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Hurenko O, Suchikova Y, Kravchenko N, Nesterenko M, Petryk K. Employment of young people with disabilities: The potential of social partnership of universities, municipalities and the labor market of Ukraine. Work 2024:WOR230351. [PMID: 38848151 DOI: 10.3233/wor-230351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND This study analyzed the existing global experience of university and labor market partnerships concerning the employment of youth with disabilities. It was found that current cooperation models are implemented locally, in a fragmented manner, and are limited to interactions between universities and large enterprises. OBJECTIVE The research aimed to explore the current state of meeting the needs of students with disabilities in terms of providing educational services and employment opportunities and to analyze the interaction between universities, municipalities, and the labor market to improve employment opportunities for young people with disabilities. METHODS The study considered a survey of three target groups from different regions of Ukraine (105 students with disabilities, 321 university faculty members, and 102 enterprise managers) conducted to study the current state of needs satisfaction in providing educational services and employing people with disabilities. RESULTS The findings indicated a lack of coordination among stakeholders, an absence of systematization, and organization in addressing the issue of improving the employment of youth with disabilities. The research enabled the identification of existing and desired connections between the subjects of social partnership. A social partnership model between universities, municipalities, and the labor market was developed to improve the employment of youth with disabilities. CONCLUSION The study results are promising, as implementing the social partnership model will broadly impact society.
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Affiliation(s)
- Olha Hurenko
- Berdyansk State Pedagogical University, Zaporizhzhia, Ukraine
| | - Yana Suchikova
- Berdyansk State Pedagogical University, Zaporizhzhia, Ukraine
| | | | | | - Kristina Petryk
- Berdyansk State Pedagogical University, Zaporizhzhia, Ukraine
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Chami S, Babaee T, Jalali M, Saeedi H, Kamali M. Lived experience of children and adolescents with lower-limb loss who used a prosthesis: A qualitative study. Prosthet Orthot Int 2024; 48:320-328. [PMID: 38018993 DOI: 10.1097/pxr.0000000000000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/28/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE Children's and adolescents' level of activity, the type of activity, and other features are special to them and can result in unique experiences with lower-limb prosthesis. The specific objective of this study was to explore the lived experience of children and adolescents with lower-limb loss (LLL) who used a prosthesis. METHODS We used a descriptive qualitative study design and in-depth, semistructured, face-to-face interviews. Accordingly, 35 participants, including children and adolescents with LLL who used a prosthesis, their parents, and prosthetists, were interviewed. The collected data were analyzed thematically. RESULTS One hundred sixty-eight codes about the experiences of children, parent(s), and prosthetists were extracted from the transcripts and categorized into 32 subthemes. Finally, 7 broad themes including suitability, provoke reactions, intrinsic nature, infrastructures, the school, availability, and parenting role were extracted. CONCLUSION The experiences of children and adolescents with lower-limb prosthesis are specific as each may face unique challenges and deal with different difficulties. In this study that has been conducted in a developing country, the main challenges faced by children using lower-limb prosthesis and their parents are the prosthetic components, social reactions, long distance, and costs of services. Moreover, designing a more natural prosthesis and gait training for children with LLL were the most important issues faced by prosthetists. However, close relationships with friends and family members, and children's amazing ability to adapt can aid in facilitating prosthetic management.
