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Medical Education Online Dec 2023Lack of health care providers' knowledge about the experience and needs of individuals with disabilities contribute to health care disparities experienced by people with...
PURPOSE
Lack of health care providers' knowledge about the experience and needs of individuals with disabilities contribute to health care disparities experienced by people with disabilities. Using the Core Competencies on Disability for Health Care Education, this mixed methods study aimed to explore the extent the Core Competencies are addressed in medical education programs and the facilitators and barriers to expanding curricular integration.
METHOD
Mixed-methods design with an online survey and individual qualitative interviews was used. An online survey was distributed to U.S. medical schools. Semi-structured qualitative interviews were conducted via Zoom with five key informants. Survey data were analyzed using descriptive statistics. Qualitative data were analyzed using thematic analysis.
RESULTS
Fourteen medical schools responded to the survey. Many schools reported addressing most of the Core Competencies. The extent of disability competency training varied across medical programs with the majority showing limited opportunities for in depth understanding of disability. Most schools had some, although limited, engagement with people with disabilities. Having faculty champions was the most frequent facilitator and lack of time in the curriculum was the most significant barrier to integrating more learning activities. Qualitative interviews provided more insight on the influence of the curricular structure and time and the importance of faculty champion and resources.
CONCLUSIONS
Findings support the need for better integration of disability competency training woven throughout medical school curriculum to encourage in-depth understanding about disability. Formal inclusion of the Core Competencies into the Liaison Committee on Medical Education standards can help ensure that disability competency training does not rely on champions or resources.
Topics: Humans; Curriculum; Education, Medical; Health Education; Learning; Disabled Persons
PubMed: 37148284
DOI: 10.1080/10872981.2023.2207773 -
JAMA Pediatrics Apr 2024
Topics: Humans; Foster Home Care; Disabled Persons
PubMed: 38345796
DOI: 10.1001/jamapediatrics.2023.6577 -
Special Care in Dentistry : Official... 2024
Topics: Humans; Dental Care for Disabled; Disabled Persons; United States; Academies and Institutes
PubMed: 37853638
DOI: 10.1111/scd.12924 -
The American Psychologist Nov 2023This article provides an executive summary of the American Psychological Association's (APA's) revised . The revision was requested by the Committee on Disability Issues...
This article provides an executive summary of the American Psychological Association's (APA's) revised . The revision was requested by the Committee on Disability Issues in Psychology and was approved by the APA Council of Representatives in February 2022. The task force updated and expanded the guidelines' empirical bases; squarely situated the guidelines in a changing sociocultural landscape (reflected in discussions of disability models, biases and barriers, language use, intersectionality, and respectful and fair assessment and intervention); and added many concrete suggestions for conceptualizing disability and working with disabled clients and their support systems. In this executive summary, we include key points from each of the 23 guidelines. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Societies, Scientific; Disabled Persons
PubMed: 36931825
DOI: 10.1037/amp0001150 -
Quality of Life Research : An... Nov 2023Reliable measurement of disability in multiple sclerosis (MS) using a comprehensive, patient self-reported scale, such as the World Health Organization Disability...
INTRODUCTION
Reliable measurement of disability in multiple sclerosis (MS) using a comprehensive, patient self-reported scale, such as the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, would be of clinical and research benefit.
METHODS
In the Trajectories of Outcome in Neurological Conditions-MS study, WHODAS 2.0 (WHODAS-36 items for working, WHODAS-32 items if not working, WHODAS-12 items short-form) was examined using Rasch analysis in 5809 people with MS.
RESULTS
The 36- and 32-item parallel forms, and the cognitive and physical domains, showed reliability consistent with individual or group use. The 12-item short-form is valid for group use only. Interval level measurement for parametric statistics can be derived from all three scales which showed medium to strong effect sizes for discrimination across characteristics such as age, subtype, and disease duration. Smallest detectable difference for each scale was < 6 on the standardised metric of 0-100 so < 6% of the total range. There was no substantial differential item functioning (DIF) by age, gender, education, working full/part-time, or disease duration; the finding of no DIF for time or sample supports the use of WHODAS 2.0 for longitudinal studies, with the 36- and 32-item versions and the physical and cognitive domains valid for individual patient follow-up.
CONCLUSIONS
Disability in MS can be comprehensively measured at interval level by the WHODAS 2.0, and validly monitored over time. Routine use of this self-reported measure in clinical and research practice would give valuable information on the trajectories of disability of individuals and groups.
