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Chiang IH, Huang CH, Hsieh YW, Lin YF, Huang RY, Lin CW. Evaluation of an Innovative Postgraduate Medical Education Model Incorporating Social Determinants of Health. MEDICAL TEACHER 2024:1-7. [PMID: 39382279 DOI: 10.1080/0142159x.2024.2413022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 10/02/2024] [Indexed: 10/10/2024]
Abstract
PURPOSE Incorporating social determinants of health (SDH) into medical education is crucial. However, there are limited data on standard education models and comprehensive SDH curricula in Taiwan are insufficient. This study presents a systematic SDH curriculum instructed primarily by social workers for postgraduate doctors and aims to examine the training outcomes of the innovative curriculum. METHOD This study assessed training outcomes using Kirkpatrick model levels 1 and 2 regarding trainees' satisfaction and improvement of their knowledge and skills in written and standardized patient (SP) pre- and posttests conducted between 1 August 2021 and 31 July 2022. RESULTS A total of 28 trainees completed the training. The trainees' overall satisfaction score regarding the curriculum was high (4.6 out of 5). The median pretest scores for the written and SP tests were 66.25 ± 14.38 and 14.50 ± 5.13, respectively, whereas the median posttest scores were 80.00 ± 7.50 and 20.50 ± 6.13, respectively. Both written and SP posttest scores were significantly improved compared to the pretest scores (p < .001). CONCLUSIONS The presented education model significantly improved postgraduate doctors' SDH knowledge and biopsychosocial assessment skills, and received high satisfaction scores from the trainees. Adopting social workers as primary teachers may enhance interdisciplinary collaboration between social workers and trainee doctors.
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Affiliation(s)
- I-Hui Chiang
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chi-Hsien Huang
- Department of Family and Community Medicine, E-Da Hospital and College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Wei Hsieh
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Feng Lin
- Social Work Section, Department of Family and Community Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Ru-Yi Huang
- Department of Family Medicine, Taipei Tzu Chi Hospital, Taipei, Taiwan
- Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, Hualien, Taiwan
- Data Science Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Chi-Wei Lin
- Department of Family and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Odetunde MO, Olaoye OA, Ogwogho HO, Onigbinde AT. Do facilitators and barriers to community ambulation differ among stroke survivors in low resource settings? A cross-sectional study in Nigeria. Top Stroke Rehabil 2024:1-13. [PMID: 39374173 DOI: 10.1080/10749357.2024.2411876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 09/28/2024] [Indexed: 10/09/2024]
Abstract
PURPOSE Stroke survivors (SSV) in many low- and middle-income countries experience frustrating participation restriction in community ambulation (CA), which impedes community life. This study assessed facilitators and barriers to CA among community-dwelling SSV in a southwest state of Nigeria. METHODS This cross-sectional study involved 66 community-dwelling ambulating SSV, purposively recruited from physiotherapy out-patient clinics of selected hospitals in southwest Nigeria. Semi-structured questionnaire containing physical and social environment elements of the ICF domains was administered on respondents. Mobility status at home and community, socio-demographic and clinical data of SSV were also obtained. Responses from open-ended questions were triangulated with appropriate close ended options. Data were analyzed using descriptive statistics and logistic regression at p < 0.05 Alpha value. RESULTS Majority of the SSV were independent in their homes (59.1%), used mobility aids (87.9%) and assisted in CA (66.7%). They identified limited physical accessibility by crowds 25 (37.9%), lack of inclined surfaces 40 (95.2%), uneven floors 36 (87.8%), public seating arrangements 33 (78.6%), rain (73.8%) and inability to use services, systems and policies (77.3%) as barriers to CA. Built physical environment was a significant predictor of home (OR = 0.754, p = 0.001) and community mobility (OR = 0.850; p = 0.018), while post-stroke depression was a significant predictor of community mobility (OR = 1.038; p = 0.014). CONCLUSION Mobility aids, social attitudes and general support were identified as facilitators, whereas barriers to CA included built physical environment, services and policies, products and technology. Facilitators and barriers to CA are similar to some HIC contexts, perceived difficulties and experiences differ for infrastructural and social reasons among others.
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Affiliation(s)
- Marufat O Odetunde
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olumide A Olaoye
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Halimat O Ogwogho
- Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ayodele Teslim Onigbinde
- Department of Physiotherapy, Faculty of Medical Rehabilitation, University of Medical Sciences, Ondo, Nigeria
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Park GR, Haseeb S, Namkung EH. The effects of poor housing conditions on depressive symptoms in persons with disabilities: Do neighborhood resources and residence type matter? Disabil Health J 2024:101712. [PMID: 39384524 DOI: 10.1016/j.dhjo.2024.101712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/30/2024] [Accepted: 10/03/2024] [Indexed: 10/11/2024]
Abstract
BACKGROUND Poor housing conditions pose significant risks to the health of persons with disabilities. However, it is not well understood how and for whom the relationship between housing conditions and health is more pronounced. OBJECTIVE This study aims to estimate the association between poor housing conditions and psychological health, and to explore whether residential characteristics, such as residence type and proximity to community resources, mitigate these risks for community-dwelling adults with disabilities. METHODS Data were obtained from three waves of the Disability and Life Dynamic Panel (n = 5,058), a nationally representative study of individuals with disabilities in Korea. Our sample were limited to those aged 20 or older for the purpose of this study. Individual-level fixed effect analyses were conducted to assess the longitudinal association between poor housing conditions and depressive symptoms, accounting for individual-level heterogeneity. We also tested the moderating effects of the residential characteristics, including proximity to community resources and residence type. RESULTS Poor housing conditions, characterized by structural unsafety and inadequate ventilation, lighting, and noise protection, were associated with increased depressive symptoms among adults with disabilities. The negative impact of poor housing conditions on depressive symptoms was less pronounced for those living close to community services or in apartment complexes where housing conditions are professionally managed. CONCLUSIONS The study indicates that the quality of housing and neighborhood environments affect the psychological health of adults with disabilities. These findings support for the need for place-based interventions aimed at improving the residential environments of community-dwelling adults with disabilities.
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Affiliation(s)
- Gum-Ryeong Park
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
| | - Saud Haseeb
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
| | - Eun Ha Namkung
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea.
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Herrman D, Chambers E, Sharp A. Working in the Margins: The Untapped Potential of Disability Inclusion. Phys Ther 2024; 104:pzae108. [PMID: 39046289 DOI: 10.1093/ptj/pzae108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 03/20/2024] [Accepted: 07/23/2024] [Indexed: 07/25/2024]
Abstract
People with disabilities are considered a historically marginalized population that experiences significant health disparities resulting from the unequal distribution of resources as evidenced in the social determinants of health. Health professions education presents an opportunity to explore the policy, systems, and environmental changes that are needed to improve social conditions and address known disparities for people with disabilities. Evidence suggests that inclusion of learners with diverse lived experiences, including students with disabilities, strengthens our understanding of the influence of social determinants on health and our ability to address known barriers. Unfortunately, people with disabilities and other minoritized individuals are grossly underrepresented in physical therapy. It is imperative that doctor of physical therapy (DPT) education more intentionally promotes the full inclusion of students with disabilities to improve representation and to better support the complex needs of this population. In this perspective, we describe key social determinants of health for people with disabilities, offer strategies for increasing representation and inclusion of students with disabilities in DPT education, and summarize how the inclusion of students with disabilities in DPT education can enhance our understanding of and ability to address social barriers for this population.
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Affiliation(s)
- Deana Herrman
- College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois, USA
| | - Emma Chambers
- AdventHealth Sports Med and Rehab, Rome, Georgia, USA
| | - Amanda Sharp
- Division of Physical Therapy and Rehabilitation Science, University of Minnesota, Minneapolis, Minnesota, USA
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Herrman D, Pechak CM, Berg K, Magasi S. Instructing to Impact: Exploration of Doctor of Physical Therapy Education Instruction of Social Determinants of Health and Health Equity for People With Disabilities. Phys Ther 2024; 104:pzae070. [PMID: 38738784 DOI: 10.1093/ptj/pzae070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE The aim of this study was to explore the instruction of social determinants of health (SDOH) for people with disabilities (PWD) in doctor of physical therapy (DPT) education programs. METHODS A sequential mixed methods study informed by a five-member disability community advisory panel was conducted. Qualitative semi-structured interviews with educators (n = 10) across 4 DPT programs in the Midwest were conducted and analyzed thematically. The qualitative findings formed the basis of the quantitative phase. An online survey was conducted with faculty of DPT programs in the United States (n = 254) with the most knowledge of instruction of SDOH and health equity for PWD (n = 74; 29% response rate). Quantitative data were analyzed with descriptive statistics and triangulated with qualitative data. RESULTS SDOH for PWD is an emerging component of instruction in DPT curricula. Five themes included: emerging instruction of SDOH for PWD; conceptual frameworks informing instruction; instructional strategies; barriers to integration of SDOH for PWD; and facilitators to integration of SDOH for PWD. Quantitative analysis revealed that 71 respondents (95.9%) included disability in health equity discussions primarily focused on health care access. Limited time (n = 49; 66.2%) was the most frequently reported barrier, and educator interest in disability health equity was the most frequently reported facilitator (n = 62; 83.7%) to inclusion of the SDOH for PWD in health equity discussions. CONCLUSION Opportunities exist in DPT curricula to build on instructional strategies, integrate SDOH frameworks, and amplify facilitators to integration of SDOH for PWD. IMPACT To meet the needs of the 67 million Americans living with disabilities, students must have the knowledge and skills to address the complex needs of this historically marginalized population. Understanding the DPT education landscape around SDOH for PWD can guide DPT educators to more fully prepare their students to recognize and ameliorate health disparities faced by PWD.
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Affiliation(s)
- Deana Herrman
- College of Health and Human Sciences, Northern Illinois University, DeKalb, Illinois, USA
| | - Celia M Pechak
- Doctor of Physical Therapy Program, The University of Texas at El Paso, El Paso, Texas, USA
| | - Kristin Berg
- Department of Disability and Human Development, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois-Chicago, Chicago, Illinois, USA
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Shapira R, Baris Ginat YJ, Lipskaya-Velikovsky L. Daily life participation in PTSD: pilot study on patterns and correlators. Front Psychiatry 2024; 15:1429647. [PMID: 39119079 PMCID: PMC11306126 DOI: 10.3389/fpsyt.2024.1429647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 06/05/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Participation in daily life activities with both the personal and community meaning is an important component of health and well-being. Even though there are mounting reports on the challenges in various aspects of daily-life functioning among individuals with post-traumatic stress disorder (PTSD), to date little research has been conducted on their comprehensive patterns of participation. The study aimed to describe objective and subjective participation dimensions in PTSD compared to healthy controls and investigate the association between personal and environmental factors and participation. Methods Sixty-one individuals were enrolled in two groups: PTSD (N=31; age: M=34.3; women:77.4%) and healthy controls matched by age and gender. The PTSD group completed standard assessments for symptom severity, general cognition, executive function (EF), sensory processing, self-efficacy, functional capacity, and environmental properties. Both groups completed a participation questionnaire. Results Individuals with PTSD participated with low intensity and diversity, more occupations were abandoned (-4.73 Discussion The study demonstrates profound restrictions in participation in PTSD raising serious concerns. There are unique patterns of association between objective participation dimensions, subjective cognitive indices, sensory modulation, and environmental factors, suggesting a need for PTSD feature-specific intervention approaches to advance the participation of those with PTSD as a means of promoting health and well-being.