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Affiliation(s)
- Sara Chami
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Auckland Bioengineering Institute, The University of Auckland, Auckland, Auckland, New Zealand
| | - Taher Babaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Jalali
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Saeedi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamali
- Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Dordunu R, Adjei CA, Kyei JM, Ani-Amponsah M. Experiences of persons with lower limb amputation after prosthetic rehabilitation in Ghana: A qualitative inquiry. Prosthet Orthot Int 2024; 48:329-336. [PMID: 37615618 DOI: 10.1097/pxr.0000000000000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/09/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Lower limb amputations (LLAs) have long been associated with physical, social, and psychological consequences. Individuals with LLAs have challenges with mobility and often become isolated from their social networks. Disability rehabilitation technologies such as prosthetic devices are used to improve the mobility capabilities of lower limb amputees. To improve clinical outcomes, feedback from the prosthetic users is a key element to consider. OBJECTIVES The study sort to explore the experiences of lower-limb prosthetic users after prosthetic rehabilitation in a prosthetic and orthotic rehabilitation center in the Eastern Region of Ghana. STUDY DESIGN This study adopted an exploratory descriptive qualitative study design. METHODS A purposive sampling technique and semistructured interview guide was used to interview 17 participants by the first author. The social model of disability underpinned the study. Lower-limb prosthetic users (≥18 years) with unilateral LLA attending outpatient follow-up at a prosthetic and orthotic rehabilitation center were recruited. The interviews were audio recoded, transcribed verbatim, and analyzed using the procedure for thematic content analysis by Braun and Clarke (2013). RESULTS Participants reported injuries and tingling in their residual limb. Internal stigma resulting from negative comments and labeling from the public were reported. Prosthetic users experienced empathy and being treated as weaklings by their family/peers. Participants avoided relationships because of recurrent rejection, embarrassment, fear of sexual abuse, and exploitation. As a coping method, some participants chose to isolate themselves to avoid humiliation and public disgrace. Other coping mechanisms included watching television, listening to music, conversing with others, ignoring criticism, and having faith in God. CONCLUSION Participants' narrative in this study gave insight into the varied lived experiences on the individual level, family/peer level, and the coping mechanisms used. Challenges relating to discomfort from the prosthesis, internal stigma, relationship avoidance, and altered sexual life should be given much attention and used in implementing initiatives to improve clinical outcomes.
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Affiliation(s)
- Rebecca Dordunu
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Charles Ampong Adjei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Josephine Mpomaa Kyei
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Mary Ani-Amponsah
- Department of Maternal and Child, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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Sayeed MSI, Oakman J, Stuckey R. Factors influencing access to and participation in rehabilitation for people with lower limb amputation in East, South, and Southeast Asian developing countries: the perspective of rehabilitation professionals - a qualitative study. Disabil Rehabil 2024; 46:2097-2116. [PMID: 37272783 DOI: 10.1080/09638288.2023.2217383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To identify barriers and enablers for access to and participation in rehabilitation for people with LLA in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. MATERIAL AND METHODS A mixed-method study involving an anonymous cross-sectional screening survey followed by in-depth interviews of rehabilitation professionals in these regions following the COREQ guidelines. Participants were surveyed online using convenience and snowball sampling techniques to inform a purposive heterogenic sample for semi-structured online interviews, between September 2021 to February 2022. Interview transcripts were analysed and thematically coded using the modified Health Care Delivery System Approach (HCDSA) framework. RESULTS A total of 201 quantitative survey responses shaped the interview questions and participation of 28 participants from 13 countries for the qualitative investigation. Important factors at the patient level were sex, economics, health issues, language differences, and lack of awareness; at the care team level, peer and/or family support, referrals, and the gender of the professional; at the organizational level, service availability, resources, and quality; and at the environmental level, policies, supports, and physical and/or social accessibility. CONCLUSIONS Identified interlinked factors at multiple levels of the HCDSA underpin the need for a systems approach to develop and address regional rehabilitation service provision but requires contextually adapted policy.
