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PubMed2004

Assessment of pain and disability in patients with chronic neck pain: reliability and construct validity of the Turkish version of the neck pain and disability scale.

OBJECTIVES: The objective of this study was to test whether a Turkish version of the Neck Pain and Disability Scale retains its reliability and validity of the original English version. METHODS: Sixty-one patients with chronic neck pain were enrolled in the study. The Neck Pain and Disability Scale (NPDS), the Pain Disability Index (PDI) and The Hospital Anxiety and Depression Scale (HADS) were filled by all subjects. Reliability was determined by internal consistency. Internal consistency was measured by calculating Cronbach's alpha and item-total correlation. Validity was examined by correlating the NPDS scores to the Visual Analogue Scale (VAS), PDI and HADS scores. RESULTS: Cronbach's alpha value for NPDS was found to be 0.86 and this was statistically significant (p<0.0001). The item-total correlations of NPDS varied between 0.08 and 0.69. The cross-sectional construct validity coefficients were 0.51 for PDI, 0.45 for VAS, 0.35 and 0.33 for Hospital Anxiety and Depression Scales. CONCLUSION: Despite its major limitations, our results seem to support previous findings of the English and French versions of the Neck Pain and Disability Scale, indicating that this functional scale is valid and reliable.

Adult↗

PubMed2006

Health promotion for people with disabilities: development and evaluation of the Living Well with a Disability program.

People with disabilities can benefit from health promotion opportunities to reduce the incidence and severity of secondary conditions that further limit their participation in society. This paper describes participatory action research (PAR) methods we used to develop, implement and evaluate the Living Well with a Disability program. Community-based agencies that provide information and referral services to people with disabilities (independent living centers funded under Title VII, Rehabilitation Act) recruited a convenience sample of 246 people with mobility impairments to participate in a randomly assigned, wait-list control health promotion intervention study. Paper-and-pencil outcome measures included the secondary conditions surveillance instrument, unhealthy days and health care utilization. Logistic regression on outcomes controlling for demographic variables and pre-test measures indicated reductions in all three outcome variables. People with mobility impairments who participated in the Living Well with a Disability program reported less limitation from secondary conditions, fewer unhealthy days and less health care utilization. PAR methods are particularly important to design useful interventions for this population.

Community Health Services↗

PubMed1996

Simulated disability exercises and their impact on attitudes toward persons with disabilities.

Two separate graduate rehabilitation counselling groups from a mid-south university either did or did not take part in a wheelchair sensitivity training pilot study designed to enhance their understanding as to what life might be like for persons who use a wheelchair. Twenty students were individually accompanied on a designated route across campus by a non-disabled graduate researcher. Eighteen other graduate students formed a control group and did not participate. Both groups completed a contextually different 14-item Likert type questionnaire designed to assess their perceptions of persons with physical disabilities based on either the sensitivity exercise or their experience in the rehabilitation programme. Results from this quasi-experimental study suggested that regardless of whether they participated in the sensitivity training, both groups perceived they would become better counsellors. t-Tests revealed significant differences in the two groups' responses to questions pertaining to daily frustrations experienced by persons with physical disabilities and a pre-occupation with how accessible places are. Other differences noted were that persons with physical disabilities must feel different from being stared at and must have a harder time in society. Implications of the utility and misuses of these one-time experiences are explored.

Activities of Daily Living↗

PubMed2000

Disability management, employee health and fringe benefits, and long-term-disability claims for mental disorders: an empirical exploration.

Mental disorders account for a large share of claims and benefit costs in both private and public long-term-disability (LTD) insurance programs. This is the first empirical study to explore factors that may explain variations in private-sector LTD claims incidence and cost across groups of employees. Employee fringe-benefit arrangements, including patterns of coverage for mental health treatment, are found to be important predictors of incidence rates. Award rates for public disability insurance coverage (SSDI) are also strongly related to claims incidence, suggesting that private LTD is an important pathway to SSDI benefits. Some employee disability-management strategies, such as front-line manager involvement and provision of alternative jobs for employees returning from disability leave, are predictive of lower claims rates and/or costs.

Adult↗

PubMed2002

The disablement process: a conceptual framework for dementia-associated disability.

