Investigating the Domains of Life Satisfaction in Middle-Aged,Late Middle-Aged,and Older Adults with a Physical Disability

Little research exists that explores which domains of life satisfaction contributed to life satisfaction among Korean older adults with a physical disability. The purpose of this study was to investigate which domains of life satisfaction predicted life satisfaction by the identified different age groups among Korean older adults with a physical disability. This study analyzed the Panel Survey of Employment for the Disabled (PSED) collected in 2015 in Korea. A total of 2331 participants were used and examined their socio-demographic status, the satisfaction of life domains (social, health, finance, leisure, work and marital), and the overall life satisfaction. The results show that marital and employment statuses play an important role in promoting the overall life satisfaction for adults and older adults with a physical disability. In addition, this study suggests that the social and leisure satisfaction of an individual are the major contribution to life satisfaction among older adults (aged 55 and over) who have a physical disability.     

Secondary conditions and women with physical disabilities: a descriptive study

OBJECTIVE: To examine secondary conditions and their relationship to life satisfaction in women with physical disabilities. DESIGN: Survey research. SETTING: Metropolitan Philadelphia. PARTICIPANTS: Women aged 18 to 65 years with self-reported functional limitations associated with neurologic, neuromuscular, brain, sensory, arthritic, spinal cord, orthopedic, or other chronic conditions. MAIN OUTCOME MEASURES: Secondary conditions, health status, functional status, and life satisfaction. RESULTS: In the past year, an average of 12 +/- 6.1 (SD) secondary conditions were experienced. Fatigue, mobility, physical deconditioning, spasticity, and joint pain were reported most frequently, followed by depression, chronic pain, access problems, weight problems, and isolation. In comparing women with multiple sclerosis (MS) and those with other disabling conditions, women with MS had higher secondary conditions problem index (SCPI) scores for bladder, bowel, and sexual dysfunction than women in the mixed disability group. Other secondary conditions with the highest SCPI scores remained similar. Self-reported emotional health status and SCPI scores were the only significant predictors of life satisfaction. CONCLUSION: Secondary conditions influence health status and quality of life for women with physical disabilities. Despite differences among disability groups in terms of the type of secondary conditions, common secondary conditions experienced by most women may be amenable to non-disability-specific health promotion programs.     

Examining the Relationship Between Self-Determination and Quality of Life in Young Adults with Autism Spectrum Disorder

Promoting self-determination (SD) in youth with disabilities is positively related to better post-secondary outcomes, such as employment and independence. Despite extensive research into SD and quality of life (QoL) for people with intellectual and developmental disabilities, the relation between the two has not been examined for young adults with autism spectrum disorder (ASD) without intellectual disability (ID). The aim of this pilot study was to examine the relationship between two complementary measures of SD, namely the Arc’s Self-Determination Scale (Wehmeyer and Kelchner 1995) and the AIR Self-Determination Scale (Wolman et al. 1994), and QoL for young adults with ASD without ID. Thirty young adults with ASD without ID living in Canada completed self-report questionnaires of SD and QoL. Correlational analyses indicated that two measures of SD were significantly associated with QoL. Regression analyses revealed that individuals with higher SD scores reported higher perceptions of life satisfaction. Thus, SD, assessed by two complementary measures, was found to be positively associated with QoL. Subsequent research should further elucidate the association between SD and QoL and examine how best to promote SD as a means of enhancing the QoL of young adults with ASD as they transition into adulthood.     

The Quality of Life of Family Caregivers of Adults with Intellectual Disabilities in Taiwan

Background Taiwanese family carers of people with intellectual disabilities not only suffer from long‐term stress but also need to cope with social difficulties. The aim of this study is to evaluate the quality of life (QOL) among family carers of people with intellectual disabilities. Materials and methods A census interview survey was conducted in Hsin‐Chu City in Taiwan and included the primary family caregivers of 792 adults with intellectual disability who were living with their families. The survey packet contained the WHOQOL‐BREF Taiwan‐version scale with four core domains and the activities of daily life/instrumental activities of daily life (ADL/IADL) scales. Results The mean score for ‘physical’ was highest and that for ‘environment’ was lowest. The strongest predictors of caregivers QOL were the caregiver's health status, their family income and the level of severity of the intellectual disability of the adult. Conclusions The results of the study support the need to expand services and individualize support to families of adults with intellectual disability living in family homes.     

