Disability and Health Journal最新文献_第5页

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 : 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

Social and attitudinal barriers to the provision of accessible housing in Canada: A qualitative study 加拿大提供无障碍住房的社会和态度障碍：一项定性研究。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-09-13 DOI: 10.1016/j.dhjo.2025.101966

Kirstin E. Yuzwa , Farah Bacchus-Misir , Siobhan Galeazzi-Stirling , Eva Cohen , Peter Athanasopoulos , Sander L. Hitzig , Christine L. Sheppard

Background

Housing is a critical social determinant of health and for individuals with accessibility needs, having a roof over one's head is not enough. For people requiring accessibility features to enter and exit their home, use the bathroom, or prepare meals, the absence of these features can limit social participation, increase reliance on caregivers, and negatively impact health, dignity, and safety.

Objective

This article presents a qualitative study with members from diverse key interest groups across the housing, disability, healthcare, and policy sectors to identify social and attitudinal barriers limiting accessible housing and home modifications options in Canada.

Methods

Semi-structured interviews and a demographic survey were conducted with 59 people. Participants included people with lived experience of disabilities and other end-users of accssible housing (i.e., family caregivers and people from the Deaf community), as well as cross-sectoral professionals with expertise in accessible housing. Inductive codebook thematic analysis was used to analyze the data.

Results

Four prevailing themes were identified from the data, including a lack of prioritization by policy makers and housing developers, cost-benefit appraisals of including accessibility features, discriminatory attitudes towards the aesthetics of accessibility and towards end-users, and underestimating of the need for preventative accessibility.

Conclusions

Attitudinal barriers are contributing to a lack of prioritization of accessibility in housing in Canada. To create a more inclusive housing landscape and improve public health, investments in accessible housing, policy advancement, and new regulatory measures are recommended.

背景：住房是健康的一个关键社会决定因素，对于有无障碍需求的个人来说，头上有屋顶是不够的。对于需要无障碍功能进出家中、使用浴室或准备饭菜的人来说，缺乏这些功能可能会限制社会参与，增加对照顾者的依赖，并对健康、尊严和安全产生负面影响。目的：本文对来自住房、残疾、医疗保健和政策部门不同关键利益团体的成员进行了定性研究，以确定加拿大限制无障碍住房和住房改造选择的社会和态度障碍。方法：对59人进行半结构化访谈和人口统计调查。与会者包括有残疾生活经历的人和无障碍住房的其他最终用户（即家庭照顾者和聋人社区的人），以及在无障碍住房方面具有专门知识的跨部门专业人员。采用归纳码本专题分析方法对数据进行分析。结果：从数据中确定了四个主要主题，包括政策制定者和住房开发商缺乏优先考虑，包括可访问性特征的成本效益评估，对可访问性美学和最终用户的歧视性态度，以及低估预防性可访问性需求。结论：态度障碍是导致加拿大住房可及性缺乏优先次序的原因。为创造更具包容性的住房环境和改善公共卫生，建议投资于无障碍住房、推进政策和采取新的监管措施。

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引用次数: 0

Hypertension prevalence and coverage and intellectual disability: a systematic review and meta-analysis. 高血压患病率和覆盖范围与智力残疾：系统回顾和荟萃分析。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-09-10 DOI: 10.1016/j.dhjo.2025.101965

Rodrigo Vargas-Fernández, Akram Hernández-Vásquez, Hannah Kuper

Background: People with intellectual disabilities (ID) frequently experience poorer health and lower treatment coverage compared to those without ID, yet differences in hypertension prevalence and treatment coverage remain unclear.

Objective: To estimate the pooled prevalence ratio (PR) of hypertension and hypertension treatment coverage comparing adults with and without ID.

Methods: We searched MEDLINE, Embase, PsychINFO, Global Health and Global Index Medicus on June 6, 2024. We included observational and intervention studies that estimated the prevalence of hypertension and/or treatment coverage. The risk of bias was assessed using the Newcastle-Ottawa Scale tool. We undertook a random-effects meta-analysis to estimate the pooled PR with 95 % confidence intervals (CI). Sources of heterogeneity were explored through sensitivity and subgroup analyses, and meta-regression.