Most of the social and economic burden of dementia is attributable to its consequences in terms of disability. In this review, we describe the concepts defined in the disablement process model of Verbrugge and Jette [Soc Sci Med 1994;38:1-14] and show how they apply to dementia. The main pathway leads from pathology to impairments, functional limitations and disability. Pathologies (any cause of dementia) are expressed by impairments in specific cognitive processes. Functional limitations are limitations in generic cognitive tasks such as remembering a list of words or orientating oneself in time and space. They are responsible for disability in activities of daily living. Predisposing risk factors as well as introduced intraindividual and extraindividual factors speed up or slow down the main pathway. We show how the model can help in understanding the functional consequences of dementia, for better assessment and management of demented subjects.

Activities of Daily Living↗

PubMedDate not supplied

Mathematical problem-solving profiles of students with mathematics disabilities with and without comorbid reading disabilities.

The purpose of this study was to describe the mathematical problem-solving profiles of students with mathematics disabilities (MD) with and without comorbid reading disabilities (RD). The disability status of fourth-grade students was verified through testing (n = 18 MD; n = 22 MD + RD). Then a hierarchy of mathematics problem-solving tasks was administered. The results demonstrated large deficits for both groups; however, the differences between students with MD and those with MD + RD were mediated by the level of problem solving (arithmetic story problems vs. complex story problems vs. real-world problem solving) and by performance dimension (operations vs. problem solving). On arithmetic story problems, the differences between the disability subtypes were similar for operations and problem solving. By contrast, on complex story problems and real-world problem solving, the differences between the subtypes were larger for problem solving than for operations.

Child↗

PubMedDate not supplied

Responsiveness to mathematical problem-solving instruction: comparing students at risk of mathematics disability with and without risk of reading disability.

This study assessed responsiveness to a 16-week mathematical problem-solving treatment as a function of students' risk for disability. Among 301 third graders, TerraNova scores were used to categorize students as at risk for both reading and mathematics disability (MDR/RDR; 20 control and 12 experimental), at risk for mathematics disability only (MDR-only; 5 and 8), at risk for reading disability only (RDR-only; 12 and 15), or not at risk (NDR; 60 and 69). Interactions among at-risk status, treatment, and time showed that as a function of treatment, MDR/RDR, MDR-only, and RDR-only students improved less than NDR students on computation and labeling, and MDR/RDR students improved less than all other groups on conceptual underpinnings. Exploratory regressions suggested that MDR/RDR students' math deficits or their underlying mechanisms explained a greater proportion of variance in responsiveness to problem-solving treatment than reading deficits or their underlying mechanisms.

Adult↗

PubMed1993

Providing appropriate education for students with learning disabilities in regular education classrooms. National Joint Committee on Learning Disabilities.

This statement was developed by the National Joint Committee on Learning Disabilities (NJCLD). Representatives of the American Speech-Language-Hearing Association (ASHA) were Rhonda S. Work, Chair; Mabel L. Rice; Stan Dublinske, ex officio. Ann L. Carey, vice president for professional and governmental affairs, was the monitoring vice president. Other member organizations of the NJCLD include the Association on Handicapped Student Services Programs in Postsecondary Education; Council for Learning Disabilities; Division for Children with Communication Disorders; Division for Learning Disabilities; International Reading Association; Learning Disabilities Association of America; National Association of School Psychologists; Orton Dyslexia Society. This statement was approved by the ASHA Legislative Council in November 1990 (LC 26-90) [see Note 1].

Child↗

PubMed2001

Social work practice with people with disabilities in the era of disability rights.

Social workers, especially those in health care and rehabilitation systems, must consider practice changes necessitated by recent legislation and the growing activism of disability rights groups. The authors review essential elements of the emerging sense of both oppression and empowerment that is occurring for many people with disabilities and groups; consider key aspects of ADA and other perti nent legislation that place new emphases on the self-determination of people with disabilities; and discuss what implications changing practice roles might have for social workers' relationships and patterns of interaction with other professionals in medical, health care and rehabilitation settings. The authors outline a beginning effort at designing a conceptual framework that promotes practice that: (1) maximizes clients' involvement in exploring an expanded range of options and choices; (2) prepares clients to be more effective in dealings with professionals, bureaucrats and agencies that often do not understand nor appreciate their need for self-determination; and (3) at the organizing level, mobilizes and helps to empower groups of people with disabilities to consider policy and program alternatives that can improve their situation. This framework may also be useful in work with people who have other long term care needs, chronic conditions.

