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Midwifery May 2021Fifteen percent of the world's population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of... (Review)
Review
OBJECTIVE
Fifteen percent of the world's population has some form of disability, the most common form being a physical disability. Ten percent of women with disabilities are of childbearing age; however, because women with disabilities are often deemed less likely to have children, accessibility to maternity care is limited. Women with disabilities experience problems during pregnancy and childbirth due to physical barriers and barriers to information, problems with communication and the attitude of providers. A recent World Health Organization statement calls for more action, dialogue, research and advocacy on disrespectful treatment during childbirth. To give substance to this, an overview of the experiences of women with a physical disability is essential. Therefore, the aim of this systematic review is to identify and provide an overview of reported maternity care experiences of women with physical disabilities, including sensory disabilities.
DESIGN
This systematic review was conducted using a meta-aggregation approach for synthesis and the steps of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search strategy focused on qualitative studies in the databases PubMed, Embase and CINAHL. The Critical Appraisal Skills Programme checklist was used to evaluate methodological quality, and a best-evidence synthesis was performed.
FINDINGS
Of the 4,486 studies screened, ten were included. The methodological quality of the studies ranged from high to moderate. The results indicated that women experience barriers related to accessibility of facilities, adapted equipment, lack of knowledge, and healthcare providers' dismissals of their concerns and unwillingness to assist. In contrast, support has a positive influence on women's experiences.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
There is evidence that women with physical disabilities continue to encounter barriers in accessing maternity care related to inaccessible care settings, lack of knowledge and the attitude of healthcare providers. Healthcare providers should be trained to be aware of women's special needs and to improve clinical practice.
Topics: Child; Disabled Persons; Female; Humans; Interviews as Topic; Maternal Health Services; Obstetrics; Parturition; Personal Satisfaction; Pregnancy; Qualitative Research
PubMed: 33636618
DOI: 10.1016/j.midw.2021.102938 -
Aging Clinical and Experimental Research Jul 2023With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function.
AIMS
To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty.
METHODS
Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale.
RESULTS
A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)].
CONCLUSION
In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.
Topics: Humans; Aged; Aged, 80 and over; Frailty; Frail Elderly; Independent Living; Cognition; Disabled Persons
PubMed: 37219756
DOI: 10.1007/s40520-023-02421-y -
Disability and Rehabilitation Oct 2022The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia,...
PURPOSE
The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia, and to describe these models through an Integrated People-Centred Health Services (IPCHS) lens.
MATERIALS AND METHODS
We identified peer-reviewed studies published between 2000 and June 2021 that met the following criteria: described or evaluated a community service delivery model, intervention or program in regional, rural or remote Australia; provided for people with a disability or a potentially disabling health condition. A scoring rubric was developed covering the five IPCHS strategies.
RESULTS
Nineteen studies were included in the review. We identified a range of service delivery models providing support to people with a range of disabilities or conditions. We report evidence of the use of the IPCHS strategies in ways relevant to the local context.
DISCUSSION
Several strengths emerged, with many services tailored to individual need, and significant community engagement. Innovative rural service delivery approaches were also identified. Key areas requiring action included improved coordination or integration within and across professions and sectors. There was limited evidence of co-production of solutions or participatory governance. While people-centred approaches show promise to improve community-based services, large-scale fundamental change is required.IMPLICATIONS FOR REHABILITATIONCommunity-based disability and rehabilitation services in rural and remote Australia performed well at delivering tailored care and engaging in community consultation.These services must urgently implement strategies to enhance community ownership of solutions and participatory governance.Services must place a greater focus on explicit strategies to integrate and coordinate across services and professions, and to create an enabling environment, to deliver people-centred care.The World Health Organisation Integrated People-Centred Health Services framework provides an important roadmap to improving service delivery in rural and remote Australian communities.
Topics: Australia; Delivery of Health Care; Disabled Persons; Humans; Life Style; Rural Health Services; Rural Population
PubMed: 34433373
DOI: 10.1080/09638288.2021.1962992 -
Disability and Health Journal Jan 2022Adults with an intellectual disability (ID) have low cardiorespiratory fitness (CRF). Low CRF has been associated with a high risk of cardiovascular disease and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Adults with an intellectual disability (ID) have low cardiorespiratory fitness (CRF). Low CRF has been associated with a high risk of cardiovascular disease and all-cause mortality. Participation in regular exercise can help adults with ID increase their CRF.
OBJECTIVE
To perform a systematic review and meta-analysis of published, peer-reviewed clinical trials that evaluated the effects of aerobic exercise (AE) interventions on CRF in adults with ID, ages 18-65 years.
METHODS
English-language articles were searched up to June 2021 from 11 electronic databases. Data were extracted using an author-developed form. Two independent authors assessed the risk of bias using the Tool for the Assessment of Study Quality and reporting in Exercise (TESTEX). Meta-analysis was performed using the RevMan 5.3.
