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PubMed2005

Predictors of physical functional disability at 5 to 6 years after heart transplantation.

BACKGROUND: Few reports were found in the literature that examined predictors of physical functional disability after heart transplantation. Therefore, the purpose of this study was to (1) describe physical functional disability, (2) identify differences in physical functional disability by demographic and clinical variables, and (3) identify predictors of physical functional disability at 5 to 6 years after heart transplantation. METHODS: A nonrandom sample of 311 patients (approximately 60 years of age, 78% male, and 90% Caucasian) who were 5 to 6 years post-heart transplantation were investigated. Patients completed 8 reliable and valid quality-of-life instruments via self-report. Data analyses included descriptive statistics, chi-square, independent t-tests, correlations, and stepwise multiple regression. Level of significance was set at p = 0.05. RESULTS: The level of physical functional disability was low at 5 to 6 years after heart transplantation, yet 59% of patients reported having physical disability. Women experienced more functional disability than men, and patients with comorbidities (i.e., diabetes mellitus and orthopedic problems) experienced more functional disability than patients without these comorbidities. At 5 to 6 years after heart transplantation, 70% of variance in physical functional disability was explained by activities of daily living, symptoms, comorbidities, psychologic status, and resource utilization variables. CONCLUSIONS: At 5 to 6 years after heart transplantation, most patients experienced low levels of physical functional disability. Differences in physical functional disability were identified by both demographic characteristics and clinical variables. Predictors of physical functional disability included activities of daily living and symptoms, and clinical, psychologic, and resource utilization variables. Knowledge of factors related to physical disability long-term after heart transplantation provides direction for the development of strategies to assist patients to reduce their level of disability or function adequately despite their disability.

Activities of Daily Living↗

PubMed2006

Evidence for sex differences in the relationships of pain, mood, and disability.

UNLABELLED: Disability demonstrates strong univariate associations with pain and negative mood. These relationships are more complex at the multivariate level and might be further complicated by sex differences. We investigated sex differences in the relationships of pain and negative mood to overall disability and to disability in specific functional domains. One hundred ninety-seven consecutive patients with low back, myofascial, neck, arthritis, and fibromyalgia pain were recruited from university pain clinics and completed measures of disability and negative mood. Overall disability and disability in voluntary activities were significantly associated with pain and negative mood (factor score) for both sexes. Significant sex differences emerged in the strength of the disability-mood relationship, with women evincing a stronger relationship. Disability in obligatory activities was also significantly related to pain and negative mood for both sexes; however, there were no sex differences in the strength of these relationships. Mediation analyses indicated that, in men, negative mood partially mediated the relationship between pain and both overall disability and disability in voluntary activities; mediation was not supported for disability in obligatory activities. In women, negative mood fully mediated the relationship between pain and all 3 types of disability. These data suggest that disability is more directly related to pain in men. In women, the effect of pain on disability appears to operate through negative mood. PERSPECTIVE: Results of this study demonstrate that sex differences exist in the relationships of pain, mood, and disability. Men and women might thus benefit from treatment interventions that differentially target these variables.

Adult↗

PubMed2002

Health maintenance and management in childhood disability.

