Caregiver Perceptions, Practices, and Challenges in Accessing Rehabilitation Services for People with Disabilities in Rural Vietnam
1
Department of Rehabilitation, Faculty of Sub-Specialties, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 24000, Vietnam
2
Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 24000, Vietnam
3
Poison Control Center, Bach Mai Hospital, Hanoi 100000, Vietnam
4
Faculty of Pharmacy, VNU University of Medicine and Pharmacy, Hanoi 100000, Vietnam
*
Author to whom correspondence should be addressed.
Disabilities 2025, 5(2), 44; https://doi.org/10.3390/disabilities5020044
Submission received: 15 February 2025
/
Revised: 4 April 2025
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Accepted: 28 April 2025
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Published: 30 April 2025
(This article belongs to the Special Issue The Care Economy and Disability Inclusion)
Abstract
:This study aimed to examine caregivers’ perceptions, practices, and challenges regarding rehabilitation services for people with disabilities, with a focus on identifying factors influencing their decisions to bring care recipients for formal rehabilitation. A cross-sectional study was conducted in rural Thai Nguyen Province, Vietnam. Data were collected from 214 primary caregivers using a structured questionnaire covering demographics, caregiving roles, and rehabilitation-related perceptions. A pilot study was conducted to refine the tool, and data were collected via face-to-face interviews by a trained team. Statistical analyses included descriptive statistics, chi-square tests, and stepwise logistic regression to identify key predictors of care-seeking behaviors. Results showed that 92% of caregivers perceived rehabilitation as necessary or very necessary. Female caregivers were more likely to provide care at home (95.3%), while male caregivers were more likely to utilize hospital-based services (73.5%) and to bring care recipients for rehabilitation overall (79.4% vs. 67.1%). Logistic regression revealed that female caregivers were significantly less likely than males to bring people with disabilities in for care (OR = 0.34, p = 0.02). Longer caregiving duration was associated with a reduced likelihood of seeking care (OR = 0.96 per year, p < 0.001), whereas caregivers of individuals with mobility needs (OR = 3.15, p < 0.001) and social integration needs (OR = 2.12, p = 0.05) were significantly more likely to seek care. These findings highlight gender-based differences and caregiving dynamics that influence access to rehabilitation. To enhance rehabilitation outcomes and support caregiver engagement, targeted policies are needed to address gender roles, caregiving fatigue, and the specific needs of care recipients.
1. Introduction
People with disabilities constitute approximately 16% of the world’s population [1], and this proportion is growing rapidly due to factors such as population aging and the emergent impacts of long-COVID [2]. Compared with those without disabilities, people with disabilities access healthcare services at nearly double the rate [3] and are more prone to concurrent chronic health conditions [1,4,5]. When seeking care, they commonly encounter ableist barriers, including discriminatory attitudes and infrastructural obstacles that impede the quality of healthcare services [1,6]. Service disruptions further exacerbate these challenges, leading to treatment delays, heightened mental distress, and poorer health outcomes over time [1,7,8]. Despite representing a substantial portion of the global population, people with disabilities remain particularly vulnerable to precarious healthcare access rooted in pervasive ableist structures.
Rehabilitation services are essential health interventions designed to optimize people’s functioning and reduce disability [9]. Rehabilitation refers to both acquired and lifelong disabilities, including congenital and developmental conditions [10]. Rehabilitation services encompass a wide range of supports, including physiotherapy, occupational therapy, speech and language therapy, orthotics and prosthetics, and audiology. Beyond benefiting users on an individual level, these services have also been shown to yield cost savings that surpass initial investments [1]. As global demand for rehabilitation expands, ensuring access to these interventions is increasingly recognized as a pivotal strategy for achieving the health-related Sustainable Development Goals [9,11,12]. Despite their proven value, an estimated 2.4 billion people worldwide—equivalent to one in three people—have unmet rehabilitation needs [13]. While rehabilitation is relevant to anyone experiencing functional limitations, people with disabilities represent a key population, as they persistently report high unmet needs for rehabilitation services and assistive devices [14,15,16]. These ongoing gaps highlight the necessity of examining the systemic and structural factors that impede people, especially those with disabilities, from fully benefiting from rehabilitation.
Effective rehabilitation hinges on strong communication among healthcare providers, patients, and caregivers, with caregivers often serving as the primary channel of information exchange. Rehabilitation professionals rely on caregivers to extend intervention programs beyond clinical settings, ensuring that exercises and therapeutic activities continue at home [7]. In this co-management role, caregivers must fully understand the patient’s needs and challenges, making their feedback vital for identifying and addressing gaps in care. However, caregiving itself can be both task-oriented and emotionally demanding, influenced by the physical dependency as well as the mental and emotional health of the patient [7]. Consequently, rehabilitation professionals must recognize and support caregivers’ needs to facilitate a healthier caregiving process, ultimately contributing to improved outcomes for both caregivers and patients [7].
