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Midwifery Apr 2022Women with physical disabilities face multiple barriers in accessing safe, respectful and acceptable healthcare. As the number of women with physical disabilities... (Review)
Review
OBJECTIVE
Women with physical disabilities face multiple barriers in accessing safe, respectful and acceptable healthcare. As the number of women with physical disabilities becoming pregnant rises, ensuring their access to acceptable and high-quality maternity care becomes increasingly important. This review aimed to explore the most recent evidence regarding access to, and experiences of, maternity care for women with physical disabilities in high-income countries.
DESIGN
A scoping review was undertaken as guided by the Preferred Reporting Items for Systematic Reviews extension for scoping reviews (PRISMA-ScR). A systematic search of five online databases identified relevant articles published in English from 2000 to 2020. Reference lists of included studies were also screened, and quality was appraised using the Joanna Briggs Institute Checklists. A thematic synthesis was undertaken to develop descriptive and analytical themes.
FINDINGS
After screening, 27 articles from eight high-income countries were included. All articles were identified as having moderate or high methodological rigour in the quality appraisal. Women with physical disabilities reported numerous barriers in accessing maternity care and described predominantly mixed and negative experiences of care. These findings were grouped under three major themes: women with physical disabilities want a "normal" pregnancy experience; the need to strengthen maternity provider's disability knowledge and skills; and promoting enabling environments for improved access to, and experiences of, maternity care.
KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
This review found that for women with physical disabilities access to, and experiences of, maternity care is suboptimal. Improving maternity providers disability knowledge and awareness, increasing the availability of support services for women, and increasing person-centred care through organisational policies and provider training may help to address the inequities women with disabilities face in accessing high-quality maternity care.
Topics: Disabled Persons; Female; Health Services Accessibility; Humans; Maternal Health Services; Obstetrics; Pregnancy; Quality of Health Care
PubMed: 35158123
DOI: 10.1016/j.midw.2022.103273 -
Predictors of access to healthcare professionals for people with intellectual disability in Ireland.Journal of Intellectual Disabilities :... Mar 2022The Irish National Intellectual Disability Database is updated annually and in 2017 contained records for nearly 22,000 persons aged 15 years and over. Information was... (Review)
Review
The Irish National Intellectual Disability Database is updated annually and in 2017 contained records for nearly 22,000 persons aged 15 years and over. Information was extracted on the contacts each person had with one of eight health professionals in the years 2007, 2012 and 2017. Over these years, there was an increase in the number of people in contact with any professional or with four and more professionals. Nevertheless, the people less likely to have contact were those with milder forms of intellectual disability, persons living with family carers or independently and those linked to smaller provider agencies. By contrast, the odds of people with more severe disability in residential settings were up to eight times greater for having contact with four or more different professionals. As demand for healthcare grows due to increased longevity and service models shift to the community, redeployment of existing professional resources will be needed along with a review of the skill mix.
Topics: Caregivers; Delivery of Health Care; Disabled Persons; Humans; Intellectual Disability; Ireland
PubMed: 32691664
DOI: 10.1177/1744629520937835 -
Neurology Feb 2020Stroke is the second leading cause of death worldwide and a leading cause of adult disability worldwide. More than a third of individuals presenting with strokes are...
Stroke is the second leading cause of death worldwide and a leading cause of adult disability worldwide. More than a third of individuals presenting with strokes are estimated to have a preexisting disability. Despite unprecedented advances in stroke research and clinical practice over the past decade, approaches to acute stroke care for persons with preexisting disability have received scant attention. Current standards of research and clinical practice are influenced by an underexplored range of biases that may hinder acute stroke care for persons with disability. These trends may exacerbate unequal health outcomes by rendering novel stroke therapies inaccessible to many persons with disabilities. Here, we explore the underpinnings and implications of biases involving persons with disability in stroke research and practice. Recent insights from bioethics, disability rights, and health law are explained and critically evaluated in the context of prevailing research and clinical practices. Allowing disability to drive decisions to withhold acute stroke interventions may perpetuate disparate health outcomes and undermine ethically resilient stroke care. Advocacy for inclusion of persons with disability in future stroke trials can improve equity in stroke care delivery.
Topics: Bioethical Issues; Clinical Decision-Making; Clinical Trials as Topic; Delivery of Health Care; Disabled Persons; Healthcare Disparities; Humans; Patient Rights; Stroke
PubMed: 31969466
DOI: 10.1212/WNL.0000000000008964 -
Disability and Health Journal Jun 2022This Supplement of the Disability and Health Journal presents research at the intersection of disability and substance use disorders (SUD). A better understanding of...
This Supplement of the Disability and Health Journal presents research at the intersection of disability and substance use disorders (SUD). A better understanding of their complex relationship is needed to (1) inform the development of culturally relevant, accessible, and inclusive prevention and intervention efforts aimed at eliminating disparities in SUD prevalence among people with disabilities; and (2) improve access, quality and outcomes of SUD treatment and other recovery support services for people with disabilities. These eleven articles include themes around prevalence and identification of disability-related disparities, perspectives of people with lived experience of disability, and adaptations to substance use measures and interventions. They highlight the importance of a public health focus on the unique needs of people with disabilities and development of accessible and person-centered interventions. Integrative and holistic SUD prevention and treatment efforts, including pain management, are essential to address the complex needs of people with both disability and SUD.
