Browsing by Author "Mji, G."

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    Access to health care for persons with disabilities in rural South Africa
    (BioMed Central, 2017-11-17) Vergunst, R.; Swartz, L.; Hem, K.-G.; Eide, A. H.; Mannan, H.; MacLachlan, M.; Mji, G.; Braathen, S. H.; Schneider, M.
    Background: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at “triple vulnerability” – poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. Methods: The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Results: Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. Conclusions: This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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    Changes in activity limitations and predictors of functional outcome of patients with spinal cord injury following inpatient rehabilitation
    (AOSIS Publishing, 2013-11-11) Joseph, C.; Mji, G.; Statham, S. B.; Mlenzana, N.; De Wet, C.; Rhoda, A.
    The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord independence measure III (SCIM III). A longitudinal study design was utilised to study the change in functional abilities of patients with spinal cord injury between admission and discharge. A convenient sampling strategy was employed, in which every consecutive patient admitted to the rehabilitation centre within a three-month period was eligible for the study. Demographic-, medical, and process of rehabilitation data were collected and collated from the patients’ medical records using a data gathering sheet that was validated and tested for reliability. functional abilities were measured by the SCIM III. Seventy-six patients met the inclusion criteria, consisting of 58 paraplegics and 18 tetraplegics. The mean age of this cohort was 34.14 years. A significant difference (p<0.001) in functional ability was detected for the total sample, with only 12.5% of patients independent in walking ability and 28.12% in stair management. four (4) factors were found to be predictors of functional outcomes on bivariate analysis, but when considered together in a multiple regression model, only functional status on admission remained correlated to functional outcomes. Conclusion and implication for practice: Significant improvement in functional abilities of persons with spinal cord injury following in-patient rehabilitation was observed. however, mobility and stair-management limitations were the most prevalent at discharge. lastly, a lower functional status should be better targeted to optimise functional ability in the future. future research should be directed towards illuminating whether personal factors or rehabilitation inefficiencies are responsible for the limitations observed at discharge.
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    Rehabilitation outcomes of persons with complete paraplegia at a private rehabilitation hospital
    (AOSIS Publishing, 2012-12-11) Henn, R.; Visagie, S.; Mji, G.
    In order to overcome activity limitations, prevent secondarycomplications and early death and achieve community integration comprehensiverehabilitation post spinal cord injury (SCI), is essential. The aim ofthe study was to evaluate outcomes of patients with complete paraplegia whoreceived rehabilitation at a private rehabilitation hospital.A quantitative, descriptive methodology was implemented. All patientswith complete, traumatic, thoracic spinal cord injuries, admitted to the studyhospital in the study period, were consecutively sampled. Thirty five patientswere identified of whom16 adhered to the inclusion criteria. The FunctionalIndependence Measure (FIM ) and Needs Assessment Checklist (NAC) wereused as measuring instruments.The mean length of stay was 95 days. Discharge FIM motor scores ranged from 72 to 83 with a mean of 79.3. Themean gain in FIM motor score was 55 and varied from 45 to 61. Discharge NAC scores ranged from 264 to 340 with amean of 300 out of a possible 347. A correlation between length of stay and discharge FIM scores (p = 0.05) were found.Both NAC and FIM scores indicated high levels of physical independence. According to NAC scores patients wereeducated on the prevention of secondary complications and received psychological counselling. Discharge planningand community integration scored lower with means of 80% and 61% respectively. Community based completionof rehabilitation programmes, the incorporation of the NAC, or another participation outcome measure and implementationof on-going programme monitoring and assessment strategies is recommended.
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    Understanding the current discourse of rehabilitation : with reference to disability models and rehabilitation policies for evaluation research in the South African setting
    (AOSIS Publishing, 2013-12-11) Mji, G.; Chappell, P.; Statham, S.; Mlenzana, N.; Goliath, C.; De Wet, C.; Rhoda, A.
    Evaluation of rehabilitation programmes is essential in order to monitor its effectiveness and relevance. There is however a need to consider policies when conducting evaluation research in rehabilitation. The aim of this paper is to present the theoretical and legislative underpinnings of rehabilitation in South Africa.A narrative review of national and international disability legislation and empirical research in context of rehabilitation was conducted.The findings of this review reveals that as a fluid construct, the discourse of rehabilitation has been underpinned by the changing theoretical and socio-political understandings of disability. This inturn has influenced various international and national health and disability policies and legislations that oversee the implementation of rehabilitation practice. Despite this, there has been little evaluation of public health rehabilitation services in context of these policies and legislations in South Africa. The fluidity of rehabilitation need to be considered when conducting evaluation research in rehabilitation.