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Advances in Health Sciences Education :... May 2024How medical students, their teachers, and school administrators understand disability appears connected to ongoing, unequal access to medical education for disabled...
How medical students, their teachers, and school administrators understand disability appears connected to ongoing, unequal access to medical education for disabled people. The stigmatization of disability within medical education affects students' disability disclosures, yet few studies have explored how understandings of disability influence inclusion practices beyond individual student actions. This paper develops the concept of legibility, derived from a constructivist grounded theory study that examined disability inclusion at four U.S. medical schools through interviews with 19 disabled students and 27 school officials (faculty and administrators). With two dimensions (recognition and assessment of possibility), legibility demonstrates that knowing disability is relational, contextual, and equivocal. Drawing from the field of disability studies, the paper argues that the current paradigm of disability inclusion demands that students' disability experiences be highly legible to themselves and others, yet increased legibility comes with potential risk due to prevalent ableism. While individual interactions can shift understandings of disability towards greater inclusivity, systemic action that embeds liberating discourses of disability into medical education is needed.
Topics: Humans; Disabled Persons; Grounded Theory; Students, Medical; Male; Female; Education, Medical; United States; Interviews as Topic; Adult
PubMed: 37479819
DOI: 10.1007/s10459-023-10268-1 -
Journal of Occupational Rehabilitation Dec 2018Purpose Amputation is a life changing event that can significantly impact an individual's physical and mental well-being. Our objective was to review literature... (Review)
Review
Purpose Amputation is a life changing event that can significantly impact an individual's physical and mental well-being. Our objective was to review literature exploring the impact of amputation upon a person's functioning and inclusion in the workplace. Methods Medline, CINAHL, and PsycINFO were searched using keywords related to amputation, employment and community reintegration. Eligible studies were published since 2000 and one of the following study designs: randomized controlled trial, non-randomized controlled trial, retrospective study, prospective study, concurrent cohort study, or cross sectional study. Studies for civilians with amputation as well as service members and Veterans with amputation were considered for inclusion. Results The search identified 995 articles, 25 of which met inclusion/exclusion criteria and were included in the review. While strong evidence for correlations and predictors of outcomes after amputation were limited, multiple factors were identified as contributing to physical functioning and employment after amputation. Conclusions Outcomes after amputation can vary widely with many potentially inter-related factors contributing. The factors identified may also serve to inform the development of interventions aiming to improve functional performance and reintegration after amputation. Furthermore, the review highlights the need for more high quality prospective studies.
Topics: Amputation, Traumatic; Disabled Persons; Employment; Humans; Lower Extremity; Rehabilitation, Vocational; Return to Work; Self-Help Devices; Upper Extremity; Walking
PubMed: 29397480
DOI: 10.1007/s10926-018-9757-y -
International Journal of Environmental... Mar 2021Persons with Parkinson's disease (PD) need to adapt to their progressive disability to achieve and maintain a high degree of life satisfaction (LS), but little is known...
Persons with Parkinson's disease (PD) need to adapt to their progressive disability to achieve and maintain a high degree of life satisfaction (LS), but little is known about the meaning of LS and adaptation. This study aimed to gain an in-depth understanding of the meaning of LS and adaptation in persons with PD. Open-ended in-depth interviews were performed with 13 persons diagnosed with PD, 9 women, 3 men, and one non-binary person (mean age 54 years, mean time since diagnosis 3.4 years). The interviews were analyzed using a phenomenological-hermeneutic approach. The participants were in the process of adapting to their new health situation. There were two quite distinct groups: one that adapted through acceptance and one that struggled to resist the disease and the profound impact it had on their lives. The thematic structural analysis covers eight themes illustrating the meaning of LS and adaptation, through either acceptance or resistance. Adaptation to PD involves a transitional process characterized by either acceptance or resistance, which influences a person's LS. Acceptance makes LS possible, whereas resistance constitutes a behavioral barrier to adaptation and LS. Rehabilitation professionals need to understand this individual process to be able to support a person with PD to reach and maintain a high level of LS. Understanding the link between LS and adaptation can support rehabilitation professionals to provide targeted interventions for people with PD.
Topics: Adaptation, Psychological; Disabled Persons; Female; Humans; Male; Middle Aged; Parkinson Disease; Personal Satisfaction; Qualitative Research; Time
PubMed: 33806884
DOI: 10.3390/ijerph18063308 -
Developmental Medicine and Child... Aug 2018
Topics: Adolescent; Adult; Child; Disabled Children; Disabled Persons; Health Services; Humans; Practice Guidelines as Topic; United Kingdom; Young Adult
PubMed: 29978914
DOI: 10.1111/dmcn.13899 -
PloS One 2020This study aimed to examine the association between disability and cardiovascular (CV) disease incidence and mortality in Korea longitudinally, using a national...