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Affiliation(s)
- Md Shapin Ibne Sayeed
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
| | - Jodi Oakman
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
| | - Rwth Stuckey
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
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Ngarambe R, Sagahutu JB, Nuhu A, Tumusiime DK. Functioning among persons with lower limb amputation with or without prostheses in Rwanda. Afr J Disabil 2023; 12:1193. [PMID: 37928627 PMCID: PMC10623480 DOI: 10.4102/ajod.v12i0.1193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background Limb loss limits functioning and restricts participation in various environments. Persons with lower limb amputations (PLLA) experience challenges ranging from self-care and independence to psychological disorders that negatively impact their functioning. Objectives To assess the functioning and the level of disability of PLLA with or without prostheses in Rwanda. Method A descriptive, cross-sectional study was conducted among PLLAs aged 18 years and above in 10 districts of Rwanda. A total of 247 participants were purposively selected to fill the questionnaires. Descriptive and inferential statistics using t-test and binary logistic regression were performed to analyse data using Statistical Package for Social Sciences (SPSS) (version 21.0). Results Out of 247 PLLA, 99 (40.1%) had prostheses and remaining 148 (59.9%) did not. Majority of PLLA without prostheses reported having more difficulties in mobility (s.d. 3.98), participation (s.d. 5.18) and life activities (s.d. 3.87). The majority of PLLA reported mild and moderate functioning in the domains of cognitive (odds ratio [OR] 8.842, 5.384 with 95% confidence interval [CI]) mobility (OR 16.154, 2.485 with 95% CI) and participation (OR 13.299, 15.282 with 95% CI). Conclusion Persons without prostheses demonstrated reduced level of functioning and high levels of disability compared to those with prostheses in all domains. However, the mobility, self-activities and the participation domains were the mainly affected. Contribution The study helps to understand the needs of the PLLA and emphasises that not only having prostheses can improve functioning but also emphasises the psychosocial aspects to reduce disability.
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Affiliation(s)
- Robert Ngarambe
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Rehabilitation, Centre of Excellence in Biomedical Engineering and e-health, University of Rwanda, Kigali, Rwanda
| | - Jean Baptiste Sagahutu
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Assuman Nuhu
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - David K Tumusiime
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Rehabilitation, Centre of Excellence in Biomedical Engineering and e-health, University of Rwanda, Kigali, Rwanda
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Sayeed MSI, Oakman J, Stuckey R. Rehabilitation professionals' perspectives of factors influencing return to occupation for people with lower limb amputation in East, South, and Southeast Asian developing countries: A qualitative study. Front Public Health 2023; 11:1039279. [PMID: 36935721 PMCID: PMC10018026 DOI: 10.3389/fpubh.2023.1039279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
Objective To identify barriers and enablers for return to occupation (RTO) for people with lower limb amputation (LLA) in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. Methods A convenience sample of rehabilitation professionals working in Asian developing countries participated in online in-depth interviews between September 2021 and February 2022. Interview transcripts were analyzed and thematically coded to the modified Health Care Delivery System Approach (HCDSA) framework. COREQ guidelines were followed. Results Twenty-eight interviewees from 13 countries shared their experiences of factors related to RTO for people with LLA. Identified factors described barriers and facilitators for RTO at all four HCDSA framework levels. The "environmental" level had the most identified factors (n = 56) and the "care team" level the least (n = 31). Common environmental RTO challenges included cultural attitudes to women; lack of rural/remote services; inadequate numbers and regulation of rehabilitation professionals; inappropriate prosthesis; limited government support for rehabilitation, and reliance on charitable models. Conclusions Despite varied cultural, religious, and geographical characteristics, consistent factors impacting RTO were identified within these thirteen countries. Identified barriers to RTO underline the need for improvements throughout service systems from the acute-care focus on saving life without consideration of RTO, the rehabilitation focused primarily on mobility, to the lack of occupational rehabilitation services and supporting policy in these countries. These interlinked factors at different levels of healthcare service systems reinforce the importance of systems approaches to best utilize limited resources toward improving RTO in this region.
