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Uzbekistan: Case for inclusion

NAM, Galina
2019

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The inclusion of children with disabilities in mainstream education has become an important agenda for many developing countries. The Uzbekistan government has also attempted to provide equal educational opportunities to this previously excluded group of children. Despite these efforts, however, many children with disabilities remain segregated. The total number of children with disabilities under 16 years old in the country is 97,000 (Uzbek Society of Disabled People, 2014). The majority of them either study at specialised educational institutions, or receive home-based education. Those who are placed at specialised institutions are often deprived of resources and services necessary to receive adequate education (UNICEF, 2013). While limited by the lack of reliable empirical data and research, this article aims to present the current situation in the development of inclusive education in Uzbekistan. It outlines the major legislative documents intended to support inclusive education and identifies some of the current obstacles to inclusive education practices.

 

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Users’ satisfaction with assistive devices in Afghanistan

MOHAPATRA, Bikram Keshari
2019

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Purpose: The objective of this study was to assess users’ satisfaction and effectiveness of assistive devices in four regions of Afghanistan, namely Mazar-e-Sharif, Ghazni, Jalalabad and Taloqan.

 

Method: A random sample of 785 users, who were provided with 874 mobility and assistive devices in four regional prosthetic and orthotic workshops of the Swedish Committee for Afghanistan (SCA), participated in the study.

 

Results: The study revealed that the majority of the participants rated the assistive devices as very useful. While 45% of respondents even described them as excellent, 49% expressed a good level of satisfaction with the services they received at treatment centres. Similarly, the majority of respondents (67%) mentioned a maximum level of improvement, while 15% claimed to have witnessed some improvement in their physical condition. Fitting, comfort, and ease of use, along with durability, weight and appearance were rated as the most important factors of assistive devices. On the other hand, slow service and limited access to maintenance and repair facilities were identified as reasons for dissatisfaction.

 

Conclusion: The study provided continuous and valuable information to rehabilitation professionals regarding device effectiveness and satisfaction. The findings also recommended a stronger focus on comfort and usefulness of mobility and assistive devices. Lastly, the study suggested that lack of local device-repair service needs to be addressed by rehabilitation professionals. 

Cross-Cultural Adaptation and Evaluation of Psychometric Properties of Persian Version of Supports Intensity Scale among Adults with Intellectual and Developmental Disabilities

SALEHI, Sajed
JAVADIPOUR, Sheyda
NASSADJ, Gholamhossein
HAGHIGHI, Mohammad Hossein
SABOOR, Shiva
SHAKHI, Kamal
2018

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Purpose: This study was designed to translate and assess the psychometric properties of Supports Intensity Scale among adults with intellectual and developmental disability in Ahvaz and Tehran, Iran.

 

Method: The cross-sectional study was carried out in two stages. The first stage consisted of the forward-backward translation of Supports Intensity Scale - Adult Version) SIS-A(. In the second stage, 197 people with intellectual and developmental disabilities were recruited in order to assess the internal consistency and test-retest reliability, concurrent and content validity of SIS-A. The confirmatory factor analysis (CFA) was performed to approve the seven-factor model of the instrument.

 

Results: The intra-class correlation coefficient values varied between 0.85 and 0.99 (very good to excellent). All subscales of the SIS-A showed Cronbach’s alpha above 0.70. Correlation coefficient between SIS-A and Barthel index was about -0.65, which shows excellent concurrent validity of SIS-A. The findings showed SIS-A had high ability to discriminate between groups with different IQ (p<0.05). There was no significant correlation between SIS-A and the age of participants (p>0.05). The result of CFA confirmed that the seven-factor model of SIS-A is the fittest pattern for SIS-A.

 

Conclusion: The results indicated that the Persian version of SIS-A is a valid and reliable instrument to assess function and disability among people with intellectual and developmental disability.

An Evaluative Study of Services Provided in Community-Based Rehabilitation Centres in Jordan

Darawsheh, Wesam B
2018

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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.

 

Method: This was a mixed-methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data was analysed using SPSS Version 22.0. Qualitative data was analysed through thematic content analysis and open coding to identify emergent themes.

 

Results:  40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.

 

Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.

 

Implications: This study was inclusive of all types of disability.  Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings. 

Social inclusion and mental health of children with physical disabilities in Gaza, Palestine

NASSER, Khaled
MACLACHLAN, Malcolm
MCVEIGH, Joanne
2016

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Purpose: Social inclusion of children with physical disabilities is essential for their mental health. The long-standing conflict and political instability in Palestine since 1948 has resulted in an unprecedented number of children with disabilities. This study aimed to assess social inclusion and mental health of children with physical disabilities in Palestine.

 

Method: A mixed methods research design was used. The 12-item General Health Questionnaire and a Social Inclusion Questionnaire were administered to 100 children with amputations, 12-18 years of age, in the Gaza Strip. Ten semi-structured interviews were also conducted with personnel working across civil society rehabilitation services in the area, particularly in services that focussed on the physical rehabilitation of children who had lost a limb.

 

Results: Quantitative findings indicated that 88% of children’s disabilities were caused by war-related incidents. While the sample of children showed on average relatively low levels of psychological distress, males reported feeling more socially included and having better mental health than did females. Furthermore, there was a strong positive correlation between mental health and social inclusion, and a moderate positive correlation between psychological distress and social inclusion. The qualitative data identified different factors that hinder social inclusion, mainly: political instability; under-resourced disability organisations; lack of coordinated efforts; and negative societal attitudes towards disability.

