Protocol for Conducting Disability Surveys
Background:
The purpose of this survey is to identify disabled patients and their caregivers
in Shoulder-to-Shoulder clinic catchment area communities. It also will list
assistive devices that future brigades should bring to benefit these patients.
Ultimately, local suppliers of needed equipment will be developed.
Methodology:
1. We will use information obtained by community leaders, clinic physicians, and
village informants to identify disabled people in the village to be visited. After
obtaining permission from the family, the following data will be collected.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
Village house location
Physical barriers in the home environment and surroundings
The disabled’s health status
The caregiver’s health status
Sources of health care for the disabled
Barriers to accessing health care
Assistive devices being used and those needed
Social supports available to the disabled
Household finances
Patient function in activities of daily living
Patient ability and motivation for rehabilitative therapy
A list will be generated for the local STS clinic, which will also be used to inform
future teams of therapy, and assistive device needs in the community. Care
plans will be developed that take into account the current limitations in local
resources. In the future local health personnel may be trained to continue
rehabilitation plans developed by visiting therapists or by the Honduran health
system.
Field Equipment:
Pens
Clipboards
GPS unit
Protocol sheets
Questionnaire in English and Spanish
Notepaper
Blood pressure cuffs for adult and child
Scale
Measuring tape (6 feet) for height and waist
Questionnaire Topics
Census
Village
GPS address
Disabled’s family Names
First Name
DOB
Sex
Marital Status
Primary caregiver
Secondary caregiver
Household relationships
Literacy of disabled
School grade completed
Literacy of caregiver
Caregiver health
Disabled’s Health
Height
Weight
Blood Pressure
Health self assessment
Disabling illness
Other illnesses
Medications
Health care:
Primary source
Last visit
Secondary source
Last visit
Tertiary source
Last visit
Physical Environment of Home & Surroundings
100 meter topography
Yard topography
Steps or other entrance challenges
Floor of home
Furniture adaptation
Access to latrines
Electricity (appliances)
Telephone
Transportation availability
Barriers to accessing care
Condition of paths
Condition of roadways
Assistive Device Use and Needs
Cane or walking stick
Crutches
Walker
Brace
Wheelchair
Other
Social Supports:
Education of household head
Occupation of household head
Social networks participation
Family support local
Family support remote