共查询到20条相似文献，搜索用时 15 毫秒
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Willi Horner-Johnson Esther L. Moe Ryan C. Stoner Krystal A. Klein Alison B. Edelman Karen B. Eden Elena M. Andresen Aaron B. Caughey Jeanne-Marie Guise 《Disability and health journal》2019,12(2):139-154
Background
Women spend most of their reproductive years avoiding pregnancy. However, we know little about contraceptive knowledge and use among women with disabilities, or about strategies to improve contraceptive knowledge and decision-making in this population.Objective
To systematically review published literature on women with disabilities and: 1) contraceptive knowledge; 2) attitudes and preferences regarding contraception; 3) contraceptive use; 4) barriers and facilitators to informed contraceptive use; and 5) effectiveness of interventions to improve informed contraceptive decision-making and use.Methods
We searched MEDLINE, PsychINFO, the Cochrane Library, CINAHL, and ERIC databases from inception through December 2017. Two reviewers independently reviewed studies for eligibility, abstracted study data, and assessed risk of bias following PRISMA guidance.Results
We reviewed 11,659 citations to identify 62 publications of 54 unique studies (total n of women with disabilities?=?21,246). No standard definition of disability existed across studies. The majority of studies focused on women with intellectual disabilities (ID). Women with ID and those who were deaf or hard-of-hearing had lower knowledge of contraceptive methods than women without disabilities. Estimates of contraceptive use varied widely, with some evidence that women with disabilities may use a narrower range of methods. Five of six studies evaluating educational interventions to increase contraceptive knowledge or use reported post-intervention improvements.Conclusions
Women with disabilities may use a more narrow mix of contraceptive methods and are often less knowledgeable about contraceptives than women without disabilities. Interventions to improve knowledge show some promise. A lack of data exists on contraceptive preferences among women with disabilities. 相似文献3.
Background
Increasing participation in recreational leisure activities (RLA) could be an effective vehicle for social inclusion and improvement - people's with disabilities health. Unfortunately, many barriers limit their participation in RLA. Interventions to improve access to RLA are often limited to therapeutic or adaptive sports in rehabilitation. Knowledge about the benefits of adaptive RLA in the community is still needed.Objective/Hypothesis
The aim of this study was to assess the benefits of adaptive RLA offered in the community for people with disabilities, and to document the facilitators and barriers to participation.Methods
This paper presents the qualitative results of a mixed-methods study. The participants were members with disabilities (n?=?19), volunteers (n?=?9), and staff members (n?=?8) of an organization offering various adaptive RLA in the community. Semi-structured interviews, focus groups, and naturalistic observations were conducted. The data were analyzed using an inductive content analysis approach.Results
Three overarching themes emerged from the analysis: 1) “Personal enrichment” illustrated the individual benefits experienced by the member with disabilities; 2) “Collective impact” represented the social benefits for the members and their communities; and 3) “Contributors to the RLA experience” concerned the facilitators and barriers to participation.Conclusions
Considering the numerous benefits of adaptive RLA, it is necessary to implement specific policies to support integrated community programs or accessible public transports to allow full participation of people with disabilities, thereby increasing their social inclusion. 相似文献4.
Colleen M. Heflin Claire E. Altman Laura L. Rodriguez 《Disability and health journal》2019,12(2):220-226
Background
Households with a disabled adult are disproportionately food insecure, yet the mechanisms linking food insecurity to disability are under-specified.Objective
To develop and empirically examine a model of the potential pathways connecting specific types of disability with food insecurity.Methods
With pooled, repeated cross-sectional National Health and Nutrition Examination Survey data (1999–2014) including 38,354 participants, we ran probit models to estimate the probability of being food insecure as a function of different sets of disability measures and our control variables. We explored the extent to which these patterns differed for prime-aged individuals (19–59) from those age 60 and older.Results
Work-limiting disabilities, functional limitations, and trouble managing money were associated with an increased likelihood of food insecurity for both prime-aged and older individuals, net of other forms of disability. Mobility limitations, trouble seeing, and trouble hearing increased the likelihood of food insecurity for prime-aged individuals only.Conclusion
These findings suggest that disabilities are associated with food insecurity through multiple pathways. Revised public health and policy solutions are needed to address the high rates of food insecurity among those with disabilities. 相似文献5.
