Disability and Health Journal最新文献_第4页

Peer mentor contributions to an early intervention vocational rehabilitation specialist service following trauma: A qualitative study 同伴导师对创伤后早期干预职业康复专家服务的贡献：定性研究。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101680

L. Barclay PhD, MOT, BAppSci(OT) , G. Hilton PhD, MPH, BOT , E. Fossey PhD, MSc, DipCOT , J. Ponsford PhD , M. Downing PhD, BBSc(Hons) , P. Analytis PhD , P. Ross PhD, BAppSci(OT)

Background

Peer mentors have a role in facilitating the participation, health and well-being of people who have had a traumatic injury. Few studies have explored the involvement of peer mentors in an early intervention vocational rehabilitation (EIVR) service following trauma.

Objective

This study aimed to explore the experience of implementing peer support within the context of an EIVR service from the perspectives of the peer mentors themselves, the vocational therapists supervising them, and the patients that received peer mentoring.

Methods

Semi-structured interviews were conducted with twenty participants from three groups: peer mentors (n = 4); vocational therapists (n = 3); and patients who received the EIVR intervention (n = 24). Data were thematically analysed.

Results

Three themes were identified: The value of peer input in an EIVR service, The facilitators impacting the value of peer involvement as part of the EIVR service, The challenges impacting peer input as part of an EIVR service.

Conclusions

The inclusion of peer mentors early after major traumatic injury was a unique and valuable addition to the EIVR service. Offering peer support early on in rehabilitation enabled patients to gain a sense of hope for their future, and the expectation that returning to work was a realistic option. The careful selection of peer mentors, and ensuring they receive adequate preparation and ongoing supervision are vital to support their well-being during the intervention. Aiming to match peer mentors with similar injuries and work backgrounds to patients is an important contributor to the likely ongoing engagement of the mentee with the mentor.

背景：同伴辅导员在促进创伤患者的参与、健康和幸福方面发挥着作用。很少有研究探讨了同伴指导者参与创伤后早期干预职业康复（EIVR）服务的情况：本研究旨在从同伴指导者、指导他们的职业治疗师以及接受同伴指导的患者的角度，探讨在早期干预职业康复服务中实施同伴支持的经验：对以下三组 20 名参与者进行了半结构式访谈：同伴指导者（4 人）、职业治疗师（3 人）和接受 EIVR 干预的患者（24 人）。对数据进行了主题分析：结果：确定了三个主题：结果：确定了三个主题：EIVR 服务中同伴参与的价值、影响 EIVR 服务中同伴参与价值的促进因素、影响 EIVR 服务中同伴参与的挑战：结论：在重大创伤后早期纳入同伴指导是对 EIVR 服务的独特而有价值的补充。在康复早期提供同伴支持使患者对未来充满希望，并期望重返工作岗位是一个现实的选择。精心挑选同伴指导者，并确保他们做好充分准备和接受持续监督，这对支持他们在干预期间的身心健康至关重要。将具有与患者相似伤情和工作背景的同伴指导者与患者相匹配，这对被指导者与指导者之间的持续互动非常重要。

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引用次数: 0

Reviewer appreciation - 2024

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101724

引用次数: 0

Understanding disability benefits decision-making among adults with self-reported work disabilities: A qualitative study 了解自述有工作残疾的成年人的残疾福利决策：定性研究。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101681

Lila Rabinovich M.Phil (Social Science Researcher), Doerte Junghaenel Ph.D. (Associate Professor), Tabasa Ozawa M.P.H. (Project Specialist)

Background

Take-up gaps in safety net programs, long documented in the US, are an important policy problem as non-take up compromises the equity objectives and efficacy of programs. The Social Security Disability program is an example of this: more than 20 million adults report a work disability, but only around 11 million currently receive disability benefits through the Social Security Disability Insurance or Supplemental Security Income programs.

Objectives

We examine decision-making around benefits application among adults with self-reported work disability who have never applied for disability benefits.

