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Lancet (London, England) Jun 2018Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population.... (Review)
Review
Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen in low-income and middle-income countries. Low back pain is now the leading cause of disability worldwide. For nearly all people with low back pain, it is not possible to identify a specific nociceptive cause. Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain. Disabling low back pain is over-represented among people with low socioeconomic status. Most people with new episodes of low back pain recover quickly; however, recurrence is common and in a small proportion of people, low back pain becomes persistent and disabling. Initial high pain intensity, psychological distress, and accompanying pain at multiple body sites increases the risk of persistent disabling low back pain. Increasing evidence shows that central pain-modulating mechanisms and pain cognitions have important roles in the development of persistent disabling low back pain. Cost, health-care use, and disability from low back pain vary substantially between countries and are influenced by local culture and social systems, as well as by beliefs about cause and effect. Disability and costs attributed to low back pain are projected to increase in coming decades, in particular in low-income and middle-income countries, where health and other systems are often fragile and not equipped to cope with this growing burden. Intensified research efforts and global initiatives are clearly needed to address the burden of low back pain as a public health problem.
Topics: Adult; Aged; Attention; Cost of Illness; Cost-Benefit Analysis; Delivery of Health Care; Disabled Persons; Female; Humans; Low Back Pain; Male; Middle Aged; Recurrence; Social Class
PubMed: 29573870
DOI: 10.1016/S0140-6736(18)30480-X -
Lancet (London, England) Dec 2021Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation...
BACKGROUND
Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritised in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.
METHODS
To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability (YLDs) of 25 diseases, impairments, or bespoke aggregations of sequelae that were selected as amenable to rehabilitation. All analyses were done at the country level and then aggregated to seven regions: World Bank high-income countries and the six WHO regions (ie, Africa, the Americas, Southeast Asia, Europe, Eastern Mediterranean, and Western Pacific).
FINDINGS
Globally, in 2019, 2·41 billion (95% uncertainty interval 2·34-2·50) individuals had conditions that would benefit from rehabilitation, contributing to 310 million [235-392] YLDs. This number had increased by 63% from 1990 to 2019. Regionally, the Western Pacific had the highest need of rehabilitation services (610 million people [588-636] and 83 million YLDs [62-106]). The disease area that contributed most to prevalence was musculoskeletal disorders (1·71 billion people [1·68-1·80]), with low back pain being the most prevalent condition in 134 of the 204 countries analysed.
INTERPRETATION
To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.
FUNDING
Bill & Melinda Gates Foundation.
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Disabled Persons; Female; Global Burden of Disease; Global Health; Humans; Male; Middle Aged; Musculoskeletal Diseases; Needs Assessment; Nervous System Diseases; Prevalence; Quality-Adjusted Life Years; Sensation Disorders; Sex Distribution; Young Adult
PubMed: 33275908
DOI: 10.1016/S0140-6736(20)32340-0 -
Journal of General Internal Medicine Jul 2019Patient-centered care for people with disability requires effective communication and compliance with the Americans with Disabilities Act (ADA).
BACKGROUND
Patient-centered care for people with disability requires effective communication and compliance with the Americans with Disabilities Act (ADA).
OBJECTIVE
To understand physicians' perspectives on communication experiences with people with disability.
DESIGN
Twenty semi-structured individual interviews. Interview recordings were transcribed verbatim for analysis.
SETTING
Massachusetts, October 2017-January 2018.
PARTICIPANTS
Twenty physicians ranging from 8 to 51 years in practice in primary care or 4 other specialties.
MEASUREMENTS
Commonly expressed themes around communication with people with disability.
RESULTS
Concerns coalesced around 4 broad categories: communication experiences with people who are deaf or hard of hearing, communication with people who are blind or have vision impairment, communication with people who have intellectual disability, and recommendations for improving communication. Although participants in this study reported various efforts to communicate effectively with patients with hearing or vision loss or intellectual disability, many gaps appear to remain, as well as instances where physicians' preferences run counter to patients' wishes and the ADA. Examples include physicians' preferences for remote, online sign language interpreters despite patients desiring in-person interpreters and suggesting that patients arrange for their own interpreters. Few educational materials are available in braille, and electronic medical records may not allow documents to be printed in large font for persons with low vision. Communicating with patients with intellectual disability raised particular concerns, with participants often preferring to interact with caregivers and minimal efforts to involve patients.
