Attending Rehabilitation Centers Research Articles

The Mediating Role of Triangulation in the Family on the Relationship Between Differentiation and Marital Conflict in Parents with Disabled Children

The purpose of this research was to investigate the mediating role of triangulation in the family on the relationship between differentiation and marital conflict in parents with disabled children. This descriptive study was correlational in nature. The population consisted of all families with disabled children attending rehabilitation centers in District 7 of Tehran. In this study, 150 individuals were selected through convenience sampling and sample size was determined using Morgan's table. For data collection, the Skowron and Friedlander (1998) Differentiation of Self Inventory, the Barati (1996) Marital Conflict Questionnaire, and the Dehghani et al. (2017) Family Triangulation Questionnaire were used. For data analysis, descriptive statistics (mean, standard deviation) and inferential statistics (correlation coefficient, univariate regression analysis) were utilized. The results indicated that there is a significant relationship between differentiation and marital conflict in parents with disabled children, and triangulation in the family plays a mediating role in the relationship between differentiation and marital conflict in parents with disabled children.

The Design of Stroke Rehabilitation Using Artificial Intelligence K.A.K.I (Kinesthetic Augmented Kinematic Inference)

Stroke is a major cause of disability worldwide that affects many people every year. Stroke rehabilitation is a process that helps stroke patients regain their lost function and improve their quality of life. However, the recovery process varies widely depending on the severity of stroke and other factors such as age, health and type of stroke. Many elderly patients face difficulties in attending rehabilitation centers due to various factors such as cost, distance and congestion. Therefore, this paper proposes methods to help stroke patients do rehabilitation exercises at home using the latest technology. Our project consists of interactive exercises that are customized to the skill level of the patients, hardware sensor inputs that can measure the strength of the hand movement of the patients, embedded processing board with camera that can detect and guide the movement of the patients and machine learning using convolutional neural network (CNN) that can analyze the movement data and provide feedback and motivation to the patients. The effectiveness of the proposed system is evaluated by the improvements in patients’ conditions through pre- and post-exercise tests. Overall, our kinesthetic augmented kinematic inferencing methods appear to be more effective than conventional methods for post-stroke rehabilitation. This project demonstrates a promising solution to enhance stroke rehabilitation, recovery and quality of life.

Nutritional status and dietary intake of children and adolescents with cerebral palsy

To analyze the association between energy and nutrient intake, nutritional status and motor compromise in children and adolescents aged 2-19 years with cerebral palsy (CP) attending rehabilitation centers in the Province of Cordoba, Argentina. Cross sectional study. Data from 105 children and adolescents of both sexes aged 2-19 years with CP (67 boys [63.8% 53.84-72.95]) were collected. Motor compromise was assessed with GMFCS. 24h records were collected and analyzed. The results were compared with the recommended by FAO/UNU/WHO for age and sex. Normal data were presented with mean and SD, while those of non-normal distribution were described as medians with their ranges. The relationship between variables was analyzed using Fisher, t, or Mann-Whitney tests, with a p value < 0.05. The mean age was 11 years 6 months (SD 4 years 4 months). Fifteen [14.3% 8.23-22.48] children failed to meet at least 80% of the recommended energy. Children with GMFCS IV-V consume fewer daily calories and carbohydrate calories than their peers (I-III). The median protein intake of children GMFCS IV-V group was significantly lower than that of their peers (47.37g vs. 71.56g, p=0.0057). Those who did not reach 80% of the recommended energy intake had lower intakes of macro and micronutrients. The greater the motor compromise in children with CP, the greater the compromise in the adequacy of nutrient intake. The intake of macro and micronutrients was different according to whether or not they were able to cover at least 80% of the recommended energy for their age.

Comparison of concurrent validity of different malnutrition screening tools with the Global Leadership Initiative on Malnutrition (GLIM) among stroke survivors in Malaysia

Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May–August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.

Correlations Between Medicine Ball Throw With Wheelchair Mobility and Isokinetic Tests in Basketball Para-Athletes.