Methods

We conducted 39 interviews with work-disabled adults who have never applied for disability benefits. Thematic analysis identified key barriers and inhibitors to disability application.

Results

High transaction costs involved in disability applications coupled with the widespread perception of low approval rates was mentioned as a critical deterrent. Uncertain and lengthy medical processes after disability onset were also frequently reported as a key deterrent. Stigma about receiving disability benefits did not emerge as a factor in application behavior, although a change in self-concept involving an adjustment to benefit-receiving, work-disabled status was cited as a barrier to claiming.

Conclusion

Our results broadly align with those of other research that examined the information, transaction, and social costs of applying for benefits. Nevertheless, the qualitative data afford a more in-depth, grounded understanding of the primary factors affecting application decisions, and how those interact. These insights are important to inform targets for interventions to reduce barriers to take-up of benefits among potentially eligible adults with disabilities.

背景：在美国，安全网计划的领取差距是一个长期存在的重要政策问题，因为不领取会损害计划的公平目标和效率。社会保障残疾计划就是一个很好的例子：2000 多万成年人报告有工作残疾，但目前只有约 1100 万人通过社会保障残疾保险或补充保障收入计划领取残疾津贴：我们研究了自我报告有工作残疾但从未申请过残疾津贴的成年人在申请津贴时的决策情况：我们对从未申请过残疾津贴的工作残疾成年人进行了 39 次访谈。主题分析确定了残疾申请的主要障碍和抑制因素：申请残障福利所涉及的高昂交易成本以及普遍认为的低批准率是阻碍申请的关键因素。残疾发生后不确定和冗长的医疗程序也经常被报告为主要阻碍因素。领取伤残津贴的耻辱感并没有成为影响申请行为的一个因素，但自我概念的改变，包括调整到领取津贴、工作残疾的状态，被认为是申请的一个障碍：我们的研究结果与其他研究结果基本一致，这些研究考察了申请福利的信息成本、交易成本和社会成本。然而，定性数据使我们对影响申请决定的主要因素以及这些因素之间的相互作用有了更深入、更全面的了解。这些见解对于确定干预目标，减少可能符合条件的成年残疾人领取福利的障碍非常重要。

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引用次数: 0

Perinatal mental health and risk of severe maternal morbidity in women with physical disabilities, Massachusetts 2003-2015. 2003-2015年马萨诸塞州身体残疾妇女围产期心理健康和严重孕产妇发病率风险。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101772

Anne Valentine, Ilhom Akobirshoev, Jiangying Zhang, Tiffany A Moore Simas, Monika Mitra

Background: Perinatal mental health and substance use disorders contribute to adverse maternal outcomes. Women with disabilities experience increased risk for severe maternal morbidity (SMM). No studies have examined the association between perinatal mental health and SMM risk in women with physical disabilities.

Objective: To examine the association between perinatal mental health and substance use disorders and SMM risk in women with physical disabilities.

Methods: We analyzed delivery hospitalizations from 2003 to 2015 from the Massachusetts Pregnancy to Early Life Longitudinal (PELL) data system. We identified physical disability using International Classification of Diseases, Ninth Revision codes. Perinatal mental health status was based on the presence of at least one emergency department visit, observational, or in-patient stay attributed to a mental health or substance use disorder anytime from gestation to delivery. We used modified Poisson regressions to obtain risk ratios (RR) for SMM in women with either a physical disability or no disability by perinatal mental health status. Non-disabled women with no perinatal mental health or substance use disorder visit served as the referent group.

Results: Deliveries in women with no physical disability and a perinatal mental health visit were not associated with risk of SMM. Compared to the referent group, women with a physical disability and a perinatal mental health or substance use disorder visit had greater risk of both SMM (RR = 1.84, 95 % CI:1.32-2.56), and nontransfusion SMM (RR = 2.35 1.52, 3.64), after adjusting for demographic and socioeconomic characteristics.

Conclusions: Increased attention should be paid to perinatal mental health status in women with physical disabilities.

