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Occupational Therapy International 2017This study aimed to examine the relationships between caregiving stress, depression, and self-esteem of family caregivers of an adult person with a disability and to...
This study aimed to examine the relationships between caregiving stress, depression, and self-esteem of family caregivers of an adult person with a disability and to identify their effects on their caregiving burden. The study was performed with 108 care providers of adult people with a disability who visited hospital rehabilitation centers. Caregiving stress showed a significant positive correlation with depression and with economic and psychological stress, and it showed a significant negative correlation with self-esteem. When the care provider was aged, female, and without a job and the caregiving cost and time were higher, the caregiving stress was high. When the care provider was female and had a lower income, the depression index was high. When the person with a disability was male and in the forties and the level of disability was higher, the caregiving stress was high. When the disability was related to spinal cord damage, the care provider's depression index was the highest. To reduce caregiving stress and depression in the family caregivers and to improve their self-esteem, continuous support and help from specialists are necessary. Additionally, a variety of intervention programs need to be designed to motivate them to participate regularly at the community level.
Topics: Adult; Aged; Caregivers; Depression; Depressive Disorder; Disabled Persons; Female; Humans; Male; Middle Aged; Occupational Therapy; Self Concept; Self Report; Stress, Psychological
PubMed: 29114184
DOI: 10.1155/2017/1686143 -
Canadian Medical Association Journal Jun 1965Motivating the physically handicapped individual to assist in his own rehabilitation is a complex problem. Difficulties in motivation are often based on disturbances in...
Motivating the physically handicapped individual to assist in his own rehabilitation is a complex problem. Difficulties in motivation are often based on disturbances in body image, which in turn are related both to the premorbid personality and the handicap. Treatment must be directed at the body image as well as the physical disability. Emotional disturbance following body injury should be expected and its absence is abnormal. Adequate rehabilitation entails a consideration of the effect of the rehabilitation process on the disabled person. The patient's basic abilities must be used to improve motivation. Rehabilitation procedures must focus on practical ways of coping with everyday life. Physical disability can mobilize underlying inferiority feelings and increase the need for dependency. Judicious use must be made of success and frustration in the rehabilitation program.
Topics: Adaptation, Psychological; Attitude; Body Image; Disabled Persons; Frustration; Humans; Medicine; Motivation; Physical Therapy Modalities; Psychology; Rehabilitation
PubMed: 14296008
DOI: No ID Found -
Europa Medicophysica Dec 2007In rehabilitative medicine, functional assessment means a decision process that results from the interaction between classifications (for example, diagnostic) and... (Review)
Review
In rehabilitative medicine, functional assessment means a decision process that results from the interaction between classifications (for example, diagnostic) and measures, and that aims to recognize, anticipate or modify the interaction between the disabled person and his environment. In this context, the measure is the intersection of a person along the conceptual gradient and continuum ''from less to more'' attributed to variability in the ''total person,'' such as independence, pain, cognitive capacity, or fatigability. The principal instrument is the additive questionnaire (functional scale). This consists of various items believed to represent a common variable. These kinds of variables are observable only partially across various aspects of the whole person, and are not completely predictable. Their measure, consequently, can only be derived from an estimated statistic. The additive questionnaire is the principal measurement instrument. Several items all representing the same variable receive scores whose sum is assumed to be proportional to the quantity of the underlying variable. For various reasons the sum of the scores does not represent a true linear and continuous measure like those seen in chemistry and physics. Recently developed methods, in particular Rasch analysis, can extract true measures from raw scores. Thanks to better measurement of variability in persons within rehabilitative medicine, functional assessment can become increasingly more valid and informative.
