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1.
BMC Public Health ; 24(1): 954, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575900

RESUMO

BACKGROUND: Policy effect might be multidimensional and spill over to non-recipients. It is unclear how the implementation of Long-Term Care Insurance (LTCI) policy affects depression in non-disabled people and how this effect differs in different non-disabled groups. METHODS: Using time-varying differences-in-differences method and nationally representative health survey data in wave 2011, wave 2013, wave 2015 and wave 2018 from the China Health and Retirement Longitudinal Study, we assessed the effect of LTCI policy on depression in non-disabled people aged 45 years and older, and discussed the heterogeneity of effect across different population characteristics: retirement, financial support and social participation status. RESULTS: We found LTCI policy statistically significant reduced depression by 0.76 units in non-disabled people compared to non-pilot cities. Depression in non-disabled people who unretired, with financial support and without social participation was reduced by 0.8267, 0.7079 and 1.2161 units, respectively. CONCLUSIONS: Depression in non-disabled people was statistically significant reduced because of LTCI policy in China, and non-disabled people who unretired, with financial support and without social participation benefited more from LTCI policy. Our findings highlight the depression-reducing effect of LTCI policy in non-recipients and suggest that non-disabled people who unretired, with financial support and without social participation should be concerned during LTCI policy progress.


Assuntos
Depressão , Seguro de Assistência de Longo Prazo , Humanos , Estudos Longitudinais , Depressão/epidemiologia , Participação Social , Políticas , China/epidemiologia , Assistência de Longa Duração
2.
Healthcare (Basel) ; 12(3)2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38338272

RESUMO

The COVID-19 pandemic disrupted healthcare and support services, creating challenges for disabled people. New Zealand implemented a range of policies to prevent and limit viral transmission of COVID-19. This study investigates disabled people's experiences accessing healthcare and disability support services during the COVID-19 pandemic, and based on this analysis, the implications of public health policy decisions on disabled people's experiences during the pandemic in New Zealand are explicated. A qualitative design underpinned by interpretive description methodology guided this study. A total of 64 disabled people or parents of disabled children participated in semi-structured interviews. The team of health services and disability researchers then engaged in an iterative thematic approach to analysis, which led to three key themes: (1) protective personal factors, which assisted disabled people to access healthcare and support services, (2) immediate pandemic policy impacts, including policy and legislative changes, which created additional access barriers for disabled people, and (3) exacerbating factors, including compounding vulnerabilities, overstretched systems, and the impact of the vaccine mandate, which worsened the already limited access to healthcare and disability services for disabled people. The pandemic overwhelmed an already stretched healthcare and disability support system, resulting in service disruptions with negative consequences for disabled people's health and wellbeing. Future policy development needs to be disability-centred in its inclusion of people with lived experience and consideration of the support needs of disabled populations. A first step in this process could include pandemic planning and policy co-design to ensure a continuum of healthcare services and support availability for individuals when services are disrupted. In addition, access to formal and informal support for disabled people should be recognised as a fundamental human right when accessing healthcare and disability support services.

3.
BMC Public Health ; 24(1): 636, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38418996

RESUMO

BACKGROUND: Physical inactivity is a global public health priority. There are known health and well-being consequences of being inactive, and the benefits of being physically active are well established. However, there are persistent inequalities when it comes to how physically active people are, with disabled people, people living with long-term health conditions, and people residing in areas of socio-economic deprivation being particularly affected. Methods such as whole system approaches (WSAs), which are dynamic, multifaceted, and engage all relevant stakeholders, have gained momentum as an approach to address such complex public health problems. However, evidence relating to the implementation of WSAs to address physical inactivity is lacking. The aim of the Prevention and Enablement Model (PEM) was to take a whole system approach in Essex to encourage and support disabled people and/or individuals living with long-term health conditions to be more active, happier, and to live more independently. METHODS: The aim of this study was to explore the enablers, challenges, and reflections associated with the process of designing and implementing the PEM. Semi-structured interviews (n = 12) were used to collect data from people involved in the PEM's design, implementation and/or delivery. Data was analysed using Braun and Clarke's reflexive thematic analysis. RESULTS: Four themes were identified: (1) Working collaboratively: Specific enablers of time and space were identified as important in the planning and implementation of a WSA (2) Leadership and planning: Distributed and flexible leadership was identified as central to successful implementation (3) Re-orientating practice: Highlighted the transformative potential of a whole system approach and how it contrasts with conventional work practices, and (4) Reflection and learning: Informing ongoing refinements and further implementation of successful system change. CONCLUSIONS: These findings highlight the challenge and complexity of implementing a WSA that involves diverse stakeholders from across adult social care, the NHS, and the third sector. Several important enablers are identified, such as leadership and planning, and the challenges and discomfort that can arise whilst changing systems. Ongoing efforts are required to ensure that different elements of the system collaborate effectively to address inequalities in physical activity participation, through the implementation of a WSA.


