Disability and arthritis in Mexico are important public health problems. There is a need to develop rehabilitation interventions aimed at reducing the prevalence and disabling effects of arthritis in low socioeconomic communities in this country. This thesis reports findings from the initial execution of a mixed-methods participatory research program. This program was designed to develop, implement and evaluate a community-based rehabilitation program to decrease disability of people living with arthritis in the municipality of Chankom, a low-income rural Mayan community located in Southeast Mexico.
Epidemiologic results showed a high prevalence of arthritis in Chankom associated with low levels of wealth and high body mass index. In addition, arthritis was associated with a higher prevalence of disability in this municipality. Further results showed that people who live with osteoarthritis in Chankom perform standardized and real-life activities with significant levels of disability. This disability was associated with levels of wealth, pain, muscle strength, self-efficacy, and physical activity. Ethnographic results showed that: a) arthritis reduces the health-related quality of life of people in Chankom through a process of disablement, b) people living with arthritis need access to culturally sensitive healthcare, and c) there are availability, attainability and acceptability barriers to accessing culturally sensitive health services in this municipality, which result from power imbalance between indigenous and non-indigenous people.
The work presented in this thesis is the extensive examination of the problems associated with arthritis in Chankom, using quantitative and qualitative methods. Our findings justify the need to develop health policies and interventions to prevent and decrease the disabling effects of arthritis in this marginalized community. Moreover, these findings will support the creation of a culturally sensitive, community-based rehabilitation program, as a multi-level strategy to promote social development and improve health-related quality of life of people living with arthritis in the municipality of Chankom. / Thesis / Candidate in Philosophy / There is a need to develop rehabilitation interventions aimed at reducing the onset and disabling effects of arthritis in poor areas of Mexico. This thesis reports findings from the initial implementation of a research project designed to decrease disability of people living with arthritis in Chankom, a poor rural Mayan community located in Southeast Mexico. These findings show that arthritis is common in Chankom and it is related to having problems performing usual activities, which reduce people’s quality of life. People living with arthritis in Chankom need culturally appropriate healthcare services; however, they don’t obtain these due to different barriers associated with their indigenous background. Consequently, it is necessary to design health policies and interventions to decrease the disabling effects of arthritis in Chankom. The findings of this thesis will help creating a rehabilitation program that increases access to appropriate healthcare, improving function and quality of life of Chankom’s inhabitants.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/17271 |
| Date | 06 1900 |
| Creators | Loyola-Sanchez, Adalberto |
| Contributors | Richardson, Julie, Rehabilitation Science |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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