Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach

Abstract Background Despite representing 70 million people in Latin America, access to comprehensive rehabilitation and participation in the community remains a challenge for persons with disability (PWDs) in the region. Through enactment of the Disability Law, Colombia has made improvements to reco...

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Main Authors: María Luisa Toro-Hernández, Alejandra Mondragón-Barrera, Sara Múnera-Orozco, Laura Villa-Torres, Wendy Camelo-Castillo
Format: Article
Language:English
Published: BMC 2019-06-01
Series:International Journal for Equity in Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12939-019-0923-4
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author María Luisa Toro-Hernández
Alejandra Mondragón-Barrera
Sara Múnera-Orozco
Laura Villa-Torres
Wendy Camelo-Castillo
author_facet María Luisa Toro-Hernández
Alejandra Mondragón-Barrera
Sara Múnera-Orozco
Laura Villa-Torres
Wendy Camelo-Castillo
author_sort María Luisa Toro-Hernández
collection DOAJ
description Abstract Background Despite representing 70 million people in Latin America, access to comprehensive rehabilitation and participation in the community remains a challenge for persons with disability (PWDs) in the region. Through enactment of the Disability Law, Colombia has made improvements to recognize and address some of the barriers for PWDs, including access to comprehensive rehabilitation. However access remains limited with significant disconnect between perspectives of various stakeholders and the needs of the population. We examined the unique perceptions on access to comprehensive rehabilitation services and participation of PWDs. We also explored the perspective of caregivers of PWDs, rehabilitation professionals, and other stakeholders on the experiences of PWDs. Our goal was to identify gaps in the implementation of comprehensive rehabilitation programs, and barriers to access resources for comprehensive rehabilitation or services that would impact participation of PWDs. Methods Qualitative study conducted in 2017. Data was collected from a purposive sample of adults with physical disability, aged 18–44 years, who had received rehabilitation services at a local partner organization and with different backgrounds and experiences with disability. Purposive sampling was also conducted with caregivers, rehabilitation professionals, and other stakeholders. Socio-demographic information was collected and semi-structured interviews were conducted by a research team member, recorded, transcribed and analyzed using a thematic analysis method to identify main themes related to our aim. CES University ethical review board approved this study. Results Thirty-two participants were interviewed: eight were male, 42.1 ± 11.1 years old, and 44% (n = 14) were PWDs. Three main themes were identified among all the participants: the meaning of rehabilitation, challenges to access services, and participation. Challenges to access services had three sub-themes: barriers to personal mobility, perceptions and knowledge on disability, and navigating the system. Conclusion The main focus of rehabilitation as perceived by stakeholders is still on functional rehabilitation. If healthcare personnel is better trained on disability and if those with disabilities are actively involved in the developing these programs, the focus may evolve to a comprehensive and equitable rehabilitation process that fosters full participation.
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spelling doaj.art-5db535f72b05408c843af4c366fd4b4a2022-12-21T23:45:59ZengBMCInternational Journal for Equity in Health1475-92762019-06-0118111110.1186/s12939-019-0923-4Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approachMaría Luisa Toro-Hernández0Alejandra Mondragón-Barrera1Sara Múnera-Orozco2Laura Villa-Torres3Wendy Camelo-Castillo4School of Physical Therapy, CES UniversitySchool of Physical Therapy, CES UniversitySchool of Physical Therapy, CES UniversityDepartment of Social Medicine, UNC School of Medicine, University of North Carolina at Chapel HillDepartment of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland BaltimoreAbstract Background Despite representing 70 million people in Latin America, access to comprehensive rehabilitation and participation in the community remains a challenge for persons with disability (PWDs) in the region. Through enactment of the Disability Law, Colombia has made improvements to recognize and address some of the barriers for PWDs, including access to comprehensive rehabilitation. However access remains limited with significant disconnect between perspectives of various stakeholders and the needs of the population. We examined the unique perceptions on access to comprehensive rehabilitation services and participation of PWDs. We also explored the perspective of caregivers of PWDs, rehabilitation professionals, and other stakeholders on the experiences of PWDs. Our goal was to identify gaps in the implementation of comprehensive rehabilitation programs, and barriers to access resources for comprehensive rehabilitation or services that would impact participation of PWDs. Methods Qualitative study conducted in 2017. Data was collected from a purposive sample of adults with physical disability, aged 18–44 years, who had received rehabilitation services at a local partner organization and with different backgrounds and experiences with disability. Purposive sampling was also conducted with caregivers, rehabilitation professionals, and other stakeholders. Socio-demographic information was collected and semi-structured interviews were conducted by a research team member, recorded, transcribed and analyzed using a thematic analysis method to identify main themes related to our aim. CES University ethical review board approved this study. Results Thirty-two participants were interviewed: eight were male, 42.1 ± 11.1 years old, and 44% (n = 14) were PWDs. Three main themes were identified among all the participants: the meaning of rehabilitation, challenges to access services, and participation. Challenges to access services had three sub-themes: barriers to personal mobility, perceptions and knowledge on disability, and navigating the system. Conclusion The main focus of rehabilitation as perceived by stakeholders is still on functional rehabilitation. If healthcare personnel is better trained on disability and if those with disabilities are actively involved in the developing these programs, the focus may evolve to a comprehensive and equitable rehabilitation process that fosters full participation.http://link.springer.com/article/10.1186/s12939-019-0923-4Physical disabilityComprehensive rehabilitationCommunity participation
spellingShingle María Luisa Toro-Hernández
Alejandra Mondragón-Barrera
Sara Múnera-Orozco
Laura Villa-Torres
Wendy Camelo-Castillo
Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
International Journal for Equity in Health
Physical disability
Comprehensive rehabilitation
Community participation
title Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
title_full Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
title_fullStr Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
title_full_unstemmed Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
title_short Experiences with rehabilitation and impact on community participation among adults with physical disability in Colombia: perspectives from stakeholders using a community based research approach
title_sort experiences with rehabilitation and impact on community participation among adults with physical disability in colombia perspectives from stakeholders using a community based research approach
topic Physical disability
Comprehensive rehabilitation
Community participation
url http://link.springer.com/article/10.1186/s12939-019-0923-4
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