Makerere University School of Public Health, Kampala, Uganda.
Makerere University School of Public Health, Kampala, Uganda.
Ann Glob Health. 2017 May-Aug;83(3-4):478-488. doi: 10.1016/j.aogh.2017.10.006.
Approximately 80% of individuals with disability reside in low- and middle-income countries where community-based rehabilitation (CBR) has been used as a strategy to improve disability. However, data relating to disability severity among CBR beneficiaries in low-income countries like Uganda remain scarce, particularly at the community or district level.
To describe severity of disability and associated factors for persons with physical disabilities receiving CBR services in the Kayunga district of Uganda.
A cross-sectional sample of 293 adults with physical disabilities receiving a CBR service in the Kayunga district was recruited. Disability severity was measured using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS2.0), and analyzed as a binary outcome (low: 0-9, high: 10-48). Inferential statistics using odds ratios were used to determine factors associated with impairment severity.
The mean WHODAS 2.0 score of persons with physical disabilities was 12.7 (standard deviation = 8.3). More than half (52.90%) of people with physical disabilities reported a high level of functional impairment. Increased disability severity was significantly associated with limited access to assistive devices (adjusted odds ratio [AOR] = 4.55, 95% confidence interval [CI]: 1.87-14.08, P < .001), and increased use of medical health care (AOR = 5.55, 95% CI: 1.84-16.79, P = .002).
These findings suggest a high level of moderate to severe functional impairments in persons with physical disabilities receiving CBR in Kayunga district. These data provide support for efforts to enhance CBR's ability to liaise with local health care, education, and community resources to promote access to needed services and ultimately improve the functional status of persons with disabilities in low-resource settings.
大约 80%的残疾人士居住在中低收入国家,这些国家采用以社区为基础的康复(CBR)作为改善残疾状况的策略。然而,关于像乌干达这样的低收入国家 CBR 受益人的残疾严重程度的数据仍然很少,特别是在社区或地区一级。
描述在乌干达卡永加地区接受 CBR 服务的身体残疾人士的残疾严重程度及其相关因素。
本研究采用横断面样本,招募了 293 名在卡永加地区接受 CBR 服务的身体残疾成年人。使用 12 项世界卫生组织残疾评估量表 2.0(WHODAS2.0)来衡量残疾严重程度,并将其作为二项结果(低:0-9,高:10-48)进行分析。使用比值比进行推断统计学分析,以确定与损伤严重程度相关的因素。
身体残疾人士的平均 WHODAS 2.0 得分为 12.7(标准差=8.3)。超过一半(52.90%)的身体残疾人士报告功能损伤程度较高。残疾严重程度的增加与辅助器具获取受限显著相关(调整后的优势比 [AOR] = 4.55,95%置信区间 [CI]:1.87-14.08,P <.001),与医疗保健使用增加显著相关(AOR = 5.55,95% CI:1.84-16.79,P =.002)。
这些发现表明,在卡永加地区接受 CBR 的身体残疾人士存在较高水平的中重度功能损伤。这些数据支持努力增强 CBR 与当地医疗保健、教育和社区资源合作的能力,以促进获得所需服务,并最终改善资源匮乏环境中残疾人士的功能状况。