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Journal of Occupational Rehabilitation Sep 2016Purpose Misinformation and negative attitudes toward disability contribute to lower employment rates among people with disabilities. Diversity training is an... (Review)
Review
Purpose Misinformation and negative attitudes toward disability contribute to lower employment rates among people with disabilities. Diversity training is an intervention intended to improve intergroup relations and reduce prejudice. We conducted a systematic review to determine the use and effectiveness of disability diversity training aimed at improving employment outcomes for employees with disabilities. Methods Five databases were searched for peer-reviewed studies of disability diversity training interventions provided within the workplace. Studies identified for inclusion were assessed for quality of methodology. Results Of the total of 1322 articles identified by the search, three studies met the criteria for inclusion. Two of the three articles focused specifically on training to improve outcomes related to workplace injuries among existing employees. The other study provided an initial test of a more general disability diversity training program. Conclusions There is currently a lack of empirically validated diversity training programs that focus specifically on disability. A number of disability diversity trainings and resources exist, but none have been well researched. Related literature on diversity training and disability awareness suggests the possibility for enhancing diversity training practices through training design, content, participant, and outcomes considerations. By integrating best practices in workplace diversity training with existing disability training resources, practitioners and researchers may be able to design effective disability diversity training programs.
Topics: Cultural Diversity; Disabled Persons; Employment; Humans; Personnel Management; Workplace
PubMed: 26519035
DOI: 10.1007/s10926-015-9612-3 -
Disability and Rehabilitation Apr 2017Exergames have the potential to enable persons with disabilities to take part in physical activities that are of appropriate "dose-potency" and enjoyable within a... (Review)
Review
INTRODUCTION
Exergames have the potential to enable persons with disabilities to take part in physical activities that are of appropriate "dose-potency" and enjoyable within a relatively safe home environment. It overcomes some of the challenges regarding transportation difficulties in getting to commercial gymnasium facilities, reducing physical activities perceived as "boring" or getting access into the built environment that may be "wheelchair unfriendly".
OBJECTIVE
This systematic review assessed available evidence whether "exergaming" could be a feasible modality for contributing to a recommended exercise prescription according to current ACSM™ or WHO guidelines for physical activity.
METHODS
Strategies used to search for published articles were conducted using separate search engines (Google Scholar™, PubMed™ and Web of Science™) on cardiometabolic responses and perceived exertion during exergaming among neurologically-disabled populations possessing similar physical disabilities. Each study was categorized using the SCIRE-Pedro evidence scale.
RESULTS
Ten of the 144 articles assessed were identified and met specific inclusion criteria. Key outcome measures included responses, such as energy expenditure, heart rate and perceived exertion. Twelve out of the 17 types of exergaming interventions met the ACSM™ or WHO recommendations of "moderate intensity" physical activity. Exergames such as Wii Jogging, Bicycling, Boxing, DDR and GameCycle reported moderate physical activity intensities. While Wii Snowboarding, Skiing and Bowling only produced light intensities.
CONCLUSION
Preliminary cross-sectional evidence in this review suggested that exergames have the potential to provide moderate intensity physical activity as recommended by ACSM™ or WHO in populations with neurological disabilities. However, more research is needed to document exergaming's efficacy from longitudinal observations before definitive conclusions can be drawn. Implications for Rehabilitation Exergaming can be deployed as physical activity or exercise using commercially available game consoles for neurologically disabled individuals in the convenience of their home environment and at a relatively inexpensive cost Moderate-to-vigorous intensity exercises can be achieved during exergaming in this population of persons with neurological disabilities. Exergaming can also be engaging and enjoyable, yet achieve the recommended physical activity guidelines proposed by ACSM™ or WHO for health and fitness benefits. Exergaming as physical activity in this population is feasible for individuals with profound disabilities, since it can be used even in sitting position for wheelchair-dependent users, thus providing variability in terms of exercise options. In the context of comprehensive rehabilitation, exergaming should be viewed by the clinician as "at least as good as" (and likely more enjoyable) than traditional arm-exercise modalities, with equivalent aerobic dose-potency as "traditional" exercise in clinic or home environments.
Topics: Disabled Persons; Exercise Therapy; Humans; Nervous System Diseases; Video Games
PubMed: 27108475
DOI: 10.3109/09638288.2016.1161086 -
BMC Psychiatry Nov 2012Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full... (Review)
Review
BACKGROUND
Schizophrenia is a significantly disabling disease that affects all major areas of life. There is a lack of comprehensive synthesis of research findings on the full extent of psychosocial difficulties (PSDs) experienced by people living with schizophrenia. This paper provides a systematic review of the literature concerning PSDs and their associated factors in schizophrenia. PSDs were conceptualized in accordance with the International Classification of Functioning, Disability and Health (ICF) as disabilities, in particular impairments of mental functions, activity limitations and participation restrictions.
METHODS
An electronic search using MEDLINE and PsychINFO plus a manual search of the literature was performed for qualitative and longitudinal studies published in English between 2005 and 2010 that examined PSDs in persons with schizophrenia. The ICF was used as a conceptual framework.