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Bosman CE, van der Sluis CK, Geertzen JHB, Kerver N, Vrieling AH. User-relevant factors influencing the prosthesis use of persons with a transfemoral amputation or knee-disarticulation: A meta-synthesis of qualitative literature and focus group results. PLoS One 2023; 18:e0276874. [PMID: 36649233 PMCID: PMC9844830 DOI: 10.1371/journal.pone.0276874] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/17/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Persons with a transfemoral amputation or knee-disarticulation are heavily reliant on an adequate set of components for their prosthesis. To improve the process of adjusting the specific prosthetic properties to the expectations of the prosthesis users, it is of importance to first identify which factors have an influence on prosthesis use. Therefore, we aimed to identify factors that influence prosthesis use in adults with a transfemoral amputation or knee-disarticulation. METHODS A qualitative meta-synthesis was conducted by searching five databases (last update January 20th 2022). Studies were considered eligible if they contained qualitative data about adult persons with a transfemoral amputation or knee-disarticulation with experience in using a prosthesis and focused on the users' opinions. All eligible studies were independently screened by two reviewers. The results sections of the included studies were entered in Atlas.ti software (v8) and coded using the framework approach. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) qualitative research checklist. Results of the meta-synthesis were validated with prosthesis users (n = 8) in a focus group. RESULTS Out of 5757 articles, 14 studies were included. An overview of seven themes ('prosthesis related'; 'rehabilitation, costs and prosthetist'; 'mental'; 'physical'; 'social'; 'activities and participation' and 'walking') containing 84 factors was created. Ten factors were added during the focus group, resulting in an overview of 94 factors that may influence the prosthesis use of lower-limb prosthesis users. Participants would like more user-involvement from the rehabilitation team. The development of a patient decision aid could help this process in the future. CONCLUSION The large number of factors demonstrates that there is a great variety between prosthesis users and the factors that influence their prosthesis use. Therefore, it is important to take individual preferences into account for the selection of a new prosthesis.
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Affiliation(s)
- Charlotte E. Bosman
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Corry K. van der Sluis
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan H. B. Geertzen
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nienke Kerver
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aline H. Vrieling
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Ngarambe R, Sagahutu JB, Nuhu A, Tumusiime DK. The status and use of prosthetic devices by persons with lower limb amputation in Rwanda. Afr J Disabil 2022; 11:1081. [PMID: 36567927 PMCID: PMC9772723 DOI: 10.4102/ajod.v11i0.1081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/12/2022] [Indexed: 12/23/2022] Open
Abstract
Background Amputation is one of the leading causes of disabilities because of reduced mobility. Without assistive devices specifically prostheses, the quality of life of persons with lower limb amputation (PLLA) further deteriorates. Therefore, prostheses are fundamental to improving their quality of life. Objectives This study aimed to establish the number of PLLA with or without prosthesis and to determine their socio-economic profile in Rwanda. Method A descriptive, cross-sectional study was conducted in all sectors of Rwanda. As a result of coronavirus disease 2019 movement restrictions, data collection was carried out through telephone calls with participants to complete the questionnaires. Descriptive, inferential statistics and chi-square test were performed to analyse data using Statistical Package for Social Science (SPSS) 21.0. Results Of the 3026 participants identified countrywide, 68.8% were males and 60.3% of them did not have any prosthesis (p = 0.003). The majority (62.4%) of those who had prosthetic devices needed repair of their prostheses while 14.8% of participants reported that their prosthetic devices were completely broken and/or damaged (p = 0.604). Among the participants, 63.7% had no source of income and 66.7% had dependents (p ≤ 0.001). Conclusion The majority of the PLLA in Rwanda did not have prosthetic devices and even those with prostheses did not fully function and thus required repair. Therefore, it adversely affects their livelihood. Contribution The government should collaborate with stakeholders working with persons with disabilities and implement mechanisms and/or strategies to make prosthetic devices accessible and affordable.