CONCLUSIONS
Effective communication is necessary for ensuring the quality of health care for people with disability, and it is legally required under the ADA. Our results suggest that important gaps may remain in ensuring effective communication, and some practicing physicians could benefit from formal training in effective methods for communicating with patients with disability.
Topics: Adult; Aged; Communication; Communication Barriers; Disabled Persons; Female; Humans; Male; Middle Aged; Patient-Centered Care; Physician-Patient Relations; Physicians
PubMed: 30887435
DOI: 10.1007/s11606-019-04911-0 -
PloS One 2019To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009...
AIMS
To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009 to 2017.
BACKGROUND
Disability in older people is associated with health problems, increased health costs and low quality of life. There are no updated data in Spain with a representative sample about disability.
METHODS
Cross-sectional study with 25,465 non-institutionalized older people who participated in the European Health Survey in 2009 and 2014 and the National Health Survey in 2011/12 and 2017 in Spain. The prevalence rates of disability were evaluated using the Katz Scale and Lawton and Brody Scale. Logistic regression was used to determine if there was an association between basic and instrumental activities of daily living and sociodemographic characteristics.
RESULTS
More individuals had disability for instrumental activities of daily living (31.9%) than disability for basic activities of daily living (11.1%). The most predominant disability for instrumental activities of daily living was performing severe housework (34%). The prevalence of disabilities decreased from 2009 to 2017. In general, disability was associated with female gender, advanced age, lower education, restricted daily activity, being bedridden and higher pain levels.
CONCLUSION
There is a considerable prevalence of disabilities for basic and instrumental activities of daily living in older people in Spain. Although the disability prevalence has decreased slowly from 2009 to 2017, it continues to remain a health problem. Gender may influence the disabilities for basic and instrumental activities of daily living. Health policymakers should establish prevention strategies and effective interventions (e.g., physical exercise) for prevention and reduction of the disabilities for basic and instrumental activities of daily living, particularly in older females.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Cross-Sectional Studies; Disability Evaluation; Disabled Persons; Female; Geriatric Assessment; Health Surveys; Humans; Logistic Models; Male; Prevalence; Sex Factors; Socioeconomic Factors; Spain
PubMed: 31348797
DOI: 10.1371/journal.pone.0220157 -
MMWR. Morbidity and Mortality Weekly... Aug 2018Persons with disabilities face greater barriers to health care than do those without disabilities (1). To identify characteristics of noninstitutionalized adults with...
Persons with disabilities face greater barriers to health care than do those without disabilities (1). To identify characteristics of noninstitutionalized adults with six specific disability types (hearing, vision, cognition, mobility, self-care, and independent living),* and to assess disability-specific disparities in health care access, CDC analyzed 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. The prevalences of disability overall and by disability type, and access to health care by disability type, were estimated. Analyses were stratified by three age groups: 18-44 years (young adults), 45-64 years (middle-aged adults), and ≥65 years (older adults). Among young adults, cognitive disability (10.6%) was the most prevalent type. Mobility disability was most prevalent among middle-aged (18.1%) and older adults (26.9%). Generally, disability prevalences were higher among women, American Indians/Alaska Natives (AI/AN), adults with income below the federal poverty level (FPL), and persons in the South U.S. Census region. Disability-specific disparities in health care access were prevalent, particularly among young and middle-aged adults. These data might inform public health programs of the sociodemographic characteristics and disparities in health care access associated with age and specific disability types and guide efforts to improve access to care for persons with disabilities.
Topics: Adolescent; Adult; Age Distribution; Aged; Behavioral Risk Factor Surveillance System; Disabled Persons; Female; Healthcare Disparities; Humans; Male; Middle Aged; Prevalence; Socioeconomic Factors; United States; Young Adult
PubMed: 30114005
DOI: 10.15585/mmwr.mm6732a3 -
BMC Medicine Jan 2018Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to...
