Disability and Health Journal最新文献_第3页

Is disability prevalence higher in rural areas? Evidence from functional difficulty and nightlight data in 15 low- and middle-income countries 农村地区的残疾患病率是否更高？来自15个低收入和中等收入国家的功能困难和夜间照明数据的证据。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-09-04 DOI: 10.1016/j.dhjo.2025.101964

Katherine Theiss , Bradley Carpenter , Jill Hanass-Hancock , Sureshkumar Kamalakannan , Rachel J. Kulchar , G.V.S. Murthy , Monica Pinilla-Roncancio , Minerva Rivas Velarde , Shailaja Tetali , Sophie Mitra

Background

There has been emerging evidence from country-level studies that disability prevalence tends to be lower in urban areas than in rural areas. However, such studies are difficult to compare as countries use different ways of categorizing rural and urban areas.

Objectives

We examine the association between disability measured through functional difficulties (seeing, hearing, walking, cognition, selfcare, communicating) and urban development measured through the satellite nightlight composite—an internationally comparable proxy for urban development.

Methods

We use Demographic and Health Survey data for 15 low- and middle-income countries (LMICs) with the Washington Group Short Set of questions on disability. This study uses multilevel random intercept models to estimate whether functional difficulties are negatively associated with village-level nightlight composite.

Results

While country level results vary, in the pooled sample, adults living in villages above the 80th percentile of nightlight activity have odds of reporting any functional difficulty that are 0.765 times those of adults in villages below the 80th percentile of nightlight (AOR = 0.765; 95 % CI = 0.717 to 0.816). The result is robust for each functional domain but the correlation is higher for hearing, cognition and communicating.

Conclusions

In 15 LMICs, adults in rural areas are significantly more likely to have functional difficulties compared to adults in urban areas. Research is needed on the factors that drive such a correlation, including poorer living conditions and access to services in rural areas, differential access to resources and environmental barriers in rural and urban areas and potential differences in rural-urban migration opportunities across functional difficulty status.

背景：从国家一级的研究中出现的新证据表明，城市地区的残疾患病率往往低于农村地区。然而，这些研究很难进行比较，因为各国使用不同的方法对农村和城市地区进行分类。目的：我们研究了通过功能障碍（视觉、听觉、行走、认知、自理、沟通）测量的残疾与通过卫星夜灯组合测量的城市发展之间的关系。卫星夜灯组合是城市发展的国际可比代理。方法：我们使用15个低收入和中等收入国家（LMICs）的人口和健康调查数据以及华盛顿小组关于残疾的短问题集。本研究使用多水平随机截距模型来估计功能困难是否与村庄水平的夜间灯光合成负相关。结果：虽然国家层面的结果有所不同，但在汇总样本中，生活在夜间灯光活动超过80百分位的村庄的成年人报告任何功能困难的几率是低于80百分位的村庄的成年人的0.765倍（AOR = 0.765; 95% CI = 0.717至0.816）。结果在各个功能领域都是鲁棒性的，但在听力、认知和交流方面的相关性更高。结论：在15个中低收入国家中，农村地区的成年人比城市地区的成年人更容易出现功能障碍。需要对推动这种相关性的因素进行研究，包括农村地区较差的生活条件和获得服务的机会，农村和城市地区获得资源和环境障碍的差异，以及不同功能困难状况的农村-城市移徙机会的潜在差异。

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引用次数: 0

Factors associated with uncertainty in parents of children with developmental disabilities: A scoping review 与发育障碍儿童父母的不确定性相关的因素：范围审查。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-09-07 DOI: 10.1016/j.dhjo.2025.101962

Heejung Choi , GyeongAe Seomun , Jeongeun Song

Background

Parents of children with developmental disabilities (DD) experience ongoing uncertainty, which contributes to various physical and mental health challenges. However, studies mapping the factors influencing this uncertainty and its effects on other variables remain scarce.

Objective

This study aimed to analyze and synthesize existing evidence on the factors influencing uncertainty among parents of children with DD and its impact on parental outcomes.

Methods

A scoping review was conducted following Arksey and O'Malley's framework. Relevant studies were identified through a literature review conducted across five databases—Medline/PubMed, CINAHL, Cochrane Library, Embase, and APA PsycArticles—up to March 1, 2024. Studies with English abstracts were included without time restrictions.

