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International Journal of Environmental... Aug 2022This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in... (Review)
Review
This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access to disability care; there is little focus on informational and technological resources. Second, functional disabilities are the dominant focus of the research, followed by cognitive, mental, and locomotor disabilities; there is little focus on speech, hearing, and visual disabilities. Third, barriers, inhibitors, and catalysts of physical access are the dominant focus, with relatively less focus on virtual access; there is very little emphasis on the drivers to access. Fourth, the primary, although not dominant, focus is on access for urban and rural populations; there is very little focus on access for underserved and indigenous populations. Future research must address these gaps systematically to improve access. This paper adds: (a) a systemic framework for the study of an important, complex, emerging problem; (b) a systematic review of the global research on the problem; and (c) a research roadmap to address the emerging problem in India.
Topics: Aged; Disabled Persons; Health Services Accessibility; Humans; India; Rural Population
PubMed: 36011654
DOI: 10.3390/ijerph191610018 -
Journal of Intellectual Disabilities :... Feb 2023This systematic review aimed to explore the impact educational interventions have on undergraduate nursing and medical students' attitudes and empathy levels towards... (Review)
Review
This systematic review aimed to explore the impact educational interventions have on undergraduate nursing and medical students' attitudes and empathy levels towards people with disability. There are over one billion people with some form of disability currently. A growing body of research reveals that nurses and doctors display negative attitudes including decreased empathy towards people with disability. A systematic review using narrative synthesis of chosen randomized controlled trials was employed. A comprehensive search was completed in June 2021 on six databases (CINAHL, Medline, Science Direct, Health Research Premium - PROQUEST, Scopus. Cochrane Library). The search strategy yielded 21,616 studies and only three randomised controlled trials fulfilled the eligibility criteria. These trials included 125 participants ( = 50 medical students and = 75 nursing students) and evaluated the effectiveness of a disabled health course, disability education module with bedside teaching and wheelchair workshop intervention. Findings from one study revealed that a disabled health course using affective learning method based on a transformative learning theory significantly improves attitudes to disability amongst nursing students however there was no statistically significant difference in empathy levels. More high-quality randomised controlled trials with greater theoretical and methodological complexity are needed to identify more effective educational approaches that enhance attitude and empathy levels of these key stakeholders.
PubMed: 36798039
DOI: 10.1177/17446295231155781 -
Epidemiology and Health 2022Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL)... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Functional disability is a common consequence of the ageing process and can lead to poor health outcomes due to the inability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) independently. However, the prevalence of functional disability among older adults in the Association of Southeast Asian Nations (ASEAN) region is poorly documented. This study aimed to assess the prevalence of functional disability and its impact on older adults in the ASEAN region.
METHODS
A systematic literature search was performed on 4 databases from inception until March 2021 to identify studies examining individuals aged 60 years and above reporting functional disabilities in the ASEAN region. Information on the prevalence and impact of functional disability was extracted, assessed for bias, summarised, and analysed using a random-effects meta-analysis.
RESULTS
Thirty-four studies with 59,944 participants were included. The pooled prevalence of ADL disability was 21.5% (95% confidence interval [CI], 16.2 to 27.3) and that of IADL disability was 46.8% (95% CI, 35.5 to 58.3). Subgroup analyses showed higher prevalence among those of advanced age and women. Adverse impacts included increased years of life with disability and poor health-related quality of life.
CONCLUSIONS
Nearly a quarter of the older adult population in the ASEAN region experience functional disability. These findings highlight the need for further research on the burden and impact of functional disability within this region to allow decision-makers to gauge the severity of the issue, develop policies to reduce the risk of developing functional disabilities, and foster healthy ageing.
