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1.
Mónica Pinilla-Roncancio 《Disability and health journal》2018,11(3):398-404
Background
Disability and poverty are interconnected and although this relationship has been recognised, there is a lack of empirical evidence to support any possible causal relationship in this topic, particularly in the context of Latin America (LA).Hypothesis
This study tests the hypothesis “Disability increases the risk of multidimensional poverty of people living with disabilities and their families”.Methods
Using national census data from Brazil, Chile, Colombia, Costa Rica and Mexico, the Global Multidimensional Poverty Index (Global MPI) was calculated with the aim of measuring and comparing the levels of multidimensional poverty of people living in households with and without disabled members in the five countries.Results
We found that in the five countries people with disabilities and their families had higher incidence, intensity and levels of multidimensional poverty compared with people living in other households. Their levels of deprivation were also higher for all the indicators included in the Global MPI and the contribution of this group to the national MPI was higher than their share of the population, thus people with disabilities and their families are overrepresented in those living in multidimensional poverty.Conclusions
People with disabilities and their families are in worse conditions than poor households without disabled members and social policies should aim to reduce their high levels of multidimensional poverty and deprivation. 相似文献2.
Background
Evidence suggests there is an association between depressive symptoms and disability.Objective/Hypothesis
The objective of this study was to examine whether people with disabilities in the United Kingdom and Greece face more depressive symptoms than people without disabilities. The hypothesis was that people with disabilities in both countries are more likely to experience depressive symptoms.Methods
We used data from the 2014 European Health Interview Survey (wave 2). After performing principal-component factor analysis, we carried out logistic regressions, in order to investigate differences in depressive symptoms between people with and without disabilities, and examine the factors affecting depressive symptoms for people with disabilities.Results
People with disabilities in the UK were 2.8 times more likely to experience depressive symptoms compared to people without disabilities (95% C.I.: 2.51–3.05, p?<?.001), while in Greece, they were 2.2 times more likely to do so (95% C.I.: 1.90–2.64, p?<?.001). Our findings regarding people with disabilities showed that women, older people (in Greece), unemployed and inactive people (in Greece), and better-educated people (in the UK) were more likely to experience depressive symptoms. Married people, older people (in the UK), people living in densely-populated areas (in Greece), people who assessed their health as ‘average’ or ‘good’, and people who enjoyed social support (in Greece) were less likely to face depressive symptoms.Conclusions
Due to population-ageing and higher incidence of depressive symptoms in disabled people, it is important that policies are put in place to address the mental health needs of this population. 相似文献3.
Megan Armstrong Christopher Morris Charles Abraham Mark Tarrant 《Disability and health journal》2017,10(1):11-22
Background
Children with disabilities are often the target of prejudice from their peers. The effects of prejudice include harmful health consequences. The Contact Hypothesis has previously shown to promote positive attitudes towards a range of social groups.Objective
To conduct a systematic review and meta-analysis on the effectiveness of school-based interventions for improving children's attitudes towards disability through contact with people with disabilities.Methods
A comprehensive search was conducted across multiple databases. Studies were included if it evaluated an intervention that aimed to improve children's attitudes towards disability and involved either direct (in-person) or indirect (e.g., extended) contact with people with disabilities. Data were synthesised in a meta-analysis.Results
Twelve studies met the inclusion criteria. Of these, 11 found significant effects: six used direct contact, two used extended contact, two used parasocial (media-based) contact and one used guided imagined contact. One parasocial contact intervention found no significant effects. Three meta-analyses showed direct contact (d = 0.55, 95% CI 0.20 to 0.90) and extended contact (d = 0.61, 95% CI 0.15 to 1.07) improved children's attitudes; there was no evidence for parasocial contact (d = 0.20, 95% CI -0.01 to 1.40).Conclusions
Direct, extended, and guided imagined contact interventions are effective in improving children's attitudes towards disability; there was no evidence for parasocial contact. 相似文献4.
Background
According to prior studies, it is possible to consider the emergency care utilization due to ambulatory care sensitive conditions (ACSCs) as a proxy measure of access to primary care but there was no confirmed study among people with disabilities.Objective/Hypothesis
We examined overall emergency department (ED) utilization patterns among people with disabilities compared with the general population and estimated factors affecting ED utilization. Additionally, we examined whether there were any differences in ED visits due to ACSCs according to type and severity of disability.Methods
The nationally representative Korean Health Panel Survey was used. Data from 14,616 individuals who participated in the survey from 2008 to 2012 were analyzed. The frequency and causes of emergency visits were examined between individuals with and without disabilities. A generalized regression model with Poisson distribution was applied to identify factors that affect ED visits.Results
In 2012, people with disabilities were about two times as likely to visit the ED compared to people without disabilities, and people with external disability represented the largest proportion of people with disabilities. According to generalized linear model, disability was a strong predictor of ED visits, along with lower education level, being elderly, having a chronic disease, and being less healthy. Overall, ED visits due to ACSCs were about three times higher in the disabled group than in the non-disabled group.Conclusions
Public health authorities should consider strengthening the primary care system to avoid unnecessary and preventable ED utilization among all Korean people, including people with disabilities. 相似文献5.
