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The Australian Journal of Rural Health Aug 2023Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and... (Review)
Review
The experiences of people with disability and their families/carers navigating the NDIS planning process in regional, rural and remote regions of Australia: Scoping review.
BACKGROUND
Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas.
METHODOLOGY
Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process.
RESULTS
Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio-economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process.
CONCLUSION
There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process.
Topics: Humans; Caregivers; Australia; Disabled Persons; Insurance, Disability; Indigenous Peoples; Health Services, Indigenous
PubMed: 37367630
DOI: 10.1111/ajr.13011 -
Age and Ageing Apr 2023community ageing in place, advancing better living for elders (CAPABLE), which is a biobehavioural environmental approach by addressing individual capacities and the... (Meta-Analysis)
Meta-Analysis
The effectiveness of community ageing in place, advancing better living for elders as a biobehavioural environmental approach for disability among low-income older adults: a systematic review and meta-analysis.
BACKGROUND
community ageing in place, advancing better living for elders (CAPABLE), which is a biobehavioural environmental approach by addressing individual capacities and the home environment, aims to reduce the impact of disability among low-income older adults.
OBJECTIVE
this meta-analysis aims to elucidate the efficacy of the CAPABLE program on related outcomes in low-income older adults.
METHODS
a systematic search of MEDLINE/PubMed, CINAHL and EMBASE was conducted for articles published up to August 2022. A systematic review and meta-analysis were performed to calculate the pooled effect sizes of the efficacy of the CAPABLE program on home safety hazards, activities of daily living (ADLs), instrumental ADLs (IADLs), depression, falls efficacy, pain and quality of life.
RESULTS
seven studies involving 2,921 low-income older adults (1,117 as the CAPABLE group and 1,804 served as a control) with an average age ranging from 65 to 79 were included in the present meta-analysis. Pre-post effect analyses showed that CAPABLE was significantly associated with lower home safety hazards, ADLs, IADLs, depression, falls efficacy, pain and quality of life. Additionally, there were statistically significant associations between the CAPABLE program with improvements in ADLs, IADLs and quality of life compared with controls.
CONCLUSION
CAPABLE intervention may be a promising strategy to reduce health disparities, and disability limitations, and improve the quality of life in low-income community-dwelling older adults who suffer from disabilities by addressing both the person and the environment.
Topics: Aged; Humans; Activities of Daily Living; Aging; Disabled Persons; Independent Living; Quality of Life; Poverty; Home Environment
PubMed: 37078754
DOI: 10.1093/ageing/afad053 -
Disability and Rehabilitation Sep 2013The aim of this systematic review was to determine the efficacy of thoracic spine manipulation (TSM) in reducing pain and disability in patients diagnosed with... (Review)
Review
PURPOSE
The aim of this systematic review was to determine the efficacy of thoracic spine manipulation (TSM) in reducing pain and disability in patients diagnosed with non-specific neck pain.
METHODS
An extensive literature search of PubMed, The Cochrane Library, CINAHL and EMBASE was conducted in February 2012. Randomized controlled trials (RCTs) or controlled clinical trials evaluating the effect of TSM in patients aged 18 to 65 years with non-specific neck pain were eligible. Methodological quality of the studies was assessed according to the Physiotherapy Evidence Database scale (PEDro). Qualitative analyses were conducted by means of the best evidence synthesis of van Peppen et al.
RESULTS
The methodological quality of the 10 included RCTs (677 patients) varied between four and eight points. Eight studies reported significant reduction in pain and/or disability by TSM. Overall, according to the best evidence synthesis, there is insufficient evidence that TSM is more effective than control interventions in reducing pain and disability in patients with non-specific neck pain.
