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PubMed1995

Legal status of the mentally disabled person in South African law.

Mental illness or insanity has a dramatic influence on a person's legal status. A person's status determines his or her competencies such as legal capacity, capacity to act, accountability and capacity to litigate. A mentally ill person is incapable of performing juristic acts; he or she is not capable of becoming a party to legal proceedings; is virtually incapable of committing a crime or being liable for a delict; etc. However, not all mentally ill persons are precluded from performing legal acts or, for that matter, giving valid consent to medical treatment. The reason being that status is factually determined according to the degree to which the mental illness is present at the time when the mentally ill person participates in the legal traffic. The measure of capability depends on the patient's intellectual and volitional capacities that will decide whether the patient can validly contract, litigate or consent to medical treatment. More specifically medical research of a non-therapeutic nature can only be carried out on mental patients who are capable of consenting thereto. This article endeavours to touch upon the different aspects of the mentally ill person's legal status.

Civil Rights↗
PubMed1994

Posttraumatic stress disorder in persons with developmental disabilities.

Persons with developmental disabilities are more frequently abused physically, emotionally and sexually than nondisabled persons (Ammerman, Van-Hasselt, Herson, McGonigle, & Lubetsky, 1989; Sobsey, Gray, Pyper, & Reimer-Heck, 1991). Persons with developmental disabilities are susceptible to the full range of psychiatric disorders (Szymanski, Madow, Mallory, Menolascino, & Pace, 1991). There has been no comprehensive study of posttraumatic stress disorder (PTSD) in this population (Hudson & Pilek, 1990), a recent textbook of mental health and mental retardation does not contain index listings on this condition (Fletcher & Menolascino, 1989), and psychometric tests currently proposed for use with the retarded do not examine for this condition (Aman, Watson, Singh, Turbott, & Wilsher, 1986). In this preliminary study, descriptive data from 51 persons with developmental disabilities who met DSM-IIIR criteria for posttraumatic stress disorder are reported. The majority of cases were detected upon routine initial psychiatric interview and record review. Demographics, family histories, and comorbid psychiatric conditions are described. In this sample all patients who received comprehensive recommended treatment improved.

Adult↗
PubMedDate not supplied

Tower of Hanoi and working memory in adult persons with intellectual disability.

Persons with intellectual disability (ID) have been found to perform more poorly than their mental age would suggest in the visuo-spatial problem solving task Tower of Hanoi (TOH). Inefficient performance has been assumed to be related to inability to use sophisticated problem solving strategies because of restricted working memory capacity. In the present study, the TOH performance of adult persons with ID was found to be equal to that of fluid-intelligence-matched general children. However, persons with ID violated the rules of the TOH more often, and needed more trials to solve the TOH problems than the children did. Visuo-spatial and executive working memory tasks were significantly connected to the TOH performance of persons with ID, whereas phonological working memory tasks were not. Poor inhibition ability was related to the poor performance of subjects with ID in the TOH. We suggest that for persons with ID, TOH performance is determined by individual differences in fluid intelligence, controlled attention, and inhibition ability.

Adult↗
PubMed1984

Analyzing surveys on deaf adults: implications for survey research on persons with disabilities.

Differences in operationalizing definitions of disability, variations in methods of data collection and diversities in salient characteristics of disabled persons are generic problems in conducting social research surveys with persons who have disabilities. These problems are of concern not only to social scientists seeking to improve survey methods, but they also have practical significance to decision makers needing high quality information to guide social policies that influence the provision of health care, education and social services to persons with chronic impairments. Reports of 41 surveys on deaf adults in the United States and Canada conducted between 1959 and 1981 were analyzed to determine how rates of response, a key indicator of reliability of survey data, are affected by three methods of data collection, degree of verification efforts, scope of the sample and socio-demographic characteristics of those in the survey populations. Measurable results are provided so that planners of future surveys can correct for anticipated rates of sample attrition under various survey conditions. Other data indicate that trade-offs can be made between changes in the size of the sample and method of data collection to lead to more effective surveys. Important terms such as deafness, deaf population and deaf community are discussed as these relate to interpreting the results of survey studies on deaf adults. Discussion is also given to conducting social surveys with groups of individuals having other disabilities besides loss of hearing.

Adult↗
PubMed1992

Long term care arrangements for elderly persons with disabilities: private and public roles.