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Affiliation(s)
- Ruth Shapira
- Day care ward, School of Occupational Therapy, Faculty of Medicine, the Hebrew University, Jerusalem, Israel
- The Jerusalem Mental Health Center, Jerusalem, Israel
| | | | - Lena Lipskaya-Velikovsky
- Day care ward, School of Occupational Therapy, Faculty of Medicine, the Hebrew University, Jerusalem, Israel
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Eisenberg Y, Hofstra A, Twardzik E. Quantifying active travel among people with disabilities in the US. Disabil Health J 2024; 17:101615. [PMID: 38565481 PMCID: PMC11194152 DOI: 10.1016/j.dhjo.2024.101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND People with disabilities have higher rates of physical inactivity than people without. Active travel (e.g., walking/wheeling to nearby destinations or transit) is a recommended approach to increasing total physical activity (PA) but limited research has examined active travel among people with disabilities. OBJECTIVE To describe active travel among a nationally representative sample of people with disabilities, analyze variation between sub-groups, and examine factors associated with active travel. METHODS Using the 2017 National Household Travel Survey, our cross-sectional analysis summarized counts and duration of walking/wheeling trips for people with four different types of disabilities. We examined which factors were associated with doing any active travel and the duration of active travel, using zero inflated negative binomial regression models. RESULTS Our analysis identified that 14.55% of people with disabilities took a mean of 2.56 (95%CI = 2.42-2.69) walking/wheeling trips per day. Compared to non-active travelers, a higher proportion of active travelers were low-income, lived alone, had no-vehicle, and were Black or Hispanic. For active travelers, daily walking minutes, on average, were 46.41 (95%CI = 40.25-52.57) among people who used ambulatory devices, 41.55 (95%CI = 24.61-58.49) among people who were blind/low-vision, 39.93 (95%CI = 35.41-44.45) among people who used no device, and 29.58 (95%CI = 23.53-35.64) among people who used chair devices. Our analysis identified individual, household, and community factors associated with the likelihood and duration of walking/wheeling for travel and variation across disability types. CONCLUSIONS Understanding the multiple identities of active travelers with disabilities can inform walking/wheeling intervention strategies. Infrastructure improvements that support less reliance on automobiles could increase active travel among people with disabilities.
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Affiliation(s)
- Yochai Eisenberg
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States.
| | - Amy Hofstra
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States; College of Urban Planning and Public Affairs, University of Illinois-Chicago, Chicago, IL, 412 S. Peoria St., Chicago, 60607, United States.
| | - Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
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Kersey J, R McArthur A, Hammel J. Ongoing Challenges Related to the COVID-19 Pandemic Among People With Brain Injury. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:478-487. [PMID: 38414253 PMCID: PMC11179991 DOI: 10.1177/15394492241233260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
The COVID-19 pandemic exacerbated social isolation among people with traumatic brain injury (TBI). Yet, little is known about how changes in personal factors, environmental factors, or the characteristics of activities affected social participation. We examined experiences with social isolation and barriers to social participation using the person-environment-occupation-performance model as a framework. Twelve adults with TBI participated in a series of three focus groups. Data were analyzed using thematic analysis. We identified two primary themes with sub-themes: (1) social isolation experiences: (1a) emotional impact and (1b) managing personal risk; and (2) greater barriers but a lack of strategies to address them: (2a) access and opportunities and (2b) social and societal factors. New environmental barriers and task demands affected occupational performance, and participants identified few successful strategies to overcome these barriers. Occupational therapy can develop new strategies to re-balance the person-environment fit and enhance social participation.
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Choi J, Park J. Developing Problematic Performance Value Scores: Binding Routine Activity Performance, Environmental Barriers, and Health Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:764. [PMID: 38929010 PMCID: PMC11203909 DOI: 10.3390/ijerph21060764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Community design features, such as sidewalks and street crossings, present significant challenges for individuals with disabilities, hindering their physical performance and social integration. However, limited research has been conducted on the application of Universal Design (UD) to address these challenges, particularly concerning specific demographic groups and population cohorts. Understanding the influence of environmental features on physical performance is crucial for developing inclusive solutions like UD, which can enhance usability and social integration across diverse populations. OBJECTIVE This study aims to bridge this gap by investigating the complex relationships between environmental barriers, health conditions, and routine activity performance. An index was developed to evaluate users' UD performance based on functional capacity, providing scientifically rigorous and objectively measured evidence of UD effectiveness in creating inclusive built environments. METHOD Using data from the Problematic Activities Survey (PAS) conducted in the U.S., Canada, and Australia and targeting individuals with and without functional limitations, multinomial logit models were employed to estimate the probabilities of encountering performance problems. This analysis led to the development of the Problematic Performance Value (PPV) score. RESULTS The results demonstrated significant disparities in PPVs across various health conditions, particularly concerning curb ramps. Individuals facing mobility issues in their legs/feet, arms/hands, or back/neck encounter more pronounced challenges, especially when curb ramps lack proper design elements. Similarly, individuals with vision impairments face heightened difficulties with traffic signals, particularly due to issues with audible signal systems. These findings underscore the importance of addressing micro-level environmental challenges to accommodate individuals with varying functional capacities effectively. CONCLUSIONS By providing insights into the most problematic daily activities encountered by diverse populations, the PPV score serves as a valuable indicator for guiding environmental design improvements and promoting equitable space usage. This can be used to guide improved UD solutions and decide areas of concentration by providing generalized information on specific environmental features that contribute to user performance.
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Affiliation(s)
- Jimin Choi
- Center for Inclusive Design & Environmental Access, School of Architecture & Planning, University at Buffalo, SUNY, Buffalo, NY 14214, USA;
| | - JiYoung Park
- Department of Urban and Regional Planning, University at Buffalo, SUNY, Buffalo, NY 14214, USA
- MUREPA Korea, Seoul 13640, Republic of Korea
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Saarimäki SM, Reiterä P, Täckman A, Arokoski J, Vainionpää A, Kallinen M, Tallqvist S, Koskinen E, Hämäläinen H, Kauppila AM, Anttila H, Hiekkala S. Environmental barriers perceived by the Finnish population with spinal cord injury: a cross-sectional survey. Spinal Cord 2024; 62:348-355. [PMID: 38654113 PMCID: PMC11199142 DOI: 10.1038/s41393-024-00990-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
STUDY DESIGN Cross-sectional survey of the Finnish population with spinal cord injury (SCI). OBJECTIVES To explore the frequencies of perceived environmental barriers (EB) that made participation harder for the Finnish population with SCI and to compare the occurrence of perceived EBs by gender, age, time since injury, and injury severity. SETTING Participants were recruited from the registers of the three SCI outpatient clinics responsible for the lifelong care of people with SCI in Finland. METHODS The self-administered Nottwil Environmental Factors Inventory Short Form (NEFI-SF) collected in the Finnish Spinal Cord Injury Study (FinSCI) (n = 1772) was used. Nonparametric tests and multinomial logistic regression models were utilized. RESULTS 880 individuals responded to the NEFI-SF items (response rate 50%). Climate was perceived as a barrier by 72% and a serious one by 44% of the respondents. The rates regarding public access were 59% and 24%, private home access 46% and 18%, and long-distance transport 45% and 20%. Four out of ten respondents reported that finances, lack of assistive devices for short-distance transport, and political decisions restricted their participation. The NEFI-SF total scores were higher (meaning more perceived restrictions by EBs) for those more severely injured. CONCLUSIONS Climate, access to public and private places, challenges with transport, finances, and political decisions were the EBs most frequently perceived to restrict participation by the Finnish population with SCI. Most EBs that were prominent causes of restrictions are modifiable. Greater accessibility to the built environment, equal services to all, and positive special treatment could reduce their effects.
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Affiliation(s)
- Sanna-Mari Saarimäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Paula Reiterä
- Biostatistics Unit, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anni Täckman
- The Finnish Association of Spinal Cord Injured Akson, Helsinki, Finland
| | - Jari Arokoski
- Department of Internal Medicine and Rehabilitation / Spinal Cord Injury Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Aki Vainionpää
- Department of Rehabilitation, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Mauri Kallinen
- Department of Rehabilitation Medicine, Hospital Nova of Central Finland, Central Finland Health Care District, Jyväskylä, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | | | - Eerika Koskinen
- Department of Sensory, Neural, and Musculoskeletal Medicine, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Harri Hämäläinen
- Department of Internal Medicine and Rehabilitation / Spinal Cord Injury Outpatient Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Anna-Maija Kauppila
- Department of Medical Rehabilitation / Spinal Cord Injury Outpatient Clinic, Oulu University Hospital, Oulu, Finland
| | - Heidi Anttila
- Public Health and Welfare Department, Finnish Institute for Health and Welfare (THL), Knowledge Management and Co-creation Unit, Helsinki, Finland
| | - Sinikka Hiekkala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- The Finnish Association of People with Physical Disabilities, Helsinki, Finland
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Evans R, Douglas J, Winkler D, Cubis L. Understanding the interaction between support and social participation for people with physical disabilities: a scoping review protocol. BMJ Open 2024; 14:e083102. [PMID: 38816056 PMCID: PMC11138261 DOI: 10.1136/bmjopen-2023-083102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/09/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Around the world, the disability rights movements and the social model of disability have placed emphasis on the importance of social participation for people with disability. People with physical disability who have high and complex support needs often need support to access their communities, however, very little is known about the interaction between support and social participation for this population of people. Therefore, the aim of this scoping review is to explore the literature related to the interaction between support and social participation for adults with disability and understand any existing gaps in the literature where further research may be required in order to maximise quality support and social participation. METHODS AND ANALYSIS This scoping review will be conducted and reported according to scoping review guidelines outlined by Arksey and O'Malley and later modified by Levac et al, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews. Thorough database searches will be conducted across MEDLINE, PsycINFO, CINAHL and Scopus. The search will be limited to papers published in English from 2013 onwards. Citations will be uploaded into Covidence and screened by two independent reviewers. Data extraction will extract data regarding participants, housing, support and study characteristics, as well as qualitative and quantitative data relevant to the research question. A narrative synthesis will be used to summarise findings. A minimum of three consultants with lived experience of disability will be engaged to review and contribute to the final scoping review paper. ETHICS AND DISSEMINATION It is anticipated that the findings of this scoping review will be made available in peer-reviewed publications and also in plain language formats to ensure accessibility to a wide range of audiences. Ethics will not be required for this scoping review.
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Affiliation(s)
- Rebecca Evans
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Di Winkler
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Lee Cubis
- Summer Foundation, Box Hill, Victoria, Australia
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
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Pryde SJ, Williams O, O'Hare MP, Murdock C, Pedlow K. Exploring access to community neurorehabilitation for people with progressive neurological conditions: a qualitative study. Disabil Rehabil 2024:1-14. [PMID: 38632940 DOI: 10.1080/09638288.2024.2338198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Community neurorehabilitation enables people with progressive neurological conditions (PNCs) to manage their symptoms to live an active, fulfilling life; however, it is not accessible to all. This study explored the factors influencing access to community neurorehabilitation in Northern Ireland from the perspective of people with PNCs and their carers. METHODS Eleven people living with a PNC and three carers took part in virtual focus groups. Data was thematically analysed using the framework method. RESULTS Access to neurorehabilitation was described as a staged journey, driven by people with PNCs, and impacted by interactions with others. Four themes were identified: the person in the driving seat, describing the value of person-centred care and the need for proactivity; the traffic lights, depicting the role and influence of health care professionals (HCPs); the need for direction; and roadworks and roadblocks, identifying additional barriers to access. In addition, six fundamentals of good access were identified. CONCLUSIONS This study adds depth to our understanding of the complexity, and the roles and needs of people with PNCs and HCPs, in accessing community neurorehabilitation. Further research is needed to determine how best to empower people to access rehabilitation.