Topics: Disabled Persons; Humans; Prevalence; Public Health; Substance-Related Disorders
PubMed: 35346601
DOI: 10.1016/j.dhjo.2022.101285 -
International Journal of Environmental... Jul 2022Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and... (Review)
Review
Over the life course, persons with disabilities require a range of supports to be integrated into their communities, to participate in activities that are meaningful and necessary, and to have access, on an equal basis to persons without disabilities, to community living. We conducted a scoping review of the peer-reviewed and grey literature on community support for persons with disabilities in low- and middle-income countries (LMICs). The main findings of this review concern the following: there are gaps in access to community support for persons with disabilities in LMICs; there are barriers to the provision of such support; formal and informal strategies and interventions for the provision of community support exist across the life cycle and different life domains, but evidence concerning their effectiveness and coverage is limited; and the role of community-based rehabilitation and Organisations of Persons with Disabilities in the assessment of needs for, and the development and provision of, community support, needs to be more clearly articulated. Research needs a more robust theory of change models with a focus on evaluating different aspects of complex interventions to allow for effective community support practices to be identified.
Topics: Community Support; Developing Countries; Disabled Persons; Humans; Income; Poverty
PubMed: 35886121
DOI: 10.3390/ijerph19148269 -
Spinal Cord Series and Cases 2019
Topics: Climate Change; Disabled Persons; Humans; Spinal Cord Injuries; Sustainable Development
PubMed: 31700686
DOI: 10.1038/s41394-019-0232-6 -
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 -
Journal of Rehabilitation Medicine Feb 2021Many patients have disabilities; it is therefore essential that medical education includes comprehensive teaching on disability and rehabilitation. In 2006 Hannover...
BACKGROUND
Many patients have disabilities; it is therefore essential that medical education includes comprehensive teaching on disability and rehabilitation. In 2006 Hannover Medical School implemented an introductory course in the curriculum for medical students, on how to communicate with persons with disability and the need for rehabilitation. The course, entitled "Introduction to medicine", has the main goals of teaching the strategy and systematic approach of medicine to solving patients' problems.
METHODS
This paper describes the content, methods and outcomes of 1 of the 4 main themes of the "Introduction to medicine" course; the theme "Pain and disability", which is covered in the second week of the course.
RESULTS
Evaluation of the "Pain and disability" module found that students' ratings for the category "patient involvement" were very high (93%), whereas their ratings for the category "examination of student knowledge" were low. The overall rating of the module was "good" (10.8 out of 15 points), but not "very good".
CONCLUSION
The concept of the "Pain and disability" module is feasible and successful, even though it is scheduled early in the first year of the curriculum and approximately 350 students participate. Factors related to this success are: a mixture of teaching knowledge, supporting students' understanding, and applying communication and physical examination skills.
Topics: Curriculum; Disabled Persons; Humans; Students, Medical
PubMed: 33594446
DOI: 10.2340/16501977-2797 -
Psychiatria Danubina Dec 2023The Convention on the Rights of Persons with Disabilities (CRPD) enshrines the right of persons with disabilities to enjoy the highest standard of health and access to...
The Convention on the Rights of Persons with Disabilities (CRPD) enshrines the right of persons with disabilities to enjoy the highest standard of health and access to health care without discrimination, but persons with disabilities have logistical and assistive support needs that must be known in order to build a health service offer that meets their needs and respects their rights in line with the CRPD. Examples of accessibility of medical care include the removal of an architectural barrier, the adaptation of a protocol, and ensuring information about care is delivered using easy to understand means of communications. An example of full inclusion and accessibility of the healthcare system for persons with intellectual disabilities is the DAMA (Disabled Advanced Medical Assistance), a project developed and tested at the Milan San Paolo Hospital. DAMA is an inclusive service provision methodology and offers a model that can follow, with a multidisciplinary approach, the person at every stage of the diagnostic and clinical pathway, and to support his or her family in dealing with the hospital. The diffusion of the DAMA model has demonstrated the flexibility of the model itself and its ability to adapt to hospitals with different characteristics and dimensions. The future is the institution of an organized network of all DAMA centres that share common clinical protocols and homogeneous archives. It will grant us the capability of collecting consistent epidemiological and clinical data, valuable for scientific researching and for training health personnel.
Topics: Humans; Male; Female; Disabled Persons; Delivery of Health Care; Intellectual Disability; Hospitals; Health Services Accessibility
PubMed: 37994066
DOI: No ID Found -
International Journal of Environmental... Jun 2022The aim of this systematic review was to identify the main factors affecting the training process of para-athletes, as well as the barriers they encounter. For this... (Review)
Review
The aim of this systematic review was to identify the main factors affecting the training process of para-athletes, as well as the barriers they encounter. For this purpose, a systematic review was carried out in accordance with the PRISMA declaration guidelines, in which six databases were analysed (Web of Science, Scopus, SportDiscus, Pubmed, Eric, and PsycInfo). A total of 19 articles were selected for analysis after applying the inclusion criteria. The results show that the figures of the coach and families in the sporting and social contexts, respectively, had a relevant influence on the training process of para-athletes. Furthermore, in terms of psychological aspects, stress reduction, the importance of self-esteem, and motivation were highlighted. On the other hand, there are some barriers hindering the training and performance of athletes, which are related to the lack of financial support, lack of visibility in the media, and dependence on other people. These considerations can be of great help to coaches and competent institutions in the field (Paralympic committees, federations, etc.) in order to improve the training process and performance of para-athletes and to eliminate the barriers encountered by this group, promoting policies which facilitate access to sports for people with disabilities.
Topics: Athletes; Disabled Persons; Humans; Motivation; Para-Athletes; Sports
PubMed: 35742492
DOI: 10.3390/ijerph19127242