Activities of Daily Living↗

PubMed2004

Predicting impact of childhood disability on families: results from the 1995 National Health Interview Survey Disability Supplement.

Predictors of impact on families with a child who has developmental disabilities were examined using results from the 1995 National Health Interview Study Disability Supplement (NHIS-D). From this sample, 505 children who met criteria for a developmental disability were selected. Predictors of impact on these families were investigated across and within racial groups. A multiple regression analysis was completed on the entire sample, which was divided by race/ethnicity. A separate multiple regression analysis was completed for White, African American, and Hispanic families. Predictors of family impact differed for each racial or ethnic group. Results of this study add to the body of literature suggesting that the meaning of disability and its impact on families is culturally relative.

Child↗

PubMed1988

Referential communication abilities of learning-disabled, language-learning-disabled, and normal school-age children.

Past research in referential communication has indicated normally developing children show developmental progression in ability to communicate a specific referent to a listener. In one paradigm subjects were given lists of word-pairs in which one member of each pair was designated as the referent. It was shown that communicating about referents found in word-pairs associated in some way was more difficult than communicating about referents in dissimilar word-pairs. The present study extended this methodology to learning-disabled children. Learning-disabled, language-learning-disabled, and normally achieving children were asked to communicate about 30 pictured referents on three different tasks. On Tasks 1 and 2 each subject was asked to give a clue for the referent that would distinguish it from the other picture. Stimuli for Task 1 were 30 pairs of pictures that were related in some way and the stimuli for Task 2 were 30 pairs of unrelated pictures. Task 3 required the subjects to evaluate the adequacy of the examiner's clues for Task 1 stimuli. The disabled subjects were matched to the normally achieving subjects on the basis of receptive vocabulary age. Few differences were noted among the groups' performances on these referential communication tasks. Implications include the importance of vocabulary and concept development to referential communication.

Adolescent↗

PubMed1992

The Americans With Disabilities Act of 1990 expands employment opportunities for persons with developmental disabilities.

The primary purpose of the ADA is the full inclusion of persons with disabilities within their communities. The ADA prohibits discrimination on the basis of disability in the areas of employment, transportation, public accommodations, telecommunications, and state and local government agencies. The person described in this report encountered some of this discrimination. He successfully obtained paid community-integrated employment only after overcoming major obstacles and barriers, the greatest being transportation. In our highly mobile society, reliable transportation is essential for the acquisition and maintenance of community-integrated employment. The participant was repeatedly denied access to public transportation on the basis of his disability. To help overcome this barrier, Transition Services had to provide needed transportation at great expense, which delayed opportunities for the participant to gain control of this aspect of his life. Enactment of the ADA makes it more difficult for public transportation agencies to deny services to persons with disabilities by claiming inconvenience or lack of accessible vehicles. When publicly funded transportation programs assume their full responsibility for transportation to the public, agencies like Transition Services can focus on individualized employment and training issues rather than on providing transportation. In the workplace, the employer's willingness to work cooperatively with the participant and the staff of Transition Services resulted in several low-cost and reasonable accommodations based on the participant's needs and abilities. A simple rearrangement of work space allowed the participant to perform his job while benefiting the other workers in the crowded restaurant kitchen.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMed1999

Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions.

The premise of this article is that, until recently, health promotion for people with disabilities has been a neglected area of interest on the part of the general health community. Today, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of Americans with disabilities. The aims of a health promotion program for people with disabilities are to reduce secondary conditions (eg, obesity, hypertension, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. A greater emphasis must be placed on community-based health promotion initiatives for people with disabilities in order to achieve these objectives.

Activities of Daily Living↗

PubMed2002

Measuring disability in ankylosing spondylitis: comparison of bath ankylosing spondylitis functional index with revised Leeds Disability Questionnaire.