 

Conclusion: A new questionnaire for social inclusion was developed, which can now be used as a tool to assess social inclusion in similar contexts; as well as a culturally-adapted form of the General Health Questionnaire-12 to assess mental health. There is a clear need for service-providers to move beyond a medical model of care to one that embraces community-based rehabilitation and the realisation of rights, in order to promote the social inclusion and mental health of children with disabilities in Palestinian society.

Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey

EL ESSI, K
EL-SHAFIE, J M
AL HAWAMDAH, Z
ZAQOUT, S I
2012

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Shoulder pain among paraplegic persons has negative effects on their lives. The prevalence of shoulder pain among persons with spinal cord injury (SCI) varies from 30% to 70% in different studies and may be related to repetitive use of the shoulder during self-care and wheelchair-related activities.

 

Purpose: This study focused on the prevalence of shoulder pain and examined its effects on activities of daily living and social participation, and on functional, work and recreational or athletic activities. It also aimed to detect the degree ofsatisfaction with shoulder functioning in wheelchair users who were paraplegic due to spinal cord injury, in the Gaza strip.

 

Methods: Cross sectional study design was used to collect data from 80 persons with paraplegia, post rehabilitation, who were still using manual wheelchairs (MWC) for ambulation. After giving informed consent, the selected persons were interviewed directly in their homes, and filled questionnaires which included demographic data, Wheelchair User’s Shoulder Pain Index (WUSPI) and Shoulder Rating Questionnaire (SRQ).

 

Results: The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Sixty four percent from among the study sample mentioned that they had no limitation in shoulder-using ability during daily personal and household activities, while the rest experienced different degrees of limitation. Seventy-four percent reported no limitation during recreational or athletic activities, while the rest (26%) agreed that pain has variably limited their participation in these activities. Fourteen percent from the sample rated the overall degree of satisfaction with their shoulder functioning as fair, and the rest rated their satisfaction from good to excellent.

 

Conclusion: Shoulder pain, ranging from mild to severe, was highly prevalent among SCI paraplegics who use MWCs during their usual activities, and other activities which involve wheelchair propulsion. About two- thirds of the subjectsreported no limitation in shoulder use during daily personal and household activities and in recreational or athletic activities.

Disability among clients attending Taif Rehabilitation Centre, Saudi Arabia

AL-SHEHRI, Abdul-Salam A
ABDEL-FATTAH, Moataz M
2008

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This is a cross-sectional study of hospital records of people who were admitted to Rehab Armed Forces Rehabilitation Center, Taif, Saudi Arabia from 1999- 2005. Eight hundred and fifty records were reviewed. Data were collected on age, sex, nationality, data of admission and discharge and type of disability. Univariate and multivariate logistic regression analysis were performed to determine predictors of long stay at the hospital. Trauma as an etiology of disability was more common than non-traumatic incidents among male and middle aged clients (16-45 years). Traumatic accidents mostly result in quadriplegia (72.8%). Male, single, less than 45 years old, people with traumatic accidents and people with paralytic types of disability were significantly more likely to stay longer at the hospital. Home care programme should be expanded to minimize duration of stay at the rehabilitation centres. Health education of the public would help in encouraging disabled people to adapt to daily life activities.

Disability and development: is the rights model of disability valid in the Arab region? An evidence-based field survey in Lebanon and Jordan

NAGATA, Kozue Kay
2008

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This paper reviews the process and outcome of constructing a "rights model of disability" which is culturally specific to Jordan and Lebanon. The objective of the empirical part was, to survey the current level of attitudes of non-disabled people towards their disabled fellows in Jordan, and to compare the attitudes of Lebanon's university students towards five different categories of disabled people (mentally disabled people, psycho-socially disabled people, physically disabled people, hearing impaired people and visually impaired people) to highlight the variations and diversity among them. It also examined the relationship between the attitudes and various demographic and social characteristics of the respondents. The set of findings was further tested and triangulated through meta-analysis of individual views expressed in the qualitative studies.

In Jordan, the attitude of 191 randomly selected non-disabled people was studied, using a Scale of Attitudes towards Disabled Persons (SADP). The participants from 4 communities of Jordan, exhibited overall negative attitudes towards disabled people. Socio-economic-demographic characteristics showed almost no difference regarding their attitudes towards disabled people.

In Lebanon, a more complex scale, composed of four sub-scales, namely a, "Baseline Survey of Student Attitudes towards People with a Disability" was used, to survey 94 university students' attitudes towards five different categories of disabled people, and a set of indices for future comparison was constructed. The results indicated the same pattern of gradations of attitude differences (found in other countries) towards persons with physical or sensory impairments (better), intellectual impairment (middle) and mental illness (worse). The main findings of this empirical field research showed particularly negative public attitudes towards people with intellectual impairment and mental illness in Lebanon.

Finally, the validity of the proposed rights model of disability and the empirical findings of this study, were further examined and co-validated through analysis of the collective views of those who took part in the questionnaire surveys and the participatory focus group discussions, which took place in Lebanon in 2005 and 2007, and in Jordan in 2005, as well as a series of intensive on-line and/or telephone interviews of a few informants comprising of disabled persons and experts. The policy implications of the findings are discussed.

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

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