Results

Eight studies involving 1986 participants were analyzed. The identified influencing factors were categorized into health condition-related factors (e.g., the severity of the child's condition), family and community resources (e.g., maternal education level, trust in healthcare professionals, and appraisal support), and appraisals of uncertainty as either a risk (e.g., caregiver burden and marital conflict) or an opportunity (e.g., adaptation, quality of life, parenting efficacy, sense of coherence, optimism, and self-help).

Conclusions

The findings of this study provide essential evidence for developing effective healthcare strategies to reduce parental uncertainty. By addressing these factors, the study aims to contribute to decreasing parental uncertainty and promoting the optimal development of children with DD.

背景：发育障碍儿童（DD）的父母经历了持续的不确定性，这导致了各种身心健康挑战。然而，绘制影响这种不确定性的因素及其对其他变量的影响的研究仍然很少。目的：本研究旨在对影响DD患儿父母不确定性的因素及其对父母结局的影响进行分析和综合。方法：根据Arksey和O'Malley的框架进行范围审查。相关研究是通过对五个数据库（medline /PubMed， CINAHL, Cochrane Library， Embase和APA psycarticles）进行的文献综述确定的，截止到2024年3月1日。有英文摘要的研究纳入，没有时间限制。结果：对8项涉及1986名参与者的研究进行了分析。确定的影响因素被分类为健康状况相关因素（如儿童病情的严重程度）、家庭和社区资源（如母亲教育水平、对医疗保健专业人员的信任和评价支持），以及不确定性评估（如适应、生活质量、养育效能、一致性、乐观主义和自助），或者是风险（如照顾者负担和婚姻冲突）。结论：本研究结果为制定有效的医疗保健策略以减少父母的不确定性提供了必要的证据。通过解决这些因素，本研究旨在有助于减少父母的不确定性，促进DD儿童的最佳发展。

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引用次数: 0

The disability squeeze: Out-of-pocket expenses and unmet needs for disability-related goods and services in the U.S. 残障挤压：美国残障相关商品和服务的自付费用和未满足需求

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-07-19 DOI: 10.1016/j.dhjo.2025.101930

Zachary A. Morris , Stephanie Rennane , Nanette Goodman , Daniel Mont , Michelle Ballan , Amber Davis , Stephen McGarity , Brooke Ellison , Ghenet Weldeslassie

Background

Few studies have quantified the higher cost of living with a disability and the extent of unmet needs for disability-related goods and services as experienced by adults with disabilities in the U.S.

Objective

To provide national estimates of total annual out-of-pocket disability-related expenditures, their burden, and the prevalence of unmet needs, and to investigate whether persons with disabilities from underserved communities experience disparate impacts from “the disability squeeze.”

Methods

We designed and fielded a survey in June of 2023 to a nationally representative sample of adults with disabilities through the Understanding America Study, an online panel survey. Multivariate regression analyses examine correlates with out-of-pocket expenditures, the financial burden of the expenditures, and unmet needs.

Results

Among 1168 working-age adults with disabilities, mean annual expenditures on disability-related goods and services was $5341 in June 2023, equating to 20 % of household income. Additionally, 67 % of adults with disabilities reported an unmet need. Controlling for sociodemographic characteristics, adults with disabilities with incomes below the federal poverty level reported significantly lower expenditures (p < .05) but greater financial burden from their out-of-pocket expenses (p < .05). Hispanic persons with disabilities also reported significantly lower expenditures (p < .05) but higher rates of unmet need (p < .05).

Conclusion

Adults with disabilities in the U.S. experience considerable financial strain from their disability-related expenses and sustain high rates of unmet needs with disproportionate impacts identified for those from underserved communities.

背景：很少有研究量化了美国成年残疾人较高的生活成本和未满足的残疾相关商品和服务需求的程度。提供全国每年与残疾相关的自费支出总额、负担和未满足需求的普遍程度的估计，并调查来自服务不足社区的残疾人是否受到“残疾挤压”的不同影响。方法：我们在2023年6月设计并实施了一项调查，通过在线小组调查“了解美国研究”，对全国具有代表性的成年残疾人样本进行了调查。多元回归分析检验了与自费支出、支出的经济负担和未满足需求的相关性。结果：在1168名工作年龄的残疾成年人中，2023年6月，与残疾相关的商品和服务的平均年支出为5341美元，相当于家庭收入的20%。此外，67%的成年残疾人报告需求未得到满足。控制社会人口学特征，收入低于联邦贫困水平的残疾成年人报告的支出显着降低(p结论：美国残疾成年人因残疾相关费用而承受相当大的经济压力，并且维持较高的未满足需求率，对那些来自服务不足社区的人产生了不成比例的影响。