Assuntos
Pessoas com Deficiência , Comportamento Sedentário , Adulto , Humanos , Saúde Pública , Análise de Sistemas
4.
Disabil Health J ; 17(2): 101579, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38242753

RESUMO

BACKGROUND: Economically developed economies continue to display large and long-standing disability employment gaps. Train-then-place activation models have traditionally dominated efforts to support non-working disabled people to gain employment but recently there has been increasing interest in place-then-train Supported Employment (SE) activation models. OBJECTIVE: Evidence regarding the effectiveness of SE approaches is growing. However, authors have called for greater understanding of the mechanisms underpinning these interventions. We therefore carried out a systematic review of qualitative research to understand the processes operating. METHODS: We carried out a systematic review of qualitative research around SE interventions carried out in developed countries since 2000 in any population excepting those with severe mental illness. We used thematic synthesis and logic modelling methods and assessed the quality of the body of literature. RESULTS: We identified and included 13 relevant source studies containing qualitative data. Key aspects of the programmes reported were the nature of the support, the employment advisor, and the type of employment. Influencing factors were client-related, employer and employment-related, programme-related, and system-related. Effects beyond the gaining of employment included a changed attitude to work, different outlook, increased skills and/or confidence. Suggested longer-term impacts were on health and wellbeing, financial security, independence, contribution to society and sense of belonging. CONCLUSIONS: This review adds to the growing evidence regarding the value of SE interventions for disabled people. It adds insights regarding the key elements of the programmes, and suggests outcomes beyond the measures typically considered within quantitative studies.


Assuntos
Pessoas com Deficiência , Readaptação ao Emprego , Transtornos Mentais , Humanos
5.
BMC Public Health ; 24(1): 41, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38166865

RESUMO

BACKGROUND: Persons with disabilities experience higher risks of mortality as well as poorer health as compared to the general population. The aim of this study is to estimate the correlations between functional difficulties across several domains in six countries. METHODS: National census data with questions on disability from six countries (Mauritius, Morocco, Senegal, Myanmar, Vietnam, and Uruguay) was used in this study. We performed logistic regressions to assess the extent to which having a functional difficulty in one domain is correlated with having a functional difficulty in each of the other domains and report weighted odds ratios (ORs) overall and within age-groups ('18-44' years and '45+' years). Models adjust for age, sex, and location (rural or urban). Sensitivity analyses around different choices of predictors and response variables were conducted. FINDINGS: For all countries, reporting a functional difficulty in one domain was consistently and significantly positively correlated with reporting a functional difficulty in other domains (overall) and for each of the two age-groups considered - '18-44' years and '45+' years. All ORs were greater than one. Cognition, mobility, and hearing were the domains that were the most correlated ones with other domains. The highest pairwise correlations were for i/ hearing and cognition; ii/ mobility and cognition. Results were robust to changing the severity thresholds for functional difficulties. Across countries, Uruguay, the only high-income country among the six countries under study, had the lowest correlations between functional domains. CONCLUSIONS: There are consistent positive associations in the experience of functional difficulties in various domains in the six countries under study. Such correlations may reflect barriers to social services including healthcare services and resources (e.g. assistive devices) that may lead to an avoidable deterioration of functioning across domains. Further research is needed on the trajectories of functional difficulties and on structural barriers that people with functional difficulties may experience in their communities and in healthcare settings in particular. This is important as some functional difficulties may be preventable.


Assuntos
Pessoas com Deficiência , Tecnologia Assistiva , Humanos , Adolescente , Adulto Jovem , Adulto , Cognição , Audição , Maurício
6.
Artigo em Russo | MEDLINE | ID: mdl-38142334

RESUMO

In connection with the growing number of people with disabilities in the Russian Federation, there is a need to improve rehabilitation care and bring it into line with international models. The article discusses possibilities of ergo-therapy in improving quality of life of people with disabilities living in nursing homes. The results of qualitative study of medical and social work in nursing homes of elderly and disabled people are presented. The purpose of the study was to identify needs in professional ergo-therapy work in stationary type institutions. The article presents the results of original study carried out in 2023 using method of interviewing medical and social workers (n = 13) in two regions (Saratov, Penza). The study permitted to identify the most acute problem areas requiring ergo-therapy to improve the quality of life of patients in nursing homes for disabled and elderly persons. The study resulted in conclusions that to improve the quality of life both of patients in residential institutions and the level of satisfaction of citizens with social policy it is necessary to organize and implement ergo-therapy service in stationary institutions. The current situation requires presence of ergo-therapists in social institutions and health care, as their role and importance in supporting patients are increasing.