Health and health-related needs of children with disabilities are very broad in scope, and it is impossible to adequately cover all aspects in a single article. This article has tried, however, to highlight the issues common to disability, and lay the groundwork for the development of health maintenance guidelines for this population. The prevalence of childhood disability is on the rise, yet life expectancies are improving, and it is not uncommon for children even with severe disabilities to live well into adulthood. The ICIDH2 paradigm shift to focus on health and function rather than impairment and disability fits well with the national initiative to promote health for all. There is a paucity of information on the impact of childhood interventions on health in adulthood, yet it would be prudent to surmise that early interventions will be effective. Directed attention to the basic health needs and preventive measures for the management of children with disabilities is required. This can be difficult because the management of a child with disability is dynamic and challenging, and health care providers may find their time and energies consumed with just managing the more obvious and striking disability-related problems. The widespread ramifications of disability on both the individual and society, call for teamwork between family, health care providers, and the community. Although the specific needs of such a diverse group vary widely; as a group, children with disabilities have many common needs. These include the need for basic health maintenance and health promotion measures such as nutrition, immunizations and physical fitness, as well as coordination of services, psychologic and family support, technical assistance, funding resources, communication between health and education fields, and access to a "medical home," the site for primary care of the child. As a tree is bent, so it will grow. Efforts to promote growth and maximize opportunities for development, to inculcate healthy eating habits, to encourage exercise and socialization behaviors, and to strengthen the bond between the child with disability, family, and community will help minimize disability-related problems in adulthood. As children with disabilities are drawn into the mainstream of the concept of health, we should start to see the much awaited change in societal attitudes toward disability. The conditions resulting in childhood disability are many varied. Rather than developing condition specific health guidelines, it would be more advantageous to use a general health framework of anticipatory guidance, growth, development, medical management, psychologic and vocational counseling, and resource planning. Working off this framework, health maintenance and promotion measures can then be further individualized to suit the child and family's specific needs.

Cerebral Palsy↗

PubMed1999

Factors affecting disability in patients attending the internal medicine departments of general hospitals.

The aim of this study was to investigate the effect of sociodemographic factors, physical factors and mental factors on the physical and social disability of patients attending outpatient clinics of general hospitals. Physical and psychiatric morbidity in 1580 consecutive patients attending the internal medicine department of general hospitals was assessed using a stratified two-stage sampling design method. Of the total, 336 patients completed the second stage interview composed of Primary Care Version of Composite International Diagnostic Interview and Groningen Social Disability Schedule to assess sociodemographic, physical and mental factors. In this study, restricted activity days, disability days and Brief Disability Questionnaire were used for the assessment of physical disability, and Groningen Social Disability Schedule was used for social disability. Sociodemographic, physical and mental factors were all related to disability. Among sociodemographic factors, unemployment was associated with physical disability and social disability mildly. Among physical factors, the severity of physical disease was not associated with disability and medically explained somatic symptoms were associated with disability. Furthermore, the mental factor was more strongly associated with physical and social disability. It could be said that the mental factor is more strongly associated with physical and social disability than sociodemographic or physical factors. In addition, even mild mental symptoms not leading to ICD-10 mental disorders affected disability. From the viewpoint of the patients' burden, it is important to assess the mental symptoms as well as physical status in outpatient clinics of internal medicine or primary care.

Adolescent↗

PubMed2001

Coimpairments as predictors of severe walking disability in older women.

OBJECTIVE: Severe disabilities are common among older people who have impairments in a range of physiologic systems. It is not known, however, whether the presence of multiple impairments, or coimpairments, is associated with increased risk of developing new disability. The aim of this study was to determine the combined effects of two impairments, decreased knee-extension strength and poor standing balance, on the risk of developing severe walking disability among older, moderately-to-severely disabled women who did not have severe walking disability at baseline. DESIGN: The Women's Health and Aging Study is a 3-year prospective study with 6 semi-annual follow-up data-collection rounds following the baseline. SETTING: At baseline, knee-extension strength and standing balance tests took place in the participants' homes. PARTICIPANTS: 758 women who were not severely walking disabled at baseline. MEASUREMENTS: Severe walking disability was defined as customary walking speed of < 0.4 meters/second and inability to walk one quarter of a mile, or being unable to walk. RESULTS: Over the course of the study, 173 women became severely disabled in walking. The cumulative incidence of severe walking disability from the first to the sixth follow-up was: 7.8%, 12.0%, 15.1% 19.5% 21.2%, and 22.8%. In Cox proportional hazards models, both strength and balance were significant predictors of new walking disability. In the best balance category, the rates of developing severe walking disability expressed per 100 person years were 3.1, 6.1, and 5.3 in the highest- to lowest-strength tertiles. In the middle balance category, the rates were 9.6, 13.2, and 14.7, and in the poorest balance category 21.6, 12.7, and 37.1, correspondingly. The relative risk (RR) of onset of severe walking disability adjusted for age, height, weight, and race was more than five times greater in the group with poorest balance and strength (RR 5.12, 95% confidence limit [95% CI] 2.68-9.80) compared with the group with best balance and strength (the reference group). Among those who had poorest balance and best strength, the RR of severe walking disability was 3.08 (95% CI 1.33-7.14). Among those with best balance and poorest strength, the RR was 0.97 (95% CI 0.49-1.93), as compared with the reference group. CONCLUSION: The presence of coimpairments is a powerful predictor of new, severe walking disability, an underlying cause of dependence in older people. Substantial reduction in the risk of walking disability could be achieved even if interventions were successful in correcting only one of the impairments because a deficit in only one physiologic system may be compensated for by good capacity in another system.

