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International Journal of Environmental... Dec 2022Physical function is one of the most important constructs assessed in health-related quality of life (HRQOL), and it could be very useful to assess movement ability from... (Review)
Review
Physical function is one of the most important constructs assessed in health-related quality of life (HRQOL), and it could be very useful to assess movement ability from the perspective of the patient. The objective of this study was to compare the content of the domains related to mobility covered by the HRQOL questionnaires based on the International Classification of Functioning, Disability and Health (ICF) and to evaluate their quality according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. For this, a systematic review was carried out in the databases Scopus, Web of Science and Science Direct. The inclusion criteria were development and/or validation studies about generic HRQOL measures, and the instruments had to include items related to mobility and studies written in English or Spanish. The comparison of content was performed using the ICF coding system. A total of 3614 articles were found, 20 generic HRQOL instruments were identified and 120 (22.4%) mobility-related items were found. Walking was the most represented category. Low-quality evidence on some measurement properties of the generic HRQOL instruments was revealed. The CAT-Health is a useful questionnaire to be used in rehabilitation due to its psychometric properties and its content.
Topics: Humans; Quality of Life; Disabled Persons; Activities of Daily Living; Surveys and Questionnaires; Walking; Psychometrics
PubMed: 36554369
DOI: 10.3390/ijerph192416493 -
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 -
Soins; La Revue de Reference Infirmiere 2020
Topics: Disabled Persons; Humans
PubMed: 33160476
DOI: 10.1016/S0038-0814(20)30154-7 -
International Journal of Environmental... Dec 2020This study examines the relationships between loneliness, gender, and age for people without and with disabilities (moderate versus severe) in Germany. Using data taken...
This study examines the relationships between loneliness, gender, and age for people without and with disabilities (moderate versus severe) in Germany. Using data taken from the German Socio-Economic Panel (SOEP) for the years 2013 and 2017 and using the UCLA (University of California, Los Angeles) Loneliness Scale, in general we found that males report lower loneliness scores as compared to those for females. Furthermore, we found a strong association between loneliness and the individual's age, but with differences according to gender and disability status. For example, for males with severe disabilities levels of loneliness decrease with age, whereas for females with severe disabilities the opposite result is found. In addition, we found that participation in leisure activities and having a higher frequency of contacts with family, friends, and social online networks (measured by the relational time index) contribute to reducing loneliness for all individuals. From a public policy perspective, it is necessary to undertake the design, promotion, and implementation of instrumental, emotional, and social support measures for people with disabilities (in particular for females that are severely limited in their daily activities), which can contribute to reducing their loneliness scores and increasing their levels of life satisfaction.
Topics: Adult; Age Factors; Aged; Disabled Persons; Female; Germany; Humans; Loneliness; Male; Middle Aged; Sex Factors; Social Networking; Social Participation
PubMed: 33302577
DOI: 10.3390/ijerph17249176 -
International Journal For Equity in... Feb 2023Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and...
BACKGROUND
Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and correlates of psychological distress and post-traumatic stress disorder (PTSD) among persons with physical disabilities in Cambodia.
METHODS
From July to December 2021 data were collected as part of a mental health screening programme for persons with physical disabilities who access prosthetic and orthotic services. Psychological distress was measured using the Kessler-10 (K-10) and PTSD using the PC-PTSD-5. Bivariate and multiple linear regression analyses were conducted to identify factors associated with levels of psychological distress and PTSD among this population.
RESULTS
Our study found a high prevalence of psychological distress and PTSD in this patient cohort. Of the 213 participants, 31.5% were likely to be experiencing mild to moderate psychological distress indicative of a mental health disorder, with 13.6% likely to have a severe mental health disorder. Sixty-five percent of patients reported experiencing PTSD symptoms, with forty-six percent meeting the criteria for probable PTSD. Psychological distress was associated with pathological worry, rumination, and facets of mindfulness. Rumination and pathological worry were found to be significant predictors of psychological distress. PTSD symptoms were associated with pathological worry but not facets of mindfulness or rumination. Facets of mindfulness and pathological worry were found to be significant predictors of PTSD.