A detailed analysis of wheelchair basketball skills in beginner wheelchair basketball players (WBP) can provide practitioners with important indications regarding the selection and prospective development of potential sports talents. A comprehensive WBP evaluation can be very time consuming, mainly during the initial phases of the training processes, which could be a barrier in clinical and practical settings. Moreover, the large number and the turnover of beginner WBP attending rehabilitation centers make the applicability of field and strength tests unfeasible. To verify the relationships between the medicine ball throw (MBT) and wheelchair basketball mobility performance field tests and the shoulder and trunk peak torque in male and female beginner WBP. Cross-sectional study. Rehabilitation Hospital Network, Paralympic Program. Thirty-seven female and male beginner WBP. Participants performed wheelchair basketball field tests (speed, agility, strength, and power tests) and the maximum strength test in the isokinetic dynamometer. The outcomes were correlated with the MBT results. The MBT presented significantly very high and perfect correlations with all wheelchair basketball field tests assessed (5-m sprint, 20-m sprint, and zig-zag agility test with and without a ball), and peak torque (R2 ranging from .810 to .995; P ≤ .05) for male and female athletes. The MBT, a simple and feasible test, can be used for estimating and determining the wheelchair mobility performance of female and male beginner WBP. It is suggested to measure the distance of a 5-kg medicine ball thrown by athletes during training and testing routines to follow the players' progression.

Nutritional status of children with cerebral palsy attending rehabilitation centers.

To describe the nutritional status of children with cerebral palsy (CP) from rehabilitation and therapeutic centers in Argentina, and to analyze their risk of undernutrition based on their Gross Motor Function Classification System (GMFCS) level. This was a cross-sectional study with data collected from 321 children (196 males, 125 females) with CP age 2 to 19 years (mean age 9y 3mo, SD 4y 5mo) from 17 rehabilitation and therapeutic centers in five Argentine provinces. Nutritional status was defined by height, weight, and body mass index for age z-scores using World Health Organization growth charts. Odds ratios were used to evaluate the association between GMFCS level and nutritional status. Of the children with CP studied, 52.4% were in GMFCS levels IV and V. Regarding the nutritional status, 41.7% were normal, 19.0% had moderate undernutrition, 33.9% severe undernutrition, 2.5% overweight, and 2.8% obese. When compared to those in GMFCS levels I to III, the odds of children in GMFCS levels IV and V having moderate undernutrition are four times greater and the odds of having severe undernutrition are 14 times greater. There is a high prevalence of undernutrition associated with CP (GMFCS levels IV and V) among children in rehabilitation and therapeutic centers in Argentina. Risk of severe undernutrition increases with increased motor compromises.

Perception of Mothers among Cerebral Palsy Children with Disabilities in Tamil Nadu, India

The purpose of the study is to check the perception of mothers of cerebral palsy children with disabilities in Tamil Nadu. Data, from India, on perceptions about Cerebral palsy disability are scant. This study explored mother’s knowledge, social well-being and awareness of treatment rendered. During the development of the questionnaire, review of the literature has been primarily made; during developing the questionnaire personal and social values were considered. The questionnaire was emerged with 9 themes, Knowledge of disability condition, Parental stress, Community support, Child ability, Mothers Confidence, Improvement, Health status, Benefits &amp; Belief. Data were collected from mothers of both male and female children with cerebral palsy aged between 1 to 18 years. 220 mothers, averaged 33.44 + 6.14years, of children with CP were randomly selected for this study. Data was collected from mothers attending rehabilitation centers from different institution and special schools in Tamil Nadu. Mothers can hold both a fatalistic view of disability and a belief in the course of disability.The raw data was tabulated and analyzed by using SPSS 17 version software. Cronbach’s Alpha was calculated, the results showed that its Cronbach’s Alpha was extremely good (r=0.96). Our results suggest that there is significance difference with in the mother’s perception towards types of disability in Parental stress, child’s ability, mother’s confidence, improvement, health status, benefits and belief.Mothers should be motivated to maximize rehabilitation services in order to improve their children’s functional capacity. The appreciation of this phenomenon could move towards a model for the delivery of rehabilitation that integrates and harmonizes such beliefs.

