Showing papers on "Physical disability published in 2016"

Population prevalence of personality disorder and associations with physical health comorbidities and health care service utilization: A review.

Abstract: Personality disorder (PD), outcomes of diverse comorbid physical health conditions, and the associated burden on health service resources have seldom been studied at a population level. Consequently, there is limited evidence that might inform a public health approach to managing PD and associated mental and physical disability. A review was conducted of population-based studies examining the prevalence of PD and associations between physical comorbidities and service utilization. The prevalence of any PDs were common (4.4% -21.5%) among populations spanning England, Wales, Scotland, Western Europe, Norway, Australia, and the United States. Preliminary evidence supports associations between PDs from Clusters A and B and physical comorbidities, namely cardiovascular diseases and arthritis. PD appears to increase health care utilization, particularly in primary care. In order to facilitate rational population health planning, further population studies are required.

Relationship between Physical Disability and Depression by Gender: A Panel Regression Model

Abstract: Background Depression in persons with physical disabilities may be more common than in the general population. The purpose of this study was to examine the relationship between physical disability and depression by gender among adults, using a large, nationally representative sample. Methods This study used data from the Korean Longitudinal Study of Aging, Wave one through four, and ran a series of random effect panel regression models to test the relationship between physical disability status and depression by gender. We tested the moderating effect of gender on the relationship between disability status and depression level by examining the significance of the cross-product term between disability status and gender. Results After controlling for self-rated health, marital status, employment status, education, and age, subjects who were female or diagnosed as having any disability presented higher levels of depression scores. Further, the difference in terms of their depression level measured by Center for Epidemiologic Studies Short Depression Scale (CES-D 10) scores between those who were diagnosed as having any disability and those who were not was greater for females than for their male counterparts. Conclusion This study reaffirmed that disability is the risk factor of depression, using longitudinal data. In addition, female gender is the effect modifier rather than the risk factor. The effect of gender in the non-disability group, mostly composed of older persons, is limited. On the contrary, the female disability group showed more depressive symptoms than the male disability group. The gender difference in the disability group and the role of culture on these differences need further research.

The Disability Rate of 5-Year Post-Stroke and Its Correlation Factors: A National Survey in China.

Abstract: Few studies on long-term functional outcome have been conducted in post-stroke patients in China. The objective of this study was to conduct a nationwide survey in China to investigate the 5-year prevalence of post-stroke disability and its correlation factors. A total of 893 patients with ischemic stroke were included. Demographic, clinical and neuro-imaging information were collected with standardized instruments that assessed stroke severity, depression, cognitive impairment, stroke recurrence and physical disability. Disability was assessed with the modified Ranking Score (mRS), of which a cutoff score ≥2 indicates disability. Statistical analysis included chi-square tests, two independent samples t-tests, Mann-Whitney U test and multiple logistic regression analysis. The frequency of disability in this study population was 45%. Multivariate analyses revealed that older age, lower education level, previous history of stroke, stroke severity at admission, depression, cognitive impairment at 3 months, and stroke recurrence within 5 years follow up were all significantly associated with post-stroke disability. The disability rate in 5-year post-stroke was high in Chinese patients. Treatment of depression, secondary prevention of stroke and rehabilitation may benefit disabled patients with stroke in China.

Growing Older With a Physical Disability: A Special Application of the Successful Aging Paradigm.

Abstract: Objectives In the United States, the average age of people living with early-acquired physical disabilities is increasing. This cohort is said to be aging with disability and represents a unique population among older adults. Given recent policy efforts designed to merge aging and disability services, it is critical that models of "successful aging" include and are relevant to this population. However, many current definitions of successful aging emphasize avoidance of disability and high levels of physical function as necessary to well-being. Method In 9 focus groups, we examined perspectives of "successful aging" in 49 middle-aged and older individuals living with spinal cord injury, multiple sclerosis, muscular dystrophy, or postpolio syndrome. Transcripts were analyzed using a structured qualitative coding approach and Dedoose indexing software. Results Participants ranged in age from 45 to 80 years (M = 62) and had lived with their disability diagnosis for an average of 21 years. Analysis revealed 4 primary themes of successful aging: resilience/adaptation, autonomy, social connectedness, and physical health (including access to general and specialty healthcare). Discussion Results highlight the need for a nuanced application of the "successful aging" paradigm in this population.

