# Situation: The public health nurse coordinates a community-based rehabilitation (CBR) program for persons with disabilities (PWDs) in an upland municipality. The nurse drafts the CBR plan with a group of PWDs and their families. Which activities belong in the plan? 1. Home modifications such as ramps and grab bars 2. Enrollment of children with disabilities in separate special schools away from regular classes 3. Peer counseling by persons with similar disabilities 4. Linkage to livelihood programs and PWD ID benefits

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=627170  
> language: ko  
> subject: Nursing Practice I — Community Health Nursing

## 문제

Situation: The public health nurse coordinates a community-based rehabilitation (CBR) program for persons with disabilities (PWDs) in an upland municipality.

The nurse drafts the CBR plan with a group of PWDs and their families. Which activities belong in the plan?
1. Home modifications such as ramps and grab bars
2. Enrollment of children with disabilities in separate special schools away from regular classes
3. Peer counseling by persons with similar disabilities
4. Linkage to livelihood programs and PWD ID benefits

## 보기

1. 1, 2 and 3
2. 1, 2 and 4
3. 1, 3 and 4 **✔ 정답**
4. 2, 3 and 4

**정답: 3**

## 해설

CBR keeps the person in the community and uses local resources. Home modification removes environmental barriers, peer counseling promotes self-help and empowerment, and linkage to livelihood programs and PWD ID benefits supports inclusion and rights. Placing children with disabilities in separate schools away from regular classes works against inclusion; CBR and the Inclusive Education Act (RA 11650) favor learning in regular schools with support.

## 심화 해설

Community-based rehabilitation is built on the principle that persons with disabilities remain within their own community and participate in everyday life with the support of local resources. When the public health nurse drafts a CBR plan together with PWDs and their families, every activity should promote access, self-determination, economic participation, and social inclusion.

The correct set of activities is 1, 3 and 4.

Why home modifications belong in the plan

Home modifications such as ramps and grab bars are a direct application of the environmental component of CBR. Disability is understood not as a problem residing only in the person, but as the result of the interaction between a health condition and environmental barriers. A person with limited mobility may be fully capable of self-care and community participation if the physical environment allows safe movement. Ramps remove the barrier of steps, and grab bars reduce the risk of falls in the bathroom. These modifications keep the person at home rather than forcing relocation to an institution, which is consistent with the CBR goal of maintaining the person in the community.

Why peer counseling belongs in the plan

Peer counseling by persons with similar disabilities supports the empowerment component of CBR. A peer counselor has lived experience of the same functional limitation and the same social barriers. This shared experience builds trust and provides a realistic model of coping and self-management. Peer counseling also shifts the relationship from a professional telling a PWD what to do, to a person with a disability supporting another person with a disability. That shift reinforces autonomy and self-help, which are core values of CBR.

Why linkage to livelihood programs and PWD ID benefits belongs in the plan

Livelihood programs address the economic dimension of inclusion. Many PWDs are excluded from employment not because they cannot work, but because training opportunities, workplaces, and financing mechanisms are not accessible. Linking PWDs to livelihood programs enables income generation within the community. PWD ID benefits support the rights-based component of CBR. The PWD ID entitles the holder to discounts, access to services, and other legal protections. Helping PWDs obtain the ID is not merely administrative work; it is a way of ensuring that legal entitlements are actually realized.

Why separate special schools are not included

Placing children with disabilities in separate special schools away from regular classes is inconsistent with the inclusion principle of CBR. Segregated education removes the child from the natural peer group and from the regular school environment. The inclusive education framework favors enrolling children with disabilities in regular schools with appropriate support, such as assistive devices, teacher training, and individualized education plans. In the Philippine setting, the Inclusive Education Act institutionalizes this approach. A CBR plan that sends children away to separate schools would work against the very inclusion that CBR seeks to achieve.

Key point! CBR activities are selected by asking one question: Does this keep the person in the community and increase participation in ordinary life? Home modification, peer counseling, and linkage to livelihood and benefits all answer yes. Separate schooling answers no because it removes the child from the regular community setting.

CBR is not a set of medical interventions delivered to passive recipients; it is a community strategy that removes barriers, builds capacity, and secures rights so that PWDs can participate on equal terms.

| Activity | CBR principle | Inclusion effect |
| --- | --- | --- |
| Home modifications (ramps, grab bars) | Environmental accessibility | Keeps PWD safe and mobile at home |
| Peer counseling | Empowerment and self-help | Builds autonomy through shared lived experience |
| Livelihood and PWD ID linkage | Economic participation and rights | Supports income and access to legal benefits |
| Separate special schools | Segregation | Removes child from regular peers and community |

Watch out! In licensure examinations, any option that separates, isolates, or institutionalizes a person with a disability is usually the wrong choice in a CBR or mental health community integration question. The preferred answer is the option that keeps the person in the least restrictive, most community-based setting.

The nursing role in CBR is to coordinate local resources so that the environment, the peer network, and the legal system all work together to support the PWD in daily community life.

## 임상 시나리오

CBR Plan Activities for PWD InclusionSelecting community-based interventions that promote access, empowerment, and rights
A community-based rehabilitation plan should keep the person in the community and use local resources. Home modifications such as ramps and grab bars remove environmental barriers, allowing safe mobility and self-care at home.

Peer counseling by persons with similar disabilities builds empowerment and self-help through shared lived experience. Linkage to livelihood programs and PWD ID benefits supports economic participation and access to rights.

CautionPlacing children with disabilities in separate special schools away from regular classes works against inclusion. CBR and the Inclusive Education Act (RA 11650) favor learning in regular schools with support.

## 핵심 개념

- **Community-Based Rehabilitation (CBR)** — A strategy that keeps persons with disabilities in their community and uses local resources to promote inclusion, empowerment, and participation.
- **Inclusive Education Act (RA 11650)** — Philippine law that favors learning in regular schools with support rather than separate special schools for children with disabilities.
- **Environmental barriers** — Physical or social obstacles in the environment that limit participation of persons with disabilities, such as steps or lack of grab bars.
- **Peer counseling** — Support provided by persons with similar disabilities, promoting self-help, empowerment, and realistic coping models.
- **PWD ID benefits** — Government-issued identification that entitles persons with disabilities to discounts and privileges, supporting their rights and economic participation.

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