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Affiliation(s)
- Shona J Pryde
- School of Health Sciences, Ulster University, Londonderry, UK
- Physiotherapy Department, Belfast Health and Social Care Trust, Belfast, UK
| | | | | | - Carolyn Murdock
- School of Health Sciences, Ulster University, Londonderry, UK
| | - Katy Pedlow
- School of Health Sciences, Ulster University, Londonderry, UK
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Hassani Mehraban A, Fallahzadeh Abarghuei A, Lajevardi L, Shamili A. The Effect of ICF-Core Set-Based Occupational Therapy Interventions on the Function and Satisfaction of Individuals with Chronic Stroke: A Randomized Clinical Trial. Occup Ther Health Care 2024; 38:177-195. [PMID: 36036175 DOI: 10.1080/07380577.2022.2114612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 07/23/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Stroke can affect all aspects of a person's health and functioning. Therefore, it is important occupational therapists, have a comprehensive understanding of various levels of function and the factors affecting function. The ICF (International Classification of Functioning, Disability, and Health) and the selections of ICF categories or Core Sets relevant for people with a specific health condition, offer a model for intervention. This study aimed to investigate the effect of ICF-CS-based occupational therapy interventions on the function and satisfaction of individuals with chronic stroke. This study was designed as a randomized, single-blind, parallel-group clinical trial. Twenty-five patients with stroke were randomly assigned to the control group (which received traditional occupational therapy) or the treatment group (Stroke ICF-CS based occupational therapy). Patients were evaluated before and after the intervention (two months, three sessions per week, 45 minutes each session), as well as two weeks after the end of the intervention, using Fugl-Meyer and COPM (Canadian Occupational Performance Measure) tools. The independent T-test, Chi-square, and ANOVA with repeated measures were used to analyze the data. The results showed that the interaction effect of time and group was not significant in none of the Fugl-Meyer test sections (p > 0. 05), but it was significant in the performance and satisfaction of COPM (p < 0.05). The results suggest that ICF-CS-based occupational therapy interventions may assist persons with chronic stroke improve their functional level and satisfaction.
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Affiliation(s)
- Afsoon Hassani Mehraban
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Laleh Lajevardi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aryan Shamili
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, and Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
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Chiu V, Fields BE, Lin YN, Kang JH, Han DS, Wu YH, Su Y, Skidmore ER, Chang FH. Implementing strategy training in Taiwan: perspectives of individuals with Acquired brain injury. Disabil Rehabil 2024; 46:1121-1129. [PMID: 36970997 DOI: 10.1080/09638288.2023.2191013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Strategy training is a rehabilitation intervention that aims to enhance problem-solving skills with respect to daily activity-related challenges and has achieved favorable results in Western countries. This study explored the perspectives of individuals with acquired brain injury (ABI) in Taiwan who received strategy training. MATERIALS AND METHODS Semi-structured interviews with community-dwelling adults with ABI were conducted, and reflective memos made by research team members were recorded. Interviews and memos were analyzed through thematic analysis. RESULTS This study included 55 participants. The analysis of the participants' interview responses and memos yielded nine themes under three categories: 1) expectations regarding strategy training, 2) perceived benefits of strategy training, and 3) barriers affecting the process and outcomes of strategy training. CONCLUSIONS All the participants endorsed strategy training through different gains. Most participants' expectations before the intervention were uncertain. Including family members into the strategy training is of key importance for a successfulness of their goals. The participants' experiences about strategy training were affected by various barriers (i.e., health and medical problems, the physical environment, and natural events). Clinicians and researchers should consider these expectations, benefits, and barriers when studying and implementing strategy training in non-Western contexts.IMPLICATIONS FOR REHABILITATIONStrategy training provides clients the opportunity to actively engage in their own goal setting and decision making.Strategy training increases the client's confidence in their ability to participate in the community, communicate, and perform daily living and physical activities.Therapists should consider the health conditions and physical environment of clients when helping them set goals and before facilitating their engagement in the community.Taiwanese family members play a crucial role in supporting acquired brain injury survivors in strategy training.
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Affiliation(s)
- Valeria Chiu
- Department of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Beth E Fields
- Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, Madison, MI, USA
| | - Yen-Nung Lin
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hsuan Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu Su
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Feng-Hang Chang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Labbé D, Heider A, Eisenberg Y, Gould R, Jones R. Reflection on the application of the Consolidated Framework for Implementation Research to a national policy to improve inclusion of people with disabilities. EVALUATION AND PROGRAM PLANNING 2024; 102:102367. [PMID: 37708627 DOI: 10.1016/j.evalprogplan.2023.102367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 08/08/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
People with disabilities face many barriers in the built environment impacting their mobility, health, and social participation. In the US, under the Americans with Disabilities Act (ADA), municipalities were required to develop and implement barrier-removal plans for pedestrian infrastructure, called ADA transition plans, but very few have done so. Many communities know they need a plan but do not know how to get it done because of a lack of understanding of the many different implementation considerations. Implementation science offers a useful approach for understanding complex policy implementation such as ADA plans. This paper provides a reflection on the adaptation of the Consolidated Framework for Implementation Research (CFIR) to evaluate the implementation of ADA transition planning. To apply the CFIR, we tailored the construct definitions and modified them to fit the specific context of the ADA transition planning process. We documented the constructs that were more challenging to apply, those that were not relevant, and those that were particularly useful. This paper can serve as a valuable example that other researchers can use when considering adapting the CFIR or other implementation frameworks for the evaluation of complex social policy beyond the ADA.
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Affiliation(s)
- Delphine Labbé
- Great Lakes ADA Center, Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA.
| | - Amy Heider
- Great Lakes ADA Center, Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA
| | - Yochai Eisenberg
- Great Lakes ADA Center, Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA
| | - Robert Gould
- Great Lakes ADA Center, Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA
| | - Robin Jones
- Great Lakes ADA Center, Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA
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Martin Ginis KA, Sinden AR, Bonaccio S, Labbé D, Guertin C, Gellatly IR, Koch L, Ben Mortenson W, Routhier F, Basham CA, Jetha A, Miller WC. Experiential Aspects of Participation in Employment and Mobility for Adults With Physical Disabilities: Testing Cross-Sectional Models of Contextual Influences and Well-Being Outcomes. Arch Phys Med Rehabil 2024; 105:303-313. [PMID: 37607656 DOI: 10.1016/j.apmr.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To use structural equation modeling to test research- and theory-informed models of potential predictors and outcomes of subjective experiences of employment and mobility participation in a national sample of people with physical disabilities. DESIGN Cross-sectional survey. SETTING Canada. PARTICIPANTS English or French-speaking adults with a physical impairment affecting mobility and restricting activities or participation, and who participated in employment (n=457) or mobility (n=711) life domains. INTERVENTIONS N/A. MAIN OUTCOME MEASURES Participants completed standardized measures of perceived health, and employment-specific and/or mobility-specific measures of perceived abilities, social support, accessibility and policies (predictor variables); the Measure of Experiential Aspects of Participation (MeEAP) in employment and/or mobility; and standardized measures of emotional well-being, social well-being and life satisfaction (outcome variables). RESULTS Analyses using structural equation modeling showed that in both employment and mobility domains, perceived health, abilities, social support, and accessibility were positively related to experiential aspects of participation. Participation experiences were positively related to social well-being, emotional well-being, and life satisfaction. CONCLUSIONS Results support and extend current theorizing on participation experiences among adults with physical disabilities. Intrapersonal and environmental factors may play a role in optimizing participation experiences in employment and mobility which, in turn, may lead to better well-being and life satisfaction. These results emphasize the importance of conceptualizing participation from an experiential perspective and provide a basis for advancing theory and practice to understand and improve the participation experiences and well-being of adults living with physical disabilities.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, Canada; Centre for Chronic Disease Prevention and Management, Kelowna, Canada; School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
| | - Adrienne R Sinden
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Silvia Bonaccio
- Telfer School of Management, University of Ottawa, Ottawa, Canada; Institute for Work & Health, Toronto, Canada
| | - Delphine Labbé
- Disability and Human Development Department, College of Applied Health Sciences, University of Illinois, Chicago, IL
| | - Camille Guertin
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Ian R Gellatly
- Department of Strategy, Entrepreneurship, and Management, Alberta School of Business, University of Alberta, Edmonton, Canada
| | - Laura Koch
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - W Ben Mortenson
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - François Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, Canada
| | - C Andrew Basham
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Arif Jetha
- Institute for Work & Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - William C Miller
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
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Parry R, Buttelli O, Sellam N, Riff J, Vidailhet M, Welter ML, Lalo E. 'Le regard des autres': the experience of walking in social environments as a person with Parkinson's disease. Psychol Health 2024; 39:171-194. [PMID: 35255746 DOI: 10.1080/08870446.2022.2047187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To examine the experience of people with Parkinson's disease when walking in different social situations, and improve understanding of how this affects participation in meaningful activity. METHODS A convenience sample of fourteen people with Parkinson's disease and a history of gait dysfunction was recruited. In-depth interviews and direct observations were conducted in the participants' home environments. Specific examples from community mobility were reviewed using first person interviewing techniques with the support of video footage. Interview transcripts were analyzed using an interpretive phenomenological approach to derive key themes. RESULTS The feeling of 'being looked at' (le regard des autres) was the central theme in participant discourse. This sentiment was inextricably linked to the given norms of the social setting, and the relationships between participants and others within that environment. Participants sought to manage how they were perceived by others through modification of posture/gait patterns; disclosure of their neurological disease; and avoidance/withdrawal from social situations. CONCLUSION Further to the functional aspects of mobility, gait is important for maintaining self-image in people with Parkinson's disease. Affective gaze interactions have significant consequences upon participation restriction. These findings underscore the interest of activities which strengthen self-image and validate movement diversity in PD rehabilitation.
