Showing papers on "Physical disability published in 2019"
TL;DR: Clinicians should determine both parent and young person commitment to a physical activity before enrolment and should be aware that teenagers may be more ready to be active as they develop greater independence and should raise awareness of the benefits of physical activity.
Abstract: Purpose: Existing research has explored the barriers and facilitators of physical activity participation for young people with disability from the perspective of young people and their families. However, little research has investigated the views of clinicians who facilitate access to physical activity programs and compared this with their child client’s perspectives.Method: Interviews were conducted with six allied health and sports development professionals associated with a programme which supports access to recreation and sporting activities. Interviews explored facilitators and barriers to physical activity experienced by their clients. Open-ended survey questions investigating barriers and facilitators of physical activity participation were also completed by 28 young people with disability aged 10–17 years who were clients of this programme.Results: The most salient facilitator of participation described by clinicians was “planning programs to promote success and inclusion.” Young people de...
78 citations
TL;DR: Depressed stroke patients are generally more disabled, however, depressed mood might not restrict improvements in physical disability during rehabilitation and recovery, although it seems to be linked to a delayed increase in the risk of poor functional outcome.
60 citations
TL;DR: Females with autism were more likely to have each additional condition than males, including intellectual disabilities, suggesting they may have more severe autism than males and adding evidence that autism may be currently underdiagnosed in more intellectually able females.
Abstract: This study investigated the comorbid conditions in a whole country population of children/young people aged 0–24 years with and without autism. Data were drawn from Scotland’s Census 2011. We calcu...
57 citations
TL;DR: Quality of life, in patients with multiple sclerosis is an issue that worries health personnel, it is essential to implement strategies for reducing the impact of the disease on patients' lives, mainly through the application of programs aimed to decrees depression and improve social support.
Abstract: Objective The aim of this work was to evaluate the quality of life of patients with multiple sclerosis and its association with depressive symptoms and physical health. Method A total of 117 patients clinically diagnosed with Multiple Sclerosis (MS) were studied. The MSQOL-54 scale was applied. The depressive symptoms were assessed using the Beck Depression Inventory (BDI), while degree of physical disability was evaluated with the EDSS (Expanded Disability Status Scale). The results of these last two instruments were associated with MSQOL-54 to determine its influence on the perception of quality of life. Results We evaluated 65 women (56%) and 52 men (44%), with a mean age of 35 years, a mean age of 27 years at the time of diagnosis, and a mean evolution of 8 years. 88% of the patients showed the relapsing-remitting subtype; 42% had paid employment; 29% of the studied patients required help to perform daily activities; 75% took disease-modifying medications. They obtained on average a score of 3.62 ± 2.30 on the EDSS and 11.5 ± 9.21 on the BDI. The general average in MSQOL-54 was 64.67 ± 17.52. Conclusions Quality of life, in patients with multiple sclerosis is an issue that worries health personnel, it is essential to implement strategies for reducing the impact of the disease on patients' lives, mainly through the application of programs aimed to decrees depression and improve social support.
44 citations
TL;DR: The results confirm the independent contribution of self-reported fatigue and SCI on work capacity and highlight the importance of assessment in clinical practice.
Abstract: Objectives:The impact of physical disability in multiple sclerosis on employment is well documented but the effect of neurological symptoms has been less well studied. We investigated the independe...
43 citations
TL;DR: Cognitive function affects the financial situation of MS patients negatively and independently of physical disability, warranting cognitive testing as a routine measure in health care services for MS patients.
Abstract: Background:In multiple sclerosis (MS), various aspects of cognitive function can be detrimentally affected, thus patients’ employment and social functioning is commonly impacted.Objective:To analys...
39 citations
TL;DR: Parents of children with chronic conditions, particularly parents ofChildren with neuromuscular disorders, cancer, and cerebral palsy, should be screened for depression and receive psychosocial services aimed at reducing these symptoms, if needed.
