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This study investigated the efficacy of a "lifestyle" planning process for persons with severe disabilities. The planning process involved five steps: (a) description of a desired integrated lifestyle (pre- test), (b) identification of attitudinal, knowledge, and opportunity barriers present in an individual's service delivery system, (c) development of weekly schedules and plans that are based on an individual's personal preferences (mid- test), (d) implementation of valid teaching technologies and assessments if needed to achieve greater community participation, and (e) application of evaluative measures to monitor success (post-test). The planning process was implemented by means of a consultant model. The process involved planning meetings, on-site visits, in-service training, problem solving, written program planning, and demonstration of instructional techniques. Planning and implementation spanned approximately 12-14 months. The consulting teams were composed of education and behaviour consultants. Four persons with severe disabilities and challenging behaviour served as subjects. These individuals resided in four communities in the Province of British Columbia, and received consultative services from 1989-1991. Data were collected on three dependent measures at the beginning, midpoint, and end of intervention periods. The measures were type and frequency of integrated activities performed, program quality, and mastery of core steps of priority instructional goals in areas such as behaviour management and augmentative communication. All four persons engaged in a greater number of preferred integrated activities at the mid- and post- test than at the pre- test. The social networks of all four individuals were higher at the mid- and post- test than at the pre- test. Program quality scores were collected at the pre- and post- test only. All scores were higher at the post- test than at the pre- test. Behavioral problems reported at the referral stage were substantially reduced at the post-test for all individuals. These results are discussed in relation to previous research done in this area. Limitations of the study are identified, such as sample size, sample bias, and programmatic change that occurred outside of the planning process. Problems in implementing the process by means of a consultant model are discussed and areas for future research are suggested. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

A research report in partial fulfilment of Masters of Arts in Social and Psychological Research, School of Human and Community Development, University of Witwatersrand, 2018 / Caregiving is reported in numerous studies to have adverse effects on caregivers, including caregiver stress; mental and emotional strain; feelings of burden; and even the risk of mortality. Specifically for caregivers of adults with physical disabilities (AWPD), it is appreciated that caregiving is a life-changing experience as major modifications have to be made. These numerous changes have been reported to expedite the manifestation of stress that is differently perceived by the caregivers. Caregivers of AWPD are therefore anticipated to be at high risk of stress as this type of caregiving has been reported to be burdensome. In South Africa, researchers seem to have overlooked caregivers of adults with physical disabilities as a group that potentially have specific and unique perceptions in the role of caregiving. Most importantly the literature seemed limited in presenting how caregivers of AWPD qualify stress levels. Another paucity observed in the existing literature is that there are no accounts by caregivers on how the qualified stress levels impact on the relationship between the caregiver and care recipient. The aim of the current research was to explore perceived stress levels of caregivers of AWPDs. A second aim was to establish how caregivers of AWPD perceive stress levels to impact on the caregiver-care recipient relationship. The results highlighted that caregivers perceived stress levels to be fluctuating with time and affecting their health. According to the perspectives of the caregivers of AWPD, stress has either positive or negative impacts on the caregiver-care recipient communication, cooperation and closeness, differing amongst caregivers. / XL2018