Efficacy of leisure intervention groups and their impact on quality of life among people with spinal cord injury

Leisure is an important component in the lives of persons with disabilities and it is often associated with life satisfaction, self-esteem and depression. However, leisure specialists have all but ignored the leisure patterns and needs of people with disabilities. Thus this study attempts leisure intervention through groups by altering the attitude of patients towards leisure and subsequently finding out the effect on leisure satisfaction and quality of life. This study was a clinical trial conducted for patients with spinal cord injury who were evaluated using both the World Health Organization quality of life scale and the leisure satisfaction scale prior to intervention and afterwards. The experimental group had five 1 h-long group sessions as intervention while the control group had none. Twenty-five clients with paraplegia were included in both the experimental and the control groups. The mean ages of clients in both the groups were 33.40 and 37.24 years respectively. Significant improvements were observed in all domains of quality of life and leisure satisfaction in the experimental group as compared with the control group. The data show the definite impact of leisure satisfaction on quality of life. It is evident from the study that leisure intervention groups facilitate both leisure satisfaction and improved quality of life. Such an assertion definitely requires further research, corroboration and substantiation.     

Love Over Gold—The Correlation of Happiness Level with Some Life Satisfaction Factors Between Persons with and Without Physical Disability

The aim of this research was to examine levels of happiness among persons with and without physical disability, and to study prediction of happiness from satisfaction with various life aspects. A group of persons with physical disability (N = 397) and the control group of persons from the general population (N = 913) filled in the Fordyce instrument (Social Indicators Research, 20:355–381, 1988) to evaluate levels of happiness and the “International Well-being Index” to measure satisfaction with particular life aspects. Both groups expressed positive happiness level and satisfaction with the majority of life aspects. However, happiness level of persons with disability was significantly lower. Forty-eight percent of the variance in happiness among persons with disability and 30% of the variance in happiness among the control group can be assigned to various life satisfaction aspects. Satisfaction with health, relationships, and achievements contribute to happiness in both groups, while satisfaction with physical safety and acceptance by the community are significant happiness predictors only for persons with disability. Economic status is the only significant predictor for the control group.     

Development of the Guernsey community participation and leisure assessment—Revised (GCPLA-R)

A sufficiently psychometrically robust measure of community and leisure participation of adults with intellectual disabilities was not in existence, despite research identifying this as an important outcome and a key contributor to quality of life. The current study aimed to update the Guernsey Community Participation and Leisure Assessment (GCPLA). Adults with intellectual disabilities, carers and experts were consulted in creating a revised pool of 46 items. These were then tested and data from 326 adults with intellectual disabilities were analysed for their component structure and psychometric properties. Principal component analysis discovered a stable set of components describing seven different clusters. This revised measure (the GCPLA-R) was demonstrated to have satisfactory reliability, and scores were related to challenging behaviour and adaptive behaviour in theoretically consistent ways and were correlated with scores on comparable measures.     

兰州市城关区残疾人生存质量的影响因素解析

目的：研究兰州市城关区残疾人生存质量，为加强城关区残疾人保障体系建设提供基线资料和询证。方法：采用多阶段分层整群抽样抽取兰州市城关区登记在册的606例残疾人，首先使用世界卫生组织残疾人生存质量量表、残疾态度量表、残疾人照顾质量量表和自编基本情况问卷以面访或指导自填形式完成，其次通过拟合生存质量影响因素结构方程模型构建多维度残疾人生存质量综合评价体系，从残疾严重程度、残疾照顾护理质量和残疾态度3个方面探讨对生存质量的综合作用。结果：城区残疾人生存质量量表评分(40.76±14.79)分，不同人口学特征残疾人间生存质量评分有统计学差异(P<0.05)；本组残疾人残疾态度总分(55.31±14.58)分、残疾人护理质量总分(50.33±11.25)分；结构方程模型分析结果显示，残疾态度、残疾严重程度、护理质量对兰州市城区残疾人生存质量的总效应分别为0.36、-0.23、0.49，残疾严重程度通过影响护理质量和残疾态度产生间接作用。结论：研究发现兰州市城关区残疾人生存质量水平较低，受自身、家庭和社会，生理和心理以及社会保障制度等各方面影响，应针对性加强残疾人福利救助体系建设。     

Quality of life of older adults in Canada and Brazil

In this study, we examined the factors contributing to quality of life (QOL) of older adults in regions of Canada and Brazil. The WHOQOL-BREF and a demographic data sheet were administered to random samples of 202 older adults from Canada and 288 from Brazil. Ratings on overall QOL and on the physical, psychological, and environmental domains were higher in the Canadian sample. Social domain scores were not significantly different. The authors found the same pattern of factors (health satisfaction, enough money, meaning in life, and opportunities for leisure activities) contributed to the variance of QOL in both countries, except for physical environment, which was significant in Brazil and not in Canada. Health satisfaction was the strongest contributor to QOL in both samples, and satisfaction with personal relationships was not significant in either country.     