Abstract: Objective Caring for children with chronic health conditions is associated with stressors that may impair mental health. The goal of our meta-analysis was to analyze depressive symptoms among parents who care for a child or adolescent with chronic physical disease and/or sensory disability and/or physical disability compared with parents of healthy children or test norms. Methods A systematic search through electronic databases identified 460 relevant studies that were included in a random-effects meta-analysis. Results Parents of children with chronic conditions showed small to moderate elevations of depressive symptoms compared with parents of healthy/nondisabled children and test norms (g = .46 SD units). Twelve studies using structured clinical interviews provided a weighted mean depression rate of 20.9%. The highest elevations were found among parents of young people with neuromuscular disorders, cancer, and cerebral palsy. Elevations of depressive symptoms were greater in cases with shorter durations of the chronic condition, in mothers compared with fathers, and in parents from economically less developed countries rather than developed countries. Conclusions Parents of children with chronic conditions, particularly parents of children with neuromuscular disorders, cancer, and cerebral palsy, should be screened for depression and receive psychosocial services aimed at reducing these symptoms, if needed.
38 citations
SIDI1
TL;DR: Findings from the focus group discussions showed that barriers and facilitators of physical activity in Moroccan adolescents belonged to different levels of the social-ecological model, but most were at the individual level.
Abstract: Physical activity levels are low among adolescents in Morocco; however, the influences on physical activity behavior of adolescents have not yet been explored in a qualitative study. Here, we explored potential social-ecological barriers and facilitators of physical activity in Moroccan adolescents with the goal of developing a successful intervention program aimed at improving their physical activity level. For this study, we conducted 17 focus group discussions (100 participants, composed of 56 adolescents, 26 parents, and 18 teachers from two middle schools in Taza city, Morocco). Discussions during focus groups were facilitated by a semi-structured interview guide. Guide questions were underpinned by the social-ecological model as a theoretical framework. Data analysis was carried out by two coders using thematic analysis. We found that barriers and facilitators of physical activity in adolescents are organized into six themes that belong to different levels of the social-ecological model. Three themes belonged to the intrapersonal level (perceived motivating and limiting factors, physical activity awareness, and time constraints), two themes were classified into the interpersonal/cultural level (social support and gender and cultural norms), and one theme belonged to the environmental level (access to opportunities). Most of the themes were at the individual level, with each theme including both barriers and facilitators. Adolescent participation in physical activity can be facilitated or hampered by many factors. Results from the focus group discussions showed that these factors belonged to different levels of the social-ecological model, but most were at the individual level. Our findings have several implications. First, they may offer suggestions for a tailored intervention program aimed at improving adolescent physical activity. Second, they can improve quantitative research by enriching the battery of questions of physical activity instruments (e.g., a question related to physical disability). Third, the proposed thematic map can contribute to understanding interactions and causal pathways in the social-ecological model.
38 citations
TL;DR: Responses were women, with a high education, fully employed and living with families reported better HRQoL, particularly those with physical disability and mental problem, and there is a significant effect of comorbidity influence on the decreased HRZoL.
Abstract: Objectives To evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version. Design Data were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service. Setting A representative sample was recruited from 26 specialist outpatient clinics in HK. Participants A total of 4528 patients with hypertension aged 18 or above who responded to the survey. Intervention EQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life. Results More respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=−0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility. Conclusions Respondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.
34 citations
TL;DR: The authors conducted face-to-face interviews with 48 individuals with disabilities (hearing loss n = 11, visual impairment n = 15, and physical disability n = 22) who were drawn from four districts in the Northern Region of Ghana.
Abstract: Consistently, it has been reported that persons with disabilities face multiple challenges in societies and thus it is important that deliberate intervention programs are initiated to empower them to overcome exclusion. The United Nations has taken the lead through the Sustainable Development Goals (SDGs) project, which is a framework for assisting countries and donors in their efforts to alleviate poverty. This article documented the experiences of persons with disabilities with respect to global efforts towards poverty reduction via SDGs. Face‐to‐face interviews were conducted with 48 individuals with disabilities (hearing loss n = 11, visual impairment n = 15, and physical disability n = 22) who were drawn from four districts in the Northern Region of Ghana. Analysis of the interview data revealed common themes related to hardship, poverty, limited access to education, and underemployment. The results indicated that the SDG project engendered little tangible improvement in the lives of persons with disabilities. The need for concerted efforts to address barriers faced by individuals with disabilities is discussed extensively.
