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British Dental Journal Aug 2019Diagnostic overshadowing can be described as a concept whereby symptoms of physical ill health are mistakenly attributed by healthcare professionals to either a mental...
Diagnostic overshadowing can be described as a concept whereby symptoms of physical ill health are mistakenly attributed by healthcare professionals to either a mental health or behavioural problem, or as being inherent in the person's disability. This can lead to a failure to diagnose and treat appropriately. Although widely discussed in medicine, this issue has not been previously highlighted in the dental speciality, yet it can lead to significantly detrimental general and oral health outcomes for vulnerable patients. This article focuses on the care of patients with learning disabilities and the prevention of diagnostic overshadowing in dentistry through the application of reasonable adjustments to care and education within the dental team.
Topics: Dental Care for Disabled; Dentistry; Disabled Persons; Humans; Learning Disabilities
PubMed: 31444449
DOI: 10.1038/s41415-019-0623-x -
Bundesgesundheitsblatt,... Sep 2016
Topics: Disability Evaluation; Disabled Persons; Germany; Health Policy; Health Services Research; Humans; Social Isolation; Social Marginalization; Social Participation
PubMed: 27558144
DOI: 10.1007/s00103-016-2419-3 -
Rehabilitation Psychology Feb 2016Research data clearly indicate most people living with a disability return to premorbid levels of psychological functioning. However, some individuals living with a... (Review)
Review
PURPOSE/OBJECTIVE
Research data clearly indicate most people living with a disability return to premorbid levels of psychological functioning. However, some individuals living with a disability are vulnerable for the development of psychological disorders including depression, anxiety, and posttraumatic stress disorder. Rather than understanding this phenomenon of vulnerability solely as the presence of psychopathology, it can be understood from a positive psychology standpoint as a deficit of well-being. We extend this approach by demonstrating the links between the historic foundational principles of rehabilitation psychology and the relevant current research on psychology of well-being. The article then explores the implications of providing meaningful interventions that could improve the lives of persons living with disability and chronic illness.
RESULTS
Based on this view, well-being therapy is proposed as an intervention because it has proven efficacy in acting as a buffer against the development of some negative affective states. The assumptions and dimensions underlying this approach are shown to be relevant to both persons living with disability and to the foundational principles of rehabilitation psychology. A model for assisting people with disability in improving their well-being and decreasing negative aspects of their life by balancing factors relevant to well-being is discussed.
CONCLUSIONS/IMPLICATIONS
The authors conclude by exploring the benefits of engendering positive well-being versus the traditional focus on solely alleviating negative affective states.
Topics: Adaptation, Psychological; Chronic Disease; Disabled Persons; Humans; Mental Disorders
PubMed: 26881305
DOI: 10.1037/rep0000060 -
Patient Education and Counseling Aug 2019To integrate findings on the information infrastructure for people with intellectual or developmental disability (I/DD) living in supported accommodation, to understand... (Review)
Review
OBJECTIVES
To integrate findings on the information infrastructure for people with intellectual or developmental disability (I/DD) living in supported accommodation, to understand how documentation use impacts person-centred support.
METHODS
We conducted an integrative literature review. Following screening by two independent reviewers, we included English language peer-reviewed empirical studies (nā=ā34) on documentation use for people with I/DD in domestic-scale supported accommodation. We appraised quality and extracted information for iterative comparative thematic and content analysis.
RESULT
All studies reported written documentation regarding either the person with disability or the residence. Eighteen studies focused on health-specific information. We identified three key themes impacting on the person-centred support; 1) level of inclusion and independence of people with I/DD, 2) the culture of support within group homes, and 3) the quality use of information.
CONCLUSIONS
Information infrastructure is closely aligned with the support culture in residences and can affect whether and to what extent key stakeholders (i.e., people with I/DD, family members) are involved in making decisions about healthcare and support needs.
PRACTICE IMPLICATIONS
Surveying local service health information infrastructure can provide crucial insights which can be leveraged to improve the safety and quality of supports provided for people living in supported accommodation.
