the study was to develop a model for the rehabilitation of CWDs in the rural community of Giyani in South Africa.
Methods: A qualitative, theory-generating, exploratory, descriptive, contextual approach was used.Data collection comprised phases 1 and 2 conducted and facilitated by the first author.
In Phase 1, data were collected through individual face-to-face interviews with ten (n=10) caregivers of CWDs, eight (n=8) rehabilitation professionals, and two (n=2) community-rehabilitation workers (CRWs) to develop concepts.
In Phase 2, concepts were further expanded through focus group discussions (FGDs) with ten (n=10) caregivers of CWDs who participated in three groups, and six (n=6) rehabilitation professionals who participated in one group. Data were transcribed verbatim, translated and analysed using an inductive approach.
Results: Sixteen concepts and non-relational statements were developed:
Cause of childhood disability;
Available services;
Role of caregivers;
Caregivers' sources of support / coping strategy/ level of satisfaction/expectations;
Role of rehabilitation professionals;
Professionals' competencies;
Factors affecting professionals' work ethic;
Professionals plan of action; Role of CRWs;
Role of municipality towards CWDs;
Role of schools for the disabled;
Challenges experienced by CWDs and Societal perception of CWDs.
Seven relational statements were developed:
(1) causes of childhood disability,
(2) available services and roles,
(3) expectations and satisfaction of caregivers with available services,
(4) challenges experienced by caregivers and societal perception/attitude of CWDs,
(5) role of caregivers, sources of support and coping strategies,
(6) rehabilitation professionals' work ethic and competencies and
(7) rehabilitation professionals' plan of action and challenges experienced by caregivers were developed.
The seven relational statements were rearranged and reorganised using the available literature to show:
(1) causes of childhood disability clearly,
(2) available services for CWDs in Giyani,
(3) goal of rehabilitation from the WHO's perspective,
(4) challenges experienced by CWDs and caregivers,
(5) role of rehabilitation professionals,
(6) role of CRWs,
(7) role of family/caregivers,
(8) role of local municipality and
(9) role of the education sector.
Conclusion(s): The rehabilitation model was developed based on the relationship between the
(1) roles of rehabilitation professionals, CRWs, the local municipality and education sector;
(2) challenges experienced by CWDs and caregivers, and
(3) caregivers/family's ability to support CWDs and ensure continuity of care or treatment.
Implications: The model implies that professionals and CRWs have a responsibility to reduce child-related, family-caregiver related, and health-care related challenges. In addition, the local municipality and the education sector have a duty to mitigate community-related problems. The model assumes that a reduction in child-related, family-caregiver related, health-care related, and community-related difficulties are likely to improve the caregivers' ability to support the CWD and ensure that there is continuity of care or treatment.
Keywords: Rehabilitation model, children with disability, rural community
Funding acknowledgements: South African National Research Foundation (NRF)
Topic: Disability & rehabilitation; Paediatrics
Ethics approval required: Yes
Institution: University of Pretoria
Ethics committee: Faculty of Health Sciences
Ethics number: 109/2009
All authors, affiliations and abstracts have been published as submitted.