34 citations
TL;DR: The results challenge prevailing stereotypes that women over-report and men under-report health problems and highlight the importance of attending to health problems reported by women and men with equal care.
TL;DR: It is concluded that multiple sclerosis is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.
Abstract: In multiple sclerosis (MS), half of affected people are unemployed within 10 years of diagnosis. The aim of this study was to assess the economic impact of MS in adult subjects with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). A multicenter, non-interventional, cross-sectional study was conducted. The Expanded Disability Status Scale (EDSS) and the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) were used to assess disability and work performance, respectively. Only indirect costs were considered using the human capital method, including work costs. Professional support costs and informal caregivers’ costs were also estimated. A total of 199 subjects were studied (mean age: 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS). Median EDSS score was 2.0 (interquartile range: 1.0–3.5) and median MSWDQ-23 total score was 31.5 (15.2, 50.0). The number of employed subjects decreased after MS diagnosis from 70.6 to 47.2%, and the number of retired people increased (23.6%). Mean age of retirement was 43.6 ± 10.5 years. Ten percent of the population had sick leaves (absenteeism was seen in 90.9% of the student population and 30.9% of the employed population). Professional support in their daily life activities was needed in 28.1% of subjects. Costs for sick leave, work absenteeism, premature retirement and premature work disability/pensioner were €416.6 ± 2030.2, €763.4 ± 3161.8, €5810.1 ± 13,159.0 and €1816.8 ± 9630.7, respectively. Costs for professional support and informal caregiving activities were €1026.93 ± 4622.0 and €1328.72, respectively. MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.
TL;DR: This systematic review and meta-analysis confirms the association between the presence of physical disabilities and male sex, multibacillary leprosy, leproSy reactions, and lepromatous presentation and can guide the development of targeted interventions for early identification of individuals at greater risk of developing physical disabilities.
Abstract: Importance: The World Health Organization (WHO) 2016–2020 Global Leprosy Strategy aims to reinvigorate efforts to control leprosy and avert leprosy disability to less than one per million population.
Objective: This study aimed to identify systematically clinical factors associated with physical disability in patients with leprosy.
Data source: Searches were performed in Scopus, PubMed and Web of Science databases to identify studies published up to May 2018, using the keywords leprosy and physical disability and related terms.
Study selection: We included studies that evaluated patients using the WHO leprosy disability grading and reported the number of patients with and without disability by clinical characteristics.
Data Extraction and Synthesis: The study was conducted following the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) statement. We used the odds ratio (OR) as a measure of association between the clinical features and physical disability. Summary estimates were calculated using random-effects models.
Main Outcome(s) and Measure(s): Our primary outcome was physical disability according the WHO disability classification. We evaluated the association between clinical features and physical disability.
Results: Thirty-two studies were included in the systematic review. Males were more likely to have physical disability than females (pooled OR: 1.66; CI95% 1.43-1.93). Multibacillary (MB) leprosy were 4-fold more likely to have physical disability than paucibacillary (PB) leprosy 4 patients (pooled OR 4.32; CI95% 3.37-5.53). Patients having leprosy reactions were more likely to have disability (pooled OR 2.43, CI95% 1.35-4.36). Patients with lepromatous leprosy experienced 5- to 12-fold higher odds of disability.
Conclusion and Relevance: This systematic review and meta-analysis confirms the strong association between the presence of physical disabilities and male gender, MB leprosy, leprosy reactions and lepromatous presentation. These findings can guide the development of targeted interventions to identify early individuals at greater risk of developing physical disabilities and education campaigns to promote early consultation to institute treatment for leprosy reactions and to prevent physical disability.
TL;DR: Evidence from international studies clearly shows that nonviolent, positive discipline delivers better results, while any type of violence is associated with many negative one.
Abstract: Violence against children includes all forms of violence against people under 18 years old whether perpetrated by parents or other caregivers, peers, partners, teacher or strangers. This is a public health, human rights, and social problem: levels of violence against children are frightfully high and it is estimated that up to 1 billion children aged 2–17 years, have experienced a type of violence. Very few studies provided physical violence perpetrated at school but it can have a physical impact, causing psychological distress, permanent physical disability and long-term physical or mental ill-health. Children who experienced any type of violence at school may develop reactive attachment disorder, modest physical inactivity, overweight or obesity, diabetes, smoking habits, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease and other negative outcomes. Evidence from international studies clearly shows that nonviolent, positive discipline delivers better results, while any type of violence is associated with many negative one.