Child and youth experiences and perspectives of cerebral palsy: a qualitative systematic review

Abstract: Background Cerebral palsy (CP) is one of the most common causes of physical disability in childhood, and many children with CP access rehabilitation services throughout their lives. The aim of this qualitative systematic review was to synthesize the experiences and perspectives of youth living with CP to inform the development of rehabilitation and social programmes. Methods A thematic qualitative synthesis integrating qualitative evidence was undertaken where six electronic databases (MEDLINE, Embase, Healthstar, Cumulative Index to Nursing and Allied Health Literature, Proquest and PsychInfo) were searched from 1980 to September 2014. Results Thirty-three articles involving 390 youth, aged from 2 to 25 years, across six countries were included. Themes were classified according to the International Classification of Functioning Child and Youth Version framework. Youth's accounts focused on social inclusion and the physical environment (i.e. services and supports, transportation, accessibility, accommodations, safety and weather), the role of family and peers and participation (i.e. leisure and recreation, school and civic engagement). Youth described how body structure and function (i.e. pain and physical functioning, mental health, fatigue and unpredictability of body function) affected them – often disrupting their biographies. Some youth described personal factors such as independence, coping and body image that affected their ability to cope with their condition. There was much less focus on youth's experiences of mobility, activities of daily living and assistive devices. Conclusions Youth with CP experience pain, fatigue and impairments to body function, along with social exclusion, which can affect their biographies. However, youth had strategies to revise their biographies to maintain personal and social normalcy.

“It means you are grounded” – caregivers’ perspectives on the rehabilitation of children with neurodisability in Malawi

Abstract: Purpose: Rates of childhood disability are estimated to be high in African settings; however, services to provide information and support are limited. This study aims to explore perspectives and experiences of caregivers of children with disabilities (CWD) from acquired brain injury to inform the development of training packages for health-workers (HW) in hospital settings. Methods: The study was conducted in a tertiary hospital using qualitative methods. Fourteen in-depth interviews (IDIs) were conducted with parents/carers (PC), and 10 IDIs and 4 focus-group discussions (FGDs) with HW. Data were audio-recorded, transcribed, translated and analysed using thematic approaches. Results: HWs and PCs held varying perspectives on aetiology and prognosis for CWD. HWs raised concerns about impact on families, risks of neglect and abuse. Barriers to care and support included prioritisation of acute illness, lack of HW knowledge and confidence, stigma, poor communication, focus on physical disability, and ...

Exposure to Traffic-Related Air Pollution in Relation to Progression in Physical Disability among Older Adults

Abstract: Background:Physical disability is common though not inevitable in older age and has direct bearing on a person’s ability to perform activities essential for self-care and independent living. Air po...

Purpose in Life is Associated with a Reduced Risk of Incident Physical Disability in Aging U.S. Military Veterans

Abstract: Objectives The current study evaluated the incidence and determinants of physical disability in a contemporary, nationally representative sample of U.S. military veterans. Design, Setting, Participants Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, prospective cohort study of 1,686 veterans aged 55 years and older. Waves 1 and 2 were conducted in 2011 and 2013, respectively. Measurements Potential determinants of incident disability in activities of daily living (ADL; e.g., bathing, dressing) and instrumental activities of daily living (IADL; e.g., food preparation, medication adherence) were assessed at Wave 1, and included sociodemographic characteristics, and risk (e.g., medical conditions, psychiatric distress), and protective psychosocial (e.g., psychological resilience, purpose in life) factors. Results The two-year incidence of any physical disability (ADL or IADL) among veterans aged 55 years and older was 11.5%, and the incidence of ADL and IADL disability was 3.0% and 11.4%, respectively. Older age, being married/cohabiting, and number of medical conditions—specifically, diabetes, heart attack, and chronic pain—were associated with an increased risk of any incident physical disability and incident IADL disability (adjusted odds ratio [AOR] range: 1.10–3.10). Retirement was associated with an increased risk of incident ADL disability (AOR: 7.53, 95% CI: 1.37–41.51). Purpose in life was found to be protective for incident IADL disability (AOR: 0.93, 95% CI: 0.87–0.99). Conclusions Although greater medical burden is associated with increased incidence of physical disability in U.S. veterans, results of this study suggest that initiatives designed to foster greater purpose in life may help protect against the development of physical disability in this rapidly growing segment of the population.

Barriers to breast and cervical cancer screening for women with physical disability: A review

Abstract: This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and articles not meeting the eligibility criteria, twenty-five articles were systematically and critically reviewed. Sociodemographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, health care workers, and physical barriers. Sociodemographic, health insurance, health workers, and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in health care, rather than being marginalized because of their disability.

Community-based rehabilitation for people with physical and mental disabilities in low- and middle-income countries: a systematic review and meta-analysis

Abstract: We conducted a systematic review to assess the effectiveness of community-based rehabilitation (CBR) for people with physical and mental disabilities in low- and middle-income countries, and/or the...