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Affiliation(s)
- Ross Parry
- LINP2 - Laboratoire Interdisciplinaire en Neurosciences, Physiologie et Psychologie: Activité Physique, Santé et Apprentissages, UPL, Université Paris Nanterre, Nanterre, France
| | - Olivier Buttelli
- Sciences et Techniques des Activités Physiques et Sportive, Université d'Orléans, Orléans, France
| | - Narjis Sellam
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
| | - Jacques Riff
- Sciences et Techniques des Activités Physiques et Sportive, Université d'Orléans, Orléans, France
| | - Marie Vidailhet
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
- Department of Neurology, AP-HP, Salpêtrière Hospital, Paris, France
| | - Marie-Laure Welter
- Paris Brain Institute, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
- Department of Neurophysiology, Rouen University Hospital and University of Rouen, Rouen, France
| | - Elodie Lalo
- Sciences et Techniques des Activités Physiques et Sportive, Université d'Orléans, Orléans, France
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Twardzik E, Schrack JA, Pollack Porter KM, Coleman T, Washington K, Swenor BK. TRansit ACessibility Tool (TRACT): Developing a novel scoring system for public transportation system accessibility. JOURNAL OF TRANSPORT & HEALTH 2024; 34:101742. [PMID: 38405233 PMCID: PMC10883474 DOI: 10.1016/j.jth.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Introduction Although federal laws require equal access to public transportation for people with disabilities, access barriers persist. Lack of sharing accessibility information on public transportation websites restricts people with disabilities from making transportation plans and effectively using public transportation systems. This project aims to document information provided about public transportation systems accessibility and share this information using an open data platform. Methods We reviewed the top twenty-six public transportation systems in the United States based on federal funding in fiscal year 2020. Information about accessibility was abstracted from each public transportation system website by two independent reviewers from February-March 2022. Informed by universal design principles, public transportation systems were scored across six dimensions: facility accessibility (0-22 points), vehicle accessibility (0-11 points), inclusive policies (0-12 points), rider accommodations (0-9 points), paratransit services (0-6 points), and website accessibility (0-2 points). Total scores were calculated as the sum of each dimension (0-62 points). Data and findings were publicly disseminated (https://disabilityhealth.jhu.edu/transitdashboard/). Results The average overall accessibility information score was 31.9 (SD=6.2) out of 62 possible points. Mean scores were 8.4 (SD=2.9) for facility accessibility, 4.5 (SD=2.1) for vehicle accessibility, 7.8 (SD=1.6) for inclusive policies, 4.9 (SD=1.6) for rider accommodations, 4.5 (SD=2.0) for paratransit services, and 1.8 (SD=0.4) for website accessibility. Eleven public transportation systems (42%) received the maximum score for paratransit services and 20 (77%) received the maximum score for website accessibility. No public transportation system received the maximum score for any of the other dimensions. Conclusions Using a novel scoring system, we found significant variation in the accessibility information presented on public transportation system websites. Websites are a primary mode where users obtain objective information about public transportation systems and are therefore important platforms for communication. Absence of accessibility information creates barriers for the disability community and restricts equal access to public transportation.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
| | - Keshia M. Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Taylor Coleman
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
| | - Kathryn Washington
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
| | - Bonnielin K. Swenor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Suarez-Balcazar Y, Balcazar F, Labbe D, McDonald KE, Keys C, Taylor-Ritzler T, Anderson SM, Agner J. Disability rights and empowerment: Reflections on AJCP research and a call to action. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:317-327. [PMID: 37853910 DOI: 10.1002/ajcp.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/06/2023] [Accepted: 08/22/2023] [Indexed: 10/20/2023]
Abstract
People living with physical, sensory, intellectual, and/or developmental disabilities experience complex social, environmental, political, and cultural challenges along with stigma and marginalization in education, employment, and community life. These multiple and complex barriers often hinder their full and effective participation in society. In this reflection, we curated articles on physical, sensory, intellectual, and/or developmental disabilities published in the American Journal of Community Psychology from 1973 to 2022. We reviewed titles and abstracts to identify themes that grouped manuscripts in relevant community psychology core concepts and values. From our analysis, five themes emerged: (a) promoting empowerment and advocacy; (b) promoting organizations and settings that support people with disabilities; (c) including people with disabilities in knowledge production; (d) promoting social justice in disability research, and (e) promoting support networks of families of people with disabilities. We conclude this reflection with a discussion of recommendations for future research, practice, and a call to action.
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Affiliation(s)
| | | | | | | | | | | | | | - Joy Agner
- University of Southern California, Los Angeles, California, USA
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20
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Butzer JF, Kozlowski AJ, Hern R, Gooch C. Randomized Trial of Two Exercise Programs to Increase Physical Activity and Health-Related Quality of Life for Persons With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2023; 29:51-60. [PMID: 38076491 PMCID: PMC10704219 DOI: 10.46292/sci22-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Objectives To compare the effectiveness of two different interventions that promote physical activity in individuals with traumatic spinal cord injury (SCI) and determine the effect of relapse prevention. Methods A sequential, multiple assignment, randomized trial was conducted at a universally designed community-based exercise facility. Participants were individuals with traumatic SCI, >3 months post injury, levels C5 to T12, age ≥18 years (N = 79). After randomization, Bridge Program participants completed an 8-week personalized, less intense, exercise program informed by American College of Sports Medicine (ACSM) guidelines and supported with hands-on peer mentoring, exercise of choice, and caregiver training. Structured Exercise participants completed an 8-week program in a group format based on ACSM guidelines. After intervention, participants were randomized to receive or not receive relapse prevention for 6 months. The time and intensity of physical activity and psychological change in depression, anxiety, self-efficacy, and function were assessed with self-reported measures. Results Compared to baseline, physical activity increased post intervention for both the Bridge and Structured Exercise programs. Compared to baseline, participants in the Bridge Program recorded fewer anxiety symptoms. No significant changes were noted for either program in depressive symptoms, self-efficacy, or function. There was no difference in relapse prevention between the two groups at 6 months. Conclusions The Bridge Program, a novel personalized exercise program with peer support, exercise of choice, and caregiver training, and a structured exercise program both improved self-reported physical activity, but the Bridge Program also reduced anxiety symptoms. This study provides important insight into the limitations of commonly used measures of physical activity and psychosocial domains in people with SCI.
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Affiliation(s)
- John F. Butzer
- John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan
- Division of Rehabilitation Michigan, State University-College of Human Medicine, Grand Rapids, Michigan
| | - Allan J Kozlowski
- John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan
| | - Rachel Hern
- John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan
- Department of Biostatistics, Grand Valley State University, Grand Rapids, Michigan
| | - Cally Gooch
- John F. Butzer Center for Research and Innovation, Mary Free Bed Rehabilitation Hospital, Grand Rapids, Michigan
- Department of Biostatistics, Grand Valley State University, Grand Rapids, Michigan
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Labbé D, Tao G, Maas ET, Best K, Bundon A, Sauvé J, Miller WC. Predicting high quality of participation in adaptive snow-sports for individuals with disabilities: An exploratory study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 69:102501. [PMID: 37665936 DOI: 10.1016/j.psychsport.2023.102501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVES This exploratory study aimed to examine the individual, program and environmental (social and physical) characteristics which predict high quality of participation in adaptive snowsports for each dimension of the Quality of Participation in Parasport Framework (QPPF): autonomy, belongingness, mastery, challenge, engagement and meaning. METHODS A survey was completed by 133 individuals with disabilities or their representatives on each dimension of the QPPF in adaptive snowsports and on the factors impacting the quality of participation. Descriptive statistics were used to describe the study participants, and a multivariate logistic regression model was constructed for each dimension of the QPPF to evaluate the relative contribution of individual, snowsport-related, program and environmental factors to each dimension. RESULTS Individuals with disabilities in this study reported high quality of participation on all dimensions of the QPPF. The individual characteristics only predicted the QPPF dimension of challenge. However, the program and environmental characteristics such as equipment, number of instructors and barriers were robust predictors of quality of participation. CONCLUSION Overall, participants experienced high quality participation. Supporting the adaptive snowsports programs while reducing the barriers faced by people with disabilities should be a continued effort to promote quality of participation.
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Affiliation(s)
- D Labbé
- Disability and Human Development Department, University of Illinois at Chicago, Chicago, IL, USA.
| | - G Tao
- Occupational Science and Occupational Therapy Department, UBC, Vancouver, BC, Canada; Rehabilitation Research Program, Vancouver, BC, Canada
| | - E T Maas
- Methodology and Applied Biostatistics, Faculty of Science, Vrije Universiteit Amsterdam, Netherlands
| | - K Best
- Rehabilitation, Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Quebec City, QC, Canada; Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - A Bundon
- School of Kinesiology, The University of British Columbia. (UBC), Vancouver, BC, Canada
| | - J Sauvé
- School of Kinesiology, The University of British Columbia. (UBC), Vancouver, BC, Canada; British Columbia Adaptive Snowsports, Vancouver, BC., Canada
| | - W C Miller
- Occupational Science and Occupational Therapy Department, UBC, Vancouver, BC, Canada; Rehabilitation Research Program, Vancouver, BC, Canada
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Jørgensen A, Toftager M, Eghøj M, Ried-Larsen M, Bjørk Petersen C. Heart rate responses, agreement and accuracy among persons with severe disabilities participating in the indirect movement program: Team Twin-an observational study. Front Sports Act Living 2023; 5:1213655. [PMID: 37941848 PMCID: PMC10627970 DOI: 10.3389/fspor.2023.1213655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/22/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Heart rate (HR) monitors are rarely used by people living with disabilities (PLWD), and their accuracy is undocumented. Thus, this study aims to describe the HR response during the Team Twin co-running program and, secondly, to assess the agreement and accuracy of using HR monitors among PLWD. Methods This 16-week single-arm observational study included 18 people with various disabilities. During the study, the subjects wore a Garmin Vivosmart 4 watch (wrist). To evaluate the agreement and accuracy we applied Garmin's HRM-DUAL™ chest-worn HR monitors for comparison with the Vivosmart 4. The HR response analysis was performed descriptively and with a mixed regression model. The HR agreement and accuracy procedure was conducted on a subsample of five subjects and analyzed using Lin's concordance analysis, Bland and Altman's limits of agreement, and Cohen's kappa analysis of intensity zone agreement. This study was prospectively registered at Clinical Trials.gov (NCT04536779). Results The subjects had a mean age of 35 (±12.6), 61% were male, 72% had cerebral palsy were 85% had GMFCS V-IV. HR was monitored for 202:10:33 (HH:MM:SS), with a mean HR of 90 ± 17 bpm during training and race. A total of 19% of the time was spent in intensity zones between light and moderate (30%-59% HR reserve) and 1% in vigorous (60%-84% HR reserve). The remaining 80% were in the very light intensity zone (<29% HR reserve). HR was highest at the start of race and training and steadily decreased. Inter-rater agreement was high (k = 0.75), limits of agreement were between -16 and 13 bpm, and accuracy was acceptable (Rc = 0.86). Conclusion Disability type, individual, and contextual factors will likely affect HR responses and the agreement and accuracy for PLWD. The Vivosmart 4, while overall accurate, had low precision due to high variability in the estimation. These findings implicate the methodical and practical difficulties of utilizing HR monitors to measure HR and thus physical activity in adapted sports activities for severely disabled individuals.
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Affiliation(s)
- Andreas Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mette Toftager
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martin Eghøj
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
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Twardzik E, Clarke PJ, Lisabeth LD, Brown SH, Roth DL, Judd SE, Colabianchi N. Enhanced Street Crossing Features are Associated with Higher Post-Stroke Physical Quality of Life. Top Stroke Rehabil 2023; 30:578-588. [PMID: 35924680 PMCID: PMC9898471 DOI: 10.1080/10749357.2022.2108970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Features of the physical environment may affect post-stroke recovery, but empirical evidence is limited. This study examines associations between features of the physical environment and post-stroke physical quality of life (PH-QOL). METHODS The study sample included stroke survivors enrolled in the Caring for Adults Recovering from the Effects of Stroke project, a prospective cohort. Features of the physical environment surrounding participants' home addresses were audited using Google Earth. Audits captured information about crossings (e.g. curb-cuts; range 0-4), street segments (e.g. sidewalks; range 0-17.5), and a route (e.g. parks; range 0-27) near participants' home. Summary scores were categorized into tertials representing "few," "some," and "many" pedestrian-friendly features. Post-stroke PH-QOL was measured by the SF-12 (range 0-100) around 6 to 12-, 18-, 27-, and 36-months post-stroke. Linear mixed models were used to estimate PH-QOL over time. Chained multiple imputation was used to account for missing data. RESULTS Two hundred and seventy-five participants were eligible, among whom 210 had complete data. Most participants lived in areas with "few" features to promote outdoor mobility. Participants living in environments with "some" crossing features had a 4.90 (95% CI: 2.32, 7.48) higher PH-QOL score across the observation period in comparison to participants living in environments with "few" crossing features. Features of the physical environment along street segments and routes were not associated with post-stroke PH-QOL. CONCLUSION Crossing features are associated with post-stroke PH-QOL. Modifying features of the physical environment at nearby crossings, such as curb-cuts, may be a promising strategy for increasing PH-QOL.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Philippa J. Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lynda D. Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Susan H. Brown
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - David L. Roth
- Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Suzanne E. Judd
- Department of Biostatistics, University of Alabama at Birmingham, AL
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Rasalingam A, Brekke I, Stenberg U, Haaland-Øverby M, Helseth S. 'Struggling to participate in everyday life': emerging adults' experiences of living with long-term health challenges. BMC Public Health 2023; 23:1368. [PMID: 37460986 PMCID: PMC10353226 DOI: 10.1186/s12889-023-16291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
AIM To gain a deeper understanding of the experiences of participation in the everyday life of emerging adults living with long-term health challenges and how this influences their own quality of life. METHODS Using an explorative study design, data were collected through in-depth interviews with a sample of 12 young people aged 18-29 years living with long-term health challenges in Norway. FINDINGS The analysis identified one overarching theme of struggling to participate in everyday life, and four subthemes: the notion of being independent but also dependent, experiencing mismatch between needs and support, experiencing deprivation of spontaneity and feeling uncertain about the future. The emerging adults experienced difficulties with participation in key areas of life such as education, employment and leisure activities. Associated symptoms of their diagnosis, limited physical abilities and lack of sufficient support made it hard to participate in everyday life the way they aspired to. CONCLUSION The challenges of living with a long-term health challenge as an emerging adult contributed to limitations in participation in different areas of life that was perceived as important for their quality of life.
