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PubMed2004

Normative values for the Health Assessment Questionnaire disability index: benchmarking disability in the general population.

OBJECTIVE: The Health Assessment Questionnaire (HAQ) disability index (DI) has been commonly used in rheumatology to quantify functional disability in patient groups, but current general population values of this index are not available. This study was undertaken to establish normative values for the HAQ DI in a general population and to analyze its correlates. METHODS: The HAQ DI (range of scores 0-3) was measured in a random sample of 1,530 adults in the Central Finland District. Prevalence rates of disability by strata of age, sex, education level, body mass index (BMI), and health behaviors (including smoking and exercise habits) were calculated. Pearson's product-moment correlation coefficient and ordinary least squares regression were used to analyze the data. RESULTS: The estimated population mean HAQ DI was 0.25 (95% confidence interval 0.22-0.28), and 32% of respondents had at least some disability. Both for men and for women, functional disability increased exponentially with age. The HAQ DI was correlated with pain (r = 0.58) and global self assessment (r = 0.61). The prevalence of disability decreased with increasing number of years of education, lower BMI, and increasing frequency of physical exercise. CONCLUSION: Almost one-third of the general population has some functional disability. Functional disability is associated in part with lifestyle choices and increases with age in a nonlinear manner. The normative values of the HAQ DI that we have presented could be used as a reference benchmark for clinical and epidemiologic studies using this measure of disability.

Adult↗
PubMed1977

Disabled-worker beneficiaries under OASDI: comparison with severely disabled PA recipients.

The 1972 Survey of Disabled and Nondisabled Adults found that more than 1 million severely disabled persons aged 20-64 were receiving payments under Federal-State public assistance programs. To determine the reasons why most of these individuals did not qualify for disabled-worker benefits under the social security program, their characteristics were compared with those of the approximately 1.5 million disabled-worker beneficiaries. The public assistance recipients were found to be younger and less well educated than their disabled-worker beneficiary counterparts. A greater proportion of them were women and more were members of minority races. Public assistance recipients became disabled at an earlier age and had been disabled longer. Compared with disabled-worker beneficiaries, they had held less skilled jobs, had earned less money, and had had a weaker attachment to the labor force. These characteristics greatly reduced their chances of qualifying for disabled-worker benefits. Lack of knowledge about the program was also an important contributing factor.

Adult↗
PubMedDate not supplied

Awareness about the persons with disability act among leprosy patients and other disabled persons.

To assess the level of awareness about the different provisions of the Persons with Disability Act (PWD Act) among leprosy patients and other disabled, 233 disabled persons from the self-help groups formed by Vadathorasalur Leprosy Control Unit have been interviewed using a structured interview checklist. The results show that 74.7% of the respondents were aware that identity cards are available for the disabled, 56.2% were aware of the free education benefit to the disabled, as low as 35.6% were aware of the scholarships, 33% knew about the employment reservations, 24.9% heard about the housing scheme of the government for the disabled, but 24.5% only knew about law against discrimination, 31.8% came in contact with institutions for the severely disabled and only 16% were aware of the unemployment allowance to the disabled. The level of awareness is low among women with regard to all components of the Act. It was found that students studying up to secondary level were not aware of the availability of scholarships and free education, which needs to be seriously looked into, especially by educational institutions. The level of formal education played a significant role in increasing awareness about the Act among literates. The knowledge is low among persons of all occupations. The study showed that there is a great need for an educational intervention programme to publicize the provisions of the Act among the disabled and their families.

Adolescent↗
PubMed1986

[Illness status, causes for disability and social factors influencing disability in pregnancy. 3. Social factors influencing disability].

The following statistically significant dependences could be demonstrated. The average duration of unfitness for work higher was with the increasing age. Unmarried pregnant women had a shorter average duration of unfitness for work than married ones. Corresponding to the degree of the professional qualification the average duration of unfitness for work increased. Pregnant women who were working in the industrial production, in the sphere of trade and service and in the educational system had a higher average frequency of unfitness for work than other groups of occupation. In connection with the results possible engagements and behavioural patterns of pregnant women are discussed, especially the correlations between occupation and pregnancy.

Adolescent↗
PubMed1986

[Morbidity status, causes for work disability and social factors influencing work disability in pregnancy. 2. Causes for work disability].