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Affiliation(s)
- Robert Ngarambe
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Baptiste Sagahutu
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Assuman Nuhu
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - David K. Tumusiime
- Department of Physiotherapy, Faculty of Health Sciences, University of Rwanda, Kigali, Rwanda,Department of Rehabilitation, The Regional Centre of Excellence in Biomedical Engineering and eHealth, University of Rwanda, Kigali, Rwanda
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Sayeed MSI, Oakman J, Dillon MP, Stuckey R. Influential factors for access to and participation in rehabilitation for people with lower limb amputation in East, South, and Southeast Asian developing countries: a scoping review. Disabil Rehabil 2022; 44:8094-8109. [PMID: 34719308 DOI: 10.1080/09638288.2021.1994025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE To explore factors impacting access to and participation in rehabilitation for people with lower limb amputation (LLA) in East, South, and Southeast Asian developing countries. MATERIALS AND METHODS A scoping review was undertaken following the PRISMA-ScR guidelines. Five electronic databases (PsycINFO (Ovid), Medline (Ovid), CINAHL (EBSCO), AMED, and Proquest Social Sciences) were searched for articles from January 1980 till March 2020. Two authors independently assessed articles for inclusion. Included articles were classified according to the Health Care Delivery System Approach (HCDSA) framework levels. RESULTS Twenty-four studies from 14 countries were identified. At patient level, age, gender, limited rehabilitation awareness, and economic status; at the rehabilitation level, gaps in referrals, family support, and professional skills; at the environmental level, services availability, and location; and, at government level, service costs, income loss, and lack of supporting policies were identified as important influencing factors. CONCLUSIONS Rehabilitation access and participation factors were identified at multiple levels of the HCDSA. Contextually appropriate and accessible services considering individual characteristics and socio-economic status of individuals with LLA are needed, with timely referral to rehabilitation by trained professionals. Improving rehabilitation services for people with LLA in Asian developing countries requires supportive environments, accessible transport, social and financial security, and increased awareness, underpinned by appropriate policy.Implications for rehabilitationProvision of timely referral to rehabilitation by primary/acute health care settings with involvement of family/peer supports.Improved government support systems to facilitate individual access to and participation in rehabilitation with consideration of contextual socio-demographic and economic factors.Prioritisation of adequately resourced and well-designed rehabilitation centres by health care organisations in accessible locations.Implementation by local government of strategies to support development and implementation of well resourced, accessible, equitable, and contextually responsive rehabilitation services.
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Affiliation(s)
- Md Shapin Ibne Sayeed
- Department of Public Health, Ergonomics, Safety and Health, La Trobe University, Melbourne, Australia
| | - Jodi Oakman
- Department of Public Health, Ergonomics, Safety and Health, La Trobe University, Melbourne, Australia
| | - Michael P Dillon
- Department of Physiotherapy, Podiatry, Prosthetics & Orthotics, La Trobe University, Melbourne, Australia
| | - Rwth Stuckey
- Department of Public Health, Ergonomics, Safety and Health, La Trobe University, Melbourne, Australia
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Rakbangboon T, Guerra G, Kla-arsa S, Padungjaroen U, Tangpornprasert P, Virulsri C, Sasaki K. High-Level Mobility of Trans-Tibial Prosthesis Users Wearing Commercial and sPace Energy-Storing Prosthetic Feet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12606. [PMID: 36231917 PMCID: PMC9566704 DOI: 10.3390/ijerph191912606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Outcomes of users provided with a commercial ESR Vari-Flex foot (Össur, Reykjavik, Iceland) and a locally designed sPace foot were investigated. Step activity with users' own prosthetic foot compared to the sPace foot was explored. METHODS Eleven individuals with unilateral trans-tibial amputation participated and were provided with an sPace and Vari-Flex foot. Ten- and twenty-meter walk tests (10/20MWT) at comfortable and fast walking speeds (CWS/FWS), the two-minute walk test (2-MWT) and Comprehensive High-Level Activity Mobility Predictor (CHAMP) were administered. A subgroup was provided a pedometer to record their steps over a 7-day period in their own foot and later the sPace. RESULTS The sPace foot performed well in a battery of high-level mobility outcome measures. On CHAMP, participants scored 16.94 ± 5.41 and 16.72 ± 6.09 with the sPace and Vari-Flex feet, respectively. Subgroup testing of step activity showed 4490 ± 3444 steps in users' own feet and 3115 ± 1967 in the sPace foot, p = 0.176. CONCLUSIONS Participants using the sPace foot were capable of performing walking, high-level mobility and activity outcome measures.