Topics: Female; Humans; Aged; Activities of Daily Living; Prevalence; Quality of Life; Disabled Persons; Asian People; Disability Evaluation
PubMed: 35843601
DOI: 10.4178/epih.e2022058 -
Topics in Spinal Cord Injury... 2017Power wheelchairs capable of overcoming environmental barriers, such as uneven terrain, curbs, or stairs, have been under development for more than a decade. We... (Review)
Review
Power wheelchairs capable of overcoming environmental barriers, such as uneven terrain, curbs, or stairs, have been under development for more than a decade. We conducted a systematic review of the scientific and engineering literature to identify these devices, and we provide brief descriptions of the mechanism and method of operation for each. We also present data comparing their capabilities in terms of step climbing and standard wheelchair functions. We found that all the devices presented allow for traversal of obstacles that cannot be accomplished with traditional power wheelchairs, but the slow speeds and small wheel diameters of some designs make them only moderately effective in the basic area of efficient transport over level ground and the size and configuration of some others limit maneuverability in tight spaces. We propose that safety and performance test methods more comprehensive than the International Organization for Standards (ISO) testing protocols be developed for measuring the capabilities of advanced wheelchairs with step-climbing and other environment-negotiating features to allow comparison of their clinical effectiveness.
Topics: Disabled Persons; Durable Medical Equipment; Equipment Design; Humans; Wheelchairs
PubMed: 29339886
DOI: 10.1310/sci2302-98 -
Journal of Rehabilitation Medicine Jun 2018To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low-... (Review)
Review
OBJECTIVE
To compare models of rehabilitation services for people with mental and/or physical disability in order to determine optimal models for therapy and interventions in low- to middle-income countries.
DATA SOURCES
CINAHL, EMBASE, MEDLINE, CENTRAL, PsycINFO, Business Source Premier, HINARI, CEBHA and PubMed.
STUDY SELECTION
Systematic reviews, randomized control trials and observational studies comparing >2 models of rehabilitation care in any language. Date extraction: Standardized forms were used. Methodological quality was assessed using AMSTAR and quality of evidence was assessed using GRADE.
DATA SYNTHESIS
Twenty-four systematic reviews which included 578 studies and 202,307 participants were selected. In addition, four primary studies were included to complement the gaps in the systematic reviews. The studies were all done at various countries. Moderate- to high-quality evidence supports the following models of rehabilitation services: psychological intervention in primary care settings for people with major depression, admission into an inpatient, multidisciplinary, specialized rehabilitation unit for those with recent onset of a severe disabling condition; outpatient rehabilitation with multidisciplinary care in the community, hospital or home is recommended for less severe conditions; However, a model of rehabilitation service that includes early discharge is not recommended for elderly patients with severe stroke, chronic obstructive pulmonary disease, hip fracture and total joints.
CONCLUSION
Models of rehabilitation care in inpatient, multidisciplinary and specialized rehabilitation units are recommended for the treatment of severe conditions with recent onset, as they reduce mortality and the need for institutionalized care, especially among elderly patients, stroke patients, or those with chronic back pain. Results are expected to be generalizable for brain/spinal cord injury and complex fractures.
Topics: Activities of Daily Living; Aged; Disabled Persons; Female; Humans; Male; Mental Disorders; Poverty; Quality of Life
PubMed: 29616278
DOI: 10.2340/16501977-2325 -
PLoS Neglected Tropical Diseases Jul 2021Leprosy, podoconiosis, and lymphatic filariasis (LF) are among the priority neglected tropical diseases (NTDs) in Ethiopia. The disability, psychosocial, and mental...
