The National and Regional Prevalence Rates of Disability, Type, of Disability and Severity in Saudi Arabia-Analysis of 2016 Demographic Survey Data

Predictors of health-related quality of life (HRQoL) for caregivers of children with developmental disabilities in Saudi Arabia: An observational study

To examine predictors of health-related quality of life (HRQoL) for caregivers of children with developmental disabilities, a cross-sectional design was used. Participants were primary caregivers of children with developmental disabilities. Caregivers completed a demographic form about the child and the family, and the Arabic version of Patient-Reported Outcomes Measurement Information System-Profile 29 (PROMIS-29 v2.0). Descriptive statistics were used to report on demographic data, 1-sample Z tests to compare PROMIS domain scores with the general population, and multiple linear regression analyses to identify predictors of each domain. Participants were 111 primary caregivers, mostly mothers (65.8%). Caregivers reported higher levels of anxiety, depression, fatigue, sleep disturbance, and pain interference, and lower levels of physical function and social participation compared to the general population, P < .05. The regression models for predicting the HRQoL accounted for 12.3% of the variance in the physical function domain (P = .016), 13.9% in the anxiety domain (P = .009), 24.7% in the ability to engage in social activities and roles (P < .001), and 11.4% in the pain interference domain (P = .02). In these models, the severity of the child's disability and/or the child's age were common significant predictors. Specifically, child's age was the only significant predictor in 2 domains, the anxiety domain (β = -.29, P < .01) and ability to participate in social activities and roles domain (β = .42, P < .05). The severity of the child's disability was the only significant predictor in the physical function domain (β = -.52, P < .01). Both the severity of the child's disability and the child's age were significant predictors in the pain interference model (β = .40, P < .05), and (β = -.23, P < .05), respectively. However, the models did not significantly predict depression, fatigue, or sleep disturbance, P > .05. HRQoL is a complex construct and is influenced by multiple child and family factors. Implications of the study emphasize the importance of regular HRQoL screening for caregivers, the development of efficient referral systems for support services, and the exploration of respite care options.

Assessment of Oral Health Conditions Among Physically Disabled Patients in Saudi Arabia

OBJECTIVES

This study was undertaken to assess the oral health status among physically disabled Saudi patients.

METHODS

Recruitment took place in the Armed Forces Centre for Health Rehabilitation in Taif, Saudi Arabia. 124 patients living with a physical disability were enrolled and divided into three groups: hemiplegia, paraplegia and quadriplegia. Data was collected on demographics and different oral indices, including the Decayed Missing Filled Teeth (DMFT) index, the Mean Decayed Teeth score, the Community Periodontal Index (CPI), the Community Periodontal Index of Treatment Needs (CPITN), and the Simplified Oral Hygiene Index (OHI-S).

RESULTS

High DMFT was observed among the hemiplegia group (mean = 22.61; P-value = .008) with no difference in the Mean Decayed Teeth. All groups showed signs of gingivitis in the form of gingival bleeding. The most compromised periodontal health in the form of pockets 6 mm or deeper was found in the hemiplegia group (53.7%; P-value = .001). This was also reflected in the CPITN (39.0%; P-value = .001), indicating the need for complex treatments in the same group. Regarding oral hygiene, all groups showed a "fair" oral hygiene condition (OHI-S < 3.0), with significantly poorer hygiene (mean = 2.49; P-value = .042) and greater debris accumulation (mean = 1.52; P-value = .024) among the quadriplegia group. In the regression analysis, both age and gender had significant effects on some indices, while disability type showed borderline effects.

CONCLUSION

The findings indicate poor oral health in these individuals, mainly due to physical limitations, hindering effective self-care practices.

CLINICAL SIGNIFICANCE

Oral health is a critical aspect in people with physical disabilities, as it is intrinsically linked to overall health and well-being. Recognizing the clinical importance of oral health among physically disabled patients is essential to improve access and affordability of dental care for this vulnerable group of the population.

Nutritional Status and Dietary Behaviors of Children with Intellectual or Developmental Disabilities in Saudi Arabia: A Systematic Review

Children with intellectual or developmental disabilities are susceptible to malnutrition. This systematic review was conducted to assess the nutritional status and dietary behaviors of children with intellectual or developmental disabilities in Saudi Arabia. The target population was children from Saudi Arabia aged 18 years or younger and diagnosed with intellectual or developmental disabilities. Appropriate research studies that were published from inception up to December 2023 were obtained and reviewed. The outcomes of interest, including anthropometric data, laboratory data, dietary intake data, and dietary behaviors data, were collected and organized in relevant tables. The methodological quality and bias risk for the involved studies were evaluated. Out of 286 screened articles, 31 research articles were selected. The review results show that the rates of overweight and obesity were significantly higher among children with intellectual or developmental disabilities compared to typically developing children. The laboratory data revealed that they were more likely to have nutritional deficiencies. Low intake of energy, protein, and several micronutrients is frequently reported among them. Moreover, they are anticipated to have unhealthy dietary behavior. In conclusion, the findings suggested that children with intellectual or developmental disabilities were at higher risk of malnutrition including deploying obesity and nutritional deficiencies. Healthy and balanced nutrition that considers dietary requirements and food preferences is critical to maintaining the optimal development of these children. This review could invite researchers and policy-makers in Saudi Arabia to put more effort into integrating individuals with disability into the healthcare system and community. Further research is required to determine the types of intervention measures that can be taken to reduce the risk of malnutrition. Additional action is needed to monitor the implementation of national policies and programs that target this part of society.

Facilitators and barriers to learning faced by female students with disability in higher education

This study was aimed to investigate the learning experiences' facilitators and barriers that is encountered by the physically disabled female students during their higher education. Twenty semi-structured interviews were conducted with female students with physical disabilities aged between 19 and 33 years. Interviews were transcribed, confirmed, and analyzed after being recorded. The average age of the sample was 22.15 ± 3.48 years and one-fourth of the participants' disability was due to cerebral palsy and 35% participants used wheelchairs. All the factors promoted inclusive education and equal opportunities for both disabled and nondisabled students. This study reveals that in order to improve the learning experiences of students with disabilities (SwD) and to give them more opportunities for success, it is important to consider all the barriers discussed in this study. It can be concluded that high effort is required to transform the higher educational institutions to be more accommodating for students with disabilities.