RESULTS
A total of 104 papers were included. The most frequent PSDs addressed in the literature were not specific ones, directly linkable to the ICF categories of mental functions, activity limitations or participation restrictions, but broad areas of psychosocial functioning, such as psychopathological symptoms (53% of papers) or global disability and functioning (37%). Among mental functions, the most extensively studied were cognitive functions (27%) and emotional functions (27%). Within the domain of activities and participation, the most widely investigated were difficulties in relationships with others (31%) and employment (20%). Of the factors associated with the intensity or course of PSDs, the most commonly identified were treatment modalities (56%), psychopathological symptoms (26%), and socio-demographic variables (24%). Medication tended to improve the most relevant PSD, but at the same time was the only consistently reported determinant of onset of PSDs (emerging as unwanted side-effects).
CONCLUSIONS
The present review illustrates the remarkably broad scope and diversity of psychosocial areas affected in schizophrenia and shows how these areas are interconnected and how they interact with contextual factors. The need for a shift in focus of schizophrenia research is suggested--from an excessive reliance on global measures of psychopathology and disability for defining outcomes to the creation of profiles of specific PSDs that have a more direct bearing on the disabling experience and real-world functioning of patients and can serve to guide interventions and monitoring over time.
Topics: Disabled Persons; Humans; Schizophrenia; Schizophrenic Psychology
PubMed: 23137171
DOI: 10.1186/1471-244X-12-193 -
Disability and Rehabilitation Sep 2022Developing self-determination skills is an important component of youth's maturation. However, many youths with disabilities lack opportunities to engage in activities...
PURPOSE
Developing self-determination skills is an important component of youth's maturation. However, many youths with disabilities lack opportunities to engage in activities that can promote these skills. The purpose of this study was to conduct a systematic review of self-determination interventions for children and youth with disabilities.
METHODS
A systematic review was performed on seven international databases that identified 28 studies meeting our inclusion criteria.
RESULTS
Among the 28 studies, 5184 youth with disabilities (aged 9-29, mean age 16.8 years) were represented across three countries. The interventions varied in duration, length, number of sessions, and delivery format, which included curriculum-based, workshops, experiential or residential learning, peer coaching and mentoring, self-directed individual learning, computer games, and multi-component designs. 19/28 studies reported a significant improvement in self-determination. Of these 13/18 studies showed improvements as measured by Arc's self-determination scale, while 8/13 studies reported a significant improvement as measured by AIR self-determination scale. Other significant differences were reported in vocational skills self-efficacy and self-determination inventory.
CONCLUSIONS
Our findings highlight that there are several types of interventions that have the potential to improve self-determination for youth with disabilities. Further research is needed to understand what program components could help youth to obtain optimal outcomes.Implications for RehabilitationSeveral types of interventions (school-based, community, online) have potential to influence self-determination for youth with disabilities.Clinicians and educators should consider having multiple components including workshops, one-to-one and group-based learning, mentoring and coaching for optimal program outcomes.Interventions that are targeted to enhance self-determination for youth with disabilities should be theoretically informed and use a validated measure to assess their effectiveness.
Topics: Adolescent; Child; Disabled Persons; Humans; Mentors; Personal Autonomy; Schools; Self Efficacy
PubMed: 34056997
DOI: 10.1080/09638288.2021.1928776 -
Brazilian Journal of Physical Therapy 2023Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint.
OBJECTIVE
To evaluate the effectiveness of hip interventions on pain and disability in patients with LBP in the short-, medium-, and long-term.
METHODS
PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in November 2022. Randomized controlled trials involving hip-targeted interventions compared to specific low back interventions in patients with LBP were selected. The outcomes were pain intensity and disability. The quality of the studies was assessed with the risk of bias tool. GRADE was used to rate the certainty of evidence. Meta-analyses were conducted using random effects models.
RESULTS
A total of 2581 studies were screened. Eight were included in the meta-analysis involving 508 patients with LBP. The results provided very low certainty that both hip strengthening and hip stretching improved pain (MD = -0.66; 95% CI -0.86, -0.48; I:0%) (MD = -0.55; 95% CI -1.02, -0.08) and disability (SMD = -0.81; 95% CI -1.53, -0.10; I: 80%) (SMD = -1.03; 95% CI -1.82, -0.25) in the short-term, respectively. No benefits were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence.
CONCLUSIONS
Very low certainty evidence suggest a positive effect of hip strengthening in isolation or combined with specific low back exercise and hip stretching combined with specific low back exercise for decreasing pain intensity and disability in the short-term, in patients with LBP.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42022303173.
Topics: Humans; Chronic Pain; Low Back Pain; Exercise Therapy; Pain Measurement; Disabled Persons
PubMed: 37037144
DOI: 10.1016/j.bjpt.2023.100502 -
Neuroscience Letters Sep 2021People with disabilities face many travel barriers. Autonomous vehicles and services may be one solution. The purpose of this project was to conduct a systematic review...