Aged↗

PubMed2001

Population-based survey of childhood disability in eastern Jeddah using the ten questions tool.

PURPOSE: To identify the prevalence of handicapping disabilities among children up to 15 years of age and their epidemiological pattern in the eastern part of Jeddah. METHODS: In a population-based cross-sectional household survey in the eastern Jeddah area, Saudi Arabia, a multistage sampling method was applied to screen children in 875 houses using the ten questions survey tool for identification of disabilities. Further information collected for detected disabilities included possible risk factors, cause of the disability as perceived by the family and services previously provided to the child. RESULTS: A total of 137 cases of disability were detected giving a point prevalence rate of 36.7 per 1,000 children. Twenty-nine children (21.2%) were discovered for the first time during the survey. The majority of cases were male (57.7%) and the mean age for all cases was 10 years (SD = 5.5) with no case detected under one year of age. Disabled children were in the fourth or fifth birth order among their brothers and sisters and 47 (34%) of them were recorded as a second or third disability in the same family. Number of disabilities in the same child varied widely: 59% of cases had a single disability. 22% had two conditions and 19% had three or more conditions. Speech. motor and mental disabilities ranked top of the disabilities detected by the ten-question tool. The commonest cause of these disabilities as perceived by the family was hereditary diseases followed by childhood illnesses. Significant risk factors associated to these conditions included larger number of children in the family, older age of either parent. histories of handicapping conditions in the original families of either of the parents and presence of handicapping condition in the mothers. Families reported lack of services provided to their disabled children in the community. CONCLUSIONS: The survey tool managed to document. successfully, a prevalence rate of childhood disabilities in the community with a general picture of their types and suspected causes which is quite comparable to that found in Saudi Arabia. It also reported a low service delivery for these disabilities and identified some risk factors related to their occurrence. It is recommended to apply this survey method with certain modifications to suit the local culture in Saudi Arabia. Improvement of the services rendered to handicapped children in Jeddah is also recommended.

Adolescent↗

PubMed2004

Advancing the taxonomy of disability in older adults.

BACKGROUND: Refinement of the traditional task-based classification of disability is needed to advance the field of disability research and to inform clinical practice. We propose an enhancement of the taxonomy of disability that incorporates information about symptoms and impairments that directly contribute to disability. In the first step of this new development, we present evidence to support five categories of disability related to pain, balance, weakness, endurance, and other symptoms. METHODS: The Women's Health and Aging Study, begun in 1992, was a population-based study of older disabled women living in the Eastern region of Baltimore and surrounds. In-home examinations were conducted every 6 months for 3 years. During the second examination, the 879 participants were asked the main symptom cause of their disability for each activity with which they had difficulty. Symptom causes of disability in activities of daily living were grouped into five nonmutually exclusive categories as stated above. Descriptive analyses were used to compare groups according to sociodemographic, health, disease, and physical performance information. RESULTS: Women with pain-related disability were younger, more obese, and had high prevalence of widespread pain and symptomatic osteoarthritis. Balance-related disability was related to having an age of 85 years or older, being Caucasian, and poor performance in tests of standing balance and gait. Women with weakness-related disability were older, more often African American and sedentary, had high prevalence of stroke and diabetes, and performed poorly in chair-stands and knee strength tests. Endurance-related disability was associated with low self-rated energy, depressive symptoms, smoking history, and lung and cardiovascular diseases. CONCLUSIONS: The proposed refinement of the taxonomy of disability describes a set of empirically derived symptom and impairment-related disability groupings that have criterion and face validity. Further research about symptom and impairment-related disability in other populations of older persons is warranted.

