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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 -
Physical Medicine and Rehabilitation... Nov 2019The rapid development of medical rehabilitation services in China over the last 30 years has progressed from minimal to the present various models of rehabilitation... (Review)
Review
The rapid development of medical rehabilitation services in China over the last 30 years has progressed from minimal to the present various models of rehabilitation services in general hospitals, specialized rehabilitation hospitals, and community-based and home-based rehabilitation. Contributing factors such as rapid economic growth, rehabilitation needs after natural disasters, changes in insurance policies, an aging population, and new government policies have accelerated the growth in rehabilitation services. Persons with disability in China include 85 million permanently disabled persons, more than 200 million with disabilities from chronic diseases, and more than 240 million elderly individuals.
Topics: China; Delivery of Health Care; Disabled Persons; Health Policy; Health Services Accessibility; Health Services Needs and Demand; Humans; Physical and Rehabilitation Medicine
PubMed: 31563168
DOI: 10.1016/j.pmr.2019.07.010 -
The Journal of Medicine and Philosophy Jul 2021In the polarized debates about abortion and voluntary euthanasia, disability advocates, who normally align with left-wing social forces, have tended to side with...
In the polarized debates about abortion and voluntary euthanasia, disability advocates, who normally align with left-wing social forces, have tended to side with conservative and religious voices in expressing concerns about the impact of technological and sociopolitical developments on disabled futures. This paper draws on the social model of disability and the virtue ethics tradition to explain the alignment between the religious and disability perspectives, and the theory of transformative choice to highlight the limits and biases of the pro-choice logic. Yet, it also recognizes the inherent contradiction of disabled advocates taking a paternalistic position against the personal agency of women and people facing terminal illnesses. A disability perspective serves the discussion of abortion and euthanasia as an encouragement to work together for the building of a society that enables people with diverse disabilities to exist and flourish, and helps pregnant women, people facing disabling and terminal illnesses, and politicians and social influencers to make informed choices.
Topics: Abortion, Induced; Disabled Persons; Ethics; Euthanasia; Euthanasia, Active, Voluntary; Female; Humans; Pregnancy
PubMed: 34219161
DOI: 10.1093/jmp/jhab008 -
Bulletin of the World Health... Nov 2022Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive,...
Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all.
Topics: Child; Adolescent; Infant, Newborn; Humans; Disabled Persons; Global Health; Self-Help Devices; Workforce; Government Programs
PubMed: 36324557
DOI: 10.2471/BLT.22.288147 -
Health Psychology : Official Journal of... Sep 2019Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses... (Review)
Review
OBJECTIVE
Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses on disease-specific phenomena, such as diminished lung capacity in chronic obstructive pulmonary disease, which can result in functional limitations. This review takes a different approach by highlighting the potential role of a biological process-inflammation-that is common to many chronic medical conditions and thus, from a medical perspective, relatively disease nonspecific.
METHOD
Beginning with a description of inflammation and its measurement, this paper will provide an overview of research on inflammation as a predictor of disease risk in healthy adults and of adverse outcomes (e.g., disability) in those with multimorbidity.
RESULTS
The discussion of inflammation is then situated in the context of biopsychosocial influences on health, as inflammation has been shown to be sensitive to a wide range of social and psychological processes that are thought to contribute to healthy aging, including successful adaptation to multimorbidity and reduced risk of disability.
CONCLUSIONS
Finally, implications of this broader perspective for interventions to improve outcomes in aging adults with multimorbidity are briefly considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Topics: Adult; Chronic Disease; Disabled Persons; Humans; Inflammation; Multimorbidity
PubMed: 31436464
DOI: 10.1037/hea0000749 -
Rehabilitation Psychology Feb 2020This article describes the initial factor exploration of disability identity and preliminary psychometric characteristics based on an adult self-report tool. Disability...
PURPOSE/OBJECTIVE
This article describes the initial factor exploration of disability identity and preliminary psychometric characteristics based on an adult self-report tool. Disability was defined broadly, and the sample included individuals with visible and/or hidden disabilities across many disability groups (i.e., physical, intellectual, learning, mental illness).
METHOD
Items were developed ( = 102) and a pilot measure was administered to a sample of adults with disabilities ( = 566). An exploratory factor analysis (EFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator was conducted. The resulting items were sent to expert reviewers for evaluation.
RESULTS
Following the exploratory analyses, 37 items were retained that made up four factors: internal beliefs about own disability and the disability community, anger and frustration with disability experiences, adoption of disability community values, and contribution to the disability community. The pilot measure aligned well with the theoretical framework that guided its development.
