Levels of community integration achieved by adults with disabilities post discharge from a specialised in-patient rehabilitation unit in the Western Cape

[摘要] ENGLISH ABSTRACT: Background: Community integration is one of the most important outcomes of rehabilitation.Rehabilitation services should strive to optimise community integration of persons withdisabilities through the processes of functional restoration, prevention of secondarycomplications, provision of assistive devices and/or environmental modification. Studiesconducted in South Africa show that rehabilitation services in the country often do notachieve community integration of persons with disabilities. The need to quantify the levels ofcommunity integration of persons with disabilities who received in-patient rehabilitation wasidentified.Aim: To determine the levels of community integration of adults with disabilities postdischarge from a specialised in-patient rehabilitation unit in the Western Cape Province.Methods: A quantitative, cross-sectional, descriptive study design was used. Individualsdischarged from the rehabilitation centre between 1 September 2012 and 30 November2012, who met the inclusion criteria, made up the study sample. Fifty-nine individualsparticipated in the study. A demographic and medical data sheet was used to gatherinformation from the participants' medical folders. Levels of community integration weredetermined with the Reintegration to Normal Living Index (RNLI).Descriptive statistics on the variables age, gender and medical diagnosis as well as scoresof the various RNLI domains, subscales and the overall RNLI score are presented in graphsand tables. To determine if a relationship existed between the variables age, gender andmedical diagnosis and levels of community integration, interferential tests (t-test andKraskal-Wallis tests) were applied. A P-value of <0.05 was observed as statisticallysignificant.Results: Fifty-four percent of study participants were women. Participant's median age was43 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 interquartilerange of 53.24 and 87.50. The RNLI items personal relationships and presentation of selfrecordedthe highest median scores (88.89). The RNLI items work and related activitiesscored the lowest median score of 55.56. Home mobility, community mobility, travel out oftown and recreational activities also had median scores below 70.No statistically significant differences could be found when examining the relationshipsbetween the variables age, gender and medical diagnosis and the domains, subscales andthe overall RNLI scores.Conclusion: The results of this study show that persons with disabilities, who received inpatientrehabilitation and were discharged into their home and community environments,achieve lower overall RNLI scores than persons with disabilities living in well-resourcedcountries such as the United States of America (USA) and Canada. Rehabilitationprofessionals may need to adjust rehabilitation programmes offered to improve communityintegration outcomes of clients. Low levels of integration in areas such as communitymobility, and participation in social and meaningful work activities might be an indication thatpersons with disabilities still face many barriers in the communities. Persons who suffered atraumatic brain injury or a cerebrovascular accident (CVA) achieved lower levels ofcommunity integration in comparison to persons who suffered a SCI or have an impairmentof the peripheral neural/muscular system(s).

[发布机构] Stellenbosch University