Thesis (MCur)- -University of Stellenbosch, 2011 / ENGLISH ABSTRACT: It generally is a problem for persons with disabilities to have barrier free access to buildings, which is their constitutional right. It is however, not only the physical facility that causes barriers for persons with disabilities but also the attitudes of the able-bodied persons. The aim of the study was to explore what opinions the nurses and persons with disabilities held in two healthcare settings in Kimberley with reference to the nursing care provided to persons with disabilities. To the researcher, it was important to gather the opinions of the nursing staff on how they saw persons with disabilities, but also to hear what they thought the problem areas in caring for persons with disabilities were. On the other hand, it was equally important to understand the persons with disabilities’ perceptions of the hospitals, nursing and what they saw as solutions to the problems. The objectives of the study were: • To determine what the opinions and knowledge of nurses working in two healthcare services in Kimberley are regarding the nursing management of persons with disabilities. • To determine what the opinions of persons with disabilities are in healthcare settings in Kimberley, with reference to the nursing care provided for persons with disabilities. Data was collected in two phases namely Phase 1 amongst the nursing staff in the private and state hospital in Kimberley and Phase 2 amongst the persons with disabilities. A list of staff members which was obtained from the Human Resource office in both the private and state hospitals were sent to the statistician Prof Kidd and who prepared a randomised list which was used for the participants in the study. The same process was followed when a list of all the people who are members of the Association for Persons with Disabilities (APD) and with the help of the statistician a randomised list was compiled from which the participants in the study were chosen. The design of this research is an explorative, descriptive non-experimental study with a quantitative approach, utilizing a structured questionnaire with closed and open ended questions. In this study it was found that the nursing staff was aware of the problems and barriers persons with disabilities encounter. The nurses, however, were aware of their own shortcomings. For example, the nurses identified the lack of training to equip them to assist the persons with disabilities during nursing care, while persons with disabilities also saw this as a problem. By addressing this shortcoming, nurses would be able to provide more holistic care. Recommendations were made based on the findings regarding the facility, perceptions, caregivers, procedures, doctors and the training of the nurses. / AFRIKAANSE OPSOMMING: Om toegang te hê tot geboue wat hulle grondwetlike reg is, is vir die meeste mense met gestremdhede ‘n voortdurende stryd. Dit is egter dikwels nie net die fisiese ontoeganklikheid van die geboue wat dit vir die persone met gestremdhede onmoontlik maak om ‘n normale lewe te lei nie, maar die houding van verpleegpersoneel wat dikwels meer ontoeganklik is as die toegang tot die geboue. Die doel van die studie was om te bepaal wat die opinies die verpleegpersoneel sowel as persone met gestremdhede het ivm gesondheidsorg in die privaat en staatshospitale in Kimberley Dit was vir die navorser belangrik om te bepaal hoe die verpleegpersoneel mense met gestremdhede sien, maar ook om hulle opinies te hoor ivm die probleme wat hulle ondervind sowel as moontlike oplossings daarvoor. Aan die ander kant wou die navorser ook weet wat die opinie van mense met gestremdhede is van die hospitale wat hulle besoek. Doelwitte van die studie was: • Om die kennis van verpleegpersoneel in die staat sowel as privaathospitale te bepaal ivm die versorging van persone met gestremdhede.. • .Om die opinies van persone met gestremdhede te bepaal tov die verpleegsorg in die staat sowel as privaathospitale in Kimbelrey. Data is in twee fases versamel. In Fase 1 was die verpleegpersoneel in beide die staat sowel as die privaathospitaal ingesluit en in Fase 2 was die deelname van die persone met gestremdhede verkry. Nadat ‘n personeellys van die Menlike hullpbronafdeling van beide hospitale verkry is, is dit aan die statistikus, Prof Kidd gestuur is vir steekproefneming. .Die persone met gestremdhede is genader nadat ‘n lys van die Assosiasie vir persone met gestremdheide (APD) verkry is. Die lys is deur die statistikus herrangskik,en die personeel en persone met gestremdhede is gevra om deel te neem aan die studie na aanleiding van die orde op die lys, nadat hulle ingligting ontvang het en toestemming geteken het vir deelname aan die studie. Die studie is eksploratief, beskrywend en nie-eksperimenteel van aard met ‘n kwantitatiewe benadering. Gestruktureerde vraelyse wat oop en geslote –einde vrae bevat het, is gebruik.. In die studie is bevind dat die verpleegpersoneel bewus was van die leemtes in die versorging van persone met gestremdhede. Een van die leemtes wat geïdentifiseer is, was dat verpleegsters nie formele opleiding ontvang in die versorging van persone met gestremdhede nie. Die persone met gestremdhede het ook hierdie leemte identifiseer. Deur hierdie leemte aan te spreek behoort verpleegpersoneel ‘n meer holistiese versorging aan persone met gestremdhede te lewer. Aanbevelings wat gemaak is, is gebasseer op die bevindinge in die studie en sluit in: fasiliteitt, persepsies, versorgers, prosedures, dokters en die opleiding van verpleegsters.

University of Macau / Faculty of Social Sciences and Humanities / Department of Government and Public Administration

ABSTRACT This study focuses on the implementation strategy of free health care policy for disabled persons at hospital level in KwaZulu-Natal. Since the introduction nationally, in 2003 of free health care policy for disabled persons, no evaluation has been conducted in KwaZulu- Natal to inform health service managers and the KwaZulu-Natal Department of Health on the implementation of this policy. A provincial implementation strategy is needed for effective implementation of the policy. To date, no such provincial implementation strategy is available and the lack of an implementation strategy for this policy motivated this study. METHODS An exploratory qualitative study design was implemented to elicit information from health service providers and representatives of persons with disabilities to inform the development of an implementation strategy for the free health care policy for disabled persons at public hospitals in KwaZulu-Natal. Data was collected through interviews and focus group discussions. Data was analysed by utilising a thematic approach. RESULTS Respondents reported a variety of understandings with regard to policy context of the Free Health Care Policy for disabled persons, policy content in terms of purpose and eligibility, policy implementers and their roles in implementing the policy, and the implementation process of this policy at state hospitals of KwaZulu-Natal. CONCLUSION There is limited understanding of the Free Health Care Policy among some health service personnel and some disability groups, and this may have contributed to the erratic and poor implementation of the policy at public hospitals in KwaZulu-Natal. Factors necessary for policy implementation such as a communication strategy, guidelines for implementation, assessment of availability of resources, training of implementers, monitoring and evaluation strategy are crucial for effective implementation of any policy including the Free Health Care Policy for disabled persons. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