Quality of life among caregivers of children with disabilities attending rehabilitation centre in Kuala Lumpur and Selangor

Quality of life (QoL) is an awareness of an individual in their situation 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. Caregivers of children with disabilities seem to display a higher burden and impaired Quality of Life (QOL). Evaluating QOL and sources of stress among caregivers of children with disabilities is an essential for interventions focused on rehabilitation. An 82 caregivers of persons with a disability registered under Community Based Rehabilitation (CBR) Centres based in Kuala Lumpur and Selangor were selected for the study. Self- administered questionnaires by using WHOQOL-BREF was used to assess the quality of life of caregivers. The mean age of the caregivers was found to be 42.45 years, with 47 (57.3%) females and 35 (42.7%) males. The mean Quality of Life of these caregivers was 74.60. The physical domain was significantly associated with education, income, occupation, and age; the psychological domain was associated with education, race, income, and age, while the environmental domain was associated with relation to caregiver education, race, income, age, and occupation. Social domain was the most affected; marital status (p-value=0.01), education (p-value=0.01), race, race (p-value=0.03), relationship with the children (p-value=0.01), income (p-value=0.01) and occupation (p-value=0.03). Income was observed to affect all the domains, and caring for the disabilities' children with health problems were the major sources of stress to the caregivers. Quality of Life among the caregivers was obviously influenced by various factors that necessity to be addressed. Specific supports and interventions should be highlighted to benefit the caregivers to ensure the betterment of care for children with disabilities.

Beliefs of Medical Faculty Students Toward Mental Illnesses and Impacts of Visiting Community Mental Health Centre on This Beliefs

Objective: Doctors’ beliefs about mental illness and approaches to them are important in the prevention as well as for an accurate diagnosis of mental disorders and the provision of treatment. For this reason, identifying the thoughts and behavioral inclinations of medical students needs to be taken seriously. The purpose of the current study is to determine beliefs of Medical Faculty students about mental illness. The study also aims to identify the relationship between the effects of visiting Community Mental Health Centers and the stigmatization of mental illnesses by medical faculty students. Method: The study was conducted with 153 students from Kocaeli University Medical Faculty during the academic year 2017-2018, including groups from grade 1 (n=25), grade 2 (n=16), grade 3 (n=21), grade 4 (n=14), and the first three intern groups from grade 5 (n=77). A Sociodemographic Form was administered and the Beliefs Toward Mental Illness (BMI) scale was completed by the participants. Results: In the study, the participants were divided into three groups: Group 1 (grades 1 and 2), Group 2 (grades 3 and 4), and Group 3 (grade 5). There was no statistically significant difference between the three participant groups for any of the subscales of the BMI. After the visit to the Community Mental Health Center, a statistically significant decrease in the scores for the “dangerousness” subscale of the BMI was found in Group 3. In addition, there was a negative correlation between income status and “dangerousness” subscale. Conclusion: The study demonstrated that it can be beneficial for prospective medical graduates to come into contact with patients who after attending rehabilitation centers are showing partial improvement in their health. Moreover, this activity can assist in changing the negative perception and behaviors of medical students toward persons with a mental illness. Our research suggests that this activity could be included in the Medical School curriculum.

Pain and Quality of Life in Human T-cell Lymphotropic Virus Type 1-Associated Myelopathy or Tropical Spastic Paraparesis After Home-Based Exercise Protocol: A Randomized Clinical Trial.

Human T-cell lymphotropic virus type 1-associated myelopathy or tropical spastic paraparesis (HAM/TSP) causes, among other abnormalities, chronic pain that may impair quality of life (QOL). Home protocols can help those who have difficulty attending rehabilitation centers. This study aimed to evaluate the impact of a home-based exercise protocol on pain and QOL in people with HAM/TSP. A randomized clinical trial of people with HAM/TSP (World Health Organization criteria) classified as probable or definite. The supervised group (SG) underwent training for 12 weeks and continued the protocol at home for another 12 weeks; the unsupervised group (UG) performed the same protocol at home without physical therapist supervision for 24 weeks; and the control group (CG) maintained the usual care. QOL was assessed by the Short Form-36 health survey and the pain condition by the Brief Pain Inventory (BPI). The Chi-square, analysis of variance, Kruskal-Wallis, and Friedman tests (5% alpha) were used for the analyses. The intention-to-treat method was adopted in case of follow-up losses. Record number RBR-849jyv/UTN: U1111-1176-2858. Of 56 participants, 49 completed the protocol. Mean pain was moderately reduced (>30%) in the UG and CG and mildly reduced (20%) in the SG. Loss in the vitality score of QOL in the CG was noted. The protocol generated mild and moderate pain relief and reduced losses in the functional QOL in the treatment groups.