In Vietnam, approximately 7.8% of the population, or over 7 million people, live with some form of disability [17]. The Vietnamese government, in collaboration with organizations such as the Vietnam Assistance for the Handicapped (VNAH) and international partners like the U.S. Agency for International Development (USAID), has made significant strides in enhancing rehabilitation services and support for persons with disabilities. These efforts include training over 22,000 local service providers—including rehabilitation doctors, therapists, social workers, and caregivers—and establishing numerous rehabilitation units and vocational training schools to improve service accessibility [18]. Despite these advancements, challenges persist, particularly in rural and underserved areas, where access to comprehensive rehabilitation services remains limited. Caregivers in these regions often face significant burdens due to a lack of resources and support, underscoring the need for ongoing efforts to address these disparities and ensure equitable access to rehabilitation services across the country [19].
This paper presents the findings of a community-based survey that investigated caregivers’ perceptions regarding the accessibility and utilization of rehabilitation services for people with disabilities. By exploring the sociodemographic characteristics of caregivers, their awareness of rehabilitation options, and the factors influencing service uptake, the study provides valuable insights for policymakers, healthcare providers, and community organizations. These insights are expected to inform interventions aimed at strengthening rehabilitation services and ensuring that people with disabilities receive the comprehensive support they need to improve their health outcomes and overall quality of life.
2. Materials and Method
2.1. Study Setting and Participants
A cross-sectional study was conducted from December 2017 to May 2019 in rural areas of Phu Luong District, Thai Nguyen Province, Vietnam. The selected study sites included four communes and towns: Hop Thanh, Phu Ly, On Luong, and Du Town (Thi tran Du). These areas were purposively chosen due to their geographical diversity and varying degrees of access to health and social services, allowing the study to capture a range of caregiving contexts in rural Northern Vietnam. The district is characterized by a largely agricultural economy, dispersed population centers, and limited infrastructure, which pose unique challenges to caregiving and access to formal rehabilitation services. The region also reflects diverse demographic and socioeconomic profiles, with ethnic minority groups residing alongside the majority Kinh population and disparities in educational attainment, income levels, and health service availability. These contextual factors make Phu Luong District a representative and relevant setting for investigating caregiving dynamics in rural environments (Figure 1).
Participants were unpaid, family-based primary caregivers of people with disabilities who met the following inclusion criteria: being aged 18 years or older, residing in the study area during the data collection period, and providing regular care to a person with a disability within their household. For the purpose of this study, “disability” was operationally defined using the International Classification of Functioning, Disability and Health (ICF) framework as an umbrella term encompassing impairments, activity limitations, and participation restrictions, viewed as the result of interactions between an individual’s health condition and their contextual factors (environmental and personal) [20].
To ensure data integrity and avoid duplication, only one caregiver per household was selected for participation. This individual was identified as the primary caregiver—defined as the person most involved in the day-to-day care and decision-making for the person with a disability. The total population of eligible households with people with disabilities in the selected communes was estimated at approximately 230, based on records maintained by commune health stations. Of these, 16 caregivers either declined to participate or were unavailable during the data collection period, resulting in an exclusion rate of 7%. Consequently, 214 primary caregivers were successfully recruited, yielding a response rate of 93%.
2.2. Data Collection and Measurement
Data for this study were collected using a structured questionnaire specifically designed by the research team to capture key dimensions of caregiving and rehabilitation access in rural Vietnam. The instrument was informed by a comprehensive review of prior validated questionnaires from studies conducted in Southeast Asia and sub-Saharan Africa that examined caregiver experiences and rehabilitation services [7,14,15,16]. While no single validated tool was adopted in full, relevant constructs and question formats were adapted and integrated into the design to ensure both contextual appropriateness and alignment with existing global literature. The final questionnaire consisted of 42 items grouped into four main sections: (1) caregiver demographic information (e.g., age, gender, education, occupation, marital and economic status); (2) caregiving characteristics (e.g., relationship with the person with a disability, caregiving duration, care tasks performed); (3) information about the person with a disability (e.g., cause, type, and severity of disability); and (4) caregiver perceptions, practices, and challenges related to rehabilitation services, including perceived necessity, type of support provided, barriers to access, and sources of information.
The initial version was drafted in English and translated into Vietnamese by two bilingual public health researchers. A back-translation into English was then performed independently to ensure semantic consistency and conceptual equivalence. To account for local dialectical differences and ensure cultural relevance, the Vietnamese version was reviewed by a panel of local public health professionals and rehabilitation experts based in Thai Nguyen Province. All recommended changes were incorporated to improve clarity and regional appropriateness.