TL;DR: This study supports the potential benefits of a 10-day mind–body interactive exercise (Chan-Chuang qigong) program for subacute stroke inpatients and provides information that may be useful in planning adjunctive rehabilitative care for stroke inPatients.
Abstract: Background:Stroke, a medical condition that causes physical disability and mental health problems, impacts negatively on quality of life. Post-stroke rehabilitation is critical to restoring quality...
TL;DR: There is notable variability in the prevalence of sleep problems between subgroups of children with CP and objective measures (such as polysomnography or actigraphy in well-described, large, broadly recruited samples are recommended.
TL;DR: The aim was to examine the relationship between length of ICU stay and PICS among older adults receiving home care, and to identify patient characteristics increasing the odds of disability.
Abstract: Background/objectives New or worsened disabilities in functional, cognitive, or mental health following an intensive care unit (ICU) stay are referred to as post-intensive care syndrome (PICS). PICS has not been described in older adults receiving home care. Our aim was to examine the relationship between length of ICU stay and PICS among older adults receiving home care. We expected that patients in the ICU for 3 days or longer would demonstrate significantly more disability in all three domains on follow-up than those not in the ICU. A secondary aim was to identify patient characteristics increasing the odds of disability. Design Retrospective cohort study. Setting Hospitalization for sepsis in the United States. Participants A total of 21 520 Medicare patients receiving home care and reassessed a median of 1 day (interquartile range 1-2 d) after hospital discharge. Measurements PICS was defined as a decline or worsening in one or more of 16 indicators tested before and after hospitalization using OASIS (Home Health Outcome and Assessment Information Set) and Medicare claims data. Results The sample was predominantly female and white. All had sepsis, and most (81.8%) had severe sepsis. In adjusted models, an ICU stay of 3 days or longer, compared with no ICU stay, increased the odds of physical disability. Overall, the declines were modest and found in specific activities of daily living (16% for feeding and lower body dressing to 26% for oral medicine management). No changes were identified in cognition or mental health. Significant determinants of new or worsened physical disabilities were sepsis severity, older age, depression, frailty, and dementia. Conclusion Older adults receiving home care who develop sepsis and are in an ICU for 3 days or longer are likely to develop new or worsened physical disabilities. Whether these disabilities remain after the early postdischarge phase requires further study. J Am Geriatr Soc 67:520-526, 2019.
TL;DR: It was found that minimal (if any) relationship exists between perceived threat and preparedness among those who reported low levels of self-efficacy, and these findings have important implications for the design of effective interventions for individuals with disabilities.
Abstract: Although individuals with physical disabilities have special needs regarding preparedness for a natural or human-made disaster, little is known about the factors involved in motivating members of this population to engage in behaviors which reduce the probability of negative health outcomes. This study proposes and empirically tests an integrated theory-based model for individuals with physical disabilities in which perceived self-efficacy for emergency preparedness moderates the relationship between perceived threat and emergency preparedness behaviors. A nationwide convenience cross-sectional sample of 294 adults self-identifying as having a physical disability completed an online survey. The general linear model was used to assess the effects on preparedness of perceived threat, perceived self-efficacy, and their interaction. In addition to the hypothesized moderating effect of self-efficacy, it was found that minimal (if any) relationship exists between perceived threat and preparedness among those who reported low levels of self-efficacy. Results suggest that self-efficacy and perceived threat operate jointly to motivate individuals with physical disabilities to take precautionary steps to reduce the consequential adverse health effects of natural and human-made disasters. These findings have important implications for the design of effective interventions for individuals with disabilities.
TL;DR: Changes in perceived social support are inversely related with the changes in depressive symptoms in adults with MS, SCI, and MD, and would be a reasonable treatment target in interventions seeking to improve psychological wellbeing in individuals with conditions that are often associated with disabilities.