Topics: Decision Making; Disabled Persons; Documentation; Humans; Organizational Culture; Patient Safety; Patient-Centered Care; Quality Improvement; Residential Facilities
PubMed: 31010602
DOI: 10.1016/j.pec.2019.03.008 -
Indian Journal of Ophthalmology Feb 2021The current practice for low vision management in India exclusively focuses on clinical aspects without much of the rehabilitation components. While making all efforts... (Review)
Review
The current practice for low vision management in India exclusively focuses on clinical aspects without much of the rehabilitation components. While making all efforts to improve independent living skills, daily living activities, and quality of life as a whole for people living visual disabilities, vision rehabilitation is an indispensable component. There is no single appropriate low vision and rehabilitation model implementable at health care institutions in the country to cover these fundamental aspects of a visually impaired individual. We did a literature review to know the existing practices of low vision and various disability models. The purpose of the review is to discern any pitfalls and shortcomings in managing visually disabled in India and to underpin the credibility and feasibility as well as suitability of the developed model. The review was done using search key terms low vision, current practices, visual disability, disability models, vision rehabilitation, and service delivery. Therefore, the article discusses the development of an inclusive low vision management model name as "Clinico-Social Model", which we consider the most appropriate for the best management of people with vision loss. The primary aim of this model is to provide both clinical and vision rehabilitation components of management for people with visual disabilities. Such an approach is likely to have the potential to improve the quality of life of people with vision loss and can provide practical guide to eye care managers across India. Given the specific context in the current practices of low vision in India, it is desirable to design a similar model to care for the visually disabled.
Topics: Disabled Persons; Humans; India; Quality of Life; Vision, Low; Visually Impaired Persons
PubMed: 33463601
DOI: 10.4103/ijo.IJO_236_20 -
Rehabilitation Psychology Feb 2020Health disparities are avoidable differences that disproportionately impact certain groups. Health equity demands attention to social determinants of health (SDOH),...
BACKGROUND
Health disparities are avoidable differences that disproportionately impact certain groups. Health equity demands attention to social determinants of health (SDOH), particularly for people with disabilities who often have poorer outcomes and face more health inequities than nondisabled peers.
OBJECTIVE
The aim of this study was to develop a Social Determinants of Health Index for people with disabilities that utilizes personal outcomes. The Index is aimed at helping disability service providers examine the SDOH of those they support, to arm them with more information to provide targeted services and supports.
METHOD
We ran an exploratory factor analysis of Personal Outcome Measures interviews with 1,078 people with disabilities from 2017 to compute composite scores for the factors underlying the model.
RESULTS
Findings revealed the Social Determinants of Health Index had 3 underlying factors: choice and engagement; person-centeredness; and health and safety. Choice and engagement are often inextricably linked as choice, self-determination, and empowerment play a key role in the social inclusion of people with disabilities. Services being person-centered are not only a right and requirement of home- and community-based services, but rights should also be person-centered-each person decides which rights are the most important to them. Finally, the third factor recognizes health and safety as foundational parts of health outcomes.
CONCLUSIONS
The creation of the Social Determinants of Health Index for people with disabilities, which utilizes person-centered outcomes, ultimately aims to reduce health disparities. Attention to SDOH can promote good health for all. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Adolescent; Adult; Aged; Disabled Persons; Female; Health Equity; Health Status Disparities; Humans; Male; Middle Aged; Social Determinants of Health; Young Adult
PubMed: 31724414
DOI: 10.1037/rep0000298 -
Nurse EducatorNursing faculty may be reluctant to fail students for a variety of reasons. Faculty may fear being viewed as discriminatory when failing nursing students with...
BACKGROUND
Nursing faculty may be reluctant to fail students for a variety of reasons. Faculty may fear being viewed as discriminatory when failing nursing students with disabilities.
PROBLEM
Schools of nursing may still be using technical standards that are outdated and noncompliant with the Americans with Disabilities Act (ADA) to determine eligibility for admission and may confuse essential functions with academic expectations. Lack of faculty awareness of the ADA may make faculty reluctant to fail nursing students with disabilities.
APPROACH
All nursing students should be assessed based on whether-not how-they meet academic and clinical standards safely. Disability accommodations should not affect the standards that must be met.
CONCLUSIONS
Faculty should base decisions on whether to assign failing grades to students on factors unrelated to a disability. Technical standards, when written correctly, should clarify whether inability or disability contributed to failure. Policies regarding failing should be clear, equitable, and accessible.
Topics: Disabled Persons; Education, Nursing; Faculty, Nursing; Humans; Students, Nursing; United States
PubMed: 33395184
DOI: 10.1097/NNE.0000000000000965 -
Public Health Reports (Washington, D.C.... 2021Given the growth in national disability-associated health care expenditures (DAHE) and the changes in health insurance-specific DAHE distribution, updated estimates of...
OBJECTIVE
Given the growth in national disability-associated health care expenditures (DAHE) and the changes in health insurance-specific DAHE distribution, updated estimates of state-level DAHE are needed. The objective of this study was to update state-level estimates of DAHE.
METHODS
We combined data from the 2013-2015 Medical Expenditure Panel Survey, 2013-2015 Behavioral Risk Factor Surveillance System, and 2014 National Health Expenditure Accounts to calculate state-level DAHE for US adults in total, per adult, and per (adult) person with disability (PWD). We adjusted expenditures to 2017 prices and assessed changes in DAHE from 2003 to 2015.