A pilot study was conducted in a neighboring rural district with similar socioeconomic and demographic characteristics to the main study area. The pilot included 20 caregivers who matched the inclusion criteria and were selected using purposive sampling to reflect diverse caregiver profiles in terms of age, gender, and caregiver–recipient relationships. This pretest was used to evaluate the clarity, reliability, and cultural fit of the instrument. Feedback was collected via debriefing sessions with participants and field staff, and minor revisions were made to question wording and response scaling. The pilot data were also used to assess internal consistency using Cronbach’s alpha, which ranged from 0.72 to 0.84 across the main domains, indicating acceptable reliability.
Data collection for the full study was conducted through face-to-face interviews by a team of six trained field researchers who were native Vietnamese speakers and experienced in community-based health research. All interviewers completed a two-day training program covering research ethics, standardized interviewing techniques, and the use of visual aids (e.g., cue cards) for complex or abstract items. Each interview lasted approximately 45–60 min and was conducted in a private, quiet location within the caregiver’s home to ensure confidentiality and reduce response bias. Interviews were not audio-recorded to maintain participant comfort and privacy, as recommended by local ethics advisors. However, all responses were documented in real-time using paper forms and subsequently double-entered into an electronic database to ensure accuracy. The combined use of contextual tool development, rigorous translation procedures, comprehensive pilot testing, and standardized data collection methods ensured high-quality, reliable data suitable for analysis and interpretation in the rural Vietnamese setting.
2.3. Statistical Analysis
Data analysis for this study was performed using Stata version 16.0. Descriptive statistics were first used to summarize the demographic characteristics of the caregivers, including their age, gender, education level, occupation, marital status, and caregiving details. Frequency distributions and percentages were used to describe categorical variables, while means and standard deviations were calculated for continuous variables. Chi-square tests were employed to compare the distribution of categorical variables, such as caregiver gender, perceived rehabilitation needs, and caregiving practices, between male and female caregivers. This test was also used to examine the relationship between caregivers’ perceptions and practices and the sociodemographic characteristics of both caregivers and people with disabilities. A p-value of less than 0.05 was considered statistically significant.
For the primary analysis, stepwise logistic regression was used to identify the factors most strongly associated with bringing people with disabilities in for care. This method was chosen to examine multiple potential predictors while controlling for confounding variables. The regression model initially included all demographic and caregiving variables such as gender, relationship to the person with disabilities, caregiving duration, type of disability, and perceived rehabilitation needs. Using a stepwise approach, non-significant variables were sequentially removed based on a significance threshold (p > 0.05). The final model included only those factors with statistically significant associations (p < 0.05), and the odds ratios (OR) with 95% confidence intervals (CI) were calculated for each predictor. The stepwise approach allowed for a more refined understanding of the key factors influencing caregivers’ decisions to seek formal rehabilitation services for people with disabilities, controlling for potential confounders in the analysis.
2.4. Ethical Approval
The study was approved by the Institutional Review Board of Thai Nguyen University of Medicine and Pharmacy. Written informed consent was obtained from all participants prior to their inclusion in the study. Confidentiality and anonymity were strictly maintained, and participants were assured that their responses would be used solely for research purposes. The study adhered to the principles of the Declaration of Helsinki.
3. Results
Table 1 summarizes the demographic characteristics of caregivers, highlighting their distribution across various variables. Of the 214 caregivers surveyed, 31.8% were male and 68.2% were female. The largest age group was 50–59 years (29.9%), followed by those aged 60 years and older (27.1%). The majority of caregivers were farmers (77.1%), with smaller proportions engaged in blue-collar (4.2%) and white-collar (3.7%) jobs. Regarding education, 43.0% had secondary education, while 35.0% and 22.0% had primary and high school education, respectively. Most caregivers were married (84.6%), and 57.5% reported having sufficient economic status. Parents constituted 35.5% of caregivers, followed by spouses (30.4%) and children (16.4%). Over a third (36.5%) of caregivers had provided care for more than 21 years, with illness (38.8%) and congenital causes (36.9%) being the most common reasons for disability. Disabilities related to mobility (50.9%) and intellectual challenges (36.9%) were prevalent, with significant rehabilitation needs identified in daily activities (57.5%) and mobility (53.3%).
Table 2 compares male and female caregivers’ perceptions and practices regarding rehabilitation services for people with disabilities. The majority of caregivers, both male (55.9%) and female (54.8%), perceived rehabilitation as most commonly conducted at home (p = 0.882). A slightly higher proportion of males (73.5%) reported hospitals as a rehabilitation location compared with females (60.3%), though the difference was marginally insignificant (p = 0.059). Female caregivers (54.8%) were more likely than males (39.7%) to perceive rehabilitation as necessary, while males were more inclined to rate it as very necessary (55.9% vs. 37.0%; p = 0.027). Rehabilitation support was provided by 66.2% of males and 73.3% of females (p = 0.286). Support at home was significantly more prevalent among females (95.3%) compared with males (84.4%; p = 0.023), while males were more likely to provide support at facilities (28.9% vs. 10.3%; p = 0.004). Both groups reported similar support types, with mobility (55.9%) and daily activities (57.2%) being the most common, and no significant gender differences were observed in these categories.