Results: 21 studies from 10 countries across three regions were included. The pooled PR were 0.71 (95 % CI: 0.47-1.05) for hypertension and 0.61 (95 % CI: 0.47-0.81) for hypertension treatment coverage. Only one study adjusted for age; most reported unadjusted estimates, making them prone to confounding. 14 studies were rated as high risk of bias. Subgroup analysis and meta-regression revealed variability in the methods used to diagnose ID, with sample size emerging as the primary source of variability in the effect estimates.

Conclusions: This systematic review showed that adults with ID have a similar prevalence of hypertension, but lower hypertension treatment coverage compared to those without disabilities. However, these results should be interpreted with caution due to the lack of adjustment for confounding in the association and variability in the diagnosis of ID.

背景：与无智力残疾者相比，智力残疾者经常经历较差的健康状况和较低的治疗覆盖率，但高血压患病率和治疗覆盖率的差异尚不清楚。目的：评估高血压合并患病率（PR）和高血压治疗覆盖率，比较患有和未患有高血压的成年人。方法：检索2024年6月6日的MEDLINE、Embase、PsychINFO、Global Health和Global Index Medicus。我们纳入了估计高血压患病率和/或治疗覆盖率的观察性和干预性研究。使用纽卡斯尔-渥太华量表工具评估偏倚风险。我们进行了随机效应荟萃分析，以95%置信区间（CI）估计合并PR。通过敏感性和亚组分析以及元回归来探索异质性的来源。结果：纳入了来自3个地区10个国家的21项研究。高血压的合并PR为0.71 (95% CI: 0.47-1.05)，高血压治疗覆盖率的合并PR为0.61 （95% CI: 0.47-0.81）。只有一项研究调整了年龄；大多数报告的是未经调整的估计，这使它们容易混淆。14项研究被评为高偏倚风险。亚组分析和元回归揭示了用于诊断ID的方法的可变性，样本量成为影响估计可变性的主要来源。结论：本系统综述显示，与无残疾的成年人相比，成年ID患者高血压患病率相似，但高血压治疗覆盖率较低。然而，这些结果应该谨慎解释，因为缺乏对相关性和ID诊断变异性的混淆调整。

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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 : 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

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 : 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。

{"title":"Is disability prevalence higher in rural areas? Evidence from functional difficulty and nightlight data in 15 low- and middle-income countries","authors":"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","doi":"10.1016/j.dhjo.2025.101964","DOIUrl":"10.1016/j.dhjo.2025.101964","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101964"},"PeriodicalIF":3.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056001","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

Author Information 作者信息

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-09-03 DOI: 10.1016/S1936-6574(25)00172-4

引用次数: 0

Prevalence, predictors and consequences of reported discrimination against children with disabilities in Lao PDR: a cross-sectional analysis in Xiengkhouang Province 老挝人民民主共和国报告的歧视残疾儿童的患病率、预测因素和后果：在湘圹省的横断面分析。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-09-02 DOI: 10.1016/j.dhjo.2025.101963

Nathaniel Scherer , Ketmany Chanthakoummane , Anousin Homsana , Mark T. Carew , Latsamy Siengsounthone , Hannah Kuper , Bounhome Soukkhaphone , Lena Morgon Banks

Background

Children with disabilities are at increased risk of discrimination, contributing to exclusion from services and community life.

Objective

This study investigates the prevalence, predictors and consequences of reported discrimination against children with disabilities in Lao People's Democratic Republic (Lao PDR).

Methods

Data were collected in the baseline assessment for a non-randomised controlled trial of a cash-plus programme for children with disabilities in Xiengkhouang Province, Lao PDR. Assessment was conducted May to October 2023. Data on reported discrimination was collected using a tool based on a validated measure. Experience of discrimination in the past 30 days was classified into “any” and “frequent”. Children aged ≥8 years reported directly on their experiences of discrimination. Caregivers provided proxy response for children <8 years or for children ≥8 years who had severe difficulties communicating.