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引用次数: 0

Incentivizing, enforcing and improving disability accessible health care: Current gaps and potential solutions 激励、执行和改善残疾人可获得的卫生保健：目前的差距和可能的解决办法。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-07-23 DOI: 10.1016/j.dhjo.2025.101933

Megan Morris , Steve Lockhart , Kori Eberle , Jennifer Oshita

Background

Despite federal requirements for health care organizations (HCOs) to provide accessible care to patients with disability, care often remains inaccessible.

Objective

To explore stakeholders’ perspectives of the effectiveness of federal requirements and factors motivating HCOs to provide accessible care to patients with disability.

Methods

We conducted 55 interviews with key informants (e.g., Disability Coordinators, researchers, policymakers, professional organizations, advocates) between May 2019 and August 2020. All interviews were conducted by qualitatively trained researchers and analyzed using content analysis methodology.

Results

We identified 3 themes: 1) existing laws are necessary, but not sufficient; 2) education is needed for health care organizations on disability as an equity issue; 3) health care is motivated by cost, quality and competition.Interview participants reported legal mandates as a major mechanism incentivizing healthcare organizations to invest in accessible care for patients with disability. These mandates, enforced through patient lawsuits and complaints, have been ineffective in driving systemic change.Additionally, organizational leaders lack knowledge on their legal obligations to provide equitable access to healthcare and the needs of patients with disability.

Participants identified a need for research demonstrating that accessible care improves outcomes and costs. Finally, participants expressed a desire for methods to facilitate competition amongst healthcare organizations to encourage provision of accessible care.

Conclusion

Federal requirements are necessary but insufficient in ensuring accessibility. Alternative solutions are needed which educate leadership and align with cost, quality and competition incentives. Diversifying the levers which incentivize accessible care could drive meaningful change in equitable healthcare for patients with disability.

背景：尽管联邦要求卫生保健组织（hco）为残疾患者提供无障碍护理，但护理往往仍然无法获得。目的：探讨利益相关者对联邦要求的有效性和激励hco为残疾患者提供无障碍护理的因素的看法。方法：在2019年5月至2020年8月期间，我们对关键信息提供者（如残疾协调员、研究人员、政策制定者、专业组织、倡导者）进行了55次访谈。所有访谈均由经过定性培训的研究人员进行，并使用内容分析方法进行分析。结果：我们确定了3个主题：1)现有法律是必要的，但还不够；2)卫生保健组织需要将残疾作为一个公平问题进行教育；3)医疗保健的动机是成本、质量和竞争。访谈参与者报告说，法律规定是激励医疗机构投资于残疾人无障碍护理的主要机制。这些通过患者诉讼和投诉来执行的命令，在推动系统性变革方面是无效的。此外，组织领导人对其提供公平获得医疗保健的法律义务和残疾患者的需求缺乏了解。与会者确定有必要进行研究，证明可获得的医疗服务可改善结果并降低成本。最后，与会者表示希望找到促进医疗保健组织之间竞争的方法，以鼓励提供可获得的医疗服务。结论：联邦要求是必要的，但不足以确保可及性。我们需要另一种解决方案，既能培养领导力，又能与成本、质量和竞争激励措施保持一致。使激励无障碍医疗的手段多样化，可以推动残疾患者获得公平医疗保健方面发生有意义的变化。

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引用次数: 0

The limited role of sex education and contraception use in unintended pregnancy by disability status among young adults 性教育和避孕措施在青少年残疾意外怀孕中的作用有限。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-08-11 DOI: 10.1016/j.dhjo.2025.101960

Darcy L. Sullivan

Background

By examining young adult women with disabilities’(WWD) experiences with pregnancy, scholars have concluded that WWD are more likely to experience unintentional pregnancies compared to women without disabilities. Yet, the reasons for this increase in unintended pregnancy observed among WWD remains unclear. While WWD lack access to sexual health education and reproductive health care, they continue to engage in sexual behaviors and experience pregnancy at similar rates compared to able-bodied women.

Objective

This study investigates if sexual health education and contraception use mediate the relationship between disability status and unintended pregnancy for women aged 15–24.