The higher level of patients of pregnant woman in comparison with non-pregnant ones results from a higher unfitness for work which nearly corresponds to the increase of sicknesses depending on gestation. From all causes of unfitness for work more than 60% were depending on gestation. Causes for the half of the release from work depending on gestation were the three diagnoses threatening abortion, threatening premature birth and bleedings. On the total level of patients of 11.66% they had a share of 5.70% points. Infections of the ureter, the diagnosis' 'Other complications in pregnancy', hyperemesis and gestoses followed. Infections of the upper respiratory tract and influenza were the causes of all releases from work which were not depending on gestation. Their share on the level of patients amounted to 0.9% points. Releases from work because of sicknesses of circulation and of the digestive tract followed in their frequency. A number of further causes of unfitness for work had only a small share on the happenings of unfitness for work.

Abortion, Spontaneous↗
PubMed1996

[Disability, the risk of disability and changes in work capacity-- unacceptable conditions for insurance in occupational injuries and diseases].

According to Croatian legislation disability, risk of disability and altered work capacity are prerequisites for recognition of job injuries, occupational diseases, and, consequently, of the worker's special rights. That is also valid for all areas of insurance. The legislation, if applied, would make it impossible for a great number of insured workers to realize their particular rights based on work related health damage, especially in the field of health insurance and reinsurance of health care costs. Health insurance boards, along with insurance companies, manage by evading the condition of disability, risk of disability and altered work capacity. This has been proved on a sample of 63 cases of job injuries and one occupational disease registered in the Occupational safety unit of the Clinical Hospital in Split from May 1994 to May 1995. In all cases the medical doctor of choice, the authorized health insurance board and the authorized insurance company enabled the insured (workers injured at work or having occupational disease, the employer) to make use of their specific insurance rights without waiting for the fulfillment of the prescribed condition of disability, risk of disability and altered work capacity. The authors consider such behaviour to be inadmissible in a state based on the rule of law. If the condition of disability, risk of disability and altered work capacity is unsuitable, as indeed it is, a solution should be sought for in changing the regulations. The simplest way of doing it is to invert the defining and taking over decrees in the Law on Pension and Disability Insurance and the Law on Health Insurance.

Accidents, Occupational↗
PubMed1994

The impact of the Americans with Disabilities Act on employment opportunity for people with disabilities.

The impact of the American with Disabilities Act (ADA) on employers and the workplace extends well beyond the provisions of the Act. Besides demanding an end to discrimination in the workplace against persons with disabilities, both the ADA and the Rehabilitation Act articulate the goals of equal opportunity, full participation, independent living, and economic self-sufficiency. They state clearly the right of each person to a full and meaningful life regardless of disability. Promoting those goals through employment requires thinking more broadly about the interaction between the individual with the disability, the workplace, and society. The employer is not the only participant. The individual with the disability plays an important role, as do the health care providers. An opportunity to align the goals of SSI and SSDI more closely with the ADA may lie in efforts to expand health care approaches to disability, based on the IOM Model of Disability, and link such practice with disability management efforts in the workplace.

Activities of Daily Living↗
PubMed2006

When do older adults become "disabled"? Social and health antecedents of perceived disability in a panel study of the oldest old.

Disability carries negative social meaning, and little is known about when (or if), in the process of health decline, persons identify themselves as "disabled." We examine the social and health criteria that older adults use to subjectively rate their own disability status. Using a panel study of older adults (ages 72+), we estimate ordered probit and growth curve models of perceived disability over time. Total prevalent morbidity, functional limitations, and cognitive impairment are predictors of perceived disability. Cessation of driving and receipt of home health care also influence older adults 'perceptions of their own disability. A dense social network slowed the rate of labeling oneself disabled, while health anxiety accelerated the process over time, independent of health status. When considering perceived disability, the oldest old use multidimensional criteria capturing function, recent changes in health status and social networks, and anxiety about their health.

Activities of Daily Living↗
PubMedDate not supplied

Rethinking disability and what to do about it: disability studies and its implications for occupational therapy.

Disability studies seeks to reframe rehabilitation's understanding and responses to disability. Disability scholars point out that rehabilitation's perspectives and practices are not objective, but instead reflect particular historical and ideological forces. By demonstrating how rehabilitation practitioners can unintentionally do things that are unhelpful or even harmful, disability scholars challenge the profession of occupational therapy to reconsider aspects of practice, education, and research. In order to provide a context for a special issue devoted to disability studies, this paper examines disability studies' major critiques of rehabilitation and considers their implications for occupational therapy. The paper identifies ways that occupational therapy can continue to respond reflectively to the themes of disability studies. It also identifies a number of questions raised by disability studies that will need to be addressed in practice, education, and research.

Disability Evaluation↗
PubMed2005

The effect of the Americans with Disabilities Act on economic well-being of men with disabilities.

