A comparison of factors associated with unmet healthcare needs in people with disabilities before and after COVID-19: a nationally representative population-based study.

BACKGROUND: People with disabilities, who require numerous healthcare services, are vulnerable to unmet healthcare needs. This study aimed to investigate and identify the factors that influence unmet healthcare needs among people with disabilities and to compare these factors before and after the COVID-19 pandemic in South Korea. METHODS: A propensity score matching analysis was conducted using two datasets from the National Survey of Disabled Persons collected in 2017 and 2020. The participants were matched based on variables known to influence healthcare utilization. Based on the Andersen model, logistic regression was performed to analyze the key characteristics of the factors associated with unmet healthcare needs, including predisposing, enabling, and need factors. RESULTS: Propensity score matching resulted in the inclusion of 1,884 participants in each group: an experimental group and control group. Before COVID-19, factors associated with unmet healthcare needs included sex, age, marital status, and education level (predisposing factors), instrumental activities of daily living dependency, satisfaction with medical staff's understanding of disability, satisfaction with medical institutional facilities and equipment (enabling factors), subjective health status, and depressive symptoms (need factors). After COVID-19, factors included physical disability, instrumental activities of daily living dependency, and discrimination (enabling factors), and subjective health status, chronic diseases, depressive symptoms, and regular medical care (need factors). No significant predisposing factors affecting unmet healthcare needs were identified after COVID-19. CONCLUSIONS: This study compared the factors affecting unmet healthcare needs among people with disabilities before and after COVID-19. Recognizing the different factors associated with unmet healthcare needs before and after COVID-19, (e.g., sex, type of disability, satisfaction with medical staff's understanding of disabilities, medical institutional facilities and equipment considering the disabled, discrimination, chronic diseases, and regular medical care) may help governments and policymakers establish strategies to reduce and prevent unmet healthcare needs during and a future crisis.

Trajectories of Self-Rated Health Among Industrially Disabled Individuals: A Latent Class Growth Analysis.

BACKGROUND: Understanding the self-rated health of industrially disabled individuals is an important variable that significantly affects their quality of life, satisfaction, and return to work after an industrial accident. Since the health of people with industrial disabilities is affected by various environments and variables, interventions and policies that are suitable for their characteristics are needed. OBJECTIVES: This study aimed to identify changes in self-rated health among industrially disabled individuals, distinguish between different latent classes, and verify predictive factors for each latent class. METHODS: Four time-point datasets from the 2018-2021 panel study of Korean workers' compensation insurance were used. Using the latent growth curve model, an overall trajectory of self-rated health of industrially disabled individuals was confirmed, and the number and characteristics of different trajectories were identified using the latent class growth model. Multinomial logistic regression analysis was used to identify the predictive factors for each class. RESULTS: Four classes of self-rated health trajectories were identified: low-decreasing (21.7%), moderate-increasing (15.7%), high-decreasing (56.1%), and low-stable (6.5%) classes. A multinomial logistic regression analysis revealed that significant determinants (age, capacity, type of industrial accident, grade of disability, mental activity, outdoor activity, and social relationships) were different for each latent class. Capacity level affected all potential class classifications. CONCLUSIONS: To improve the self-rated health of industrially disabled individuals, it is necessary to develop an appropriate strategy that considers the characteristics of the latent class.

A mixed-method systematic literature review of health literacy interventions for people with disabilities.