Activities of Daily Living↗

PubMed2002

Short-term change in physical function and disability: the Women's Health and Aging Study.

OBJECTIVES: Although measures of physical function are predictive of future disability, little is known about the short-term impact of changes in physical function on disability. METHODS: Data from 93 of the 102 women who participated in the Weekly Substudy of the Women's Health and Aging Study (WHAS) were used to explore the association of changes in physical function with disability. The WHAS Substudy included 24 weekly assessments of three standard performance tests and self-reported disability in activities of daily living (ADLs) and basic mobility. RESULTS: Using random-effects models, we found small but significant (ps <.01) changes in ADL and mobility disability during weekly follow-up. Baseline performance scores were significantly associated with both ADL and mobility disability (ps <.001), accounting for 27% and 36% of the between-person variability in each type of disability, respectively. After adjustment for baseline scores, change in performance scores was significantly associated with ADL disability (beta = 0.08, p <.01) and mobility disability (beta = 0.12, p <.001), but accounted only for a small proportion (<10%) of the variability in the rate of change in disability outcomes. There was no evidence for an additional effect on either type of disability because of having a single episode of a higher or lower than usual performance score, or because of periods of at least 4 consecutive higher or lower than usual performance test scores. DISCUSSION: Basic physical functions account for a substantial proportion of the heterogeneity in ADL and mobility disability among older disabled women, but have a relatively small impact on short-term changes in either type of disability. Effective prevention of disability may require attention to a wider array of risk factors than just limitations in basic physical functions.

Aged↗

PubMed2004

Knowledge, personal risk and experiences of HIV/AIDS among people with disabilities in Swaziland.

Although there has been research focused on the disabling consequences of HIV/AIDS, there has been very little documented information about HIV/AIDS for individuals with disability prior to infection. There is evidence to suggest that people with disabilities face inequalities in accessing health information and services. The aim of this study was to explore whether disabled and non-disabled young adults in Swaziland perceive HIV/AIDS similarly. A qualitative study using focus-group discussions was conducted. Four focus groups were conducted with a total of 56 non-disabled adults (aged 16-29 years) and four focus groups were conducted with a total of 32 adults with either a physical or hearing disability (aged 18-32 years). The focus-group schedule explored knowledge about HIV/AIDS, personal risk and experiences of health-seeking practices. Information and awareness about HIV/AIDS was good in both rural and urban areas among the non-disabled participants, who obtained their information from a wide range of sources. In contrast, participants with disability, who obtained information about HIV/AIDS from a limited range of sources, lacked knowledge about HIV/AIDS and were misinformed about modes of transmission. Women with disabilities described experiences of sexual exploitation and abuse, which was perceived to be higher among disabled women than their non-disabled peers; they felt this was because disabled women were perceived to be 'free' from the HIV virus by non-disabled men. Further research is necessary to enable HIV/AIDS programmes to address the specific needs of people with disabilities.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Should extended disability be an exclusion criterion for tertiary rehabilitation? Socioeconomic outcomes of early versus late functional restoration in compensation spinal disorders.