Table 3 presents a comparison of male and female caregivers’ practices, perceptions, and challenges related to accessing rehabilitation services for people with disabilities. A higher proportion of males (79.4%) reported bringing people with disabilities in for care compared with females (67.1%), though the difference was not statistically significant (p = 0.065). Rehabilitation at specialized facilities was more common among males (42.6%) than females (26.5%, p = 0.043), while rehabilitation at other facilities was more common among females (71.4%, p = 0.080). Lack of awareness about locations was a more frequent reason for not seeking care among female caregivers (40.0%) than males (11.8%, p = 0.032). Common information sources for rehabilitation included TV (47.2%) and healthcare staff (29.4%), with no significant gender differences. Challenges in rehabilitation, such as persons with disabilities’ non-cooperation (22.0%) and lack of guidance (38.8%), were reported similarly by both genders.
Table 4 presents the results of a stepwise logistic regression analysis identifying factors associated with bringing people with disabilities in for care. Female caregivers were significantly less likely than male caregivers to bring people with disabilities in for care (OR = 0.34, p = 0.02). The likelihood decreased slightly with each additional year of care time (OR = 0.96, p < 0.001). Relationship with the person with disabilities also influenced caregiving behavior, with spouses (OR = 0.36, p = 0.03) and children (OR = 0.29, p = 0.04) being less likely to provide care compared with parents. Among causes of disability, congenital (OR = 1.42, p = 0.42) and old age (OR = 0.34, p = 0.09) did not show strong associations. For disability types, schizophrenia (OR = 6.07, p = 0.09) exhibited a potential association, while loss of sensation did not (OR = 0.30, p = 0.20). Rehabilitation needs showed a strong influence, with mobility needs (OR = 3.15, p < 0.001) and social integration needs (OR = 2.12, p = 0.05) significantly associated with bringing people with disabilities in for care.
4. Discussion
This study explored the demographic characteristics, perceptions, practices, and challenges faced by caregivers in providing rehabilitation services for people with disabilities. While rehabilitation services were perceived as essential, significant differences existed in gender-specific caregiving practices. Male caregivers were more likely to utilize hospitals for rehabilitation, whereas females were more likely to provide care at home. The stepwise logistic regression analysis highlighted factors such as gender, caregiver relationship, care duration, and specific rehabilitation needs as influential in bringing people with disabilities in for care.
4.1. Perception of Caregivers Regarding Rehabilitation Services
Caregivers’ perceptions of rehabilitation services significantly influence their decisions to seek care for people with disabilities. This study found that caregivers widely recognized the importance of rehabilitation, with many perceiving it as necessary or very necessary. However, female caregivers, who were more likely to prioritize the necessity of rehabilitation, often encountered barriers such as financial constraints and caregiving responsibilities. These findings align with global literature highlighting the challenges faced by women as primary caregivers, who often manage day-to-day caregiving tasks but may underutilize formal rehabilitation services due to socioeconomic or cultural barriers. The reliance on home-based rehabilitation, noted among both male and female caregivers, reflects the accessibility and convenience of informal care settings. However, this preference also indicates a potential lack of trust or awareness about the benefits of institutional rehabilitation services, emphasizing the need for targeted education and outreach programs.
Caregivers’ acknowledgment of the benefits of rehabilitation often reflects their desire to improve the quality of life for people with disabilities. For example, caregivers of children with developmental disabilities in Ghana reported that while caregiving was stressful and time-consuming, rehabilitation was crucial for managing the child’s needs and enhancing their daily functioning [21]. Similarly, in Iran, caregivers of people with spinal cord injuries emphasized the importance of long-term care and community reintegration, reflecting the necessity for sustained support and adaptable rehabilitation practices [22]. These perspectives demonstrate how caregivers perceive rehabilitation not only as a means of addressing immediate needs but also as a long-term strategy for enhancing the well-being of people with disabilities and promoting social inclusion.
Despite recognizing the importance of rehabilitation, caregivers often adapt their practices based on socioeconomic factors and cultural contexts. In Ghana, caregivers of children with cerebral palsy initially pursued medical interventions but transitioned to alternative or at-home care due to cost, stigma, and convenience [23]. Similarly, caregivers frequently implement practical interventions like behavior skill training and reinforcement strategies to improve daily living skills for people with developmental disabilities [24]. These practices illustrate how caregivers navigate barriers to formal rehabilitation services by adopting adaptive, home-based strategies.