CONCLUSIONS
TSM has a therapeutic benefit to some patients with neck pain, when compared to the effect of interventions such as electrotherapy/thermal programme, infrared radiation therapy, spinal mobilization and exercises. However, in comparison to cervical spine manipulation, no evidence is found that TSM is more effective in reducing pain and disability. Implications for Rehabilitation TSM is often used in the treatment of non-specific neck pain, which is a major health problem in the Western society. There is insufficient evidence that TSM is more effective in reducing pain and disability than control treatments in patients with non-specific neck pain. Despite the insufficient evidence that TSM is more effective than control treatments, TSM has a therapeutic benefit to some patients with neck pain. Therefore, TSM alone or in combination with other interventions is a suitable intervention to use in the treatment of non-specific neck pain.
Topics: Adult; Comparative Effectiveness Research; Disabled Persons; Humans; Manipulation, Orthopedic; Middle Aged; Neck Pain; Outcome Assessment, Health Care; Pain Management; Randomized Controlled Trials as Topic
PubMed: 23339721
DOI: 10.3109/09638288.2012.750689 -
BMC Public Health Feb 2017Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses.
METHODS
Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies.
DATA EXTRACTION
Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality.
DATA SYNTHESIS
We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries.
RESULTS
There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior.
CONCLUSIONS
Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.
Topics: Disabled Persons; Health Status; Humans; Mental Disorders; Motivation; Organizational Culture; Retirement; Risk; Scandinavian and Nordic Countries; Social Support
PubMed: 28178966
DOI: 10.1186/s12889-017-4059-4 -
Journal of Occupational Rehabilitation Jun 2011Vocational rehabilitation (VR) is aimed at engaging or re-engaging individuals with work participation and employment. The International Classification of Functioning,... (Review)
Review
BACKGROUND
Vocational rehabilitation (VR) is aimed at engaging or re-engaging individuals with work participation and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization can be operationalized in the context of VR. The objective of this study is to review the literature to identify outcomes or measures being used in VR using a systematic review methodology and link those measures to the ICF.
METHODS
We applied a structured search strategy using multiple databases. Items or constructs of the measures or outcomes identified were linked to the ICF by two trained individuals.
RESULTS
We have identified 648 measures which contained 10,582 concepts that were linked to the ICF which resulted in 87 second-level ICF categories. Out of the 87 categories, 31 (35.6%) were related to body functions, 43 (49.4%) were related to activities and participation, and 13 (14.9%) were related to environmental factors. No category was related to body structures.
CONCLUSIONS
Our review found great diversity in the ICF contents of the measures used in different VR settings and study populations, which indicates the complexity of VR. This systematic review has provided a list of ICF categories which could be considered towards a successful VR.
Topics: Disability Evaluation; Disabled Persons; Humans; Recovery of Function; Rehabilitation, Vocational; Severity of Illness Index; World Health Organization
PubMed: 21328062
DOI: 10.1007/s10926-011-9290-8 -
BMC Public Health Jul 2018Stigma across HIV/AIDS, mental illness, and physical disability can be co-occurring and may interact with other forms of stigma related to social identities like race,...
BACKGROUND
Stigma across HIV/AIDS, mental illness, and physical disability can be co-occurring and may interact with other forms of stigma related to social identities like race, gender, and sexuality. Stigma is especially problematic for people living with these conditions because it can create barriers to accessing necessary social and structural supports, which can intensify their experiences with stigma. This review aims to contribute to the knowledge on stigma by advancing a cross-analysis of HIV/AIDS, mental illness, and physical disability stigma, and exploring whether and how intersectionality frameworks have been used in the systematic reviews of stigma.
METHODS
A search of the literature was conducted to identify systematic reviews which investigated stigma for HIV/AIDS, mental illness and/or physical disability. The electronic databases MEDLINE, CINAHL, EMBASE, COCHRANE, and PsycINFO were searched for reviews published between 2005 and 2017. Data were extracted from eligible reviews on: type of systematic review and number of primary studies included in the review, study design study population(s), type(s) of stigma addressed, and destigmatizing interventions used. A keyword search was also done using the terms "intersectionality", "intersectional", and "intersection"; related definitions and descriptions were extracted. Matrices were used to compare the characteristics of reviews and their application of intersectional approaches across the three health conditions.
