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Japanese to English: Quality of Life of Dominican People with Acquired Disablities
Source text - Japanese 【目的】著者は青年海外協力隊としてドミニカ共和国で活動する機会を得た．そこで当国の障害者のQuality of Life(以下，QOL)の低さを感じ，当国の障害者と作業療法士(以下，OT)がQOLの現状をどのように考えているのだろうかと疑問を持った．OT実践にはその地域の文化や生活習慣によって独自に展開されている．他国のOTが，作業療法発展のために異文化の中で活動する際には，その国の障害者の置かれている状況や背景を知ることが必要である．本研究の目的は，ドミニカ共和国の障害者のQOLの特徴を知ること，現地のOTがQOLをどのように捉えて作業療法を行っているのかを明らかにすること，そして障害者のQOL向上を目指すOT介入のための示唆を得ることである．
Translation - English Aims
The author gained an opportunity to be active as a Japan Overseas Cooperation Volunteer in the Dominican Republic. There they sensed the poor Quality of Life (herein QOL) of the country's disabled people and they wondered what the country's disabled and the occupational therapists (herein OT) thought about the present condition of the QOL. An OTs practice is uniquely developed by the area's culture and lifestyle customs. When OTs from other countries are active in a different culture for occupational therapy development, they have to understand the conditions and background the disabled person is in. The aims of this research are to understand the characteristics of the QOL of Dominican disabled people, to clarify how the local OTs perceive the QOL and carry out the therapy, and then gain suggestions towards OT intervention that aims to improve the QOL of the disabled.
Regarding the investigation of the QOL of people with acquired physical disabilities (Investigation 1): the target group was 103 people with motor-function disabilities who had agreed to the research. This breaks down to 54 males and 49 females, with an average age of 52 (between 17 and 84 years old). Data collection was carried out by basic information and the WHOQOL-26 questionnaire. Analysis used the Mann-Whitney U-test and the Kruskal Wallis-test. The level of significance was 5%.
Regarding the investigation into the local OT's awareness of QOL (Investigation 2): the target group was 19 people working as OTs who had agreed to the research. This breaks down to 2 males and 17 females, 11 working in an urban area, 8 working in a rural area, 6 members had worked for less than 2 years, 8 members between 2 to 5 years and 5 members for over 10 years. Data collection was carried out through semi-structured interviews. A predicative analysis was carried out on the acquired information. Furthermore, this research was carried out after gaining approval from this university's moral inspection committee. (Report Number 21-058)
Investigation 1 was conducted with the aim of understanding the features of the QOL of physically handicapped Dominicans. Looking at the WHOQOL-26 low rank entries, the 3 highest scoring items were “body image”, “social support” and “residential circumstances”. The 3 lowest scoring items were “capacity for work”, “monetary concerns” and “sexual activity”. Looking at comparisons between attribute classification and WHOQOL fields, it was shown that regarding gender, males had a higher significance value than women in WHOQOL physical fields. Regarding area of residence, it was shown that those living in urban areas had a higher significance value than those living in rural areas in WHOQOL mental and environmental fields. Regarding the OT's length of practice, it was shown that OTs with over 1 year in practice had a higher significance value than those with less than one year in overall WHOQOL scoring, physical and mental fields. In other attribute classifications, no significant difference was observed regarding income. Regarding education, it was shown that those who had graduated from university had a higher level of significance in physical and environmental fields than those with no education. Regarding the degree of independence on outings, independent groups were shown to have a higher significance value than aid groups in total score, physical and social fields.
Investigation 2 was conducted with the aim of understanding in what way Dominican occupational therapists perceive the QOL of disabled people. 37% thought that the concept of QOL was defined by a persons situation and the possibility of development, 47% thought it was their level of affluence. Regarding OT approaches to the improvement of QOL, 32% took a functional approach, 21% each towards family support and towards the needs of the target person, and 16% towards support in returning to work. 69% were pessimistic about disabled people's QOL. Economic reasons were given for the majority of reasons for this. 42% thought economic support was necessary for improvement of QOL of the disabled, 21% gave things such as substantiality of social security and roles in the country.
From the results of Investigation 1, it has been understood that Dominican disabled people feel satisfied with their own physical appearance and support from their friends but think that their capacity for work and the money to buy essential things is insufficient. Looking at attribute classification, previous research by BT Baune 1) showed recognition of a high significance value in gender and social fields, but this investigation gives different results. Regarding differences in residence, it was thought that problems with access to public transport and limited chances to gather information had an influence. Also, it suggested that OT intervention influenced improvement in disabled people's QOL, but a specific primary factor could not be determined.
Conclusions drawn from analysis of Investigation 2 hinted that staff were pessimistic about disabled people's QOL, but the reason given for this was the influence of the size of the economic burden on individuals and each family due to the disability. Further, from the results regarding the concept of QOL and approaches, it was suggested that for a concrete approach to improve disabled people's QOL, staff took an approach that rebuilt the disabled people's lifestyle.
Support leading to an improvement in QOL was thought to be that which enabled the disabled people to find appropriate work and which solved monetary problems. It is thought that volunteers working in this country working together with the staff in this country to give disabled people support finding employment is effective. Also, a point of note raised from this investigation is the difference in education due to location, and the difference in QOL due to education length. Therefore, it is thought that an approach towards education of disabled people in rural areas is also important.
The results gained from this research, carried out in the limited area of the Dominican Republic Rehabilitation Centre (capital and 3 branches), can not be instantly generalised. Also, as the research subjects have acquired physical disabilities and are outpatients commuting to hospital, it cannot be said that the results of this research can be adapted to all disabled people.
Due to the subjects being rehabilitation staff and people working for the Dominican Rehabilitation Association, it cannot be stated definitively that the results of this research can be adapted.
Years of translation experience: 8. Registered at ProZ.com: Jan 2010.