Methods

Data come from 2011 to 2019 National Survey of Family Growth and include a sample of 6988 women. The sample is examined descriptively using chi-square tests and t-tests. Mediated path analysis within a structural equation modeling (SEM) framework is used to analyze the relationship between sexual health education, contraception use, disability status, and unintended pregnancy.

Results

WWD were more likely to experience unintended pregnancy, less likely to receive sexual health education, and use less effective forms of contraception. No mediation effect of sexual health education or contraception use on the relationship between disability status and unintended pregnancy was found for this age group.

Conclusion

Sexual health education and contraception use did not mediate the relationship between disability status and unintended pregnancy for young adult women with disabilities. More research is needed to adequately explore the mechanisms leading to increased unintended pregnancy among WWD, particularly across additional age groups.

背景：通过研究年轻成年残疾女性（WWD）的怀孕经历，学者们得出结论，与没有残疾的女性相比，WWD更容易经历意外怀孕。然而，在WWD中观察到的意外怀孕增加的原因尚不清楚。虽然女性残疾妇女无法获得性健康教育和生殖保健，但她们继续进行性行为，怀孕率与身体健全的妇女相似。目的：探讨15-24岁女性残疾状况与意外怀孕的关系。方法：数据来自2011年至2019年全国家庭增长调查，包括6988名女性样本。使用卡方检验和t检验对样本进行描述性检验。本文采用结构方程模型（SEM）框架中的中介路径分析，分析了性健康教育、避孕措施使用、残疾状况和意外怀孕之间的关系。结果：女性女性更容易发生意外怀孕，接受性健康教育的可能性更低，使用有效的避孕方式的可能性更低。在这一年龄组中，性健康教育或避孕措施的使用对残疾状况与意外怀孕的关系没有中介作用。结论：性健康教育和避孕措施的使用并不能调节残疾状况与年轻成年残疾女性意外怀孕的关系。需要更多的研究来充分探索导致WWD中意外怀孕增加的机制，特别是在其他年龄组中。

{"title":"The limited role of sex education and contraception use in unintended pregnancy by disability status among young adults","authors":"Darcy L. Sullivan","doi":"10.1016/j.dhjo.2025.101960","DOIUrl":"10.1016/j.dhjo.2025.101960","url":null,"abstract":"<div><h3>Background</h3><div>By examining young adult women with disabilities’(WWD) experiences with pregnancy, scholars have concluded that WWD are more likely to experience unintentional pregnancies compared to women without disabilities. Yet, the reasons for this increase in unintended pregnancy observed among WWD remains unclear. While WWD lack access to sexual health education and reproductive health care, they continue to engage in sexual behaviors and experience pregnancy at similar rates compared to able-bodied women.</div></div><div><h3>Objective</h3><div>This study investigates if sexual health education and contraception use mediate the relationship between disability status and unintended pregnancy for women aged 15–24.</div></div><div><h3>Methods</h3><div>Data come from 2011 to 2019 National Survey of Family Growth and include a sample of 6988 women. The sample is examined descriptively using chi-square tests and t-tests. Mediated path analysis within a structural equation modeling (SEM) framework is used to analyze the relationship between sexual health education, contraception use, disability status, and unintended pregnancy.</div></div><div><h3>Results</h3><div>WWD were more likely to experience unintended pregnancy, less likely to receive sexual health education, and use less effective forms of contraception. No mediation effect of sexual health education or contraception use on the relationship between disability status and unintended pregnancy was found for this age group.</div></div><div><h3>Conclusion</h3><div>Sexual health education and contraception use did not mediate the relationship between disability status and unintended pregnancy for young adult women with disabilities. More research is needed to adequately explore the mechanisms leading to increased unintended pregnancy among WWD, particularly across additional age groups.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101960"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Healthcare disparities in colorectal cancer prevention for people with intellectual and developmental disabilities: A caregiver perspective 智力和发育障碍人群预防结直肠癌的保健差异：护理者视角。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-09-16 DOI: 10.1016/j.dhjo.2025.101967

Elisabeth L. Zeilinger , Theresa Wagner , Amelie Fuchs , Manon Schroeder , Nadine Brunevskaya , Jakob Pietschnig , Pavol Mikula , Matthias Unseld

Background

Colorectal cancer (CRC) screening is crucial for early detection, but people with intellectual and developmental disabilities (IDD) face significant healthcare disparities, including lower screening rates.

