Centre for Disability and Rehabilitation Studies

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Browsing Centre for Disability and Rehabilitation Studies by browse.metadata.advisor "Hendry, Jenny"

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    Do clients with spinal cord injuries know what they need to know about pressure ulcers? A descriptive study on the knowledge, beliefs and practices about pressure ulcers
    (Stellenbosch : Stellenbosch University, 2016-12) Visser, Adri Marica; Visagie, Surona; Hendry, Jenny; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH SUMMARY : Background: Pressure ulcers are a serious, but preventable, secondary complication of spinal cord injury (SCI). Pressure ulcers limit community integration, and are potentially life-threatening. They also put an increased financial and care burden on health systems. Pressure ulcers can be prevented by following the guidelines for good skin care and pressure-ulcer prevention programmes. Adherence to pressure-ulcer prevention practices is influenced by a person`s knowledge and beliefs. Aim: To describe the knowledge, beliefs and practices about pressure ulcers of clients with SCI who received rehabilitation at a Cape Town rehabilitation center. Methods: A quantitative, descriptive study, that employed consecutive sampling, was done. Participants included in-patients (n=30), out-patients (n =33) and peer supporters (n = 8). Data was collected during April and March 2015 with a questionnaire developed through collating existing questionnaires and adapting them for the study context. Descriptive and inferential analyses of data was done. To determine if any relationship existed between the variables, the Fisher’s exact test and Kruskal-Wallis test were applied. A P-value of <0.05 was considered statistically significant. Results: The mean age of participants was 36.3 years with 86% being male. Only 31% of participants finished school and 77% were unemployed. Of all the participants, 43% had developed a pressure ulcer at some stage. The mean combined knowledge score was 23.9 out of a possible 56 (42.7%). The in-patients and out-patients had similar scores (40.4% and 39.4% respectively). Areas of knowledge that were particularly challenged, included nutrition to prevent pressure ulcers, the staging of pressure ulcers, the time it takes for a pressure ulcer to develop and the risk factors for pressure ulcer development. While having a similar knowledge score as in-patients, personal experience of life with SCI and contact with others might have influenced the beliefs of out-patients over time as more of them saw themselves as likely to develop pressure ulcers, and a higher percentage believed PU would seriously impact their activities. Peer supporters had a higher mean knowledge score than the other two groups. Despite their higher mean knowledge score, their scores might be too low to effectively teach others PU prevention practices. The majority of participants (88.7%) believed pressure ulcers to be serious and 45% thought they were likely to develop a PU. They believed daily skin checks (80.3%), weight shifting (86%) and limiting sitting time (80.3%) could prevent PU development. Pressure relief was not practiced correctly by 51% of participants, while 39% did not perform skin inspection correctly and 38% of participants smoked. Inferential statistics showed that most of the variables did not have a statistically significant relationship. An increase in time since injury had a significant impact on the belief that pressure ulcers would interfere with ADL (p=0.024), and increased knowledge scores impacted significantly on correct pressure relief practices (p=0.001). Conclusion: Participants showed a lack of knowledge which might have impacted their beliefs and pressure-ulcer prevention practices negatively. It seems as if participants were not equipped with sufficient knowledge to assist them in adhering to pressure-ulcer prevention practices, even though they realized pressure ulcers were serious and would impact their lives negatively. The study findings can be used to assist with the development of a contextually relevant training programme on pressure care.
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    Prosthetic use by persons with unilateral above knee amputation in the Western Cape
    (Stellenbosch : Stellenbosch University, 2018-03) Pienaar, Elzbeth; Visagie, Surona; Hendry, Jenny; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Centre for Rehabilitation Studies.
    ENGLISH SUMMARY : Background: Walking with an above knee prosthesis places high physical demands on a person. People with an above knee amputation tend to use their prosthesis less frequently compared to people with a below knee amputation. Within the Western Cape’s Public Health Sector, guidelines for pre-prosthetic rehabilitation services and prosthetic prescription are well developed and practised. However, once a prosthesis has been obtained, access to, and use of, prosthetic rehabilitation services seem limited. Furthermore, little is known about prosthetic use and mobility once the person has received an above knee prosthesis. Aim: To determine prosthetic mobility and prosthetic use of people with unilateral above knee amputation who have received their prosthesis from the Western Cape Government. Methods: The study used a quantitative, descriptive study design. The study population included all adults who had received a first prosthesis from the Orthotic and Prosthetic Centre in the Western Cape between 1 June 2011 and 31 December 2014. 43 people participated in the study. Data was collected through telephone interviews. An adapted version of the Prosthetic Profile of the Amputee (PPA) was completed. The original tool was tested for validity and reliability, but in a different context, with a different population. Data was captured on an Excel spreadsheet. Descriptive and some inferential analysis, with the Ci square- test, were done. Results: The majority of the 43 study participants were older than 50 years (77%), and men (79%). Vascular conditions (47%), followed by diabetes (23%), caused the highest number of amputations. More than half of participants waited longer than a year before receiving their prosthesis, however, it had no clinical or statistically significant impact on prosthetic use. Thirty five participants (81%) used their prostheses at least once a week and eighteen (42%) used it daily. A statistically significant effect (p=0.000) was found between prosthetic rehabilitation and prosthetic walking distance. Seventeen, less than half of participants, that received prosthetic rehabilitation, reported that they could walk for longer distances. Two (5%) participants could walk 1 000 or more steps without having to rest, however, more than half (56%) were limited to less than 200 steps. Of the prosthetic users, twenty six (74%) could walk indoors without assistive devices. On outdoor, uneven terrain, twenty six (74%) needed one or two elbow crutches, where nine (26%) did not rely on any hand held assisted devices across all terrains. Less than half (44%) of the participants felt the prosthesis completely met their expectations. Conclusion: The majority of the study participants used their prosthetic leg; although limitations were experienced in frequency of wear and mobility, such as walking distances and the need for additional hand held assisted devices. Initial expectations of what the prosthesis will offer were not often met. The results highlight the lack of prosthetic rehabilitation and also the benefit of prosthetic rehabilitation on mobility. It is recommended that access to rehabilitation is improved, from pre-prosthetic which could shorten waiting time to prosthesis, through to prosthetic rehabilitation, to improve mobility outcomes. It is also recommended that emphasis is placed on education at the pre-prosthetic phase, to determine realistic goals for the prosthetic phase.