However, structural challenges inherent to rural settings significantly shape caregiving practices and access to rehabilitation services. In rural Vietnamese provinces like Thai Nguyen, limited transportation infrastructure, long distances to specialized care centers, and infrequent public transit options pose logistical hurdles for caregivers. Moreover, many rural households face economic hardships, contributing to disparities in access to healthcare resources [25,26]. The scarcity of formal rehabilitation facilities, along with lower health literacy levels, further restricts caregivers’ ability to seek or sustain care for people with disabilities. To support caregivers more effectively, healthcare systems must address these barriers through community-based interventions, financial assistance, and programs promoting caregiver education and empowerment.
4.2. Caregivers’ Practices Regarding Bringing People with Disabilities in for Care
Caregivers’ practices in seeking care for people with disabilities are shaped by gender roles, caregiving duration, and the relationship between caregiver and care recipient. Male caregivers in this study were more likely to bring people with disabilities to institutional facilities such as hospitals, possibly reflecting traditional roles that position men as facilitators of external interactions with formal systems. In contrast, female caregivers, often engaged in daily caregiving tasks, were more likely to provide home-based care. This discrepancy may stem from cultural norms, time constraints, and the burden of caregiving responsibilities borne disproportionately by women. While these practices are adaptive, they may limit access to formal rehabilitation services, underscoring the need for interventions that address gender-specific barriers and responsibilities.
Longer caregiving durations were associated with a decreased likelihood of seeking formal care, indicating potential caregiver fatigue or adaptation to the disability over time. Parents were the most likely to bring people with disabilities in for care, driven by emotional investment and a sense of responsibility. In contrast, spouses and children were less inclined to seek formal care, possibly due to competing priorities or a lesser perceived obligation. These findings align with studies showing that caregivers often spend extensive time, sometimes exceeding ten hours daily, providing care [27,28]. Prolonged caregiving can lead to burnout and stress, highlighting the importance of support systems that address the psychological and emotional needs of caregivers.
Programs that promote caregiver well-being and skill development are essential to support effective caregiving practices. Initiatives like the Caregiver Wellness Self-Care program focus on mitigating caregiver burden through self-care promotion and community support [29]. Additionally, training caregivers in behavior skill training and intervention strategies has been shown to improve the autonomy and self-sufficiency of people with disabilities [24]. Despite the effectiveness of such skills, caregivers frequently lack access to adequate training and resources, limiting their ability to provide comprehensive support. Addressing these gaps through education, resource allocation, and structured support systems can empower caregivers to balance their responsibilities and seek appropriate care for people with disabilities more effectively.
The findings have several implications for health policy and practice. Gender-responsive approaches are necessary to address the differing perceptions and practices of male and female caregivers. Community awareness programs should aim to improve knowledge about rehabilitation services and their locations. Financial and logistical support mechanisms could reduce barriers to accessing care, especially for female caregivers. Additionally, integrating targeted interventions to address mobility and social integration needs into rehabilitation programs could improve outcomes for people with disabilities.
This study has several limitations. First, it relied on self-reported data, which may introduce recall and social desirability bias. Second, the cross-sectional design limits the ability to infer causal relationships between caregiver characteristics and their caregiving practices. Third, the study was conducted in a specific rural province of Vietnam, which may limit the generalizability of findings to urban settings or other cultural contexts. Additionally, only one respondent per household was surveyed, and this individual was identified as the primary caregiver. As such, the perceptions and practices of secondary caregivers or other family members involved in caregiving were not captured. Future research should explore caregiver dyads (e.g., comparisons between fathers and mothers or coresident vs. non-coresident caregivers) and employ longitudinal designs with more diverse and representative samples to validate and expand upon these findings.
5. Future Directions
Future research should examine the caregiving role in greater depth, particularly by distinguishing between primary and secondary caregivers and considering whether they reside with a person with a disability or live in a different household. These factors may influence caregiving practices, access to rehabilitation services, and perceived caregiver burden. Including multiple caregivers from the same household could provide valuable insights into intra-family dynamics and potential differences in perceptions and responsibilities. Additionally, future studies should employ longitudinal designs to track changes in caregiving patterns and rehabilitation access over time and extend the research to include urban and ethnically diverse populations to enhance the generalizability of findings. Developing and validating tools that assess caregiver roles and contexts will also strengthen future investigations and inform tailored interventions to support caregivers more effectively.