背景：围产期心理健康和物质使用障碍会导致不良的产妇结局。残疾妇女患严重产妇疾病（SMM）的风险增加。没有研究调查围产期心理健康与身体残疾妇女患SMM风险之间的关系。目的：探讨身体残疾妇女围生期心理健康与物质使用障碍和SMM风险的关系。方法：我们分析2003年至2015年马萨诸塞州妊娠至早期生命纵向（PELL）数据系统的分娩住院情况。我们使用国际疾病分类第九次修订代码确定身体残疾。围产期精神健康状况是基于从妊娠到分娩的任何时间因精神健康或物质使用障碍至少一次急诊就诊、观察或住院。我们使用修正泊松回归来获得围生期心理健康状况下有身体残疾或无残疾的女性发生SMM的风险比（RR）。没有围产期精神健康或物质使用障碍就诊的非残疾妇女作为参照组。结果：没有身体残疾的妇女分娩和围产期心理健康检查与SMM的风险无关。与参照组相比，在调整人口统计学和社会经济特征后，身体残疾和围产期精神健康或物质使用障碍就诊的妇女发生SMM （RR = 1.84, 95% CI:1.32-2.56）和非输血SMM （RR = 2.35 1.52, 3.64）的风险更高。结论：应重视身体残疾妇女的围生期心理健康状况。

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引用次数: 0

Adverse childhood experiences in adults with chronic traumatic brain injury: Support for a life course approach to brain injury rehabilitation 慢性脑外伤成人的不良童年经历：支持脑损伤康复的生命过程方法。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101714

Umesh M. Venkatesan PhD , Shannon B. Juengst PhD

Background

Adverse childhood experiences (ACEs) confer greater risk for adult traumatic brain injury (TBI), but little is known about their effects on post-injury outcomes.

Objective

To determine the prevalence and correlates of conventionally defined ACEs (occurring within household/in private; e.g., physical abuse) and community-level ACEs (e.g., bullying) after TBI.

Methods

Participants were 85 Philadelphia-area TBI Model System participants with chronic (>1 year post-injury) TBI. We examined cross-sectional associations between total conventional and community ACEs reported (out of 21) before age 18, mental health symptoms, and health-related quality of life (HRQoL), as well as relationships between ACEs and neighborhood deprivation (census-derived neighborhood socioeconomic status).

Results

The median number of total ACEs was 3 (range: 0–17). Emotional abuse, physical abuse, and alcohol abuse in the household were the most common conventional ACEs (each at 36.5 %). Witnessing violence (45 %) was the most common community ACE. Black individuals (n = 32) reported more community ACEs (p < .001) than White individuals (n = 45). Community ACEs were significantly associated with greater neighborhood deprivation, though this relationship was confounded by race. Total ACEs was significantly related to more severe mental health symptoms (p < .001) and poorer HRQoL (p = .005), even after covariate adjustment. A fully-adjusted path model supported mental health as a mediator between total ACEs and HRQoL.

Conclusions

Results of this preliminary study reveal an appreciable prevalence and potential far-reaching consequences of conventional and community ACEs among those with chronic TBI. The results underscore the value of trauma-informed and life course approaches to research and clinical care in TBI.

背景：童年不良经历（ACEs）会增加成人创伤性脑损伤（TBI）的风险，但人们对其对伤后结果的影响知之甚少：目标：确定创伤性脑损伤后传统定义的 ACE（发生在家庭/私人内部；如身体虐待）和社区层面的 ACE（如欺凌）的发生率和相关性：参与者为费城地区 TBI 模型系统的 85 名慢性（受伤后 1 年以上）TBI 患者。我们研究了 18 岁前报告的常规和社区 ACE（共 21 项）总数、心理健康症状和健康相关生活质量（HRQoL）之间的横截面关联，以及 ACE 与邻里贫困（人口普查得出的邻里社会经济状况）之间的关系：ACE总数的中位数为3（范围：0-17）。家庭中最常见的传统 ACE 是情感虐待、身体虐待和酗酒（各占 36.5%）。目睹暴力（45%）是最常见的社区 ACE。黑人（n = 32）报告了更多的社区 ACE（p 结论：黑人报告的社区 ACE 更多：这项初步研究的结果显示，在慢性创伤性脑损伤患者中，传统和社区 ACE 的发生率相当高，并可能产生深远的影响。这些结果凸显了创伤知情和生命历程方法在创伤性脑损伤研究和临床治疗中的价值。

