Modifying homes for persons with physical disabilities in Thailand

Accessible independent housing for people with disabilities: A scoping review of promising practices, policies and interventions

BACKGROUND

Accessible housing is imperative to enabling independent living for many people with disabilities; yet, research consistently shows how people with disabilities often lack appropriate accessible housing and are more likely to experience unaffordable, insecure, and/or poor quality housing. Therefore, the aim of this study was to understand promising practices, policies and interventions regarding accessible independent housing for people with disabilities.

METHODS

We conducted a scoping review that involved searching seven international literature databases that identified 4831 studies, 60 of which met our inclusion criteria.

RESULTS

The reviewed studies involved 18 countries over a 20-year period. Our review highlighted the following key trends: (1) removing barriers to obtaining accessible housing (e.g., advocacy, builders enhancing housing supply, subsidies and financial incentives); (2) policies influencing accessible housing; (3) interventions to enhance accessible housing (i.e., home modifications, smart homes, mobile applications and other experimental devices); and (4) the impact of accessible independent housing on health and wellbeing.

CONCLUSIONS

Our findings emphasize the importance of accessible housing for people with disabilities and the urgent need to advance accessible housing options.

Effects of a diabetes mellitus-specific care intervention and home environment among older adults following hip fracture surgery

OBJECTIVES

To explore the impact of home environment on effects of a diabetes mellitus (DM)-specific care model among older adults following hip-fracture surgery.

METHODS

A secondary analysis using the Home Environmental Barriers Scale assessed home environment (intervention group=81, control group=79) at 1- and 3-months post-discharge. Outcomes of physical functioning were assessed at 1-, 3-, 6-, and 12-months post-discharge.

RESULTS

The intervention group had better home environmental improvements compared with the control group. Participants were characterized as having good or poor environmental improvements. Those with good improvements and received the intervention had better activities of daily living compared with matched controls. Participants with poor improvements and received the intervention had better scores for hip range of motion and quadriceps muscle strength compared with matched controls.

DISCUSSION

A DM-specific home rehabilitation for older adults following hip-fracture surgery that includes assessment of the home environment can facilitate complex postoperative functional recovery.

Managing health care needs of the elderly through an elderly care manager: Thailand

Background: This mixed method research aimed to investigate health needs of older people and the attributes of the Elderly Care Managers (ECMs), and to evaluate the outcomes of two ECMs coordination. Methods: Three phases were: 1) a field survey of the health needs of 94 older persons; 2) group discussions between ten relevant persons involved in ECMs characteristics; 3) two ECMs coordinating with health-related agencies and measuring the outcomes of older people who needed assistance. Results: 63.1% of the participants had difficulties with their health, 12.8% of them had no caregiver, 26.6% of them had >1 health condition. Group talks dealt with the characteristics, role and attributes of ECMs. The two-month of ECMs coordination with health-related agencies according to older adults' needs, and made home visits encouraged the aged to acquire knowledge on their diseases. Conclusion: ECMs's coordination with health-related agencies could support the needs of those of advanced age.

Unravelling 'low-resource settings': a systematic scoping review with qualitative content analysis

INTRODUCTION

The effects of healthcare-related inequalities are most evident in low-resource settings. Such settings are often not explicitly defined, and umbrella terms which are easier to operationalise, such as 'low-to-middle-income countries' or 'developing countries', are often used. Without a deeper understanding of context, such proxies are pregnant with assumptions, insinuate homogeneity that is unsupported and hamper knowledge translation between settings.

METHODS

A systematic scoping review was undertaken to start unravelling the term 'low-resource setting'. PubMed, Africa-Wide, Web of Science and Scopus were searched (24 June 2019), dating back ≤5 years, using terms related to 'low-resource setting' and 'rehabilitation'. Rehabilitation was chosen as a methodological vehicle due to its holistic nature (eg, multidisciplinary, relevance across burden of disease, and throughout continuum of care) and expertise within the research team. Qualitative content analysis through an inductive approach was used.

RESULTS

A total of 410 codes were derived from 48 unique articles within the field of rehabilitation, grouped into 63 content categories, and identified nine major themes relating to the term 'low-resource setting'. Themes that emerged relate to (1) financial pressure, (2) suboptimal healthcare service delivery, (3) underdeveloped infrastructure, (4) paucity of knowledge, (5) research challenges and considerations, (6) restricted social resources, (7) geographical and environmental factors, (8) human resource limitations and (9) the influence of beliefs and practices.

CONCLUSION

The emerging themes may assist with (1) the groundwork needed to unravel 'low-resource settings' in health-related research, (2) moving away from assumptive umbrella terms like 'low-to-middle-income countries' or 'low/middle-income countries' and (3) promoting effective knowledge transfer between settings.

Home Modification Assessments for Accessibility and Aesthetics: A Rapid Review

PURPOSE

The purpose of this study was to identify assessments used to evaluate the homes of people with disabilities in terms of accessibility, usability, activities, comfort/satisfaction, and aesthetics.

BACKGROUND

The home is increasingly becoming an environment for healthcare as more people desire to age in place. Research indicates home environmental modifications to be beneficial to promote a better person-environment fit, especially when using a standardized assessment approach. There is not a comprehensive list of assessments that address home modifications, adaptations, or interior designs for people with disabilities.

METHOD

Researchers conducted a rapid review of articles, with data collection scales, instruments, and procedures for home modifications published between 2000 and 2017.

RESULTS

A total of 26 articles met the inclusion criteria, resulting in the identification of 33 distinct assessments, including 18 assessments evaluating the accessibility of home modifications, 3 assessments examining usability, 15 assessments addressing activities of daily living or functional activities, and 5 assessments addressing comfort and/or satisfaction. No assessments for aesthetics were located.

CONCLUSION

Researchers developed a list of assessments that could be used for research or practice. Further research is needed to address the lack of assessments focusing on the aesthetics or attractiveness of home modifications, as well as more assessments tailored to specific diagnoses and population groups.