Objective

This study explores barriers and facilitators to CRC screening for individuals with IDD from the caregiver perspective.

Methods

Semi-structured interviews were conducted with 13 caregivers (eight women, mean age 45) of individuals with IDD in Austria and analyzed using thematic analysis. A modified version of the Bowel Cancer Awareness Measure (CAM) questionnaire was used to assess CRC-related healthcare literacy of the caregivers.

Results

The modified CAM revealed low CRC knowledge among caregivers, with gaps in symptom and risk factor recognition and low self-reported confidence in symptom detection. Four themes emerged from the interviews: (1) Improving access to inclusive healthcare, highlighting systemic healthcare challenges, inclusive environments, clinician expertise, and health education; (2) Managing IDD-specific challenges, including communication difficulties, reliance on routines, and comorbidities; (3) The critical role of caregiver support, focusing on the empowerment of people with IDD; and (4) Challenging stigma and bridging social gaps, addressing stereotypes and social segregation of people with IDD.

Conclusions

This study serves as a case study, illustrating how the exclusion of people with IDD from the design of preventive healthcare perpetuates inequities in CRC screening, and emphasizing the need for more inclusive systems and practices. Addressing these shortcomings requires improved knowledge and educational resources, disability-sensitive training for professionals, accessible healthcare environments and systemic efforts to promote autonomy and reduce stigma.

背景：结直肠癌（CRC）筛查对于早期发现至关重要，但智力和发育障碍（IDD）患者面临着显著的医疗差距，包括筛查率较低。目的：本研究从护理者的角度探讨IDD患者CRC筛查的障碍和促进因素。方法：对奥地利IDD患者的13名护理人员（8名女性，平均年龄45岁）进行半结构化访谈，并采用主题分析法进行分析。一个修改版本的肠癌意识测量（CAM）问卷被用来评估crc相关的护理人员的卫生保健素养。结果：改进后的CAM显示护理人员对结直肠癌的认知程度较低，在症状和危险因素认知方面存在差距，在症状检测方面自报信心较低。访谈中出现了四个主题：(1)改善获得包容性医疗的机会，突出系统性医疗挑战、包容性环境、临床医生专业知识和健康教育；(2)应对idd特有的挑战，包括沟通困难、对日常生活的依赖和合并症；(3)护理人员支持的关键作用，重点是增强缺乏症患者的权能；(4)挑战耻辱感，弥合社会差距，解决对缺乏症患者的刻板印象和社会隔离问题。结论：本研究作为一个案例研究，说明将IDD患者排除在预防性医疗保健设计之外如何使CRC筛查中的不公平现象长期存在，并强调需要更具包容性的系统和实践。要解决这些缺点，需要改进知识和教育资源，对专业人员进行对残疾问题敏感的培训，提供无障碍的医疗保健环境，并系统性地努力促进自主和减少耻辱感。

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引用次数: 0

Analyzing the relationship between ableist microaggressions and well-being in a cross-sectional sample of adults with varied disabilities 分析不同残疾成人的横截面样本中残疾主义者微侵犯与幸福感之间的关系。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-07-05 DOI: 10.1016/j.dhjo.2025.101925

Whitney M. Morean , Abigail Hayden, Angela Maccarrone, Jacob A. Bentley

Background

In prior research ableist microaggressions have correlated with higher measures of psychological distress. However, research has not yet examined the relationship between ableist microaggressions and well-being as measured not merely by the absence of distressing mental health symptoms, but rather about effective functioning and flourishing.

Objective

The present study addressed this gap by analyzing the relationship between ableist microaggressions and well-being and assessing if different coping strategies moderate the relationship in a sample of adults with varied disabilities.

Methods

A cross-sectional survey was conducted with (n = 132) adults who self-identified as having a health condition that significantly impacts one or more major life activities. Participants were recruited online to complete a Qualtrics survey of measures of well-being, ableist microaggressions, coping, and depression symptoms.

Results

Ableist microaggression scores did not significantly predict well-being. Depression scores and disability visibility predicted well-being. In planned exploratory post-hoc analyses, those who endorsed having a more visible disabilities reported experiencing statistically significant more ableist microaggressions and statistically significant higher well-being scores than those endorsing less visible disabilities.

