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A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia

TAY, Ee Lin
WONG, Chee Piau
2018

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Purpose: Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.

 

Method: A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.

 

Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.

 

Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.

Virtual Reality Games as an Intervention for Children: A Pilot Study

Muneer, Reema
Saxena, Tanushree
Karanth, Prathibha
2015

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Purpose: This pilot study explored the use of virtual reality-based games as an enjoyable yet effective intervention to improve skills in children with developmental disabilities. Although the intervention was primarily targeted at the enhancement of motor skills, the children’s communication, cognitive and social/emotional skills were also monitored and changes, if any, were tracked during this period.

 

Methods: Therapists guided 5 children (4 boys with Autism Spectrum Disorder and 1 girl with Learning Disability) while they played carefully chosen games on the Xbox-Kinect, in individual sessions. Each child attended between 4 and 6 sessions over a span of one month. Therapists used a 4-point rating scale to evaluate specific skills in each of the four domains (motor, communication, cognitive and social/emotional) at the beginning of the intervention, and again at the end.

 

Results: Pre-and post-intervention scores revealed that the children made significant progress, not only in certain motor skills but also in skills from the cognitive and social/emotional domains. None of the children regressed in any of the skills monitored from the different domains.

 

Conclusions: Initial findings indicate that virtual reality games provide a useful platform for building interventions for children with developmental disabilities. There is much scope for future research in this area. The results of the study provide insights into the skills which might require prolonged, consistent inputs during the intervention, and the ones which might be acquired quickly through leaps in learning. The different ways in which children with varied developmental profiles might benefit from virtual reality-based interventions were also highlighted.

Evaluation of Environmental Barriers faced by Wheelchair Users in India

DEVI, S
GOYAL, S
RAVINDRA, S
2013

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Purpose: Environmental factors restrict the extent to which people with disabilities can participate in society. The reduction of environmental barriers will increase their participation in the social, educational and vocational spheres of life. With the use of a valid and reliable tool - the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaire - this study aimed to evaluate the environmental barriers faced by wheelchair users in Bangalore city, India.

 

Method: A convenience sample of 100 wheelchair users, between 16 and 40 years of age, and working in different institutions in Bangalore, participated in the study. The CHIEF questionnaire was administered to each participant. It consisted of multiple questions pertaining to the 5 components of environmental barriers faced by wheelchair users: Accessibility, Accommodation, Resource availability, Social support and Equality. Percentage values for the responses in each component were calculated.

 

Results: The results showed that 52% of wheelchair users faced problems in Accessibility on a daily basis, and 77% of them felt the problem was big. With respect to Accommodation, 41% faced problems once a month and 50% of them felt that this was a big problem. The maximum percentage of participants did not face problems in Resource availability (43%), Social support (50%) and Equality (59%), and therefore these aspects were not felt to be a big problem.

 

Conclusion: An understanding of the environmental barriers faced by wheelchair users can provide guidance in mapping policies and strengthening laws which would help to improve their quality of life.

The Application of ICF-based Functioning Data on Home Environment Adaptation for Persons with Disabilities

TONGSIRI, S
HAWSUTISIMA, K
2013

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Purpose: This study illustrates how the International Classification of Functioning, Disability and Health (ICF) domains and qualifiers could be used to create functioning profiles of persons with disabilities in order to plan environmental changes. The outcome of the interventions can be measured by before-and-after comparisons of these profiles.

 

Method: 33 persons with disabilities (11 each from three provinces), with an average age of 43 years, were interviewed between November 2011 and May 2012. 67% of them were male. The functioning profiles of all the subjects were used as guidelines for home environment adaptations.

 

Results: The data helped to understand the limitations of persons with disabilities and identified the areas that needed enhancement to improve their functioning. Modification lay-outs were provided for all 33 persons with disabilities.

 

Conclusion and Implications: It was demonstrated that the ICF framework could help create functioning profiles to guide modifications in the home environment. Future studies should examine whether ICF can measure actual changes that occur after the modifications.

Risks to Client Confidentiality when Communicating Health Information to Blind and Partially Sighted Persons

THURSTON, M
THURSTON, A
2013

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Purpose: This research was carried out to give a more accurate picture of the particular needs of the blind and partially sighted people living in Scotland. It explores the risks to client confidentiality if information is not provided in accessible formats.

 

Method: Data were gathered from a survey of 228 blind and partially sighted persons in 15 Health Authorities across Scotland. The survey reported NHS clients’ experiences of receiving health information in accessible reading formats.

 

Results: The data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves.

 

Conclusions: The implications for client privacy, confidentiality and the wider impact on life and healthcare have been highlighted. The implications for professional ethical medical practice and for public policy are discussed, and recommendations for improved practice are made.