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引用次数: 0

The language of inclusion: A randomized trial of how DEI statements influence hiring practices for people with visible and invisible disabilities 包容的语言：一项随机试验，研究 DEI 声明如何影响有形和无形残疾人士的招聘实践。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101717

Mason Ameri Ph.D., Terri R. Kurtzberg Ph.D.

Background

Companies are increasingly motivated to ensure that they are effective at hiring people with disabilities, but bias in the process remains a challenge. While Diversity, Equity, and Inclusion (DEI) statements are generally crafted as external-facing signaling devices, little is known about their potential effect on the employees themselves with regard to internal decisions, such as hiring.

Objective

This study aims to explore whether various DEI statements may encourage more positive hiring decisions for job candidates with both visible and invisible disabilities.

Methods

An experiment with a 2 × 4 × 2 design was used (DEI Language: legal/traditional or heartfelt; Disability Type: none, visible, and two types of invisible disabilities; Candidate's Tone: warm or overconfident). Quantitative and qualitative items measured general reactions to the candidate as well as perceptions about his employability, degree of risk as a new hire, skills at negotiating for his salary, and integrity. Statistical tests include analyses of variance and z-tests for proportions.

Results

Heartfelt statements improved ratings of candidates with disabilities in general, and more so for those with invisible disabilities. In addition, the two types of invisible disability were distinct from each other, with the mental health disability more stigmatized than the neurological one.

Conclusions

These results suggest that the DEI language that a company uses is an important signaling device not just for external constituents but also for internal employees. In addition, it is among the first to demonstrate differences in types of invisible disabilities, indicating that more nuance is needed to understand bias in this context.

背景：公司越来越有动力确保有效聘用残障人士，但这一过程中的偏见仍是一个挑战。虽然多元化、公平与包容（DEI）声明通常是作为面向外部的信号装置而制定的，但人们对其在内部决策（如招聘）方面对员工本身的潜在影响却知之甚少：本研究旨在探讨各种公平与平等（DEI）声明是否会鼓励有可见和不可见残疾的求职者做出更积极的招聘决定：方法：采用 2 × 4 × 2 设计进行实验（残疾人就业指数语言：合法/传统或发自内心；残疾类型：无残疾、可见残疾和两种隐形残疾；求职者语气：热情或过度自信）。定量和定性项目测量的是对候选人的一般反应，以及对其就业能力、作为新员工的风险程度、薪酬谈判技巧和诚信度的看法。统计检验包括方差分析和比例 Z 检验：真心话普遍提高了残疾应聘者的评分，隐形残疾应聘者的评分则更高。此外，两种类型的隐形残疾彼此不同，心理健康残疾比神经残疾更受鄙视：这些结果表明，公司所使用的 DEI 语言是一种重要的信号装置，不仅对于外部选民，对于内部员工也是如此。此外，这也是首次证明隐形残疾类型的差异，表明要了解这方面的偏见还需要更多的细微差别。