The effect of adaptive sports on employment among people with disabilities

Abstract: Purpose: The purpose of this study is to analyse the role of adaptive sport in predicting employment for individuals with physical disabilities. Method: This study is cross-sectional. We collected survey data on employment and other covariates including education, age, age at disability onset, veteran status and athletic classification from 140 mobility impaired athletes who play either wheelchair rugby or wheelchair basketball. Results: One hundred and thirty-one participants were studied. Our analysis shows that playing an additional year of adaptive sport is associated with an approximately 4% increase in likelihood of employment. Education and duration of disability are found to be positive predictors of employment, while veteran status and severity of injury are negative predictors of employment. Age of disability onset is not found to be a predictor of employment when other controls are included. Conclusions: This result indicates that a substantial economic benefit would result from increas...

Physical Disability and IncreasedLoneliness among Married Older Adults: TheRole of Changing Social Relations

Abstract: Examining the social context of disablement, we investigated how changes in social relations affect loneliness among married older men and women. With longitudinal data on 914 married persons from the National Social Life, Health, and Aging Project (NSHAP), we found that changes in the quality of marital and nonmarital relations moderate the effect of disability on loneliness in unexpected ways. Increases in negative marital quality buffer the effect of physical disability, while increases in nonmarital support exacerbate it. Although not predicted by existing theory, these findings are consistent with some prior work suggesting that health-related stressors, like physical disability, condition the meaning of changes in social relations. We find, however, that negative social relations ameliorate loneliness only among disabled married men; disabled married women experience increased loneliness under similar circumstances. These differences have not been previously identified. We conclude by discussing the gendered nature of the social context of disablement.

Physical Disability and Increased Loneliness among Married Older Adults: The Role of Changing Social Relations

Abstract: Examining the social context of disablement, we investigated how changes in social relations affect loneliness among married older men and women. With longitudinal data on 914 married persons from the National Social Life, Health, and Aging Project (NSHAP), we found that changes in the quality of marital and nonmarital relations moderate the effect of disability on loneliness in unexpected ways. Increases in negative marital quality buffer the effect of physical disability, while increases in nonmarital support exacerbate it. Although not predicted by existing theory, these findings are consistent with some prior work suggesting that health-related stressors, like physical disability, condition the meaning of changes in social relations. We find, however, that negative social relations ameliorate loneliness only among disabled married men; disabled married women experience increased loneliness under similar circumstances. These differences have not been previously identified. We conclude by discussing the gendered nature of the social context of disablement.

Attitudes of health service providers: The perspective of people with disabilities in the Kumasi Metropolis of Ghana.

Abstract: Introduction : Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods : A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results : The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39). Conclusion : The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.

Self-reported stigma and its association with socio-demographic factors and physical disability in people with intellectual disabilities: results from a cross-sectional study in England

Abstract: Purpose The aim of this study was to investigate whether socio-demographic variables and physical disability (e.g. sensory impairment and mobility problems) were associated with self-reported stigma in people with intellectual disabilities (ID), and to examine whether age, sex and ethnicity modified the relationship between severity of intellectual disability and self-reported stigma. Methods 229 participants with mild or moderate intellectual disabilities were recruited from 12 centres/sites in England from community intellectual disability services, day centres, supported housing schemes, voluntary organisations and invitation letters. Information on physical disability and socio-demographic variables were obtained using a structured data collection form. Self-reported stigma was measured using a validated questionnaire. Results Age was associated with self-reported stigma, with older adults reporting more stigmatising experiences. Participants with moderate intellectual disabilities were more likely to report being treated differently such as being made fun of and being treated like children. Physical disability such as sensory, mobility and speech problems were not associated with self-reported stigma. Gender modified the relationship between severity of ID and self-reported stigma as participants who were male and had moderate ID were more likely to report stigma compared to females with moderate ID. Categorical age also modified the relationship between severity of ID and self-reported stigma as older participants who had moderate ID were more likely to report stigma compared to younger people with moderate ID. Conclusions Older adults and those with moderate ID are potentially at higher risk of being targets of public stigma or are more likely to report stigma. Interventions to help individuals cope with stigma could be targeted to this group.

Assessment of physical disability using Barthel index among elderly of rural areas of district Jhansi (U.P), India.

