Community integration of adults with disabilities post discharge from an in-patient rehabilitation unit in the Western Cape

Abstract

IntroductionCommunity integration is an important outcome of rehabilitation, because the ultimate focus of rehabilitation is to enable people to participate in their life roles.AimTo determine community integration scores achieved by adults with disabilities post discharge from an in-patient rehabilitation centre in the Western Cape Province.MethodFifty-nine individuals participated in this cross-sectional study. Community integration was determined using the Reintegration to Normal Living Index (RNLI). Descriptive analysis of age, gender, medical diagnosis and RNLI scores was performed. Kruskal–Wallis test and t-tests were used to determine whether there exists any relationship between age, gender, medical diagnosis and RNLI scores (p < 0.05).ResultsParticipants’ mean age was 45 (± 15.9) years. Of the study participants, 54% were women. The most common diagnosis was stroke (41%), followed by spinal cord injury (30%). The mean overall RNLI score was 66.3 (± 25.5). Persons with brain trauma (stroke or head injury) had a mean of 60.9 (±20.3); those with spinal cord injury had a mean of 75.2 (± 25.8) and those with peripheral impairments had a mean of 65.5 (± 30.5). The RNLI domains ‘personal relationships’ 73.45 (± 31.6) and ‘presentation of self’ 72.13 (± 35.4) recorded the highest mean scores. The domain ‘work or meaningful activities’ had the lowest mean score 52.54 (± 35.3). ‘Community mobility’ (59.9; ± 34.6) and ‘recreation’ (57.3; ± 37.2) also had mean scores below 60. No statistically significant relationships were found between age, gender and medical diagnosis and RNLI scores.ConclusionThe relatively low mean scores indicate that participants achieved poor community reintegration.

‘No one prepared me to go home’: Cerebrovascular accident survivors’ experiences of community reintegration in a peri-urban context

“…In turn, these role losses led to role reversals, with an increased level of dependency on family impacting the individual’s sense of self. These findings resonate with findings from other South African studies 3,4,5,6,7,8,18,19,20 and highlight the challenges that CVA survivors experience across the country regardless of the differences in their geographical location.…”

“…Activity limitations have been acknowledged as a barrier to participation. 3,4,6,7,8,20 These activity limitations lead to difficulty in mobilising around the home and community, as well as the ability to engage in meaningful activities. This results in difficulty in resuming various roles and participation in premorbid activities.…”

“…1,2 Several authors have highlighted that CVA survivors experience multiple impairments that negatively influence their ability to participate in their premorbid daily activities. 3,4,5,6,7,8 The South African health system has policies and strategies that guide rehabilitation and community reintegration, an example of which is the Framework and Strategy for Disability and Rehabilitation 9 ; however, implementation of such guidelines remains an issue. 10,11,12,13,14 Despite the focus of the Department of Health on reengineered primary health care (PHC), CVA survivors still have difficulty accessing rehabilitation services.…”

“…Community reintegration remains a key goal for rehabilitation professionals as it focuses on the CVA survivor’s ability to function, participate in premorbid life roles (which form part of the survivor’s identity) and contribute to the community. 4,5,13,15,17 Numerous authors have highlighted the poor reintegration among South Africans, who have had a CVA or a spinal cord injury, into their respective communities. 4,8,17,18,19 Gretschel et al 4 found that adults with a disability face challenges with participating in work or meaningful activities, community mobility and recreation.…”

“…4,5,13,15,17 Numerous authors have highlighted the poor reintegration among South Africans, who have had a CVA or a spinal cord injury, into their respective communities. 4,8,17,18,19 Gretschel et al 4 found that adults with a disability face challenges with participating in work or meaningful activities, community mobility and recreation. Similarly, Carwood et al 18 and Pang et al 20 highlighted the difficulties experienced with participation in social, leisure, work and community activities.…”