An ageing population is demanding more of healthcare services worldwide, particularly for long-term conditions. In the UK, the challenge of limited healthcare service resources and the influence of the Equality Act on services have increasingly led to the consideration of people's access to community rehabilitation services. These present a potential opportunity for Inclusive Design. The literature suggests that Inclusive Design and its associated tools have been widely applied to the accessibility of buildings and public transport, as well as consumer products and services, but there is little evidence of their application to healthcare services. A review of the literature highlights the importance of improving people's access to community-based rehabilitation by providing care at or closer to home which has become an increasingly prevalent option to meet the healthcare demand for long-term conditions in an ageing population. Therefore, this thesis investigates how Inclusive Design can be applied to healthcare delivery services to improve patients' experiences of accessing these services. It accomplished this through two case studies: community-based rehabilitation services of back pain and chronic obstructive pulmonary disease (COPD). The case studies involved online surveys and interviews with healthcare professionals and patients in understanding the patients' care journeys and challenges in accessing these services. The impact of services demands on patients' capability and their access to services was analysed using an Inclusive Design tool, the Exclusion Calculator. An inclusive approach integrating tools and procedures was summarised to facilitate the understanding of patients' capability-related needs both for the recipients of care and for the providers of care. This research provides a novel contribution by filling the gaps in the literature on the application of Inclusive Design to healthcare delivery services, i.e., community-based rehabilitation. It demonstrates that an Inclusive Design approach can be used to improve people's access to healthcare services and the tools applied can make a useful contribution to understanding service provision and hence service improvement. The Inclusive Design approach focuses on identifying the demands that healthcare services make of their users' capability and in estimating services' exclusion. The process of applying Inclusive Design in this research may be used to improve other healthcare services.

Section 508 of the Rehabilitation Act Amendments of 1998 took effect in 2001 and provides encouragement for universal design and compliance requirements to the federal sector for purchases that are accessible by people with disabilities. A division of General Dynamics Advanced Information Systems (GDAIS) is located in Pittsfield, Massachusetts and provides electronic and information technology solutions to federal customers in the defense, intelligence, and homeland security communities. The general lack of training is a major factor for low compliance to Section 508. Improving awareness is important at GDAIS in order to increase its federal sales market share, develop new products and services, transfer technology to other fields, and support a global market for users with different human conditions. The study aimed to implement a computer-based training program for design engineers and managers within GDAIS to foster universal design skills and increase accessibility awareness. The four-level model created by Donald L. Kirkpatrick was utilized to evaluate the training. Survey, test, and interview instruments were designed to evaluate the reaction, learning, and behavior of the participants. An expert panel provided validation and reliability of the instruments. A case study methodology was used to analyze Section 508 compliance in depth for four months. Also analyzed were the possible effects of the training on the engineering design, the organization both financial and cultural, and the individual. Learning of the standards and universal design concepts through better application of usability and accessibility features were improved. While the training did improve compliance slightly, there was a lack of Section 508 inclusion within solicitations. The organizational culture to support the disabled community showed a possibility of improving through awareness and education.

Text in Afrikaans / Indigenous literature about the experience of a couple, where one of the spouses experiences a spinal cord injury, is scarce in the frame of social work. The experience of 5 couples (10 participants), after a spinal cord injury of one of the spouses was researched in this qualitative study. The aim of this research study is: • to reconnoiter participants’ experience of a spinal cord injury of a spouse, through semi-structured interviews with a purposeful chosen sample • to subject the research findings to a literature control • to make recommendations about how spouses can support each other, as well as how professional people can support client systems, where one of the spouses experience a spinal cord injury From the data it was determined that a spinal cord injury had significantly influenced the couples: - emotions - needs - perceptions (origination of experiences) Recommendations to couples as well as to professional people have been made. / Social Work / Thesis (M. Diac.)

Text in Afrikaans / Indigenous literature about the experience of a couple, where one of the spouses experiences a spinal cord injury, is scarce in the frame of social work. The experience of 5 couples (10 participants), after a spinal cord injury of one of the spouses was researched in this qualitative study. The aim of this research study is: • to reconnoiter participants’ experience of a spinal cord injury of a spouse, through semi-structured interviews with a purposeful chosen sample • to subject the research findings to a literature control • to make recommendations about how spouses can support each other, as well as how professional people can support client systems, where one of the spouses experience a spinal cord injury From the data it was determined that a spinal cord injury had significantly influenced the couples: - emotions - needs - perceptions (origination of experiences) Recommendations to couples as well as to professional people have been made. / Social Work / Thesis (M. Diac.)