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Disability and Rehabilitation Oct 2022The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia,...
PURPOSE
The aim of this systematic review was to identify models of community disability, rehabilitation and lifestyle service delivery in non-metropolitan areas of Australia, and to describe these models through an Integrated People-Centred Health Services (IPCHS) lens.
MATERIALS AND METHODS
We identified peer-reviewed studies published between 2000 and June 2021 that met the following criteria: described or evaluated a community service delivery model, intervention or program in regional, rural or remote Australia; provided for people with a disability or a potentially disabling health condition. A scoring rubric was developed covering the five IPCHS strategies.
RESULTS
Nineteen studies were included in the review. We identified a range of service delivery models providing support to people with a range of disabilities or conditions. We report evidence of the use of the IPCHS strategies in ways relevant to the local context.
DISCUSSION
Several strengths emerged, with many services tailored to individual need, and significant community engagement. Innovative rural service delivery approaches were also identified. Key areas requiring action included improved coordination or integration within and across professions and sectors. There was limited evidence of co-production of solutions or participatory governance. While people-centred approaches show promise to improve community-based services, large-scale fundamental change is required.IMPLICATIONS FOR REHABILITATIONCommunity-based disability and rehabilitation services in rural and remote Australia performed well at delivering tailored care and engaging in community consultation.These services must urgently implement strategies to enhance community ownership of solutions and participatory governance.Services must place a greater focus on explicit strategies to integrate and coordinate across services and professions, and to create an enabling environment, to deliver people-centred care.The World Health Organisation Integrated People-Centred Health Services framework provides an important roadmap to improving service delivery in rural and remote Australian communities.
Topics: Australia; Delivery of Health Care; Disabled Persons; Humans; Life Style; Rural Health Services; Rural Population
PubMed: 34433373
DOI: 10.1080/09638288.2021.1962992 -
Rehabilitation Psychology May 2017The purpose of this systematic review was to synthesize existing empirical research on disability identity development. This review is organized to present the... (Review)
Review
PURPOSE/OBJECTIVE
The purpose of this systematic review was to synthesize existing empirical research on disability identity development. This review is organized to present the demographics of participants and types of disabilities represented in the existing data, measures of disability identity development and theoretical models of disability identity development.
METHOD
Electronic databases (EBSCO, PsycINFO, ERIC, and Sociological Abstracts) were searched for all peer reviewed empirical studies published between 1980 and 2017. Articles were excluded if they were theoretical and/or did not include participants with disabilities, or focused on a disability-specific community identity rather than general disability identity.
RESULTS
Empirical articles (N = 41) were included in the final review. An overwhelming majority (75.6%) were qualitative in nature, with only 22% of the articles reviewed being quantitative and only 1 that utilized a mixed methods design. The results suggest that disability identity can be considered a unique phenomenon that shapes persons' ways of seeing themselves, their bodies, and their way of interacting with the world.
CONCLUSIONS/IMPLICATIONS
Disability identity development has the potential to become an important factor in developing effective interventions and/or therapies. Identity development is a fundamentally social process, and identities are formed through mirroring, modeling, and recognition through available identity resources, and so it is imperative that able-bodied professionals (i.e., rehabilitation professionals, therapists, teachers and caregivers) working with individuals with disabilities become aware of this developmental process to be able to better support individuals along this journey. (PsycINFO Database Record
Topics: Disabled Persons; Humans; Self Concept
PubMed: 28406650
DOI: 10.1037/rep0000134 -
Journal of Intellectual & Developmental... Dec 2012Social inclusion is central to disability policies internationally. The high risk of social exclusion for people with intellectual disability is compounded for those... (Review)
Review
BACKGROUND
Social inclusion is central to disability policies internationally. The high risk of social exclusion for people with intellectual disability is compounded for those with challenging behaviour.
METHOD
A systematic literature review examined how social inclusion of people with intellectual disability and challenging behaviour has been researched and operationalised in the empirical literature, and aimed to determine what evidence exists about the extent of social inclusion by people with intellectual disability and challenging behaviour.
RESULTS
A thematic analysis of the 14 papers identified that social inclusion has been poorly defined and measured, and that the little research that has occurred in respect of people with challenging behaviour has demonstrated their potential to be socially included.