A society's moral heart can be judged by how well it provides for its weakest and most vulnerable citizens. In recent years significant strides have been made to improve the quality of institutionalized persons' lives. However, because we have not yet fully developed a moral vision of long-term care living, residents do not always receive the basic care that they should. Particularly ignored and inadequately addressed is the complex moral and social issue of residents' sexual lives. Currently there is little support for sexual activity or sexual care in long-term care settings. Society's moral rules are designed for independent people living in their own homes. Professional governance bodies have created moral rules regulating short-term professional interactions and responsibilities but rarely have ones that pertain to longterm care settings. The aim of the present research is to contribute to the development of a moral vision of how long-term care institutions should manage sexual activity and sexual care. A qualitative study was designed to identify the factors that negatively influence sexual activity and sexual care, and the supports that residents and staff respectively need in order to have sexual lives and provide sexual care. Using an exploratory design the investigator conducted in-depth interviews with twenty-four residents and staff and carried out twenty hours of participant observation with two community residents. Six negative influences on residents' sexual lives and nine negative influences on staffs provision of sexual care were identified. The work also explores ethical and legal issues pertaining to the provision o f sexual care. It is argued that residents have moral rights to sexual care which impose duties on institutions to provide that care. Legal barriers to providing such care are then considered, and found not to be insurmountable. The above research and explorations led to three conclusions. First, unless sexual care is available residents cannot have sexual lives. Second, for sexual care to be available institutions must accept that it is their moral responsibility to provide it and ensure that staff are adequately supported. Third, institutions should develop a framework for the delivery of sexual care. / Arts, Faculty of / Graduate and Postdoctoral Studies / English, Department of / Graduate

The purpose of this study was to explore the views of adults with disabilities and their care providers with regard to extent to which health promotion implementation was facilitated within Protective Workshops across several service areas in South Africa. Quantitative and Qualitative Data was collected via a combination of data collection approaches that included the use of a descriptive survey, a self-administered questionnaire and a semi-structured interview. Structured questionnaires and an interview schedule were used to generate data from both the patient and care provider participants in each of the selected facilities. Participants with disabilities and care providers working in the Protective Workshops were identified and sampled through a multi-stage sampling procedure. Participants from 48 facilities participated in the study. The findings revealed that health promotion in Protective Workshops was cursory and informal. Even though health education was provided whenever the need arose, it was neither individualized nor customized in accordance with reasonable accommodation of people with disabilities. There were provincial differences in terms of the levels of participation and organizational support for people with disabilities. In certain cases bureaucratic obstacles were identified during field work. Results show inconsistency regarding access to equal opportunities for people with disabilities, albeit some agreed to a lesser extent (30.5%), others moderately (21.5%) compared to only 22.6% who agreed, were exceeded by 25% of respondents who completely disagreed to the notion that equal opportunities existed for people with disabilities. The latter was confirmed by care providers. The study recommended an urgent need for the development of inclusive health promotion, the enforcement of the requirements for reasonable accommodation and adherence to policy and legal imperatives. / Health Studies / D. Litt. et Phil. (Health Studies)

Community-based Rehabilitation (CBR) emerged as a response to the failure of the conventional rehabilitation system in developing countries. CBR involves service provision to People with Disabilities (PWDs), changing community attitudes towards disability and transferring knowledge and skills to PWDs, their families and their community. The study investigated the impact of the CBR strategy on PWDs and their families within the Oniipa Constituency in Namibia. The study used a mixed methods research approach and adopted explorative and descriptive research designs. It determined that CBR has initiated positive change processes in community attitudes and increased social integration of PWDs. The study recommends reviewing the definition of CBR, providing financial incentives to CBR Volunteer Workers and reviewing the current legislations on disability in Namibia. A final recommendation is that government should formalise disability studies in the country through the provision of accredited training courses to ensure greater assistance to PWDs and their families. / Public Administration / M.P.A.

The purpose of this study was to explore the views of adults with disabilities and their care providers with regard to extent to which health promotion implementation was facilitated within Protective Workshops across several service areas in South Africa. Quantitative and Qualitative Data was collected via a combination of data collection approaches that included the use of a descriptive survey, a self-administered questionnaire and a semi-structured interview. Structured questionnaires and an interview schedule were used to generate data from both the patient and care provider participants in each of the selected facilities. Participants with disabilities and care providers working in the Protective Workshops were identified and sampled through a multi-stage sampling procedure. Participants from 48 facilities participated in the study. The findings revealed that health promotion in Protective Workshops was cursory and informal. Even though health education was provided whenever the need arose, it was neither individualized nor customized in accordance with reasonable accommodation of people with disabilities. There were provincial differences in terms of the levels of participation and organizational support for people with disabilities. In certain cases bureaucratic obstacles were identified during field work. Results show inconsistency regarding access to equal opportunities for people with disabilities, albeit some agreed to a lesser extent (30.5%), others moderately (21.5%) compared to only 22.6% who agreed, were exceeded by 25% of respondents who completely disagreed to the notion that equal opportunities existed for people with disabilities. The latter was confirmed by care providers. The study recommended an urgent need for the development of inclusive health promotion, the enforcement of the requirements for reasonable accommodation and adherence to policy and legal imperatives. / Health Studies / D. Litt. et Phil. (Health Studies)