The relation of abuse to physical and psychological health in adults with developmental disabilities
Rosemary B. Hughes Susan Robinson-Whelen Dora Raymaker Emily M. Lund Mary Oschwald Marsha Katz Albert Starr Elesia Ashkenazy Laurie E. Powers Christina Nicolaidis 《Disability and health journal》2019,12(2):227-234
Background
People with developmental disabilities are at disproportionately high risk of abuse. Although considerable evidence exists on the health-related consequences of abuse in the general population, little is known about those consequences in people with developmental disabilities.Objective
To examine the relation of abuse with psychological and physical health outcomes in adults with developmental disabilities.Methods
We used an accessible audio computer-assisted self-interview to collect anonymous data on demographic and disability characteristics, childhood and adult abuse experiences, and physical and psychological health from 350 women and men with developmental disabilities. Abuse experience was reflected by five factor scores consisting of three child abuse factors (childhood sexual abuse, childhood physical abuse, childhood disability-related abuse) and two adult abuse factors (adult sexual abuse, adult mixed abuse). We examined each of four health outcomes (depression, post trraumatic stress disorder, physical health symptoms, secondary health conditions) separately to determine the extent to which childhood and adult abuse experiences uniquely predicted psychological and physical health outcomes above and beyond demographic and disability-related characteristics.Results
All five abuse factor scores were significantly related to all four health outcomes. When examined simultaneously, childhood disability-related abuse and adult mixed abuse accounted for unique variance in outcomes. Exploratory analyses revealed no difference in the impact of abuse by gender.Conclusions
In this study, childhood disability-related abuse and adult mixed abuse significantly predicted lower levels of psychological and physical health in a sample of adults with developmental disabilities. Our findings highlight the importance of addressing abuse and its sequalae in the developmental disabilities community. 相似文献6.
Background
In recognition of the importance of services and supports that are defined and chosen by the recipient with disabilities, there has been a shift toward person-centered services. Quality person-centered services not only aim to ensure people have control over their own lives, but also to improve individually defined outcomes.Objective
The aim of this study was to explore the relationships between people with disabilities (PWD) choosing their services and their quality of life (QOL).Methods
We had two main research questions: 1) what factors predict PWD choosing their services – who was most/least likely to choose their services?; and, 2) how does choosing their services impact the QOL of PWD? To examine these questions, we analyzed Personal Outcome Measures® interviews from approximately 1100 PWD.Results
Our findings have revealed that when PWD are able to choose their services, the impact can be widespread.Conclusions
By ensuring PWD are able to choose their services, organizations are not only facilitating self-determination, but, ultimately, improving PWD's QOL. 相似文献7.
Anne C. Wheeler Amanda Wylie Adrienne Villagomez Ellen Bishop Melissa Raspa 《Disability and health journal》2019,12(2):269-277
Background
Previous research suggests that individuals with intellectual or developmental disabilities (IDD) may experience challenges accessing quality health care.Objective/Hypothesis
This study explored parent perceptions of access and quality of health care services for children with fragile X syndrome (FXS), the leading hereditary cause of intellectual/developmental disabilities.Methods
Nearly 600 primary caregivers of at least one child with FXS completed an online survey on access, barriers, and quality of health care for their family member with FXS (N?=?731).Results
In a convenience sample of well-educated and affluent caregivers, the majority did not report experiencing difficulties with access to services. Caregivers of younger children and those with lower family incomes reported greater challenges with health care access. Nearly 40% of caregivers indicated that their child's PCP was not as knowledgeable about FXS-related needs as they would prefer, indicating a possible knowledge gap on the part of providers.Conclusions
These factors represent potential barriers to quality health care for individuals with FXS, with potential lifelong effects ranging from delayed age of diagnosis to difficulty accessing a PCP in adulthood. 相似文献8.
Nicole Fran Kahn Chirayath M. Suchindran Carolyn Tucker Halpern 《Disability and health journal》2019,12(2):155-163
Background
Timing of first sex has important implications for later sexual health, but little research has considered this in populations with physical disabilities.Objective
The purpose of this paper was to examine timing of sexual experiences among populations with physical disabilities in the United States from adolescence to early adulthood, and how timing varies by biological sex, race/ethnicity, and sexual orientation. We hypothesized that those with physical disabilities would exhibit earlier initiation of each type of sexual activity compared to those without disabilities, but the degree of differences would depend on disability severity. We further hypothesized that these associations would be moderated by biological sex, race/ethnicity, and sexual orientation.Methods
Data were from 13,458 respondents to Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health. Cox proportional hazards models assessed differences in timing of vaginal, oral, anal, and first sex by disability severity.Results
Populations with the most severe physical disabilities had a significantly slower progression to first vaginal sex, oral sex, and their first sexual experience compared to those without disabilities (aHR: 0.74–0.77). Timing also differed by biological sex, race/ethnicity, and sexual orientation, though the direction and degree of these differences varied by disability severity.Conclusions
Results fill an important gap in the literature by considering variations in sexual timing among populations with physical disabilities using a longitudinal, nationally representative sample. Future research should continue to promote inclusion of populations with disabilities to inform future policies and programs for healthy sexual development. 相似文献9.