RESULTS
Ninety-eight reviews met the inclusion criteria. The majority (99%) of reviews examined only one of the health conditions. Just three reviews focused on physical disability. Most reviews (94%) reported a predominance of behavioural rather than structural interventions targeting stigma in the primary studies. Only 17% of reviews used the concept and/or approach of intersectionality; all but one of these reviews examined HIV/AIDS.
CONCLUSIONS
The lack of systematic reviews comparing stigma across mental illness, HIV/AIDS, and physical disability indicates the need for more cross-comparative analyses among these conditions. The integration of intersectional approaches would deepen interrogations of co-occurring social identities and stigma.
Topics: Adult; Disabled Persons; Female; HIV Infections; Humans; Male; Mental Disorders; Social Stigma; Systematic Reviews as Topic
PubMed: 30049270
DOI: 10.1186/s12889-018-5861-3 -
The British Journal of General Practice... Apr 2007To systematically review the evidence on the influence of sociodemographic, lifestyle, and (bio)medical variables on the course of prevalent disability and transition... (Review)
Review
AIM
To systematically review the evidence on the influence of sociodemographic, lifestyle, and (bio)medical variables on the course of prevalent disability and transition rates to different outcome categories in community-dwelling older people.
METHOD
Articles were identified through searches of PubMed, EMBASE, and PsycINFO databases and reference lists of relevant articles. Prospective population studies that assessed disability at baseline and reported on associations between potential prognostic variables and disability were included. Methodological quality of studies was assessed by standardised criteria, after which relevant data were extracted. A synthesis of the available evidence was carried out.
RESULTS
Nine cohort studies reported transition rates and eight cohort studies presented multivariate analyses on prognostic factors. There was some heterogeneity among studies in definition and assessment of disability. There is moderate to strong evidence that higher age, cognitive impairment, vision impairment, and poor self-rated health are prognostic factors of disability.
CONCLUSION
Prognostic factors, partly modifiable, are identified that should be taken into account in targeting treatment and care for older people with disabilities. Further conceptual and methodological standardisation is required in order to enable a meta-analysis and obtain higher levels of evidence.
Topics: Aged; Aged, 80 and over; Aging; Cognition Disorders; Cohort Studies; Disabled Persons; Female; Health Status; Humans; Male; Multivariate Analysis; Prognosis; Vision Disorders
PubMed: 17394736
DOI: No ID Found -
Maturitas Jul 2011Progressive disability develops with older age in association with underlying disease, comorbidity and frailty. Physical performance characteristics are important to... (Review)
Review
BACKGROUND
Progressive disability develops with older age in association with underlying disease, comorbidity and frailty. Physical performance characteristics are important to improve the physical condition of older persons and therefore may be able to prevent or delay the onset of (progressive) disability. However lack of understanding of the physiology and etiology of functional decline leading to disability causes a problem in the development of effective preventive interventions. The aim of the present review is to determine which physical performance characteristics are determinants of disability in the older general population.
METHODS
We searched systematically the electronic databases of PubMed (MEDLINE), CINAHL, Cochrane Library, Psychlit and Embase for cohort studies and randomized controlled trials assessing disability in the older general population. Outcomes of interest were handgrip strength, upper and lower extremity function, balance gait and physical activity. The searching strategy resulted in 22 studies included in the present systematic review.
RESULTS
Although heterogeneity was present in the measurements of disability, consistent findings were shown for physical performance characteristics and disability. In general, a lower score of the physical performance characteristics was associated with a higher probability of (the development of) disability. The association for other aspects of gait (e.g. gait-step continuity, gait-step symmetry, path deviation and turning) and disability seems to be present, though the number of studies is limited.
CONCLUSION
In the present systematic review, associations were found for hand grip strength, upper and lower body strength, gait speed, physical activity and the probability of disability.