Topics: Humans; Multiple Sclerosis; Reproducibility of Results; Quality of Life; Disabled Persons; Disability Evaluation; Psychometrics; World Health Organization
PubMed: 37589773
DOI: 10.1007/s11136-023-03470-6 -
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 -
Psychiatria Danubina Dec 2023Intellectual Abilities, as defined in the twelfth edition of the classification manual of the American Association on Intellectual and Developmental Disabilities, are a...
Intellectual Abilities, as defined in the twelfth edition of the classification manual of the American Association on Intellectual and Developmental Disabilities, are a fundamental part of the rehabilitation process, also understood as functional rehabilitation or the rehabilitation of specific more or less complex functions, in a paradoxical game of mirrors even in the rehabilitation of intellectual functions themselves. Intellectual Disability changes the rules of the game, all the more radically the more severe it is, exacerbating the importance of multidimensional assessment of residual abilities and impaired functions on the basis of which to define realistic goals and choose the tools of rehabilitation and the ways of implementing therapeutic programs in a team effort that consists of the professionals, family and care givers, as well as the disabled person to the extent that he or she is able to actively participate in conducting his or her own rehabilitation.
Topics: Humans; Male; Female; Disabled Persons; Intellectual Disability; Cognition; Medicine
PubMed: 37994074
DOI: No ID Found -
Scandinavian Journal of Occupational... Aug 2023Critical occupational therapists have exhorted their profession to engage with disability studies' scholarship, curtail occupational therapy's promotion of ableism and... (Review)
Review
BACKGROUND
Critical occupational therapists have exhorted their profession to engage with disability studies' scholarship, curtail occupational therapy's promotion of ableism and amend its disabling practices. These appeals have largely been ignored despite their importance for a profession that researches, theorizes, assesses, and intervenes in the lives of disabled people.
AIMS AND OBJECTIVES
To interrogate occupational therapy's collusion with an ableist neoliberal agenda; and call for occupational therapists to resist their profession's disabling practices.
MATERIAL AND METHODS
This paper draws from critical disability scholarship to expose, critique and contest the ableist ideology underpinning occupational therapy.
RESULTS
Interlinked with racism, heteronormativity and gender binarism, ableism upholds certain bodies as normal and appropriate. Ableist values shape occupational therapy, with clients classified according to their proximity to 'normality', and exhorted to minimize their occupational performance deviations from dominant norms.
CONCLUSIONS
Collusion with colonialism's binary classificatory systems and neoliberal ableist norms, and avowed aspirations to improve bodies, 'normalize' performances, promote individualism, self-reliance, independence, self-care, and productivity contribute to the perception that ours is a disabling profession.
SIGNIFICANCE
This paper calls for occupational therapists to resist their profession's promotion of ableism, and refuse to collude with colonial practices that contribute to the oppression of disabled people.
Topics: Humans; Occupational Therapy; Social Discrimination; Self Care; Disabled Persons; Occupational Therapists
PubMed: 36219559
DOI: 10.1080/11038128.2022.2130821 -
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 -
LGBT Health Apr 2024This study explored the impact of delayed and foregone care due to COVID-19 on well-being among disabled and gender diverse adults. Using data from the 2021 National...
This study explored the impact of delayed and foregone care due to COVID-19 on well-being among disabled and gender diverse adults. Using data from the 2021 National Survey on Health and Disability and logistic regression modeling we assessed the impact of delayed or foregone care due to COVID-19 on well-being among disabled people ( = 1638), with comparisons between cisgender ( = 1538) and gender diverse ( = 100) people with disabilities. We report odds ratios (OR) and confidence intervals (CI). Disabled people reported high rates of delayed (79.36%) and foregone (67.83%) care and subsequent negative effects on well-being (72.07%). Gender diverse disabled people were over four times more likely to have delayed any care (OR 4.45, 95% CI 1.86-10.77) and three times more likely to have foregone any care (OR 3.14, 95% CI 1.71-5.79) due to COVID-19 compared to cisgender disabled people. They were three times more likely to report any negative impact on their health and well-being because of delayed and foregone care (OR 2.78, 95% CI 1.43-5.39). The COVID-19 pandemic affected the health care utilization of disabled people, resulting in high rates of delayed care, foregone care, and negative impacts on well-being. These effects were intensified at the intersection of disability and marginalized gender identity, with gender diverse disabled people having higher odds of delayed and foregone care and negative effects on well-being, including physical health, mental health, pain levels, and overall level of functioning.
Topics: Adult; Humans; Male; Female; Gender Identity; Pandemics; COVID-19; Disabled Persons; Patient Acceptance of Health Care
PubMed: 38060697
DOI: 10.1089/lgbt.2022.0385