This paper estimates the effect of the Americans with Disabilities Act (ADA) on the economic well-being of working-age (20-62) men with disabilities by fitting a fixed-effects model to the U.S. Survey of Income and Program Participation (SIPP) panel data. This paper constructs a new and alternative measure of disability utilizing rich information on limitations to functional activities (FA), activities of daily living (ADL), and instrumental activities of daily living (IADL). The new objective measure of disability identifies a larger group of people as being disabled than conventional self-reported measure. Probability of employment for disabled men fell 5.8% compared to nondisabled men significantly at the 5% level. Log-real-wages of men with disabilities fell 5.3% relative to men without disabilities significantly at the 10% level.

Adult↗
PubMed1998

The impact of ratee's disability on performance judgments and choice as partner: the role of disability-job fit stereotypes and interdependence of rewards.

An experiment assessed the impact of disability-job fit stereotypes and reward interdependence on personnel judgments about persons with disabilities. Students (N = 87) evaluated 3 confederates. The experiment varied disability of the target confederate (dyslexia vs. nondisabled), task, and dependence of rater rewards on partner performance. Two disability-task combinations represented stereotypical poor fit and good fit. Dependent variables were performance evaluations, performance expectations, and ranking of target as a partner. There was negative bias against the confederate with dyslexia in poor-fit conditions. In the interdependent reward condition, there was a negative main effect for disability, regardless of fit. No effects for disability were found on performance ratings or expectations. Results indicate the need to consider disability-job fit stereotypes and consequences to raters when assessing the impact of disability on personnel judgments.

Adult↗
PubMed2004

Differential responses in three thalamic nuclei in moderately disabled, severely disabled and vegetative patients after blunt head injury.

In vivo imaging techniques have indicated for many years that there is loss of white matter after human traumatic brain injury (TBI) and that the loss is inversely related to cognitive outcome. However, correlated, quantitative evidence for loss of neurons from either the cerebral cortex or the diencephalon is largely lacking. There is some evidence in models of TBI that neuronal loss occurs within the thalamus, but no systematic studies of such loss have been undertaken in the thalamus of humans after blunt head injury. We have undertaken a stereological analysis of changes in numbers of neurons within the dorsomedial, ventral posterior and lateral posterior thalamic nuclei in patients assessed by the Glasgow Outcome Scale as moderately disabled (n = 9), severely disabled (n = 12) and vegetative (n = 10) head-injured patients who survived between 6 h and 3 years, and controls (n = 9). In histological sections at the level of the lateral geniculate body, the cross-sectional area of each nucleus and the number and the mean size of neurons within each nucleus was quantified. A statistically significant loss of cross-sectional area and number of neurons occurred in the dorsomedial nucleus in moderately disabled, and both the dorsomedial and ventral posterior thalamic nuclei in severely disabled and vegetative head-injured patients. However, there was no change in neuronal cell size. In the lateral posterior nucleus, despite a reduction in mean cell size, there was not a significant change in either nuclear area or number of neurons in cases of moderately disabled, severely disabled or vegetative patients. We posit, although detailed neuropsychological outcome for the patients included within this study was not available, that neuronal loss in the dorsomedial thalamus in moderately and severely disabled and vegetative patients may be the structural basis for the clinical assessment in the Glasgow Outcome Scale. In severely disabled and vegetative patients, loss of neurons from the ventral posterior thalamic nucleus may also reflect loss of response to afferent stimuli.

Adolescent↗
PubMed2002

Late life function and disability instrument: I. Development and evaluation of the disability component.

BACKGROUND: Efforts to evaluate the effectiveness of clinical and community-based interventions designed to impact late-life disability have been hindered significantly by limitations in current instrumentation. More conceptually sound and responsive measures of disability are needed. METHODS: Applying Nagi's disablement model, we wrote questionnaire items that assessed disability in terms of frequency and limitation in performance of 25 life tasks. We evaluated their validity and test-retest reliability with 150 ethnically and racially diverse adults aged 60 and older who had a range of functional limitations, using factor analysis and Rasch analytic techniques to examine and refine the instrument. RESULTS: Our analyses resulted in a 16-item disability component with two dimensions, one focused on frequency of performance and the other addressing limitation in performance of life tasks, with two disability domains within each dimension. The frequency dimension consisted of a personal and a social role domain, and the limitation dimension consisted of an instrumental and a management role domain. Expected differences in summary scores of known-functional limitation groups support the validity of this instrument. Test-retest intraclass correlations of the reproducibility of each overall dimension summary score were moderate to high (intraclass correlation coefficients .68-.82). CONCLUSIONS: The Late-Life Function and Disability Instrument has potential to assess meaningful concepts of disability across a wide variety of life tasks with relatively few items.

Activities of Daily Living↗