Background
The National Health Interview Survey (NHIS) is changing the annual inclusion of standardized disability identifiers, reinvigorating the priority to examine existing disability question sets. These sets include questions developed by the United States (U.S.) National Center for Health Statistics in conjunction with the U.S. Census Bureau (the American Community Survey questions, ACS) and United Nations (the Washington Group Short Set questions, WGSS), that are policy relevant, comparable across populations, and short enough to be included in censuses and surveys across countries.Objective
To compare disability prevalence estimates from federal and international standardized disability questions across demographic factors.Methods
Bivariate analysis of disability question sets asking adults about vision, hearing, ambulation, cognition, and self-care difficulties and demographic factors using secondary data from supplements in the 2010 and 2013–2015 NHIS.Results
Our study found substantial and statistically significant differences in the percentage of disabilities (overall and by type) based on comparable ACS and WGSS questions across demographic categories. Dependent on response coding, WGSS-based disability prevalence was consistently and significantly larger or smaller than ACS-based disability prevalence. Overall disability prevalence using ACS and two different WGSS response combinations were 16.3% and 9.2% or 39.4%, respectively.Conclusion
ACS and WGSS measures identify predictably different sized populations of adults with disabilities. Further, with some exceptions, ACS and WGSS questions identify populations with disabilities with relatively consistent demographic factors. Additional research is recommended to understand the comparability of disability prevalence and health disparities and inequities people with disabilities experience when using these measures. 相似文献10.
Joan Úbeda-Colomer José Devís-Devís Cindy H.P. Sit 《Disability and health journal》2019,12(2):278-286
Background
Despite the positive effects of regular physical activity (PA), university students with disabilities are less active than their able-bodied peers, which could be due to the wide range of barriers to PA that these individuals face across all social ecological levels.Objective
To identify the barriers to PA experienced by university students with disabilities at the different social ecological levels and to examine the differences in these barriers by sociodemographic variables.Methods
The reduced Spanish version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was administered to a sample of 1219 Spanish university students with disabilities. Non-parametric tests were performed to examine the differences in the barriers experienced by sociodemographic variables.Results
The most important barriers were intrapersonal (e.g. fatigue, pain, lack of motivation), followed by organizational ones (e.g. lack of adapted programs, economic cost). At the interpersonal level, the inactivity of friends and family were the main barriers. Potholes in the streets or other public spaces were found to be the most important barriers at the community level. Significant differences were found in barriers by sex, age, disability grade, congenital-acquired disability and disability type. The groups most affected by the barriers were, in general, those with multiple disabilities and higher disability grade.Conclusions
The results indicate the need for PA promotion programs to be implemented for university students with disabilities addressing the most important barriers found at each social ecological level, as well as the differences identified by sociodemographic variables. 相似文献11.
Julia Jackson Toni L. Williams Brittany M. McEachern Amy E. Latimer-Cheung Jennifer R. Tomasone 《Disability and health journal》2019,12(2):296-301
Background
Opportunities to be physically active within one's community need to be available and accessible to individuals with physical disabilities in order to increase participation; however, what constitutes quality participation within these opportunities and how exercise programs can foster quality experiences for this population have yet to be explored.Objectives
(1) To explore the participation experiences of adults with physical disabilities in a community-based exercise program from two perspectives; (2) To establish whether the participants' experiences could be understood through an existing quality participation framework.Methods
Participants were thirteen members and ten providers (i.e., coordinators, trainers, and supervisors) recruited from a community-based exercise program for adults with physical disabilities. Six focus groups (three with program members and three with each distinct group of program providers) were carried out, audio recorded and transcribed. Following an initial inductive thematic analysis, themes were deductively mapped to Martin Ginis and colleagues' (2017) conceptualization of the experiential aspects of participation.Results
Six themes (autonomy, belongingness, challenge, engagement, mastery and meaning) important for experiencing quality participation were identified and were in line with Martin Ginis and colleagues' (2017) framework.Conclusion
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. Practitioners and researchers can use the findings as a starting point for designing, implementing and evaluating programs with the goal of optimizing quality participation. 相似文献12.