Translation, cross cultural adaptation, and validation of Arabic version of Interview administered version of Work Rehabilitation Questionnaire (WORQ)

BACKGROUND

Accurate assessment tools for work rehabilitation are essential in healthcare settings. Adapting the Work Rehabilitation Questionnaire (WORQ) to Arabic-speaking populations ensures effective evaluation and intervention for individuals with work-related disabilities.

OBJECTIVE

To execute a cross-cultural adaptation of interview-administered version Work Rehabilitation Questionnaire -Arabic (WORQ-A) and assess the psychometric properties of WORQ-A in patients with musculoskeletal problems.

METHODS

WORQ is mainly intended to assess the work functioning of persons who are involved in vocational rehabilitation. Psychometric properties were scrutinized in the outpatient rehabilitation center. Test-retest reliability was examined with intraclass correlation coefficient (ICC), and internal consistency was evaluated with Cronbach's alpha. The usability of WORQ-A was established in 46 patients with musculoskeletal problems.

RESULTS

WORQ-A exhibited exceptional internal consistency (0.93) and a great test-retest reliability (0.87). Regarding usability, the ability to understand the questions and answer choices was established as good. Five percent of the participants encountered minor difficulties with certain words, while the majority found it quite straightforward to choose the correct answers.

CONCLUSIONS

The WORQ-A is an effective, consistent, and very easy to administer questionnaire to assess the work-related functions assumed in our study context and the individualities of the sample.

Disability inclusion assessment in primary healthcare centers in Eastern Saudi Arabia: a way forward

Individuals with disabilities often experience barriers in accessing healthcare facilities, including physical barriers such as inaccessible facilities, transportation difficulties, and a lack of assistive devices. Other barriers may include a lack of communication assistive devices and stigma or negative attitudes from healthcare personnel or society. Published literature emphasizes the value of creating a supportive and safe environment for the inclusion of persons with disabilities in society. Establishing guidelines for disability inclusion becomes imperative to ensure equitable access to healthcare services. This study aimed to identify challenges related to accessibility in infrastructure, services, equipment, processes, and training in primary healthcare settings. The study was conducted in Dammam, AlKhobar, and AlQatif in August 2022, using an analytical, quantitative cross-sectional approach. A total of 56 primary healthcare centers (PHCs) were assessed across multiple domains. Government-built PHCs had an average accessibility rate of 83.2%, while those located in rented buildings scored an average of 67.1%. One domain that scored highly among both building types was the clinic rooms domain, with an average score of 90%. Conversely, the services domain showed significant differences, with an average accessibility rate of 47% for rented buildings and 75% for government-built buildings. Finally, the study looked into recommendations drawn from other health systems and recommended ways to help improve disability needs inclusion in the Eastern Region of Saudi Arabia.

The Changing Incidence and Prevalence of Falls and Its Disability Burden Among the Geriatric Population in Saudi Arabia from 1990 to 2019: A Longitudinal Analysis Using Global Burden of Disease Study Data

BACKGROUND

Falls represent a significant and growing public health issue among older adults worldwide. This study provides a comprehensive analysis of the trends in the incidence, prevalence, and disability burden of falls among older adults in Saudi Arabia over 29 years, with a focus on gender disparities.

METHODS

Utilizing the Global Burden of Disease (GBD) Study data, this observational analysis tracked the epidemiology of falls from 1990 to 2019. The study employed ICD-9 and ICD-10 codes to identify falls, analyzing incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs), stratified by gender and reported with 95% uncertainty intervals (UIs).

RESULTS

The incidence and prevalence of falls increased for both genders from 1990 to 2019, with males showing a higher relative increase in prevalence rates (57% for males vs. 26% for females). The disability burden, indicated by DALYs, increased by 4% for males and decreased by 10% for females, whereas YLDs saw an increase of 38% for males and 8% for females. The analysis highlights a notable rise in both the frequency of falls and their associated disability, with gender-specific variations emphasizing greater impacts on males.

CONCLUSIONS

The findings illustrate a significant increase in fall-related incidents and associated disabilities among older adults in Saudi Arabia, with distinct gender differences. These trends call for targeted public health interventions and further research into the underlying causes of falls, risk factors, and effective prevention strategies. Such measures are essential to mitigate the impact of falls, improve health outcomes, and enhance the quality of life for the aging population.

Exploring the Influence of the Coronavirus Disease 2019 Pandemic on the Accessibility of Rehabilitation Services Provided to Children with Disabilities: A Cross-Sectional Study

Background and Objectives: Children with disabilities (such as cerebral palsy, autistic spectrum disorder, and Down syndrome) are the most vulnerable and marginalized subset of the population, representing 2.7% of the total population of Saudi Arabia. The COVID-19 outbreak might have disproportionately affected children with disabilities, augmented their isolation, and induced severe disruptions to the services on which these children rely. Limited research has been conducted in Saudi Arabia to understand the impact of the COVID-19 pandemic on the rehabilitation services provided to children with disabilities and barriers. This study aimed to investigate the effect of the lockdown implemented as a result of the coronavirus disease-2019 (COVID-19) pandemic on the accessibility of rehabilitation services, including communication, occupational therapy, and physical therapy, in Riyadh, Kingdom of Saudi Arabia. Materials and Methods: In this cross-sectional study, a survey was conducted between June and September 2020 during the lockdown in Saudi Arabia. A total of 316 caregivers of children with disabilities from Riyadh participated in the study. The accessibility of rehabilitation services provided to children with disabilities was assessed by designing a valid questionnaire. Results: A total of 280 children with disabilities received rehabilitation services before the COVID-19 pandemic and showed improvement following therapeutic sessions. However, during the pandemic, most children stopped receiving therapeutic sessions because of lockdown, which deteriorated their condition. This shows a significant reduction in the accessibility of the rehabilitation services provided during the pandemic. Conclusions: The findings of this study revealed a drastic decline in services provided to children with disabilities. This caused a notable deterioration in the abilities of these children.