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Affiliation(s)
- Thanyaporn Rakbangboon
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Gary Guerra
- Department of Exercise and Sport Science, St. Mary’s University, San Antonio, TX 78228, USA
| | - Saloottra Kla-arsa
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Uthumporn Padungjaroen
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pairat Tangpornprasert
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chanyaphan Virulsri
- Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kazuhiko Sasaki
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Barbareschi G, Teerlink W, Njuguna JG, Musungu P, Kirino MD, Holloway C. Evaluating the use of a thermoplastic socket in Kenya: A pilot study. Prosthet Orthot Int 2022; 46:532-537. [PMID: 35333813 PMCID: PMC9554758 DOI: 10.1097/pxr.0000000000000130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 01/30/2022] [Accepted: 02/15/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many people with amputations who live in low-resourced settings struggle to access the workshops where qualified prosthetists provide appropriate care. Novel technologies such as the thermoplastic Confidence Socket are emerging, which could help facilitate easier access to prosthetic services. OBJECTIVES The objective of this study was to evaluate the satisfaction and the performance of transtibial prosthesis featuring the Confidence Socket. STUDY DESIGN This is a longitudinal repeated-measures design study. METHODS A convenience sample of 26 participants who underwent transtibial amputation were fitted with the Confidence Socket. The performance of the socket was evaluated after a follow-up period between 1 month and 6 months using the L test of functional mobility and the amputee mobility predictor. Satisfaction with the prosthesis was measured using the Trinity Amputation and Prosthetic Experience Scales and purposefully designed 7-point Likert scales. RESULTS Ten of the 26 participants returned for follow-up. Perceived activity restriction and L test times improved significantly at follow-up, but the self-reported satisfaction with the Confidence Socket was lower at follow-up compared with that after fitting. CONCLUSIONS The Amparo Confidence Socket represents a potentially viable alternative to improve access to appropriate prosthesis in Kenya, but some aspects of users' self-reported satisfaction should be further investigated.
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Affiliation(s)
| | | | | | | | - Mary Dama Kirino
- Association for the Physically Disabled of Kenya, Mombasa, Kenya
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Jerwanska V, Kebbie I, Magnusson L. Coordination of health and rehabilitation services for person with disabilities in Sierra Leone – a stakeholders’ perspective. Disabil Rehabil 2022; 45:1796-1804. [DOI: 10.1080/09638288.2022.2074551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Victoria Jerwanska
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ismaila Kebbie
- National Rehabilitation Centre, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Lina Magnusson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Morgado Ramirez DZ, Nakandi B, Ssekitoleko R, Ackers L, Mwaka E, Kenney L, Holloway C, Donovan-Hall M. The lived experience of people with upper limb absence living in Uganda: A qualitative study. Afr J Disabil 2022; 11:890. [PMID: 35747758 PMCID: PMC9210140 DOI: 10.4102/ajod.v11i0.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 01/19/2022] [Indexed: 11/08/2022] Open
Abstract
Background The impact of upper limb absence on people's lived experiences is understudied, particularly in African countries, with implications for policy and service design. Objectives The objective of this study was to explore the lived experiences of people with upper limb absence (PWULA) living in Uganda. Method Informed by preliminary work, we designed a qualitative study employing semi-structured interviews to understand the experience of living with upper limb absence in Uganda. Seventeen adults with upper limb absence were individually interviewed and their interviews were analysed utilising thematic analysis. Results Seven themes illustrating the impact on the individual's life after amputation were identified and categorised into (1) living and adapting to life, (2) productivity and participation and (3) living within the wider environment. This study presents three main findings: (1) PWULA need psychological and occupational support services which are not available in Uganda, (2) PWULA want to work, but face multiple barriers to employment and has limited support, combined with the complex parenting and caring responsibilities, (3) the local Ugandan culture and social structures affect the everyday life of PWULA, both in positive and negative ways. Conclusion This study provides information on the lived experiences of PWULA in Uganda which are lacking in the literature. People with upper limb absence face ableism and hardship underpinned by a lack of formal support structures and policies, which may in turn exacerbate the impact of upper limb absence on multiple facets of life.