Conclusions

Consistent with prior literature, depression scores predicted lower well-being. Participants with more visible disabilities reported experiencing more ableist microaggressions and also endorsed higher well-being. This research supports that depression and well-being are independent constructs. Further research needs to examine factors such as, positive disability identity, connection to the disability community, and disability pride, that might contribute to why those with more visible disabilities experience more ableist microaggression while also endorsing higher levels of well-being.

背景：在先前的研究中，残疾微侵犯与较高的心理困扰水平相关。然而，研究还没有检验能力主义者的微侵犯行为和幸福感之间的关系，这种关系不仅是通过缺乏痛苦的心理健康症状来衡量的，而是通过有效的功能和繁荣来衡量的。目的：本研究通过分析残疾微攻击与幸福感之间的关系，并评估不同的应对策略是否会调节这种关系，从而弥补这一空白。方法：对（n = 132）名自认为有严重影响一项或多项主要生活活动的健康状况的成年人进行横断面调查。研究人员在网上招募了参与者，让他们完成一项关于幸福感、能动性微侵犯、应对和抑郁症状的质量调查。结果：Ableist微攻击得分不能显著预测幸福感。抑郁得分和残疾可见度预测了幸福感。在计划的探索性事后分析中，那些认可有更明显残疾的人报告说，与那些认可不太明显残疾的人相比，他们经历了统计上显著更多的残疾主义微侵犯，统计上显著更高的幸福感得分。结论：与先前的文献一致，抑郁得分预示着较低的幸福感。有更多明显残疾的参与者报告说，他们经历了更多的残疾主义微侵犯，也认可了更高的幸福感。本研究支持抑郁和幸福感是相互独立的概念。进一步的研究需要检查诸如积极的残疾认同、与残疾社区的联系以及残疾自豪感等因素，这些因素可能有助于解释为什么那些明显残疾的人经历了更多的残疾主义微攻击，同时也认可了更高水平的幸福感。

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引用次数: 0

Healthcare's blind spot—why people with disabilities remain marginalized and overlooked 医疗保健的盲点——为什么残疾人仍然被边缘化和忽视。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-10-28 DOI: 10.1016/j.dhjo.2025.101975

Michael M. McKee MD, MPH (Professor,Director of MDisability,Co-Director of Center of Disability Health & Wellness,Co-Editor-in-Chief) , Monika Mitra (Co-Editors-in-Chief,Director,Nancy Lurie Marks Professor of Disability Policy)

引用次数: 0

Accessibility and utilisation of reproductive healthcare services among women with disabilities in Lithuania: Insights from a mixed-methods study 立陶宛残疾妇女获得和利用生殖保健服务的情况：来自一项混合方法研究的见解。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-07-19 DOI: 10.1016/j.dhjo.2025.101928

Ugnė Grigaitė , Simona Aginskaitė , Rokas Uscila

Background

Women with disabilities worldwide face barriers to reproductive healthcare, including accessibility challenges and negative attitudes from medical professionals. These issues reflect multiple intersecting forms of discrimination.

Objective

This study aims to examine how women with various disabilities in Lithuania access reproductive healthcare services, evaluate their experiences with these services, and explore the related attitudes of clinicians.

Methods

This cross-sectional study employs a mixed-methods convergent design. Quantitative and qualitative data were collected through an online survey (n = 154) and two focus groups with medical professionals (n = 12). Statistical and thematic analyses were performed using SPSS and MAXQDA.

Results

Over half of the women rated their reproductive healthcare experiences as average to very bad. Issues spanned preventive, general, pregnancy, labour, childbirth, and postpartum care. Participants with hearing, mobility, physical disabilities, and autism reported more issues, often citing inaccessible infrastructure, lack of Sign language interpretation, written consultations, or Easy-to-Read materials. Intellectual disabilities were also associated with reports of negative attitudes from medical professionals, highlighting widespread communication and support inadequacies.

Conclusions

Improving reproductive healthcare for women with disabilities in Lithuania and globally requires educating medical professionals on the human rights-based model of disability and accessibility. Implementing individual accommodations in healthcare is essential and should involve medical staff, administrators, and policymakers. Ensuring access to sex education for women with disabilities and addressing societal stereotypes about their sexuality and motherhood are also vital. Further research with larger sample sizes is needed to evaluate and enhance the accessibility and quality of reproductive healthcare services for women with disabilities.