Topics: Decision Making; Disability Evaluation; Disabled Persons; Humans; Physical Therapy Modalities; Psychometrics; Rehabilitation; Surveys and Questionnaires
PubMed: 18084176
DOI: No ID Found -
Europa Medicophysica Jun 2005Transition to adulthood requires consolidation of identity, achievement of independence establishment of adult relationships and finding vocation. Those with... (Review)
Review
Transition to adulthood requires consolidation of identity, achievement of independence establishment of adult relationships and finding vocation. Those with disabilities and health problems experience difficulty in this through lack of social opportunity. There are 340,000 affected UK individuals of 16-29 years. Most, having survived childhood disability, may experience later deterioration in functional level. Most will require long term monitoring. Health needs include treatment for the complications and progression of their condition, appropriate treatment for everyday, and unrelated diseases, and health maintenance knowledge. Leaving a cohesive paediatric service and entering the uncoordinated adult health services has been described as hurtling into a void''. Therefore, number of health service models have been proposed, including the person-focussed model, a disease-focussed model, a hospital-based model, a team-based outside the health service, a named person, a voluntary organisation and a primary care model. For those with complex disabilities an interdisciplinary team comprising a consultant in Rehabilitation Medicine, (who will facilitate referral to other medical consultants) occupational therapy, speech therapy, psychology and social work input with support from physiotherapy and nursing addresses all these needs. Young Adult Teams can both teach skills, and facilitate health and other service usage. This whole area of work is under-researched. The outcomes for disabling childhood conditions must be investigated, and planning for adulthood must influence the pattern of care in childhood. The most urgent need is to set up effective services for young adults, which will help to ensure that their 50 years of adulthood have quality of life.
Topics: Adolescent; Adult; Disabled Children; Disabled Persons; Health Services Needs and Demand; Humans; Models, Theoretical; Nervous System Diseases; Psychology, Adolescent
PubMed: 16200026
DOI: No ID Found -
Sociology of Health & Illness May 2017Rehabilitation research investigating activity participation has been largely conducted in a realist tradition that under-theorises the relationship between persons,...
Rehabilitation research investigating activity participation has been largely conducted in a realist tradition that under-theorises the relationship between persons, technologies, and socio-material places. In this Canadian study we used a post-critical approach to explore activity/setting participation with 19 young people aged 14 to 23 years with complex communication and/or mobility impairments. Methods included integrated photo-elicitation, interviews, and participant observations of community-based activities. We present our results using the conceptual lens of assemblages to surface how different combinations of bodies, social meanings, and technologies enabled or constrained particular activities. Assemblages were analysed in terms of how they organised what was possible and practical for participants and their families in different contexts. The results illuminate how young people negotiated activity needs and desires in particular 'spacings' each with its own material, temporal, and social constraints and affordances. The focus on assemblages provides a dynamic analysis of how dis/abilities are enacted in and across geotemporal spaces, and avoids a reductive focus on evaluating the accessibility of static environmental features. In doing so the study reveals possible 'lines of flight' for healthcare, rehabilitation, and social care practices.
Topics: Adolescent; Canada; Communication Aids for Disabled; Communication Disorders; Disabled Persons; Female; Humans; Male; Mobility Limitation; Social Participation; Sociology; Young Adult
PubMed: 27868201
DOI: 10.1111/1467-9566.12496 -
Arthritis and Rheumatism Oct 2008To determine whether research evaluating the effectiveness of behavioral interventions for arthritis demonstrates that these interventions are effective with, and... (Review)
Review
OBJECTIVE
To determine whether research evaluating the effectiveness of behavioral interventions for arthritis demonstrates that these interventions are effective with, and appropriately utilized by, minority participants.
METHODS
A systematic review was conducted of arthritis intervention research from 1997 to 2008. For each article, information was gathered on the percentage of participants who were from different racial/ethnic groups, whether interventions were shown to be effective for minority participants, whether differential attrition analyses were conducted, whether efforts were reported in minority recruitment and retention, and whether attempts were made to make interventions culturally appropriate.
RESULTS
We identified 25 randomized intervention studies. Of these, only 2 reported on whether the intervention was similarly effective for white and black patients (equal effectiveness was found), and 6 studies reported examining differences in attrition by race (higher attrition in nonwhites was found in 1 study). Most studies did not report the percentage of participants from specific minority groups, and in many studies the percentage of minority participants was small. No studies reported making systematic efforts to assure that interventions were culturally appropriate for minority participants.