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Affiliation(s)
- Anurajee Rasalingam
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - Idunn Brekke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Una Stenberg
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway
| | - Mette Haaland-Øverby
- National advisory unit on learning and mastery in health, Oslo university hospital, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Bergström M, Larsson Ranada Å, Sverker A, Thyberg I, Björk M. A dyadic exploration of support in everyday life of persons with RA and their significant others. Scand J Occup Ther 2023; 30:616-627. [PMID: 34846249 DOI: 10.1080/11038128.2021.2007997] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 10/22/2021] [Accepted: 11/13/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations. AIMS To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA. MATERIAL AND METHODS Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis. RESULTS Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life. CONCLUSIONS Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads. SIGNIFICANCE The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.
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Affiliation(s)
- Maria Bergström
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Åsa Larsson Ranada
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Annette Sverker
- Department of Activity and Health and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ingrid Thyberg
- Department of Rheumatology in Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Brown-Hollie JP, Suarez-Balcazar Y. Participation Outcomes Among Black Children with Disabilities: A Scoping Review. Phys Occup Ther Pediatr 2023; 44:78-95. [PMID: 37211802 DOI: 10.1080/01942638.2023.2212073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/25/2023] [Accepted: 05/03/2023] [Indexed: 05/23/2023]
Abstract
AIM Participation disparities among Black children with disabilities are widely documented in a variety of disciplines. Grounded in the Social Model of Disability and Disability Critical Race Theory, the purpose of this scoping review was to examine the extent to which occupational therapy has contributed to the study of participation outcomes among Black children with disabilities. METHODS Empirical studies published from 2010 to 2021 that reported participation outcome data published in nine frequently cited journals were included in this scoping review. Twenty studies were found to meet the criteria. RESULTS Participation outcomes were reported for six occupations: play, social participation, activities of daily living (ADLs), education, sleep, and health management). The majority of studies reviewed recruited small samples of Black children with disabilities and provided limited to no description of the specific participation differences by racial/ethnic demographics. CONCLUSION Occupational therapy has made few contributions to the growing literature on participation disparities for Black children with disabilities. Implications for practice are discussed.
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Carlozzi NE, Graves C, Troost JP, Kallen MA, Tulsky DS, Hanks RA, Ianni PA, Miner JA, Sander AM. Initial Evidence for Reliable and Valid Use of Scores on the 8-Item Econ-QOL Short Form to Measure Economic Quality of Life in Caregivers of Persons With Traumatic Brain Injury. Arch Phys Med Rehabil 2023; 104:430-437. [PMID: 35944601 PMCID: PMC9899870 DOI: 10.1016/j.apmr.2022.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To provide reliability and validity data to support the clinical utility of Economic Quality of Life Measure (Econ-QOL) scores in caregivers of civilians and service members/veterans with traumatic brain injury (TBI). DESIGN Cross-sectional survey study. SETTING Three academic medical centers and a Veterans Affairs treatment facility. PARTICIPANTS 376 caregivers of civilians (n=213) and service members/veterans (n=163) with TBI (N=376). INTERVENTIONS N/A. MAIN OUTCOME MEASURES Econ-QOL and several patient-reported outcome measures (Traumatic Brain Injury Caregiver Quality of Life Caregiver-Specific Anxiety and Caregiver Strain, Patient-Reported Outcomes Measurement Information System sleep-related impairment, Neurological Quality of Life Measurement System positive affect and well-being) and measures of financial status (self-reported income). RESULTS Internal consistency reliability of the Econ-QOL Short Form scores were excellent (all Cronbach's alphas ≥.92). There were no floor or ceiling effects for scores. There was evidence of convergent and discriminant validity, with the Econ-QOL scores having the strongest relationships with self-reported income (convergent validity evidence) and weak relationships with the other measures (discriminant validity evidence). Individuals with scores that were "below or possibly below" the poverty line (according to 2016 federal government poverty level thresholds) reported worse economic quality of life relative to those individuals who were definitely above the poverty line, supporting known-groups validity. CONCLUSIONS This article establishes the clinical utility of scores on the Econ-QOL Short Form in caregivers of persons with TBI and provides evidence that it is valid and appropriate to use such scores not only in a variety of different disability populations (eg, spinal cord injury, stroke) but also in caregivers.
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Affiliation(s)
- Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Christopher Graves
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Jonathan P Troost
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI
| | - Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; MHBS, James A. Haley Veterans' Hospital, Tampa, FL
| | - David S Tulsky
- Center for Health Assessment Research and Translation, and Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE
| | - Robin A Hanks
- Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI; Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | - Phillip A Ianni
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI
| | - Jennifer A Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
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Golos A, Zyger C, Lavie-Pitaro Y, Anaby D. Improving Participation among Youth with Disabilities within Their Unique Socio-Cultural Context during COVID-19 Pandemic: Initial Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3913. [PMID: 36900924 PMCID: PMC10002320 DOI: 10.3390/ijerph20053913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Participation in meaningful activities is important for quality of life among youth with disabilities; yet participation is often restricted during adverse times. This study aimed to explore the effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention among ultra-Orthodox Jewish Israeli youth with disabilities during the COVID-19 pandemic. METHODS A 20-week single-subject research design with multiple baselines measuring participation goals/activities was employed with two youths (15 and 19 years old) combining quantitative and qualitative descriptive data. Changes in participation levels were measured biweekly using the Canadian Occupational Performance Measure; COPM; participation patterns were measured using the Participation and Environment Measure-Children and Youth; PEM-CY pre- and post-intervention; parents' satisfaction was measured using the Client Satisfaction Questionnaire, CSQ-8. Semi-structured interviews were conducted post-intervention. RESULTS Both participants significantly improved participation in all selected goals and participation patterns, and were highly satisfied with the intervention. The interviews revealed additional information on personal and environmental barriers, factors supporting intervention, and intervention effects. CONCLUSIONS The results indicated that an environment-centered and family-centered approach can potentially improve the participation of youths with disabilities within their unique socio-cultural context, during adverse times. Flexibility, creativity, and collaboration with others also contributed to intervention success.
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Affiliation(s)
- Anat Golos
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Chani Zyger
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Yael Lavie-Pitaro
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem 91240, Israel
| | - Dana Anaby
- School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G 1Y5, Canada
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29
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Desai RH, Hamlin E, Eyler A, Putnam M, Stark S, Doering M, Morgan K. The Role of the Built Environment in the Community Participation of Adults Aging With Long-Term Physical Disabilities: A Scoping Review. JOURNAL OF AGING AND ENVIRONMENT 2023; 38:232-256. [PMID: 39190651 PMCID: PMC10961975 DOI: 10.1080/26892618.2023.2175099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The purpose of this scoping review was to characterize the nature and scope of existing literature on the role of built environments in the community participation of adults aging with physical disabilities (AAwPD). A scoping review was selected to identify the volume and types of evidence available, pinpoint knowledge gaps, and clarify key concepts. Twenty-one articles were included for review, all of which were published within the last 20 years and identified components of the built environment for intervention. Results demonstrated the need for investigators to identify common indicators, use a shared lexicon, and improve dissemination of results across disciplines.
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Affiliation(s)
- Rachel Heeb Desai
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Emily Hamlin
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Amy Eyler
- Brown School of Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Susan Stark
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Kerri Morgan
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
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Chang FH, Lin YN, Liou TH, Ni PS. Predicting trends of community participation after hospital discharge for younger adults after stroke. Ann Phys Rehabil Med 2023; 66:101644. [PMID: 35150932 DOI: 10.1016/j.rehab.2022.101644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 01/04/2022] [Accepted: 01/15/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Community participation is an indicator of recovery for younger adults after stroke who generally have a greater need to return to society than do older adults. However, little is known about the trends of participation and their determinants in this population. OBJECTIVE To explore the trends of community participation by younger (<65 years) adults with stroke in Taiwan after their hospital discharge and to identify predictors of these trends. METHODS This longitudinal, multicenter, prospective cohort study enrolled 570 relatively young adults (aged 20-65 years) with stroke. Participants were assessed at hospital discharge and at 3-, 6-, and 12-month follow-up. The primary outcome measure was the Participation Measure-3 Domains, 4 Dimensions (PM-3D4D). Sociodemographic and stroke-related variables were derived by using standardized instruments and questionnaires. Mixed models were used to derive the trends of each participation domain and to identify predictors. RESULTS PM-3D4D score changes showed a positive trend from discharge to 1-year follow-up (particularly in social and community subscales); however, the improvement was mild and mainly occurred in the first 3 months. Sociodemographic factors, such as income and education levels, and stroke-related variables, such as stroke severity, comorbidity, and physical function, significantly predicted changes in PM-3D4D scores over time. Physical function demonstrated the strongest prediction ability for all participation domains and dimensions. CONCLUSION Multiple sociodemographic and stroke-related variables, particularly physical function, predicted improvement in community participation by younger adults after stroke. These findings may help clinicians identify younger adults at risk of unfavorable long-term participation outcomes after stroke.
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Affiliation(s)
- Feng-Hang Chang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Yen-Nung Lin
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Peng-Sheng Ni
- Health Law, Policy, and Management Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
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Cunningham C, O'Donoghue G, Cosgrave S, Sands T, Leacy B, Markievicz I, Monaghan A, Shields N. Gym staff perspectives on disability inclusion: a qualitative study. Disabil Rehabil 2023; 45:441-448. [PMID: 35191365 DOI: 10.1080/09638288.2022.2036826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To explore gym staff perspectives on the inclusion of people with disability in the gym setting. MATERIALS AND METHODS Semi-structured interviews were conducted with 16 staff at four urban gym facilities, exploring perspectives on disability inclusion. An interpretive descriptive approach was adopted with reflexive thematic analysis of interview data and subsequent mapping of themes to the socioecological model. RESULTS Consistent with the socioecological model, the themes identified were "people with disability benefit from participation in gym settings" (personal); "positive interactions with people with disability" (interpersonal); "managing expectations of other gym users" (interpersonal); "inclusion is supported by a positive ethos, staff training and accessible facilities" (organisational); "people with disability lack awareness of inclusive exercise opportunities" (community); "desire to increase collaboration with healthcare professionals" (community); "access to transport can facilitate gym attendance" (community) and "local gym policy" (policy). CONCLUSION Although an overall ethos of inclusion was apparent, areas identified for enhancement were: awareness of gym services in the community; inter-sectoral collaboration with healthcare and disability organisations; comprehensive disability inclusion training; transport systems and accessibility; engaging people with disability in gym service planning. Implications for rehabilitationGym staff value collaboration with healthcare and rehab professionals to support inclusion of people with disability in exercise.Standardised disability inclusion training for gym staff is recommended.Individuals with disability should be empowered to contribute to the development of inclusive gym facilities and services.Rehab professionals have a role to play in raising awareness and advocating for inclusive exercise opportunities.
