The attitudes of community based rehabilitation workers towards people with disabilities in south India

Facilitating learning of community-based rehabilitation through problem-based learning in higher education

BACKGROUND

The quality of community-based rehabilitation (CBR) personnel is one of the key factors that contributes to the success of CBR programs. Integrating knowledge and practical skills in various stages of the learning process is essential in community-based rehabilitation. Problem-based learning (PBL) is a pedagogical strategy that uses real-world situations as the basis for developing knowledge and problem-solving skills. Through PBL, learners are guided and facilitated in assuming active problem-solving roles in real-world situations. This study developed and tested a framework and a PBL protocol for use in teaching community-based rehabilitation (CBR) in higher education.

METHODS

Part I of this study focused on the development of a framework and a protocol for PBL. An initial framework for the development of this protocol was formed based on a review of relevant literature. Concrete guidelines were delineated to describe the application, process, and delivery of teaching and learning. PBL was implemented in three CBR related courses. Students were facilitated to learn CBR in passing various stages of PBL through a self-directed learning process. The cumulative efforts of each group were compiled, recorded, and displayed using e-portfolios. In Part II, the processes and outcomes of using this new learning mode were evaluated using a case study approach to examine the protocol's efficacy. Focus group interviews, a questionnaire, and a detailed examination of the e-portfolios were administered for evaluation.

RESULTS

One hundred thirty-three students from three CBR related courses were recruited. PBL was regarded as an effective, realistic and practical method that enables critical thinking in CBR. Practicality was addressed by covering context-related materials with the use of real cases or examples. Participants were actively engaged in the learning process and their CBR competence was enhanced.

CONCLUSIONS

Through the new protocol, the students were equipped with active learning, critical thinking, and problem-solving skills that should facilitate success in CBR.

Adolescent group empowerment: Group-centred occupations to empower adolescents with disabilities in the urban slums of North India

This study aimed to understand how adolescents with disabilities can assume greater control over their rehabilitation and participation within a community-based rehabilitation programme in the urban slums of North India. A critical ethnographical approach using multiple qualitative and participatory data collection methods was adopted. Fieldwork was conducted from January to May 2005 and October 2006 to March 2007 with 21 adolescents with and 11 adolescents without disabilities (aged 12 to 18 years), and 10 community-based rehabilitation staff members. A conceptual framework called the 'Adolescent Group Empowerment Pyramid' was developed. Four themes informed the framework: group participation, group demonstration, group recognition and the socio-cultural environment's interaction with disability. Group empowerment, achieved through group-centred occupations, encourages adolescents to work together to address their rehabilitation challenges and agendas. Three external support factors and 10 areas for nurturing the group empowerment process also emerged. A limitation of this study is the lack of data on how the familial and local political and economic environment impact adolescents' ability to make decisions about their rehabilitation. Further research might explore group occupations and occupational recognition, and what this means for social change and the personal and collective growth of adolescents in underserviced communities.

The impact of community based rehabilitation as implemented by community rehabilitation facilitators on people with disabilities, their families and communities within South Africa

PURPOSE

To find out the impact of community based rehabilitation (CBR) as implemented by mid-level rehabilitation workers known as community rehabilitation facilitators (CRFs) on people with disabilities (PWD), their families and the communities in South Africa.

METHOD

A qualitative research design was used with an emphasis on participatory methods with PWD and their family members. Data collection took the form of individual interviews, focus groups and transects walks in both urban and rural settings within six provinces of South Africa.

RESULTS

Although CRFs work with individuals, groups, families and the community, they appear to have had a stronger impact on individuals with disabilities rather than the community at large. Various gaps were also identified and were related to the poor recognition of the scope of practice of CRFs as well as to individual CRFs abilities to carry out certain tasks.

CONCLUSIONS

Although the results suggest that CRFs have had a positive impact, there are still a number of issues that need to be addressed. These include proper support of CRFs and intersectoral collaboration between government departments to ensure the future of CBR in South Africa.

Factors Influencing Asian Indian Graduate Students' Attitudes Toward People With Disabilities

Asian Indians are one of the fastest-growing immigrant groups in the United States, yet little is known about their attitudes toward persons with disabilities and rehabilitation. The purpose of this study was to examine factors influencing Asian Indian students' attitudes toward people with disabilities, using a conjoint analysis design ( N = 90). The design used a conjoint measurement where the variables included disability type, gender, age, education, and employment status. The results indicate that disability type was most heavily involved in the decision-making process, that attitude and preference formation were significantly affected by characteristics other than disability type, and that students' previous contact with people with disabilities affected the relative importance of disability type and age in attitudes and preference formation. The findings of this study are similar to those of conjoint analysis studies of other Asian and American students. Implications for rehabilitation counseling practices with Asian Indian Americans are discussed.

The evidence base for community-based rehabilitation: a literature review

Literature on community-based rehabilitation (CBR) published between 1978 and 2002 is reviewed to assess the evidence base for CBR. There were 128 articles found that met the criteria set by the authors. The articles have been classified according to the methodology used and the key aspects studied. The review showed an ever-increasing number of publications on CBR. Theory papers and descriptive studies are the most common types of papers in CBR literature. Intervention studies and case reports are relatively rare. No systematic review has yet been carried out although reviews on specific aspects of CBR have become available. The key aspects of 'implementation' and 'stakeholders' are relatively well presented but the numbers of articles on 'participation' and 'use of local resources' are noticeably low. This study reveals that there is no real focus of research in CBR and therefore the evidence base for CBR is fragmented and incoherent on almost all aspects of CBR. It is recommended that comprehensive review studies should be carried out on key aspects of CBR projects. This should be supported by systematic research in CBR projects in order to establish evidence-based practices.