CONCLUSIONS
Clearer conceptualisation of inclusion, and greater understanding of practices that support social inclusion and system level mechanisms, which ensure goals around inclusion gain prominence in funding and support plans, may address the neglect of this critical quality-of-life domain for people with challenging behaviour.
Topics: Conduct Disorder; Disabled Persons; Evidence-Based Medicine; Humans; Intellectual Disability; Severity of Illness Index; Social Identification; Social Isolation; Social Participation; Social Support
PubMed: 23002899
DOI: 10.3109/13668250.2012.721878 -
BMC Geriatrics Jan 2014The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties. The... (Review)
Review
BACKGROUND
The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties. The Late-Life Function and Disability Instrument (LLFDI) has been widely used to assess functional limitations and disability in studies with older adults. The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI.
METHODS
Published studies of any design reporting results based on administration of the original version of the LLFDI in community-dwelling older adults were identified after searches of 9 electronic databases. Data related to construct validity (convergent/divergent and known-groups validity), test-retest reliability and sensitivity to change were extracted. Effect sizes were calculated for within-group changes and summarized graphically.
RESULTS
Seventy-one studies including 17,301 older adults met inclusion criteria. Data supporting the convergent/divergent and known-groups validity for both the Function and Disability components were extracted from 30 and 18 studies, respectively. High test-retest reliability was found for the Function component, while results for the Disability component were more variable. Sensitivity to change of the LLFDI was confirmed based on findings from 25 studies. The basic lower extremity subscale and overall summary score of the Function component and limitation dimension of the Disability component were associated with the strongest relative effect sizes.
CONCLUSIONS
There is extensive evidence to support the construct validity and sensitivity to change of the LLFDI among various clinical populations of community-dwelling older adults. Further work is needed on predictive validity and values for clinically important change. Findings from this review can be used to guide the selection of the most appropriate LLFDI subscale for use an outcome measure in geriatric research and practice.
Topics: Activities of Daily Living; Aged, 80 and over; Disability Evaluation; Disabled Persons; Geriatric Assessment; Humans; Psychometrics
PubMed: 24476510
DOI: 10.1186/1471-2318-14-12 -
Rehabilitation Psychology May 2023People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have... (Meta-Analysis)
Meta-Analysis
PURPOSE
People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have not changed key statistics such as unemployment rates. Previous research has focused on explicit attitudes, generally found to be positive, prompting investigation into factors such as implicit bias. This systematic review and meta-analysis investigated implicit bias toward PWD and associated factors.
METHOD
Forty-six peer-reviewed studies published between January 2000 and April 2020 utilizing the Implicit Association Test were included. Of these, 12 studies met the inclusion criteria for meta-analysis.
RESULTS
A significant moderate pooled effect (mean difference = 0.503, 95% CI [0.497-0.509], < .001) was found, suggesting moderate negative implicit attitudes toward general disability. Negative implicit attitudes were also found toward physical, and intellectual disability. PWD were implicitly stereotyped as incompetent, cold, and "child-like." Findings were inconsistent for factors associated with bias including age, race, sex, and individual differences. Contact with PWD may be associated with implicit bias; however, measures were inconsistent.
CONCLUSION
This review has found moderate negative implicit biases toward PWD, however, factors associated with this bias remain unclear. Further research should investigate implicit bias toward specific disability groups and strategies to shift such biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Bias, Implicit; Quality of Life; Disabled Persons; Bias
PubMed: 37079819
DOI: 10.1037/rep0000493 -
Sensors (Basel, Switzerland) Oct 2022The epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the... (Review)
Review
The epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults' disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, = 8), cognitive function (Mini-Mental State examination, = 7), gait speed (walk test, = 6), and endurance (Chair stand-test, = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, = 4 studies, the Lawton and Brody Instrumental ADL, = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults' disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.
Topics: Humans; Aged; Independent Living; Activities of Daily Living; Hand Strength; Disabled Persons; Self Report
PubMed: 36365968
DOI: 10.3390/s22218270 -
Cancer Treatment Reviews Dec 2017People with cancer frequently report limitation in Activities of Daily Living (ADLs); essential activities required to live independently within society. Although... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
People with cancer frequently report limitation in Activities of Daily Living (ADLs); essential activities required to live independently within society. Although several studies have assessed ADL related disability, variability in assessment, setting, and population means evidence is difficult to interpret. We aimed to determine the prevalence of ADL related disability, overall and by setting, and the most commonly affected ADLs in people living with cancer.
