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The Effect of Age, Gender and Socioeconomic Status on Self-esteem, Body Image and Quality of Life of Amputees: An Evaluation Seven Years after the 2008 Sichuan Earthquake

LAM, Tin-Wai J
TANG, Long-Ching L
CHAU, WW
LAW, SW
CHAN, KM
2019

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Purpose: Psychological well-being is a growing concern in society. It is starting to play a pivotal role in the treatment and care of clients. This study aimed to evaluate the effect of age, sex and socioeconomic status on the self-esteem, body image and quality of life of the 2008 Sichuan earthquake amputees. Many of them are at a significant stage in their lives, especially those who are making the transition from childhood and adolescence into adulthood.

 

Methods: This cross-sectional study was conducted in October 2015. Forty-five participants were recruited from clinic sessions in Sichuan. The main outcome measures were Rosenberg Self-Esteem Scale (RSE), Chinese Amputee Body Image Scale (CABIS), and WHO Quality of Life-Bref Instrument (WHO-QOL-Bref). Results were analysed using Student’s T-test and Chi-square test where appropriate, and ANOVA for multi-group comparisons.

 

Results: Participants under 18 years of age scored higher in RSE (p=0.05), and lower in CABIS (p<0.005). They also scored higher in various QOL domains (D3: p<0.08, D4: p=0.06) and WHOQOL-Bref question 2 (p=0.06). Participants of different SES did not show any significant differences in the outcome measures. Female subjects scored higher in WHOQOL-Bref Question 1 (p=0.03).

 

Conclusion and Implication: Younger amputees have less body image distortion, higher quality of life and self-esteem compared to older amputees. Female amputees also appear to have a higher quality of life compared to male amputees. Socioeconomic status does not affect rehabilitation outcome and psychological well-being of amputees. However, the main factors affecting psychological well-being appear to be predominantly age and, possibly, gender.

Part 2: The feasibility of utilising photovoice method and the World Health Organization Quality of Life instrument in evaluating the Community-Based Rehabilitation programme in Namibia: A pilot study

SHUMBA, Tonderai W.
MOODLEY, Indres
2018

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Background: Evaluation of Community-Based Rehabilitation (CBR) programmes in Namibia has been primarily quantitative, focusing mainly on outputs, including numbers of persons with disabilities served, referrals made and activities implemented. Little or no evidence is available on experiences and quality of life of persons with disabilities, despite the CBR programme being operational for more than 20 years. The 2011 World Report on Disability recommended the use of appropriate tools to fill the research gap by integrating the experiences of persons with disabilities and their quality of life.

 

Objectives: The overall objective of the larger cohort study is to develop a monitoring and evaluation tool that can measure and integrate the experiences of persons with disabilities and their quality of life within the context of the CBR Programme in Namibia.

 

Method: An adapted photovoice process was conducted with six purposively selected participants over a period of 1 month. The World Health Organization Community-Based Rehabilitation (WHO CBR) Matrix was used to identify the themes and subthemes. Participants were requested to complete the World Health Organization Quality of Life (abbreviated version) (WHOQOL-BREF) instrument at the end of the photovoice process to determine their quality of life.

 

Results: Administering the WHOQOL-BREF instrument at the end of the photovoice process measured both the quality of life of persons with disabilities and at the same time indicated the convergence and divergence in the two data collection methods. The study demonstrated a stronger convergence than divergence of the two methods. A feasibility criterion was mapped for future studies.

 

Conclusion: This study demonstrated that photovoice is a flexible method that can be used with a variety of disabilities and has the potential of being combined with the WHOQOL-BREF assessment form. A larger cohort study may consider implementing photovoice and WHOQOL-BREF on multiple study sites and be able to compare results, considering geographical and demographic variables. The feasibility of utilising each method alone and in combination offered valuable insights on future conceptual framing of CBR programme evaluation. This conceptual framing will allow CBR practitioners to appreciate how these two methods contribute to a rigorous process of CBR programme evaluation.