RESULTS
Of the 1870 article titles and abstracts screened, 16 articles were included. The average TESTEX score (out of 15) was 8.1 (SD = 3.5, range 2-14). The pooled effect was statistically significant (SMD = 0.41, 95% CI: 0.19 to 0.63, z = 3.59; p = .000) with moderate heterogeneity (I = 35%, p = .000). Both types of intervention produced statistically significant CRF gains, with interventions that combined AE with resistance, balance, and/or flexibility exercises being slightly more effective (SMD = 0.40, 95% CI: 0.11 to 0.70, p = .007) than non-combined interventions (SMD = 0.42, 95% CI: 0.05 to 0.79, p = .02). Heterogeneity was moderate but non-significant for both types of intervention.
CONCLUSIONS
The review supports the use of AE interventions in promoting CRF in adults with ID. The interpretation is limited by the quality of evidence and by poorly described and/or executed familiarization and measurement protocols.
Topics: Adolescent; Adult; Aged; Cardiorespiratory Fitness; Disabled Persons; Exercise; Exercise Therapy; Humans; Intellectual Disability; Middle Aged; Young Adult
PubMed: 34452861
DOI: 10.1016/j.dhjo.2021.101185 -
International Journal of Environmental... Dec 2022This article reviews the peer-reviewed and grey literature published from January 1985 to November 2022 that has quantitatively evaluated the effects of personalized... (Review)
Review
This article reviews the peer-reviewed and grey literature published from January 1985 to November 2022 that has quantitatively evaluated the effects of personalized budgets for people with disabilities (PwDs), in terms of a range of benefit and cost outcomes. Benefit metrics of interest comprised measures of well-being, service satisfaction and use, quality of life, health, and unmet needs. A search was conducted using the PsycINFO, MEDLINE, CINAHL, ASSIA, and Social Care Online databases. Based on inclusion criteria and a quality assessment using the Downs and Black Checklist, a final count of 23 studies were identified for in-depth review. Given the heterogeneous nature of the studies, a narrative synthesis, rather than a formal meta-analysis, was undertaken. Taking the relatively scarce and often methodologically limited evidence base at face value, the findings suggest that-overall-personalized budget users tend to benefit in terms of well-being and service satisfaction outcomes, with the exception of mixed effects for people with mental health conditions. Only a minority of studies have investigated the cost-effectiveness or costs-only of personalized budgets, finding mixed results. Two out of the three cost-effectiveness studies find personal budgets to be more cost-effective than alternative options, meaning that the possibly higher costs of personalized budgets may be more than outweighed by additional benefits. Some evidence looking at service use and/or costs only also points to significant reductions in certain service use areas, which at least hints at the potential that personalized budgeting may-in some cases-entail reduced costs. Further research is needed to explore the generalizability of these conclusions and to better capture and understand the factors driving the observed heterogeneity in some of the results.
Topics: Humans; Budgets; Cost-Benefit Analysis; Disabled Persons; Mental Disorders; Quality of Life
PubMed: 36498302
DOI: 10.3390/ijerph192316225 -
Disability and Health Journal Oct 2021Opioid use experiences among people with disability (PWD) as a group has not been clearly articulated in the current literature, despite links between pain and measures... (Review)
Review
BACKGROUND
Opioid use experiences among people with disability (PWD) as a group has not been clearly articulated in the current literature, despite links between pain and measures of disability.
OBJECTIVE
To conduct a systematic search and scoping study examining the characteristics of current literature focused on opioid use among PWD.
METHODS
Four databases were queried (i.e., Medline, PsycINFO, Embase, and CINAHL) for peer-reviewed, empirical, English-language, journal articles focused on long-term opioid use among PWD. Collected data points included: disability details (specific condition, onset of disability), opioid details (category of opioid use, and specified substance), study details, and design.
RESULTS
A total of 196 articles were included, with 83.7% published since 2000 largely from the US. The majority of articles (70.4%) focused on the use of opioids as medical treatment, with fewer articles focusing on recreational opioid use or substance use disorders. The majority of included sources (73%) focused on opioid use in acquired conditions; neuropathic pain (21.9%) and attention deficit hyperactivity disorder (20.4%) were the most commonly studied. Differences were observed in the distribution of disability conditions across category of opioid use and study design classification; 73.5% were considered observational in design.
CONCLUSIONS
The varied representation of disability conditions, and differences across opioid use category and study design classification point to a complicated relationship between opioid use and disability. The present research portfolio would benefit from research matching informational needs of a specific disability area or opioid use category to provide the evidence necessary to advance current knowledge and promote inclusion in national agendas.