METHODS
We searched twelve databases to June 2016 for observational studies assessing ADL disability in adults with cancer. Data on study design, population, ADL instruments and disability (difficulty with or requiring assistance in ≥1 activity) were extracted, summarised, and pooled to estimate disability prevalence with 95% confidence intervals (95% CI) overall and by setting.
RESULTS
Forty-three studies comprising 19,246 patients were included. Overall, 36.7% (95% CI 29.8-44.3, 18 studies) and 54.6% (95% CI 46.5-62.3, 15 studies) of patients respectively reported disability relating to basic and instrumental ADLs. Disability was marginally more prevalent in inpatient compared to outpatient settings. The Katz Index (18 studies) and Lawton IADL Scale (11 studies) were the most commonly used instruments. Across the activities studied, the most frequently affected basic ADLs were personal hygiene, walking and transfers, and instrumental ADLs were housework, shopping and transportation.
CONCLUSIONS
About one-third and half of adults with cancer respectively have difficulty or require assistance to perform basic and instrumental ADLs. These findings highlight the need for rehabilitation focused on functional independence, and underscore the importance of professionals skilled in occupational assessment and therapy within cancer services.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Disability Evaluation; Disabled Persons; Humans; Middle Aged; Neoplasms
PubMed: 29125982
DOI: 10.1016/j.ctrv.2017.10.006 -
Social Science & Medicine (1982) Jul 2022In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that... (Review)
Review
In many settler-colonial countries, Indigenous people do not access disability services at rates commensurate with disability prevalence. Existing research suggests that services often do not reflect Indigenous values and social practices, impacting on accessibility. Furthermore, disability services have historically been implicated in processes of colonisation. There is an urgent need to decolonise disability services. Understanding Indigenous knowledge and experience of disability is a necessary step towards achieving this. We systematically reviewed the disability conceptualisations, practices and experiences of First Nations peoples of Australia. Twelve studies met inclusion criteria. There was a consensus among these studies that Western constructs of disability do not resonate with many First Nations people across Australia. The studies reported that many First Nations people conceptualise most disabilities as unremarkable conditions that reflect the normal range of human diversity, although some conditions may be associated with social stigma. Inclusive attitudes and practices of caregiving in First Nations families facilitate the participation of First Nations people with disabilities in family and community life. However, ableism and racism in broader society combine to exclude many First Nations peoples with disabilities from public spaces and from labour markets. Disability services regularly fail to reflect First Nations values and social practices, and can lead to further disempowerment and marginalisation due to diagnostic processes; displacement from country and communities; gendered discrimination; and poor relationships with service providers. We argue that intersectional experiences of colonialism, racism, ableism and sexism, particularly in disability services, can lead to the marginalisation of First Nations participants and families. The decolonisation of disability services requires services to embrace diverse First Nations values and practices associated with human capability, social participation and caregiving. Decolonising disability services also necessitates First Nations control of the governance of disability services and reform across service, organisational, systemic and conceptual levels.
Topics: Colonialism; Concept Formation; Disabled Persons; Humans; Indigenous Peoples; Population Groups
PubMed: 35617764
DOI: 10.1016/j.socscimed.2022.115047 -
AIDS Care 2014More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported... (Meta-Analysis)
Meta-Analysis Review
More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02-1.69) overall; 1.16 (0.71-1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58-1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap.
Topics: Adult; Africa South of the Sahara; Disabled Persons; Female; HIV Infections; HIV Seropositivity; Humans; Male; Prevalence; Risk Assessment; Risk Factors; Sex Distribution
PubMed: 25033274
DOI: 10.1080/09540121.2014.936820 -
Journal of Back and Musculoskeletal... 2023Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength.
OBJECTIVE
This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength.
METHODS
We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence.
CONCLUSIONS
Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.
Topics: Adult; Humans; Low Back Pain; Exercise Therapy; Resistance Training; Disabled Persons; Pain Measurement
PubMed: 37458013
DOI: 10.3233/BMR-220301