Masters of Science - Msc (Physiotherapy) / People with disabilities face many challenges. Some are made to feel inferior by others because of their physical or mental disabilities. Primary healthcare described by the Alma Ata Declaration as "health for all", is a process of care which encompasses a comprehensive approach to meet the basic healthcare needs of all, including people with disabilities. The main focus of the primary healthcare approach is to put people at the centre of healthcare. Primary healthcare utilises rehabilitation as a service. Rehabilitation services worldwide are set to improve the standard that the United Nations Convention of the Rights of People with Disabilities and National Committee of Rights People with Disabilities aims to achieve. There are however, gaps in the delivery of healthcare services at a primary level, as identified by the Western Cape Department of Health in South Africa. The 2030 healthcare plan was developed to fill the gaps at this level of service. The plan builds on the comprehensive service plan of healthcare 2010 which aimed to strengthen community-based services, primary healthcare and district hospitals. The plan also looks at how the Department of Health will operate using this platform. The framework was established to focus on changes inclusive of threats in the environment such as technological advances and the availability of resources, building on lessons learned in the Comprehensive Service Plan 2010 as well as a reimagined future to improve healthcare services for all. Key stakeholders in the Western Cape aim to improve these health services by providing patientcentred care, moving towards a goal orientated outcome, improving services at a district health level, improvement of equity, affordable health services and establishing premeditated partnerships.

The Michelle P. Waiver (MPW) is the primary means of health insurance for more than 10,000 people in the state of Kentucky. The waiver is especially popular among families with young children with disabilities because it is robust in its benefit offerings and also one of the few Medicaid resources that does not include parental income as a qualifying factor in eligibility. Through the waiver, children receive a medical card as well as additional coverage for medical expenses that fall beyond the scope of traditional health insurance. For these young children to gain access to the comprehensive offerings of the MPW, their parents must apply for the waiver, negotiate the terms of service, and make critical health care decisions on their behalf, or at least until they reach adulthood—although this responsibility often extends throughout the child’s life. The present study builds upon recent research on parental uncertainty in caregiving for children with complex care needs. By combining two ecological approaches to health communication research, Brashers’s (2001) uncertainty management theory (UMT) and Ball-Rokeach, Kim, and Matai’s (2001) communication infrastructure theory (CIT), my aim in this dissertation was to explain how meso-level (e.g., community organization) interactions influenced parental caregivers’ experiences of uncertainty. I collected data through narrative interviews with 31 parents of children who are currently receiving services through the MPW and analyzed them using narrative thematic analysis. The analysis focused on the community-level communication that contributes to parent caregivers’ ability to successfully access and negotiate care within the MPW system. Findings show that parents experience unique personal, social, and medical uncertainties related to the MPW. In addition, the findings demonstrate that MPW-related uncertainty and decision making are managed with a variety of strategies aimed to decrease, increase, or maintain desired levels of uncertainty. Finally, findings showcase how one’s connectedness to community storytelling at the meso level, particularly within online communities and disability network communities supports their adaptive management of MPW-related uncertainty. This project contributes to the health communication literature theoretically by (a) expanding the conceptualization of the uncertainty in illness framework to include the means of health care (i.e., Medicaid) as a consequential element of an individual’s illness experience, (b) identifying two additional strategies of uncertainty management (i.e. advocacy and vigilance), and by (c) extending existing notions of residency, connectedness, and belongingness within the CIT framework to include membership in online and disability-specific networks. Practically, this project offers important insights that can guide future research exploring the role of meso-level communication in parent caregivers’ management of waiver-based care, such as in identifying the need for a systematic communication process that introduces potentially eligible families to the MPW.

For my thesis I have chosen the theme of the importance and possibilities of a teacher assistant in school integration of children with disabilities. The research was conducted in the district of Český Krumlov. There are currently 20 basic schools and 26 kindergartens of which eight basic schools and two kindergartens have integrated pupils with disabilities. My two hypotheses are based on the fact that teacher assistants are the ones who, in my opinion, form an indispensable part of a pedagogic team, ensuring successful and beneficial integration of disabled children into the regular type of schools and school facilities and affecting the process of integration (hypothesis 1). Moreover, I believe that the competencies of two different professional groups, being teacher assistants and personal assistants, are often confused and neither professionals nor the lay public are able to clearly distinguish between their functions (hypothesis 2). In order to obtain information in respect of the set out issues, the method of interviews in the form of questionnaires was used. The questionnaire was designed for directors and teachers of basic schools and kindergartens integrating pupils with disabilities and also for parents of disabled children integrated in a regular school. The processed data are displayed in graphs and tables. Both the raised hypotheses have been confirmed. It was revealed that the respondents consider a teacher assistant as an indispensable element without which the school integration would not be successful. Some of them refer to their previous experience when no teacher assistant was available. The hypothesis which assumed confusion of competencies of an assistant teacher and a personal assistant was also clearly confirmed. The research revealed that some respondents suggested an interesting idea to unify these two assistants' functions into one that would fall under one resort. By this diploma thesis I would like to contribute to the explanation of ambiguities in the competences of a teacher assistant and a personal assistant and to promote the importance of a teacher assistant in school integration of children with disabilities.

This thesis called 'Socio-Pedagogical Assistance to Partially-Autonomous Patients and to Their Families" (as conducted at GARC Kladno, s.r.o.). aims to map the health and social situation of partially-autonomous patients (hereafter PAP) as a result of a chronic condition, a disability or geriatric conditions in the context of their actual living environment. The theoretical part deals with health and social challenges confronted by PAP focusing on social and individual rehabilitation in conducting daily life. It is divided into five parts. Part One describes health issues faced by PAP with emphasis on particular issues which affect this group. Part Two defines the basic terminology of disability and autonomy.Through work experience it was possible to provide first-hand observation of particular issues which affect this group, e.g. physical disability as a factor limiting autonomy. Both subjective and objective observations of this group can weigh heavily on the value of the outcome. Part Three places PAP in his environment and at the same time evaluates the role of the family members and various services available to PAP under the Social Services Act No. 108/2008 Coll. Part Four looks into rehabilitation services available to PAP and other assistance available to them. Particular methodologies...