TL;DR: It is found that perceived personal and group discrimination influence self-esteem through different paths and may contribute to the design of interventions to enhance the quality of life of people with physical disabilities.
Abstract: OBJECTIVE To analyze the consequences for self-esteem of perceived discrimination against people with physical disabilities, as individuals and as a group. METHOD A structural model based on the psychosocial literature was tested in a sample of 288 Spanish participants with different degrees of physical disability. This model predicted that personal perceived discrimination would be associated with the internalization of stigma that, in turn, would be negatively associated with the self-esteem of people with physical disabilities. On the other hand, group perceived discrimination, was predicted to enhance group identification and promote intention to contribute to collective action and hence have a beneficial effect on the self-esteem of people with physical disabilities. RESULTS The model provided a good fit to the data. The relationship between personal discrimination and the self-esteem of people with physical disabilities was completely mediated by internalized stigma. The model also showed that group perceived discrimination had only an indirect effect on self-esteem. CONCLUSION This research makes two main contributions. From a theoretical perspective we found that perceived personal and group discrimination influence self-esteem through different paths. From an applied point of view, our results may contribute to the design of interventions to enhance the quality of life of people with physical disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: The results confirm the presence of multiple pathways of adjustment surrounding late-life disability, with the most common outcome being near-zero depressive symptoms for the duration of the study.
Abstract: OBJECTIVE Adjustment to chronic disability is a topic of considerable focus in the rehabilitation sciences and constitutes an important public health problem given the adverse outcomes associated with maladjustment. While existing literature has established an association between disability onset and elevated rates of depression, resilience and alternative patterns of adjustment have received substantially less empirical inquiry. The current study sought to model heterogeneity in mental health responding to disability onset in later life while exploring the impact of socioeconomic resources on these latent patterns of adaptation. METHOD Latent growth mixture modeling was utilized to identify trajectories of depressive symptoms surrounding physical disability onset in a population sample of older adults. Individuals with verified disability onset (n = 3,204) were followed across four measurement points representing a 6-year period. RESULTS Four trajectories of depressive symptoms were identified: resilience (56.5%), emerging depression (17.2%), remitting depression (13.4%), and chronic depression (12.9%). Socioeconomic resources were then analyzed as predictors of trajectory membership. Prior education and financial assets at the time of disability onset robustly predicted class membership in the resilient class compared to all other classes. CONCLUSION The course of adjustment in response to disability onset is heterogeneous. Our results confirm the presence of multiple pathways of adjustment surrounding late-life disability, with the most common outcome being near-zero depressive symptoms for the duration of the study. Socioeconomic resources strongly predicted membership in the resilient class compared with all other classes, indicating that such resources may play a protective role during the stress of physical disability onset. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: The findings suggest that healthcare services should be modified to address the psychological needs of people with different types of disability, and that disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities.
Abstract: WHAT IS KNOWN ON THE SUBJECT?: Physical appearance, as in the case of individuals with physical disabilities who use a cane, walker or wheelchair, also influence others' reactions and as a result, may lead to one's negative or positive feelings and thoughts. A disability that is not observable by others, as in the case of individuals with psychiatric disabilities (mental illnesses), may also have a negative impact on one's feelings and thoughts, due to stigma associated with psychiatric disabilities. To date, research has mainly focused on the way persons with a noticeable type of disability think about themselves. It is also important to evaluate the impact of disability type on ones' feelings and thoughts, and compare persons with visible and invisible disabilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We asked 119 adults (over the age of 18 years) with different types of disabilities to complete a set of questionnaires and found that those who had a disability that was not observable by others (a psychiatric disability) felt more negative about themselves and their body than those who had a disability that was observable by others (a physical disability). The study extends the current knowledge on the impact of disability type and its visibility on the way persons with disabilities think about themselves. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that healthcare services should be modified to address the psychological needs of people with different types of disability. Mental health nurses should identify practices in the community that will improve the feelings and thoughts of consumers with disabilities, and especially those who cope with a psychiatric disability. Abstract Introduction Individuals with disabilities often face stigma and discrimination, which may negatively affect their self-concept. To date, research has mainly focused on the psychological implications of living with a noticeable physical disability. Less attention has been given to individuals with invisible psychiatric disabilities as a stigmatized subgroup in the disability community. Aim To evaluate the impact of disability type and its visibility on the self-concept and body image. Method A cross-sectional quantitative study design was implemented to compare the self-concept and body image of individuals with visible physical disabilities and individuals with invisible psychiatric disabilities (n = 119). Pearson correlations, ANOVA and multiple linear regression models were performed. Results Individuals with invisible psychiatric disabilities reported lower levels of self-concept and body image compared to individuals with visible physical disabilities. Gender, family status and the severity level of the disability were found to be associated with self-concept and body image. Discussion The study extends the current knowledge by showing that disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities. Implications for Practice Mental health nurses should apply practices to enhance the self-concept and body image of consumers with invisible psychiatric disabilities.