This study aimed to examine the association between disability and cardiovascular (CV) disease incidence and mortality in Korea longitudinally, using a national representative sample. We used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) database, which includes information on the disability of the National Screening Program participants such as severity and type of disability, which were obtained from the Korean National Disability Registry. Cox proportional hazard models were used to evaluate the association between disability and CV disease incidence and mortality. We constructed four models with different levels of adjustment, in which Model 3 was a fully adjusted model. This study included 514,679 participants, and 7,317 CV deaths were reported within a mean follow up of 10.8 ± 3.9 years (maximum, 13.9 years). For 5,572,130 person-year (PY) follow-up, the CV mortality rate was 1.313 per 1,000 PY. In Models 1 and 2, CV disease incidence was significantly higher in participants with disability than in those without disability. In Model 3, the incidence was higher only among participants aged 50-64 years and severe disabled participants aged <50 years. CV mortality was significantly higher in participants with disability than in those without disability in all Models, and the mortality increased in both sexes in Models 1 and 2 but only increased in men in Model 3. Similar results were observed in the subgroup analysis of health behavior and chronic diseases. People with disability showed higher CV disease incidence and mortality than those without disability, regardless of the type of disability or risk factors for CV disease.
Topics: Aged; Cardiovascular Diseases; Comorbidity; Databases, Factual; Disabled Persons; Female; Health Behavior; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; National Health Programs; Proportional Hazards Models; Republic of Korea; Severity of Illness Index; Survival Rate
PubMed: 32730313
DOI: 10.1371/journal.pone.0236665 -
Asian Nursing Research Dec 2014To evolve a management plan for rheumatoid arthritis, it is necessary to understand the patient's symptom experience and disablement process. This paper aims to... (Review)
Review
To evolve a management plan for rheumatoid arthritis, it is necessary to understand the patient's symptom experience and disablement process. This paper aims to introduce and critique two models as a conceptual foundation from which to construct a new model for arthritis care. A Disability Intervention Model for Older Adults with Arthritis includes three interrelated concepts of symptom experience, symptom management strategies, and symptom outcomes that correspond to the Theory of Symptom Management. These main concepts influence or are influenced by contextual factors that are situated within the domains of person, environment, and health/illness. It accepts the bidirectional, complex, dynamic interactions among all components within the model representing the comprehensive aspects of the disablement process and its interventions in older adults with rheumatoid arthritis. In spite of some limitations such as confusion or complexity within the model, the Disability Intervention Model for Older Adults with Arthritis has strengths in that it encompasses the majority of the concepts of the two models, attempts to compensate for the limitations of the two models, and aims to understand the impact of rheumatoid arthritis on a patient's physical, cognitive, and emotional health status, socioeconomic status, and well-being. Therefore, it can be utilized as a guiding theoretical framework for arthritis care and research to improve the functional status of older adults with rheumatoid arthritis.
Topics: Activities of Daily Living; Aged; Arthritis, Rheumatoid; Disability Evaluation; Disabled Persons; Frail Elderly; Humans; Models, Theoretical
PubMed: 25529905
DOI: 10.1016/j.anr.2014.08.004 -
Annali Dell'Istituto Superiore Di Sanita 2020The huge increase of people with mental and intellectual disability worldwide, and the advocacy capacity achieved by these patients, which culminated in the Convention... (Review)
Review
The huge increase of people with mental and intellectual disability worldwide, and the advocacy capacity achieved by these patients, which culminated in the Convention on the Rights of Persons with Disabilities (CRPD), came along the shifts in the way governments deliver public services. In particular, in the last decades, many countries examined how to provide a person with disabilities an acceptable social functioning, improve wellbeing, according to the principles of equity, solidarity and participation. A new political and social-health model was born, called "welfare community", users are protagonists of their health project and the resources put in place assume an investment character on the community and its economic development. Personalisation of social and health services is also considered in many countries as a "new mode of care", although in different forms depending on financial aspect and recipients. The present article is a narrative review that examines and summarize international research and non-research material to survey the different implementation strategies of personalisation in different countries, with a special focus on Italy, in attempting to provide conceptual clarity about this topic in terms of opportunities and pitfalls.
