Sunsern, R., Ph.D*Pothong,J., MSc

Rukkaumsook, S., MSc

• An umbrella term, covering impairments, activity limitations, and participation restrictions (WHO, 2001).

1.1 Definition of Disability (1)1.1 Definition of Disability (1)

1.Background and 1.Background and SignificanceSignificance

• Disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.

Figure: Percentage of disabled persons in Thailand 1970 to 2007

0

0.5

1

1.5

2

2.5

3

3.5

1970 1976 1981 1986 1991 1996 2001 2007

Source: National Statistical Office, Ministry of Information and Communication Technology, Thailand (2008)

1.2 Context of Disability in Thailand (1)1.2 Context of Disability in Thailand (1)

Classifications of disabled persons1. physical or movement disability at 48.4 %

2. auditory disability at 13.8 %

3. intellectual disability at 12.4 %

4. visual disability at 10.21 %

5. psychological disability at 5.9 %

(Office of Disability and Development, 2010)

1.2 Context of Disability in Thailand (2)1.2 Context of Disability in Thailand (2)

Problems and Needs Problems and Needs

of of Disabled peopleDisabled people

1. Health Problems & Needs

2. Educational Problems & Needs

3. Occupational Problems & Needs

4. Social Problems & Needs

1.2 Context of Disability in Thailand (3)1.2 Context of Disability in Thailand (3)

Health Problems & Needs

• Physical problem

• Psychological problem

• Rehabilitation problem

• Complication from disability problem

• Early Screening of disability problem

• Problem related to caring

1.2 Context of Disability in Thailand (3)1.2 Context of Disability in Thailand (3)

Discharge from the hospital home

Community based

rehabilitation

Primary health care

Help/support/careHelp/support/care

Health problems = Re-Admit in hospital

Patient with disability at home (physical limitation, cognitive deterioration and degree of disturbance)

1.2 Context of Disability in Thailand (4)1.2 Context of Disability in Thailand (4)

community

• Community care is based on an ideology of dependency.

• On the other hand, community support is rhetoric about helping people to live independent lives.

1.2 Context of Disability in Thailand (5)1.2 Context of Disability in Thailand (5)

Innovative care for chronic conditions: ICCC Innovative care for chronic conditions: ICCC (WHO, 2002)(WHO, 2002)

1.2 Context of Disability in Thailand (6)1.2 Context of Disability in Thailand (6)

What are the real needs of Thai disabled people

by community support?

2.Research 2.Research QuestionQuestion

To explore situations, problems and needs of community support as perceived by disabled people in Thailand.

3.Purpose of the 3.Purpose of the studystudy

4.Research result 4.Research result expectation expectation

Get the preliminary results for developing Thai community support system for disabled people

Qualitative Research

5.Research 5.Research DesignDesign

6.Sample group6.Sample group76 samples of disabled people were selected by

purposive sampling including:

1. physical or movement disability = 362. visual disability = 153. auditory disability = 124. intellectual disability (caregivers) = 85. psychological disability = 5

(recovery stage)

7.Setting7.Setting

Na-yaiarm District

Chantaburi province

Eastern region

Thailand

8.Instrument8.Instrument

• Focus group guideline

• In-depth interviewing and

brainstorming guideline

• Tape recorders

9.Data Collection 9.Data Collection TechniquesTechniques

• focus group discussion

• in-depth interviewing

• brainstorming

Data Analysis

•The researcher translated the focus group

and interview tapes verbatim

•Content analysis was used to

• analyzed the qualitative data

• validated by key informants and experts.

10.Data Analysis &10.Data Analysis &Credibility of Content Credibility of Content

AnalysisAnalysis

11.Protection of 11.Protection of Human SubjectsHuman Subjects

Participation was entirely voluntary and subjects were free to withdraw from the study at any time without reprisal.

All potential participants will be asked to:• sign a consent form (or mark with a fingerprint if

participants cannot read or write).• nominate a time and place convenient to them.• permission to audio-tape record the conversation to

ensure an accurate record.• participant’ name and identity will not be used in any

reports.

1. Perceive in person

2. Perceive in community support– Stakeholder & Role– Types of support– Outcomes of support– Needs of support

Disabled people’s Disabled people’s ViewView

• low class in the society because of living limitation

• low level of education

• Unemployed

• Very low income

• participation restrictions in life situations

Perceive in personPerceive in person

Community supportCommunity support

Formalcommunity

leaders

Peer groups

Village health volunteers

Informalcommunity

leaders

Stakeholders

Who are stakeholders in the community? (1)Who are stakeholders in the community? (1)

• Stakeholders played a low-moderate role as a

collaborated work in community based

rehabilitation program.

• Also stakeholders were not clear in the details of

policy on the care of people with disabilities

(Local Administrative Organization).

What are the roles of stakeholders?What are the roles of stakeholders?

• Individual supports

– Money (500baht/month=CAD$15) from Local

Administrative Organization

– Health information from health volunteers

• Group supports

– Health information from health volunteers

What are the types of supports?What are the types of supports?

• Most of them were less likely to develop, knowledge, capabilities and functionality because of lack of support from community, especially support for independent living.

• Thai disable people have a recognized group in caring support but relatively little attention has been given to their health and wellbeing from community.

What are the outcomes of support?What are the outcomes of support?

Emotional Support– Psychological encouragement– Provide stress management

Appraisal Support – Reduce stigma– Be accepted from community as a general person

Information Support – Provide self care knowledge to disable people, family and

stakeholders – Provide information about access to health services, education,

occupation)– Raise awareness & positive view of disabled people for

stakeholders

What are the needs of support? (1)What are the needs of support? (1)

Instrumental support• Develop the ‘effective community support

system’– Build up easily accessible to disabled people– Arrange community activities (neighborhood, peer)– Arrange environment that facilitate to them– Co-ordinate services through a ‘link’ of community

organizations, people in the community, disabled people and family

– Set up a learning and rehabilitation center in the community

What are the needs of support? (1)What are the needs of support? (1)

• The solutions to the difficult problems facing disabled people require problem solvers with varying levels of skills, information, and contacts.

Concerning pointConcerning point

Researchers & practitioners should • improve community support, • enhancing knowledge, • developing skills, • ensuring enabling support systems,• making use of related networks, collaboration among health

professionals, community partners, families, and group members support each other were considered.

In addition, it goes on to consider the role of community in relation to the country and in the articulation of the political demands to response problem and needs of disabled people.

Go to the peopleLive among themLove themStart with what they knowBuild on what they haveBut of best leadersWhen their task is accomplishedTheir work is doneThe people all remarkWe have done it ourselves

(Chabot 1976, cited by Ashton 1990)

This Research was This Research was Supported Supported

byby

QUESTIONS?