TL;DR: Findings suggest that, for people with disabilities, addressing psychologically oriented secondary health conditions may be as important as functional impairment in predicting long-term social health.
Abstract: Objective Individuals living with physical disability due to early acquired or traumatic conditions often experience a range of psychological and physical health problems that are associated with their condition but are not directly caused by it. Known as "secondary health conditions," these problems can interact with existing functional limitations and other medical comorbidities to limit social participation. The current study assessed the concurrent and longitudinal associations between secondary health conditions, chronic medical comorbidities, and functional limitations, with a PROMIS® measure of social role participation. Methods A longitudinal survey study of community-dwelling adults with one of four chronic physical conditions (multiple sclerosis, muscular dystrophy, spinal cord injury, postpoliomyelitis syndrome). The baseline survey (T1) was mailed to 2041 individuals, and1862 baseline surveys were completed and returned (91% response rate). The follow-up survey (T2) was mailed roughly three years later; 1594 completed and returned the T2 survey (86% of T1 survey completers). Results Multiple linear regression analyses revealed that secondary health conditions, functional impairments, and chronic medical comorbidities accounted for 52% of the variance in satisfaction with social roles concurrently at T1. The amount of variance of change in satisfaction with social roles over the ∼3-year period accounted for by these variables was 3%. Functional limitations and more psychologically oriented secondary conditions were the strongest predictors of satisfaction with social roles. Conclusions Findings suggest that, for people with disabilities, addressing psychologically oriented secondary health conditions may be as important as functional impairment in predicting long-term social health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
TL;DR: Findings support the use of Martin Ginis and colleagues' (2017) conceptualization of quality participation within the context of community-based exercise programs for adults with physical disabilities.
TL;DR: The study results show an association between frailty and disability among elderly people in rural areas, and prevention should occur at the pre-frailty stage of a person’s life to prevent further disability.
Abstract: Background: The rapid increase in the elderly population in Korea is associated with an expanded burden of health problems. The purpose of this study was to investigate the association between frailty and physical disability among Koreans using the frailty index, which was developed to assess health conditions in elderly people. Methods: We included 503 elderly people from the Namgaram-II cohort. We used the Korean version of the Kaigo-Yobo checklist as our frailty assessment tool. For the disability assessment tool, we used the Korean version of the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12). We fit multiple linear regression models for men and women for each section. Our models also included variables for musculoskeletal diseases that are known to be associated with frailty, such as sarcopenia, osteoporosis, and radiologic knee osteoarthritis. Results: After correcting for social demographic characteristics, blood profiles, high blood pressure, and diabetes, the Kaigo-Yobo results showed a significant difference in frailty between men (1.53 ± 0.74) and women (2.60 ± 0.77), and WHODAS-12 also showed a significant difference between men (6.59 ± 5.08) and women (15.99 ± 5.70). After correcting for social demographic characteristics, blood profiles, high blood pressure, and diabetes, Kaigo-Yobo and WHODAS-12 were significantly associated with each other among both men (β = 2.667) and women (β = 3.200) (p < 0.001). Conclusions: The study results show an association between frailty and disability among elderly people in rural areas. Therefore, prevention should occur at the pre-frailty stage of a person’s life to prevent further disability. Also, disability welfare programs should be provided to elderly people who present with frailty.
TL;DR: This study confirms that rheumatoid arthritis causes impairment of all aspects of QOL (limitation of physical function, physical disability, and pain), mental health disorders (anxiety and depression), and social, environmental, and also sexual dysfunction.
