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Rehabilitation Psychology May 2020Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on...
PURPOSE/OBJECTIVE
Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes.
RESULTS
While on average, provider's explicit attitudes ( = 4.41) indicated little prejudice, their implicit attitudes ( = 0.54) revealed they moderately preferred nondisabled people-they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability).
CONCLUSIONS/IMPLICATIONS
This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Topics: Adult; Attitude of Health Personnel; Disabled Persons; Female; Health Personnel; Health Services for Persons with Disabilities; Humans; Male; Prejudice; Young Adult
PubMed: 32105109
DOI: 10.1037/rep0000317 -
Disability and Rehabilitation.... Jan 2023Existing wheelchair (WC) designs lack independent toilet accessibility, transferability and indoor manoeuvrability combined in a WC. In this regard, a new WC model is...
PURPOSE
Existing wheelchair (WC) designs lack independent toilet accessibility, transferability and indoor manoeuvrability combined in a WC. In this regard, a new WC model is proposed to simultaneously accommodate these distinct and essential features. In this open-source hardware project, the design, analysis and fabrication of a new active commode WC for indoor applications are performed.
MATERIALS AND METHOD
A field survey is conducted to identify the requirements of users so as to choose specific features and design constraints for the WC. In this multipurpose self-propelled model, a temporarily detachable circular section is fitted in the seat position to access the water closet bowl. This hinged portion can be released by gravity before reaching above the closet basin. After the toilet usage, the circular lid can be brought back to the initial seating using a lever mechanism and a spring-loaded lock restrains its downward movement. Thereafter, it can be used as an ordinary WC for indoor applications. Moreover, a small wheel with 22 in diameter and removable hand-rests ensured the transferability between utilities. A CAD model is prepared and numerical simulation is performed to verify the structural stability of the design.
RESULTS
The optimized model is fabricated using standard manufacturing practices and is delivered to different persons with disabilities to collect user feedback. A systematic skill test is conducted to validate the compliance of the prototype with the user requirements including transferability and independent restroom access.
CONCLUSION
The opinions from most of the users are positive which categorically indicated that the proposed design addresses the multipurpose mobility requirements at indoors.Implications for rehabilitationThe expected outcomes and implications of the current commode WC project with regard to rehabilitation purpose are enlisted below:In the present scenario, a WC user is heavily dependent on external assistance to access private spaces in general and toilets in particular. The introduced model is capable to address this shortcoming by enabling the user to access the toilet utility directly by self propelling.Indeed, for a person with locomotor disability, a WC is the natural extension of his physical body. Thereby, this multipurpose commode WC design offers much Independence and greater flexibility to the indoor movements.The proposed design instils confidence to a WC user to access and transfer between facilities by means of self effort. Consequently it is expected to improve the quality of one's personal life significantly.Importantly, this is an open-source project, those who are interested in rehabilitation motives can modify the present design to suit their local requirements especially in resource-limited settings.
Topics: Humans; Bathroom Equipment; Wheelchairs; Self-Help Devices; Disabled Persons; Toilet Facilities; Equipment Design
PubMed: 33337923
DOI: 10.1080/17483107.2020.1839574 -
Behavioral Sciences & the Law Mar 2017This article provides an overview of definitions and assessment instruments of disability, an important topic in the diagnosis and treatment of chronic illnesses, and in... (Review)
Review
This article provides an overview of definitions and assessment instruments of disability, an important topic in the diagnosis and treatment of chronic illnesses, and in expert appraisals in social and forensic medicine. Health problems are manifested not only in symptoms, but also regularly in impairment or disability in everyday life, which is especially true for mental disorders. According to the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization, disability can be understood as chronic suffering from symptoms of illness, or limitations of executing capacities, or inability to participate in selected areas of life. Operationally, disability can be defined as "capacity limitations which hinder the ability to execute needed activities and thereby participation in a given environment". This capacity-context-interaction model shows that there is no general disability but only context-related disability, which has manifold consequences for diagnosis and care. Copyright © 2017 John Wiley & Sons, Ltd.
Topics: Disabled Persons; Humans; Mental Disorders; World Health Organization
PubMed: 28295575
DOI: 10.1002/bsl.2283 -
Journal of Affective Disorders Sep 2023Our study aimed to investigate the association between psychological distress and disability-free life expectancy (DFLE).
