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Rehabilitation Psychology May 2020Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on...
PURPOSE/OBJECTIVE
Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes.
RESULTS
While on average, provider's explicit attitudes ( = 4.41) indicated little prejudice, their implicit attitudes ( = 0.54) revealed they moderately preferred nondisabled people-they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability).
CONCLUSIONS/IMPLICATIONS
This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Topics: Adult; Attitude of Health Personnel; Disabled Persons; Female; Health Personnel; Health Services for Persons with Disabilities; Humans; Male; Prejudice; Young Adult
PubMed: 32105109
DOI: 10.1037/rep0000317 -
Europa Medicophysica Dec 2007In this commentary, we argue that the current biomedical and psychosocial models of illness that form the basis of medicine are insufficient to describe this interface.... (Review)
Review
In this commentary, we argue that the current biomedical and psychosocial models of illness that form the basis of medicine are insufficient to describe this interface. We offer a biopsycho-ecological model of illness and disability referred to as health environmental integration (HEI) as a framework intended to encourage a more complete understanding of disability as arising at the interface between the person's internal and external worlds. By this model, person-level functional abilities as well as the subjective meaning of those functions result in part from interactions created by the exchange of energy and information between the person and his environment. Three components are essential in measuring function: severity of deficit, type of deficit, and meaning. We present functional status staging as an approach to measuring severity and type of deficit, and recovery preference exploration as a way to measure meaning. Rehabilitation medicine can come closer to bridging the gap between biological and the subjectively-based aspects of human function, by measuring all three concepts.
Topics: Activities of Daily Living; Disability Evaluation; Disabled Persons; Environment; Health Status Indicators; Humans; Models, Statistical; Outcome Assessment, Health Care; Psychometrics; Quality of Life; Severity of Illness Index
PubMed: 18084178
DOI: No ID Found -
Developmental Medicine and Child... Jan 2017This review outlines a conceptual approach to inform research and practice aimed at supporting children whose lives are complicated by impairment and/or chronic medical... (Review)
Review
This review outlines a conceptual approach to inform research and practice aimed at supporting children whose lives are complicated by impairment and/or chronic medical conditions, and their families. 'Participation' in meaningful life activities should be an essential intervention goal, to meet the challenges of healthy growth and development, and to provide opportunities to help ensure that young people with impairments reach their full potential across their lifespan. Intervention activities and research can focus on participation as either an independent or dependent variable. The proposed framework and associated hypotheses are applicable to children and young people with a wide variety of conditions, and to their families. In taking a fresh 'non-categorical' perspective to health for children and young people, asking new questions, and exploring issues in innovative ways, we expect to learn lessons and to develop creative solutions that will ultimately benefit children with a wide variety of impairments and challenges, and their families, everywhere.
Topics: Child; Concept Formation; Developmental Disabilities; Disabled Persons; Environment; Health Promotion; Humans; Outcome Assessment, Health Care
PubMed: 27640996
DOI: 10.1111/dmcn.13237 -
Archives of Physical Medicine and... Jan 2011To systematically review the research findings regarding the associations between psychosocial factors and adjustment to chronic pain in persons with physical... (Review)
Review
OBJECTIVE
To systematically review the research findings regarding the associations between psychosocial factors and adjustment to chronic pain in persons with physical disabilities.
DATA SOURCES
A key word literature search was conducted using articles listed in PubMed, PsychInfo, and CINAHL up to March 2010, and manual searches were made of all retrieved articles to identify published articles that met the review inclusion criteria.
STUDY SELECTION
To be included in the review, articles needed to (1) be written in English, (2) include adults with a physical disability who report having pain, (3) include at least 1 measure of a psychosocial predictor domain, (4) include at least 1 criterion measure of pain or patient functioning, and (5) report the results of associations between the psychosocial factors and criterion measures used in the study. Twenty-nine studies met the inclusion criteria.
DATA EXTRACTION
Three reviewers tabulated study details and findings.