Impacts of health expenditures and environmental degradation on health status—Disability-adjusted life years and infant mortality

Introduction

Human health and well-being are intimately related to environmental quality. In this respect, the present study contributes to the existing health economic literature by examining whether public and private health expenditures (PPHE) moderate the incidences of environmental degradation on the health status in Saudi Arabia, particularly disability-adjusted life years (DALYs) and infant mortality.

Methods

Using the fully modified ordinary least squares (FMOLS) method.

Results and Discussion

The empirical results revealed that (i) unconditional positive impacts of CO2 emissions on increasing DALYs and infant mortality; (ii) conditional negative impacts of public health expenditures on DALYs and infant mortality in all the estimated models, whereas global and private expenditure contribute only on reducing infant mortality; (iii) public health expenditure is more effective than private health expenditure in reducing infant mortality; (iv) the effects of the interactions between the indicators of both health expenditures and CO2 emissions on DALYs and infant mortality are negative and significant only for the specifications relating to public health expenditures, indicating that this later could be employed as a policy or conditional variable that moderates the adverse impacts of carbon emissions on the population’s health status. Generally, the study presents an overview of environmental health change’s effects and examine how these effects may be reduced through increasing health spending. The study provides recommendations for addressing health status, health expenditures, and carbon emissions, all of which are directly or indirectly linked to the study.

Occupational Therapy Education in Saudi Arabia: Barriers and Solutions From a Cross-Sectional Survey Study

Objective Occupational therapy (OT) is an important healthcare profession in Saudi Arabia (SA). Yet, no studies have explored the status of OT education in SA. The current study aims to investigate the status of OT education in SA, as well as the barriers and solutions. Methods A cross-sectional-based survey was conducted. Institutions that offered OT programs were identified and an electronic survey was sent to OT program directors across SA that agreed to participate. The survey included items that focused on the number of students in programs, current faculty members, and their characteristics, as well as barriers and solutions to advancing the OT profession and education in SA. Results Out of 74 institutions, eight offered OT programs and all responded to the survey. Among all programs, one was inactive, seven (87.5%) were governmental institutions, and none were nationally accredited. There was a total of 538 currently enrolled students and 76 full-time faculty members. There are no current OT postgraduate programs. Staff shortages and ineffective communication between institutions (87.5%), financial barriers, and lack of knowledge/awareness of the OT profession (75%) were the most common barriers reported. Conclusion OT education is growing in SA but is still not well-represented throughout the different regions of the country. Initiatives to advance the profession are urgently needed by establishing new OT programs and departments as well as introducing OT to more diverse scopes of practice and in more clinical settings. Further research exploring OT education including curriculum content, teaching methods, and assessment strategies of OT programs. Addressing the barriers identified in the current study and methods to overcome them is needed.

The Intersection of Health Rehabilitation Services with Quality of Life in Saudi Arabia: Current Status and Future Needs

Quality of life (QoL) is essential for maintaining a healthy, balanced lifestyle, especially among individuals with chronic diseases. Saudi Arabia (SA) launched a health sector transformation program as part of the nationwide Vision 2030 initiative to ensure the sustainable development of efficient healthcare services, aiming to improve health by increasing well-being and QoL. More investigation into the current status of health rehabilitation services provided to individuals with chronic diseases and future needs to optimize services and improve QoL is needed. This was narratively discussed by experts from different health rehabilitation services in SA. Comprehensive health rehabilitation services including orthopedic, occupational, cardiac, pulmonary, critical care, perioperative, hearing and speech, substance use disorders, and vocational rehabilitation services were addressed. Health rehabilitation services in SA, as in other countries, are suboptimal for individuals in health rehabilitation programs. To optimize the QoL of individuals with chronic diseases, health rehabilitation services should be tailored based on the unique requirements of each service and its serving patients. The shared need to improve health rehabilitation services includes the adoption of home-based and telehealth services, the integration of multi-governmental sectors, the empowerment and allocation of health rehabilitation specialists, public awareness campaigns, policy legislation and guideline development, and the implementation of a long-term follow-up system. This review is one of the first to address the intersection of health rehabilitation services and QoL in SA; urgent and holistic actions are paramount to address the pressing need to optimize SA's health rehabilitation services. The experts' recommendations in this study may be applicable to other countries' health systems, as health rehabilitation services are not well optimized globally.

Online Health Information Seeking by Individuals With Physical Disabilities Caused by Neurological Conditions in Saudi Arabia

Background In recent years, there has been an increase in the use of the internet and information technology for accessing health information. This study aimed to determine the factors that affect patients with neurological disabilities and their willingness to search for information via the internet. In addition, we aimed to assess how patients manage this information, considering the increasing availability of online information and websites that discuss health and diseases, as well as the spread of communication technology and its accessibility to the public. Methodology A cross-sectional, online, self-administered, questionnaire study was conducted in Saudi Arabia. The study targeted patients with neurological diseases who had disabilities. The questionnaire was designed to measure the demographic data, physical disability using the 10-item physical function component of the 36-Item Short Form Health survey, the perceived usefulness of online health information, the perceived ease of use, and the perceived risk of online health information. Lastly, the questionnaire measured online health information-seeking intentions and information use. Data analysis was performed using RStudio (R version 4.1.1, Posit, Boston, USA). Results We received 1,179 responses, of which 399 were excluded due to using another way to get information rather than the internet, 31 did not have neurological disabilities, and 136 did not complete the questionnaire. The remaining 613 responses were included in the final analysis. The participants were mostly male (54.6%), not married (54.6%), and had a bachelor's degree (49.99%). The average age of participants was 18-25 years (24.5%) and 26-35 years (23.2%), Additionally, most participants resided in the western (26.9%) and eastern (25.9%) regions. Most participants (39.5%) had a monthly income of 5,000 to 10,000 SAR. Further, the most common neurological diseases were multiple sclerosis and epilepsy (26.9% and 23.2%, respectively). Based on the analysis of the data, the most important factor affecting online health information-seeking intention was that people with higher monthly incomes were more likely to seek online health information; these included people with an income of 10,000-20,000 SAR and >20,000 SAR. The most common factor affecting information use was the region of residence. The southern and western regions were less likely to adopt information use. Conclusions The monthly income and the area of residence had the greatest impact on people with neurological disabilities who sought online health information in the Kingdom of Saudi Arabia. Educational campaigns and workshops should be arranged to increase the population's awareness of this topic, as well as to reveal the extent and prevalence of online health information seeking among disabled patients.

