Impact of community-based rehabilitation on quality of life and self-esteem of persons with physical disabilities and their family members

Objective:Community-based rehabilitation(CBR)is a strategy by which persons living with disability(PWDs)access comprehensive rehabilitation services with limited evidence regarding its impact on the quality of life(QOL)and self-esteem(SE)of PWDs and their family members.This study compared the QOL and SE of Nigerian PWDs in communities with and without a CBR programme(CBR and non-CBR respectively),and the family quality of life(FQOL)of their family members.Methods:Cross-sectional study involving 2604 PWDs(1302 in CBR and 1302 in non-CBR);5208 family members of PWDs(2604 in CBR and 2604 non-CBR),recruited from four randomly selected geo-political zones in Nigeria,purposive/consecutive selection of eight CBR programmes,PWDs and their family members(CBR and non-CBR).Outcomes assessed using Rosenberg Self-Esteem Scale(RSES),World Health Organization Quality of Life Instrument-short form(WHOQOL-BREF)and Beach Centre Family Quality of Life Instrument(BCFQOL).Mann-Whitney U test and Spearman's rank order correlation were used to analyse data at P<0.05.Results:PWDs in CBR scored higher in all domains of WHOQOL-BREF(P<0.0001 in all cases)and RSES than non-CBR group(P<0.0001).The CBR families scored significantly higher than non-CBR families in all domains(P<0.05)except Emotional Well-Being of the BCFQOL.The CBR group scores on Psychological and Social Health domains of the WHOQOL-BREF showed significant positive correlation with CBR families'Family Interaction(P=0.06)and Parenting(P=0.07)domains and total FQOL(P=0.07).Conclusion:Community-based rehabilitation positively impacted on SE and QOL of PWDs and their family members.