AIMS: To identify the components and characteristics of health literacy interventions for people with disabilities and to explore the outcomes in terms of health literacy competencies. DESIGN: A mixed-method systematic literature review. REVIEW METHODS: The search results were reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The quality appraisal was guided by the Mixed Methods Appraisal Tool. The contents of each intervention were mapped to the health literacy intervention model and the outcomes were annotated using the integrated model of health literacy. DATA SOURCES: The literature search was conducted using several electronic databases, including PubMed, EMBASE, CINAHL, Cochrane library and PsycINFO in December 2022. RESULTS: Ten studies were selected for this systematic literature review. Seven studies were quantitative, two were qualitative and one was a mixed-methods study. The four components of the health literacy interventions included empowering individuals with low-health literacy (n = 10), strengthening individuals' social support system (n = 3), improving communication with health professionals (n = 1) and reducing barriers to access health systems (n = 3). No intervention addressed improving health professionals' health literacy competencies. Health literacy competencies identified as outcomes in the studies included access (n = 1), understand (n = 7), appraise (n = 1) and apply (n = 9) the health information. CONCLUSIONS: The significant findings of this systematic literature review provide baseline data and evidence for developing health literacy interventions for people with disabilities. However, this review demonstrates that only a handful of intervention studies have addressed the low-health literacy of people with disabilities. Further and more rigorous interventions addressing health literacy for people with diverse disabilities are warranted. IMPACT: This review provides insights into how health literacy interventions can be tailored to the type of disability. Further, efforts should be expanded to comprehensively promote all the four core competencies of health literacy to reduce health disparities for individuals living with disabilities. NO PATIENT OR PUBLIC CONTRIBUTION: Systematic literature review.

Relationship between oral health and social activity among community-dwelling older adults in Korea: Focusing on the mediating effect of depressive symptoms.

AIM: This study aimed to examine the relationship between oral health and social activity, and explore the mediating effect of depressive symptoms on the relationship between oral health and social activity among community-dwelling older adults in Korea. METHODS: A total of 5033 community-dwelling older adults aged ≥65 years were included in the analysis. Data were obtained from the seventh wave (2018) of the Korean Longitudinal Study of Aging. Descriptive statistics, Pearson's correlation analysis and path analysis for mediation analysis were used. RESULTS: Path analysis showed that older adults with better oral health had more social activities (ß = 0.177, P < 0.001) and fewer depressive symptoms (ß = -0.174, P < 0.001). Depressive symptoms had a mediating role partially in the relationship between oral health and social activity (ß = 0.014, P < 0.001). The results of in-depth exploration using oral health subdomains showed that physical oral function and oral pain or discomfort were directly related to the social activity (ß = 0.083 and ß = 0.149, respectively) and indirectly mediated by depressive symptoms (ß = 0.006 and ß = 0.004, respectively). However, psychosocial oral function only had an indirect effect on social activity mediated by depressive symptoms (ß = 0.006, P = 0.005). CONCLUSIONS: Better oral health had a significant association with higher levels of social activities, which was partially mediated by decreased depressive symptoms. It is necessary to pay more attention to oral health promotion for older adults to decrease depressive symptoms and increase participation in social activities. Geriatr Gerontol Int 2022; 22: 766-772.

Template-Free Electrochemical Growth of Ni-Decorated ZnO Nanorod Array: Application to an Anode of Lithium Ion Battery.

ZnO nanorods (NRs) decorated with Ni nanoparticles were synthesized using a template-free electrochemical deposition in an ultra-dilute aqueous electrolyte and a subsequent galvanic reaction. The electrochemical properties of the ZnO NRs as an anode material for rechargeable Li-ion batteries were evaluated for different binder morphologies (film and close-packed spherical particles) of polyvinylidene fluoride (PVDF). Results showed that the close-packed spherical PVDF simultaneously improved electrochemical capacity and cyclability because the free-volume between the spherical PVDF helped to accommodate the volume change in the anode caused by the Li ions discharge and charge processes. Furthermore, the Ni nanoparticles decorated on the surface of ZnO NRs enhanced the electrical conductivity of the ZnO NR anode, which enabled faster electronic and ionic transport at the interface between the electrolyte and the electrode, resulting in improved electrochemical capacity. The free-volume formed by the close-packed spherical PVDF, and the decoration of metal nanoparticles are expected to provide insight on the simultaneous improvement of electrochemical capacity and cyclability in other metal oxide anode nanostructures.