Disability as a health outcome deserves more attention than it has so far received. With people living longer and the epidemiological transition from infectious to noncommunicable diseases as the major cause of health burden, we need to focus attention on disability - the non-fatal impact of heath conditions - over and above our concern for causes of mortality.With the first Global Burden of Disease study, WHO provided a metric that enabled the comparison of the impact of diseases, drawing on a model of disability that focused on decrements of health. This model has since been elaborated in the International Classification of Functioning, Disability and Health as being either a feature of the individual or arising out of the interaction between the individual's health condition and contextual factors. The basis of WHO's ongoing work is a set of principles: that disability is a universal human experience; that disability is not determined solely by the underlying health condition or predicated merely on the presence of specific health conditions; and finally, that disability lies on a continuum from no to complete disability. To determine whether interventions at individual or population levels are effective, an approach to disability measurement that allows for an appropriate and fair comparison across health conditions is needed. WHO has designed the Model Disability Survey (MDS) to collect information relevant to understand the lived experience of disability, including the person's capacity to perform tasks actions in daily life, their actual performance, the barriers and facilitators in the environment they experience, and their health conditions. As disability gains prominence within the development agenda in the United Nations Sustainable Development Goals, and the implementation of the United Nations Convention on the Rights of Persons with Disabilities, the MDS will provide the data to monitor the progress of countries on meeting their obligations.The lesson learned from WHO's activities is that disability is a universal human experience, in the sense that everyone can be placed on a continuum of functioning and either currently experiences or is vulnerable to experiencing disability over the course of their lives. This understanding of disability is the key to mainstreaming disability within the public discourse.
Topics: Comprehension; Disability Evaluation; Disabled Persons; Environment; Female; Health Status Indicators; Humans; International Classification of Functioning, Disability and Health; Male; Patient Rights; Public Health; Surveys and Questionnaires; Thinking; United Nations; World Health Organization
PubMed: 29370847
DOI: 10.1186/s12916-017-1002-6 -
Soins; La Revue de Reference Infirmiere 2020There is often confusion between the notion of disability in everyday life in society and the more specific notion of disability in the workplace. A health problem...
There is often confusion between the notion of disability in everyday life in society and the more specific notion of disability in the workplace. A health problem cannot be considered as a disability in everyday life, even if it makes life less agreeable, but can become one in the context of a professional activity. What and who exactly do we mean when we refer to disabled workers? Here we explore the different types of disabilities and their effects on employment as well as the tools currently available.
Topics: Disabled Persons; Employment; Humans; Workplace
PubMed: 33160463
DOI: 10.1016/S0038-0814(20)30141-9 -
Communications Biology Jul 2021July is Disability Pride Month here in New York, where part of the Communications Biology team is based. To mark this occasion, we are featuring a series of scientist...
July is Disability Pride Month here in New York, where part of the Communications Biology team is based. To mark this occasion, we are featuring a series of scientist interviews on the Nature Portfolio Ecology & Evolution Community site and wanted to elaborate on our motivations behind this post and our hopes for the future concerning the lived experience of disability in science.
Topics: Disabled Persons; Science
PubMed: 34272479
DOI: 10.1038/s42003-021-02411-8 -
The Lancet. Public Health May 2024Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities.... (Review)
Review
Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities. This Review provides an overview of the existing evidence on health inequities faced by people with disabilities and describes existing approaches to making health systems disability inclusive. Our Review documents a broad range of health-care inequities for people with disabilities (eg, lower levels of cancer screening), which probably contribute towards health differentials. We identified 90 good practice examples that illustrate current strategies to reduce inequalities. Implementing such strategies could help to ensure that health systems can expect, accept, and connect people with disabilities worldwide, deliver on their right to health, and achieve health for all.
Topics: Humans; Disabled Persons; Healthcare Disparities; Delivery of Health Care
PubMed: 38702096
DOI: 10.1016/S2468-2667(24)00042-2 -
Developmental Medicine and Child... Oct 2015
Topics: Disabled Persons; Human Rights; Humans; United States
PubMed: 26347353
DOI: 10.1111/dmcn.12877