The importance of leisure in the lives of persons with congenital physical disabilities.

Although occupational therapists emphasize a balance among the three occupational areas of self-care, productivity, and leisure in people's lives, leisure often is focused on less than the other areas in both the research literature and clinical practice. Very little research has been conducted on the benefits of leisure activities in adults with congenital disabilities. The information contained in this article is a secondary analysis of the interview protocols of nine adults (30-50 years of age) with either cerebral palsy or spina bifida. The primary purpose of the interview was to determine protective processes surrounding turning points in the lives of persons with disabilities. This secondary analysis allowed us to determine the benefits and meaning of leisure for this population. Consistent with literature that focused on either persons without disabilities or persons with acquired disabilities, the participants in the present study reported that involvement in leisure activity provides mental and physical health benefits, enjoyment, opportunity to develop a self-concept and increase self-esteem, and opportunities to build and enhance social relationships. All these benefits enable people to find meaning in life through doing, belonging, and understanding self in the context of their worlds.     

Promoting Leisure Physical Activity Participation among Adults with Intellectual Disabilities: Validation of Self‐Efficacy and Social Support Scales

Background Many individuals with intellectual disabilities are not sufficiently active for availing health benefits. Little is known about correlates of physical activity among this population on which to build health promotion interventions. Materials and Methods We developed scales for measurement of self‐efficacy and social support for leisure physical activity among adults with intellectual disabilities. Study participants were 152 adults with mild to moderate intellectual disabilities. Results The scales demonstrated good internal consistency and fair to excellent test–re‐test reliability. Confirmatory factor analyses revealed good fit for each of the scales, supporting the hypothesized structure of each. Scales also correlated with self‐reported leisure physical activity, providing evidence of construct validity. Conclusions Studies of physical activity correlates are needed to formulate evidence‐based programmes to promote physical activity participation. This measure demonstrated good psychometric properties, and will be useful for examining social support and self‐efficacy for physical activity by adults with intellectual disabilities.     

Secondary conditions and life satisfaction among polio survivors.

Persons living with the effects of polio are often at increased risk for the development of secondary conditions and disabilities that can lead to further decline in health status, independence, functional status, life satisfaction, and overall quality of life. The purpose of this study was to explore the frequency of selected secondary conditions, factors associated with these conditions, and the relationship between secondary conditions and quality of life among polio survivors. Data from a large convenience sample (N = 2,153) indicate that secondary conditions are prevalent and associated with decreased life satisfaction. Prompt identification and treatment of secondary conditions before they progress to greater impairment and/or disability and attention to an overall healthful lifestyle is important to preserve function and maintain quality of life of polio survivors.     

Pain measurement in persons with intellectual disabilities

OBJECTIVE: The goal was to study the utility of nonverbal facial expressions as a research tool for assessing pain in persons with intellectual disabilities. Biases and stereotypes related to age, gender, physical attractiveness, and intellectual disability that may influence the ability of observers to evaluate pain reactions were also examined. DESIGN: Facial reactions to an intramuscular injection of 40 adults (mean age = 49.6 years) with an intellectual disability were videotaped and objectively examined using the Facial Action Coding System. Self-reported pain ratings were obtained using a Colored Visual Analogue Scale for pain. Pain reactions were also rated by untrained observers. RESULTS: A significant proportion of participants (35%) was unable to provide valid self-report. The intensity of objectively coded facial activity as well as observer-rated pain intensity showed significant increases from baseline to injection segments. Observers' pain ratings were primarily determined by the intensity of facial activity and were not significantly affected by stereotypes based on perceived level of intellectual disability, gender, age, or physical attractiveness. CONCLUSIONS: The findings support the validity of both objectively coded and observer-rated facial expressions of pain as research tools in treatment outcome studies involving persons with intellectual disabilities. Self-report has substantial limitations for the assessment of pain in this population.     