{"title":"The language of inclusion: A randomized trial of how DEI statements influence hiring practices for people with visible and invisible disabilities","authors":"Mason Ameri Ph.D., Terri R. Kurtzberg Ph.D.","doi":"10.1016/j.dhjo.2024.101717","DOIUrl":"10.1016/j.dhjo.2024.101717","url":null,"abstract":"<div><h3>Background</h3><div>Companies are increasingly motivated to ensure that they are effective at hiring people with disabilities, but bias in the process remains a challenge. While Diversity, Equity, and Inclusion (DEI) statements are generally crafted as external-facing signaling devices, little is known about their potential effect on the employees themselves with regard to internal decisions, such as hiring.</div></div><div><h3>Objective</h3><div>This study aims to explore whether various DEI statements may encourage more positive hiring decisions for job candidates with both visible and invisible disabilities.</div></div><div><h3>Methods</h3><div>An experiment with a 2 × 4 × 2 design was used (<em>DEI Language</em>: legal/traditional or heartfelt; <em>Disability Type</em>: none, visible, and two types of invisible disabilities; <em>Candidate's Tone</em>: warm or overconfident). Quantitative and qualitative items measured general reactions to the candidate as well as perceptions about his employability, degree of risk as a new hire, skills at negotiating for his salary, and integrity. Statistical tests include analyses of variance and z-tests for proportions.</div></div><div><h3>Results</h3><div>Heartfelt statements improved ratings of candidates with disabilities in general, and more so for those with invisible disabilities. In addition, the two types of invisible disability were distinct from each other, with the mental health disability more stigmatized than the neurological one.</div></div><div><h3>Conclusions</h3><div>These results suggest that the DEI language that a company uses is an important signaling device not just for external constituents but also for internal employees. In addition, it is among the first to demonstrate differences in types of invisible disabilities, indicating that more nuance is needed to understand bias in this context.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101717"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478907","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

Self-reported hearing loss and health during a pandemic: Findings from a cross-sectional analysis using a 2021 household survey 自我报告的听力损失与大流行期间的健康状况：利用 2021 年家庭调查进行横断面分析的结果

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101706

Eunice Y. Park PhD , Erin R. Nelson-Bakkum AuD , Amy A. Schultz PhD , Lauren K. Dillard AuD, PhD

Background

The COVID-19 pandemic differentially impacted individuals with hearing loss, likely in part due to increased communication difficulties from masking, a commonly implemented protective measure.

Objective

This study examines the association between self-reported hearing loss and health during the pandemic.

Methods

This study uses data from the COVID-19 Survey collected by the Survey of the Health of Wisconsin from February to March 2021. Hearing loss was defined as self-reported fair or poor hearing. The outcomes were self-reported symptoms of anxiety and depression, separately, and self-reported general health. Multivariable models adjusted for age, gender, and race/ethnicity were used to examine the associations between hearing loss with each outcome. Results are presented as prevalence ratios (PR) with corresponding 95 % confidence intervals (CI).

Results

There were 1857 participants (60.3 % female, 12.9 % non-white) with a mean age of 57.1 years in this cross-sectional study. In multivariable models, individuals with hearing loss (versus none) had higher prevalence of depression (PR: 1.22, 95 % CI: 1.06, 1.39), anxiety (PR: 1.13, 95 % CI: 1.02, 1.27), and self-reported fair or poor health (PR: 2.61, 95 % CI: 1.89, 3.61).

Conclusion

Hearing loss was associated with poorer self-reported health during winter 2021 of the COVID-19 pandemic, when mask use in public was newly mandated and vaccines were not widely available to the general public. Further research on the impact of public health policies on vulnerable populations, including those with hearing loss, is warranted. Such research could inform policy decisions that accommodate these populations.

COVID-19 大流行对听力损失患者造成了不同程度的影响，部分原因可能是由于掩蔽这一普遍采用的保护措施增加了交流困难。本研究探讨了大流行期间自我报告的听力损失与健康之间的关系。本研究使用的数据来自威斯康星州健康调查局于 2021 年 2 月至 3 月期间收集的 COVID-19 调查。听力损失被定义为自我报告的听力一般或较差。结果分别为自我报告的焦虑和抑郁症状，以及自我报告的一般健康状况。使用调整了年龄、性别和种族/族裔的多变量模型来研究听力损失与各项结果之间的关联。结果以患病率比 (PR) 和相应的 95 % 置信区间 (CI) 表示。这项横断面研究共有 1857 名参与者（60.3% 为女性，12.9% 为非白人），平均年龄为 57.1 岁。在多变量模型中，听力损失患者（与无听力损失患者相比）的抑郁（PR：1.22，95 % CI：1.06，1.39）、焦虑（PR：1.13，95 % CI：1.02，1.27）和自我报告的健康状况一般或较差（PR：2.61，95 % CI：1.89，3.61）发生率较高。在 COVID-19 大流行的 2021 年冬季，听力损失与自我报告的健康状况较差有关，当时新规定在公共场合使用口罩，而疫苗尚未向公众普及。有必要进一步研究公共卫生政策对弱势群体（包括听力损失者）的影响。此类研究可为适应这些人群的决策提供参考。