Quantitative Exploratory Evaluation of the Frequency, Causes and Consequences of Rehabilitation Wheelchair Breakdowns delivered at a Paediatric Clinic in Mexico

TORO, M L
GARCIA, Y
OJEDA, A M
DAUSEY, D J
PEARLMAN, J
2012

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Purpose: The United Nations Convention on the Rights of Persons with Disabilities recognises assistive technology such as wheelchairs (WCs) as a tool for social inclusion for this population. In less resourced settings, organisations lack information about effective models of WC service provision. The goal of this study was to investigate the lifespan of WCs and whether they provided reliable mobility, at one clinic in Mexico.

 

Methods: Caregivers of children, who had requested replacements for their WCs from a clinic in Mexico, were interviewed in Spanish. Among others, the questions pertained to repairs/modifications, adverse events and WC usage characteristics. The owners exchanged their WCs for new ones at the clinic, and the maintenance status of each returned WC was evaluated using the WC Assessment Checklist (WAC).

 

Results: Twenty-three donated WCs, used by children aged 3 to 14 years for an average of 19 months, were evaluated. Brakes (n=18), seat and back-sling upholstery (n=11 and 7 respectively), and armrests (n=14) were the components that failed most frequently. A total of 26 adverse events due to WC failure were reported. Adverse events were significantly associated with poor WAC scores (rs=-0.544, p=0.007).

 

Conclusions: Poor WC reliability, associated with adverse events which could undermine social engagement, indicates the need for a stronger WC and for regular maintenance. For instance, brake failures which were most often associated with adjustment issues, could have been resolved with maintenance, while seat and back-sling upholstery and armrest failures suggest that the WC may not be appropriate for the environment. Future work should investigate the robustness of these WCs using standardised methods (ISO 7176), as well as the impact of maintenance interventions on WC reliability.

Assistive Technologies in a Workplace Environment: Barriers for the Employment of People with Disabilities

JAKOVLJEVIC, M
BUCKLEY, S
2011

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Purpose: The employment equity policies and implementation of technology- specific guidelines within the South African ‘Code of Good Practice on the Employment of People with Disabilities’, was created to encourage employment equity for employees with disabilities, by companies in Johannesburg.

 

This study reports on the results of the investigation in assistive technologies in a workplace environment, and barriers for the employment of persons with disabilities in the South African environment.

 

Method: Qualitative data, collected from two retail and service companies in the form of semi-structured individual and focus group interviews, was analysed using a constant comparative method, identifying major themes and sub-themes.

 

Results: A surprisingly small number of persons with disabilities were found to be employed by participating companies, which tended not to focus on these people when formulating their policies and plans. In addition, technological aspects of the Code were largely unacknowledged, with little effort being made to accommodate the needs of persons with disabilities. An even lower incidence of assistive technology usage was found, along with a large number of conceptual and perceived barriers that hinder the employment of persons with disabilities and the implementation of appropriate technology.

Employability of People with Disabilities in the Northern States of Peninsular Malaysia: Employers’ Perspective

TA, T L
WAH, L L
LENG, K S
2011

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Purpose: This study investigates employers’ perspective towards employing people with disabilities in the northern states of Peninsular Malaysia. The research also endeavoured to identify factors that promote or hinder gainful employment of people with disabilities in Malaysia.

 

Method: The data were collected through postal questionnaires distributed to several types of industries in the northern region of Malaysia.

 

Results: The results indicated that most of the employers are in favour of employing persons with disabilities. However, very few have such enabling policies, or a mechanism to handle issues related to persons with disabilities, or a built environment which is fully accessible to persons with disabilities. They are also concerned about the ability of workers with disabilities to comprehend and follow orders, as well as the costs involved in employing and training them. These results imply that if employers want to fulfil their intentions of recruiting persons with disabilities, a lot has to be done to employ and sustain them in their jobs.

‘Welcome to My Life!’ Photovoice: Needs Assessment of, and by, Persons with Physical Disabilities in the Kumasi Metropolis, Ghana

TIJM, M M
CORNIELJE, H
EDUSEI, A K
2011

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Persons with physical disabilities face many architectural and social barriers to community participation. This research employed the ‘Photovoice’ method. The aim was to gain insight into the daily lives of persons with physical disabilities, and to assess their needs in the Kumasi metropolis. Participants in this study were trained and instructed to photograph their everyday activities, so as to document their struggles and concerns, to promote critical dialogue and to reach policymakers. Results indicated a number of concerns, such as poor accessibility to public toilets, transport and buildings, as well as a need for attitudinal change and equal opportunities. Other needs which were raised by theparticipants included economic empowerment, marketable vocational training, accident prevention, affordable and quality rehabilitation, and the establishment of emergency shelters. It was concluded that the most pressing needs of persons with disabilities were related to overall social, employment and accessibility issues. Finally, the ‘Photovoice’ methodology offered a suitable, structured, and participatory way to assess the needs of persons with disabilities. It gave this marginalised group a voice through photographs, and formed an excellent way of disseminating the findings of this study to the stakeholders involved.

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