Andrea C. Betts Katherine Froehlich-Grobe Simon Driver Danielle Carlton M. Kaye Kramer 《Disability and health journal》2018,11(2):315-323
Background
People with impaired mobility (IM) disabilities have a higher prevalence of obesity and obesity-related chronic conditions; however, lifestyle interventions that address the unique needs of people with IM are lacking.Objective
This paper describes an adapted evidence-based lifestyle intervention developed through community-based participatory research (CBPR).Methods
Individuals with IM, health professionals, disability group representatives, and researchers formed an advisory board to guide the process of thoroughly adapting the Diabetes Prevention Program Group Lifestyle Balance (DPP GLB) intervention after a successful pilot in people with IM. The process involved two phases: 1) planned adaptations to DPP GLB content and delivery, and 2) responsive adaptations to address issues that emerged during intervention delivery.Results
Planned adaptations included combining in-person sessions with conference calls, providing arm-based activity trackers, and adding content on adaptive cooking, adaptive physical activity, injury prevention, unique health considerations, self-advocacy, and caregiver support. During the intervention, participants encountered numerous barriers, including health and mental health issues, transportation, caregivers, employment, adjusting to disability, and functional limitations. We addressed barriers with responsive adaptations, such as supporting electronic self-monitoring, offering make up sessions, and adding content and activities on goal setting, problem solving, planning, peer support, reflection, and motivation.Conclusions
Given the lack of evidence on lifestyle change in people with disabilities, it is critical to involve the community in intervention planning and respond to real-time barriers as participants engage in change. A randomized controlled trial (RCT) is underway to examine the usability, feasibility, and preliminary effectiveness of the adapted intervention. 相似文献6.
Catherine Ipsen Cathy Chambless Noelle Kurth Sara McCormick Rebecca Goe Jean Hall 《Disability and health journal》2018,11(3):447-450
Background
Disability prevalence estimates are used to identify populations, establish priorities and allocate funding for a broad range of federal, state, and local initiatives. Increasingly, these estimates are based on a set of six questions developed and tested for use in the American Community Survey (ACS). A key assumption about the ACS disability screeners is that they sufficiently capture the entire population of people with disabilities, but some studies indicate that certain disability groups are underrepresented.Objectives
The objective of this study is to explore potential underrepresentation of certain disability groups identified by the ACS disability questions.Methods
We compared disability prevalence rates from two data sources for adolescents with disabilities, aged 14 to 16, who receive Supplemental Security Income (SSI, n = 2051). The Social Security Administration (SSA) provided disability determination data for each adolescent, and adolescents (or proxy-rater) provided baseline self-report data about functional limitation based on the six ACS disability questions.Results
Approximately 17% of the sample did not endorse any ACS questions. Excluding SSA categories with cell counts less than 10, the top five conditions not captured by ACS questions included respiratory conditions (38%), mood disorders (28%), other mental disorders (27%), schizophrenic and other psychotic disorders (27%) and developmental disorders (20%).Conclusions
Our findings suggest that people with mental health and developmental disabilities and those with respiratory conditions are among those groups under-represented by the ACS disability questions. Changes or additions to ACS questions should be considered to ensure that all disability groups are addressed in public health planning. 相似文献7.
Carli Friedman 《Disability and health journal》2018,11(3):351-358
Background
The Personal Outcome Measures® is a person-centered tool to measure the quality of life (QOL) of people with disabilities, especially those who receive long term services and supports. While the outcomes examine people's satisfaction with their lives in a wide range of areas, the organizational supports determine if service agencies are appropriately supporting people with disabilities to ensure people with disabilities have the best possible QOL. The Personal Outcome Measures® has been administered to tens of thousands of people with disabilities and older adults over its twenty-five years of existence.Objective
In order for the Personal Outcome Measures® to adequately measure the QOL of people with disabilities, it must continuously be refined in alignment with the advances made by people with disabilities, and the disability service system. Therefore, the purpose of this study was to re-validate the Personal Outcome Measures®.Methods
A Principal Components Analysis was used to analyze data from 1473 people with disabilities to determine if any indicators needed to be removed as well as the underlying structure of the Personal Outcome Measures®.Results
The analysis revealed the Personal Outcome Measures® has construct validity. It also found that the 21 indicators fall into five underlying factors: my human security; my community; my relationships; my choices; and, my goals.Conclusions
Taken together these twenty-one indicators and five factors represent a multifaceted and comprehensive QOL assessment that aims to improve the lives of people with disabilities. 相似文献8.