Leprosy, podoconiosis, and lymphatic filariasis (LF) are among the priority neglected tropical diseases (NTDs) in Ethiopia. The disability, psychosocial, and mental health status of people affected by these NTDs are still overlooked in global NTD discourse. The objective of this systematic review was to synthesize the existing evidence describing the disability, psychosocial, and mental health status of people affected by leprosy, podoconiosis, and LF prior to developing a holistic physical and psychosocial care package for these individuals. We searched papers reporting on disability, psychosocial, and mental health status linked to these 3 NTDs. The protocol was registered in PROSPERO with registration number CRD42019128400. Peer-reviewed articles were searched and extracted from Medline, PsycINFO, Global Health, and Embase. Articles published in English, irrespective of the year of publication, using a quantitative study methodology, were included. Abstracts and full texts were reviewed by 2 reviewers. Data were extracted and narratively summarized, as the studies were heterogeneous and used different outcome measures. Out of 1,318 titles/abstracts screened and 59 full text studies reviewed, 24 fulfilled the inclusion criteria. Fourteen studies provided evidence of the disability associated with leprosy, podoconiosis, or LF. Ten studies provided evidence on the association between the 3 NTDs and mental health or psychosocial outcomes. The prevalence of grade 2 disability varied from 3.9% to 86%. The most commonly reported mental health impacts were depression and mental distress. A high burden of mental illness was reported, varying from 12.6% to 71.7%; the suicidal ideation was also high (18.5%). In conclusion, disability and poor psychosocial and mental health status are associated with leprosy, podoconiosis, and LF. For optimum management of these NTDs, holistic care including both physical and psychosocial interventions is vital.
Topics: Disabled Persons; Elephantiasis; Elephantiasis, Filarial; Humans; Leprosy; Mental Health; Neglected Diseases
PubMed: 34237079
DOI: 10.1371/journal.pntd.0009492 -
BMC Pregnancy and Childbirth Feb 2014Health care providers are often unfamiliar with the needs of women with disability. Moreover maternity and postnatal services may not be specifically tailored to the... (Review)
Review
BACKGROUND
Health care providers are often unfamiliar with the needs of women with disability. Moreover maternity and postnatal services may not be specifically tailored to the needs of women with disability and their families. We conducted a systematic review to determine the effectiveness of healthcare interventions to improve outcomes for pregnant and postnatal women with disability and for their families.
METHODS
Studies on pregnant and postnatal women with disability and their families which evaluated the effectiveness of an intervention using a design that met the criteria used by the Cochrane Effective Practice and Organization of Care group were eligible for inclusion in this review. A comprehensive search strategy was carried using eleven electronic databases. No restriction on date or language was applied. Included studies were assessed for quality and their results summarized and tabulated.
RESULTS
Only three studies fully met the inclusion criteria. All were published after 1990, and conducted as small single-centre randomized controlled trials. The studies were heterogeneous and not comparable. Therefore the main finding of this review was the lack of published research on the effectiveness of healthcare interventions to improve outcomes for pregnant women with disability and their families.
CONCLUSIONS
More research is required to evaluate healthcare interventions to improve outcomes for pregnant women with disability and their families.
Topics: Disabled Persons; Family; Female; Humans; Parturition; Postnatal Care; Pregnancy; Pregnant Women; Prenatal Care
PubMed: 24499308
DOI: 10.1186/1471-2393-14-58 -
Social Science & Medicine (1982) Mar 2018Approximately 10% of the world's population have a cognitive disability. Cognitive disabilities can have a profound impact on a person's social, cognitive or mental... (Review)
Review
Approximately 10% of the world's population have a cognitive disability. Cognitive disabilities can have a profound impact on a person's social, cognitive or mental functioning, requiring high levels of costly health and social support. Therefore, it is imperative that interventions and services received are based upon a sound evidence-base. For many interventions for this population, this evidence-base does not yet exist and there is a need for more Randomised Controlled Trials (RCTs). The process of conducting RCTs with disabled populations is fraught with methodological challenges. We need a better understanding of these methodological barriers if the evidence-bases are to be developed. The purpose of this study was to explore the methodological and practical barriers to conducting trials with adults with cognitive disabilities. As a case example, the literature regarding RCTs for people with intellectual disabilities (ID) was used to highlight these pertinent issues. A systematic literature review was conducted of RCTs with adults with ID, published from 2000 to 2017. A total of 53 papers met the inclusion criteria and were reviewed. Some of the barriers reported were specific to the RCT methodology and others specific to people with disabilities. Notable barriers included; difficulties recruiting; obtaining consent; resistance to the use of control groups; engaging with carers, staff and stakeholders; the need to adapt interventions and resources to be disability-accessible; and staff turnover. Conducting RCTs with people with cognitive disabilities can be challenging, however with reasonable adjustments, many of these barriers can be overcome. Researchers are not maximising the sharing of their experience-base. As a result, the development of evidence-bases remains slow and the health inequities of people with disabilities will continue to grow. The importance of the MRC guidelines on process evaluations, together with implications for the dissemination of 'evidence-base' and 'experience-base' are discussed.