Paolo Dionigi Rossi Sarah Damanti Carolina Nani Mauro Pluderi Giulio Bertani Daniela Mari Matteo Cesari Dario Consonni Diego Spagnoli 《Journal of the American Medical Directors Association》2019,20(3):373-376.e3
Objectives
To evaluate the effects of repeated cerebrospinal fluid (CSF) tap procedures in idiopathic normal pressure hydrocephalus (iNPH) patients ineligible for surgical treatment.Design
Prospective, monocentric, pilot study.Setting
University hospital.Participants
Thirty-nine patients aged 75 years and older, ineligible for shunting surgical intervention.Intervention
Repeated CSF taps.Measurements
All patients underwent a comprehensive geriatric assessment before and after each CSF tap. Adverse events were recorded.Results
No major side effect was reported. Eleven patients showed no response to the first CSF tap test and were excluded. In the remaining 28 patients, all physical and cognitive functions improved after the drainage procedures, except for continence (which seemed poorly influenced). According to clinical judgment, the mean time frame of benefit between CSF taps was 7 months. Patients withdrawing from the protocol during the clinical follow-up showed a worsening of functional and cognitive performances after the interruption.Conclusions/Implications
Periodic CSF therapeutic taps are safe, allow a better control of iNPH symptoms, and prevent functional decline in geriatric patients. 相似文献13.
P. Lievense V.S. Vacaru J. Liber M. Bonnet P.S. Sterkenburg 《Disability and health journal》2019,12(2):310-317
Background
Individuals with disabilities are at heightened risk for bullying and can lack the ability to cope in bullying situations. Teachers and caregivers have an important responsibility to promote optimal strategies for individuals with disabilities to cope with bullying. Three types of strategies have been identified: autonomy-supporting, autonomy-neutral, and autonomy-undermining strategies.Objectives
The current study investigates the effectiveness of a serious game, “Stop bullying now!”, for teachers to use in working with individuals with disabilities to enhance autonomy-promoting strategies and increase generalized self-efficacy.Methods
In this superiority parallel randomized controlled trial, we tested 150 participants in three conditions: the experimental group (n?=?62) played the serious game for 20?min, the active control group (n?=?41) read a digital information package about bullying, and the passive control group (n?=?47) read a digital information package that was not bullying related. Outcomes were measured before and after the interventions and at 4–6 weeks of follow-up.Results
The serious game significantly improved autonomy-supporting strategies post-intervention, and marginally significant effects were identified at follow-up. The experimental group did not significantly differ from the active control group, and the experimental group and the active control group showed significant improvements compared to the passive control group.Conclusions
Findings suggest that playing the serious game yields positive effects in promoting autonomy-supporting strategies compared to not receiving an intervention. The effects are comparable to reading the information based on which the game was developed. 相似文献14.
Christina Chauvenet Molly De Marco Carolyn Barnes Alice S. Ammerman 《Journal of the Academy of Nutrition and Dietetics》2019,119(3):416-424.e2
Background
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program is an important intervention for prevention and treatment of obesity and food insecurity, but participation has dropped among eligible populations from 2009 to 2015. Program satisfaction is integral to participant retention, and the retail experience is a vital component of program satisfaction.Objective
This article applies behavioral economics principles to explore the retail experience of WIC participants and ways in which it may be improved.Design
The authors designed and conducted semistructured interviews and focus groups with WIC participants.Participants/setting
A convenience sample of WIC participants aged 18 years and older were recruited through WIC clinics in Texas, North Carolina, Oregon, and Illinois (n=55, 27 participants from four focus groups and 28 individual interviews).Statistical analysis conducted
Responses were analyzed qualitatively using principles of content analysis.Results
Challenges in identifying WIC-allowable items throughout the store as well as perceived stigmatization during the checkout process were the chief complaints. Study participants described a learning curve in successful use of WIC in retail environments over time. Study participants also reported acceptance of restrictions, such as a requirement to purchase the least expensive brand.Conclusions
Dissatisfaction with the retail experience may lead to the underutilization of WIC benefits or program exit. Behavioral economics strategies that facilitate a better shopping experience, such as creating a section for WIC items in the store or improving in-store education, may improve the retail experience for WIC customers. Further research is needed to ensure such strategies are effective and do not contribute to stigma. 相似文献15.