Background
People with disabilities experience mental health disparities and higher rates of violence compared to people without disabilities. Few studies have examined the psychological consequences of violence against people with disabilities, and whether they differ from those experienced by people without disabilities.Objective
This study compared psychological consequences of violence among men and women with and without disabilities.Methods
We analyzed data from the 2008–2014 waves of the National Crime Victimization Survey. Multiple logistic regressions were estimated to compare the psychological impact of violent crime on respondents without disabilities to those with disabilities, who comprised roughly 20% of the sample (n?=?8,070). We stratified by gender to compare the effects of violence experienced by men and women.Results
Men with disabilities were more likely than men without disabilities to report severe distress (AOR?=?2.07, p?<?0.001), anxiety (1.79, p?<?0.001), depression (2.32, p?<?0.001), and anxiety and depression (2.34; p?<?0.001), but were less likely to experience each outcome compared to women with disabilities. Men with disabilities had similar odds of adverse psychological outcomes compared to women without disabilities. Women with disabilities had higher odds of severe distress following violence compared to men without disabilities (3.90, p?<?0.001) or women without disabilities (1.86, p?<?0.001). Similarly, women with disabilities had higher odds of anxiety, depression, and anxiety and depression compared to men and women without disabilities.Conclusions
Women with disabilities are at higher risk of negative psychological consequences resulting from violence compared to other gender-disability groups. Men with disabilities also experience worse outcomes relative to men without disabilities. 相似文献9.
10.
Wilbert S. Aronow Tatyana A. Shamliyan 《Journal of the American Medical Directors Association》2018,19(6):472-479
Objectives
Critical appraisal of all available evidence regarding the role of noninvasive communication technology for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF).Design
Systematic literature review and grading of the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach.Setting and Participants
Four databases were searched in March 2018 to find 2 high-quality meta-analyses and published and unpublished data from 58 randomized controlled trials (RCTs) that compared noninvasive communication technology with usual care in community-dwelling adults with HF.Measures
Direct meta-analysis of aggregate data with random effects models.Results
Moderate-quality evidence suggests that there are no differences in all-cause mortality between telemonitoring and usual care, whereas complex telemonitoring that includes transmission of patient parameters and analysis by health care professionals decreases all-cause mortality (relative risk [RR] 0.78, 95% confidence interval [CI] 0.62, 0.99; 2885 people in 12 RCTs). Moderate-quality evidence suggests that telemonitoring prevents HF-related hospitalizations (RR 0.74; 95% CI 0.62, 0.88; 4001 people in 11 RCTs). Moderate-quality evidence suggests that structured telephone support decreases all-cause mortality (RR 0.86; 95% CI 0.77, 0.97; 9535 people in 24 RCTs) and HF-related hospitalizations (RR 0.83; 95% CI 0.73, 0.94; 7030 people in 16 RCTs). Use of a mobile personal digital assistant prevents HF-related hospitalizations (RR 0.58; 95% CI 0.44, 0.77; 674 people in 3 RCTs). The evidence regarding the comparative effectiveness of specific telecommunication devices is insufficient. The results from many completed studies are not available.Conclusions
Clinicians should offer noninvasive monitoring with communication technology applications to all HF patients. Future research should examine comparative effectiveness of technology applications in patient subpopulations. 相似文献11.
12.
13.
Background
Experiences of discrimination lead people from vulnerable groups to avoid medical healthcare. It is yet to be known if such experiences affect people with disabilities (PWD) in the same manner.Objectives
To determine the association between perceived discrimination and healthcare-seeking behavior in people with disabilities and to explore differences of this association across disability types.Methods
We performed a cross-sectional study with data from a national survey of people with disabilities. Perceived discrimination and care-seeking behavior were measured as self-reports from the survey. Dependence for daily life activities, possession of health insurance, and other disability-related variables were included and considered as confounders. We used Poisson regression models and techniques for multistage sampling in the analyses. A stratified analysis was used to explore effects of discrimination across types of disability.Results
Most of PWD were 65 years or older (67.1%). Prevalence of healthcare seeking was 78.8% in those who perceived discrimination, and 86.1% in those who did not. After adjusting for potential confounders, the probability of not seeking care was higher in people who reported perceived discrimination (adjusted PR = 1.15; 95%CI: 1.04–1.28). In a stratified analysis, significant effects of discrimination were found in people with communication disability (adjusted PR = 1.34, 95%CI: 1.07–1.67) and with physical disability (adjusted PR = 1.17, 95%CI: 1.03–1.34).Conclusions
People with disabilities who perceive discrimination are less likely to seek healthcare. This association was higher for people with communication and physical disabilities. These results provide evidence to institutions who attempt to tackle discrimination. 相似文献14.