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引用次数: 0

Health disparities and injection drug use behaviors among adults with and without disabilities in the National Survey on drug use and health, 2015–2019 2015-2019 年全国毒品使用和健康调查中残疾和非残疾成年人的健康差异和注射吸毒行为。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101715

Roberto Abadie Ph.D. , Manuel Cano Ph.D.

Background

Little is known about the prevalence of injection drug use in people with disabilities (PWD) when compared by disability type and to other adults without disabilities.

Objective or hypothesis

The prevalence of past-year injection drug use will be higher in adults with a reported disability than adults without any reported disability.

Methods

This study consisted of secondary analyses of data from the 2015–2019 National Survey of Drug Use and Health. The analytic sample comprised 214,505 US adults. Self-reported past-year injection drug use represented the outcome of interest. Disability status and socioeconomic characteristics were conceptualized as predictors, and sex and age were used as controls.

Results

Past-year prevalence of self-reported injection drug use was 0.24 % (95 % CI, 0.22–0.27) in adults without a disability but 0.66 % (95 % CI, 0.59–0.73) in adults with a disability. All disability types examined were associated with increased odds of reporting past-year injection drug use, but the strongest association was observed for disability related to difficulty concentrating (AOR, 4.90; 95 % CI, 3.92–6.14). Adjusted odds of past-year methamphetamine injection were more than three times as high in adults with a disability, compared to those without a disability (AOR, 3.21; 95 % CI, 2.37–4.33) and more than two times as high in adults with a disability for cocaine injection (AOR, 2.77; 95 % CI, 1.84–4.15).

Conclusion

Disability status is associated with injection of various types of drugs, and a variety of disability types are associated with higher odds of injection drug use.

背景：关于残疾人（PWD）注射吸毒的流行率，如果按残疾类型与其他非残疾成年人进行比较，则知之甚少：有残疾报告的成年人上一年注射吸毒的流行率将高于无残疾报告的成年人：本研究包括对 2015-2019 年全国毒品使用和健康调查数据的二次分析。分析样本包括 214,505 名美国成年人。自我报告的上一年注射吸毒情况是研究的结果。残疾状况和社会经济特征被视为预测因素，性别和年龄被用作控制因素：在无残疾的成年人中，上一年自我报告的注射吸毒流行率为 0.24 %（95 % CI，0.22-0.27），而在有残疾的成年人中，上一年自我报告的注射吸毒流行率为 0.66 %（95 % CI，0.59-0.73）。所研究的所有残疾类型都与报告过去一年注射吸毒的几率增加有关，但与注意力难以集中有关的残疾的关联性最强（AOR，4.90；95 % CI，3.92-6.14）。与无残疾的成年人相比，有残疾的成年人过去一年注射甲基苯丙胺的调整后几率高出三倍多（AOR，3.21；95 % CI，2.37-4.33），有残疾的成年人注射可卡因的调整后几率高出两倍多（AOR，2.77；95 % CI，1.84-4.15）：结论：残疾状况与注射各类药物有关，各种残疾类型与注射使用药物的较高几率有关。

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引用次数: 0

Effect of COVID-19 on livelihoods of people with and without disabilities: Results from a cross-sectional survey in 3 urban areas of Viet Nam COVID-19 对残疾人和非残疾人生计的影响：越南 3 个城市地区横断面调查的结果

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101674

Lena Morgon Banks PhD , Divya Goyal MSc , Luong Anh Ngoc MSc , Sara Rotenberg PhD , Sarah Marks MSc , Xanthe Hunt PhD , Shaffa Hameed PhD , Hoang Van Minh PhD , Vu Quynh Mai MSc

Background

The COVID-19 pandemic has had widespread health, social and economic impacts worldwide. In many contexts, it has likely exacerbated existing inequalities.