Abstract: Introduction: The health of the elderly will be an important issue defining the health status of a population. With the rise in aged population, there is a greater need to look into their physical disability aspects, which is otherwise neglected. The rationale behind the study is to assess the physical disability of the elderly living in rural area of Jhansi. The aims of the study were to study the prevalence of physical disability among the elderly of rural area, and to find out the factors and association affecting the physical disability. Methods: A community-based cross-sectional study was carried out in a Baragaon block of rural area of Jhansi, Uttar Pradesh, India, from July 2015 to October 2015. Multistage random sampling was performed. A total of 265 participants of age 60 years and above were selected. Physical disability was assessed using Barthel index. Appropriate data entry and statistical analysis were done in EpiInfo. Frequency tables were used to calculate the prevalence, and Chi-square test was used to find out the association. Results: The overall prevalence of physical disability was 23.4%. 70% belongs to the age group from 60 to 69 years. Physical disability was significantly higher among age group >80 years. Similarly, women were more affected with physical disability than men. Conclusions: High prevalence of physical disability is the major area of concern. More extensive postdischarge health facilities to be provided to elderly.

The Relationship Between Mobility Dysfunction Staging and Global Cognitive Performance.

Abstract: OBJECTIVES To assess the relationship and the directionality between mobility and cognitive performance. METHOD A cross-sectional analysis of a racially/ethnically diverse sample of 327 community-dwelling adults (mean age=68.9±9.9 y; range, 40 to 100 y) categorized as having no mobility dysfunction, upper-extremity (UE) impairment, lower-extremity (LE) impairment, or mobility limitation (both UE and LE impairments), and compared by global cognition with multiple hierarchical linear regression adjusted for sociodemographic, health, and mood factors. A bootstrapping mediation analysis investigated the directionality of the mobility-cognition association. RESULTS LE (Est.=-2.95±0.77, P=0.001) but not UE impairment (Est.=-1.43±1.05, P=0.175) was associated with a poorer global cognitive performance/impairment. The presence of mobility limitation had the strongest effect on cognition (Est.=-3.78±1.09, P<0.001) adjusting for sociodemographic factors, body composition, comorbidities, and mood. Mediation analysis indicated that the relationship between cognition and mobility likely operates in both directions. DISCUSSION The association between cognitive function and mobility follows a dose-response pattern in which the likelihood of poor global cognition increases with the progression of mobility dysfunction, with evidence that LE impairments may be better indicators of an impaired cognitive status than UE impairments. Using brief, valid tools to screen older patients for early signs of mobility dysfunction, especially when the LE is affected, is feasible, and may provide the first detectable stage of future cognitive impairment and provide actionable steps for interventions to improve performance, reduce burden, and prevent the development of physical disability and loss of independence.

Perceptions of people living with Parkinson's disease: a qualitative study in Iran

Abstract: Aim: This study explores the primary concerns and perceptions of patients living with Parkinson's disease (PD). Method: This was an exploratory qualitative study. A purposive sample of 17 patients with PD who were attending a hospital outpatients' neurology clinic in Iran were recruited. Study data were collected through semi-structured interviews and analysed using the conventional qualitative content analysis approach. Findings: We identified the ‘fear of becoming disabled’ as a primary concern in these patients. This concern affected the physical, emotional, mental, and social aspects of their lives. The ‘fear of becoming disabled’ fell into four categories, including progressive physical disability, mental alteration, decreasing social connectedness, and self-change. Conclusion: The study results showed that older adults with PD face a number of challenges in self-care. In addition, the ‘fear of becoming disabled’ was the main concern of patients with PD, particularly in late stages of the disease.

Caregiving-specific worry, affiliate stigma, and perceived social support on psychological distress of caregivers of children with physical disability in Hong Kong.

Abstract: The present study tested a model on the relationship between functional status of children with physical disability, caregiving-specific worry, affiliate stigma, and psychological distress among their caregivers. One hundred thirty-one caregivers of children with physical disability in Hong Kong completed a self-report questionnaire. Structural equation modeling showed that the final model had good fit to the data: χ2 = 102.05, (df = 83, p = .08), comparative fit index = .98, nonnormed fit index = .98, standardized root mean square residual = .08, root mean square error of approximation = .04. Caregivers whose children had a lower functional status reported more caregiving-specific worry. Affiliate stigma had significant and positive indirect effect on psychological distress through increasing worry. Results also supported the direct and indirect effects of perceived social support in ameliorating worry, affiliate stigma, and psychological distress. Findings suggested that health care and social service providers should consider the functional impairment of each child when designing stress reduction interventions for their caregivers. Findings implicate the importance of establishing barrier-free environment and public facilities in the society. Caregivers are encouraged to distinguish those worries that are actionable and convert them into problem solving plans and to actively engage in peer support and social activities to reduce their affiliate stigma. To truly promote inclusion and well-being of individuals with disability and their caregivers, the scope and targets of social services and stigma reduction programs by the government should include not only the persons with disabilities, but also their caregivers and family members who play essential roles in the rehabilitation journey. (PsycINFO Database Record