Topics: Humans; Intellectual Disability; Randomized Controlled Trials as Topic
PubMed: 29421458
DOI: 10.1016/j.socscimed.2018.01.032 -
International Journal of Environmental... Jan 2023Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with... (Review)
Review
Although sexuality, reproductive health, and starting a family are human rights that should be guaranteed for all citizens, they are still taboo issues for people with intellectual disability (ID), and even more so for women with ID. This paper systematically reviews the current qualitative and quantitative evidence on the rights of people with ID in regard to Articles 23 (right to home and family) and 25 (health, specifically sexual and reproductive health) of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the current literature, following PRISMA 2020, was carried out in ERIC, PsychInfo, Scopus, PubMed, ProQuest, and Web of Science. In all, 151 articles were included for review. The studies were categorized into six themes: attitudes, intimate relationships, sexual and reproductive health, sexuality and sex education, pregnancy, and parenthood. There are still many barriers that prevent people with ID from fully exercising their right to sexuality, reproductive health, and parenthood, most notably communicative and attitudinal barriers. These findings underline the need to continue advancing the rights of people with ID, relying on Schalock and Verdurgo's eight-dimensional quality of life model as the ideal conceptual framework for translating such abstract concepts into practice and policy.
Topics: Pregnancy; Humans; Female; Intellectual Disability; Quality of Life; Reproductive Health; Sexual Behavior; Sexuality; Disabled Persons; Health Knowledge, Attitudes, Practice
PubMed: 36674341
DOI: 10.3390/ijerph20021587 -
Developmental Medicine and Child... Oct 2015The aim of this study was to systematically review the effect of adaptive seating systems (AdSSs) in young people less than 19 years of age with severe cerebral palsy... (Review)
Review
Adaptive seating systems in children with severe cerebral palsy across International Classification of Functioning, Disability and Health for Children and Youth version domains: a systematic review.
AIM
The aim of this study was to systematically review the effect of adaptive seating systems (AdSSs) in young people less than 19 years of age with severe cerebral palsy (CP), with particular focus on child-related outcomes across all components of the functioning and disability domains of the International Classification of Functioning, Disability, and Health for Children and Youth version (ICF-CY).
METHOD
Literature searches of studies published from 1975 to October 2014 were performed. Methodological quality and the risk of bias were analysed using Sackett's level of evidence, the American Academy for Cerebral Palsy and Developmental Medicine guidelines, and Mallen criteria for observational studies.
RESULTS
Nine studies fulfilled the selection criteria. All studies had level IV evidence and were of moderate methodological quality. The results focused on the effects of AdSSs on postural control and on upper extremity function and on additional child-related outcomes. The results suggested that AdSSs that include trunk and hip support devices may improve postural control outcomes, and that special-purpose AdSSs may improve self-care and play behaviour at home.
INTERPRETATION
Because of a low level of evidence and the moderate methodological quality of the studies available, no robust conclusions can be drawn. Nevertheless, the data suggest that AdSSs may be able to improve activity and participation at home among children with severe CP. More studies of high methodological quality addressing the effect of AdSSs on activity and participation are urgently needed. Suggestions for future research are provided.
Topics: Adolescent; Cerebral Palsy; Child; Child, Preschool; Disability Evaluation; Disabled Children; Humans; Self-Help Devices
PubMed: 25857828
DOI: 10.1111/dmcn.12762