6. Conclusions
This study highlights critical factors influencing access to rehabilitation services for people with disabilities, including gender dynamics, caregiving roles, and the structural challenges of rural settings. Male caregivers were more likely than female caregivers to bring individuals to institutional care, while female caregivers more commonly provided home-based support—reflecting both traditional caregiving roles and constraints on mobility and time. Longer caregiving duration was associated with a reduced likelihood of seeking formal care, suggesting caregiver fatigue or adaptation. Conversely, caregivers of individuals with mobility or social integration needs were significantly more likely to pursue rehabilitation services. While the perceived importance of rehabilitation was high among participants, substantial barriers—such as financial limitations, low awareness of service availability, and inadequate caregiver support—persisted. Importantly, the rural context amplified these challenges due to limited transportation infrastructure, geographic isolation, and sparse distribution of rehabilitation services. These structural constraints in rural environments compound caregiver burdens and restrict access to care. To improve outcomes for both caregivers and people with disabilities, targeted interventions are urgently needed. These should include gender-responsive health policies, culturally tailored caregiver education programs, and the expansion of community-based rehabilitation models that bring services closer to rural households. Addressing the intersection of gender, caregiving strain, and rural disadvantage is essential for promoting equitable and sustainable access to rehabilitation services in underserved areas.
Author Contributions
Conceptualization, S.P.N.; data curation, D.D.N.; formal analysis, D.D.N.; investigation, S.P.N. and H.T.T.; methodology, S.P.N. and B.X.N.; resources, S.P.N., H.T.T. and D.D.N.; supervision, S.P.N.; validation, B.X.N. and H.T.T.; writing—original draft, S.P.N., D.D.N. and B.X.N.; writing—review and editing, S.P.N., D.D.N. and B.X.N.; visualization, H.T.T. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The Institutional Review Board of Thai Nguyen University of Medicine and Pharmacy has approved the research. No. 446/DHYD-HDDD.
Informed Consent Statement
Informed consent was obtained from all participants involved in the study.
Data Availability Statement
The data presented in this study are available on request from the corresponding author.
Acknowledgments
This study would like to thank the volunteers and researchers who participated in the study.
Conflicts of Interest
The authors declare no conflicts of interest.
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Figure 1.
Maps of Phu Luong district, Thai Nguyen Province (Source: Google Maps).
Table 1.
Demographic characteristics of caregivers.
| Variables | Categories | Male | Female | Total |
|---|---|---|---|---|
| n (%) | n (%) | n (%) | ||
| Total | Male | 68 (31.8) | 146 (68.2) | 214 (100.0) |
| Age group | 18–29 | 3 (4.4) | 9 (6.2) | 12 (5.6) |
| 30–39 | 11 (16.2) | 20 (13.7) | 31 (14.5) | |
| 40–49 | 15 (22.1) | 34 (23.3) | 49 (22.9) | |
| 50–59 | 21 (30.9) | 43 (29.5) | 64 (29.9) | |
| ≥60 | 18 (26.5) | 40 (27.4) | 58 (27.1) | |
| Job | Farmer | 50 (73.5) | 115 (78.8) | 165 (77.1) |
| Blue-collar | 3 (4.4) | 6 (4.1) | 9 (4.2) | |
| White-collar | 1 (1.5) | 7 (4.8) | 8 (3.7) | |
| Retired | 8 (11.8) | 4 (2.7) | 12 (5.6) | |
| Others | 6 (8.8) | 14 (9.6) | 20 (9.3) | |
| Education | ≤Primary | 22 (32.4) | 53 (36.3) | 75 (35.0) |
| Secondary | 30 (44.1) | 62 (42.5) | 92 (43.0) | |
| ≥High School | 16 (23.5) | 31 (21.2) | 47 (22.0) | |
| Marital status | Married | 58 (85.3) | 123 (84.2) | 181 (84.6) |
| Not Married | 10 (14.7) | 23 (15.8) | 33 (15.4) | |
| Economic status | Poor | 11 (16.2) | 45 (30.8) | 56 (26.2) |
| Near Poor | 11 (16.2) | 24 (16.4) | 35 (16.4) | |
| Sufficient | 46 (67.6) | 77 (52.7) | 123 (57.5) | |
| Relation | Parent | 17 (25.0) | 59 (40.4) | 76 (35.5) |
| Spouse | 11 (16.2) | 54 (37.0) | 65 (30.4) | |
| Children | 21 (30.9) | 14 (9.6) | 35 (16.4) | |
| Sibling | 11 (16.2) | 3 (2.1) | 14 (6.5) | |
| Others | 8 (11.8) | 16 (11.0) | 24 (11.2) | |
| Care time | 1–5 Years | 9 (13.2) | 31 (21.2) | 40 (18.7) |
| 6–10 Years | 17 (25.0) | 35 (24.0) | 52 (24.3) | |
| 11–15 Years | 7 (10.3) | 18 (12.3) | 25 (11.7) | |
| 16–20 Years | 4 (5.9) | 15 (10.3) | 19 (8.9) | |
| ≥21 Years | 31 (45.6) | 47 (32.2) | 78 (36.5) | |
| Cause of disability | Congenital | 29 (42.7) | 50 (34.2) | 79 (36.9) |
| Accident | 8 (11.8) | 26 (17.8) | 34 (15.9) | |
| Old Age | 5 (7.4) | 9 (6.2) | 14 (6.5) | |
| Illness | 25 (36.8) | 58 (39.7) | 83 (38.8) | |
| Unknown | 5 (7.4) | 9 (6.2) | 14 (6.5) | |
| Disability type | Mobility | 28 (41.2) | 81 (55.5) | 109 (50.9) |
| Hearing/Speech | 14 (20.6) | 41 (28.1) | 55 (25.7) | |
| Vision | 11 (16.2) | 16 (11.0) | 27 (12.6) | |
| Intellectual | 30 (44.1) | 49 (33.6) | 79 (36.9) | |
| Epilepsy | 5 (7.4) | 10 (6.8) | 15 (7.0) | |
| Schizophrenia | 7 (10.3) | 11 (7.5) | 18 (8.4) | |
| Loss of Sensation | 0 (0.0) | 6 (4.1) | 6 (2.8) | |
| Rehabilitation need | Daily Activities | 36 (52.9) | 87 (59.6) | 123 (57.5) |
| Mobility | 29 (42.7) | 85 (58.2) | 114 (53.3) | |
| Communication | 20 (29.4) | 57 (39.0) | 77 (36.0) | |
| Social Integration | 28 (41.2) | 52 (35.6) | 80 (37.4) |
Table 2.
