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Indian Journal of Medical Ethics 2016Different models have defined the term disability and grouped persons with disabilities accordingly. Time and again, various terms and phrases have been used in...
Different models have defined the term disability and grouped persons with disabilities accordingly. Time and again, various terms and phrases have been used in different languages to identity persons according to the differences in their bodies and the level of functioning of those bodies. Analogies and metaphors create stereotypes and can affect the formation of an individual's self-concept. Clichés like "divyang", ie one who has some divine powers to compensate for the deficiency in the body, based on the supercrip theory of disability, can distort the self-concept and hamper identity formation. Society and the state cannot and must not shrug off their responsibility by using such sugar-coated terms to label individuals. The real requirement is the creation of a nondisabling environment and the provision of equal opportunities to those with disabilities rather than coining of new terms.
Topics: Disabled Persons; Human Rights; Humans; India; Literature; Mass Media; Metaphor; Metaphysics; Self Concept; Social Behavior; Social Environment; Stereotyping; Terminology as Topic
PubMed: 27474697
DOI: 10.20529/IJME.2016.045 -
Health Psychology : Official Journal of... Sep 2019Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses... (Review)
Review
OBJECTIVE
Multimorbidity is a robust predictor of disability in aging adults, but the mechanisms by which multimorbidity is disabling are not clear. Most existing research focuses on disease-specific phenomena, such as diminished lung capacity in chronic obstructive pulmonary disease, which can result in functional limitations. This review takes a different approach by highlighting the potential role of a biological process-inflammation-that is common to many chronic medical conditions and thus, from a medical perspective, relatively disease nonspecific.
METHOD
Beginning with a description of inflammation and its measurement, this paper will provide an overview of research on inflammation as a predictor of disease risk in healthy adults and of adverse outcomes (e.g., disability) in those with multimorbidity.
RESULTS
The discussion of inflammation is then situated in the context of biopsychosocial influences on health, as inflammation has been shown to be sensitive to a wide range of social and psychological processes that are thought to contribute to healthy aging, including successful adaptation to multimorbidity and reduced risk of disability.
CONCLUSIONS
Finally, implications of this broader perspective for interventions to improve outcomes in aging adults with multimorbidity are briefly considered. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Topics: Adult; Chronic Disease; Disabled Persons; Humans; Inflammation; Multimorbidity
PubMed: 31436464
DOI: 10.1037/hea0000749 -
Bulletin of the World Health... Nov 2022Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive,...
Considerable progress has been made in saving the lives of children younger than 5 years. Nevertheless, these advances have failed to help all children thrive, particularly children with disabilities. We describe the increasing prevalence of disability among children and adolescents. We evaluate the current situation regarding children with disabilities and rehabilitation in the context of health systems, particularly those in low- and middle-income countries. Within the newborn health agenda, congenital anomalies often require early intervention and rehabilitation. We provide Argentina as an example of a country where rehabilitation for congenital anomalies is integrated into the health system. We argue that congenital anomalies that require rehabilitation have the potential to strengthen rehabilitation systems and policies by: strengthening coordination between primary care and rehabilitation; identifying and understanding pathways that allow families to engage with services; providing human resources for rehabilitation; and building systems and resources that support assistive technology and rehabilitation. We propose ways for countries to prioritize and integrate early identification, referral and care for children with congenital anomalies to strengthen health systems for all. We identify opportunities to expand policy and planning and to design service delivery and workforce strategies through World Health Organization guidelines and frameworks for rehabilitation. We argue that the global health community must act to ensure that rehabilitation services to support functioning from birth are well established, accepted and integrated within health systems, and that disability is prioritized within child health. These steps would strengthen health systems, ensure functioning from birth and make rehabilitation accessible to all.
Topics: Child; Adolescent; Infant, Newborn; Humans; Disabled Persons; Global Health; Self-Help Devices; Workforce; Government Programs
PubMed: 36324557
DOI: 10.2471/BLT.22.288147 -
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 -
Health & Place May 2019A scoping review was conducted, using a social ecological model approach, of 106 articles examining the effect of disability on food access and (in)security. Results of... (Review)
Review
A scoping review was conducted, using a social ecological model approach, of 106 articles examining the effect of disability on food access and (in)security. Results of the review show a consistently increased risk of food insecurity among people with disabilities with a higher risk for mental health disabilities, and among disabled younger adults. Mediators of this relationship were underexplored. Disability was mainly conceptualized as a problematic category preventing food access while ignoring disabling social and environmental barriers. A social model of disability can inform future research by acknowledging the role of socio-environmental influences on the production and experience(s) of disability.
Topics: Disabled Persons; Food Supply; Humans; Internationality; Mental Disorders; Mobility Limitation; Risk Factors
PubMed: 31026771
DOI: 10.1016/j.healthplace.2019.03.011 -
International Journal For Equity in... Jan 2021Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were...
BACKGROUND
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi's National Disability Mainstreaming Strategy and Implementation Plan.
METHODS
We applied an analytical methodology to review the Malawi's National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
RESULTS
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
CONCLUSIONS
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production - co-implementation - co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
Topics: Community Participation; Disabled Persons; Health Policy; Humans; Malawi; Policy Making; Vulnerable Populations
PubMed: 33413443
DOI: 10.1186/s12939-020-01378-y -
Rehabilitation Psychology Feb 2020This article describes the initial factor exploration of disability identity and preliminary psychometric characteristics based on an adult self-report tool. Disability...