Assuntos
Casas de Saúde , Qualidade de Vida , Humanos , Idoso , Atenção à Saúde , Serviço Social , Federação Russa
7.
Saude e pesqui. (Impr.) ; 16(4): 11414, out./dez. 2023.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1518412

RESUMO

O objetivo deste trabalho foi avaliar o nível de conhecimento de fisioterapeutas que atuam nos serviços públicos e privados de reabilitação pediátrica sobre o conhecimento das F-Words, assim como identificar as principais barreiras de aplicação destas ferramentas na assistência. Trata-se de um estudo transversal, conduzido de acordo com as recomendações do STROBE. A amostra apresentou uma média etária de 28,1 ± 5,8 anos, constituída por 54 fisioterapeutas que atuam nos serviços públicos e privados de reabilitação pediátrica. Foi observado que 55,6% da amostra já ouviram falar nas F-Words; 44,4% não sabiam sobre a importância; 94,4% estabelecem metas terapêuticas em parceria com a família; 57,4% nunca ouviram falar nas F-Words Tools; 77,8% nunca aplicaram essas ferramentas na assistência. Conclui-se que, as F-Words são importantes, mas são pouco utilizadas na assistência em decorrência da falta de conhecimento dos fisioterapeutas em relação à ferramenta e aos instrumentos.


The aim of this study was to assess the level of knowledge of physiotherapists who work in public and private pediatric rehabilitation services about knowledge of F-Words, as well as to identify the main barriers to applying these tools in care. This is a cross-sectional study, conducted in accordance with the STROBE recommendations. The sample had a mean age of 28.1 ± 5.8 years, consisting of 54 physiotherapists who work in public and private pediatric rehabilitation services. It was observed that 55.6% of the sample had already heard about F-Words; 44.4% did not know about the importance; 94.4% establish therapeutic goals in partnership with the family; 57.4% had never heard of F-Words Tools; 77.8% never applied these tools in care. It is concluded that the F-Words are important, but are little used in assistance due to the lack of knowledge of physiotherapists in relation to the tool and instruments.

8.
Artigo em Inglês | MEDLINE | ID: mdl-37835075

RESUMO

Multi-sensory environments (MSEs) are specialised spaces purposely designed to stimulate the senses, whilst providing a calming and relaxing environment for leisure and enjoyment, predominantly intended for disabled people. Most MSEs are in institutions, hospitals, or educational settings, with a few in community-based settings. We explored disabled users' experiences of a community based MSE in a large metropolitan area in New Zealand, with a view to expanding access to MSE-type environments within the area. We used a convergent mixed method design with a web-based electronic survey (e-survey; n = 105), as well as semi-structured interviews (n = 14) with disabled MSE users (adults and children), who were supported, where necessary, by their support person/s. We collected the MSE users' demographics, frequency of use with respect to age, disability, and ethnicity, and experiences of the room, equipment, and accessibility. The participants and their support persons' perspectives about their experiences of using the MSE were represented by four themes: (i) Self-determination; (ii) Enhancing wellbeing opportunities; (iii) the MSE itself; (iv) Accessibility. While the MSE was considered positively, the MSE experience could be enhanced by addressing access challenges and broadening the scope of equipment to improve the usability and make it a more inclusive environment for all.


Assuntos
Pessoas com Deficiência , Adulto , Criança , Humanos , Meio Social , Meio Ambiente , Atividades de Lazer , Inquéritos e Questionários
9.
Rev. enferm. Cent.-Oeste Min ; 13: 4672, jun. 2023.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1436487

RESUMO

Objetivo: Avaliar a qualidade de vida e grau de deficiência da pessoa idosa com estomia. Método: Trata-se de um estudo transversal, realizado com pessoas idosas com estomias de um serviço público de saúde brasileiro que foram avaliadas pelos instrumentos City of Hope ­ Quality of Life ­ Ostomy Questionary e pelo WHO Disability Assessment Schedule. Resultados: A qualidade de vida média foi de 8,0 e o grau de deficiência 3,8. Houve associação entre aptidão para o autocuidado e a melhor qualidade de vida (p<0,005). A associação é maior entre os domínios bem-estar psicológico e espiritual entre idosos, aptos para o autocuidado ou não. O bem-estar espiritual se mostrou maior entre aqueles com mais de cinco anos de cirurgia. Também houve associação entre maior grau de deficiência e quando a causa da estomia era câncer (p<0,003). Conclusão: Idosos com estomia apresentaram boa qualidade de vida e baixo grau de deficiência.