Comparison of male and female caregiver perceptions and practices regarding rehabilitation services for people with disabilities.
Table 2.
Comparison of male and female caregiver perceptions and practices regarding rehabilitation services for people with disabilities.
| Variables | Categories | Male | Female | Total | p-Value |
|---|---|---|---|---|---|
| n (%) | n (%) | n (%) | |||
| Perceived rehabilitation location | At home | 38 (55.9) | 80 (54.8) | 118 (55.1) | 0.882 |
| At health station | 8 (11.8) | 15 (10.3) | 23 (10.7) | 0.743 | |
| At hospital | 50 (73.5) | 88 (60.3) | 138 (64.5) | 0.059 | |
| Unknown location | 5 (7.4) | 15 (10.3) | 20 (9.3) | 0.494 | |
| Rehabilitation necessity | Very necessary | 38 (55.9) | 54 (37.0) | 92 (43.0) | 0.027 |
| Necessary | 27 (39.7) | 80 (54.8) | 107 (50.0) | ||
| Unclear | 1 (1.5) | 10 (6.8) | 11 (5.1) | ||
| Not necessary | 2 (2.9) | 2 (1.4) | 4 (1.9) | ||
| Providing rehabilitation support for disabled person | Yes | 45 (66.2) | 107 (73.3) | 152 (71.0) | 0.286 |
| No | 23 (33.8) | 39 (26.7) | 62 (29.0) | ||
| Support at home | Yes | 38 (84.4) | 102 (95.3) | 140 (92.1) | 0.023 |
| No | 7 (15.6) | 5 (4.7) | 12 (7.9) | ||
| Support at facility | Yes | 13 (28.9) | 11 (10.3) | 24 (15.8) | 0.004 |
| No | 32 (71.1) | 96 (89.7) | 128 (84.2) | ||
| Support type | Mobility | 22 (48.9) | 63 (58.9) | 85 (55.9) | 0.257 |
| Communication | 9 (20.0) | 23 (21.5) | 32 (21.1) | 0.836 | |
| Daily activities | 29 (64.4) | 58 (54.2) | 87 (57.2) | 0.244 | |
| Social integration | 12 (26.7) | 19 (17.8) | 31 (20.4) | 0.213 |
Table 3.
Gender differences in caregiver perceptions, challenges, and practices in accessing rehabilitation services for people with disabilities.
Table 3.
Gender differences in caregiver perceptions, challenges, and practices in accessing rehabilitation services for people with disabilities.