CONCLUSION
Minority patients with arthritis are at risk for higher levels of disability than white patients, but little is known about whether evidence-based interventions for arthritis are effective for culturally diverse patients. In addition, minority patients appear to be underrepresented in intervention research, and too little attention has been paid to minority recruitment and assuring that interventions are culturally appropriate for diverse patients.
Topics: Adaptation, Psychological; Arthritis; Behavior Therapy; Cultural Diversity; Disabled Persons; Humans; Minority Groups
PubMed: 18821638
DOI: 10.1002/art.24117 -
Journal of Rehabilitation Medicine Apr 2016To expand on a previous systematic review of shoulder-specific outcome measures by investigating how concepts of functioning were conceptualized and measured, using... (Review)
Review
OBJECTIVE
To expand on a previous systematic review of shoulder-specific outcome measures by investigating how concepts of functioning were conceptualized and measured, using International Classification of Functioning, Disability and Health (ICF) constructs as a reference.
METHODS
The material consisted of the linked content of 17 condition-specific measures. The distribution of the key concepts of functioning was assessed in relation to the 3 ICF levels: body level (body functions and structures), personal level (activities) and societal level (participation). Based on this cate-gorization, the concepts were further explored; body functions as to whether they were informed by any contextual information, and activities and participation as to whether they measured a person's capacity, capability or performance.
RESULTS
Seven measures assessed all 3 levels of functioning, 8 measured 2 levels, and 2 measured a single level. The majority of the 15 measures including body functions assessed a mix of decontextualized and contextualized functions. Of the 13 measures of activities, 7 measured capabilities, 4 performance and 2 used both constructs. In comparison, among the 11 measures of participation, 5 measured capabilities, 2 performance and 4 a mixture of these. No measure used the capacity construct.
CONCLUSION
Shoulder-specific outcome measures differ in their choice of measurement levels and measurement constructs. The inconsistent use of the capability and performance constructs to measure activities and participation, raise important questions about the suitability of the measures for their intended use.
Topics: Concept Formation; Disability Evaluation; Disabled Persons; Health Status; Humans; International Classification of Functioning, Disability and Health; Outcome Assessment, Health Care; Shoulder
PubMed: 26999035
DOI: 10.2340/16501977-2072 -
Wound Management & Prevention Jun 2019People with an ostomy need care appropriate to their needs and should be encouraged to adapt to their situation. In Brazil, persons with a stoma meet the legal...
UNLABELLED
People with an ostomy need care appropriate to their needs and should be encouraged to adapt to their situation. In Brazil, persons with a stoma meet the legal definition of being disabled, enabling them to access comprehensive health care services.
PURPOSE
The objective of this study was to evaluate the degree of disability experienced by persons with a colostomy.
METHODS
A cross-sectional study was conducted among people with a colostomy in one Brazilian public health service. Between May 2017 and January 2018, persons at least 18 years of age who had a colostomy for at least 3 months were eligible to participate. Sociodemographic and stoma characteristic variables were collected, and the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 was used to assesses perceived levels of disability. Higher scores indicated greater degree of difficulty. All persons with a WHODAS score ⟩0 were classified as disabled. Descriptive statistics, chi-squared, and Fisher's exact tests were used for data analysis, with a significance level of 5%.
RESULTS
Among the 58 predominantly elderly participants (29 women, 29 men; mean age 64 ± 12 years), the overall mean WHODAS score suggested a small degree of impairment (3.1 ± 7.1). The highest scores were observed in the domains (6.3 ± 16.1), (5.6 ± 17.3), and (5.3 ± 15.6). The majority of participants (41, 70.7%) had a disability score of 0 (no disability). The proportion of persons who did or did not perceive any level of disability did not differ significantly by the stoma variables assessed.