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Affiliation(s)
- Caitríona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Grainne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sinead Cosgrave
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Tiarna Sands
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brendan Leacy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Igor Markievicz
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Andrew Monaghan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nora Shields
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
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Mills CJ, Tracey D, Kiddle R, Gorkin R. Evaluating a virtual reality sensory room for adults with disabilities. Sci Rep 2023; 13:495. [PMID: 36627351 PMCID: PMC9832154 DOI: 10.1038/s41598-022-26100-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 12/09/2022] [Indexed: 01/11/2023] Open
Abstract
Sensory processing difficulties can negatively impact wellbeing in adults with disabilities. A range of interventions to address sensory difficulties have been explored and virtual reality (VR) technology may offer a promising avenue for the provision of sensory interventions. In this study, preliminary evidence about the impact of Evenness, an immersive VR sensory room experience, for people with disabilities was investigated via a single intervention pre-post mixed methods design. Quantitative methodology included single intervention pre-post design (five month timeframe) with 31 adults with various developmental disabilities to determine the impact of use of aVR sensory room using a head mounted display (HMD) in relation to anxiety, depression, sensory processing, personal wellbeing and adaptive behaviour. Qualitative semi-structured interviews were also conducted with thirteen purposefully selected stakeholders following Evenness use. Results indicated significant improvements in anxiety, depression and sensory processing following Evenness use. Qualitative analysis corroborated the anxiety findings. No significant changes were observed in personal wellbeing or adaptive behaviour. Results are promising and indicate that a VR sensory room may have a positive impact on anxiety, depression and sensory processing for adults with disabilities. A longer study timeframe and a more rigorous experimental methodology is needed to confirm these findings.
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Affiliation(s)
- Caroline J. Mills
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Danielle Tracey
- grid.1029.a0000 0000 9939 5719School of Education, Western Sydney University, Bankstown Campus, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1029.a0000 0000 9939 5719Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Ryan Kiddle
- grid.1007.60000 0004 0486 528XInnovation Campus, Bunji Solutions, University of Wollongong, iAccelerate, Building 239Squires Way, North Wollongong, NSW 2500 Australia
| | - Robert Gorkin
- grid.1007.60000 0004 0486 528XSMART Intrastructure Facility, University of Wollongong, Wollongong, NSW 2522 Australia
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Kim DK, Oh DW. Investigation of walking tasks experienced by community-living individuals with chronic stroke using a validated community ambulation survey. Disabil Rehabil 2023; 45:252-259. [PMID: 35220844 DOI: 10.1080/09638288.2022.2030417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to demonstrate the necessary walking skills for community ambulation of individuals with chronic stroke using a validated community ambulation survey. METHODS A total of 107 older adults and 99 ambulatory, urban-living people with chronic stroke were sampled by convenience method. A community ambulation survey was developed to establish content and concurrent validity. Using the survey, older adults and individuals with stroke documented the frequency with which walking tasks were performed throughout the day. RESULTS The survey was valid for clinical use (kappa coefficients ranging from 0.737 to 0.873). Compared with those encountered by the older adult group, walking tasks less frequently performed by the stroke group included the use of revolving doors, navigating stairs, walking through crossways, carrying and manipulating objects, and walking at a fast pace and for long distances. Participants in the stroke group used automatic doors to enter buildings and walked through underpasses to pass crossways more frequently than those in the older adult group. CONCLUSIONS These findings identify the walking tasks that people with chronic stroke show less participation in community, which should be involved in routine rehabilitation schedules to restore functional walking in the community.Implications for rehabilitationCommunity ambulation survey is appropriate to identify the challenging walking tasks that people with chronic stroke show less participation in community.People with chronic stroke showed less frequent participation in walking tasks such as using stairs, using crossways, carrying objects, and walking fast and long distances, which are challenging for them.To achieve the final goal of stroke rehabilitation, it is necessary to repeatedly practice challenging walking tasks in a routine rehabilitation schedule.
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Affiliation(s)
- Dong-Kyu Kim
- Department of Physical Therapy, National Traffic Injury Rehabilitation Hospital, Dogok-ri, Republic of Korea
| | - Duck-Won Oh
- Department of Physical Therapy, College of Health and Medical Science, Cheongju University, Cheongju, Republic of Korea
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Fernández-Solano AJ, Rodríguez-Bailón M, Del Baño-Aledo ME. Increasing occupational participation: A qualitative analysis within the “Occupational Self-Analysis” program. Br J Occup Ther 2022. [DOI: 10.1177/03080226221145389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: Occupational participation is a key element to increase the quality of life in the population. One of the effective interventions to increase occupational participation is the “Occupational Self-Analysis” program. The aim of this study was to analyze participant’s reported benefits about the “Occupational Self-Analysis” program. Method: This is a qualitative study with 26 participants (12 people with intellectual disability, 7 affected by acquired brain injury, and 7 students) who participated in weekly group sessions and one individual session. The outcomes were measured based on participant diaries and focus group transcriptions. Results: Two main themes emerged: (1) supports for occupational participation and (2) barriers for occupational participation. The thematic analysis of the categories was based on the Model of Human Occupation to increase applicability of the program in occupational therapy practice. Conclusions: The “Occupational Self-Analysis” program allowed participants to increase their knowledge of supports provided for and the barriers against occupational participation.
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Affiliation(s)
- Ana Judit Fernández-Solano
- Occupational Therapy Department, Facultad de Ciencias de la Salud, Universidad Católica de Murcia, Murcia, Spain
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Harrison M, Forsyth K, Murray AL, Angarola R, Henderson S, Irvine Fitzpatrick L, Fisher G. Establishing the measurement properties of the Residential Environment Impact Scale (Version 4.0). Scand J Occup Ther 2022:1-10. [PMID: 36490204 DOI: 10.1080/11038128.2022.2143891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Developed as an environment assessment informed by the Model of Human Occupation, the Residential Environment Impact Survey considered the physical, social and activity features of the environment, evaluating the impact of the environment on resident's quality of life. Clinicians reported that the Residential Environment Impact Survey was a useful tool; however, it had not been structured to be a measurement tool and did not have established psychometric properties. AIMS/OBJECTIVES This study examines the psychometric properties of the restructured Residential Environment Impact Scale Version 4.0 (REIS), which measures the level of environment support provided to residents. MATERIAL AND METHODS The REIS was completed across residential sites for people with complex mental health needs. A many facets Rasch analysis was conducted to establish the reliability and validity of the REIS. RESULTS The REIS demonstrated reasonable psychometric properties, with items demonstrating internal scale validity and scale items following an expected pattern of increasingly challenging environment support. CONCLUSIONS AND SIGNIFICANCE Initial evidence suggests that the REIS provides a valid and reliable measure of environment support, providing a detailed assessment of how physical, social and activity elements of the environment support or inhibit participation and can be applied across a range of living environments.
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Affiliation(s)
- Michele Harrison
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Aja Louise Murray
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland.,School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, Scotland
| | - Rocco Angarola
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland.,Midlothian Health and Social Care Partnership, Dalkeith, Scotland
| | - Shona Henderson
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | | | - Gail Fisher
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, USA
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Hezam IM, Mishra AR, Rani P, Alshamrani A. Assessing the barriers of digitally sustainable transportation system for persons with disabilities using Fermatean fuzzy double normalization-based multiple aggregation method. Appl Soft Comput 2022. [DOI: 10.1016/j.asoc.2022.109910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Della Vecchia C, Préau M, Haesebaert J, Viprey M, Rode G, Termoz A, Dima A, Schott AM. Factors associated with post-stroke social participation: A quantitative study based on the ICF framework. Ann Phys Rehabil Med 2022; 66:101686. [PMID: 35779831 DOI: 10.1016/j.rehab.2022.101686] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Post-stroke social participation is a major determinant of quality of life and life satisfaction. However, few data relating to participation determinants are available, especially the influence of psychological factors and factors related to the living environment. OBJECTIVES This study investigated determinants of post-stroke social participation within the International Classification of Functioning, Disability and Health framework. METHODS We contacted people with stroke who had been hospitalized in the Rhône County, included in a previous cohort study, were aged ≥18 years and were not institutionalized. The primary outcome was social participation measured with the Stroke Impact Scale (SIS) 2.0. We performed multiple hierarchical linear regressions to test the following predictors: clinical factors (stroke-related variables, limitations in Activities of Daily Living [ADL]/Instrumental ADL), personal factors (sociodemographic factors, coping strategies) and environmental factors (satisfaction with social relationships and living environment). RESULTS Among the 352 participants, 63% were men, and mean age was 68.7(SD 14.5) years. In the last multivariate model, variables associated with higher levels of social participation were the use of the positive thinking coping strategy (B (SD)=1.17(0.52), p = 0.03), higher perceived satisfaction with the living environment (B (SD)=0.17(0.07), p = 0.03) and fewer perceived activity limitations (B (SD)=0.55 (0.06), p < 0.001). Conversely, the seeking social support coping style (B (SD)= -1.98 (0.60), p = 0.001), and a higher number of stroke-related sequelae (B (SD)= -1.93(0.53), p = 0.001) were associated with lower social participation. CONCLUSIONS The identification of potentially modifiable personal and environmental factors that influence social participation provides elements to strengthen existing rehabilitation programs and opens the way for possible psychosocial interventions.
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Affiliation(s)
- Claire Della Vecchia
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France.
| | - Marie Préau
- Pole of Social Psychology, Inserm U1296 Unit 'Radiation: Defense, Health Environment', Lyon 2 University, Lyon, France
| | - Julie Haesebaert
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Marie Viprey
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Gilles Rode
- INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon (CRNL), Equipe ImpAct, Bron, France; Service de Médecine Physique et Réadaptation, Hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Anne Termoz
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
| | - Alexandra Dima
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Anne-Marie Schott
- Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France; Hospices Civils de Lyon, Pôle Santé Publique, F-69008 Lyon, France
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Inclusive Environments: Home, Work, Public Spaces, Technology, and Specialty Environments within Occupational Therapy Practice. Am J Occup Ther 2022; 76:24009. [PMID: 36735994 DOI: 10.5014/ajot.2022.76s3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This position statement describes the role and importance of occupational therapy practitioners in integrating inclusive environments into their professional services and into their underlying science. Primary documents that define the occupational therapy profession clearly support its role in creating and ensuring inclusive environments.
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Black L, Shaunfield S, Labellarte PH, Gaebler-Spira D, Foster CC. Physical and Environmental Barriers to Mobility and Participation in Children With Medical Complexity: A Qualitative Study. Clin Pediatr (Phila) 2022; 61:717-726. [PMID: 35610774 DOI: 10.1177/00099228221099097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative study evaluated barriers and facilitators to mobility in the homes of children with medical complexity (CMC) and the subsequent impact on CMC and their families. Eighteen caregivers of CMC were interviewed. Parents described that accessibility barriers impaired delivery of care at home and impacted the child's participation in family life. The most inaccessible areas were stairs and bathrooms. Mobility and transfers became more difficult as children grew larger. Parents and children sustained injuries from performance of activities of daily living (ADLs). When available, durable medical equipment (DME) and home modifications improved home access and typically were funded using insurance and state Title V funds. However, parents reported that larger home modifications, such as bathroom modifications, were cost prohibitive. A pediatrician's inquiry about mobility barriers may reveal crucial information about delivery of home care to CMC. CMC may be referred to rehabilitation specialists to address mobility needs.
