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International Journal of Environmental... Apr 2023The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model...
The widely accepted model of prevention, including primary, secondary and tertiary prevention, focuses predominantly on diseases. The WHO provides a comprehensive model of health conceptualized on the basis of the International Classification of Functioning, Disability and Health (ICF). This paper develops a conceptual description of prevention aimed at functioning on the basis of the ICF model. Starting from the ICF-based conceptual descriptions of rehabilitation as a health strategy, a conceptual description of functioning prevention has been developed. Prevention aiming at functioning is the health strategy that applies approaches to avoid or reduce risks of impairing bodily functions and structures, activity limitations and participation restrictions; to strengthen the resources of the person; to optimize capacity and performance; to prevent impairments of bodily functions and structures; to prevent activity limitations and participation restrictions; to reduce contextual risk factors and barriers, including personal and environmental factors; to promote and strengthen contextual facilitators, with the goal of enabling people with impairments and people at risk of disability; and to maintain or improve the level of functioning in interactions with the environment. The proposed concept widens the scope of prevention to all aspects of functioning, including contextual factors.
Topics: Humans; Disability Evaluation; Disabled Persons; Medicine; International Classification of Diseases; Activities of Daily Living; International Classification of Functioning, Disability and Health
PubMed: 37048012
DOI: 10.3390/ijerph20075399 -
Quality of Life Research : An... Jan 2021To identify Health-related Quality of Life (HR-QoL) trajectories in a large heterogeneous cohort of people with a physical disability and/or chronic disease during and...
Trajectories of health-related quality of life among people with a physical disability and/or chronic disease during and after rehabilitation: a longitudinal cohort study.
PURPOSE
To identify Health-related Quality of Life (HR-QoL) trajectories in a large heterogeneous cohort of people with a physical disability and/or chronic disease during and after rehabilitation and to determine which factors before discharge are associated with longitudinal trajectory membership.
METHODS
A total of 1100 people with a physical disability and/or chronic disease were included from the longitudinal cohort study Rehabilitation, Sports and Active lifestyle. All participants participated in a physical activity promotion programme in Dutch rehabilitation care. HR-QoL was assessed using the RAND-12 Health Status Inventory questionnaire at baseline (T0: 3-6 weeks before discharge) and at 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. A data-driven approach using Latent Class Growth Mixture modelling was used to determine HR-QoL trajectories. Multiple binomial multivariable logistic regression analyses were used to determine person-, disease- and lifestyle-related factors associated with trajectory membership.
RESULTS
Three HR-QoL trajectories were identified: moderate (N = 635), high (N = 429) and recovery (N = 36). Trajectory membership was associated with person-related factors (age and body mass index), disease-related factors (perceived fatigue, perceived pain and acceptance of the disease) and one lifestyle-related factor (alcohol consumption) before discharge from rehabilitation.
CONCLUSIONS
Most of the people who participated in a physical activity promotion programme obtained a relatively stable but moderate HR-QoL. The identified HR-QoL trajectories among our heterogeneous cohort are disease-overarching. Our findings suggest that people in rehabilitation may benefit from person-centred advice on management of fatigue and pain (e.g. activity pacing) and the acceptance of the disability.
Topics: Chronic Disease; Cohort Studies; Disabled Persons; Exercise; Female; Health Promotion; Humans; Life Style; Longitudinal Studies; Male; Middle Aged; Quality of Life; Surveys and Questionnaires
PubMed: 32986126
DOI: 10.1007/s11136-020-02647-7 -
European Journal of Physical and... Apr 2017Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability... (Review)
Review
Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.
Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.
Topics: Disability Evaluation; Disabled Persons; Europe; Global Health; Humans; International Agencies; Physical and Rehabilitation Medicine; Societies, Medical
PubMed: 27882907
DOI: 10.23736/S1973-9087.16.04436-1 -
Life Sciences, Society and Policy Jun 2021People with disabilities face attitudinal barriers including prejudice, stereotypes, and low expectations. Many young people without disabilities may doubt that people...