DATA SYNTHESIS
The disability groups studied included spinal cord injury (SCI), acquired amputation, cerebral palsy (CP), multiple sclerosis (MS), and muscular dystrophy (MD). Psychosocial factors were shown to be significantly associated with pain and dysfunction in all disability groups. The psychosocial factors most closely associated with pain and dysfunction across the samples included (1) catastrophizing cognitions; (2) task persistence, guarding, and resting coping responses; and (3) perceived social support and solicitous responding social factors. Pain-related beliefs were more strongly associated with pain and dysfunction in the SCI, CP, MS, and MD groups than in the acquired amputation group.
CONCLUSIONS
The findings support the importance of psychosocial factors as significant predictors of pain and functioning in persons with physical disabilities. Clinical trials to test the efficacy of psychosocial treatments for pain and dysfunction are warranted, as are studies to determine whether psychosocial factors have a causal influence on pain and adjustment in these populations.
Topics: Activities of Daily Living; Adaptation, Psychological; Chronic Disease; Disabled Persons; Humans; Mental Health; Pain; Social Support; Socioeconomic Factors
PubMed: 21187217
DOI: 10.1016/j.apmr.2010.09.021 -
Disability and Rehabilitation Feb 2017Purpose Transitioning to independence may be problematic for persons with spina bifida (SB). Experiences of young persons with SB may provide insights into this group's...
Purpose Transitioning to independence may be problematic for persons with spina bifida (SB). Experiences of young persons with SB may provide insights into this group's needs for support. Therefore, the aim of this study was to investigate children's and adolescents' experiences of living with SB, their social and emotional adjustment, and their thoughts about becoming independent adults. Method Semi-structured interviews were conducted with young persons with SB (N = 8, age range 10-17 years). Social and emotional problems were assessed using Beck Youth Inventories. The interview transcripts were analyzed using qualitative content analysis. Results Three main themes were found: being a person with SB; everyday living as a person with SB; and preparing for life as an adult with SB. Indications of emotional and social problems were most prominent among participants with milder physical disability. Conclusions The findings indicate that young persons with SB may overestimate their independence. Other potentially problematic areas were lack of motivation, planning and preparedness for becoming independent. Research on transition to independence in this group should consider assistance at an early age in planning and executing strategies for independence. In addition, the potentially difficult situation for young persons with mild SB should be investigated further. Implications for rehabilitation Children and adolescents with spina bifida might lack the motivation and skills for planning their future and health care programmes should therefore include preparations for life as an adult. Clinical assessment of the level of independence should specifically distinguish between the activities they know how to do and what tasks they actually execute independently. Routine follow-ups should include screening for problems with social and emotional adjustment. Be aware of a potential condition-severity paradox whereby those with less severe impairment might have an increased risk of developing symptoms of social and emotional problems.
Topics: Activities of Daily Living; Adolescent; Child; Disabled Persons; Female; Health Services Needs and Demand; Humans; Independent Living; Interviews as Topic; Male; Motivation; Psychiatric Status Rating Scales; Spinal Dysraphism
PubMed: 26939640
DOI: 10.3109/09638288.2016.1146355 -
BMJ Open Mar 2018Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way... (Review)
Review
INTRODUCTION
Clothing is an important aspect of nearly all human societies from performing social and cultural functions to indicating social status, a form of protection and a way for self-expression. It can help or hinder the ability to fulfil everyday activities and social roles and with the rising industry of wearable technologies, smart textiles are adding health-monitoring functions to clothing. The influence that clothing can have on the life of someone with a physical disability is significant, and further research is needed to understand it better. To achieve this, a scoping review will be performed with the aim of understanding the role of clothing in participation (ie, at home, in the community, etc) of individuals with a physical disability. This article presents the protocol and procedure to be adopted.
METHODS AND ANALYSIS
An in-depth iterative analysis of the scientific literature from six databases (MEDLINE, Embase, CINAHL, Scopus, PsycINFO and ERIC) as well as a hand search of grey literature and reference lists will be performed. After an abstract and full-text review of references by three reviewers independently, data from the selected articles will be tabulated and synthesised with a qualitative and quantitative approach using the International Classification of Functioning, Disability and Health as a unifying conceptual framework. A multidisciplinary consultation group of experts from various stakeholder groups will be involved in multiple steps to ensure validation and relevance of the data.