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Affiliation(s)
- Laura Black
- Department of Pediatrics, Division of Physical Medicine and Rehabilitation, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - Sara Shaunfield
- Department of Medical Social Sciences, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Patricia H Labellarte
- Mary Ann & J. Milburn Smith Child Health Research, Advocacy, and Outreach Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Department of Pediatrics, Division of Physical Medicine and Rehabilitation, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
- Department of Pediatrics, Northwestern Feinberg School of Medicine, Northwestern University/Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Carolyn C Foster
- Mary Ann & J. Milburn Smith Child Health Research, Advocacy, and Outreach Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Beit Yosef A, Refaeli N, Jacobs JM, Shames J, Gilboa Y. Exploring the Multidimensional Participation of Adults Living in the Community in the Chronic Phase following Acquired Brain Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11408. [PMID: 36141678 PMCID: PMC9517339 DOI: 10.3390/ijerph191811408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/19/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
This exploratory study aimed to examine multiple aspects of the participation of adults in the chronic phase following acquired brain injury (ABI), considering different disability levels. Our study included 25 adults ≥6 months after ABI (predominantly stroke), living at home, without severe cognitive decline. Primary measures included the Canadian Occupational Performance Measure (subjective participation) and the Mayo-Portland Adaptability Inventory-4 Participation Index (objective participation). The results indicated subjective participation problems in all of the International Classification of Functioning, Disability and Health participation domains. In addition, objective participation was reported as most limited in the areas of leisure and recreational activities, residence, and employment. Both subjective and objective participation profiles varied according to the disability level except for the social and leisure areas, which were found to be similar across all subgroups. However, only partial compatibility was found between the subjective and objective participation aspects. To conclude, our findings indicated that chronic ABI survivors report a variety of subjective and objective participation concerns that varied according to their disability levels. Moreover, the incongruity between the participation aspects suggests that the level of limitation may not necessarily correspond to the importance of a particular participation area. This highlights the need for comprehensive assessments to determine unique individual participation profiles in order to facilitate client-centered interventions supporting the rehabilitation of community-dwelling ABI survivors.
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Affiliation(s)
- Aviva Beit Yosef
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| | - Nirit Refaeli
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
| | - Jeremy M. Jacobs
- School of Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
- Department of Geriatrics and Geriatric Rehabilitation, Hadassah Medical Center, Jerusalem 9124001, Israel
| | - Jeffrey Shames
- Medical and Health Professions Division, Maccabi Health Services, Tel Aviv 6812509, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9124001, Israel
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Yokoyama H, Deguchi M, Hongu N. The Role of Diets and Dietitians for Para-Athletes: A Pilot Study Based on Interviews. Nutrients 2022; 14:nu14183720. [PMID: 36145095 PMCID: PMC9505573 DOI: 10.3390/nu14183720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/23/2022] Open
Abstract
Efforts to provide nutrition support to para-athletes have not been established to date, and are far behind those established for athletes without disabilities. In the present study, we attempted to clarify the actual situation regarding dietary challenges of para-athletes. The aim of this study was to obtain clues to effective intervention methods that encourage the practice of sports nutrition. Six active elite para-athletes (30–70 years, four males) and a female physical therapist without physical disability participated in semi-structured interviews. All para-athletes had lower-limb disabilities and participated in the international wheelchair sports competitions (tennis, softball, and table tennis, with 2–26 years of player history). The interview items were on the ideal diet for improving competitive performance, evaluation of their typical diets, and the role of the dietitian as support. Responses obtained from participants were analyzed using quantitative content analysis by language analysis software. There are differences in the ideal diet based on the characteristics of the sport, but most participants believed that a nutritionally well-balanced diet with abundant vegetables was ideal for improving competitive performance. Para-athletes who use a wheelchair daily pay attention to their total calorie intake, because gaining weight is a critical issue for operating their wheelchairs and transferring themselves to and from their wheelchairs. Despite their world-class competition levels, none of them received routine dietary advice from dietitians. Some para-athletes did not even feel the need to engage with dietitians. Even for these para-athletes at a high level of competition, the “ideal diet” they considered was not always the optimal diet for improving their competitive performance. In addition, there are various barriers to practicing their optimal diet due to disability characteristics. Dietitians need to understand these barriers, their concerns and conflicts, and how to help them plan the optimal diet to improve their performance and maintain overall health.
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Affiliation(s)
- Hisayo Yokoyama
- Research Center for Urban Health and Sports, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
- Department of Environmental Physiology for Exercise, Graduate School of Medicine, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
- Correspondence: ; Tel.: +81-06-6605-2947
| | - Miwako Deguchi
- Department of Environmental Physiology for Exercise, Graduate School of Medicine, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
- Department of Nutrition, Graduate School of Human Life and Ecology, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
| | - Nobuko Hongu
- Research Center for Urban Health and Sports, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
- Department of Nutrition, Graduate School of Human Life and Ecology, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi 558-8585, Osaka, Japan
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Marlow NM, Xie Z, Tanner R, Jacobs M, Hogan MK, Joiner TE, Kirby AV. Association between functional disability type and suicide-related outcomes among U.S. adults with disabilities in the National Survey on Drug Use and Health, 2015-2019. J Psychiatr Res 2022; 153:213-222. [PMID: 35841817 PMCID: PMC9811968 DOI: 10.1016/j.jpsychires.2022.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 07/02/2022] [Indexed: 01/07/2023]
Abstract
While research on suicidal behavior for people with disability (PWD) suggests they experience higher risk than people without disability, less is known about variations among individuals with different disability types. This nationally representative, cross-sectional study compared differences in suicide-related outcomes (ideation, planning, attempts) among PWD by functional disability type (hearing, vision, cognitive, mobility, complex activity) and number. Secondary analysis of adult PWD in the 2015-2019 National Survey on Drug Use and Health (unweighted N = 35,544; representing 47,723,378 PWD, weighted) was used to estimate relationships between suicide-related outcomes and disability type and number. Most respondents were female (55.9%), and 36.0% were aged ≥65 years. Adjusted odds ratios (AORs) from multivariable logistic regression indicated that suicidal ideation and suicide attempt, respectively, were significantly more likely among individuals with cognitive (AOR = 1.71, 95% CI = 1.24-2.35; AOR = 2.54, 95% CI = 1.31-4.91), complex activity (AOR = 1.96, 95% CI = 1.37-2.81; AOR = 2.67, 95% CI = 1.32-5.41), and ≥2 limitations (AOR = 2.02, 95% CI = 1.52-2.69; AOR = 3.46, 95% CI = 1.84-6.50) than hearing limitation. Also, relative to other disability types, suicide-related outcomes were significantly more likely among individuals with cognitive limitation and complex activity limitation (p < 0.001). Additionally, suicide-related outcomes elevated in likelihood as the number of limitations increased, with the largest associations among those with ≥5 limitations for suicidal ideation (AOR = 2.31, 95% CI = 1.46-3.66), suicide planning (AOR = 3.34, 95% CI = 1.97-5.68), and suicide attempt (AOR = 6.37, 95% CI = 3.76-10.79). Subgroup analyses showed that presence of cognitive limitation and multiple limitations differentiated between suicidal ideators and suicide attempters. Further research is needed to identify causes of these risks and develop suicide prevention efforts for these particularly vulnerable groups.
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Affiliation(s)
- Nicole M Marlow
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA.
| | - Zhigang Xie
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA
| | - Rebecca Tanner
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA
| | - Molly Jacobs
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, FL, USA
| | - Michaela K Hogan
- Department of Family, Community and Health Systems Science, University of Florida, Gainesville, FL, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Anne V Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, UT, USA
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Norouzi N, Swenson A, Harvey S. Designing for Success: Integrating Theories of Human Development into Architectural Design for Intergenerational Programming. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2022. [DOI: 10.1080/15350770.2022.2113951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Neda Norouzi
- School of Architecture and Planning, University of Texas at San Antonio, San Antonio, TX, USA
| | - Andrea Swenson
- Marshfield Clinic Research Institute • Marshfield Clinic, Marshfield, WI, USA
| | - Sarah Harvey
- School of Architecture and Planning, University of Texas at San Antonio, San Antonio, TX, USA
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Futeran N, Mackenzie L, Wilkes‐Gillan S, Dickson C. Understanding the participation outcomes for persons with disability when partnered with assistance dogs: A scoping review. Aust Occup Ther J 2022; 69:475-492. [PMID: 35470459 PMCID: PMC9540062 DOI: 10.1111/1440-1630.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Assistance dogs are trained to support persons living with disability and mitigate limitations that hinder their participation in everyday activities. Despite participation being a frequent challenge for people with disabilities, evidence linking assistance dog provision to improved participation outcomes is underdeveloped. This scoping review aimed to improve understanding by mapping the participation outcomes claimed in research on assistance dogs using the International Classification of Functioning (ICF), Disability and Health framework. METHODS Using the Arksey and O'Malley's six-step framework, this scoping review searched six databases. Data were collected, mapped and summarised in accordance with the domains outlined in the ICF. RESULTS In total, 38 studies across 41 papers met the inclusion criteria. Included studies investigated assistance dogs who were partnered with people living with physical disabilities, mental illness, autism and chronic conditions that require alerting (e.g., epilepsy and diabetes). Mapping of participation outcomes suggested that assistance dogs can have a positive impact on participation in many areas of daily life. CONCLUSION Findings can assist practitioners, funders and policymakers to recognise the value of assistance dogs as a support for people with disability. However, further research is needed to address limitations regarding study designs, for example, the outcome measures used.
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Affiliation(s)
- Nicola Futeran
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Sarah Wilkes‐Gillan
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Claire Dickson
- Occupational TherapyAssistance Dogs AustraliaEngadineNew South WalesAustralia
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Fortune N, Curryer B, Badland H, Smith-Merry J, Devine A, Stancliffe RJ, Emerson E, Llewellyn G. Do Area-Level Environmental Factors Influence Employment for People with Disability? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159082. [PMID: 35897452 PMCID: PMC9330484 DOI: 10.3390/ijerph19159082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022]
Abstract
Employment is an important social determinant of health and wellbeing. People with disability experience labour market disadvantage and have low labour force participation rates, high unemployment rates, and poor work conditions. Environmental factors are crucial as facilitators of or barriers to participation for people with disability. Understanding how the physical, social, and economic characteristics of local areas influence employment for people with disability can potentially inform interventions to reduce employment inequalities. We conducted a scoping review of research investigating associations between area-level environmental factors and employment for people with disability. Eighteen articles published between 2000 and 2020 met the inclusion criteria, and data were extracted to map the current evidence. Area-level factors were categorised into six domains relating to different aspects of environmental context: socioeconomic environment, services, physical environment, social environment, governance, and urbanicity. The urbanicity and socioeconomic environment domains were the most frequently represented (15 and 8 studies, respectively). The studies were heterogeneous in terms of methods and data sources, scale and type of geographic units used for analysis, disability study population, and examined employment outcomes. We conclude that the current evidence base is insufficient to inform the design of interventions. Priorities for future research are identified, which include further theorising the mechanisms by which area-level factors may influence employment outcomes, quantifying the contribution of specific factors, and interrogating specific factors underlying the association between urbanicity and employment outcomes for people with disability.
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Affiliation(s)
- Nicola Fortune
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW 2006, Australia; (B.C.); (J.S.-M.); (R.J.S.); (G.L.)