背景：世界各地的残疾妇女在生殖保健方面面临障碍，包括无障碍挑战和来自医疗专业人员的消极态度。这些问题反映了多种交叉形式的歧视。目的：本研究旨在调查立陶宛不同残疾妇女获得生殖保健服务的情况，评估她们获得这些服务的经历，并探讨临床医生的相关态度。方法：本横断面研究采用混合方法收敛设计。通过在线调查（n = 154）和两个医疗专业人员焦点小组（n = 12）收集定量和定性数据。采用SPSS和MAXQDA进行统计和专题分析。结果：超过一半的妇女认为她们的生殖保健经历一般到非常差。问题包括预防，一般，怀孕，分娩，分娩和产后护理。听力、行动不便、身体残疾和自闭症的参与者报告了更多的问题，通常是缺乏无障碍的基础设施、缺乏手语翻译、书面咨询或易于阅读的材料。智力残疾还与医疗专业人员的消极态度有关，突出表明普遍缺乏沟通和支持。结论：改善立陶宛和全球残疾妇女的生殖保健需要对医疗专业人员进行基于人权的残疾和无障碍模式的教育。在医疗保健中实施个人住宿是必不可少的，应该包括医务人员、管理人员和决策者。确保残疾妇女获得性教育，消除社会对她们的性行为和母性的刻板印象也至关重要。需要进行更大样本量的进一步研究，以评估和提高残疾妇女获得生殖保健服务的机会和质量。

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引用次数: 0

Bayesian modeling of underreported disabilities: Gender insights from the Bangladesh national household survey 低报残疾的贝叶斯模型：来自孟加拉国全国家庭调查的性别见解。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2026-01-01 Epub Date: 2025-07-01 DOI: 10.1016/j.dhjo.2025.101922

Maiko Sakamoto, Nanami Kakuta

Background

According to the World Health Organization, about 16 % of the global population has a disability, with many residing in developing countries. The Washington Group (WG) on Disability Statistics recommends the WG Short Set on Functioning to foster consistent, internationally comparable measures. However, this data is subject to biases due to societal misunderstandings and misreporting, including false positives and, more commonly, false negatives, particularly in developing countries.

Objective

This paper examines discrepancies between reported and actual numbers of persons with disabilities and aims to advance methodological approaches and highlight the challenges faced by persons with disabilities in Bangladesh.

Methods

We employ a classification error modeling framework with a binary response variable and a Bayesian approach to estimate the true percentage of persons with disabilities and investigate associations with social variables. The 2016 Household Income and Expenditure Survey from Bangladesh serves as our case study.

Results

Bayesian analysis suggests a prevalence of 7.71 %–4.8 times higher than the raw estimates—with a notable false negative rate of 0.79 under the WG's initially recommended guidelines, which define persons with “at least a lot of difficulty” as disabled. The rate drops to 0.33 when “some difficulty” is also included. The findings underscore the detrimental effects of disability on educational attainment, earning capacity, and marital experiences, highlighting the need for targeted support, especially for male persons with disabilities up to the junior secondary level.

Conclusions

This study emphasizes the importance of a deeper understanding of the complexities of disability data and the societal structures that influence its reporting to inform effective policy and support mechanisms.

背景：据世界卫生组织统计，全球约有16%的人口患有残疾，其中许多人居住在发展中国家。残疾统计华盛顿小组（WG）建议WG功能短集，以促进一致的、国际可比的衡量标准。然而，由于社会误解和误报，这些数据存在偏见，包括假阳性，更常见的是假阴性，特别是在发展中国家。目的：本文检查报告和实际残疾人人数之间的差异，旨在推进方法方法，突出孟加拉国残疾人面临的挑战。方法：我们采用带有二元响应变量的分类误差建模框架和贝叶斯方法来估计残疾人的真实百分比，并研究与社会变量的关联。2016年孟加拉国家庭收入和支出调查作为我们的案例研究。结果：贝叶斯分析表明，患病率为7.71%——比原始估计高4.8倍——根据工作组最初推荐的指导方针，将“至少有很多困难”的人定义为残疾人，假阴性率为0.79。如果把“某些难度”也算进去，这个比率就降到了0.33。研究结果强调了残疾对教育成就、收入能力和婚姻经历的不利影响，强调了有针对性的支持的必要性，特别是对初中以下的男性残疾人士。结论：本研究强调了深入了解残疾数据的复杂性和影响其报告的社会结构的重要性，以便为有效的政策和支持机制提供信息。

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