People with disabilities face attitudinal barriers including prejudice, stereotypes, and low expectations. Many young people without disabilities may doubt that people with disabilities can be fulfilling partners in any loving adult relationship. The objective of the present research was to assess the willingness of non-disabled youth to engage in conjugal relationships with persons with disabilities in Wolaita Sodo town, Ethiopia. Both descriptive and explanatory study designs were used and quantitative data were collected. A self-administered questionnaire was designed and distributed to randomly selected 403 (202 females & 201 males) unmarried youth. Data analysis was undertaken using SPSS software in which both descriptive and inferential statistical techniques were utilized for data presentation. The result showed that most (85.5%) of the young people without disabilities participated in the survey were not willing to have any type of personal relationships with persons with disabilities and the main reason for 44.2% of these respondents being the fear of reaction from family members. Furthermore, it was found that the level of willingness of youth without disabilities to engage in romantic love and marital relationships was not influenced by the socio-economic status of people with disabilities. Moreover, the result of binary logistic regression analysis showed that the willingness of respondents to have marital and romantic love relationship with persons with disabilities is significantly associated to the sex (OR = 2.376; P < 0.05; 95%CI = 1.210, 4.664), raised-up area (OR = 2.512; P < 0.01; 95%CI = 1.319, 4.783), age (OR = 2.886; P < 0.05; 95%CI = 1.012, 8.228) and the presence of person with disability in the family (OR = 3.945; P < 0.01; 95%CI = 1.648, 9.442) of respondents. The findings of the present research demonstrate that people with disabilities have continued to face stereotypes and discriminations. Such stereotypes extend to assuming them as asexual and unfit to carryout roles that arise from love or marital relationships which violates the rights of PWDs to form their own family and have children. It is therefore, important to raise the awareness of young people about the differences between disability and sexuality and that physical disability has nothing to do with sexuality and relationship formation.
Topics: Adolescent; Adult; Child; Disabled Persons; Female; Humans; Love; Male; Marriage; Sexual Behavior; Sexuality
PubMed: 34154669
DOI: 10.1186/s40504-021-00114-w -
BMC Public Health Feb 2017Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses.
METHODS
Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies.
DATA EXTRACTION
Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality.
DATA SYNTHESIS
We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries.
RESULTS
There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior.
CONCLUSIONS
Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.
Topics: Disabled Persons; Health Status; Humans; Mental Disorders; Motivation; Organizational Culture; Retirement; Risk; Scandinavian and Nordic Countries; Social Support
PubMed: 28178966
DOI: 10.1186/s12889-017-4059-4 -
Journal of Rehabilitation Research and... 2012The rehabilitation counseling field has a long history of working with veterans with disabilities. This unique discipline pays special attention to person-centered...
The rehabilitation counseling field has a long history of working with veterans with disabilities. This unique discipline pays special attention to person-centered client factors and encourages a long-term team effort. Another important characteristic of the field is that each client is uniquely assessed to identify strengths and not deficits. In doing so, rehabilitation counselors work with clients to set goals based on their strengths, with the ultimate goal of a high quality of life. Advocacy is an essential part of the rehabilitation counselor's job. Counselors are strongly committed to the concepts of holistic counseling, full inclusion in society and in the counseling process, and empowerment. Rehabilitation counselors place an emphasis on the rights of individuals with disabilities to live independent, integrated lives and on collaboration between counselor and client. For persons with disabilities, the journey to full community participation has been a long one that can be described as a work in progress. The movement away from the perspective of care and protection to expectation and involvement of persons with disabilities in planning for their future is reflected in the growing use of person-centered planning strategies
Topics: Community Participation; Counseling; Disabled Persons; Health Services Needs and Demand; Humans; Military Personnel; Rehabilitation; Veterans
PubMed: 23341322
DOI: 10.1682/jrrd.2012.07.0131 -
AMA Journal of Ethics Jul 2021When disability is defined by behavior, researchers and clinicians struggle to identify appropriate measures to assess clinical progress. Some choose the reduction or...
When disability is defined by behavior, researchers and clinicians struggle to identify appropriate measures to assess clinical progress. Some choose the reduction or elimination of diagnostic traits, implicitly defining typical appearance as the goal of service provision. Such an approach often interferes with more meaningful, person-centered goals; causes harm to people with disabilities; and is unnecessary for dealing with traits that are intrinsically harmful or personally distressing, such as self-injury. Disability stakeholders should reevaluate outcome measures that seek to eliminate disability-related traits that are stigmatized but not harmful. Using autism and the emergent neurodiversity movement as a case study, this article explores ethical challenges in selecting outcome measures in behaviorally defined disability diagnoses.
Topics: Autistic Disorder; Disabled Persons; Humans; Outcome Assessment, Health Care
PubMed: 34351268
DOI: 10.1001/amajethics.2021.569 -
Journal of Rehabilitation Medicine Sep 2009To determine the effectiveness of mobility device interventions in terms of activity and participation for people with mobility limitations. (Review)
Review
OBJECTIVE
To determine the effectiveness of mobility device interventions in terms of activity and participation for people with mobility limitations.