Objetivo: Evaluar la calidad de vida y el grado de discapacidad de ancianos ostomizados. Método: Se trata de un estudio transversal realizado con ancianos ostomizados de un servicio público de salud brasileño que fueron evaluados mediante el City of Hope ­ Quality of Life ­ Ostomy Questionary y el WHO Disability Assessment Schedule. Resultados: La calidad de vida media fue de 8,0 y el grado de discapacidad de 3,8. Hubo asociación entre la aptitud para el autocuidado y una mejor calidad de vida (p<0,005). La asociación es mayor entre los dominios de bienestar psicológico y espiritual entre los ancianos, ancianos capaces de autocuidado. El bienestar espiritual también fue mayor entre aquellos con más de cinco años de cirugía. También hubo asociación entre mayor grado de discapacidad y cuando la causa de la ostomía fue cáncer (p<0,003). Conclusión: Los ancianos ostomizados tenían una buena calidad de vida y un bajo grado de discapacidad.


Objective: To assess the quality of life and degree of disability of elderly people with ostomies. Method: This is a cross-sectional study, carried out with elderly people with ostomies from a Brazilian public health service. They were evaluated using the City of Hope ­ Quality of Life ­ Ostomy Questionnaire and the WHO Disability Assessment Schedule. Results: The mean quality of life was 8.0 and the degree of disability was 3.8. There was an association between aptitude for self-care andbetter quality of life (p<0.005). The association is greater between the psychological and spiritual well-being domains among the elderly, elderly able to self-care. Spiritual well-being was also higher among those with more than five years of surgery. There was also an association between a higher degree of disability and when the cause of the ostomy was cancer (p<0.003). Conclusion: Elderly people with an ostomy had a good quality of life and a low degree of disability.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Idoso , Estomia , Pessoas com Deficiência , Estomaterapia
10.
BrJP ; 6(2): 113-120, Apr.-June 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1513774

RESUMO

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation is an event that has consequences that can affect daily life, including pain, enhancing changes, whether in sleep or in quality of life. The objective of this study was to evaluate the pressure pain threshold (PPT) in people with amputations submitted to the use of different postural elevation equipment. METHODS: Experimental crossover study, carried out from September to October 2022, with people with lower limb amputation (n=15) and people without amputation (n=15). PPT in four regions (T12-L1, L5-S1, anterior tuberosity of the tibia and calcaneus) were evaluated before and after the use of different versions (A and B) of an equipment for postural elevation, gravity and pain interference. Presence of signs and symptoms of central sensitization (CS) and sleep quality. RESULTS: The groups did not present PPT alterations when compared between the different versions of the equipment (p<0.05) in the four locations analyzed. Furthermore, the groups did not show differences in relation to the evaluation days or among themselves regarding the severity and interference of pain and the presence of signs and symptoms of CS. The control group indicated poor sleep quality (p=0.0173) and remained worse than people with amputation. CONCLUSION: The versions of the equipment did not change PPT in the analyzed areas. The groups did not differ between themselves, suggesting that the equipment promoted similar responses, that is, no change in sensitivity was evidenced in the analyzed regions which have greater contact with stabilization elements and weight discharge of the equipment.


RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação é um evento que acarreta consequências que podem afetar o cotidiano, entre elas a dor, potencializando alterações, seja no sono ou na qualidade de vida. O objetivo deste estudo foi avaliar o limiar de dor por pressão (LDP) em pessoas com amputação submetidas ao uso de diferentes equipamentos de elevação postural. MÉTODOS: Estudo experimental cruzado, realizado de setembro a outubro de 2022, com pessoas com amputação no membro inferior (n=15) e pessoas sem amputação (n=15). Foram avaliados o LDP em quatro regiões (T12-L1, L5-S1, tuberosidade anterior da tíbia e calcâneo) pré e pós uso de distintas versões (A e B) de um equipamento de elevação postural, gravidade e interferência da dor. Presença de sinais e sintomas de sensibilização central (SC) e qualidade do sono. RESULTADOS: Os grupos não apresentaram alterações no LDP quando comparados em relação às diferentes versões do equipamento (p<0,05) nos quatro locais analisados. Além disso, os grupos não mostraram diferenças em relação aos dias de avaliação ou entre si quanto a severidade e interferência de dor e presença de sinais e sintomas de SC. O grupo controle indicou uma qualidade de sono ruim (p=0,0173) e manteve-se pior que as pessoas com amputação. CONCLUSÃO: As versões do equipamento não alteraram o LDP nas áreas analisadas. Os grupos não apresentaram diferença entre si, sugerindo que o equipamento promoveu respostas semelhantes, ou seja, não foi evidenciada uma alteração de sensibilidade nas regiões que possuem maior contato com elementos de estabilização e descarga de peso dos equipamentos.

