Health promotion needs of physically disabled individuals with lower limb amputation in selected areas of Rwanda

Abstract

This thesis is a quantitative and qualitative study, reflecting the health promotion I needs of individuals with lower limb amputation in Rwanda. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, and this may be exacerbated by poor choices of lifestyle. Rehabilitation services have been traditionally designed for those experiencing sudden on-set, traumatic disabling conditions. Although physically disabled persons desire to engage in wellness-enhancing activities, limited programs based on their health promotion needs' assessment have been developed. In this study, participants' health promotion needs and factors that influence their health-related behaviours were examined using a questionnaire survey and in-depth face-to-face interviews. Data analysis, using SPSS version 10.0, was used to obtain frequency tables and histograms. Chi-square tests, Fisher's exact Tests and Pearson's correlation coefficient were utilized to test for associations between several variables. Audiotape recordings and process notes were translated, and then transcribed verbatim. Strong themes that ran through the data were identified. In order to qualify for between method triangulation used in the study, complementally strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. Participants were 334, comprising more males (8O%) than females (20%). The most frequently reported cause of amputation was land mines injuries (44.6%). Most participants were either unilateral below-knee (40.7%) or above-knee (40.1%) amputees. The. majority of participants led physically inactivity lifestyles (64.7%), others consumed alcohol (60.5%), used tobacco (33.5%) and drugs (9.6%). In-depth interviews revealed that participants' low psycho-social status and self-perception led to depression and frustration. Negative peer influence and lack of access to relevant information predisposed them to involvement in risky health behaviours. Further interviews indicated that the participants' perceived health-related needs included access to relevant information and new lifestyle habits to improve their health. Participants also desired job opportunities, particularly vocational training programmes and the formation of support groups, to enhance various programmes. The study findings are extremely challenging. Over 50% of participants were engaged in health-risk behaviours, which would certainly result in the deterioration of their health status. This places a greater demand on rehabilitation services, increasing morbidity and mortality rates, thus further straining the national health -- budget. There is therefore an urgent need to develop, encourage and promote - wellness-enhancing behaviours and activities, to improve the participants' health status and ultimate quality of life. Finally, further studies need to focus on barriers and determinants of health-promoting behaviours, and to explore more about issues related to self-perception and risky health behaviours.