Results

405 children with disabilities aged ≤18 years were recruited. Prevalence of any reported discrimination in the past 30 days was 72.3%, and of frequent discrimination 28.4%. Reported discrimination was more common against children with cognitive disabilities (aRR: 1.55, 95% CI: 1.03-2.33), Hmong/Lu Mien children (aRR: 1.25, 95% CI: 1.10-1.41), and children without friends (aRR: 1.61, 95% CI: 1.16-2.23). Children experiencing frequent discrimination were substantially more likely to avoid others (aRR: 5.19, 95% CI: 3.48-7.74) and worry about how others act towards them (aRR: 4.05, 95% CI: 2.79-5.88).

Conclusions

Children with disabilities in Lao PDR experience high levels of discrimination. Action is needed to reduce disability-related stigma and discrimination in line with the United Nations Convention on the Rights of Persons with Disabilities.

背景：残疾儿童受到歧视的风险越来越大，导致他们被排除在服务和社区生活之外。目的：本研究调查老挝人民民主共和国（Lao PDR）报告的残疾儿童歧视的流行程度、预测因素和后果。方法：收集老挝人民民主共和国兴圹省残疾儿童现金+项目的非随机对照试验基线评估数据。评估于2023年5月至10月进行。报告的歧视数据是使用基于有效测量的工具收集的。过去30天的歧视经历分为“有”和“频繁”。≥8岁的儿童直接报告了他们的歧视经历。结果：招募了405名年龄≤18岁的残疾儿童。在过去30天内有任何歧视报告的发生率为72.3%，经常受到歧视的发生率为28.4%。报告的歧视对认知障碍儿童（aRR: 1.55, 95% CI: 1.03-2.33）、苗族/鲁族儿童（aRR: 1.25, 95% CI: 1.10-1.41）和没有朋友的儿童（aRR: 1.61, 95% CI: 1.16-2.23）更为常见。经常遭受歧视的儿童更有可能避免他人（aRR: 5.19, 95% CI: 3.48-7.74），并担心他人如何对待他们（aRR: 4.05, 95% CI: 2.79-5.88）。结论：老挝人民民主共和国的残疾儿童受到高度歧视。需要根据《联合国残疾人权利公约》采取行动，减少与残疾有关的耻辱和歧视。

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引用次数: 0

Direct support professional perspectives on the value of virtual healthcare for adults with intellectual and developmental disabilities: Trends over four years 对智力和发育障碍成人的虚拟医疗保健价值的直接支持专业观点：四年趋势。

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-08-13 DOI: 10.1016/j.dhjo.2025.101961

Avra Selick , Sarah Ludmilla Bernier , Nicole Bobbette , Katharine Cardiff , Yona Lunsky

Background

Direct support professionals (DSPs) often play a critical role in supporting healthcare interactions for people with intellectual and developmental disabilities (IDD) but little is known about their experience supporting virtual healthcare.

Objective

This study explored utilization of virtual care and DSP experiences of supporting virtual care at four time points in Ontario, Canada.

Methods

DSPs in Ontario were invited to participate in an online survey in 2020 (n = 867), 2021 (n = 428), 2022 (n = 698) and 2023 (n = 603). This study focuses on the subset of questions related to DSP experience supporting virtual healthcare. Descriptive statistics were used to summarize quantitative data and content analysis was used to analyze open text responses.

Results

Over the four surveys, reported utilization of phone-based care was consistently higher (53–60 %) than video-based care (20–30 %). DSPs were more likely to provide positive feedback for video-based care compared with phone-based care, however, there was a decline in positive feedback for both over the four surveys. Though video-based care in particular was identified as valuable for patients who struggle to attend in-person appointments, ongoing challenges were reported including technical issues and poor communication quality.

Conclusions

Without the overwhelming concern of COVID transmission, for many patients, the benefits of virtual care may not outweigh the ongoing challenges. However, there appears to be a subset of people for whom virtual care can be critically important to support accessible care. DSPs require more training and resources to effectively support virtual healthcare visits.