People with disabilities face many travel barriers. Autonomous vehicles and services may be one solution. The purpose of this project was to conduct a systematic review of the grey and scientific literature on autonomous vehicles for people with disabilities. Scientific evidence (n = 35) was limited to four observational studies with a very low level of evidence, qualitative studies, reviews, design and model reports, and policy proposals. Literature on older adults was most prevalent. Grey literature (n = 37) spanned a variety of media and sources and focuses on a variety of disability and impairment types. Results highlight opportunities and barriers to accessible and usable AVs and services, outline research gaps to set a future research agenda, and identify implications for policy and knowledge translation. People with disabilities are a diverse group, and accessible and usable design solutions will therefore need to be tailored to each group's needs, circumstances, and preferences. Future research in diverse disability groups should include more participatory action design and engineering studies and higher quality, prospective experimental studies to evaluate outcomes of accessible and usable AV technology. Studies will need to address not only all vehicle features but also the entire travel journey.
Topics: Automobiles; Autonomous Vehicles; Disabled Persons; Humans; Travel
PubMed: 34237416
DOI: 10.1016/j.neulet.2021.136103 -
Disability and Rehabilitation Mar 2021The objective of this systematic review was to describe the prevalence and processes of disability disclosure for persons with autism spectrum disorder.
PURPOSE
The objective of this systematic review was to describe the prevalence and processes of disability disclosure for persons with autism spectrum disorder.
METHODS
Systematic searches of seven international databases revealed 26 studies meeting our inclusion criteria. We analyzed these studies with respect to participant demographics, methodology, results and quality of the evidence.
RESULTS
Among the 26 studies, 7006 participants (aged 13-75, mean 28.1 years) were represented across seven countries. Our findings showed that rates of disclosure and receiving workplace accommodations varied considerably. Benefits of disclosing in the workplace included greater acceptance and inclusion, receiving accommodations, and increasing awareness about autism. Limitations of disclosing to employers involved experiencing stigma and discrimination. Factors affecting decisions to disclose included age at diagnosis, social demands of the job, and workplace policies. Types of accommodations that were received or desired included adjustments to the job interview process, schedules (i.e., flexibility, working from home), job content or working conditions, environment (i.e., lighting, quiet space); support with communication and social skills; and disability awareness training for their workplace colleagues.
CONCLUSIONS
Our findings highlight that disclosing a condition of autism in the workplace and requesting accommodations is complex. More research is needed to explore processes of disclosing and accommodation and how these processes vary by autism sub-type, gender, and industry type.Implications for rehabilitationClinicians and vocational Counselors should support people with autism to advocate for their needs in the workplace, including the potential benefits of disclosing their conditions so they can access accommodations that allow them to keep healthy and productive in workplace.Clinicians should recognize that people with autism spectrum disorder may have different workplace accommodation needs than those with other types of disabilities, in particular support with social and communication skills.Clinicians should aid people with autism to access resources and supports that are available to them to access workplace accommodations.
Topics: Autism Spectrum Disorder; Autistic Disorder; Disabled Persons; Disclosure; Humans; Workplace
PubMed: 31282214
DOI: 10.1080/09638288.2019.1635658 -
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 Medicine Sep 2021The sustainable development goals aim to improve health for all by 2030. They incorporate ambitious goals regarding tuberculosis (TB), which may be a significant cause... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The sustainable development goals aim to improve health for all by 2030. They incorporate ambitious goals regarding tuberculosis (TB), which may be a significant cause of disability, yet to be quantified. Therefore, we aimed to quantify the prevalence and types of TB-related disabilities.
METHODS
We performed a systematic review of TB-related disabilities. The pooled prevalence of disabilities was calculated using the inverse variance heterogeneity model. The maps of the proportions of common types of disabilities by country income level were created.
RESULTS
We included a total of 131 studies (217,475 patients) that were conducted in 49 countries. The most common type of disabilities were mental health disorders (23.1%), respiratory impairment (20.7%), musculoskeletal impairment (17.1%), hearing impairment (14.5%), visual impairment (9.8%), renal impairment (5.7%), and neurological impairment (1.6%). The prevalence of respiratory impairment (61.2%) and mental health disorders (42.0%) was highest in low-income countries while neurological impairment was highest in lower middle-income countries (25.6%). Drug-resistant TB was associated with respiratory (58.7%), neurological (37.2%), and hearing impairments (25.0%) and mental health disorders (26.0%), respectively.
CONCLUSIONS
TB-related disabilities were frequently reported. More uniform reporting tools for TB-related disability and further research to better quantify and mitigate it are urgently needed.
PROSPERO REGISTRATION NUMBER
CRD42019147488.
Topics: Disabled Persons; Humans; Mental Disorders; Prevalence; Tuberculosis; Tuberculosis, Multidrug-Resistant
PubMed: 34496845
DOI: 10.1186/s12916-021-02063-9 -
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