11.
Sensors (Basel) ; 23(7)2023 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-37050605

RESUMO

Research in the field of gathering and analyzing biological signals is growing. The sensors are becoming more available and more non-invasive for examining such signals, which in the past required the inconvenient acquisition of data. This was achieved mainly by the fact that biological sensors were able to be built into wearable and portable devices. The representation and analysis of EEGs (electroencephalograms) is nowadays commonly used in various application areas. The application of the use of the EEG signals to the field of automation is still an unexplored area and therefore provides opportunities for interesting research. In our research, we focused on the area of processing automation; especially the use of the EEG signals to bridge the communication between control of individual processes and a human. In this study, the real-time communication between a PLC (programmable logic controller) and BCI (brain computer interface) was investigated and described. In the future, this approach can help people with physical disabilities to control certain machines or devices and therefore it could find applicability in overcoming physical disabilities. The main contribution of the article is, that we have demonstrated the possibility of interaction between a person and a manipulator controlled by a PLC with the help of a BCI. Potentially, with the expansion of functionality, such solutions will allow a person with physical disabilities to participate in the production process.


Assuntos
Interfaces Cérebro-Computador , Pessoas com Deficiência , Humanos , Eletroencefalografia , Automação , Lógica
12.
Sociol Health Illn ; 45(6): 1300-1316, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36917517

RESUMO

This paper draws attention to the health-related work that disabled people do when engaging with rehabilitation services. Medical sociology has a rich history of looking at the 'illness work' that patients do, while disability studies scholars have explored the cultural value placed upon paid work and the effects on social status of being unable to work. Yet, a longstanding froideur between these two disciplines, which have fundamentally opposed ontologies of illness and disability, means that neither discipline has attended closely to the rehabilitation-related work that disabled people do. The concept of 'adjusting' to illness highlights seemingly irreconcilable disciplinary differences. Yet this article argues that the notion of 'adjustment work' can elucidate the socio-political character of the work disabled people do in their rehabilitation, which could create a more substantial and sustainable dialogue on this subject between disability studies and medical sociology. To make this case, we discuss interview data from the Rights-based Rehabilitation project, which sought to explore disabled people's lived experiences of rehabilitation.


Assuntos
Pessoas com Deficiência , Medicina , Humanos , Sociologia Médica , Estudos sobre Deficiências , Pessoas com Deficiência/reabilitação
13.
Artigo em Inglês | MEDLINE | ID: mdl-36981880

RESUMO

Accessibility to housing is crucial for people with disabilities as it provides them with equal opportunities and allows them to live independently. A systematic literature review has been conducted to understand the current research on accessibility in housing for people with disabilities in Latin America. The study analysed 56 papers and used co-word analysis to identify common themes and topics within the documents. The results of the analysis showed that Brazil (61%) is the country with the most research on the subject, physical disability, at 36%, is the impairment most analysed, and interventions or analysis for the older people (45%) in their homes is the most researched type of population. The co-word analysis revealed that topics such as policy, regulations, the use of technologies, ergonomics interventions, and architectural criteria or barriers to the daily life of disabled people were frequently discussed in the papers. Although this work shows a substantial and growing increase in research on housing for people with disabilities in Latin America, it also demonstrates the importance of increasing research on other types of impairment, such as visual and cognitive-intellectual disabilities, and including children, caregivers, or even young adults.