CONCLUSION
Integration of mental health services within the disability sector is required to address psychological distress and PTSD symptoms among people with physical disabilities in Cambodia. Health system interventions, such as screening, referral, and the training of health providers, need to be strengthened. Further studies focussing on the psychosocial determinants of mental health of persons with disabilities in Cambodia are required.
Topics: Humans; Stress Disorders, Post-Traumatic; Cambodia; Mental Health; Disabled Persons; Psychological Distress; Stress, Psychological
PubMed: 36765360
DOI: 10.1186/s12939-023-01842-5 -
Annals of Physical and Rehabilitation... Jul 2020The aim of this study was to examine the association of childhood sexual and physical abuse with disability in adulthood, and to assess how several demographic,...
OBJECTIVE
The aim of this study was to examine the association of childhood sexual and physical abuse with disability in adulthood, and to assess how several demographic, physical, behavioral, psychosocial, and psychiatric factors may influence this association.
METHODS
This study used nationally representative cross-sectional data from 7403 people aged≥16 years who participated in the 2007 Adult Psychiatric Morbidity Survey. Information on childhood sexual talk, sexual touching, sexual intercourse, and physical abuse occurring before the age of 16, and disability in activities of daily living and instrumental activities of daily living in adulthood were collected. Multivariable logistic regression analyses were conducted.
RESULTS
After adjusting for age, sex, and ethnicity, we found a positive association between different types of childhood abuse and adulthood disability: sexual talk (OR 1.54; 95% CI 1.27-1.85); sexual touching (OR 1.82; 95% CI 1.49-2.22); sexual intercourse (OR 2.58; 95% CI 1.75-3.81); physical abuse (OR 2.84; 95% CI 2.20-3.68). Increasing number of types of childhood abuse was associated with increased odds of adulthood disability. The odds of adulthood disability was increased for individuals who experienced all types of childhood abuse versus no childhood abuse (OR 3.59; 95% CI 1.64-7.84). Finally, the association between any childhood abuse and adulthood disability was largely explained by anxiety disorder, number of chronic physical conditions, and loneliness.
CONCLUSIONS
Childhood abuse is positively associated with adulthood disability in England. Future longitudinal studies are warranted to understand the potentially complex interplay of factors that may increase risk for disability in individuals who experienced childhood abuse.
Topics: Adolescent; Adult; Adult Survivors of Child Abuse; Child; Child Abuse, Sexual; Cross-Sectional Studies; Disabled Persons; England; Female; Humans; Male; Odds Ratio; Physical Abuse; Prevalence; Risk Factors; Young Adult
PubMed: 31276839
DOI: 10.1016/j.rehab.2019.06.005 -
International Journal of Environmental... Mar 2021Persons with Parkinson's disease (PD) need to adapt to their progressive disability to achieve and maintain a high degree of life satisfaction (LS), but little is known...
Persons with Parkinson's disease (PD) need to adapt to their progressive disability to achieve and maintain a high degree of life satisfaction (LS), but little is known about the meaning of LS and adaptation. This study aimed to gain an in-depth understanding of the meaning of LS and adaptation in persons with PD. Open-ended in-depth interviews were performed with 13 persons diagnosed with PD, 9 women, 3 men, and one non-binary person (mean age 54 years, mean time since diagnosis 3.4 years). The interviews were analyzed using a phenomenological-hermeneutic approach. The participants were in the process of adapting to their new health situation. There were two quite distinct groups: one that adapted through acceptance and one that struggled to resist the disease and the profound impact it had on their lives. The thematic structural analysis covers eight themes illustrating the meaning of LS and adaptation, through either acceptance or resistance. Adaptation to PD involves a transitional process characterized by either acceptance or resistance, which influences a person's LS. Acceptance makes LS possible, whereas resistance constitutes a behavioral barrier to adaptation and LS. Rehabilitation professionals need to understand this individual process to be able to support a person with PD to reach and maintain a high level of LS. Understanding the link between LS and adaptation can support rehabilitation professionals to provide targeted interventions for people with PD.