STUDY DESIGN: A prospective cohort design with two groups of patients representing short-term or long-term disability (n = 497) who were selected from a larger cohort (n = 938) of consecutively treated spinal disorder patients with chronic compensation injuries. OBJECTIVES: To prospectively evaluate the impact of length of spinal disability on socioeconomic outcomes of medically directed rehabilitation. SUMMARY OF BACKGROUND DATA: Despite an increasing tendency of managed care organizations to limit rehabilitation services for disabled workers with chronic spinal disorders, there has been a surprising lack of prospective research evaluating the impact of length of disability on objective socioeconomic treatment outcomes. Although only approximately 10% of all patients with spinal disorders are disabled beyond 4 months, they account for nearly 80% of all workers' compensation expenditures. Little is known about whether relatively early intervention improves outcomes after chronicity has been established or whether any predictors distinguish between these groups. METHODS: Two comparison groups of functional restoration tertiary treatment graduates were identified from the same community referral pool. The "long-term disabled" group involved a minimum of 18 months of disability (n = 252). This group was compared with a "short-term disabled" group (n = 245), no more than 8 months since injury, but chronic based on a minimum of 4 months after injury. The long-term disabled group showed significantly higher rates of pretreatment surgery than the short-term disabled group (P < 0.001). All patients were evaluated prospectively with specific physical, psychological, and occupational measurements. They also underwent a structured interview 1 year after treatment evaluating work status, health care use, and recurrent injury. RESULTS: The short-term disabled group showed statistically higher return to work (P < 0.001) and work retention (P < 0.05) relative to the long-term disabled group. However, health care use and recurrent lost time injury claims were low in both groups and did not differ significantly. No predictors of outcome were found among the prospectively collected physical performance or psychosocial variables. CONCLUSIONS: This study suggests that early tertiary nonoperative care, once patients with chronic spinal disorders are identified as having potentially high-cost chronic pain and disability, is efficacious in achieving goals of better work return and work retention. Such early rehabilitation may also prevent significant indemnity expense, as well as some late surgical interventions sought by progressively more desperate patients. However, individuals with long-term disability achieve respectable work return and retention rates, while faring no worse on other socioeconomic outcomes that represent major "cost drivers" to the workers' compensation system. Early intervention is not a panacea or a necessary condition for the successful rehabilitation of workers with disabling chronic spinal disorders.

Adult↗

PubMed2000

Understanding disability in mental and general medical conditions.

OBJECTIVE: This study characterized the prevalence, characteristics, and impact of mental and general medical disabilities in the United States. METHOD: The 1994-1995 National Health Interview Survey of Disability was the largest disability survey ever conducted in the United States. A national sample was screened for disability, defined as limitation or inability to participate in a major life activity. Analyses compared cohorts who attributed their disability to physical, mental, or combined conditions. RESULTS: Of 106,573 adults, 1.1% reported functional disability from mental conditions, 4.8% from general medical conditions, and 1.2% from combined mental and general medical conditions. Disabilities attributed to a mental condition were predominantly associated with social and cognitive difficulties, those attributed to general medical conditions with physical limitations, and combined disabilities with deficits spanning multiple domains. In multivariate models, comorbid medical and mental conditions were associated with a twofold increase in odds of unemployment and a two-thirds increase in odds of support on disability payments compared to respondents with a single form of disability. More than half the nonworking disabled reported that economic, social, and job-based barriers contributed to their inability to work. One-fourth of working disabled people reported discrimination on the basis of their disability during the past 5 years. CONCLUSIONS: An estimated three million Americans (one-third of disabled people) reported that a mental condition contributes to their disability. Mental, general medical, and combined conditions are associated with unique patterns of functional impairment. Social and economic factors and job discrimination may exacerbate the functional impairments resulting from clinical syndromes.

Adolescent↗

PubMed2006

[Factors affecting national health insurance mass screening participation in the disabled].

OBJECTIVES: As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. METHODS: In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income; disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. RESULTS: The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan regions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health insurance program for the self-employed than for employees (95% CI=2.56-2.63); 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23); 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI= 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). CONCLUSIONS: The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.

Adolescent↗

PubMed2003

Time trends in disability pensioning for rheumatoid arthritis, osteoarthritis and soft tissue rheumatism in Norway 1968-97.