Self-esteem and Locus of Control in the Initial and Final Stages of Drug Withdrawal Among Addicts Attending Rehabilitation Centers

Self-esteem and Locus of Control in the Initial and Final Stages of Drug Withdrawal Among Addicts Attending Rehabilitation Centers

Socio demographic profile in relation to care givers of persons with permanent disabilities attending rehabilitation centre in H.D. Kote Taluk, Mysore District

Socio demographic profile in relation to care givers of persons with permanent disabilities attending rehabilitation centre in H.D. Kote Taluk, Mysore District

Assessment of mental health status among caregivers of persons with permanent disabilities attending rehabilitation centre in H. D. Kote taluk, Mysore district

Background: People with disabilities have constant health needs for very long periods in their life. They may have limitations in the activities of daily living and communication abilities. Disability is highly demanding, requiring consistent care. The physical and psychological well-being of a caregiver is important for the well-being of the person receiving care. The objective of the study was to assess the mental health status of caregivers of persons with permanent disabilities.Methods: A hospital based cross sectional study was carried out from July 2014 to December 2014. 100 caregivers of cases registered under “Chaithanya Vahani” programme by SVYM Hospital were selected for study. GHQ-28 questionnaire was used to in the structured proforma to assess mental health status of caregivers.Results: Mean age was found to be 38.25 years with 87 (87%) females and 13 (13%) males. Mean GHQ-28 score was found to be 8.09 with a standard deviation of ±4.85 which is quite higher than the cut off value of 4. 76% of caregivers had a score higher than the mean score indicating mental stress. Social impairment domain of GHQ-28 was found to be significantly associated with gender (p=0.009), age (p=0.009) and duration of care (p=0.008). Anxiety domain was significantly associated with duration of care (p=0.033) and severe depression domain was found to be associated with marital status (p=0.003).Conclusions: Association between mental health status of caregivers and gender, age, marital status and duration of care giving was found to be statistically significant. Psychological counselling is to be done at regular intervals for caregivers to help them in overcoming stress, anxiety and depression. Screening of caregivers should be done at regular intervals to detect any kind of mental distress at the earliest.

Contributing factors to relapse of drug addiction among clients attending rehabilitation centres of Dharan, Nepal

Relapse is the resumption of substance after a period of abstinence. It is frustrating but frequent part of recovery process. Several substance including opiates, cocaine and alcohol have particularly has high relapse rate with majority of client re­lapsing within 1 year following treatment. The first 90 days after treatment are very vulnerable time. Hence, the objective of the study is to assess the contributing factors to relapse of drug addiction since the aftercare services, the psycho-social aspect of the treatment has been ignored and high relapse is prevalent among the treated clients. A descriptive cross-sec­tional study was carried out among clients attending three rehabilitation centres of Dharan using lottery method of simple random sampling among 72 respondents using structured questionnaires from 20th September to 4th October, 2015. Findings of the study showed that majority (63.9%) of the respondents had started taking drugs again due to lack of self confidence. In addition to this another contributing factor to relapse was peer pressure (50%) followed by inability to give old habits (44.4%), easy accessibility of drugs (30.6%). The finding also indicated that there was significant relationship (p value = 0.054) between peer pressure and employment status. Lack of self-confidence, peer pressure, easy accessibility of drugs, lack of acceptance in society and family, adjustment problems had increased the chance of relapse after treatment. So, the treatment centres of Dharan should develop program that incorporate the overall development and treatment of client to prevent from relapse of drug addiction.

Low knowledge and perceived Hepatitis C risk despite high risk behaviour among injection drug users in Kathmandu, Nepal