BACKGROUND
Our study aimed to investigate the association between psychological distress and disability-free life expectancy (DFLE).
METHODS
In 2006, a cohort study was conducted of 12,365 Japanese individuals aged ≥65 years, who were followed-up for 13 years. Psychological distress was measured using the Kessler 6-item psychological distress scale and was categorized into no (0-4), mild (5-9), moderate (10-12), and serious distress (13-24). The number of participants was 1277 (22.4 %) for mild distress, 330 (5.8 %) for moderate, and 208 (3.6 %) for serious in men, and was 1635 (24.6 %), 467 (7.0 %), and 384 (5.8 %) in women. Sex-specific DFLE was defined as the mean years a person could expect to live without disability and calculated by Interpolated Markov Chain (IMaCh) software.
RESULTS
Compared to no distress, DFLE loss per person was 1.21, 2.61, and 4.43 years for mild, moderate, and serious distress respectively in men. At population level, DFEL loss (i.e., DFLE loss per person×number of participants) was 1545.17, 861.30, and 921.44 years for mild, moderate, and serious distress respectively in men. Accordingly, 46.4 % of the total DFLE loss was attributable to mild distress, 25.9 % to moderate, and 27.7 % to serious in men. Similarly, the results were 42.2 %, 25.4 %, and 32.4 % in women.
LIMITATIONS
Psychological distress was measured only once at baseline, and 2409 participants were excluded from the analysis because of missing data on exposure.
CONCLUSIONS
At population level, almost half of the total DFLE loss could be attributable to mild distress, underscoring the importance of population strategy for all levels of distress in promoting healthy aging.
Topics: Adult; Aged; Female; Humans; Male; Cohort Studies; Disabled Persons; East Asian People; Healthy Life Expectancy; Life Expectancy; Psychological Distress
PubMed: 37263359
DOI: 10.1016/j.jad.2023.05.090 -
Clinical Rehabilitation Mar 2023What is rehabilitation? From 1994 to 2021, while I was privileged to be Editor of Clinical Rehabilitation, I explored this in editorials. I also encouraged and selected...
What is rehabilitation? From 1994 to 2021, while I was privileged to be Editor of Clinical Rehabilitation, I explored this in editorials. I also encouraged and selected submissions that considered, in one way or another, the central features of rehabilitation. Why? Because when I started in rehabilitation, the general attitude among doctors and other healthcare professionals was that rehabilitation was pleasant but with no evidence of effectiveness. Further, they did not think a doctor had a role to play and did not think there was anything special for rehabilitation experts to know or have skills in. In this editorial, I discuss how, as editor, I used my position to support and encourage the publication of articles that produced evidence, considered the conceptual and scientific basis of rehabilitation, and ultimately answered the above question. I illustrate this with a few specific papers published in Clinical Rehabilitation. After 30 years, I have concluded that the essential feature characterising rehabilitation is its way of thinking about the patient's problems and how to solve them. Rehabilitation is holistic, person-centred, and concerned about social integration rather than disease or disability. Moreover, there is a mass of evidence showing it benefits patients.
Topics: Humans; Disabled Persons; Health Personnel
PubMed: 36203369
DOI: 10.1177/02692155221131248 -
BMJ Open Mar 2018Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way... (Review)
Review
INTRODUCTION
Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way for self-expression. It can help or hinder the ability to fulfil everyday activities and social roles and with the rising industry of wearable technologies, smart textiles are adding health-monitoring functions to clothing. The influence that clothing can have on the life of someone with a physical disability is significant, and further research is needed to understand it better. To achieve this, a scoping review will be performed with the aim of understanding the role of clothing in participation (ie, at home, in the community, etc) of individuals with a physical disability. This article presents the protocol and procedure to be adopted.
METHODS AND ANALYSIS
An in-depth iterative analysis of the scientific literature from six databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO and ERIC) as well as a hand search of grey literature and reference lists will be performed. After an abstract and full-text review of references by three reviewers independently, data from the selected articles will be tabulated and synthesised with a qualitative and quantitative approach using the International Classification of Functioning, Disability and Health as a unifying conceptual framework. A multidisciplinary consultation group of experts from various stakeholder groups will be involved in multiple steps to ensure validation and relevance of the data.