Topics: Activities of Daily Living; Aged; Disabled Persons; Gait; Geriatric Assessment; Humans; Motor Activity; Muscle Strength; Physical Fitness
PubMed: 21596497
DOI: 10.1016/j.maturitas.2011.04.008 -
American Journal of Physical Medicine &... Jul 2019Historically, medical students have received little training about working with patients with disability, but there is now a greater recognition of the need to educate...
Historically, medical students have received little training about working with patients with disability, but there is now a greater recognition of the need to educate medical students in this domain. The aims of this review were to define the body of literature and to determine effective strategies for teaching medical students about disability. A systematic search protocol executed across six databases identified journal articles reporting interventions implemented to teach disability to medical students. Seventy-seven articles spanning 1960-2018 met inclusion criteria. Most articles reported objectives related to increasing knowledge and skills or changing attitudes. However, only half included evaluations for all of their stated objectives in those domains. In addition, few articles used longitudinal evaluations, resulting in most articles basing conclusions on immediate posttest evaluations. Overall, the reported interventions exhibit a high risk of potential bias, with only 10% of the articles receiving a global quality rating of "good." Thus, although several articles have reported educational interventions to teach medical students about disability, the high risk of bias, incomplete reporting, and limitations of the evaluations prevent evidence-based determinations of effective strategies for teaching medical students about disability. The findings highlight ways to improve future studies in this domain.
Topics: Attitude of Health Personnel; Clinical Competence; Curriculum; Disability Evaluation; Disability Studies; Disabled Persons; Education, Medical, Undergraduate; Health Occupations; Humans; Students, Medical
PubMed: 30730327
DOI: 10.1097/PHM.0000000000001154 -
Disability and Rehabilitation 2011In 1976, the World Health Organization (WHO) estimated worldwide disability prevalence at 10%; recent evidence suggests the prevalence is even higher. Given the extent... (Review)
Review
INTRODUCTION
In 1976, the World Health Organization (WHO) estimated worldwide disability prevalence at 10%; recent evidence suggests the prevalence is even higher. Given the extent of disability around the world, it is essential for researchers and policy makers to have a uniform language for describing and discussing disability. The International Classification of Functioning, Disability and Health (ICF) is WHO's attempt to provide that standard language. Linking rules were published in 2002 and 2005 suggesting a method for standardising the process of connecting outcome measures to the ICF classification. The objective of this study is to study the extent to which the linking rules have been used by researchers to link health and health-related information to the ICF and collect the feedback about the current practices, applications and areas to improve the linking method.
METHOD
Using a systematic review of health-based literature between 2001 and February 2008, we (1) determined research areas where the linking method is applied, (2) examined the characteristics of studies that linked information to the ICF and (3) described current practices and issues related to the process of linking health and health-related information to the ICF both quantitatively and qualitatively.
RESULTS
The systematic review yielded 109 articles from 58 journals that linked health information to the ICF and 58 of the articles employed published linking rules. The majority of articles were descriptive in nature, used linking for connecting content of health instruments to the ICF and linked English health content. Quality controls such as reliability checks, multiple raters and iterative linking processes were found frequently among users of the linking rules. Qualitative analysis created themes about: preparing units of information, who links to the ICF, reliability, matching or translating concepts from text to ICF categories, information unable or difficult to capture, quantitative reporting standards and overall linking process.
DISCUSSION
This review also shows that the linking process is a useful way to apply the ICF classification in research. With over 100 articles published in 58 peer-reviewed journals across 50 focus areas, linking health and health-related information to the ICF has been shown to be a useful tool for describing, comparing and contrasting information from outcome measures used to collect quantitative data, qualitative research results and clinical patient reports across diagnoses, settings, languages and countries.
Topics: Activities of Daily Living; Disability Evaluation; Disabled Persons; Electronic Data Processing; Health; Health Status; Health Status Indicators; Humans; International Classification of Diseases; Outcome Assessment, Health Care
PubMed: 21303198
DOI: 10.3109/09638288.2011.553704