RESULTS
In 2015, DAHE were $868 billion nationally (range, $1.4 billion in Wyoming to $102.8 billion in California) accounting for 36% of total health care expenditures (range, 29%-41%). From 2003 to 2015, total DAHE increased by 65% (range, 35%-125%). In 2015, DAHE per PWD were highest in the District of Columbia ($27 839) and lowest in Alabama ($12 603). From 2003 to 2015, per-PWD DAHE increased by 13% (range, -20% to 61%) and per-capita DAHE increased by 28% (range, 7%-84%). In 2015, Medicare DAHE per PWD ranged from $10 067 in Alaska to $18 768 in New Jersey. Medicaid DAHE per PWD ranged from $9825 in Nevada to $43 365 in the District of Columbia. Nonpublic-health insurer per-PWD DAHE ranged from $7641 in Arkansas to $18 796 in Alaska.
CONCLUSION
DAHE are substantial and vary by state. The public sector largely supports the health care costs of people with disabilities. State policy makers and other stakeholders can use these results to inform the development of public health programs that support and provide ongoing health care to people with disabilities.
Topics: Disabled Persons; Health Expenditures; Humans; Medicaid; Medicare; State Government; United States
PubMed: 33673781
DOI: 10.1177/0033354920979807 -
Scandinavian Journal of Caring Sciences Mar 2018Whereas 'health promotion' is a well-known concept for healthcare professionals, the concept of 'health promotion for people with intellectual disabilities' and its... (Review)
Review
BACKGROUND
Whereas 'health promotion' is a well-known concept for healthcare professionals, the concept of 'health promotion for people with intellectual disabilities' and its unique associated challenges are not well understood.
AIMS AND OBJECTIVE
This article provides a systematic analysis of how health promotion is being conceptualised for people with intellectual disabilities and how health promotion can work best in the light of this group's specific needs and limitations.
DESIGN
Rodgers' evolutionary concept analysis.
METHOD
MEDLINE, PsycINFO, CINAHL and SocINDEX were searched using the search terms 'health promotion', 'people with intellectual disabilities' and 'developmental disabilities'. This review includes studies published between 1992 and 2014. A total of 52 articles were included.
RESULTS
Health promotion for people intellectual disabilities, as discussed in the literature, focuses on four aspects, namely supporting a healthy lifestyle, providing health education, involving supporters and being person-centred. Antecedents of the concept 'health promotion for people with intellectual disabilities' were healthcare access and sensitised healthcare providers. The outcomes were improved health, being empowered, enhanced quality of life and reduced health disparities.
CONCLUSION
This analysis provides a solid foundation for healthcare stakeholders' planning, implementing and evaluating health-promotion activities for people with intellectual disabilities at the policy level and in the community.
Topics: Adult; Aged; Aged, 80 and over; Disabled Persons; Education of Intellectually Disabled; Female; Health Behavior; Health Promotion; Humans; Intellectual Disability; Male; Middle Aged
PubMed: 28497855
DOI: 10.1111/scs.12448 -
Rehabilitation Psychology Nov 2018Personal disability identity (PDI) refers to a positive self-concept as a person with a disability. This study examined the reliability and structural validity of scores...
PURPOSE/OBJECTIVE
Personal disability identity (PDI) refers to a positive self-concept as a person with a disability. This study examined the reliability and structural validity of scores on the Personal Disability Identity Scale (PDIS; Hahn & Belt, 2004) and correlates of PDI in adults with retinitis pigmentosa (RP). Research Method/Design: Two hundred six adult participants with RP completed a cross-sectional online survey measuring PDI, general self-efficacy, mobility tool use, age at diagnosis, education level, and demographic variables.
RESULTS
Confirmatory factor analysis (CFA) supported a two-factor model of PDI: denial of disability and affirmation of disability. Findings from multiple linear regression indicated that lower disability denial in individuals with RP was associated with higher general self-efficacy. Both disability denial and disability affirmation were associated with use of mobility tool, but not with age at diagnosis.
CONCLUSIONS/IMPLICATIONS
Future research on disability identity may benefit from a separate consideration of disability denial and disability affirmation. Lower disability denial predicts higher general self-efficacy in RP. Clinical implications include supporting personal disability acceptance rather than attempting to "normalize" individuals with disabilities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Topics: Adolescent; Adult; Aged; Attitude to Health; Cross-Sectional Studies; Disabled Persons; Female; Humans; Internet; Male; Middle Aged; Reproducibility of Results; Retinitis Pigmentosa; Self Concept; Self Efficacy; Surveys and Questionnaires; Young Adult
PubMed: 30211602
DOI: 10.1037/rep0000238