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
- Correspondence:
| | - Bernadette Curryer
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW 2006, Australia; (B.C.); (J.S.-M.); (R.J.S.); (G.L.)
| | - Hannah Badland
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
- Centre for Urban Research, RMIT University, Melbourne, VIC 3000, Australia
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW 2006, Australia; (B.C.); (J.S.-M.); (R.J.S.); (G.L.)
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
| | - Alexandra Devine
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Roger J. Stancliffe
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW 2006, Australia; (B.C.); (J.S.-M.); (R.J.S.); (G.L.)
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
| | - Eric Emerson
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW 2006, Australia; (B.C.); (J.S.-M.); (R.J.S.); (G.L.)
- NHMRC Centre of Research Excellence in Disability and Health, Parkville, VIC 3010, Australia; (H.B.); (A.D.); (E.E.)
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Rajala C, Waterhouse C, Evans E, Erler KS, Bergin MJ, Bannon SM, Slavin MD, Kazis LE. Conceptualization of Participation: A Qualitative Synthesis of Brain Injury Stakeholder Perspectives. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:908615. [PMID: 36188936 PMCID: PMC9397755 DOI: 10.3389/fresc.2022.908615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/17/2022] [Indexed: 12/04/2022]
Abstract
Background The return to participation in meaningful life roles for persons with acquired brain injury (pwABI) is a goal shared by pwABI, their families, clinicians, and researchers. Synthesizing how pwABI define participation will help to identify the aspects of participation important to pwABI and can inform a person-centered approach to participation outcome assessment. To-date, the qualitative synthesis approach has been used to explore facilitators and barriers of participation post-stroke, and views about participation among individuals with stroke in the UK. Objectives This paper's objectives are to (1) conduct a scoping review of qualitative literature that defines and characterizes participation from the perspective of pwABI of any type, (2) synthesize how pwABI define and categorize participation, and (3) link the themes identified in the qualitative synthesis to the International Classification of Functioning, Disability, and Health (ICF) using standardized linking rules to enhance the comparability of our findings to other types of health information, including standardized outcome measures. Methods We completed a scoping review of qualitative literature. Our search included PubMed, APA PsychInfo, CINAHL, and Embase databases and included articles that (1) had qualitative methodology, (2) had a sample ≥50% pwABI, (3) had aims or research questions related to the meaning, definition, perception, or broader experience of participation, and (4) were in English. Qualitative findings were synthesized using Thomas and Harden's methodology and resultant themes were linked to ICF codes. Results The search identified 2,670 articles with 2,580 articles excluded during initial screening. The remaining 90 article abstracts were screened, and 6 articles met the full inclusion criteria for the qualitative synthesis. Four analytical themes emerged: (1) Essential Elements of Participation (2) How pwABI Approach Participation, (3) Where pwABI Participate, and (4) Outcomes of Participation. Each overarching theme included multiple descriptive themes. Conclusion In this paper, we identified themes that illustrate key components of participation to pwABI. Our results provide insight into the complex perspectives about participation among pwABI and illustrate aspects of participation that should hold elevated importance for clinicians and researchers supporting participation of pwABI.
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Affiliation(s)
- Caitlin Rajala
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
- *Correspondence: Caitlin Rajala
| | - Camden Waterhouse
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Emily Evans
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Kimberly S. Erler
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, United States
| | - Michael J. Bergin
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah M. Bannon
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mary D. Slavin
- Rehabilitation Outcomes Center, Spaulding Rehabilitation Hospital, Boston University School of Public Health, Boston, MA, United States
| | - Lewis E. Kazis
- Rehabilitation Outcomes Center, Spaulding Rehabilitation Hospital, Harvard Medical School and Boston University School of Public Health, Boston, MA, United States
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Spinal Cord Injury Patient's Physical and Psychological Care Needs at Home from Patients’ and Caregivers’ Perspectives: A Qualitative Study. ARCHIVES OF NEUROSCIENCE 2022. [DOI: 10.5812/ans-123462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Limited studies have attempted to identify the care needs of patients with spinal cord injury (SCI) and their professional caregivers at home and after discharge from the hospital. However, little information about these needs has led to increased physical and psychological complications and thus a reduced quality of life in SCI patients. Objectives: This study aimed to explain the experiences of patients and their caregivers regarding physical and psychological care needs at home. Method: This qualitative descriptive study was conducted on 24 SCI patients and their professional caregivers using the conventional content analysis. Data were collected through unstructured and semi-structured interviews. Purposeful sampling was continued until data saturation was reached. The conventional content analysis approach proposed by Graneheim and Lundman (continuous comparison) was used to analyze the data. Results: The age range of the participants was 29 - 48 years, with an average age of 37.8 years. Seven of the participants had paraplegia, and three of them had tetraplegia. The results of data analysis led to the extraction of two main categories, including physical and psychological care needs. Conclusions: By identifying the real needs of patients after discharge from the hospital, we emphasize the need to remove barriers to home health care services and provide more financial support to meet patients' needs. Therefore, policymakers are encouraged to use the results of this study to plan at-home patient care services.
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Hughes DM, Vento-Wilson M, Boyd LE. Direct Speech-Language Intervention Effects on Augmentative and Alternative Communication System Use in Adults With Developmental Disabilities in a Naturalistic Environment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1621-1636. [PMID: 35442756 DOI: 10.1044/2022_ajslp-21-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Research involving the effects of augmentative and alternative communication (AAC) intervention in adults, especially in naturalistic settings, has been identified as a critical public health need. Despite rapid advances in high-tech AAC, many adults with developmental disabilities have experienced reduced access to assistive technology and AAC, which can function as a de facto environmental barrier to participation, for these individuals. As a means of decreasing barriers to participation, this study targeted skill increases in the operational, linguistic, social, and strategic use of AAC systems. METHOD This study used a preexperimental, single-case AB design to identify skill level changes in the operational, linguistic, social, and strategic use of their AAC system from baseline to the completion of intervention. The four adult participants with developmental disabilities and limited use of natural speech as a primary modality of communication were identified through a collaborative relationship between a communication sciences and disorder university program and a state-run adult day program for individuals who had aged out of the K-12 school system. Each participant received direct intervention in the four areas described across 7 weeks. RESULTS Visual analysis and percent of nonoverlap of all pairs were used to identify changes in performance occurring between baseline and the conclusion of the intervention period. Results revealed increases across the specific skills, with individuals' variation across participants and target area. Out of 22 total goals targeted, strong effect sizes were observed for 10 goals and moderate effect sizes were observed for seven. CONCLUSIONS Skill increases in the four areas of AAC system use can be achieved with direct intervention in adults with developmental disabilities and limited use of natural speech as a primary modality of communication. This approach also underscores the value of collaborations between university training programs, providers of adult services, and adult participants as a cost-effective strategy for service delivery.
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Affiliation(s)
- Deanna M Hughes
- Communication Sciences & Disorders, Crean College of Health & Behavioral Sciences, Chapman University, Irvine, CA
| | - Margaret Vento-Wilson
- Department of Speech-Language Pathology, College of Health and Human Services, California State University, Long Beach
| | - LouAnne E Boyd
- Computer Science, Fowler School of Engineering, Chapman University, Irvine, CA
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Reber L, Kreschmer JM, James TG, Junior JD, DeShong GL, Parker S, Meade MA. Ableism and Contours of the Attitudinal Environment as Identified by Adults with Long-Term Physical Disabilities: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127469. [PMID: 35742718 PMCID: PMC9224372 DOI: 10.3390/ijerph19127469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/09/2022] [Accepted: 06/15/2022] [Indexed: 12/04/2022]
Abstract
Adults with physical disabilities experience a continuum of enabling and disabling attitudes in the environment. This study identified where adults with physical disabilities experience the attitudinal environment, the continuum of those attitudes, and how they impact emotional and psychological health and well-being. Focus groups and interviews were conducted in 2019 and 2020 with adults with physical disabilities in southeastern Michigan in the United States. Participants discussed environmental factors that impact healthy aging. From an initial thematic coding of narratives, the attitudinal environment was identified. Transcripts were recoded and analyzed focusing on societal attitudes. Qualitative analyses revealed that participants did not experience societal attitudes as simply positive or negative, and that the contexts in which these attitudes were expressed were not limited to interpersonal interactions. Rather, these attitudes were also experienced in the built environment and through social institutions and organizations and their programs, systems, and structures that provide or deny needed accommodations, resources, and support. The spectrum of overlapping attitudes that participants articulated ranged from understanding and supportive, to not understanding, to being viewed and treated as less than human. Societal structures reflect and influence societal attitudes and have material consequences on the lives of adults with physical disabilities.
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Affiliation(s)
- Lisa Reber
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA; (J.M.K.); (M.A.M.)
- Correspondence:
| | - Jodi M. Kreschmer
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA; (J.M.K.); (M.A.M.)
| | - Tyler G. James
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104, USA;
| | - Jaime D. Junior
- Civil Rights, Inclusion and Opportunity Department, Detroit, MI 48226, USA;
| | | | - Shan Parker
- Department of Public Health and Health Sciences, University of Michigan, Flint, MI 48502, USA;
| | - Michelle A. Meade
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA; (J.M.K.); (M.A.M.)
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Warfield ME, Lorenz L, Ali HN, Gittell JH. Strengthening Community Participation by People With Disabilities in Community-Based Group Homes Through Innovative Action Research. Front Public Health 2022; 10:747919. [PMID: 35570906 PMCID: PMC9099021 DOI: 10.3389/fpubh.2022.747919] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
In the US and beyond, a paradigm shift is underway toward community-based care, motivated by changes in policies, payment models and social norms. A significant aspect of this shift for disability activists and policy makers is ensuring participation in community life for individuals with disabilities living in residential homes. Despite a U.S. government ruling that encourages community participation and provides federal and state funding to realize it, little progress has been made. This study builds on and integrates the expanded model of value creation with relational coordination theory by investigating how the resources and relationships between care providers, adults with disabilities, family members, and community members can be leveraged to create value for residents through meaningful community participation. The purpose of our community case study was to assess and improve the quality of relationships between stakeholder groups, including direct care staff and managers, residents, family members, and the community through an action research intervention. This study took place in a residential group home in a Northeastern US community serving adults with disabilities from acquired brain injury. A pre-test post-test design was used and quantitative assessments of relational coordination were collected through electronic surveys, administered at baseline, and post-intervention. Direct care staff, supervisors, the house manager, and nursing staff completed the survey. Qualitative data were collected through focus groups, change team meetings, and key informant interviews. Direct care staff formed a change team to reflect on their baseline relational coordination data and identified the weak ties between direct care staff, family members, and the community as an area of concern. Staff chose to hold a community-wide open house to provide an opportunity to foster greater understanding among staff, residents, family, and community members. The change team and other staff members coordinated with local schools, business owners, town officials, churches, and neighbors. The event was attended by 50 people, about two-thirds from the community. Following the intervention, there was an increase in staff relational coordination with the community. While statistical significance could not be assessed, the change in staff RC with the community was considered qualitatively significant in that real connections were made with members of the community both directly and afterwards. Despite a small sample size, a residential setting where management was favorable to initiating staff-led interventions, and no comparison or control group, our small pilot study provides tentative evidence that engaging direct care staff in efforts to improve relational coordination with community members may succeed in building relationships that are essential to realizing the goal of greater participation in community life.
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Affiliation(s)
- Marji Erickson Warfield
- Center for Youth and Communities, Lurie Institute on Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Laura Lorenz
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Hebatallah Naim Ali
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
| | - Jody Hoffer Gittell
- Institute for Health Systems, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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