Abstract: Quality of life (QOL) is a multidimensional concept that is used to describe the individuals’ perceptions, satisfaction, and evaluation of different areas of their own lives, such as physical health and functioning, psychological and emotional well-being, social roles, and relationships. Few studies have addressed the effect of rheumatoid disease on the QOL in the Egyptian community. Functional disability based on health assessment questionnaire disability index was significantly increased with the increase in disease activity based on disease activity score-28, where all patients on remission and 56% of those with low disease activity had mild functional disability. Approximately 89% of patients with low disease activity had mild anxiety based on Hamilton anxiety scale, and the majority (75%) of those patients with moderate disease activity and 83.3% of patients on remission had mild anxiety. The majority (85.7%) of those with high disease activity were depressed based on Zung self-rating depression score. Disease activity score-28 score had a positive significant correlation with health assessment questionnaire disability index (P=0.01, r=0.40), Hamilton anxiety scale-A (P=0.01, r=0.46), Zung score (P=0.01, r=0.46), and rheumatoid arthritis QOL (r=0.70, P=0.00), and negative correlation with female sexual index (r=-0.80, P=0.00), all domains of SF-36, and all five domains of WHOQOL. This study confirms that rheumatoid arthritis causes impairment of all aspects of QOL (limitation of physical function, physical disability, and pain), mental health disorders (anxiety and depression), and social, environmental, and also sexual dysfunction.
TL;DR: Despite rehabilitation services, people with physical disability experienced lower QOL in terms of the physical health, psychological, and environmental domains than did people without disability.
Abstract: The aim of this study was to compare QOL among people in India using lower-limb prostheses or orthoses with people without disability. A further aim was to compare subgroups and investigate whether QOL was associated with physical disability, gender, income, living area, and education. A cross-sectional questionnaire study in which the World Health Organization Quality of Life-Bref was used to collect self-reported data. A total of 277 participants from India were included, 155 with disability and 122 without. Group comparisons were conducted using the Mann–Whitney U and the Kruskal–Wallis tests and associations were explored using regression analyses of the four QOL domains: physical health, psychological, social relationships, and environment. Participants with physical disability scored significantly lower than did participants without disability in three of the four QOL domains, i.e., physical health, (Median 14.29 vs 16.29; p < .001) psychological, (Median 14.67 vs. 15.33; p = .017) and environment (Median13.00 vs 14.00; p = .006). For people with disability those with no or irregular income and those not attending school having the lowest QOL scores in all four domains. Education was associated with all four QOL domains and income was associated with psychological and environment. Living in urban slums was associated with a higher risk of lower QOL in three QOL domains, i.e., physical health, psychology, and environment. Despite rehabilitation services, people with physical disability experienced lower QOL in terms of the physical health, psychological, and environmental domains than did people without disability. Community-based rehabilitation programmes for prosthetic and orthotic users need to increase and improve their rehabilitation services to increase income and improve access to education. Priority could be given to those who have no or irregular income, live in urban slums, and have not attended school to further improve their QOL.
TL;DR: The overall theme that emerged was that participants experienced a lack of attitudinal and institutional preparation both from healthcare professionals and healthcare facilities, illustrated through three subthemes: lack of acknowledgment of disability, unseeing disability and physical inaccessibility.
Abstract: Objectives The aim of this study was to explore the barriers to accessing cancer services faced by adults with pre-existing physical disabilities.
Design Cross-sectional, exploratory qualitative study. Data were collected by semistructured interviews and analysed thematically.
Setting Participants were recruited through statutory and third sector organisations in England and Wales between October 2017 and October 2018.
Participants 18 people with a diagnosis of cancer and a pre-existing physical disability.
Results The findings illustrate that people with physical disabilities in England and Wales face a variety of barriers to accessing cancer services. The overall theme that emerged was that participants experienced a lack of attitudinal and institutional preparation both from healthcare professionals and healthcare facilities. This overall theme is illustrated through three subthemes: lack of acknowledgment of disability, unseeing disability and physical inaccessibility.
