Sunsern, R., Ph.D* Pothong,J., MSc Rukkaumsook, S., MSc Exploring Thai Community Support for Disable People Sunsern, R., Ph.D* Pothong,J., MSc Rukkaumsook, S., MSc

Introduction

1.Background and Significance 1.1 Definition of Disability (1) An umbrella term, covering impairments, activity limitations, and participation restrictions (WHO, 2001). 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.

1.2 Context of Disability in Thailand (1) Figure: Percentage of disabled persons in Thailand 1970 to 2007 Source: National Statistical Office, Ministry of Information and Communication Technology, Thailand (2008)

1.2 Context of Disability in Thailand (2) Classifications of disabled persons physical or movement disability at 48.4 % auditory disability at 13.8 % intellectual disability at 12.4 % visual disability at 10.21 % psychological disability at 5.9 % (Office of Disability and Development, 2010) 5

Problems and Needs of Disabled people 1.2 Context of Disability in Thailand (3) Problems and Needs of Disabled people 1. Health Problems & Needs 2. Educational Problems & Needs 3. Occupational Problems & Needs 4. Social Problems & Needs

Health Problems & Needs 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 (4) Health problems = Re-Admit in hospital Discharge from the hospital home Patient with disability at home (physical limitation, cognitive deterioration and degree of disturbance) Help/support/care community Primary health care Community based rehabilitation

1.2 Context of Disability in Thailand (5) 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 (6) Innovative care for chronic conditions: ICCC (WHO, 2002)

What are the real needs of Thai disabled people 2.Research Question What are the real needs of Thai disabled people by community support? 3.Purpose of the study To explore situations, problems and needs of community support as perceived by disabled people in Thailand.

4.Research result expectation Get the preliminary results for developing Thai community support system for disabled people 12

Methodology

5.Research Design Qualitative Research

6.Sample group 76 samples of disabled people were selected by purposive sampling including: physical or movement disability = 36 visual disability = 15 auditory disability = 12 intellectual disability (caregivers) = 8 psychological disability = 5 (recovery stage)

7.Setting Na-yaiarm District Chantaburi province Eastern region Thailand

8.Instrument Focus group guideline In-depth interviewing and brainstorming guideline Tape recorders

9.Data Collection Techniques focus group discussion in-depth interviewing brainstorming

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

11.Protection of Human 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.

Results

Disabled people’s View Perceive in person Perceive in community support Stakeholder & Role Types of support Outcomes of support Needs of support 22

Perceive in person low class in the society because of living limitation low level of education Unemployed Very low income participation restrictions in life situations

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

What are the roles of stakeholders? 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). 25

What are the types of supports? Individual supports Money (500baht/month=CAD$15) from Local Administrative Organization Health information from health volunteers Group supports

What are the outcomes of support? 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 needs of support? (1) 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 28

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

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

Recommendation

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.

(Chabot 1976, cited by Ashton 1990) Go to the people Live among them Love them Start with what they know Build on what they have But of best leaders When their task is accomplished Their work is done The people all remark We have done it ourselves (Chabot 1976, cited by Ashton 1990)

This Research was Supported by Institute of Health Promotion for People with Disabilities , Thailand

Thank You For Your Attention

QUESTIONS?