When private resources are defined broadly to include informal care as well as private expenditures, 73 percent of the elderly long term care population rely entirely on private resources for their care. The emphasis of current programs on institutional care directs public resources toward those with more serious disability and less family to care for them. Among those with four or five disabilities in ADLS, 35 percent of those without a spouse or children currently receive no public support, compared with nearly 80 percent of those with both a spouse and children. Thus, even if restricted to seriously disabled persons, a new program expanding public long term care financing would increase eligibility for public benefits disproportionately among those with greater informal care resources.

Activities of Daily Living↗
PubMed2005

What policymakers need and must demand from research regarding the employment rate of persons with disabilities.

Enabling persons with disabilities to prepare for and engage in gainful employment has become a priority concern in U.S. society. As a result, federal and state policymakers are adopting employment-related initiatives designed to enhance the employment rate of persons with disabilities. Policymakers need credible evidence in order to assess and reform these initiatives. This recognized need, however, begs the question of what constitutes 'credible evidence.' Of particular concern in the disability policy arena is the debate over the types of conclusion about employment rates that can and cannot be drawn from analyses of national survey data sets. This article connects standard research methodology concepts with the complexities of evaluating disability policy to help stakeholders appreciate the issues involved in this debate. This appreciation can help policymakers (1) recognize unwarranted cause-and-effect conclusions based solely on existing national survey data and (2) demand better data and stronger research designs to complement the potential over-reliance on correlational studies using problematic survey data to estimate policy impacts. To this end, the article concludes with a practical framework with a checklist for assessing the adequacy of research regarding the employment rate of persons with disabilities.

Persons with Disabilities↗
PubMedDate not supplied

Risk factors for heart disease and stroke among diabetic persons, by disability status.

OBJECTIVE: To determine whether disabled diabetic persons have a higher prevalence of risk factors for heart disease and stroke than do diabetic persons without disability. RESEARCH, DESIGN, AND METHODS: Data were analyzed for noninstitutionalized adults in 27 states and the District of Columbia that participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 2001 and/or 2003. Logistic regression analysis was used to estimate the adjusted prevalence and odds ratios of disabled diabetic persons, by sociodemographic characteristics. The logit form of each model was used to estimate conditional marginal probabilities of risk factors for heart disease and stroke among diabetic persons, by disability status. RESULTS: Diabetic persons with disability were more likely than those without disability to have more risk factors for heart disease and stroke, including insufficient leisure-time physical activity or inactivity (adjusted prevalence: 75.2% vs. 63.3%; P<.001), obesity (58.9% vs. 43.3%; P<.001), hypercholesterolemia (52.6% vs. 48.4%; P=.038), and hypertension (63.9% vs. 56.6%; P<.001). They were also more likely to have one or more, two or more, three or more, and four or more risk factors (97.2% vs. 95.6%, 83.5% vs. 74.0%, 56.5% vs. 41.1%, and 22.2% vs. 13.6%, respectively; P< or =.005). CONCLUSIONS: Diabetic persons with disability are more likely than those without disability to have clusters of risk factors for heart disease and stroke. Health care guidelines specifically targeting diabetic patients with disability may be needed to aid health care providers in addressing these risk factors.

Adult↗
PubMed2004

[Osteoarthritis, disability, travel and recreational activities: comments from physicians and travel specialists].

IMPACT OF DISABILITY: A survey of general practitioners, rheumatology specialists, and tourism specialists conducted by NEGMA-LERADS Laboratories demonstrated that subjects with osteoarthritis avoid vacation trips more readily than recreational activities. VACATION TRIPS ARE STILL POSSIBLE: Certain tourism organisms have nevertheless developed specialized services for disabled persons. Special emphasis is placed on adequate preparation before the vacation trip. PROBLEMS WITH WALKING: Many persons disabled by osteoarthritis do not require a wheel chair, yet have difficulty walking long distances. It is important to recognize the specific disabilities related to osteoarthritis and their effects on grip force and/or ambulation.

Activities of Daily Living↗
PubMed1991

The health insurance coverage of working-age persons with physical disabilities.

In this article, we examine the health insurance status of working-age, physically disabled persons, and particularly the question of whether the public sector insures a disproportionate share of the highest-risk disabled population. We use descriptive statistics to develop an insurance profile of respondents with severe physical disabilities, and multivariate procedures to model differences between privately and publicly insured, disabled persons. Results of logistic regression procedures indicate that respondents with private insurance alone are more likely to have a high functional level, a positive perception of their health, and to be married, than are those with public (or a combination of public and private) insurance. Specific type of disability, age, and wheelchair use were also found to predict the type of insurance, their effects largely mediated by employment status and income.

Adult↗
PubMedDate not supplied

Disability awareness for clinical staff.