ETHICS AND DISSEMINATION
As this is a review involving analysis of data available in the public domain and does not involve human participants, ethical approval was not required. Results will be presented in a co-constructed format with the expert consultation group to ensure validity and maximise its practicality moving forward. Our dissemination plan includes peer-reviewed publications, presentations and stakeholder meetings.
Topics: Clothing; Disabled Persons; Humans; Qualitative Research; Social Environment; Wearable Electronic Devices
PubMed: 29523570
DOI: 10.1136/bmjopen-2017-020299 -
Health Policy (Amsterdam, Netherlands) Aug 2017Work disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the... (Review)
Review
Work disability due to low back pain is a significant global health concern. Current policy and practice aimed at tackling this problem is largely informed by the biopsychosocial model. Resultant interventions have demonstrated some small-scale success, but they have not created a widespread decrease in work disability. This may be explained by the under-representation of the less measurable aspects in the biopsychosocial evidence base; namely the influence of relevant systems. Thus, a 'best-evidence' synthesis was conducted to collate the evidence on how compensatory (worker's compensation and disability benefits), healthcare and family systems (spouse/partner/close others) can act as obstacles to work participation for those with low back pain. Systematic searches of several scientific and grey literature sources were conducted, resulting in 1762 records. Following a systematic exclusion process, 57 articles were selected and the evidence was assessed using a system adapted from previous large-scale policy reviews conducted in this field. Results indicated how specific features of relevant systems could act as obstacles to individual efforts/interventions aimed at tackling work disability due to LBP. These findings reinforce the need for a 'whole-systems' approach, with all key players onside and have implications for the revision of current biopsychosocial-informed policy and practice.
Topics: Disabled Persons; Family; Humans; Insurance, Disability; Low Back Pain; Return to Work; Workers' Compensation
PubMed: 28595897
DOI: 10.1016/j.healthpol.2017.05.011 -
Prosthetics and Orthotics International Dec 2020In the inaugural edition of in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional... (Review)
Review
In the inaugural edition of in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic-orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of in shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.
Topics: Disabled Persons; Humans; Orthotic Devices; Prostheses and Implants; Quality of Life; Self-Help Devices
PubMed: 33164660
DOI: 10.1177/0309364620967780 -
American Journal of Physical Medicine &... Oct 2017Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor,... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life.
DESIGN
In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool.
RESULTS
Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs.
CONCLUSION
Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.
Topics: Animals; Disabled Persons; Equine-Assisted Therapy; Gait; Horses; Humans; Postural Balance; Quality of Life
PubMed: 28252520
DOI: 10.1097/PHM.0000000000000726 -
Neurology India 2020Many neurological conditions may result in long-term disability. The measures of prevalence and mortality vastly understate the disability they cause. In the Persons...
Many neurological conditions may result in long-term disability. The measures of prevalence and mortality vastly understate the disability they cause. In the Persons with Disabilities Act 1995 (equal opportunities, protection of rights, and full participation), neurological conditions are ignored. Although Indian Disability Evaluation and Asessment Scale (IDEAS), which assesses psychiatric conditions, does include dementia as one of the neurodegenerative conditions. Additionally, according to the global burden of disease report, 33% of years lived with neurological disability and 13% of disability-adjusted life years (DALYs) are due to neurological and psychiatric disorders. In 2001, the World Health Organization (WHO) established a new definition of disability, declaring it an umbrella term with the following three major components; 1) impairments: problems in body function or structure, 2) activity limitations: difficulties encountered by a person in executing a task or action, and 3) participation restrictions: problems of involvement in life situations experienced by a person. Hence, an attempt was made to rectify the above concerns. To address the above mentioned concerns, we think that there is a need of a comprehensive format for neurological disabilities assessment which would also include objective neuropsychological assessments. As future directions, national level meetings are required to formulate 'Indian Standard Track for Assessing Neurological Disability' (I-STAND) and uniform guidelines for disability assessment in 'chronic neurological conditions' with a special focus on "neuropsychological disability".
Topics: Chronic Disease; Disability Evaluation; Disabled Persons; Female; Humans; India; Male; Nervous System Diseases; Prevalence; Quality-Adjusted Life Years
PubMed: 32129266
DOI: 10.4103/0028-3886.279709