Oral Health Status, Oral Health Behaviors, and Oral Health Care Utilization among Persons with Disabilities in Saudi Arabia

Various studies have indicated that persons with special needs may face several barriers to dental treatment, which increases the prevalence of oral diseases in this population. Moreover, these studies suggested that Saudis with special needs have a higher prevalence of oral diseases, such as dental caries and periodontal disease. The aim of this review is to synthesize evidence regarding the current status, trends in oral health behaviors, and oral health care utilization among these individuals, as well as to assess the quality of the literature. Furthermore, this review seeks to recommend directions for future research and oral health care policymaking. An electronic search was conducted using the following databases and registers: PubMed/Medline, Embase, ISI Web of Science, Scopus, ClinicalTrials.gov, and CENTRAL. Gray literature, which included conference proceedings and unpublished literature, was searched via the library services and Google/Google Scholar, and the quality of studies was assessed using the AXIS scale for cross-sectional studies. A total of 38 studies were included in this review, with the majority of the studies graded as 'low'. Within the limitations of this study, it can be concluded that individuals with special needs have limited access to oral health care, poor oral health status, and a general lack of awareness in regard to oral health. Therefore, nationwide surveys should be carried out to ascertain the actual extent of the oral inequities among individuals with special needs.

Caregivers’ Perception about the Relationship between Oral Health and Overall Health in Individuals with Disability in Qatif, Saudi Arabia: A Cross-Sectional Study

Background

In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry.

Objective

This study focused on assessing caregivers' perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers' perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting.

Results

A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p < 0.05).

Conclusion

This study has shown the extent to which caregivers of individuals with special care needs to understand the role of oral health in the general health of an individual. Three-quarters of the caregivers agree that dental health affects overall health, and age is a factor that might influence this understanding.

LidSonic V2.0: A LiDAR and Deep-Learning-Based Green Assistive Edge Device to Enhance Mobility for the Visually Impaired

Over a billion people around the world are disabled, among whom 253 million are visually impaired or blind, and this number is greatly increasing due to ageing, chronic diseases, and poor environments and health. Despite many proposals, the current devices and systems lack maturity and do not completely fulfill user requirements and satisfaction. Increased research activity in this field is required in order to encourage the development, commercialization, and widespread acceptance of low-cost and affordable assistive technologies for visual impairment and other disabilities. This paper proposes a novel approach using a LiDAR with a servo motor and an ultrasonic sensor to collect data and predict objects using deep learning for environment perception and navigation. We adopted this approach using a pair of smart glasses, called LidSonic V2.0, to enable the identification of obstacles for the visually impaired. The LidSonic system consists of an Arduino Uno edge computing device integrated into the smart glasses and a smartphone app that transmits data via Bluetooth. Arduino gathers data, operates the sensors on the smart glasses, detects obstacles using simple data processing, and provides buzzer feedback to visually impaired users. The smartphone application collects data from Arduino, detects and classifies items in the spatial environment, and gives spoken feedback to the user on the detected objects. In comparison to image-processing-based glasses, LidSonic uses far less processing time and energy to classify obstacles using simple LiDAR data, according to several integer measurements. We comprehensively describe the proposed system's hardware and software design, having constructed their prototype implementations and tested them in real-world environments. Using the open platforms, WEKA and TensorFlow, the entire LidSonic system is built with affordable off-the-shelf sensors and a microcontroller board costing less than USD 80. Essentially, we provide designs of an inexpensive, miniature green device that can be built into, or mounted on, any pair of glasses or even a wheelchair to help the visually impaired. Our approach enables faster inference and decision-making using relatively low energy with smaller data sizes, as well as faster communications for edge, fog, and cloud computing.

Effect of physical activity and sedentary sitting time on psychological quality of life of people with and without disabilities; A survey from Saudi Arabia

Background

Mental and psychological health issues are on the rise globally. People with disabilities are at greater risk of poor psychological quality of life especially after covid-19 pandemic. Along with other factors physical activity (PA) may have a significant effect on mental health. This study aims to analyze the difference of PA participation and sitting time among people with and without disabilities and their association with psychological quality of life.

Methods

A standard questionnaire was used to collect the data from disabled and non-disabled participants above 15 years of age. Bivariate and multivariate analysis was performed to yield statistical results.

Results

Total study sample consisted of 359 participants (67.7% without disability and 32.3% with disability). Participants without disabilities reported a significantly better psychological quality of life (QOL) (Mean score = 68) as compared to the ones with disabilities (Mean score = 61), (p < 0.01). There was significant difference between the sitting time of two groups with longer sitting time among people with disabilities (6.1 h/day) as compared to non-disabled (5.3 h). Optimum level of PA was strongly associated with better psychological quality of life among individuals without disabilities (p = 0.00). Younger age (p = 0.00) and being single (p = 0.01) were significant predictors of poor psychological health among non-disables. Increase in sedentary sitting time was significantly associated with poor psychological quality of life among both groups.

Conclusions

Tailored health policies to encourage PA and reduce sitting hours should be formulated to improve psychological health with special focus on individuals with disabilities. Future studies with large sample size are recommended to validate the current results and further explore the difference in association of PA and psychological wellbeing in people with and without disabilities.