Knowledge, personal risk and experiences of HIV/AIDS among people with disabilities in Swaziland

Although there has been research focused on the disabling consequences of HIV/AIDS, there has been very little documented information about HIV/AIDS for individuals with disability prior to infection. There is evidence to suggest that people with disabilities face inequalities in accessing health information and services. The aim of this study was to explore whether disabled and non-disabled young adults in Swaziland perceive HIV/AIDS similarly. A qualitative study using focus-group discussions was conducted. Four focus groups were conducted with a total of 56 non-disabled adults (aged 16-29 years) and four focus groups were conducted with a total of 32 adults with either a physical or hearing disability (aged 18-32 years). The focus-group schedule explored knowledge about HIV/AIDS, personal risk and experiences of health-seeking practices. Information and awareness about HIV/AIDS was good in both rural and urban areas among the non-disabled participants, who obtained their information from a wide range of sources. In contrast, participants with disability, who obtained information about HIV/AIDS from a limited range of sources, lacked knowledge about HIV/AIDS and were misinformed about modes of transmission. Women with disabilities described experiences of sexual exploitation and abuse, which was perceived to be higher among disabled women than their non-disabled peers; they felt this was because disabled women were perceived to be 'free' from the HIV virus by non-disabled men. Further research is necessary to enable HIV/AIDS programmes to address the specific needs of people with disabilities.     

Physical impairment and disability: relationship to performance of activities of daily living in community-dwelling older men

BACKGROUND AND PURPOSE: The decline of physical function of older adults, associated with loss of independent living status, is a major public health concern. The purpose of this study was to examine the relationship of physical impairment and disability to performance of activities of daily living (ADL) among community-dwelling older adults. SUBJECTS AND METHODS: Eighty-three community-dwelling older men who were referred to a comprehensive outpatient geriatric evaluation program (mean age=75.5 years, SD=7.0, range=64-97) were examined. Measurements of physical impairment (muscle force production, flexibility, and fitness) and physical disability (gait speed, stride length, risk for recurrent falls, and physical function) were recorded. RESULTS: A stepwise linear regression was used to determine the relationship of physical impairments and disability measures with ADL. The results indicated that walking speed, fall risk, and muscle force contributed independently to the characterization of the activities of daily living of the community-dwelling older men studied (adjusted R2=.68; F=56.81; df=3,80; P<.001). Using a principal components factor analysis, 4 domains were identified that explained 68.2% of the variance in performance of ADL: (1) mobility/fall risk=26.5%, (2) coordination=15%, (3) fitness=14.7%, and (4) flexibility=12.0%. DISCUSSION AND CONCLUSION: The identification of domains of physical function may be useful to physical therapists in the development of interventions targeted for physical impairments and disabilities that contribute to deficits in performance of ADL. Targeting interventions for physical impairments and disabilities related to function may improve the effectiveness of physical therapist interventions and reduce the loss of independence among community-dwelling older people.     

Disability and race: a comparative analysis of physical activity patterns and health status

Purpose: Minority groups, specifically African Americans (AAs), are more likely to be physically inactive than the general population. Although the aforementioned finding is well documented, there is a dearth of literature that examines levels of physical activity among AA adults with disabilities. The purpose of this article was to study the patterns of physical activity and health status among AA adults with disabilities in comparison with their White counterparts. Methods: Data from the Centers for Disease Control and Preventions 2007 Behavioral Risk Factor Surveillance System survey were used to conduct comparative analyses of physical activity patterns and health status among 7315 AAs and 82?482 Whites who self-reported a disability. Results: Significant differences (p < 0.05) were found between health status and physical activity patterns across racial groups. AAs with disabilities were less likely to engage in moderate and vigorous physical activity than their White counterparts. AAs were also less likely to engage in physical activity as health status declined in comparison with White respondents. Conclusion: When considering the health of minorities with disabilities, physical activity must be central to improving their health status. The authors of this study provide additional support for developing unique health programming for AAs with disabilities. Rehabilitation and health care professionals can gain insight into lifestyle patterns of minorities with disabilities, which can be useful in addressing health behaviors that may be counter to physical well-being.

Implications for Rehabilitation

• African Americans with disabilities tend to report poorer health status and engage in less moderate and vigorous physical activity, even as health status decline, than their White counterparts.

• The use of a multilayered approach incorporating culturally tailored programming would be useful in improving health and physical activity outcomes of African Americans with disabilities.