| Variables | Categories | Male | Female | Total | p-Value |
|---|---|---|---|---|---|
| n (%) | n (%) | n (%) | |||
| Bringing people with disabilities in for care | Yes | 54 (79.4) | 98 (67.1) | 152 (71.0) | 0.065 |
| No | 14 (20.6) | 48 (32.9) | 62 (29.0) | ||
| Rehabilitation location | Specialized facilities | 23 (42.6) | 26 (26.5) | 49 (32.2) | 0.043 |
| Other facilities | 31 (57.4) | 70 (71.4) | 101 (66.5) | 0.080 | |
| Traditional healers | 2 (3.7) | 1 (1.0) | 3 (2.0) | 0.255 | |
| Reasons for not seeking care | Unaware of locations | 2 (11.8) | 20 (40.0) | 22 (32.8) | 0.032 |
| Financial constraints | 7 (41.2) | 26 (52.0) | 33 (49.3) | 0.441 | |
| Lack of assistance | 4 (23.5) | 20 (40.0) | 24 (35.8) | 0.221 | |
| Lack of transport | 1 (5.9) | 11 (22.0) | 12 (17.9) | 0.134 | |
| Information sources | Books | 9 (13.2) | 23 (15.8) | 32 (15.0) | 0.631 |
| TV | 31 (45.6) | 70 (48.0) | 101 (47.2) | 0.748 | |
| Internet | 3 (4.4) | 10 (6.8) | 13 (6.1) | 0.487 | |
| Healthcare staff | 19 (27.9) | 44 (30.1) | 63 (29.4) | 0.743 | |
| Village health workers | 6 (8.8) | 9 (6.2) | 15 (7.0) | 0.478 | |
| Rehabilitation practices | Self-taught rehabilitation | 21 (30.9) | 53 (36.3) | 74 (34.6) | 0.438 |
| Guided rehabilitation techniques | 17 (25.0) | 37 (25.3) | 54 (25.2) | 0.957 | |
| Greatest difficulties in rehabilitation | Person with disabilities’ non-cooperation | 14 (20.6) | 33 (22.6) | 47 (22.0) | 0.873 |
| Complex methods | 3 (4.4) | 10 (6.8) | 13 (6.1) | 0.873 | |
| Lack of workforce | 23 (33.8) | 48 (32.9) | 71 (33.2) | 0.873 | |
| Lack of guidance | 28 (41.2) | 55 (37.7) | 83 (38.8) | 0.873 | |
| Assessment of rehabilitation activities | Good | 26 (38.2) | 78 (53.4) | 104 (48.6) | 0.114 |
| Poor | 9 (13.2) | 22 (15.1) | 31 (14.5) | ||
| Not functioning | 27 (39.7) | 38 (26.0) | 65 (30.4) | ||
| Other | 6 (8.8) | 8 (5.5) | 14 (6.5) |
Table 4.
Stepwise logistic regression analysis of factors associated with bringing people with disabilities in for care.
Table 4.
Stepwise logistic regression analysis of factors associated with bringing people with disabilities in for care.
| OR | p-Value | 95% CI | ||
|---|---|---|---|---|
| Gender (female vs. male a) | 0.34 | 0.02 | 0.14 | 0.83 |
| Care time (per year) | 0.96 | 0.00 | 0.94 | 0.99 |
| Relationship with person with disabilities (vs. Parent a) | ||||
| Spouse | 0.36 | 0.03 | 0.14 | 0.90 |
| Children | 0.29 | 0.04 | 0.09 | 0.92 |
| Sibling | 0.80 | 0.79 | 0.15 | 4.13 |
| Others | 0.74 | 0.60 | 0.24 | 2.27 |
| Cause of disability | ||||
| Congenital (Yes vs. No a) | 1.42 | 0.42 | 0.61 | 3.33 |
| Old Age (Yes vs. No a) | 0.34 | 0.09 | 0.10 | 1.19 |
| Unknown (Yes vs. No a) | 4.24 | 0.10 | 0.76 | 23.57 |
| Disability Type | ||||
| Schizophrenia (Yes vs. No a) | 6.07 | 0.09 | 0.73 | 50.18 |
| Loss of Sensation (Yes vs. No a) | 0.30 | 0.20 | 0.05 | 1.84 |
| Rehabilitation need | ||||
| Mobility (Yes vs. No a) | 3.15 | 0.00 | 1.47 | 6.78 |
| Social Integration (Yes vs. No a) | 2.12 | 0.05 | 1.00 | 4.48 |
a reference group.
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MDPI and ACS Style
Nguyen, S.P.; Tran, H.T.; Nguyen, D.D.; Nguyen, B.X. Caregiver Perceptions, Practices, and Challenges in Accessing Rehabilitation Services for People with Disabilities in Rural Vietnam. Disabilities 2025, 5, 44. https://doi.org/10.3390/disabilities5020044
AMA Style
Nguyen SP, Tran HT, Nguyen DD, Nguyen BX. Caregiver Perceptions, Practices, and Challenges in Accessing Rehabilitation Services for People with Disabilities in Rural Vietnam. Disabilities. 2025; 5(2):44. https://doi.org/10.3390/disabilities5020044
Chicago/Turabian StyleNguyen, Sinh Phuong, Hoang The Tran, Duc Dang Nguyen, and Bach Xuan Nguyen. 2025. "Caregiver Perceptions, Practices, and Challenges in Accessing Rehabilitation Services for People with Disabilities in Rural Vietnam" Disabilities 5, no. 2: 44. https://doi.org/10.3390/disabilities5020044
APA StyleNguyen, S. P., Tran, H. T., Nguyen, D. D., & Nguyen, B. X. (2025). Caregiver Perceptions, Practices, and Challenges in Accessing Rehabilitation Services for People with Disabilities in Rural Vietnam. Disabilities, 5(2), 44. https://doi.org/10.3390/disabilities5020044