CONCLUSION
Based on the WHODAS scores, the majority of study participants did not perceive themselves as being physically disabled. Other clinical studies should advance this discussion in order to better understand the perception and reality of disability among ostomates.
Topics: Aged; Brazil; Colostomy; Cross-Sectional Studies; Disability Evaluation; Disabled Persons; Female; Humans; Male; Middle Aged; Surveys and Questionnaires
PubMed: 31373565
DOI: No ID Found -
Disability and Health Journal Jul 2019Children and youth with intellectual disabilities (ID) are known to face obstacles to physical activity participation, yet the activity patterns of this population are... (Comparative Study)
Comparative Study
BACKGROUND
Children and youth with intellectual disabilities (ID) are known to face obstacles to physical activity participation, yet the activity patterns of this population are not well characterized.
OBJECTIVE/HYPOTHESIS
In this study, time spent in moderate to vigorous physical activity (MVPA), type, and frequency of participation in physical activities were assessed in youth with ID and in a comparison group of typically developing (TD) youth.
METHODS
Weekly participation in MVPA in 38 youth with ID and 60 TD youth was assessed via accelerometry. Participants were also administered an interview about the frequency and type of physical activities they engaged in over the past year.
RESULTS
After adjusting for age and sex, youth with ID spent significantly less time in MVPA (33.5 vs. 46.5 min/day, p = 0.03) and were less likely to meet the US Physical Activity Guidelines than TD youth (6% vs. 29%, p = 0.01). Although time in MVPA was lower in youth with ID, females with ID participated in physical activities more frequently than TD females (47.1 vs. 28.2 times/month, p = 0.008) and also reported engaging in a greater variety of physical activities (7.8 vs. 5.2 activities/year, p = 0.01). No differences between males in the frequency of physical activity participation or the number of activities performed were observed. Both groups reported walking/hiking and active video as top activities.
CONCLUSIONS
Findings emphasize the need for targeted efforts to increase MVPA in youth with ID.
Topics: Adolescent; Disabled Persons; Exercise; Female; Humans; Intellectual Disability; Male; United States
PubMed: 30914263
DOI: 10.1016/j.dhjo.2019.02.006 -
Disability and Health Journal Jul 2019Disablement has been linked to compromised wellbeing in later life, but whether material resources buffer these negative effects is unclear.
BACKGROUND
Disablement has been linked to compromised wellbeing in later life, but whether material resources buffer these negative effects is unclear.
OBJECTIVE
Drawing upon conceptual models of stress and coping, we analyze experienced wellbeing data from time diary interviews with adults ages 60 and older. We expect that experienced wellbeing will be influenced by each stage of the disablement process and that higher income and wealth will buffer the negative effects of disability on experienced wellbeing. Because income is a better reflection of one's liquid resources while assets reflect lifetime accumulation, we expect income to be a more substantial buffer than assets.
METHODS
We use the Disability and Use of Time Supplement to the Panel Study of Income Dynamics (N = 1607). We consider several measures of the disablement process (activity limitations, impairment severity, duration of limiting condition) and history of work limitation and evaluate both pre-tax income and net worth quartiles. We estimate a series of multi-level regression models that account for clustering of individuals within couples. We calculate the marginal effects of disability on wellbeing at different quartiles of economic resources.
RESULTS
We find that impairment severity is associated with worse experienced wellbeing before and after adjusting for covariates, and income buffers these negative effects for those in the middle-income quartiles.
CONCLUSIONS
Future research should further explore the mechanisms through which income buffers the negative effects of impairment severity and specify the accommodations that enable economically disadvantaged and advantaged older adults alike to withstand physical declines while maintaining wellbeing.
Topics: Adaptation, Psychological; Aged; Aged, 80 and over; Disabled Persons; Female; Humans; Income; Male; Middle Aged; Quality of Life; Severity of Illness Index; Socioeconomic Factors
PubMed: 30871953
DOI: 10.1016/j.dhjo.2019.02.003