BackgroundIn Nepal, prevalence of Hepatitis C (HCV) among injecting drug users (IDUs) has been measured at 50% and knowledge of the virus is low. Rehabilitation and harm reduction attendees constitute populations to whom health care providers can deliver services. As such, characterizing their drug use and risk profiles is important for developing targeted service delivery. We measured drug use and risk patterns of IDUs participating in residential rehabilitation as well as those contacted through needle exchanges to identify correlates of drug use frequency, risky injection practices as well as HCV testing, knowledge and perceived risk. MethodsWe collected cross-sectional data from one-on-one structured interviews of IDUs contacted through needle-exchange outreach workers (n=202) and those attending rehabilitation centres (behaviour immediately prior to joining rehabilitation) (n=167). ResultsRoughly half of participants reported injecting at least 30 times in the past 30 days and individuals with previous residential rehabilitation experience reported frequent injection far more than those without it. About one in fourteen respondents reported past week risky injection practices. Participants were over three times as likely to report risky injection if they consumed alcohol daily (17.2%) than if they did not (5.0%) (p=0.002). Those who reported injecting daily reported risky injection practices (11.9%) significantly more than non-daily injectors (1.8%) (p<0.001). Respondents reported high HCV infection rates, low perceived risk, testing history and knowledge. HCV knowledge was not associated with differences in risky injecting. ConclusionTreatment centres should highlight the link between heavy drinking, frequent injection and risky injecting practices. The link between rehabilitation attendance and frequent injection may suggest IDUs with more severe use patterns are more likely to attend rehabilitation. Rehabilitation centres and needle exchanges should provide testing and education for HCV. Education alone may not be sufficient to initiate change since knowledge did not predict lower risk.

Association between gross motor function and nutritional status in children with cerebral palsy: a cross-sectional study from Colombia.

To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. We conducted a cross-sectional study in 177 children (ages 2-12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012-2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27-14.0) and stunting (OR 8.42; 95% CI 2.90-24.4) than those classified in GMFCS levels I to III. Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction.

Assessment of quality of life among caregivers of persons with permanent disabilities attending rehabilitation centre in H. D. Kote Taluq, Mysore district, Karnataka, India

Background: Quality of life (QoL) is defined as “an individual’s perception of their position in life in the cultural context and in the value systems in which they live and in relation to their goals, expectations, concerns and desires. Caregivers of persons with chronic health conditions run the risk of emotional distress and poor adjustment to the demands of the patient, which in turn may adversely affect the quality of care that a person in need would receive. An assessment of quality of life among caregivers is important, for interventions targeted at rehabilitation. Methods: A 100 caregivers of persons with disability registered under the rehabilitation program of SVYM at VMH Saragur were selected for the study. WHOQOL-BREF questionnaire was used to assess quality of life of caregivers. Results: The Mean age of the caregivers was found to be 38.25 years with 87 (87%) females and 13 (13%) males. The mean Quality of Life of these caregivers was 71.97. Physical domain was significantly associated with income, earning capacity and duration of care. Psychological domain was associated with income and family type. Social domain was the most affected, with factors viz. Age (p-value=0.002), employment (p-value=0.02), earning capacity (p-value=0.032), education and duration of care being significantly associated. Environmental domain was associated with relation to caregiver, earning capacity (p-value=0.032), education and income. Marital status was observed to affect all the domains. Conclusions: The Quality of Life of Caregivers was significantly affected by a multitude of factors which need to be addressed to ensure proper care of their wards. Interventions aimed at building the capacities the affected individuals as well as the caregivers would be highly beneficial to both groups.

Are Special Needs Teachers More Burned-out Than Volunteers with Disabled People?

This study was focused on the comparison between special needs teachers and volunteers in contact with disabled people in relation to levels of burnout and representation of self and disabled people (students or users). The sample was composed by 106 special needs teachers serving in two Public Junior and Senior High Schools, and 70 volunteers in contact with disabled people attending Rehabilitation Centres in Catania (Sicily, Italy). Measures: We used the 22-items version of the Maslach Burnout Inventory and two Semantic Differentials referred to Self-image and disabled students/users. Results showed that teachers were more burned-out than volunteers. For teachers, the more the self-image was positively judged, the more the levels of emotional exhaustion and reduced personal accomplishment were low. Also for volunteers, the more the self-image and disabled users were positively assessed, the more the levels of emotional exhaustion and reduced personal accomplishment were low; finally, the more the self-image was positively valued by volunteers, the more the levels of depersonalization were low. Future researches could deepen the factors which affect burnout syndrome, such as self-efficacy, self-competence, self-acceptance, and other psychological dimensions of self.

