6th Annual Meeting of the Washington Group Kampala, Uganda, october 10 - 13 2006

1. 6th Annual Meeting of the Washington Group Kampala, Uganda, october 10 - 13 2006 PARAGUAY Experience of the Cognitive Test Question onSelf-care Oscar Barrios Dirección de Estadísticas Sociales y Demográficas General Direction of Statistical, Surveys and Censuses (DGEEC)

2. Working group The field team was conformed by: 1 general supervisor of the operative 8 interviewers Criteria of selection Professional technical staff of the Department of Censuses, General Direction of Statistical, Surveys and Censuses (DGEEC) University level, with specialization in the area of demography and wide experience in the data collection Age groups: from 25 to 45 years To speak the two official languages (Spanish and Guaraní). DGEEC – General Direction of Statistical, Surveys and Censuses

3. Sample selection Residents of the metropolitan area in Asunción People who are 16 years old and more Incidence of the disability in the domains specified in the Protocol of the Washington Group according to the data of the last National Census of Population and Housings 2002. Permanent collaboration from different institutions that work with the topic disability and from voluntary people. The disability lists were obtained from Government and not governmental Institutions. DGEEC – General Direction of Statistical, Surveys and Censuses

4. Total Femenine Masculine Total 103 44 59 With Disability 85 36 49 Visual 49 20 29 Auditory 21 11 10 Cognitive 50 20 30 Motor 33 14 19 Selfcare 17 6 11 Speaking 31 10 21 Without Disability 18 8 10 Interviewed Table 1: Interviews according to sex and type of disability 111 interviewed people: 81 with disability, 30 without disability 90 interviews and with informants 13 interviews without informants 8 interviews with informants alone DGEEC – General Direction of Statistical, Surveys and Censuses

5. 16-29 (%) 30-59 (%) 60 y más (%) Patterns Total Total 103 46 37 17 A - E 82 45 34 21 B - C - F - G 17 41 53 6 D - H 4 75 25 - Some Results Table 2: Answer to the patterns according to age groups Young people tend to respond in a more direct form to the questions. Prevalence exists of young in the patterns A and E. Adult people tend to respond in contradictory form to the questions and they prevail in the patterns B, C, F and G

6. Femenino (%) Masculino (%) Patterns Total Total 103 41 59 A - E 82 37 63 B - C - F - G 17 59 41 D - H 4 50 50 Some Results Table 3: Answer to the patterns according to sex Most of the males have responded in consequent form to the questions, that is to say masculine hegemony exists in the patterns A and E, on the other hand, the women present some inconveniences because they prevail in the patterns B, C, F and G. In the patterns D and H significant differences are not observed by sex

7. Ninguno 1 - 6 years 7 - 12 years 13 years and + (%) (%) (%) (%) Patterns Total Total 103 23 33 23 20 A - E 82 21 34 24 21 B - C - F - G 17 24 29 24 24 D - H 4 75 25 - - Some Results Table 4: Answer to the patterns according to years of approved study People with no studies are in the patterns D and H Is not observed significant difference according to years of study for the remaining groups the patterns

8. Patterns A, E – Without problems “Because I don't have any difficulty for my personal care” “Because I always take care of my body, because I can take a bath without problems” “Because I can make it without problems thanks God I don't have any impediment” “Thanks God, I don't have problems in taking a bath, neither to get dressed, even in sewing my clothes I don't have problems” “I take care alone I don't need anybody to help me” “Because he is like a child, he doesn't take a bath alone” “He sometimes loses the equilibrium” “Because It's difficult for me to take a bath, to wash with a single hand” DGEEC – General Direction of Statistical, Surveys and Censuses

9. Patterns B,C “Because I don't have difficulty I can manage myself” “I make everything with my left” “Because I am a healthy person and I can make it alone” “I feel well I make everything normally” “My house is appropriate for me, so I don't have any problem” “He/She takes a bath too well, he/she does it little bit slowly” Patterns F,G “Because I cannot make it alone” “Because of a physical problem” “Because I only have problems to fasten long sleeves shirts, I get tied up the shoelaces, wash, wear, tie my tie” “I don't take a bath well, I don't brush well my teeth” Patterns B, C – F, G – Some problems DGEEC – General Direction of Statistical, Surveys and Censuses

10. Patterns H – serious Problems “Because I can't take a bath by my self. My mother washes me and I get dressed by my self”. “Without problem I take a bath, I take a bath alone, nobody helps me in anything” Cases corresponding to the patterns D were not presented DGEEC – General Direction of Statistical, Surveys and Censuses

11. Experience Why did you respond in that way? The answer to Open questions were transversal to all the domains Little detail in the answers, obvious and very concise answers: “because it’s like that” “because it is the true” “because he was born this way” “because I don't have problems.” The difficulty for the self-care is bound to the architectural barriers and not to the person's disability. “My house is appropriate for me, so I don't have any problem.” “I have a lot of difficulty for the architectural barriers, for example, the narrow doors, the steps, the handles.” “Because in order to have shower he/she needs the bathroom, to be adapted. To get dressed he/she gets dressed on bed alone.” The act of dressing is only associated with the clothes and it doesn't include the act of putting on shoes.

12. Experience To be independent from their personal care avoids them to perceive their disability appropriately “I make everything with my left” “Because I don't feel anything, I make what I have to make to wash without problems “ “I live alone and I manage to manage by my self.” They only take into account the activities mentioned as an example in the question “Because I only have problems to fasten long sleeves shirts, I get tied up the shoelaces, wash, wear, tie my tie” “Without problem, I have all the movements to make those things” “Because It makes me difficult to take a bath by myself with a single hand”

13. Experience How worried are you about the ability of taking care by yourself? The grade of concern for the personal care is associated with the concern for the cleaning and not with the capacity of taking care by one’s self “I make it with desire, nobody forces me, I like to clean my self “ “I don't take a bath well, I don't brush well my teeth” The people with mental problems, and with extreme visual or auditory disability, manifest indifference or loss of the capacity of worrying

14. Experience Do you always feel too tired or sad to get dressed or to take a bath? The answer is not always absolute, when forcing the answer, they respond with certain frequency “sometimes” or “a little” Do you need always somebody to help you with your daily activities, as eating, to take a shower, to get dressed or to go to the bathroom? People with problems of inferior mobility mention that they can carry out activities like to eat to take a shower, getting dressed except the one of going to the bathroom, for the infrastructure lack in their home, they should necessarily be assisted by another person.

15. Final Issues The patterns proposed by the WG are adjusted to the survey of Paraguay, 80% of the cases belongs to the group of those Non problematic that is to say, patterns A and E The patterns B, C, F and G that present Some problems, concentrate 17% of the cases Only 4% of the cases presents Problems and they are adjusted the pattern H Suggestions To add intermediate categories at the moment to the existent ones “sometimes”, “a little”, “from time to time” that were frequent answers in our case. For cultural factors the self care is only associated with the personal hygiene Do you have difficulty in self care? for example, washing or dressing?