Assuntos
Pessoas com Deficiência , Deficiência Intelectual , Criança , Adulto Jovem , Humanos , Idoso , Habitação , América Latina , Políticas
14.
Trials ; 24(1): 171, 2023 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-36890505

RESUMO

INTRODUCTION: Underrepresentation of disabled groups in clinical trials results in an inadequate evidence base for their clinical care, which drives health inequalities. This study aims to review and map the potential barriers and facilitators to the recruitment of disabled people in clinical trials to identify knowledge gaps and areas for further extensive research. The review addresses the question: 'What are the barriers and facilitators to recruitment of disabled people to clinical trials?'. METHODS: The Joanna Briggs Institute (JBI) Scoping review guidelines were followed to complete the current scoping review. MEDLINE and EMBASE databases were searched via Ovid. The literature search was guided by a combination of four key concepts from the research question: (1) disabled populations, (2) patient recruitment, (3) barriers and facilitators, and (4) clinical trials. Papers discussing barriers and facilitators of all types were included. Papers that did not have at least one disabled group as their population were excluded. Data on study characteristics and identified barriers and facilitators were extracted. Identified barriers and facilitators were then synthesised according to common themes. RESULTS: The review included 56 eligible papers. The evidence on barriers and facilitators was largely sourced from Short Communications from Researcher Perspectives (N = 22) and Primary Quantitative Research (N = 17). Carer perspectives were rarely represented in articles. The most common disability types for the population of interest in the literature were neurological and psychiatric disabilities. A total of five emergent themes were determined across the barriers and facilitators. These were as follows: risk vs benefit assessment, design and management of recruitment protocol, balancing internal and external validity considerations, consent and ethics, and systemic factors. CONCLUSIONS: Both barriers and facilitators were often highly specific to disability type and context. Assumptions should be minimised, and study design should prioritise principles of co-design and be informed by a data-driven assessment of needs for the study population. Person-centred approaches to consent that empower disabled people to exercise their right to choose should be adopted in inclusive practice. Implementing these recommendations stands to improve inclusive practices in clinical trial research, serving to produce a well-rounded and comprehensive evidence base.


Assuntos
Pessoas com Deficiência , Projetos de Pesquisa , Humanos , Seleção de Pacientes
15.
J Prev Med Public Health ; 56(1): 67-76, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36746424

RESUMO

OBJECTIVES: Previous studies have reported that people with disabilities are more likely to be impoverished and affected by excessive medical costs than people without disabilities. Public transfer income (PTI) reduces financial strain in low-income households. This study examined the impact of PTI on catastrophic health expenditures (CHE), focusing on low-income households and households with Medical Aid beneficiaries that contained people with disabilities. METHODS: We constructed a panel dataset by extracting data on registered households with disabilities from the Korea Welfare Panel Study 2012-2019. We then used a generalized estimating equation model to estimate the impacts of PTI on CHE. A subgroup analysis was carried out to assess the moderating effects of family income levels and health insurance types. RESULTS: As PTI increased, the odds ratio (OR) of CHE in households that contained people with disabilities decreased significantly (OR, 0.92; 95% confidence interval [CI], 0.89 to 0.94; p<0.001). In particular, PTI effectively reduced the likelihood of CHE for low-income households (OR, 0.85; 95% CI, 0.81 to 0.89; p<0.001) and those who received medical benefits (OR, 0.78; 95% CI, 0.68 to 0.89; p<0.001). CONCLUSIONS: This study highlights the positive effect of PTI on decreasing CHE. Household income and the health insurance type were significant effect modifiers, but economic barriers seemed to persist among low-income households with non-Medical Aid beneficiaries. Federal policies or programs should consider increasing the total amount of PTI targeting low-income households with disabilities that are not covered by the Medical Aid program.


Assuntos
Pessoas com Deficiência , Gastos em Saúde , Humanos , Doença Catastrófica , Pobreza , República da Coreia
16.
Omega (Westport) ; 87(3): 962-976, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34877903

RESUMO

This study aimed to examine the effect of social exclusion on psychological well-being and suicide possibilities among people with physical disabilities. This descriptive and cross-sectional type study was conducted among people with physical disabilities who are members of the Association of Disabled People. Data were collected using the face-to-face interview method with the "Participant Information Form," "Social Exclusion Scale for the People with Disabilities," "Psychological Well-Being Scale," and "Suicide Probability Scale." It was found that the disabled people participating in the study experienced moderate social exclusion with a score of 72.35 + 31.53, a moderate level of well-being with a score of 34.79 + 16.80, and above a moderate level of suicidal ideation with a score of 78.58 + 9.85. Also, there was a negative moderate and significant relationship between social exclusion and psychological well-being (p < 0.01; r: -0.492), while there was a positive strong relationship between social exclusion and the possibility of suicide (p < 0.01; r: 0.518).