To Understand the Health Care Seeking Pathways for the HIV Positive Patients attending Rehabilitation Centre

The epidemic of human Immunodeficiency virus (Retrovirus) that causes Acquired Immunodeficiency Syndrome has emerged as a serious public health problem in many parts of the World, which breaks down body's immune system leading to life threatening opportunistic infections and unusual malignancies. In which gender based difference in the health seeking behaviour has significantly precipitate to it. Rationale: Women's are much more vulnerable and likely to get discriminated with HIV infection, having so many reasons behind it than men, who plays dominant role in the society. So, there is need of gender based research to go through the health seeking behaviour of the HIV positive patients to understand the discrimination. This study also helps in policy making for National AIDS Control Program. Aims & Objectives: To study the health seeking behaviour of HIV positive case and impact ofgender discrimination over it. Methods: This study was based on qualitative data collection of 25 HIV positive patients conducted between the April 2012 to June 2012 at Rajendra Memorial Research Institute (ICMR) Patna Bihar. 25 HIV positive patients (More than 13 years of age) who visit the Rehabilitation centre during the study period. A semi-structured -interview topic guide was used for HIV positive patients with the help of the expert counsellors. In-depth interview of some randomly selected patients were arranged to collect the detailed information on health seeking behaviour at ART rehabilitation centre RMRI Patna with prior information, written and verbal consent. Prior permission will be taken from Ethical committee of Indian Institute of Public Health Delhi. Results: This study included 16 (64%) females and 9 (36%) males HIV positive cases who visited ART Rehabilitation RMRI Patna. Half of the patients (52%) were 31-40 years of age group among boththe genders. Majority of female patients (75%) were housewives. While majority of males were involvedin high risk occupations like Truck drivers (44.44%). Majority of female patients (68.75%) were illiterate. While majority of male patients (44.44%) were educated up to 7'th standard. 92% were of low incomegroup ranges Rs.2000-8000 per month. Health issues (60%) were the main issue of HIV positive patientto come at ART centre RMRI Patna . Females were more vulnerable (60%). Out of 25 patient 88%patients were referred by ICTC, doctors (private & government), NGO. First symptoms in HIVpositive patient noticed by them had history of single or multiple symptoms during initial phase, inwhich single symptom was 40% and with more than one complain was 60%. 77.8% patients initiallyhave been taking home remedies, from quacks, in which 33.33% were males and 43.75%, were females.Study shows that 60% patient contacted Government doctors, private doctors, NGO initially, in which20% were females as compared to 24% males.

Morbidity profile in a rural community-based rehabilitation programme in Butembo, North Kivu Province, Congo

BackgroundMedicine in low socio-economic countries is primarily disease-oriented; prevention and rehabilitative care are secondary concerns. Hence, curative care erodes the few resources allocated to health. Despite the well-documented benefits of community-rehabilitation in the management of chronic conditions, little is known about common conditions present in the community in Butembo.ObjectivesThe objective of this study was to determine the conditions encountered during rehabilitation in Butembo and to identify the trends of the five most common conditions during the study period.MethodData were extracted from a rehabilitation programme connect to one centre in Butembo. A descriptive retrospective medical study was performed for the period between 2004 and 2007. Descriptive statistics with percentages were computed. The Chi-square test was used to evaluate the differences with a probability of 5%.ResultsCerebral palsy (46.9%), cataract (17.3%), clubfoot (11.8%), glaucoma (6.8%), and cleft lip (4.5%) were the most commonly encountered conditions, with cerebral palsy the most common condition throughout the study period. With regard to gender, male patients were significantly more affected by cataracts (p = 0.0290), clubfoot (p < 0.0100) and glaucoma (p < 0.0100) than female patients. Children aged five or younger had a higher incidence of cerebral palsy (χ2 = 263.2, df = 1, p = 0.0000) cataract (p = 0.0170), clubfoot (p < 0.0010), and glaucoma (p = 0.0010). Additionally, the overall comparisons by gender and age demonstrated differences for the five most common conditions (χ2 = 15.3, df = 4, and p = 0.0040; and χ2 = 114, df = 4, and p < 0.0001 for gender and age, respectively).ConclusionCommon conditions and associated factors were identified that will add to the effectiveness of the programme in terms of materials needed, staff skills, and programming. Special skills are still needed to help treat some acute conditions that can be handled at the rehabilitation centre, and a triage of attending rehabilitation centres could improve the effectiveness of the programme and lower the possibility of missed opportunities for acute stage patients.