Topics: Disabled Persons; Humans; Intellectual Disability; Italy; Mental Disorders; Patient-Centered Care; Precision Medicine
PubMed: 32567569
DOI: 10.4415/ANN_20_02_09 -
Journal of Intellectual Disabilities :... Mar 2023People with profound and multiple learning disabilities are often excluded from the processes of knowledge production and face barriers to inclusion in research due to...
People with profound and multiple learning disabilities are often excluded from the processes of knowledge production and face barriers to inclusion in research due to cognitive and communicative challenges. Inclusive research-even when intending to be inclusive-tends to operate within criteria that exclude people with profound and multiple learning disabilities. The aim of this article is to provide a state-of-the-art review of the topic of inclusive research involving people with profound disabilities and thereby challenge traditional assumptions of inclusive research. The review presents themes that will inform a discussion on how to challenge the criteria in ways that make it possible to understand inclusive research for people who communicate in unconventional ways. We argue that a fruitful way of rethinking inclusive research is by applying a sensory-dialogical approach that privileges the dialogical and sensory foundations of the research. We suggest this might be a way to understand inclusive research that regards the person's communicative and cognitive distinctiveness.
Topics: Humans; Intellectual Disability; Community-Based Participatory Research; Disabled Persons; Learning Disabilities
PubMed: 35015585
DOI: 10.1177/17446295211062390 -
Medicina (Kaunas, Lithuania) May 2018Participation is a fundamental right of the child, regardless of his health status. Assessing and supporting the participation of children with spina bifida (SB)... (Review)
Review
Participation of Children with Spina Bifida: A Scoping Review Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Reference Framework.
Participation is a fundamental right of the child, regardless of his health status. Assessing and supporting the participation of children with spina bifida (SB) presents a significant challenge for practitioners. The purpose of this study was to examine what is known about the participation of children with SB. The framework for scoping reviews from Arksey & O'Malley was used. A literature search in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (Medline), PsychINFO and the Education Resources Information Centre (ERIC) databases retrieved 136 papers, 10 of which met the criteria for inclusion and were selected for analysis. Synthesis of the results on participation within occupational domains of leisure, school and community, and factors influencing participation of children with SB was performed. All the included studies were non-experimental and used cross-sectional, population-based or qualitative design. Most studies analysed social participation or participation in physical activities, except one that focused on school participation. Data from these studies have shown that children with SB experience greater participation restrictions compared to their typical peers or children with other chronic diseases. The participation was mainly affected by contextual factors. Relationships between pathology and participation were not sufficiently validated. There is little research on the participation of children with SB. Future studies must consider contextual factors and interventions facilitating or impeding participation.
Topics: Adolescent; Child; Child, Preschool; Cross-Sectional Studies; Disability Evaluation; Disabled Persons; Exercise; Female; Humans; International Classification of Functioning, Disability and Health; Male; Qualitative Research; Social Participation; Spinal Dysraphism
PubMed: 30344271
DOI: 10.3390/medicina54030040 -
Annals of Agricultural and... Dec 2023The number of disabled persons is most often only estimated. The disabled require multidirectional, effective support in almost every field of functioning. There is no...
INTRODUCTION AND OBJECTIVE
The number of disabled persons is most often only estimated. The disabled require multidirectional, effective support in almost every field of functioning. There is no arbitrarily accepted definition of disability, and those currently available outline the ranges of support for which rehabilitation measures are necessary.
OBJECTIVE
The aim of the review is to present the problem areas that contribute to the definition of disability and their interdependence and effectiveness in relation to rehabilitation interventions, as well as identification of the most frequent medical and social problems interdependent on the quality and feasibility of rehabilitation interventions.
REVIEW METHODS
Scientific literature in Polish and English for 1993-2023 and legal acts concerning the definition of disability, definition of rehabilitation and the problem of employment were reviewed. The following key words were used to search the NIZP-PZH, MZ, JAHEE and ISAP databases: disabled persons, definitions of disability, rehabilitation as a process, synchronization of thematic groups of disability definitions with the rehabilitation process.
BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE
Disability is a public health problem. The actual determination of the extent, medical and social needs of people with disabilities involves methods and measures for classifying people as disabled. The effects of treatment and rehabilitation are assessed by the level of functioning of the disabled in society.
SUMMARY
The multiplicity of characteristics included in the definitions of disability account for all problems in health and social terms. In view of the social, environmental and cultural changes, the scope of needs of people with disabilities is also changing, which can be seen in newly-developed definitions, including rehabilitation.
Topics: Humans; Disabled Persons; Employment; Poland; Public Health
PubMed: 38153059
DOI: 10.26444/aaem/177341