背景：直接支持专业人员（dsp）通常在支持智力和发育障碍（IDD）患者的医疗保健互动方面发挥关键作用，但对他们支持虚拟医疗保健的经验知之甚少。目的：探讨加拿大安大略省四个时间点虚拟护理的使用情况和DSP支持虚拟护理的经验。方法：在2020年（n = 867）、2021年（n = 428）、2022年（n = 698）和2023年（n = 603）邀请安大略省的dsp参与在线调查。本研究的重点是与DSP体验支持虚拟医疗相关的问题子集。描述性统计用于总结定量数据，内容分析用于分析开放文本回复。结果：在四次调查中，报告的电话护理使用率（53- 60%）始终高于视频护理（20- 30%）。与基于电话的护理相比，dsp更有可能为基于视频的护理提供积极的反馈，然而，在四次调查中，两者的积极反馈都有所下降。尽管视频护理被认为对那些难以参加面对面预约的患者很有价值，但据报道，持续存在的挑战包括技术问题和沟通质量差。结论：如果没有对COVID传播的压倒性担忧，对许多患者来说，虚拟医疗的好处可能不会超过当前的挑战。然而，对于一部分人来说，虚拟护理对于支持可获得的护理至关重要。dsp需要更多的培训和资源来有效地支持虚拟医疗保健访问。

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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 : 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。

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引用次数: 0

Differences in substance use treatment receipt, perceived treatment need, and barriers to receiving treatment among US adults with and without disabilities, 2022–2023 2022-2023年，美国成年残疾人和非残疾人在药物使用治疗接收、感知治疗需求和接受治疗障碍方面的差异

IF 3.3 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2025-08-05 DOI: 10.1016/j.dhjo.2025.101934

Roberto Abadie , Manuel Cano

Background

People with disabilities (PWD) are at higher risk of experiencing substance use (SU) disorders than those without a disability. While treatment for SU reduces mortality and morbidity, currently there are no national-level studies comparing US adults with and without disabilities in terms of SU treatment receipt, perceived need, and barriers.

Objective

To examine differences between US adults with and without disabilities in terms of SU treatment receipt, perceived need for treatment, and barriers to receiving treatment.

Methods

This cross-sectional study examined National Survey on Drug Use and Health (NSDUH) 2022–2023 data (n = 89,167 adults) on self-reported disability and past-year substance use disorder (SUD), SU treatment, unmet treatment need, and treatment barriers. Analyses included weighted prevalence estimates, chi-squared tests (corrected for the survey design), and binomial logistic regression.

Results

An estimated 10.0 % of adults with a disability, versus 3.9 % without a disability, reported receiving past-year SU treatment. For adults with a past-year SUD who did not receive treatment, reporting a disability was associated with 70 % higher odds (Adjusted Odds Ratio [AOR] 1.70; 95 % Confidence Interval [CI], 1.27–2.28) of “unmet need” for SU treatment (after adjusting for demographics). Among adults who reported an “unmet need” for SU treatment, barriers related to cost and stigma were reported more frequently in those with, compared to those without, a disability.

Conclusions

Findings highlight elevated SU treatment need and barriers for PWD. Understanding the intersection of disability with the cascade of care, from screening to diagnosis and treatment of SU, is critical in improving health outcomes.

背景：残疾人（PWD）经历物质使用（SU）障碍的风险高于非残疾人。虽然SU的治疗降低了死亡率和发病率，但目前还没有国家级的研究比较美国有残疾和没有残疾的成年人在SU治疗接受情况、感知需求和障碍方面的差异。目的：研究美国残疾和非残疾成年人在接受SU治疗、感知治疗需求和接受治疗障碍方面的差异。方法：本横断面研究检查了国家药物使用和健康调查（NSDUH） 2022-2023年的数据（n = 89167名成年人），包括自我报告的残疾和过去一年的物质使用障碍（SUD）、SU治疗、未满足的治疗需求和治疗障碍。分析包括加权患病率估计、卡方检验（根据调查设计进行了修正）和二项逻辑回归。结果：据估计，10.0%的残疾成年人接受了过去一年的SU治疗，而没有残疾的成年人为3.9%。对于过去一年未接受治疗的成人SUD，报告残疾的几率高出70%(调整优势比[AOR] 1.70；95%可信区间[CI]， 1.27-2.28)的SU治疗“未满足需求”（在调整人口统计学因素后）。在报告“未满足需求”的SU治疗的成年人中，与没有残疾的人相比，有残疾的人报告的与费用和耻辱相关的障碍更频繁。结论：研究结果强调了PWD的SU治疗需求和障碍。了解残疾与从筛查到SU诊断和治疗的级联护理的交集，对于改善健康结果至关重要。

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