Sexual Assistance in Italy: An Explorative Study on the Opinions of People with Disabilities and Would-Be Assistants

Abstract: Providing assistance services for sexual activity is becoming of increasing importance to the community of people with disabilities and to mental health professionals. Nevertheless, the literature on this topic is sparse. The aim of this study is to explore potential clients’ and assistants’ views, needs, experiences, opinions, and concerns about sexual assistance (SA) in Italy. Twenty-two semi-structured interviews were conducted with 12 people with a congenital physical disability and 10 would-be assistants. A Grounded Theory approach was used to analyze data. Participants with disabilities considered SA useful. Despite most of them having unfulfilled sexual needs, they would prefer to have their sexual needs met within a romantic relationship. Would-be assistants constructed themselves as people who have a “natural aptitude to being useful”. Results suggest that SA services might represent an opportunity for people with disabilities to discover new ways to satisfy their personal needs and to live more autonomously while, at the same time, allowing would-be sexual assistants to fulfill their desire to be helpful. Nevertheless, the use of SA is likely to only be a part of the answer to fulfilling the sexual needs of people with disabilities.

Effects of Telephone-Delivered Cognitive-Behavioral Therapy and Nondirective Supportive Therapy on Sleep, Health-Related Quality of Life, and Disability

Abstract: Objectives The purpose of this study was to compare the effects of cognitive-behavioral therapy delivered by telephone (CBT-T) and telephone-delivered nondirective supportive therapy (NST-T) on sleep, health-related quality of life, and physical disability in rural older adults with generalized anxiety disorder. Methods This was a secondary analysis of a randomized clinical trial on 141 rural-dwelling adults 60 years and older diagnosed with generalized anxiety disorder. Sleep was assessed with the Insomnia Severity Index. Health-related quality of life was assessed with the 36-item Short-Form Health Survey (SF-36). Physical disability was assessed with the Pepper Center Tool for Disability. Assessments occurred at baseline, 4 months, 9 months, and 15 months. Results Insomnia declined in both groups from baseline to 4 months, with a significantly greater improvement among participants who received CBT-T. Similarly, Mental and Physical Component Summaries of the SF-36 declined in both groups, with a differential effect favoring CBT-T. Participants in both interventions reported declines in physical disability, although there were no significant differences between the two interventions. Improvements in insomnia were maintained at the 15-month assessment, whereas between-group differences shrank on the Mental and Physical Component Summaries of the SF-36 by the 15-month assessment. Conclusion CBT-T was superior to NST-T in reducing insomnia and improving health-related quality of life. The effects of CBT-T on sleep were maintained 1 year after completing the treatment.

Active Videogaming in Youth with Physical Disability: Gameplay and Enjoyment

Abstract: Objective: For active videogaming (AVG) to be a meaningful, health-enhancing physical activity option for youth with physical disability, factors related to game performance and enjoyment must be understood. The objective was to explore associations between quality of gameplay, controller usage, heart rate (HR), physical function, and enjoyment during AVG play in youth with physical disability. Methods: Participants (5 girls, 11 boys, mean age 13.8 ± 2.7 years) played four AVGs on three platforms (Nintendo® Wii™, Sony PlayStation3 Move, and Microsoft Xbox® Kinect), across three sessions. Participants' primary means of mobility were manual (n = 13) and power (n = 3) wheelchairs; majority were diagnosed with cerebral palsy or spina bifida. Functional level was assessed using 17 International Classification of Functioning, Disability and Health mobility items. Participants played each AVG for 8 minutes with a 5-minute rest. Quality of gameplay and ability to use controller were recorded on a five-po...

Assessing the disability inclusiveness of university buildings in Hong Kong

Abstract: Tended to view disability inclusion as merely another mandate, building and construction practitioners have yet to recognize its value in social sustainability. In academia, similarly, it has received less attention than other building performance attributes such as environmental friendliness and indoor air quality. With rights to access now acknowledged as basic human rights, there is demand for a tool to assess building disability inclusiveness, indicating the extent to which building considerations include persons with disabilities (PWDs). This paper proposes a Building Inclusiveness Assessment Score (BIAS) to fill the existing gap. The BIAS framework comprises two hierarchies of inclusion attributes identified from literature, guides, and standards of barrier-free access and universal design. The final product consists of two building disability inclusiveness assessment tools: the Physical Disability Inclusion Sub-score (PDIS) and the Visual Impairment Inclusion Sub-score (VIIS). These are sim...