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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 -
Brazilian Journal of Physical Therapy 2021Beliefs about the body and pain play a powerful role in behavioural and emotional responses to musculoskeletal pain. What a person believes and how they respond to their... (Review)
Review
BACKGROUND
Beliefs about the body and pain play a powerful role in behavioural and emotional responses to musculoskeletal pain. What a person believes and how they respond to their musculoskeletal pain can influence how disabled they will be by pain. Importantly, beliefs are modifiable and are therefore considered an important target for the treatment of pain-related disability. Clinical guidelines recommend addressing unhelpful beliefs as the first line of treatment in all patients presenting with musculoskeletal pain. However, many clinicians hold unhelpful beliefs themselves; while others feel ill-equipped to explore and target the beliefs driving unhelpful responses to pain. As a result, clinicians may reinforce unhelpful beliefs, behaviours and resultant disability among the patients they treat.
METHODS
To assist clinicians, in Part 1 of this paper we discuss what beliefs are; how they are formed; the impact they can have on a person's behaviour, emotional responses and outcomes of musculoskeletal pain. In Part 2, we discuss how we can address beliefs in clinical practice. A clinical case is used to illustrate the critical role that beliefs can have on a person's journey from pain and disability to recovery.
CONCLUSIONS
We encourage clinicians to exercise self-reflection to explore their own beliefs and better understand their biases, which may influence their management of patients with musculoskeletal pain. We suggest actions that may benefit their practice, and we propose key principles to guide a process of behavioural change.
Topics: Disabled Persons; Humans; Musculoskeletal Pain; Pain Management
PubMed: 32616375
DOI: 10.1016/j.bjpt.2020.06.003 -
American Family Physician Feb 2021Sexual violence is a major public health and human rights issue affecting more than 40% of women in the United States during their lifetimes. Although men and women...
Sexual violence is a major public health and human rights issue affecting more than 40% of women in the United States during their lifetimes. Although men and women experience sexual assault, women are at greatest risk. Populations uniquely impacted by sexual assault include adolescents; lesbian, gay, bisexual, transgender, and queer people; and active-duty military service members. Health consequences of sexual assault include sexually transmitted infections, risk of unintended pregnancy, high rates of mental health conditions (e.g., posttraumatic stress disorder), and development of chronic medical conditions (e.g., chronic pelvic pain). Family physicians care for sexual assault survivors at the time of the assault and years after, and care should follow a survivor-centered and trauma-informed framework. Multiple organizations recommend screening all women for a history of sexual violence; however, the U.S. Preventive Services Task Force recommends only universal intimate partner violence screening in women of reproductive age. A validated tool, such as the Two-Question Screening Tool, can be implemented. Initial care should include treatment of physical injuries, prophylaxis for sexually transmitted infections, immunizations, and the sensitive management of psychological issues. Clinicians must comply with state and local requirements for the use of evidence-gathering kits. Many hospitals have developed collection protocols and employ certified Sexual Assault Nurse Examiners or Sexual Assault Forensic Examiners. Prevention of sexual violence requires a comprehensive approach to address individual, relational, community, and societal factors.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Curriculum; Disabled Persons; Education, Medical, Continuing; Female; Guidelines as Topic; Humans; Male; Middle Aged; Rape; Sex Offenses; United States; Young Adult
PubMed: 33507052
DOI: No ID Found -
Autism : the International Journal of... Feb 2023There is currently disagreement among professionals (such as teachers, therapists, researchers, and clinicians) about the most appropriate and respectful way to refer to...
There is currently disagreement among professionals (such as teachers, therapists, researchers, and clinicians) about the most appropriate and respectful way to refer to individuals with disabilities in general, and those with autism, in particular. Supporters of feel that it is important to emphasize the rather than the disorder or disability, and promote the use of terms such as, "person with autism" or "a person with ASD." The goal is to reduce stereotypes and discrimination and emphasize the person's individuality rather than their disability. However, some people within the autism community have questioned the use of person-first terms because they are awkward and use an unconventional style of language that draws attention to the disability. Moreover, autistic individuals and their families are beginning to support the use of that embraces all aspects of one's identity. Surveys in the United Kingdom and Australia support the idea that both types of language are preferred by different groups of autism stakeholder groups. In our study, we surveyed autism stakeholders in the United States. Overwhelmingly, autistic adults ( = 299) preferred identity-first language terms to refer to themselves or others with autism. Professionals who work in the autism community ( = 207) were more likely to support and use person-first language. Language is dynamic and our findings support the need for open communication among autism professionals about how we communicate with and about autistic individuals and their families.
Topics: Adult; Humans; United States; Autistic Disorder; Autism Spectrum Disorder; Disabled Persons; Emotions; Language
PubMed: 36237135
DOI: 10.1177/13623613221130845 -
Revue Medicale Suisse Sep 2020
Topics: Adult; Disabled Persons; Humans
PubMed: 32997446
DOI: No ID Found -
Soins. Gerontologie 2019
Topics: Adult; Disabled Persons; Humans; Stroke
PubMed: 31307692
DOI: 10.1016/j.sger.2019.04.005 -
The Lancet. Global Health Aug 2021
Topics: COVID-19; Data Collection; Disabled Persons; Global Health; Humans
PubMed: 34297946
DOI: 10.1016/S2214-109X(21)00312-0 -
Physical Medicine and Rehabilitation... Nov 2019A profound need for rehabilitation services exists, especially in developing countries. This article highlights the role of the epidemiology of disability in addressing... (Review)
Review
A profound need for rehabilitation services exists, especially in developing countries. This article highlights the role of the epidemiology of disability in addressing this critical need. The article concludes that national and global disability epidemiology statistics inform stakeholder development of rehabilitation policies and programs necessary to meet the global need for rehabilitation, directly supporting the World Health Organization Rehabilitation 2030: Call for Action and United Nations Sustainable Development Goal 3 to "ensure healthy lives and promote well-being for all at all ages."
Topics: Cost of Illness; Disability Evaluation; Disabled Persons; Epidemiology; Humans; International Classification of Functioning, Disability and Health; World Health Organization
PubMed: 31563163
DOI: 10.1016/j.pmr.2019.07.012 -
Physical Medicine and Rehabilitation... Aug 2019
Topics: Disability Evaluation; Disabled Persons; Forensic Medicine; Humans; Physical and Rehabilitation Medicine; Workers' Compensation
PubMed: 31227144
DOI: 10.1016/j.pmr.2019.05.001 -
Harefuah Apr 2022The prevalence of disabilities in the general population is not neglectable and gaps in providing quality health service persist between people with and without... (Review)
Review
The prevalence of disabilities in the general population is not neglectable and gaps in providing quality health service persist between people with and without disabilities. Though life expectancy of persons with disability is increasing, there is an excess of preventable morbidity and mortality. The person with disability has needs and expectations and should be partners in the process of prevention, treatment and follow-up of their health status. According to research, the medical care for the patient with disability does not meet the standards derived from the evidence. Patient safety is a core domain in the quality of care and that is true for the care of persons with disability. Communication, stigma, lack of knowledge, skills and training, are major inhibitors of the provision of high-quality care for the people with disabilities and are considered to be factors responsible for the high incidence of adverse and medical errors in this group of patients. Approaching these topics with critical attention is needed across the span of medical care from the community to the hospital and from prevention to the more complex and sophisticated care offered to the patient with disability.
Topics: Communication; Disabled Persons; Hospitals; Humans; Prevalence; Quality of Health Care
PubMed: 35466612
DOI: No ID Found