Assuntos
Pessoas com Deficiência , Suicídio , Humanos , Ideação Suicida , Estudos Transversais , Suicídio/psicologia , Isolamento Social/psicologia , Pessoas com Deficiência/psicologia
17.
J Appl Res Intellect Disabil ; 36(1): 153-164, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36341525

RESUMO

BACKGROUND: Integrating people with intellectual disabilities into the community has become a major goal in improving society in general. Our study adds an important layer to discussions of how to achieve this goal. METHOD: We examine both the willingness to integrate people into the community and their willingness to pay for this integration. Using a representative sample of 813 Israeli respondents, we consider two factors in these attitudes: familiarity with the issue and people's political attitudes. RESULTS: We found that most people are willing to integrate people with intellectual disabilities into the community and some people are willing to pay for this integration. Those who are familiar with people with intellectual disabilities and those from the left side of the political map are more willing to pay to achieve this goal. CONCLUSIONS: Familiarity and political attitudes matter in the willingness to pay to integrate people with intellectual disabilities into the community.


Assuntos
Financiamento Pessoal , Deficiência Intelectual , Humanos , Atitude , Inquéritos e Questionários
18.
Ciênc. cuid. saúde ; 22: e65777, 2023.
Artigo em Português | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1447946

RESUMO

RESUMO Objetivo: apreender a perspectiva dos Agentes Comunitários sobre a atenção à saúde de idosos com deficiências residentes em cenário rural. Método: estudo quanti-qualitativo, cuja coleta de dados, inicialmente, foi realizada com 276 pessoas com deficiência residentes em cenário rural, através de questionários aplicados de agosto de 2018 a julho de 2019. Deste total, foram selecionadas apenas as pessoas idosas para fazer parte do recorte desta pesquisa, totalizando uma amostra de 54 indivíduos. Após análise dos dados quantitativos por meio de programa estatístico, foram entrevistados 18 Agentes Comunitários de Saúde que assistiam estes idosos em suas micro áreas rurais. As entrevistas foram realizadas de julho a agosto de 2021, analisadas pela Análise de Conteúdo Temática. Resultados: pôde-se constatar a presença de doenças crônicas nos idosos, além da dependência de serviços públicos de saúde, distantes das residências. Os Agentes Comunitários de Saúde relataram suas ações de atenção aos idosos com deficiência, destacando a importância da colaboração da equipe multiprofissional para atender esta população. Conclusão: verifica-se que o atendimento a esse estrato populacional, em comunidades rurais, centra-se no Agente Comunitário de Saúde, indicando a necessidade de novas pesquisas sobre o tema.


RESUMEN Objetivo: comprender la perspectiva de los Agentes Comunitarios sobre la atención a la salud de personas mayores con discapacidades residentes en el entorno rural. Método: estudio cuanti-cualitativo, cuya recopilación de datos, inicialmente, fue realizada con 276 personas con discapacidad residentes en ambiente rural, a través de cuestionarios aplicados de agosto de 2018 a julio de 2019. De este total, fueron seleccionados solo los ancianos para formar parte del recorte de esta investigación, totalizando una muestra de 54 individuos. Tras el análisis de los datos cuantitativos por medio de programa estadístico, fueron entrevistados 18 Agentes Comunitarios de Salud que asistían a estos ancianos en sus micro áreas rurales. Las entrevistas fueron realizadas de julio a agosto de 2021, analizadas por el Análisis de Contenido Temático. Resultados: se pudo constatar la presencia de enfermedades crónicas en las personas mayores, además de la dependencia de servicios públicos de salud, lejanos a las residencias. Los Agentes Comunitarios de Salud relataron sus acciones de atención a los ancianos con discapacidad, destacando la importancia de la colaboración del equipo multiprofesional para atender a esta población. Conclusión: se verifica que la atención a ese grupo poblacional, en comunidades rurales, se centra en el Agente Comunitario de Salud, indicando la necesidad de nuevas investigaciones sobre el tema.


ABSTRACT Objective: to apprehend the perspective of Community Agents on health care of elderly people with disabilities living in rural settings. Method: quantitative-qualitative study, whose data collection was initially performed with 276 people with disabilities living in rural settings, through questionnaires applied from August 2018 to July 2019. From this total, only the elderly were selected to be part of the cut of this research, totaling a sample of 54 individuals. After analyzing the quantitative data through a statistical program, 18 Community Health Agents who assisted these elderly in their micro rural areas were interviewed. The interviews were conducted from July to August 2021, analyzed by the Thematic Content Analysis. Results: it was possible to verify the presence of chronic diseases in the elderly, in addition to dependence on public health services, far from homes. The Community Health Agents reported their actions of attention to the elderly with disabilities, highlighting the importance of the collaboration of the multidisciplinary team to meet this population. Conclusion: it appears that the care to this population stratum, in rural communities, focuses on the Community Health Agent, indicating the need for new research on the subject.

