Facilitators and barriers to employment for people with physical disabilities: A cross-sectional study.

BACKGROUND: There is increasing evidence that employment, or the lack thereof, affects an individual's health. Consequently, employment provides people with physical disabilities (PWPD) with financial independence, enhances their well-being and self-worth, and facilitates a sense of purpose. People with physical disabilities often retain job skills and motivation to return to work after acquiring a disability. Their vocational rehabilitation and job accommodation needs likely differ from people with disabilities resulting from developmental, sensory, cognitive, and mental health conditions. To better target the needs of PWPD and improve vocational rehabilitation services, it is crucial to identify the modifiable factors that influence their employment outcomes. OBJECTIVE: This research aimed to examine systematically the client-, employer-, and context-related facilitators and barriers to employment experienced by PWPD. METHODS: We recruited to this cross-sectional study, PWPD from the Midwestern United States who returned to work after injury or illness. An online survey collected data on demographic characteristics and educational history; disability and functional status; supports, facilitators and barriers to employment; and job information and accommodations. RESULTS: 347 working-age PWPD completed the survey; at the time of survey completion, 270 were working and 77 were not. People with physical disabilities who reported social support and encouragement at work were more likely to be working than respondents who did not. Negative attitudes of supervisors and colleagues, inaccessible work environments, and inflexible work schedules were barriers to employment. Important reasons for working included financial needs, a sense of purpose, and self-worth. CONCLUSIONS: Results provide insights into the importance of social supports in the work environment. Novel approaches are needed to develop supportive relationships with supervisors and coworkers.

Disability Phenotypes and Job Accommodations Utilization Among People with Physical Disability.

Purpose People with disabilities (PWD) are less likely to be employed than those without disabilities. Reasonable job accommodations are an essential factor for ensuring equal access to jobs for PWD. However, use of job accommodation is less than optimal among PWD with various types of disabilities. Sometimes, PWD have co-occurring impairments, which might affect accommodation use. This research aimed to explore disability phenotypes, frequently used accommodations, and employee- and job-related factors associated with the extent of job accommodation use. Methods A cross-sectional online survey of PWD was conducted in the Midwest region of the United States. Latent class analyses were used to identify disability phenotypes. Descriptive analysis and stepwise Poisson regression were used to identify factors associated with job accommodation use. Results A total of 326 PWD with work experience after acquiring a disability were included in this analysis. We identified three disability phenotypes: (1) Severe disability in cognitive, physical, emotional, communication and visual domains (32%), (2) Moderate cognitive and low physical disability (48%), and (3) High physical disability phenotypes (20%). 80% of PWD received at least one accommodation. Flexible working schedules, telework, and access to a support person in the workplace were the most common accommodations. Employee- (age, disability phenotypes, motor function) and job-related factors (job preparation, self-employment) are associated dependently with accommodation use. Conclusion This analysis identifies three disability phenotypes and highlights both employee- and job-related factors associated with accommodations used. It may be beneficial to consider multiple contextual factors, including co-occurring disability, employee- and job-related factors, when assisting people with job accommodations.

Descriptive analysis of free-text comments on healthcare priorities and experiences in a national sample of people with multiple sclerosis.

BACKGROUND: People with multiple sclerosis (PwMS) often require care from multiple healthcare services and providers to fulfill their physical and psychological healthcare needs, including those related to their MS and those due to co-occurring disorders. However, they often experience barriers to accessing healthcare specialists, providers, and services. OBJECTIVE: The purpose of this study is to understand patients' healthcare preferences, perceived importance of elements of their care, and encountered barriers through analyzing patients' free-text comments. METHODS: We used content analysis to analyze 7105 text responses. RESULTS: We recruited 3,003 participants with MS across the U.S. Of those, 82.9% were females. The mean age was 58.49 years (a range of 18-96 years). The participants self-reported their MS course as relapsing remitting (54.8%) or progressive (30.0%). The healthcare professionals most frequently identified as being most important to PwMS included neurologists, physicians/general practitioners, and physical/occupational therapists. Commonly identified barriers to accessing healthcare included the high cost of healthcare services, insufficient health insurance coverage, limited mobility, and transportation. Approximately 36% of respondents expressed a preference for receiving care from a comprehensive MS center, an MS research center, or an MS specialist as their main healthcare provider. Regarding priorities for improving healthcare quality, about 10% of participants stated that healthcare professionals should focus more time and attention on communicating, consulting, and understanding patients' needs and questions. CONCLUSION: PwMS prioritize accessibility, affordability, insurance coverage, and comprehensiveness in MS healthcare services.

Exploring the relationship between child physical abuse and adult dating violence using a causal inference approach in an emerging adult population in South Korea.

Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed.

The influence of childhood maltreatment and self-control on dating violence: a comparison of college students in the United States and South Korea.

Various aspects of social learning and self-control theories have been applied to partner violence among multiple samples in the United States, but these theoretical approaches have been less commonly studied cross-culturally. Consequently, childhood maltreatment and low self-control have been identified as risk factors for various outcomes in primarily American samples. This study examined the relationships between childhood maltreatment, low self-control, and dating violence among college students in South Korea and the United States. Findings indicated that experiencing childhood maltreatment and having low self-control were key predictors of perpetration and victimization for both psychological and physical relationship violence. Witnessing interparental violence during childhood was less consistently predictive of one's involvement in a violent dating relationship. Implications for theory and policy are discussed.

Exploring sex disparity in sentencing outcomes: a focus on narcotics offenders in South Korea.

Most research on sentencing outcomes reveals that legally relevant factors such as the seriousness of the offense and prior criminal record are primary determinants. There is, however, a substantial body of research that finds that extralegal factors such as a defendant's sex also influence these outcomes. Most of these latter studies conclude that female defendants receive less severe outcomes compared to their male counterparts. Most of this research, however, is limited to Western societies. To extend this body of research, the current study examines sex differences in sentencing practices for a sample of narcotics offenders in South Korea. Results support previous research; female drug offenders in South Korea are generally treated more leniently than their male counterparts. Tests for interaction effects reveal that the defendant's sex also interacts with other constellations of factors to produce lenient treatment for certain female defendants. These tests, however, also reveal that lenient sentence outcomes are not extended to all female defendants; those with prior drug convictions do not fare better than their male counterparts at the incarceration decision.

Dating violence perpetration and victimization among South Korean college students: a focus on gender and childhood maltreatment.

Unlike the attention given to intimate partner violence among adolescents and young adults in western societies, dating violence is not currently recognized in South Korea as a social phenomenon in terms of research, prevention, and intervention. Childhood maltreatment has been identified in previous research as a risk factor for violence in a later dating relationship. This study examines the relationship between childhood maltreatment and physical and psychological dating violence perpetration and victimization among 1,399 college students in South Korea, with a specific focus on gender. Poisson regression models and tests of equivalent parameters were conducted to determine whether the observed relationships were invariant across gender. Findings indicated that childhood maltreatment is a consistent predictor of involvement in dating relationships characterized by violence for males and females. The implications of the current research within a cultural context are discussed.