The portrayal of persons with disabilities in Arabic drama: A literature review

BACKGROUND

The media plays a vital role in addressing the issues of society through audiovisual means that contribute to the transmission of media messages. Drama contributes to implement positive values or negative attitudes in people's minds towards various societal issues. The negative stereotypes shaped by drama about persons with disabilities (PWDs) have attracted the attention of the researchers. Therefore, Arabic drama is required to present a true portrait of PWDs that reflects their reality without exaggeration or discrimination. It is also required to re-correct the stereotyped image that has been formed in society towards PWDs.

AIMS

This literature research was conducted to review and analyze research and theses that presented PWDs in Arabic drama. The research sought to reveal the stereotypical behavior of PWDs in Arabic drama, categories of disability, and drama genres that presented PWDs.

METHODS AND PROCEDURES

This research included 17 peer-reviewed research and thesis obtained from Arab and international databases from 2002 to 2022. The content analysis card was used to achieve the aims of this research.

OUTCOMES AND RESULTS

The findings of the literature review indicated that the majority of Arab dramas presented negative stereotypes of PWDs. The results also showed that intellectual disability, visual impairment, and physical disabilities were the most dominant in Arabic movies and television series.

CONCLUSIONS AND IMPLICATIONS

Arabic drama and media were unable to present accurate representations of PWDs. They appeared in a distorted and satirical way in movies and television series. Perhaps, these negative stereotypes emerged from the prevailing popular cultures in the Arab countries that produce these movies and series. It is thus necessary to remove these stereotypes expressed in drama to enhance awareness and societal inclusion in the Arab culture and countries.

Role of Environmental Quality of Life in Physical Activity Status of Individuals with and without Physical Disabilities in Saudi Arabia

The promotion of physical activity (PA) in various subgroups of the population such as people with physical disabilities has been spotlighted in the revised guidelines of The World Health Organization (WHO), Geneva, Switzerland. In order to update public health interventions, there is a need to identify factors that may promote or prevent engagement in PA for special subgroups of the population. This study aims to calculate the PA levels of individuals with and without physical disabilities in Saudi Arabia, their assessment of the environmental (EQoL), and the predictive role of EQoL in PA. The International Physical Activity Questionnaire (IPAQ) and the EQoL domain in standardized WHOQoL Questionnaire were administered on both groups of the population. The study sample comprised 116 individuals with physical disabilities and 243 individuals without any form of disability as a control group. A regression analysis was performed to analyze the predictors of PA in both groups. Findings showed that among the individuals with disabilities, older people were more likely to engage in PA as compared to the younger age group (p < 0.05) and males were significantly less likely to meet the PA criteria. Some of the EQoL features such as safety increased the likelihood of PA up to 2.3 times (p < 0.05) in individuals with physical disabilities. In addition, opportunities for leisure activities were a significant predictor of PA among both groups of individuals with and without physical disabilities (p < 0.05). Our findings suggest that upcoming public health interventions should focus on improving various dimensions of EQoL for the promotion of physical activity among individuals with physical disabilities. Additional studies are needed to further explore various sociodemographic and environmental factors which can affect the PA status of disabled groups.

The Patterns of Acquired Upper and Lower Extremity Amputation at a Tertiary Centre in Saudi Arabia

Introduction: Upper and lower extremity amputations are associated with variable degrees of physical disability. In Saudi Arabia, disability still represents a major challenge for healthcare systems. There are insufficient data to describe the incidence and prevalence of impairment and disability. This study attempts to identify the patterns of limb amputations at a tertiary centre.

Methods: A retrospective chart review of the data of patients who received integrated tertiary healthcare in an amputation rehabilitation program (ARP) from 2013 to 2018 at King Fahad Medical City, Riyadh, Saudi Arabia was conducted. Data were collected using the demographic data and clinical history of amputees.

Results: A total of 412 patients were included in the study. Transtibial amputation (70%) and partial hand amputation (48%) were the most common levels for lower and upper limb amputations, respectively. There was a significantly higher rate of lower limb amputations secondary to vascular causes than that of upper limb amputations, which were more related to traumatic causes. Most patients, 213 (52%), were enrolled in an amputation rehabilitation program over a year after their amputation.

Conclusion: Vascular amputation is the most common cause of amputation. Most patients entered the rehabilitation program over a year after amputation. National guidelines for the prevention and management of the risk factors for vascular amputations should be developed.

Predictors of premarital screening and genetic counseling knowledge and attitude among deaf and hard hearing females in Tabuk, Saudi Arabia

According to Saudi Arabia's 2030 vision, research should be directed to prevention, early detection, and intervention to reduce all types of disability. The current study aimed to investigate the predictors of Premarital Screening and Genetic Counseling (PMSGC) knowledge and attitude among deaf and hard hearing females' in Tabuk, Saudi Arabia. Descriptive correlational design was conducted on a convenience sample of 67 deaf and hard hearing students from the Tabuk region. Data were collected by an electronic questionnaire elaborated to the participants using sign language. The results revealed that most participants had incorrect answers regarding most PMSGC questions. Around two-thirds (68.7%, 65.7%, and 71.6%) of them strongly agree that PMSGC is very important, compatible with Islamic principles, and prevents family social and psychological problems, respectively. Older, urban area residents and university-educated participants have significantly higher knowledge and attitude scores than their peers (t=2.239, 4.887, 4.790 & p<0.05), respectively. Multiple regression shows that age (b=0.302, t=-2.795, p=0.007), education (b=0.336, t=2.425, p=0.019), mothers' education (b=0.314, t=2.345, p=0.023), and monthly income (b=-0.337, t=-2.503, p=0.015), are significant predictors of PMSGC knowledge. Furthermore, age (b=0.659, t=4.024, p=0.000), residence (b=0.293, t=2.233, p=0.030), education (b=-0.395, t=3.028, p=0.004), and type of disability (b=-0.443, t=-3.763, p=0.000) are significant predictors of PMSGC attitude. Although most deaf and hard hearing females have incorrect knowledge regarding PMSGC, most have a positive attitude. The study concluded that participants' education, mothers' education, and monthly income are significant predictors of PMSGC knowledge. Moreover, age, residence, education, and type of disability were significant predictors of higher PMSGC attitudes.