PURPOSE/OBJECTIVE
This article describes the initial factor exploration of disability identity and preliminary psychometric characteristics based on an adult self-report tool. Disability was defined broadly, and the sample included individuals with visible and/or hidden disabilities across many disability groups (i.e., physical, intellectual, learning, mental illness).
METHOD
Items were developed ( = 102) and a pilot measure was administered to a sample of adults with disabilities ( = 566). An exploratory factor analysis (EFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator was conducted. The resulting items were sent to expert reviewers for evaluation.
RESULTS
Following the exploratory analyses, 37 items were retained that made up four factors: internal beliefs about own disability and the disability community, anger and frustration with disability experiences, adoption of disability community values, and contribution to the disability community. The pilot measure aligned well with the theoretical framework that guided its development.
DISCUSSION/CONCLUSION
This factor exploration is a contribution to a growing body of literature supporting, and investigating, disability identity development. This work presents a more comprehensive understanding of disability identity development. Armed with a better understanding, this will serve as a basis to inform future scale development and validation. After this validation work is completed, there is the potential to apply findings to tailor interventions and clinical work, so that psychologists and rehabilitation professionals may be better prepared to meet the developmental needs of disabled clients. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topics: Adolescent; Adult; Aged; Attitude to Health; Disabled Persons; Factor Analysis, Statistical; Female; Humans; Male; Middle Aged; Psychometrics; Self Concept; Self Report; Young Adult
PubMed: 31944783
DOI: 10.1037/rep0000308 -
Clinics in Geriatric Medicine Aug 2010This article uses the Disablement Model conceptual framework to guide an analysis of the importance of osteoarthritis (OA) in the development of disability. The... (Review)
Review
This article uses the Disablement Model conceptual framework to guide an analysis of the importance of osteoarthritis (OA) in the development of disability. The Disablement Model describes the development and progression of disablement from impairments to specific functional limitations and disability, and the hypothesized role of predisposing risk factors, extra-individual factors, and intra-individual factors. A wide range of population and clinical studies have characterized the unequivocal contribution of arthritis to the development of functional limitations and disability. Evidence overwhelmingly supports a significant, moderate independent contribution of arthritis to the onset and progression of functional limitations and disability. With respect to important risk factors for the development of functional limitations and disability among those with OA, the evidence provides strong support for the role of physical impairments along with other predisposing and intra-individual factors such as age, body mass index, obesity, lack of exercise, comorbid conditions, depression, and depressive symptoms. Extra-individual factors included need for aids and assistance, and lack of access to public or private transportation. Future disablement research must clarify the causal mechanisms behind a potential risk factor's impact on disability and delineate the interplay between and among the various hypothesized steps in the disablement process.
Topics: Activities of Daily Living; Disability Evaluation; Disabled Persons; Disease Progression; Humans; Motor Activity; Osteoarthritis; Risk Factors
PubMed: 20699161
DOI: 10.1016/j.cger.2010.04.001 -
MMWR. Morbidity and Mortality Weekly... Jul 2015Understanding the prevalence of disability is important for public health programs to be able to address the needs of persons with disabilities. Beginning in 2013, to...
Understanding the prevalence of disability is important for public health programs to be able to address the needs of persons with disabilities. Beginning in 2013, to measure disability prevalence by functional type, the Behavioral Risk Factor Surveillance System (BRFSS), added five questions to identify disability in vision, cognition, mobility, self-care, and independent living. CDC analyzed data from the 2013 BRFSS to assess overall prevalence of any disability, as well as specific types of disability among noninstitutionalized U.S. adults. Across all states, disabilities in mobility and cognition were the most frequently reported types. State-level prevalence of each disability type ranged from 2.7% to 8.1% (vision); 6.9% to 16.8% (cognition); 8.5% to 20.7% (mobility); 1.9% to 6.2% (self-care) and 4.2% to 10.8% (independent living). A higher prevalence of any disability was generally seen among adults living in states in the South and among women (24.4%) compared with men (19.8%). Prevalences of any disability and disability in mobility were higher among older age groups. These are the first data on functional disability types available in a state-based health survey. This information can help public health programs identify the prevalence of and demographic characteristics associated with different disability types among U.S. adults and better target appropriate interventions to reduce health disparities.
Topics: Adolescent; Adult; Aged; Behavioral Risk Factor Surveillance System; Cognition Disorders; Disabled Persons; Female; Humans; Independent Living; Male; Middle Aged; Mobility Limitation; Prevalence; Self Care; United States; Vision Disorders; Young Adult
PubMed: 26225475
DOI: 10.15585/mmwr.mm6429a2 -
Global Health Action 2011Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely... (Review)
Review
BACKGROUND
Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.
OBJECTIVES
To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability.
DESIGN
Qualitative literature review and secondary data analysis.
RESULTS
Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested.
CONCLUSION
Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following natural disaster is urgently required.
Topics: Databases, Factual; Disability Evaluation; Disabled Persons; Disaster Planning; Disasters; Humans; Internationality; Needs Assessment; Regression Analysis; Relief Work; World Health Organization; Wounds and Injuries
PubMed: 21866223
DOI: 10.3402/gha.v4i0.7191