19.
Licere (Online) ; 25(4): 137-153, 12.2022. ilus, tab
Artigo em Português | LILACS | ID: biblio-1428140

RESUMO

O presente estudo, caracterizado como qualitativo, descritivo de revisão, objetiva analisar e investigar a inclusão social de pessoas com deficiência no lazer e a sustentabilidade ecológica por meio de uma revisão sistemática. Buscaram-se os principais trabalhos publicados no período de 2011 a 2022, nas bases de dados CAPES e Scielo. Foram realizadas a análise dos dados e a de conteúdos, para então criarem-se as categorizações, geradas pelos próprios artigos. Os resultados, de forma geral, mostraram que o lazer e a sustentabilidade ecológica desenvolvidos por pessoas com deficiência são pouco explorados. A falta de acessibilidade foi citada nas pesquisas como fator predominante, apesar do conhecimento do direito por lei aos espaços para essa prática. Observou-se que estudos futuros são de extrema importância para a compreensão da relevância do lazer na vida desses indivíduos e da sustentabilidade ecológica.


This study, which is characterized as qualitative, descriptive of review, aims to analyze and investigate the social inclusion of disabled people in leisure and ecological sustainability by means of a systematic review. The main works published in the period from 2011 to 2022 were searched in the CAPES and Scielo databases. Data and content analysis were carried out, so that categorizations were created, generated by the articles themselves. The results, in general, showed that leisure and ecological sustainability developed by disabled people are little explored. The lack of accessibility was cited in the surveys as a predominant factor, despite the knowledge of the right by law to spaces for this practice. It was observed that future studies are extremely important for understanding the relevance of leisure in these individuals' lives and ecological sustainability.


Assuntos
Saúde Ambiental , Atividades de Lazer
20.
Rev. psicol. polit ; 22(55): 654-667, dez. 2022. ilus
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1450371

RESUMO

Ao longo da história da humanidade diversos paradigmas influenciaram o modo como a sociedade entendia a deficiência. O presente estudo buscou compreender o fenômeno da deficiência a partir da revisão teórica dos principais modelos de concepção do tema: o modelo médico e o modelo social. O primeiro, apresenta a deficiência como responsabilidade individual, através da ênfase do corpo com lesão ou seu "mau funcionamento", seja ele físico ou intelectual. O segundo, designa que a maior intervenção a ser feita não é ao nível do indivíduo e suas lesões, mas na sociedade que tem dificuldade de abarcar a totalidade das diversidades. A compreensão desse fenômeno está em constante evolução, assim como as mudanças em relação as práticas relacionadas às pessoas com deficiência. Neste contexto, faz-se necessário debates sobre a deficiência como categoria de análise, tanto para a psicologia social quanto para subsidiar políticas públicas.


Throughout human history, several paradigms have influenced the way society understands disability. The present study sought to understand the phenomenon of disability based on a theoretical review of the main models for designing the theme: the medical model and the social model. The first presents disability as an individual responsibility, by emphasizing the injured body or its "malfunction", whether physical or intellectual. The second designates that the greatest intervention to be carried out is not at the level of the individual and ir injuries, but in society, which has difficulty embracing the totality of diversities. The understanding of this phenomenon is constantly evolving, as well as changes in practices related to people with disabilities. In this context, it is necessary to discuss disability as a category of analysis, both for social psychology and to support public policies.


A lo largo de la historia de la humanidad, varios paradigmas han influido la forma en que la sociedad entiende la discapacidad. El presente estudio buscó comprender el fenómeno de la discapacidad a partir de la revisión teórica de los principales modelos de diseño del tema: el modelo médico y el modelo social. El primero presenta la discapacidad como una responsabilidad individual, al enfatizar el cuerpo lesionado o su "mal funcionamiento", ya sea físico o intelectual. El segundo, designa que la mayor intervención a realizar no es a nivel del individuo y sus heridas, sino en la sociedad, que tiene dificultad para abarcar la totalidad de las diversidades. La comprensión de este fenómeno está constante evolución, así como los cambios las prácticas relacionadas con las personas con discapacidad. En este contexto, es necesario discutir la discapacidad como categoría de análisis , tanto para la psicología social como para apoyar políticas públicas.

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