Conclusions As the population ages and increasing numbers of people live with cancer and disability, it is important to develop knowledge to respond to the needs of this population. The mere existence of services does not guarantee their usability. Services need to be relevant, flexible, and accessible and offered in a respectful manner. It is important that healthcare professionals work towards inclusive healthcare provision, enabling the utilisation of services by all. Necessary steps to be taken include better communication between the various professionals and across the different teams involved in patients’ care, raising awareness of how physical disability can affect or interact with cancer-related treatment and creating more accessible physical environments.
TL;DR: Higher caregiver strain in life partners of persons with mild disability due to relapsing-remitting MS was primarily associated with cognitive and neuropsychiatric problems of the person with MS.
Abstract: Background Multiple sclerosis (MS) is a chronic disorder of the central nervous system with an unpredictable disease course. Life partners often become caregivers, which can be both rewarding and challenging, as the caregiver's physical and mental health is often negatively affected. Previous studies on caregiver strain focused on caregivers of persons with MS with relatively high disability levels, while caregiver strain may already be experienced by life partners living with mildly disabled persons with MS. Objective The current study examines factors associated with caregiver strain in life partners of persons with mild disability due to relapsing-remitting MS. Methods We included 173 persons with relapsing-remitting MS (79% female; mean age 42.8 years; 90% employed; median EDSS 2.0) and their life partners. The life partners completed questionnaires on caregiver strain and neuropsychiatric and cognitive functioning of the person with MS. The persons with MS completed questionnaires about demographics, fatigue, personality, physical, cognitive and neuropsychiatric functioning, and underwent neuropsychological and neurological examinations. A linear regression analysis was conducted to examine predictors of caregiver strain. Results 24% of the life partners experienced above average levels of caregiver strain. A multivariate linear regression analysis revealed that a higher age of the person with MS (β = 0.16, p = 0.04), more physical disability (β = 0.17 p = 0.04), more cognitive and neuropsychiatric problems of the person with MS as reported by the life partner (β = 0.33, p = 0.001) and higher severity of neuropsychiatric symptoms as reported by the life partner (β = 0.32, p = 0.001) were associated with higher caregiver strain (R2 = 0.49). Conclusion Higher caregiver strain in life partners of persons with mild disability due to relapsing-remitting MS was primarily associated with cognitive and neuropsychiatric problems of the person with MS.
TL;DR: There is both a need for and interest in education in the area of pregnancy and physical disability in the Canadian Ob-Gyn residency programme, which suggests that the development of educational materials in this area should be considered to address an unmet need.
Abstract: Objectives To explore the current status to which Canadian obstetrics and gynaecology (Ob-Gyn) programmes teach residents about pregnancy in patients with physical disabilities, and to assess the level of interested in providing formal education sessions in this field. This study also assesses the residents’ perception of their knowledge and their comfort level caring for women with physical disabilities (WWPD), which will further determine the need for incorporation of this topic into the residency curriculum. Design Cross-sectional survey. Setting All Canadian English accredited Ob-Gyn residency programmes. Participants Programme directors and residents. Main outcome measures The current self-reported education and exposure Canadian Ob-Gyn residents have surrounding WWPD in pregnancy, and if there is an interest in further education in this area. Methods An online survey was developed and distributed to all Canadian English accredited Ob-Gyn residency programme directors and residents. Answers were collected over a 2-month period in 2017, which consisted of an initial email and two email reminders. Questions were in three key areas: demographic characteristics, knowledge gap and level of interest in a formal method of education. Results Eighty-four residents and nine programme directors participated in the surveys. Eighty-six per cent of residents and all programme directors responded that there are no formal scheduled training sessions on WWPD as part of the residency curriculum. Two-thirds of the residents reported being uncomfortable with the management issues surrounding a woman with a disability in pregnancy. A vast majority of residents (91.67%) and all programme directors have an interest in incorporating this topic into the residency curriculum to meet the need of pregnant women with disabilities. Conclusions This survey indicated that there is both a need for and interest in education in the area of pregnancy and physical disability in the Canadian Ob-Gyn residency programme. This information suggests that the development of educational materials in this area should be considered to address an unmet need with the ultimate goal of improving the care provided to WWPD in pregnancy. Future projects in this area should focus on content development taking into account the CanMEDS and competency-based medical education framework.