The Prevalence and Correlates of Disability in Singapore: Results from a Nationwide Cross-Sectional Survey

Objective: The study aims to estimate the prevalence of disability and the association of disability with socio-demographic correlates and health outcomes among the Singapore population. Methods: Face-to-face interviews were conducted with a representative sample of Singapore’s population. Using the Washington Group’s questionnaire, disability was defined using both the ‘standard’ (a lot of difficulty or higher in one or more domains) and the ‘wider’ threshold (of ‘some’ or greater difficulty). Data on socio-demographic correlates, self-reported lifestyle, physical activity, chronic conditions, and health-related quality of life were also collected. Results: The prevalence of any disability using the standard threshold was 3.1% (95% CI: 2.4–4.1). When separated by disability type, mobility (1.8%) was the most prevalent, followed by vision (0.8%), cognition (0.5%), hearing (0.3%), and self-care (0.2). In the adjusted regression analysis, lower education and unemployed and economically inactive status (versus employed) were significantly associated with disability. Conclusions: Although this prevalence is lower than other countries, it is a significant finding in terms of actual numbers and impact at both the individual and the societal levels. Our findings also highlight the need to strengthen health services and preventive interventions targeting older adults and those who are physically inactive to reduce the burden of disability in these groups.

Quality of Life, Needs and Fears of Mothers of Children with Disabilities in Saudi Arabia during the COVID-19 Lockdown

Substantial changes in life dynamics resulting from the outbreak of the coronavirus disease 2019 (COVID-19) could have an impact on the quality of life (QoL) of mothers of children with and without disabilities. This study compared the quality of life (QoL) of mothers of children with disabilities (MCD) to the QoL of mothers of children without disabilities (CON) in Saudi Arabia during COVID-19 lockdown. It explored mothers’ concerns and the type of support they need during the quarantine. A comparative cross-sectional study was conducted during the lockdown. An online questionnaire was distributed to mothers raising children with and without disabilities in Saudi Arabia. A total of 340 mothers participated in the study by completing the survey: 93 MCD and 247 CON. The QoL of MCD and CON was assessed using the WHOQOL-BREF questionnaire. Furthermore, detailed information was provided by the mothers regarding their needs and concerns during the lockdown. The results of the study revealed that the overall QoL was significantly higher in the CON group, compared to the MCD group, during the COVID-19 lockdown. The social well-being and environmental well-being reported by MCD were significantly lower on the total scale of the WHOQOL-BREF than those reported by the CON group. The comparison between the two groups revealed significant differences in the support required by mothers during the COVID-19 pandemic: a higher percentage of MCD needed emotional and psychological support, especially from family members. The major concerns reported by MCD were the deterioration of their children’s medical conditions and the lack of medical supplies during the lockdown.

The Prevalence of Functional Disability and Associated Factors among Older People Attending Primary Health-care Centers in Riyadh City

BACKGROUND: The burden of disability among the older population is increasing as older people grow with significant social and economic negative impacts. AIM: This study examines functional disability and its associated risk factors among older Saudi citizens attending primary health-care centers (PHCCs) in Riyadh city. METHODS: This descriptive cross-sectional study was carried out on 504 older Saudi citizens aged ≥60 years who attended a PHCC in Riyadh city between December 2019 and May 2020. Interviewer-administered questionnaire was used to assessing the disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) using the Katz Index and Lawton scale. RESULTS: The prevalence of ADL and IADL disability among participants was 24.6% and 58.5%, respectively. Smoking (p = 0.019), dyslipidemia (p = 0.018), rheumatoid arthritis (p = 0.028), history of falls (p = 0.014), and an emergency visit (p = 0.049) were risk factors associated with ADL disability. Predictors of IADL disability were advanced age (p = 0.004), being female (p = 0.029), and the need for a caregiver (p = 0.000). The need for homecare was positively associated with ADL dependency (p = 0.008) and IADL dependency (p = 0.003). Furthermore, regular physical activity was a protective factor against ADL functional disabilities (p = 0.002) and IADL functional disabilities (p = 0.000). CONCLUSION: This study found a high prevalence of ADL and IADL disability among elderly Saudis. Disability was associated with several sociodemographic and health status factors. The findings of this study highlight the priority of effective and targeted preventive interventions for disability.

Frequency of molar incisor hypomineralization and associated factors among children with special health care needs

BACKGROUND

Molar incisor hypomineralization (MIH) is a frequently encountered oral condition that varies from mild opacities to posteruptive enamel breakdown. No previous published studies have investigated the frequency of MIH and associated risk factors among children with special health care needs (CSHCN) to our awareness.

OBJECTIVES

Assess the frequency of MIH and associated risk factors among CSHCN.

DESIGN

Cross-sectional.

SETTING

Schools in provincial city of Saudi Arabia.

PATIENTS AND METHODS

The study was conducted among 400 (180 boys and 220 girls) special needs children. Diagnosis of MIH was according to the European Academy of Paediatric Dentistry criteria.

MAIN OUTCOME MEASURE

Result of logistic regression analysis that assessed the association between MIH prevalence and associated prenatal, perinatal, and postnatal factors.

SAMPLE SIZE

400 (180 boys and 220 girls) special needs children.

RESULTS

Among 400 CSHCN, 98 (24.5%) presented with MIH. Children with multiple disabilities had a 3.89 times greater risk of MIH (95% CI: 1.91-6.19, P=.002). Children with positive prenatal factors had an adjusted odds ratio (aOR) of 2.31 times for MIH (95% CI: 1.22-4.73, P=.012). Children with a childhood infection history had an aOR of 2.43 times for MIH (95% CI: 1.31-5.85, P=.014). Children with a breastfeeding history >18 months had an aOR of 3.73 for MIH (95% CI: 1.62-8.60, P=.002). Permanent maxillary first molars were the most frequently affected teeth, and demarcated opacity was the most frequent MIH type.