OBJECTIVE: Disability has been identified as a core outcome measure in ankylosing spondylitis (AS). The Dougados Functional Index (DFI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) have been selected as core measures of function in this disease. However, neither of these instruments has undergone rigorous psychometric testing. METHODS: The psychometric properties of 2 measures of disability, the BASFI and the revised Leeds Disability Questionnaire (RLDQ), were compared in a cohort of 208 outpatients with AS. Rasch analysis was used to examine the properties of each measure and to compare them on a common scale. Test-retest was assessed in a cohort of 149 subjects who completed each instrument twice over an interval of 2 weeks. RESULTS: Both instruments gave an even spread of scores across the study group, but BASFI responses were positively skewed and RLDQ responses negatively skewed. There was a highly significant difference between perceived severity groups for both instruments (Kruskal-Wallis chi-squared: RLDQ, 75.1; BASFI, 80.4; both p < 0.0001). Both instruments gave acceptable test-retest scores (RLDQ ICC = 0.95, 95% CI 0.93-0.97; BASFI ICC = 0.94, 95% CI 0.92-0.96). Both instruments were found to be unidimensional according to the Rasch model, but the BASFI had more items displaying differential item functioning. Category disordering was apparent with the BASFI but not the RLDQ. However, both instruments displayed disordered item thresholds. Neither instrument can be used as an interval measure. Both measures had "towers" of thresholds whereby several thresholds were marking the same point on the underlying disability construct. This was particularly notable in the case of the BASFI. CONCLUSION: Both the BASFI and RLDQ provide a unidimensional measure of function in AS that is in accord with patient perception of disease severity. Neither instrument can be used as an interval measure. Changing the way that the instruments are scored, for example by collapsing categories, may improve their performance.

Activities of Daily Living↗

PubMed1975

[The problem complex of the disabled and the marginal group theory - socio-scientific approaches designed to explain the social discrimination of the disabled (author's transl)].

The position of disabled people in societies such as the Federal Republic of Germany, is characterised by the status of marginal groups in the sense of social discrimination. As can be demonstrated by the discrimination shown towards the disabled in employment, there are two different paradigms of the socio-scientific marginal group theory suitable for explaining this fact. According to the socio-psychological approach, vocational discrimination is understood as a sort of social punishment for the violation of norms and values. The socio-economic approach, on the contrary, considers the unfavourable job situation of the disabled a by-product of a general development towards underemployment and the de-manning programme in capitalistic systems. In some respect, the theoretical approach seems to be more resonable, but to comprehend adequately the marginal group status of the disabled, it is necessary to integrate both the socio-economic and socio-psychological theory components.

Persons with Disabilities↗

PubMed1978

[Reactions vis-a-vis the disabled. Critical comments on G. H. Neumann's article: prejudices and negative attitudes towards the disabled--their origin and methods of elimination from the viewpoint: of behavioural science and biology (author's transl)].

Neumann's opinion that prejudices towards the disabled are decisively determined by inborn reactions, i.e., the reaction towards outsiders and the fear reaction towards strangers, is put to question. Ethological and ethnological research results demonstrate that the studies of human and animal behaviour towards the "disabled" are still in an elementary stage and that hitherto available results only permit the conclusion that animals as well as human beings display a very complex and differentiated behaviour vis-a-vis the disabled. In connection with human beings this complexity is seen as evidence of the outstanding significance of societal factors--in their broadest sense--for the formation of prejudices towards the disabled. The necessity of a goal-oriented elimination of these prejudices is stressed. Furthermore, attention is drawn to terminological problems and the difficulties or comparisons between human beings and animals.

Animals↗

PubMed2006

[Towards a new social perception of people with disabilities: legislation, medicine and the work-disabled in Spain (1900-1936)].

This paper aims to analyse the role played by Medicine, against a background of social reform in the first third of the 20th Century, in helping to shape the nature of disabilities in Spain. We look at the legislation passed to regulate occupational accidents and the institutions set up to look after accident victims with physical or functional disabilities from the perspective developed in the new academic field of disability studies and using scientific and professional journals as well as documentation from Spain's legislative chambers as our main sources. We attempt to examine the extent to which these developments helped to transform the existing social perception of people with disabilities.

Accidents, Occupational↗

PubMed1980

[The changing situation of the school for the physically disabled owing to the rising numbers of most severely and multiply disabled pupils (author's transl)].

The author outlines a group of disabled who are suggested to be inadequately covered by the usual targets of rehabilitation (reintegration in the labour market, independence in the activities of daily living, starting a family--in short: "normality"), because of the presence of severe and extensive disabilities or disability combinations. Starting from an analysis of the living situation these children are facing in their childhood, and a projection on the living situations to be expected in adulthood, the essential principles of an educational concept are developed which, at the price of departure from established educational ideas, is intended, ideally, to enable the course of education to be adjusted to the living situation of the individual. These individualised programmes must be based on an established right to being different, and insistence on the inalienability of equal value and equal rights as a task of education in the schools for the physically disabled.

Child↗