AIMS: Disability pensioning with musculoskeletal diagnoses increased more than general disability pensioning in Norway during 1968-97. Incidences of disability pensioning for three main musculoskeletal diseases - rheumatoid arthritis, osteoarthritis and soft tissue rheumatism - during the period 1968-97 were assessed. Changes in incidence were related to changes in Norwegian society with respect to prevalence of these diseases, the number of individuals having high probability of disability pensioning for these diseases, the labour market and legal amendments that may have changed the probability of being granted a disability pension among these patients. METHODS: Data on all new disability pensioners aged 50-66 years registered by the National Insurance Administration during 1968-97 and the total population of Norway excluding disability pensioners were used to calculate annual incidence rates of disability pension for the selected musculoskeletal diagnoses. RESULTS: The incidence of disability pension for soft tissue rheumatism and osteoarthritis increased during the study period, and both increased more than the incidence of disability pension in general. The incidence of disability pension for rheumatoid arthritis decreased when compared with disability pensioning in general. The year an upward or downward trend started is similar for osteoarthritis and soft tissue rheumatism for men and women in the age groups studied. CONCLUSION: Changes in prevalence of a disease seem to be an important factor in explaining differences in time trends of disability pensioning with different diagnoses. Changes in unemployment, female employment, number of manual workers or the legal system do not appear to be related to the increases in incidence of disability pensioning with musculoskeletal diseases.

Adolescent↗

PubMedDate not supplied

Disability and its effects on quality of life among older people living in Antalya city center, Turkey.

The problems of older people become more prevalent with aging of the population. Occurrence of disability and its effects on living conditions are two of the major factors that determine the quality of life of elderly people. The aim of this study is to find out the frequency and severity level of disability for people aged 65 and older living in Antalya city center. We also aim to determine the effects of disability over living conditions and to detect the variables associated with disability. World Health Organization-Disability Assessment Schedule (WHO-DAS-II) was implemented to 840 people who were selected from the research population with cluster sampling method. Disability status of these 840 people was measured for six different fields of life (domains). The domains that disability was the most frequent were; "participation in society (86.7%)", "getting around (70.2%)" and "life activities (68.8%)". The fields that were found to contain the most severe disabilities were "life activities" (50.5 +/- 32.5 points), "getting around" (40.6 +/- 27.0 points) and "self care" (34.2 +/- 23.4 points). It was found that disability frequency was positively associated with age, number of chronic diseases and number of acute complaints (odds ratios are 1.05, 1.31 and 1.43, respectively). Disability was also found to be 1.71 times more frequent for women, 2.54 times more frequent for people who live in separate houses and 4.50 times more frequent for illiterates. Disability affects the fields of lives of elderly people with rates of 90.4% for "self care", 88.6% for "getting around" and 85.2% for "life activities". For the elderly population participating in our study, disability is most frequently seen in "participation in society", the most severe disability is seen in "life activities" and the most effected field is found to be "self care". These findings must to be incorporated into planning procedures as expenditure is allocated in order to decrease disability.

Activities of Daily Living↗

PubMed2001

Disability, injury and ergonomics intervention.

PURPOSE: Disability due to work injury, trauma or disease is prevalent in our society. Also, due to slower growth of population and rapid increase in ageing population there may be an increasing pressure on shrinking labour pool. The purpose of this study is to review disability profile with common disabilities, socioeconomic impact of these disabilities, make a case for ergonomics as an enabler, and provide a couple of case studies to illustrate the point. METHOD: Major disability statistical records were reviewed to reveal rates of disability in some countries of the world. Among them the age and gender association of disability has been described. Furthermore the major categories of disabilities associated with systemic disorders and their gradations have been described, e.g. cardiovascular conditions, pulmonary conditions and joint diseases. Finally, using a feed forward mechanism a specific and customized ergonomic intervention was designed for two workers with knee injury. RESULTS: The prevalence of disability has been reported to range between 0.2% -20.9%. A significant association of disability with ageing was reconfirmed. A significant socio-economic impact of disability including differential employment rate for normal and disabled was discovered. A strategy and a means to achieve increased functionality in people with disability using ergonomic intervention has been described. Using a custom designed shin pad for rehabilitation of two workers with injured knee who were also on compensation were successfully returned to work many weeks before they may have been able to resume their work. CONCLUSION: Using a functional classification and developing functional profiles of people with disability may allow ergonomists to develop generic as well as specific solutions to successfully intervene in many cases and improve their functional capacity.