Objective

This study compares the economic impacts of the COVID-19 pandemic amongst people with and without disabilities in Viet Nam.

Methods

A telephone survey was conducted in the three largest cities of Viet Nam (Da Nang, Ha Noi, and Ho Chi Minh City) between December 2021 and January 2022. Participants were recruited through convenience sampling (n = 898; 479 people with disabilities; 419 without). The survey collected data on livelihoods, employment, household economic security, and access to social protection and assistance.

Results

People with disabilities were three times more likely to have stopped working completely (PR: 2.8, 95 % CI: 2.0–4.0), 30 % more likely to report reduced earnings (PR: 1.3, 95 % CI: 1.2–1.5), twice as likely to report severe impacts on household finances (PR: 1.9, 95 % CI: 1.6–2.3) and three times more likely to report severe impacts on household food security (PR: 3.2, 95 % CI: 2.3–4.6) since the onset of the pandemic. Amongst people with disabilities, informal workers were particularly negatively affected. Households with members with disabilities were more likely to receive some types of COVID-19-related assistance (e.g. financial or food aid), but less likely to be enrolled in social insurance.

Conclusions

Urgent and inclusive responses are necessary during crises to address the unique challenges faced by people with disabilities. Implementing comprehensive social protection measures is crucial to narrowing disparities, and maintaining well-being and economic security during shocks such as COVID-19.

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引用次数: 0

Examining outpatient occupational therapy utilization among children and youth with special health care needs in South Carolina: A structural equation model of individual- and community-level factors 研究南卡罗来纳州有特殊医疗需求的儿童和青少年使用门诊职业疗法的情况：个人和社区因素的结构方程模型。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-01-01 DOI: 10.1016/j.dhjo.2024.101687

Caitlin Koob PhD, MS, OTR/L , Sarah F. Griffin PhD, MPH , Kathleen Cartmell PhD, MPH , Lior Rennert PhD , Kerry Sease MD, MPH

Background

Children and youth with special health care needs (CYSHCN) comprise 23 % of the pediatric population in South Carolina (SC), compared to state prevalences of 13.6 %–24 % nationwide. While occupational therapy (OT) is critical to maximizing CYSHCN's participation in daily activities, there are significant disparities in rehabilitation access in the Southeast region.

Objective

This study examines associations between patient-and community-level factors and outpatient OT utilization.

Methods

This study analyzes OT utilization data among CYSHCN (N = 1913) in a health system in SC from 07/01/2022-06/31/2023, merged with Child Opportunity Index 2.0 zip-code level social drivers of health (SDOH) data. SDOH are non-medical factors that affect individual's long-term health, with estimates ranging from “very low” to “very high” opportunity. Structural equation modeling was conducted to understand complex associations between observed and latent variables in a real-world context.

Results

CYSHCN were diagnosed with congenital (40.77 %), developmental (37.87 %), and neurological/neuromuscular conditions (21.36 %). CYSHCN who were non-Hispanic Black or Hispanic and were hospitalized were associated with living in lower opportunity areas. CYSHCN with private or military/other insurance/self-pay were associated with living in higher opportunity areas than Medicaid-insured CYSHCN. CYSHCN who were female and ≥12 years demonstrated lower OT utilization. CYSHCN who participated in speech and/or physical therapy demonstrated higher OT utilization. OT utilization increased with each increase in SDOH.

Conclusion

With these findings, healthcare providers may consider accessibility barriers, including transportation, when referring CYSHCN to OT services. Further research is needed to examine the impact of household-level SDOH on OT access across SC.