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Affiliation(s)
- Dafne Zuleima Morgado Ramirez
- Interaction Centre, Department of Computer Science, Faculty of Engineering, University College London, London, United Kingdom
- Global Disability Innovation Hub, London, United Kingdom
| | - Brenda Nakandi
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Robert Ssekitoleko
- Biomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Louise Ackers
- School of Health and Society, University of Salford, Salford, United Kingdom
| | - Erisa Mwaka
- Department of Anatomy, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Laurence Kenney
- Centre for Health Sciences Research, University of Salford, Salford, United Kingdom
| | - Cathy Holloway
- Interaction Centre, Department of Computer Science, Faculty of Engineering, University College London, London, United Kingdom
- Global Disability Innovation Hub, London, United Kingdom
| | - Maggie Donovan-Hall
- School of Health Sciences, Faculty of Life and Environmental Sciences, University of Southampton, Southampton, United Kingdom
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van Zyl C, Badenhorst M, Hanekom S, Heine M. Unravelling 'low-resource settings': a systematic scoping review with qualitative content analysis. BMJ Glob Health 2021; 6:e005190. [PMID: 34083239 PMCID: PMC8183220 DOI: 10.1136/bmjgh-2021-005190] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as 'low-to-middle-income countries' or 'developing countries', are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings. METHODS A systematic scoping review was undertaken to start unravelling the term 'low-resource setting'. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to 'low-resource setting' and 'rehabilitation'. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used. RESULTS A total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term 'low-resource setting'. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices. CONCLUSION The emerging themes may assist with (1) the groundwork needed to unravel 'low-resource settings' in health-related research, (2) moving away from assumptive umbrella terms like 'low-to-middle-income countries' or 'low/middle-income countries' and (3) promoting effective knowledge transfer between settings.
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Affiliation(s)
- Chanel van Zyl
- Division of Physiotherapy, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Marelise Badenhorst
- Institute of Sport and Exercise Medicine, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Susan Hanekom
- Division of Physiotherapy, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Martin Heine
- Institute of Sport and Exercise Medicine, Stellenbosch University, Faculty of Medicine and Health Sciences, Cape Town, South Africa
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Hashemi G, Wickenden M, Bright T, Kuper H. Barriers to accessing primary healthcare services for people with disabilities in low and middle-income countries, a Meta-synthesis of qualitative studies. Disabil Rehabil 2020; 44:1207-1220. [PMID: 32956610 DOI: 10.1080/09638288.2020.1817984] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
METHODS Six electronic databases were searched for relevant studies from 2000 to 2019. Forty-one eligible studies were identified. RESULTS Findings suggest that the people with disabilities' choice to seek healthcare services or not, as well as the quality of intervention provided by primary healthcare providers, are influenced by three types of barriers: cultural beliefs or attitudinal barriers, informational barriers, and practical or logistical barriers. CONCLUSION In order to achieve full health coverage at acceptable quality for people with disabilities, it is necessary not only to consider the different barriers, but also their combined effect on people with disabilities and their households. It is only then that more nuanced and effective interventions to improve access to primary healthcare, systematically addressing barriers, can be designed and implemented.IMPLICATIONS FOR REHABILITATIONPeople with disabilities in both high income and low- and middle-income country settings are more likely to experience poorer general health than people without disabilities.Barriers to accessing primary healthcare services for people with disabilities result from a complex and dynamic interacting system between attitudinal and belief system barriers, informational barriers, and practical and logistical barriers.Given primary healthcare is often the initial point of contact for referral to specialty care and rehabilitation services, it is crucial for people with disabilities to access primary healthcare services in order to get appropriate referrals for such services, specifically rehabilitation as appropriate.To achieve full health coverage at acceptable quality for people with disabilities, starting with primary healthcare, it is necessary for healthcare stakeholders, including rehabilitation professionals, to consider the combined and cumulative effects of the various barriers to healthcare on people with disabilities and their families and develop an understanding of how healthcare decisions are made by people with disabilities at the personal and the household level.