CONCLUSION

MIH should be recognized as one of the prevalent oral health problems among CSHCN to prevent tooth mortality.

LIMITATIONS

A cross-sectional study cannot establish a causal relationship.

CONFLICTS OF INTEREST

None.

Telerehabilitation Guidelines in Saudi Arabia

Rehabilitation needs are increasing globally due to population growth, aging population, high survival rates for people with disability, and severe health conditions. In the past few years, new telecommunication-based practices, including various forms of e-rehabilitation have gained attention all over the world, including the Kingdom of Saudi Arabia (KSA). Telerehabilitation is an alternative way of delivering rehabilitation services in which information and communication technologies are used to expedite communication between the health care professional and the patient at a distant location. It can be beneficial to people in rural areas, especially individuals in isolated communities. At present, the COVID-19 pandemic has forced speedy adoption of telerehabilitation due to restricted traditional in-person visits all over the world, including KSA; however, no telerehabilitation guidelines are available in the country. Since specialized rehabilitation services are limited to main cities of the country, the provision of care by reaching out the underserved areas using telemedicine technology is deemed important. These guidelines were established collaboratively by panel of various rehabilitation experts with input from other practitioners in the field and strategic stakeholders. It will facilitate rehabilitation clinicians practicing in KSA providing consultation, counseling, education, assessment, monitoring, therapy, or follow-up to a patient remotely using telemedicine communication technologies. This document includes administrative, clinical, and technical guidelines, which are aimed to standardize telerehabilitation practice across the country. The core principles are based on standards set forth by American Telemedicine Association and are guided by telemedicine policy in KSA. Additionally, ethical considerations of telerehabilitation practice pertinent to Saudi culture and health care system are elaborated as well. This document serves as a general guide for the provision of telerehabilitation services and do not describe a specialty-specific clinical practice guideline.

Traumatic dental injuries in special health care needs children and association with obesity

BACKGROUND

Special needs children are at a higher risk of dental trauma because of neurological, physical, mental, and behavioral impairments. They are also at higher risk of developing obesity due to the side effects of medication.

OBJECTIVE

Assess the association between traumatic dental injuries (TDIs) and obesity in children with special health care needs.

DESIGN

Analytical cross-sectional study.

SETTING

Schools for special needs children.

STUDY POPULATION AND METHODS

Special needs children with a diagnosis of TDI according to the Andreasen criteria were included in the study. Data on the disability status were obtained from a national demographic survey in 2016. Demographic and dental variables were measured for analysis. Multivariable logistic regression was used to analyse any relationship between TDI prevalence and obesity.

MAIN OUTCOME MEASURE

Relationship of body mass index (BMI) to TDI prevalence.

SAMPLE SIZE

350 (131 boys and 219 girls) special needs children with a median (interquartile range) age of 12.0 (2.0) years.

RESULTS

Eighty-one (23.1%) children presented with TDIs. The mean (standard deviation) BMI for the entire study population was 24.7 (7.8). Children with obesity had a 30.3% TDI prevalence compared normal-weight children (20.6%) (P=.035), but BMI category was not statistically significant in the regression analysis (P=.541), which showed that children with an overjet of >3 mm were 4.82 times (CI: 2.55-9.09, P=.001) more likely to have TDI than children with an overjet of ≤3 mm. Those with inadequate lip coverage were 2.85 times (CI: 1.49-5.44, P=.002) more likely to have TDI. Children with cerebral palsy were 3.18 times (CI: 1.89-11.32, P=.024) more likely to have TDI than children with other disabilities.

CONCLUSION

The study showed a significant association between TDI prevalence and increased overjet, inadequate lip coverage, and cerebral palsy. The prevalence of TDI among obese special needs children was statistically significant according to bivariate analysis, but not in a multivariate analysis that adjusted for other variables.

LIMITATIONS

Causal relationship cannot be established with cross-sectional study.

CONFLICT OF INTEREST

None.

Childhood disability and its associated perinatal characteristics in Bao'an district of Shenzhen, China

BACKGROUND

Disability has become a public health issues in China and around the world. This study aimed to report prevalence of children with disability by gender, delivery mode, birth weight, gestational age, birth defect and impairment type in the past 15 years in Baoan District, Shenzhen.

METHODS

Data of children with all types of disability from year 2004 to 2018 was obtained from the registry database of Baoan Disabled Persons Federation. Their perinatal information, including gender, delivery mode, birth weight, gestational age, birth defect were traced from Shenzhen Maternal and Child Health Management System and compared with the whole registered population live births information in this district. Data of children with disabilities were included to calculate the prevalence (%).

RESULTS

An overall prevalence of children disability was 1.02% in Baoan district, Shenzhen, in the past 15 years. The overall as well as mental disability prevalence rose from the first 5 years period (2004 to 2008) to the second 5 years of 2009 to 2013, and then dropped to the lowest level in the third 5 year of 2014-2018. Mental disability and intelligent disability accounted for the highest proportion. More than 70% of all kinds of the disabilities except mental disability were detected before 1 year old, 87% of the mental and intelligent disabilities were found before 3 years old. The Percentages of male, premature, low birth weight infants and children with cesarean, birth defect in disable children were higher than in whole population live birth children.

CONCLUSIONS

The overall prevalence of disability declined in the district after specific policy engagement. Mental and intelligent disabilities were still the most common disability in the district. The age of 0-3 years was an important period for early childhood detection and intervention.