Topics: Adaptation, Psychological; Disabled Persons; Female; Humans; Male; Middle Aged; Parkinson Disease; Personal Satisfaction; Qualitative Research; Time
PubMed: 33806884
DOI: 10.3390/ijerph18063308 -
International Journal of Environmental... Sep 2022The healthcare system and public health community are often underprepared to support the needs of people with disabilities and to include them equitably in wellness...
The healthcare system and public health community are often underprepared to support the needs of people with disabilities and to include them equitably in wellness programs (e.g., exercise, leisure, nutrition, stress management) offered to the general community. Consequently, the vast majority of people with disabilities are unable to make the transition from "patient" to "participant," which contributes to many of the health disparities reported in this population. People with disabilities have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes, often resulting from poor access to home and community-based health promotion/wellness programs that include physical activity, nutrition, stress reduction, and sleep hygiene, among others. Achieving health equity in people with disabilities requires a multi-stage approach that includes person-centered referral to wellness programs, empowering people with disabilities to become self-managers of their own health and ensuring that community-based programs and services are inclusive. A three-stage model for addressing health and wellness needs across the home and community settings is described, which is currently being used in a large federally funded center in the US with potential generalizability across the world.
Topics: Diabetes Mellitus, Type 2; Disabled Persons; Exercise; Health Equity; Health Promotion; Humans
PubMed: 36231189
DOI: 10.3390/ijerph191911886 -
Health Policy (Amsterdam, Netherlands) Mar 2022Investment in action is vital to confront the challenges associated with chronic diseases and disability facing European health systems. Although relevant policy... (Review)
Review
Investment in action is vital to confront the challenges associated with chronic diseases and disability facing European health systems. Although relevant policy responses are being increasingly developed, most of them fail to recognize the role of rehabilitation services in achieving public health and social goals. Comprehensive guidance is thus urgently needed to support rehabilitation policy development and expand access to rehabilitation care to meet population needs effectively. This paper describes a framework to guide policy action for rehabilitation in Europe. The framework was developed in collaboration with the European Academy of Rehabilitation Medicine based on a focused literature review and expert consultations. A review in PubMed and grey literature sources identified 458 references and resulted in 135 relevant documents published between 2006 and 2019. Thematic analysis of extracted information helped summarize the findings and develop the draft policy action framework. This was circulated to a wider group of experts and discussed in three workshops in 2018-2019. The framework was revised according to their feedback. The proposed framework contains 48 options for policy action organized in six domains and twelve subdomains that address several areas of health programming. The proposed framework provides a structure to understand the policy terrain related to rehabilitation in Europe and the measures required for translating aspirational political pronouncements into targeted programmatic action and tangible health and social outcomes.
Topics: Disabled Persons; Europe; Government; Government Programs; Humans; Policy
PubMed: 34281701
DOI: 10.1016/j.healthpol.2021.06.014 -
Journal of Physical Activity & Health Aug 2023Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of... (Review)
Review
BACKGROUND
Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of high-quality scientific evidence is due to the extent and nature of disability assessment in physical activity research. This scoping review explores how disability has been measured in epidemiological studies that included accelerometer-based measurement of physical activity.
METHODS
Data sources: MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus, and CINAHL.
ELIGIBILITY CRITERIA
Prospective and cross-sectional studies that included an accelerometer measurement of physical activity. Survey instruments used in these studies were obtained, and questions relating to the International Classification of Functioning, Disability and Health domains of (1) health conditions, (2) body functions and structures, and (3) activities and participation, were extracted for analysis.
RESULTS
Eighty-four studies met the inclusion criteria, from which complete information on the 3 domains was obtained for 68. Seventy-five percent of studies (n = 51) captured whether a person had at least one health condition, 63% (n = 43) had questions related to body functions and structures, and 75% (n = 51) included questions related to activities and participation.
CONCLUSION
While most studies asked something about one of the 3 domains, there was substantial diversity in the focus and style of questions. This diversity indicates a lack of consensus on how these concepts should be assessed, with implications for the comparability of evidence across studies and subsequent understanding of the relationships between disability, physical activity, and health.
Topics: Humans; Cross-Sectional Studies; Prospective Studies; Exercise; Disability Evaluation; Disabled Persons
PubMed: 37146983
DOI: 10.1123/jpah.2023-0017