Topics: Analgesics, Opioid; Disabled Persons; Humans; Opioid-Related Disorders; Pain; Research Design
PubMed: 33888430
DOI: 10.1016/j.dhjo.2021.101106 -
Social Science & Medicine (1982) Jul 2022In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that... (Review)
Review
In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that services often do not reflect Indigenous values and social practices, impacting on accessibility. Furthermore, disability services have historically been implicated in processes of colonisation. There is an urgent need to decolonise disability services. Understanding Indigenous knowledge and experience of disability is a necessary step towards achieving this. We systematically reviewed the disability conceptualisations, practices and experiences of First Nations peoples of Australia. Twelve studies met inclusion criteria. There was a consensus among these studies that Western constructs of disability do not resonate with many First Nations people across Australia. The studies reported that many First Nations people conceptualise most disabilities as unremarkable conditions that reflect the normal range of human diversity, although some conditions may be associated with social stigma. Inclusive attitudes and practices of caregiving in First Nations families facilitate the participation of First Nations people with disabilities in family and community life. However, ableism and racism in broader society combine to exclude many First Nations peoples with disabilities from public spaces and from labour markets. Disability services regularly fail to reflect First Nations values and social practices, and can lead to further disempowerment and marginalisation due to diagnostic processes; displacement from country and communities; gendered discrimination; and poor relationships with service providers. We argue that intersectional experiences of colonialism, racism, ableism and sexism, particularly in disability services, can lead to the marginalisation of First Nations participants and families. The decolonisation of disability services requires services to embrace diverse First Nations values and practices associated with human capability, social participation and caregiving. Decolonising disability services also necessitates First Nations control of the governance of disability services and reform across service, organisational, systemic and conceptual levels.
Topics: Colonialism; Concept Formation; Disabled Persons; Humans; Indigenous Peoples; Population Groups
PubMed: 35617764
DOI: 10.1016/j.socscimed.2022.115047 -
International Journal of Environmental... Jan 2023Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with... (Review)
Review
Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo's eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.
Topics: Pregnancy; Humans; Female; Intellectual Disability; Quality of Life; Reproductive Health; Sexual Behavior; Sexuality; Disabled Persons; Health Knowledge, Attitudes, Practice
PubMed: 36674341
DOI: 10.3390/ijerph20021587 -
International Journal of Environmental... Jul 2022The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention... (Review)
Review
The assessment of challenging behavior exhibited by people with intellectual and developmental disabilities is essential for the planning of prevention and intervention programs. This review aimed to identify and analyze the standardized instruments that exclusively focus on the assessment of challenging behavior. We identified and organized 141 articles into four categories: original instrument studies, validation studies, relational studies, and intervention studies. The results identified 24 instruments that generally show high-quality psychometric properties and other utilities beyond the observation of the presence of challenging behavior and diagnostic categorization. Age, level of adaptive behavior, disability, presence of autism spectrum disorder, and medication are some of the variables that were found to be possibly related to the occurrence of challenging behavior. Additionally, the results suggest that interventions focused on supporting positive behavior or providing training on behavior to professionals and caregivers significantly reduced the occurrence of these behaviors. Instruments that help us to understand and measure the challenging behavior exhibited by people with intellectual and developmental disabilities are essential for the design of effective evaluation and intervention protocols.
Topics: Autism Spectrum Disorder; Child; Developmental Disabilities; Disabled Persons; Humans; Intellectual Disability; Psychometrics
PubMed: 35886552
DOI: 10.3390/ijerph19148701 -
Public Health Sep 2020Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability pension.
STUDY DESIGN
Systematic review and meta-analysis.
METHODS
Articles were found in the scientific literature using keywords, and searching was limited to prospective cohort studies that had been published before August 2018. Based on the inclusion and exclusion criteria, 23 prospective cohort studies were selected. The analyses were carried out on the basis of the random-effects method. Subgroup analysis was also carried out. Finally, the bias of publication was examined using Begg's test, the Egger test, the trim-and-fill method, and the funnel plot.
RESULTS
Twenty-three studies were included. The results showed a positive association between smoking and disability pension, with a risk ratio (RR) of 1.41 and 95% confidence interval (95% CI) of 1.30-1.53 (P < 0.001). In men, the RR was equal to 1.48 and 95% CI was equal to 1.30-1.68 (P < 0.001). In women, the RR was equal to 1.23 and 95% CI was equal to 1.09-1.37 (P = 0.001). In current smokers, the RR was equal to 1.41 and 95% CI was equal to 1.26-1.57 (P < 0.001). In former smokers, the RR was equal to 1.16 and 95% CI was equal to 1.05-1.29 (P = 0.003). Qualitative evaluation showed that the studies had a low level of selection bias, data collection bias, and withdrawal and dropout bias.
CONCLUSIONS
Smoking is a risk factor for increasing disability pension, and men are at higher risk of disability pension. In addition, both current and former smokers are in high risk of disability pension. Overall, it can be concluded that smoking is a risk factor for occupational health.
Topics: Disabled Persons; Humans; Pensions; Prospective Studies; Risk Factors; Smoking
PubMed: 32882482
DOI: 10.1016/j.puhe.2020.04.013