Referral and Lost to System Rates of Two Newborn Hearing Screening Programs in Saudi Arabia

Congenital hearing loss has been commonly reported as a significant health problem. Lost to system (LTS) is a major challenge facing newborn hearing screening (NHS) programs. This retrospective cross-sectional descriptive study aimed to determine the referral and LTS rates after the two-stage NHS based on transient evoked otoacoustic emissions (TEOAEs) in two main hospitals in Riyadh, Saudi Arabia (SA). NHS was performed on newborns before hospital discharge. Newborns were only rescreened if NHS initially revealed a fail/refer outcome in one or both ears. Those who failed the first and second screenings or had risk factors were referred for auditory brainstem response (ABR) testing to confirm or exclude hearing loss. In total, 20,171 newborns (40,342 ears; 52% males; 48% females) were screened, of whom 19,498 (96.66%) passed the initial screening, while 673 (3.34%) failed. Of the 673 newborns, 235 (34.92%) were LTS, and 438 (65.08%) were rescreened, of whom 269 (61.42%) failed and were referred for a comprehensive audiological assessment to confirm the existence of hearing loss. The referral rate after the initial two-stage screening was equal to 1.33%. The lack of awareness of the importance of NHS among parents seems to be the major cause behind the LTS rate. The stakeholders have to work efficiently to reduce the LTS rate.

Dental Students' Perceptions before and after Attending a Centre for Children with Special Needs: A Qualitative Study on Situated Learning

Objectives: To develop an in-depth understanding of the perceptions and experiences of senior dental students before and after fieldwork visits to a centre for children with special needs. Methods: A qualitative study utilised open-ended questions and involved 39 fifth-year dental students. A thematic analysis of the collected responses was undertaken, and a hierarchy of themes and subthemes were developed. Results: Analysis of the pre-visit responses revealed three main themes and a number of subthemes: 'negative expectations', 'positive expectations', and 'pain expectations'. Similarly, four main themes with a number of subthemes emerged from the post-visit responses: 'positive perceptions', 'negative perceptions', 'oral problems observed', and 'recommendations'. Conclusions: Within the study limits, different perspectives were extracted. Prior to the fieldwork visit, students expressed their lack of self-confidence and inadequate preparation. Following the situated learning visit experience, students' perceptions of managing special needs children was positively influenced. Students were happy to be exposed to such an experience, but hoped for better organisation and specialised supervision in the future.

Perception of tertiary care clients toward the availability of physical therapy service at primary health care centers in Saudi Arabia: a cross-sectional survey

[Purpose] To explore the views of clients referred for physical therapy in a tertiary care setting regarding the integration of physical therapy service at primary health care centers. [Participants and Methods] A self-administered questionnaire was distributed to eligible Saudi clients. The questionnaire consisted of three sections including demographic information section; closed-ended section with 6 Likert scale items on the perceptions of potential advantages of physical therapy service at the primary health care level; and open-ended section on potential disadvantages and barriers of implementing physical therapy service. The surveys were described and analyzed quantitatively and qualitatively. [Results] A total of 412 participants were included in the analysis (56.8% females). Participants’ mean age was 35.7 ± 21.9 years; 67.2% were Riyadh city residents; and 38.1% had musculoskeletal conditions. Seventy-five percent responded in support for the availability of physical therapy service at the primary health care level. Demographic characteristics had no effect on the level of support to the service availability. [Conclusion] The results of this survey demonstrated high positive support for the integration of physical therapy service at primary health care centers in Saudi Arabia. However, challenges and barriers identified by the study results require attention when physical therapy services are to be established.

Knowledge and Attitudes of Rehabilitation Professional Toward Telerehabilitation in Saudi Arabia: A Cross-Sectional Survey

Background: Continuity of rehabilitation care after completion of a hospital-based rehabilitation program remains a challenge. This is of considerable significance in Saudi Arabia where there is a lack of community-based rehabilitation, which renders the need of telemedicine services. There is lack of data regarding understanding, awareness, and attitudes of rehabilitation professional toward telerehabilitation. This study was aimed to explore Saudi-based rehabilitation professionals' knowledge of telerehabilitation. Materials and Methods: After pilot testing, a survey questionnaire was distributed to 82 rehabilitation professionals working in different regions of Saudi Arabia. The survey included 14 close-ended questions targeting five domains: demographics, telemedicine knowledge, telerehabilitation service knowledge, social acceptance of these services, and risks associated with these services. Descriptive statistics were obtained by analyzing data using Microsoft Excel. Results: In total 46% of the participants were aware of telerehabilitation service technology but did not use it. 69.51% considered both telerehabilitation and community-based rehabilitation as the best service delivery methods. About 43% of participants reported that lack of knowledge about information technology and cost were the main factors that led to their limited use of telerehabilitation systems. The majority of the participants (52.44%) considered breach of confidentiality to be a risk associated with telerehabilitation services. Conclusions: Even though considerable number of the participants considered telerehabilitation as an important service delivery method, most of them are not involved in telerehabilitation. This renders the need of establishing local telerehabilitation guidelines and addressing the barriers pertaining to training, resources, cost, policy making, confidentiality, and perception of patients.

Normative Data for Handgrip Strength in Saudi Older Adults Visiting Primary Health Care Centers

Background and objective: Handgrip strength (HGS) plays a vital role as a predictor of adverse health outcomes. Several studies have established HGS norms by age, sex, hand, occupation, culture or disability in different countries and for children in Saudi Arabia. However, standardized values for Saudi older adults have not yet been reported. Therefore, the current study was aimed to establish normative data for HGS in Saudi older adults visiting primary health care centers (PHCCs). Material and Method: In this descriptive cross-sectional study, HGS in kilograms was measured using a hydraulic hand dynamometer in Saudi older adults (n = 2045) aged ≥60 years visiting 15 PHCCs selected randomly from the five geographical regions of Riyadh, Saudi Arabia between January 2015 and April 2017. The average mean from three successive trials, standard deviations, and 95% confidence intervals presented for the left and right hands of men and women in six age groups (60–64, 65–69, 70–74, 75–79, 80–84, and 85+ years). The analyses were performed using the ANOVA test for all the age groups and to determine whether any differences exist between them. Results: The average mean HGS was significantly (p < 0.0001) differ by the left and right hands of men and women in six age groups. Conclusions: The current study presents specific norms for HGS in Saudi older adults by age, sex, and hand. Further studies are required to examine the utility of these norms for prediction of morbidity and mortality in this population.