While nurses and other influential groups in society pay lip-service to understanding and meeting the needs of physically disabled persons, disabled people continue to encounter lack of recognition, ignorance and prejudice. The author describes how one nursing college is attempting to create a better understanding of disability for its students and clinical staff, and discusses the issues which have inspired the course's design.

Curriculum↗
PubMed1996

Access to primary health care among persons with disabilities in rural areas: a summary of the literature.

Despite the prevalence of disabilities among persons living in rural areas, scarce data exist on their health care needs. While rural residents generally experience barriers to access to primary health care, these problems are further exacerbated for people with disabilities. This article summarizes findings from the published literature on access to primary health care among people with disabilities living in rural locations. A comprehensive computerized literature search turned up 86 articles meeting the study criteria, focused on the following rural populations affected by disabilities: children and adolescents, working-age adults, the elderly the mentally ill, and people with AIDS. For each of these populations, substantial problems in accessing appropriate health care have been documented. The literature consistently emphasizes the failure of local health care systems in nonmetropolitan areas to adequately address the complex medical and related needs of individuals with disabilities. In the absence of specialized expertise, facilities, and primary care providers trained specifically to care for disabled persons, local programs rely heavily on the use of indigenous paraprofessionals and alternative models of care. Further research is needed to identify and test the efficacy of innovative service delivery strategies to improve health care access for this population.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Perceived discomfort associated with working with persons with varying disabilities.

Perceptions of discomfort by nondisabled coworkers are a major barrier to the acceptance of disabled persons into work groups. This research examined whether reported discomfort varied by the type or nature of the disability. 151 subjects rated 20 types of disabilities in terms of how uncomfortable or comfortable they would be working closely at a nonspecified task with a person with the particular disability. A stable hierarchy of the 20 disabilities was found. Patterns and implications are discussed. Gender of the rater influenced the ratings, specifically females exhibited less discomfort with disabilities over-all than did males. Prior contact with a disabled person, either personally or at unspecified work, did not affect the ratings of discomfort.

Adult↗
PubMed1999

Psychological aspects. A series of 104 posttraumatic cases of reflex sympathetic dystrophy.

Over a period of 12 years, 104 cases of posttraumatic reflex sympathetic dystrophy have been diagnosed followed up and treated according to a standard protocol, including, among other clinical items, a psychiatric examination. Apart from the traditional clinical recordings, the following has been noted: 1. All patients were over 30 years of age; 2. No relationship was found between the significance of the trauma and the severity of the dystrophy; 3. The dystrophy nearly always emerged at the time of the primary healing of the injury; 4. On psychiatric examination, 96% of the patients showed signs of chronic depression; 5. Forty-nine percent had elevated gamma GT suggestive of alcohol abuse; 6. The socioprofessional context always revealed: either a state of inactivity (jobless persons, disabled persons, childless housewives, pensioners); or an opportunity for inactivity (work injury suffered by workers, lower-rank employees, bankrupt self-employed people). There were no tradesmen, executives, lawyers, physicians, consultants, artists, sportsmen or musicians in the series, and no housewives with young children. 7. In the second phase of the survey, we decided to complement the drug therapy by systematically adding antidepressant agents. This led to a significant improvement in the course of the disease. These elements have led us to consider whether traumatic algodystrophy could be a psychosomatic disease.

Adult↗
PubMed1988

Attitudes of occupational therapy personnel toward persons with disabilities.

The study described in the following article investigated the attitudes of occupational therapy personnel toward persons with disabilities. The examination involved attitudes in general as measured by the Scale of Attitudes Toward Disabled Persons (SADP) (Antonak, 1981), specific attitudes toward infants with Down's syndrome, beliefs concerning the importance of favorable attitudes toward patients, and beliefs concerning the role of the American Occupational Therapy Association (AOTA) in the development of ethical guidelines for the delivery of health care services. The results of a survey of 619 occupational therapy personnel indicate that they hold a very favorable attitude toward persons with disabilities, and that they believe that a negative attitude would adversely affect the therapeutic relationship. The majority agree that the expression of a favorable attitude should be a criterion in student selection. The majority also agree that AOTA should develop position papers on ethical issues and take a public position on issues pertinent to the rights of the disabled person. Occupational therapy personnel proved to be very homogeneous on the general attitudinal scale. However, the Down's syndrome scenario uncovered significant differences among the different categories of respondents in the variables for professional level, area of practice, years of practice, and geographic location. A majority of respondents agreed that is is unethical to withhold needed surgery from a child because of disability. However, they differed on the ethics of aborting a fetus with Down's syndrome (most thought it was unethical).

Adult↗