Community based rehabilitation for people with disabilities in low and middle income countries : a systematic review

IEMMI, Valentina
et al
September 2015

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This Campbell Collaboration systematic review assesses the effectiveness and cost-effectiveness of community-based rehabilitation (CBR) for people with physical and mental disabilities in low- and middle-income countries, and/or their family, their carers, and their community. This review identified 15 studies that assessed the impact of community-based rehabilitation on the lives of people with disabilities and their carers in low- and middle-income countries. The studies included in the review used different types of community-based rehabilitation interventions and targeted different types of physical (stroke, arthritis, chronic obstructive pulmonary disease) and mental disabilities (schizophrenia, dementia, intellectual impairment). The authors conclude that the evidence on the effectiveness of CBR for people with disabilities in low- and middle-income countries suggests that CBR may be effective in improving the clinical outcomes and enhancing functioning and quality of life of the person with disabilities and his/her carer and recommend future studies will need to adopt better study designs, will need to focus on broader clients group, and to include economic evaluations

Campbell Systematic Reviews 2015:15

Children with Disability in Nepal: New Hope Through CBR?

MOL, Tanja Ingeborg
BRAKEL, Wim Van
SCHREURS, Merel
2014

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Purpose: This study assesses the impact of a community-based rehabilitation (CBR) programme on the quality of life (QoL) of children with disability and their families.

 

Methods: A qualitative approach was applied, using two techniques - a ranking line and semi-structured interviews. Nineteen children (ranging from 4 –18 years of age) were interviewed in their homes located in three villages - Chapakhori, Bokraha and Madesha - in Nepal.

 

Results: Children with disability and their families ranked physical health, psychological health, empowerment and level of independence as the most important factors for their QoL. Of the 19 children, 13 had experienced positive changes in their life and 1 child reported a negative change. The positive changes related mainly to their physical health and functioning. The impact of these changes was felt in the ‘social’, ‘level of independence’ and ‘empowerment’ outcome categories. The children mentioned that they had more friends, experienced less stigma, could go to school and were more hopeful about the future.

 

Conclusions: This CBR programme has brought about changes in the QoL of all children with disability and their families. The majority of them reported a positive impact.

 

 

Impact of CBR : impact of community-based rehabilitation programme in Karnataka India

BIGGERI, Mario
et al
2012

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"The main goal of the research was to understand and measure the overall role and impact of CBR in improving the quality of life of persons with different types of impairments, as well as different demographic, social and economic backgrounds. We therefore investigated the effectiveness of CBR programmes in improving the control that persons with disabilities have over their daily lives, their participation in different aspects of community life (i.e. combating stigma and prejudice) and their access to various services over the five domains of the CBR matrix (health, education, livelihood, social and empowerment)"

Evaluating the impact of rehabilitation in the lives of people with disabilities and their families in low and middle income countries : a review of tools

LONDON SCHOOL OF HYGIENE &amp; TROPICAL MEDECINE (LSHTM)
CHRISTOFFEL BLINDEMISSION (CBM)
August 2010

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“As there are many tools available for evaluating impact in the international literature, CBM commissioned this review in order to obtain clear guidance on how research can be carried across their programmes in order to generate high quality and reliable evidence on the impact of their programmes in the lives of people with disabilities and their families”

A review of community based rehabilitation evaluations : quality of life as an outcome measure for future evaluations

MANNAN, Hasheem
TURNBULL, Ann P
2007

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"This review examines key articles in evaluation of community-based rehabilitation carried out in developing countries and proposes family quality of life as an outcome measure of community-based rehabilitation. The concept of community-based rehabilitation is reviewed, quality of life and family quality of life measurement scale is presented. It presents a practical approach to future evaluations of community-based rehabilitation programmes. This review presents the features of community-based rehabilitation evaluation (i.e., service delivery system, technology transfer, community involvement, and organisation and management), methodology, and findings. Implications are defined for the enhancement of community based rehabilitation through practical suggestions for programme coordinators involved in community development for rehabilitation, equalisation of opportunities, and social inclusion of people with disabilities"

 

Asia Pacific Disability Rehabilitation Journal, Vol 18, No 1

Evaluating the impact of a community-based rehabilitation intervention

HARTLEY, Sally
2003

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This project evaluation summarizes the impact of community-based action by local women’s groups to improve the communication ability and quality of life of disabled children with communication problems. The project was designed to increase the present knowledge concerning appropriate interventions for children with communication problems who live in low-income countries. This report is useful to anyone interested in community-based nterventions for children with communication problems

WHOQOL : measuring quality of life

WORLD HEALTH ORGANIZATION
1997

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"WHO, with the aid of 15 collaborating centres around the world, developed two instruments for measuring quality of life: the WHOQOL-100 and the WHOQOLBRE. These tools can be used in a variety of cultural settings and defines quality of life as individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns"

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