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Affiliation(s)
- Goli Hashemi
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK.,Department of Occupational Therapy, Samuel Merritt University, Oakland, CA, USA
| | - Mary Wickenden
- Institute of Development Studies, University of Sussex, Brighton, UK
| | - Tess Bright
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
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Pienaar E, Visagie S. Prosthetic use by persons with unilateral transfemoral amputation in a South African setting. Prosthet Orthot Int 2019; 43:276-283. [PMID: 30730264 DOI: 10.1177/0309364619825891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Due to limitations in provision of prosthetic care in South Africa, a screening tool to select transfemoral prosthetic candidates has been implemented. OBJECTIVE To describe prosthetic services, use and mobility of people with transfemoral amputation, identified as prosthetic candidates through the Guidelines for Screening of Prosthetic Candidates: Lower Limb, and to identify variables that might influence prosthetic use and mobility. DESIGN Cross-sectional survey. METHODS The study population included all adults who received their first prosthesis from the Orthotic and Prosthetic Centre in the Western Cape between 1 June 2011 and 31 December 2014. Data were collected, with an adapted version of the Prosthetic Profile of the Amputee, from 43 participants, through telephonic interviews. Descriptive and inferential analysis, with the chi-square test, was done. RESULTS The majority of participants were older than 50 years (77%). Most participants (35; 81%) used their prosthesis; however, only 42% (18) used it daily. A significant association ( p = 0.000) was found between prosthetic rehabilitation and self-reported prosthetic walking distance. Less than half of participants received prosthetic rehabilitation and only 10 (30%) could walk 500 steps and more without resting. CONCLUSION Participants used their prosthetic leg, but experienced limitations in frequency of wear and mobility. CLINICAL RELEVANCE Current findings showed that participants' prosthetic mobility was curtailed. In less-resourced settings, carefully selecting prosthetic candidates may be necessary to provide access to services. Prosthetic provision is advised to be followed up with prosthetic rehabilitation for favourable mobility outcomes.
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Affiliation(s)
- Elzbeth Pienaar
- 1 Western Cape Rehabilitation Centre, Western Cape Department of Health, Cape Town, South Africa
| | - Surona Visagie
- 2 Centre for Rehabilitation Studies, Stellenbosch University, Cape Town, South Africa
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Dassah E, Aldersey H, McColl MA, Davison C. Factors affecting access to primary health care services for persons with disabilities in rural areas: a "best-fit" framework synthesis. Glob Health Res Policy 2018; 3:36. [PMID: 30603678 PMCID: PMC6305566 DOI: 10.1186/s41256-018-0091-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022] Open
Abstract
Background Access to primary health care (PHC) is a fundamental human right and central in the performance of health care systems, however persons with disabilities (PWDs) generally experience greater barriers in accessing PHC than the general population. These problems are further exacerbated for those with disabilities in rural areas. Understanding PHC access for PWDs is particularly important as such knowledge can inform policies, clinical practice and future research in rural settings. Methods We conducted a synthesis of published literature to explore the factors affecting access to PHC for PWDs in rural areas globally. Using an adapted keyword search string we searched five databases (CINAHL, EMBASE, Global Health, Medline and Web of Science), key journals and the reference lists of included articles. We imported the articles into NVivo and conducted deductive (framework) analysis by charting the data into a rural PHC access framework. We subsequently conducted inductive (thematic) analysis. Results We identified 36 studies that met our inclusion criteria. A majority (n = 26) of the studies were conducted in low-and middle-income countries. We found that PWDs were unable to access PHC due to obstacles including the interplay of four major factors; availability, acceptability, geography and affordability. In particular, limited availability of health care facilities and services and perceived low quality of care meant that those in need of health care services frequently had to travel for care. The barrier of geographic distance was worsened by transportation problems. We also observed that where health services were available most people could not afford the cost. Conclusion Our synthesis noted that modifying the access framework to incorporate relationships among the barriers might help better conceptualize PHC access challenges and opportunities in rural settings. We also made recommendations for policy development, practice consideration and future research that could lead to more equitable access to health care. Importantly, there is the need for health policies that aim address rural health problems to consider all the dimensions and their interactions. In terms of practice, the review also highlights the need to provide in-service training to health care providers on how to enhance their communication skills with PWDs. Future research should focus on exploring access in geographical contexts with different health care systems, the perspectives of health care providers and how PWDs respond to access problems in rural settings. Electronic supplementary material The online version of this article (10.1186/s41256-018-0091-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ebenezer Dassah
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Heather Aldersey
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Mary Ann McColl
- 1School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Colleen Davison
- 2Department of Public Health Sciences, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane, Kingston, Ontario K7L 3N6 Canada
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