DISCUSSION/CONCLUSION
This factor exploration is a contribution to a growing body of literature supporting, and investigating, disability identity development. This work presents a more comprehensive understanding of disability identity development. Armed with a better understanding, this will serve as a basis to inform future scale development and validation. After this validation work is completed, there is the potential to apply findings to tailor interventions and clinical work, so that psychologists and rehabilitation professionals may be better prepared to meet the developmental needs of disabled clients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Adolescent; Adult; Aged; Attitude to Health; Disabled Persons; Factor Analysis, Statistical; Female; Humans; Male; Middle Aged; Psychometrics; Self Concept; Self Report; Young Adult
PubMed: 31944783
DOI: 10.1037/rep0000308 -
Journal of Continuing Education in... May 2024
Topics: Humans; Education, Nursing, Continuing; Disabled Persons; Curriculum; Adult; Disability Discrimination
PubMed: 38687100
DOI: 10.3928/00220124-20240411-01 -
Disability and Rehabilitation.... May 2022The literature review presents a conceptual participatory design through accessibility technology solutions, considering the design experience to be an essential factor... (Review)
Review
PURPOSE
The literature review presents a conceptual participatory design through accessibility technology solutions, considering the design experience to be an essential factor in communication processes. Technologies must assess a wide range of disabilities based on characterisations that helps daily activities. This work includes collaboration concepts to assist in the development of accessible technology. Collaborative design requires the fostering of communication between actors involved in the design process.
METHODS
This work implemented with a protocol of guidelines developed by a group of experts in disability research. The relevant literature is included and assessed based on three categories: accessibility, assistive technologies, and participatory design.
RESULTS
A knowledge gap can be identified: the development of assistive technology processes should enhance the voice of participants and consider their ideas, desires and needs.
CONCLUSIONS
Multidisciplinary communication is necessary to identify problems and propose solutions, and it is essential that people with disabilities collaborate with experts from a range of disciplines to identify problem-solving patterns.Implications for rehabilitationA participatory design can develop a holistic understanding of the participant's motivation and rehabilitation needs. This has provided a grounded basis to offer information about the assistive technology design.A participatory work provides information about the technology design which may finally result in a better understanding of rehabilitation, other types of home-based healthcare or the gamification for rehabilitation.The rehabilitation professionals can explore requirements of a customised technology for users, which allows to transfer knowledge about disabilities and skills in rehabilitation to people with disabilities, their families and communities.The notion of a research problem in rehabilitation can be re-evaluated through a participatory design process that attempts to capture the subjective experiences of persons with disability.
Topics: Communication; Disabled Persons; Humans; Interdisciplinary Communication; Self-Help Devices; Technology
PubMed: 32620068
DOI: 10.1080/17483107.2020.1785564 -
Journal of the American Geriatrics... Dec 2021Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and... (Review)
Review
BACKGROUND
Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings. CAPABLE is one such program initially tested in a randomized control trial and has now been tested and replicated in multiple settings. CAPABLE, a 10-session, home-based interprofessional program, provides an occupational therapist, nurse, and handyworker to address older adults' self-identified functional goals by enhancing individual capacity and home environmental supports. We examine evidence for the CAPABLE program from clinical trials embedded in different health systems on outcomes that matter most to older adults with disability.
METHODS
Six trials with peer-reviewed publications or reports were identified and included in this review. Participants' outcomes included basic and instrumental activities of daily living (ADLs, IADLs), fall efficacy, depression, pain, and cost savings.
RESULTS
A total of 1144 low-income, community-dwelling older adults with disabilities and 4236 matched comparators were included in the six trials. Participants were on average ≥74-79 years old, cognitively intact, and with self-reported difficulty with ≥1 ADLs. All six studies demonstrated improvements in ADLs and IADLs, with small to strong effect sizes (0.41-1.47). Outcomes for other factors were mixed. Studies implementing the full-tested dose of CAPABLE showed more improvement in ADLS and cost savings than studies implementing a decreased dose.
CONCLUSIONS
The CAPABLE program resulted in substantial improvements in ADLs and IADLs in all six trials with other outcomes varying across studies. A dose lower than the original protocol tested resulted in less benefit. The four studies examining cost showed that CAPABLE saved more than it costs to implement.
Topics: Activities of Daily Living; Aged; Cost Savings; Disabled Persons; Female; Health Services for Persons with Disabilities; Health Services for the Aged; Home Care Services; Home Environment; Humans; Independent Living; Male; Occupational Therapy; Patient Acceptance of Health Care; Patient Care Team; Poverty; Program Evaluation; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 34314516
DOI: 10.1111/jgs.17383 -
BMJ (Clinical Research Ed.) Oct 2023
Topics: Humans; Sexual Behavior; Disabled Persons; Delivery of Health Care; Reproductive Health
PubMed: 37852639
DOI: 10.1136/bmj.p2395