Adam Whitworth 《Disability and health journal》2018,11(4):568-575
Background
Health-related unemployment is a major issue across advanced economies. Modified versions of well-evidenced Individual Placement and Support (IPS) models of employment support for health cohorts offer considerable potential. A significant gap currently however is the lack of evidence around their financial return on investment.Objective/Hypothesis
To provide robust financial return on investment estimates for analytically derived alternative specifications of modified IPS services for the first time in the literature, sensitivity tested across various levels of performance.Methods
Brings together modelled cost and savings estimates based on best available evidence to deliver modelled return on investment estimates.Results
The modelled estimates show that well-designed modified IPS services can deliver financial savings whilst tackling health-related unemployment, even at higher average unit costs than are typically considered viable in some national contexts.Conclusions
Modified IPS services offer a viable route to delivering enhanced employment outcomes for individuals with health conditions and disabilities and financial savings for governments. 相似文献15.
Samuel W. Logan Kathleen R. Bogart Samantha M. Ross Erica Woekel 《Disability and health journal》2018,11(4):562-567
Background
Emergent disability studies research is interested in the community's views on how disability, including self-directed mobility, influences social and environmental policies. We anticipate that individuals' alignment with disability models, or sets of assumptions about the cause, nature, and treatment of disability, will influence attitudes about self-directed mobility. Self-directed mobility is defined as mobility that is controlled by an individual and may include walking or assisted ambulation through the use of mobility technology such as prosthetics, walking aids, manual wheelchairs, or motorized wheelchairs.Objective
The purpose of this study was to explore how demographic factors, contact with people with disabilities, attitudes toward people with disabilities, and alignment with social or medical models of disability predict attitudes toward self-directed mobility.Methods
1545 students at a public university completed demographic questions, and measures of disability attitudes, disability model orientation, and self-directed mobility.Results
The predictors explained 16.60% of the variance in participants' attitudes toward self-directed mobility (R2?=?0.166, F(7,1537)?=?43.9, p?<?.001). Significant predictors included: female gender (β?=??0.14, p?<?.01), more positive attitudes toward people with disabilities (β?=??0.30, p?<?.001), and social model orientation (β?=?0.59, p?<?.001).Conclusions
Participants who more strongly agreed with disability as a social construct (social model) were in stronger agreement that self-directed mobility is a fundamental right. Future research extending to rehabilitation professionals is warranted. 相似文献16.
Background
The built environment can facilitate or impede an individual's ability to participate in society. This is particularly so for people with disability. Architects are well placed to be advocates for design that enhances societal equality.Objective
This qualitative study explored architectural design students' perceptions of inclusive design, their reflections resulting from an experiential learning module and the subsequent influence of these on their design practice.Methods
Twenty four architectural design students participated in focus groups or individual interviews. Data were analyzed thematically.Results
Three themes were evident: 1) Inclusive design was perceived as challenging, 2) Appreciation for the opportunity to learn about the perspectives of people with disabilities, and 3) Change of attitude toward inclusive design. Experiential learning had fostered reflection, changes in attitude and the realization that inclusive design, should begin at the start of the design process.Conclusions
For equitable access for all people to become reality, experiential learning, coupled with positive examples of inclusive design should be embedded in architectural education. 相似文献17.
18.
Jennifer S. Albrecht Lindsay Croft Daniel J. Morgan Mary-Claire Roghmann 《Journal of the American Medical Directors Association》2017,18(2):158-161
Objectives
To explore current use and perceptions of glove and gown use in nursing homes.Design
Qualitative study using focus groups and semi-structured interviews.Setting
Three community-based nursing homes in Maryland.Participants
Direct care staff, administrators, and residents.Methods
We conducted three focus groups among nursing home staff, one focus group among nursing home administrators, and five interviews with residents. Topic guides were created based on our recent study results and a review of the literature. Two investigators separately analyzed the transcribed recordings and identified recurrent themes.Results
Direct care staff reported using gowns and gloves primarily as self-protection against contact with bodily fluids, not to prevent MRSA transmission. Glove use was described as common and more acceptable to staff and residents than gown use. Administrators were surprised that MRSA transmission to health care worker hands and clothing occurred during activities when direct care staff perceives no contact with bodily fluids. Staff and administrators expressed willingness to use gowns and gloves for high-risk care activities, particularly if use is targeted toward specific types of residents such as those with pressure ulcers. There was a knowledge deficit about MRSA transmission and infection among direct care staff and residents.Conclusions
Results from this study will inform a strategy to reduce MRSA transmission in long-term care. 相似文献19.
Véronique Bissonnette-Maheux Audrée-Anne Dumas Véronique Provencher Annie Lapointe Marilyn Dugrenier Sharon Straus Marie-Pierre Gagnon Sophie Desroches 《Journal of the Academy of Nutrition and Dietetics》2018,118(7):1220-1227.e3