Adult↗

PubMed2006

Sampling survey of disability in 0-6 year-old children in China.

OBJECTIVE: To investigate the current status of disabled children and prevalence of disabilities in children aged 0-6 years and their risk factors, and to provide scientific evidence for making relevant policies for disabled children. METHODS: In a community-based cross-sectional study, multi-phase, stratified, unequal proportional and cluster sampling was adopted to survey 60 124 children aged 0-6 years. All the investigated children were screened for disabilities, and those with positive screening tests were further diagnosed by various specialties. RESULTS: A total of 819 children were diagnosed as disabled with an overall prevalence of 1.362%, 0.155% for hearing disability, 0.160% for visual disability, 0.931% for intelligent disability, 0.424% for limb disability, and 0.101% for mental disability. Prevalence of disability in children was higher in rural areas, and in families with two or more children, low educational level or in divorced families. CONCLUSION: The prevalence of disability can be reduced by economic development, improvement of health care and quality of population, as well as harmonious familial relationship, early prevention of disability, and preschool education for disabled children.

Blindness↗

PubMedDate not supplied

Sexual assault patterns among women with and without disabilities seeking survivor services.

INTRODUCTION: The primary research questions were 1) how do sexual assault patterns differ for women with disabilities as compared with women without disabilities and 2) how do patterns differ among women with different disabilities? METHODS: Study data were derived from initial encounters of 16,672 women survivors of sexual assault who sought state-funded sexual assault survivor services in Massachusetts from 1987 through 1995. Bivariate analyses and fixed effects logistic regression models compared sexual assault patterns including survivor responses for women with and without disabilities and among women with 5 different single disabilities. RESULTS: More than 10% of survivors reported > or =1 disability. If a woman had a history of a previous assault or was > or =30 at time of assault, she was significantly more likely to report a disability as compared to the referents (no history of assault or <30). Among women with a single disability, a survivor who delayed seeking services > or =6 months was more likely to have a mental health disability. In contrast, a survivor who had a cognitive disability was more likely to report sooner than 6 months compared with a survivor with other single disabilities. CONCLUSIONS: Differences were found between disabled and nondisabled groups as well as among women with different single disabilities. Some findings, such as those suggesting differential access, may require disability group-specific interventions, whereas other variations can be addressed at the individual client level. State-funded sexual assault survivor service providers may use these findings to improve outreach and service provision strategies.

Adult↗

PubMed2003

A changing relationship between disability and survival in the elderly population: differences by age.

BACKGROUND: Longitudinal studies estimating the association between disability and mortality in the elderly population have typically assumed disability constant through the follow-up study period. Current knowledge indicates that such assumptions may not be appropriate. Our purpose was to examine this association (disability and mortality) taking into account the transitions in the disablement process. METHODS: 1,294 participants (aged 65 and over) in the Health Interview Survey of Barcelona were followed up for a median of 8 years. Nine basic activities of daily living (ADLs) were measured at baseline and at the end of follow-up. Individuals were defined as "dependent" if they reported not being able to perform one or more of the activities without assistance. Survival analysis with delayed entry, age as the time variable, and disability as a time-dependent variable was performed. RESULTS: The rates of disability had increased by the end of the follow-up (from 42.0 to 60.0% among women and from 30.0 to 48.0%, among men); 7.5% of disabled women at baseline and 28.5% of men recovered from disability. The adjusted relative risk of dying for those with basic ADLs dependency varied with age: at 80 years of age it was 3.5 for women and 1.8 for men, while at 90 years it was 1.9 and 1.2, respectively. CONCLUSIONS: Disability increases monotonically over time while the risk of mortality associated with disability varies with gender and age. Elderly disabled women should be considered a target group for intervention because they show higher rates of disability and are less likely to recover from disability. Our results illustrate the need to consider disability status as a time-dependent variable, to avoid an underestimation of its association with mortality.

Activities of Daily Living↗