背景：有特殊医疗需求的儿童和青少年（CYSHCN）占南卡罗来纳州（SC）儿科人口的 23%，而该州在全国的患病率为 13.6%-24%。职业疗法（OT）对于最大限度地提高儿童健康和护理需求者参与日常活动的能力至关重要，但东南部地区在康复服务方面却存在显著差异：本研究探讨了患者和社区层面的因素与门诊职业治疗利用率之间的关系：本研究分析了南卡罗来纳州医疗系统中 CYSHCN（N = 1913）在 2022 年 1 月 7 日至 2023 年 6 月 31 日期间的 OT 使用数据，并将其与 "儿童机会指数 2.0"（Child Opportunity Index 2.0）邮政编码级别的健康社会驱动因素（SDOH）数据合并。SDOH 是影响个人长期健康的非医疗因素，估计机会从 "非常低 "到 "非常高 "不等。为了解现实世界中观察到的变量与潜在变量之间的复杂关联，我们进行了结构方程建模：被诊断患有先天性疾病（40.77%）、发育性疾病（37.87%）和神经/神经肌肉疾病（21.36%）的 CYSHCN。非西班牙裔黑人或西班牙裔儿童的住院治疗与居住在机会较少的地区有关。与有医疗补助保险的儿童健康中心相比，有私人或军队/其他保险/自费保险的儿童健康中心生活在机会较高的地区。女性且年龄≥12 岁的幼儿健康新生儿的加时治疗使用率较低。参加言语和/或物理治疗的儿童健康青年的加时治疗使用率较高。随着 SDOH 的增加，加时治疗的使用率也随之增加：有了这些发现，医疗服务提供者在将 CYSHCN 转介到加时治疗服务时，可以考虑包括交通在内的可及性障碍。还需要进一步研究家庭层面的 SDOH 对南卡罗来纳州的 OT 使用情况的影响。

{"title":"Examining outpatient occupational therapy utilization among children and youth with special health care needs in South Carolina: A structural equation model of individual- and community-level factors","authors":"Caitlin Koob PhD, MS, OTR/L , Sarah F. Griffin PhD, MPH , Kathleen Cartmell PhD, MPH , Lior Rennert PhD , Kerry Sease MD, MPH","doi":"10.1016/j.dhjo.2024.101687","DOIUrl":"10.1016/j.dhjo.2024.101687","url":null,"abstract":"<div><h3>Background</h3><div>Children and youth with special health care needs (CYSHCN) comprise 23 % of the pediatric population in South Carolina (SC), compared to state prevalences of 13.6 %–24 % nationwide. While occupational therapy (OT) is critical to maximizing CYSHCN's participation in daily activities, there are significant disparities in rehabilitation access in the Southeast region.</div></div><div><h3>Objective</h3><div>This study examines associations between patient-and community-level factors and outpatient OT utilization.</div></div><div><h3>Methods</h3><div>This study analyzes OT utilization data among CYSHCN (N = 1913) in a health system in SC from 07/01/2022-06/31/2023, merged with Child Opportunity Index 2.0 zip-code level social drivers of health (SDOH) data. SDOH are non-medical factors that affect individual's long-term health, with estimates ranging from “very low” to “very high” opportunity. Structural equation modeling was conducted to understand complex associations between observed and latent variables in a real-world context.</div></div><div><h3>Results</h3><div>CYSHCN were diagnosed with congenital (40.77 %), developmental (37.87 %), and neurological/neuromuscular conditions (21.36 %). CYSHCN who were non-Hispanic Black or Hispanic and were hospitalized were associated with living in lower opportunity areas. CYSHCN with private or military/other insurance/self-pay were associated with living in higher opportunity areas than Medicaid-insured CYSHCN. CYSHCN who were female and ≥12 years demonstrated lower OT utilization. CYSHCN who participated in speech and/or physical therapy demonstrated higher OT utilization. OT utilization increased with each increase in SDOH.</div></div><div><h3>Conclusion</h3><div>With these findings, healthcare providers may consider accessibility barriers, including transportation, when referring CYSHCN to OT services. Further research is needed to examine the impact of household-level SDOH on OT access across SC.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 1","pages":"Article 101687"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009841","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}

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