ETHICS AND DISSEMINATION
As this is a review involving analysis of data available in the public domain and does not involve human participants, ethical approval was not required. Results will be presented in a co-constructed format with the expert consultation group to ensure validity and maximise its practicality moving forward. Our dissemination plan includes peer-reviewed publications, presentations and stakeholder meetings.
Topics: Clothing; Disabled Persons; Humans; Qualitative Research; Social Environment; Wearable Electronic Devices
PubMed: 29523570
DOI: 10.1136/bmjopen-2017-020299 -
Journal of Medical Ethics Dec 2001The drawbacks of using the concepts of models in discussing the problems of disabled people are discussed. It is suggested that the terms "impairment", "disability", and... (Review)
Review
The drawbacks of using the concepts of models in discussing the problems of disabled people are discussed. It is suggested that the terms "impairment", "disability", and "handicap" can unify the different models and enhance the position of people with disabilities in society.
Topics: Chronic Disease; Disability Evaluation; Disabled Persons; Humans; Sick Role; Terminology as Topic; World Health Organization
PubMed: 11731599
DOI: 10.1136/jme.27.6.377 -
European Journal of Physical and... Feb 2015
The Global Disability Action Plan 2014-2021 of the World Health Organisation (WHO): a major step towards better health for all people with disabilities. Chance and challenge for Physical and Rehabilitation Medicine (PRM).
Topics: Disabled Persons; Global Health; Humans; World Health Organization
PubMed: 25634235
DOI: No ID Found -
Neurology India 2020Many neurological conditions may result in long-term disability. The measures of prevalence and mortality vastly understate the disability they cause. In the Persons...
Many neurological conditions may result in long-term disability. The measures of prevalence and mortality vastly understate the disability they cause. In the Persons with Disabilities Act 1995 (equal opportunities, protection of rights, and full participation), neurological conditions are ignored. Although Indian Disability Evaluation and Asessment Scale (IDEAS), which assesses psychiatric conditions, does include dementia as one of the neurodegenerative conditions. Additionally, according to the global burden of disease report, 33% of years lived with neurological disability and 13% of disability-adjusted life years (DALYs) are due to neurological and psychiatric disorders. In 2001, the World Health Organization (WHO) established a new definition of disability, declaring it an umbrella term with the following three major components; 1) impairments: problems in body function or structure, 2) activity limitations: difficulties encountered by a person in executing a task or action, and 3) participation restrictions: problems of involvement in life situations experienced by a person. Hence, an attempt was made to rectify the above concerns. To address the above mentioned concerns, we think that there is a need of a comprehensive format for neurological disabilities assessment which would also include objective neuropsychological assessments. As future directions, national level meetings are required to formulate 'Indian Standard Track for Assessing Neurological Disability' (I-STAND) and uniform guidelines for disability assessment in 'chronic neurological conditions' with a special focus on "neuropsychological disability".
Topics: Chronic Disease; Disability Evaluation; Disabled Persons; Female; Humans; India; Male; Nervous System Diseases; Prevalence; Quality-Adjusted Life Years
PubMed: 32129266
DOI: 10.4103/0028-3886.279709 -
Physical Medicine and Rehabilitation... Aug 2019Accuracy in measuring function related to one's ability to work is central to public confidence in a work disability benefits system. In the United States, national...
Accuracy in measuring function related to one's ability to work is central to public confidence in a work disability benefits system. In the United States, national disability programs are challenged to adjudicate millions of work disability claims each year in a timely and accurate manner. The Work Disability Functional Assessment Battery (WD-FAB) was developed to provide work disability agencies and other interested parties a comprehensive and efficient approach to profiling a person's function related to their ability to work. The WD-FAB is grounded by the International Classification of Functioning, Disability, and Health conceptual framework.
Topics: Disabled Persons; Humans; Mental Health; Motor Activity; Return to Work; United States; Work Capacity Evaluation
PubMed: 31227131
DOI: 10.1016/j.pmr.2019.03.004