Rocío de la Vega Ivan R. Molton Jordi Miró Amanda E. Smith Mark P. Jensen 《Disability and health journal》2019,12(2):214-219
Background
Perceived social support has been found to be associated with depression, subjective well-being and psychological health in cross-sectional studies in people with physical disabilities. No longitudinal studies have been conducted to examine these associations over time using a comprehensive measure of social support.Objective/hypothesis
We hypothesized that: (1) the amount of perceived social support would be similar across individuals with different diagnoses often associated with disability (i.e., multiple sclerosis [MS], spinal cord injury [SCI], muscular dystrophy [MD]) but (2) lower among men, relative to women, and (3) changes over time in perceived social support would be negatively associated with changes in depressive symptoms across diagnostic groups.Methods
A survey-based six-year longitudinal study. Depressive symptoms were measured with the PROMIS Depression scale. General (Total Scale), Friend, Family and Significant Other social support were measured with the Multi-dimensional Scale of Perceived Social Support (MSPSS).Results
The findings indicated no significant differences in any of the perceived social support scales as a function of diagnosis or sex. However, over the course of six years, those reporting increases in social support reported decreases in depressive symptoms, while those reporting decreases in social support reported increases in depressive symptoms.Conclusions
Changes in perceived social support are inversely related with the changes in depressive symptoms in adults with MS, SCI, and MD. Social support would be a reasonable treatment target in interventions seeking to improve psychological wellbeing in individuals with conditions that are often associated with disabilities. 相似文献16.
Teresa Botigué Olga Masot Jèssica Miranda Carmen Nuin Maria Viladrosa Ana Lavedán Sandra Zwakhalen 《Journal of the American Medical Directors Association》2019,20(3):317-322
Objective
The aim of this study was to determine the prevalence of low fluid intake in institutionalized older residents and the associated factors.Design
This was a cross-sectional study.Setting and Participants
The study was carried out at a nursing home with a capacity for 156 residents, all of whom were older than 65 years.Measures
Data were collected on the fluids consumed by each resident over a period of 1 week. Information relating to sociodemographic variables and to residents' health, nutrition, and hydration status was also collected.Results
Of 53 residents, 34% ingested less than 1500 mL/d. The factors with the greatest correlation associated with low fluid intake were cognitive and functional impairment, the risk of suffering pressure ulcers, being undernourished, a texture-modified diet, dysphagia, impaired swallowing safety, and BUN:creatinine ratio.Conclusions/Implications
The results obtained highlight the scale of low fluid intake in nursing homes and also aid to identify and understand the factors associated with this problem. The findings could help us to develop specific strategies to promote the intake of liquids and thereby reduce the incidence of dehydration in nursing homes. 相似文献17.
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Anupam Chandra Parvez A. Rahman Amelia Sneve Rozalina G. McCoy Bjorg Thorsteinsdottir Rajeev Chaudhry Curtis B. Storlie Dennis H. Murphree Gregory J. Hanson Paul Y. Takahashi 《Journal of the American Medical Directors Association》2019,20(4):444-450.e2
Objectives
Patients discharged to a skilled nursing facility (SNF) for post-acute care have a high risk of hospital readmission. We aimed to develop and validate a risk-prediction model to prospectively quantify the risk of 30-day hospital readmission at the time of discharge to a SNF.Design
Retrospective cohort study.Setting
Ten independent SNFs affiliated with the post-acute care practice of an integrated health care delivery system.Participants
We evaluated 6032 patients who were discharged to SNFs for post-acute care after hospitalization.Measurements
The primary outcome was all-cause 30-day hospital readmission. Patient demographics, medical comorbidity, prior use of health care, and clinical parameters during the index hospitalization were analyzed by using gradient boosting machine multivariable analysis to build a predictive model for 30-day hospital readmission. Area under the receiver operating characteristic curve (AUC) was assessed on out-of-sample observations under 10-fold cross-validation.Results
Among 8616 discharges to SNFs from January 1, 2009, through June 30, 2014, a total of 1568 (18.2%) were readmitted to the hospital within 30 days. The 30-day hospital readmission prediction model had an AUC of 0.69, a 16% improvement over risk assessment using the Charlson Comorbidity Index alone. The final model included length of stay, abnormal laboratory parameters, and need for intensive care during the index hospitalization; comorbid status; and number of emergency department and hospital visits within the preceding 6 months.Conclusions and implications
We developed and validated a risk-prediction model for 30-day hospital readmission in patients discharged to a SNF for post-acute care. This prediction tool can be used to risk stratify the complex population of hospitalized patients who are discharged to SNFs to prioritize interventions and potentially improve the quality, safety, and cost-effectiveness of care. 相似文献20.
Angela R. Fertig Katie A. Loth Amanda C. Trofholz Allan D. Tate Michael Miner Dianne Neumark-Sztainer Jerica M. Berge 《Journal of the Academy of Nutrition and Dietetics》2019,119(5):818-830