DESIGN
Systematic review. Search of 7 databases during the period 1996 to 2008.
METHODS
Controlled studies and non-controlled follow-up studies were included if they covered both baseline and follow-up data and focused on activity and participation. Study participants had to be aged over 18 years with mobility limitations. Mobility device interventions encompassed crutches, walking frames, rollators, manual wheelchairs and powered wheelchairs (including scooter types). Two reviewers independently selected the studies, performed the data extraction, and 4 reviewers assessed the studies' methodological quality. Disagreements were resolved by consensus.
RESULTS
Eight studies were included: one randomized controlled trial, 4 controlled studies, and 3 follow-up studies that included before and after data. Two studies dealt with the effects of powered wheelchair interventions and the other studies with various other types of mobility device. Two studies were of high, internal and external methodological quality. Interventions were found to be clinically effective in terms of activity and participation in 6 studies. The results did not, however, give a unanimous verdict on the effectiveness of mobility devices in enhancing the activity and participation of mobility impaired people.
CONCLUSION
Interventions and outcome measurement methods varied between the studies; consequently, it was not possible to draw any general conclusions about the effectiveness of mobility device interventions. However, evidence was found that mobility devices improve users' activity and participation and increase mobility. A lack of high-quality research hampers conclusions about effectiveness. More original, well-designed research is required.
Topics: Activities of Daily Living; Crutches; Disabled Persons; Evidence-Based Medicine; Humans; Movement; Outcome Assessment, Health Care; Quality of Life; Self-Help Devices; Walkers; Wheelchairs
PubMed: 19774301
DOI: 10.2340/16501977-0427 -
Disability and Health Journal Oct 2020With population aging, there is a growing need to measure and monitor the wellbeing of older people, including older people with disabilities.
BACKGROUND
With population aging, there is a growing need to measure and monitor the wellbeing of older people, including older people with disabilities.
OBJECTIVE
To estimate the extent of wellbeing for individuals age 60+ in the U.S. overall and across disability status, this paper develops a measure of wellbeing at older ages that is multidimensional and disability inclusive.
METHODS
Rates of multidimensional wellbeing among American older adults overall and among older adults with disabilities were estimated using multivariate regression analysis and data from the Panel Study of Income Dynamics matched with the 2013 Disability and Use of Time Supplement. Multidimensional wellbeing was defined as the simultaneous achievement of outcomes in five dimensions: material wellbeing, health status, personal activities, social connections/relationships, and economic security.
RESULTS
Among all older adults, 33% experience multidimensional wellbeing. However, only 4-18% of older adults with disabilities experience wellbeing. Wellbeing varies across the dimensions of wellbeing for this subpopulation. Persons with disabilities experience as much wellbeing as persons without disabilities in terms of health insurance status and social connections/relationships. In contrast, for material wellbeing, health status and personal activities, older persons with disabilities less often experience wellbeing.
DISCUSSION
This paper brings to light a disability gap in the experience of wellbeing among older adults in the U.S. There is a need for research which can inform the development of policies and practices that will enhance wellbeing for older people with disabilities, including material wellbeing, health and personal activities.
Topics: Aged; Aged, 80 and over; Aging; Disabled Persons; Female; Health Status; Humans; Male; Middle Aged; United States
PubMed: 32354618
DOI: 10.1016/j.dhjo.2020.100926 -
Journal of Child Psychology and... Jul 2017Numerous style guides, including those issued by the American Psychological and the American Psychiatric Associations, prescribe that writers use only person-first...
Numerous style guides, including those issued by the American Psychological and the American Psychiatric Associations, prescribe that writers use only person-first language so that nouns referring to persons (e.g. children) always precede phrases referring to characteristics (e.g. children with typical development). Person-first language is based on the premise that everyone, regardless of whether they have a disability, is a person-first, and therefore everyone should be referred to with person-first language. However, my analysis of scholarly writing suggests that person-first language is used more frequently to refer to children with disabilities than to refer to children without disabilities; person-first language is more frequently used to refer to children with disabilities than adults with disabilities; and person-first language is most frequently used to refer to children with the most stigmatized disabilities. Therefore, the use of person-first language in scholarly writing may actually accentuate stigma rather than attenuate it. Recommendations are forwarded for language use that may reduce stigma.
Topics: Disabled Persons; Humans; Research Personnel; Social Stigma; Terminology as Topic
PubMed: 28621486
DOI: 10.1111/jcpp.12706