Disability and Health Journal最新文献_第7页

Feasibility and preliminary efficacy of a skill-based lifestyle intervention for enhancing cooking abilities and physical fitness in young adults with intellectual disabilities 以技能为基础的生活方式干预对提高智力残疾青年烹饪能力和身体健康的可行性和初步效果。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-12-04 DOI: 10.1016/j.dhjo.2024.101767

Jessica C. Danon , Lyndsie Koon , Joseph R. Sherman , Anna M. Rice , Scott Quaife , Brian C. Helsel , Amy Bodde , Lauren T. Ptomey

Background

Individuals with intellectual disabilities (ID) often experience poorer diet quality and lower physical fitness levels as they transition from adolescence to adulthood.

Objective

The purpose of this study was to assess the initial feasibility and efficacy of Chef-ID, a 12-week intervention designed to improve cooking skills and physical function in young adults with ID.

Methods

Young adults with ID attended weekly group sessions which provided hands-on cooking skills, nutrition education, and exercise. Participants were also asked to attend monthly, virtual, goal setting sessions. Feasibility outcomes included attendance, retention, and safety. Preliminary efficacy outcomes included cooking skills, lower body muscle strength, grip strength, aerobic capacity, and body weight. Paired t-tests were used to assess the differences in cooking skills, strength measures, aerobic capacity, and weight after the 12-week intervention.

Results

Study retention was 95 %, attendance exceeded 85 % for all sessions, and no serious adverse events were reported. The number of cooking skills participants could do independently (p = 0.005), the number of cooking skills requiring only a verbal prompt (p = 0.01) and lower body strength (p = 0.004) significantly improved across the 12-week intervention. The number of cooking skills participants had no exposure to (p = 0.01) and weight (p = 0.036) significantly decreased across the intervention. No significant changes were observed for upper body strength or aerobic capacity.

Conclusions

The Chef-ID intervention was feasible with desirable initial effects on cooking skill independence, exposure to cooking skills, lower body strength, and weight. The Chef-ID intervention holds promise in enhancing cooking skills and physical function among young adults with ID.

Trial registration number

Clinicaltrials.gov, NCT05385016.

背景：智力残疾（ID）的个体在从青春期过渡到成年期时，通常会经历较差的饮食质量和较低的身体健康水平。目的：本研究的目的是评估Chef-ID的初步可行性和有效性，这是一项为期12周的干预措施，旨在提高患有ID的年轻人的烹饪技能和身体功能。方法：患有ID的年轻人参加每周的小组会议，提供动手烹饪技能，营养教育和锻炼。参与者还被要求参加每月一次的虚拟目标设定会议。可行性结果包括出勤率、留任率和安全性。初步疗效指标包括烹饪技能、下半身肌肉力量、握力、有氧能力和体重。配对t检验用于评估12周干预后烹饪技能、力量测量、有氧能力和体重的差异。结果：研究保留率为95%，所有疗程的出勤率超过85%，无严重不良事件报告。在为期12周的干预中，参与者可以独立完成的烹饪技能数量（p = 0.005）、只需要口头提示的烹饪技能数量（p = 0.01）和下半身力量（p = 0.004）显著提高。在整个干预过程中，没有接触到烹饪技能的参与者数量（p = 0.01）和体重（p = 0.036）显著减少。没有观察到上肢力量或有氧能力的显著变化。结论：Chef-ID干预是可行的，在烹饪技能独立性、烹饪技能暴露、下体力量和体重方面有良好的初步效果。Chef-ID干预有望提高患有ID的年轻人的烹饪技能和身体机能。试验注册号：Clinicaltrials.gov, NCT05385016。

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引用次数: 0

Natural disaster vulnerability among people with disabilities: Insights from the 2024 Household Pulse Survey 残疾人的自然灾害脆弱性：来自2024年家庭脉搏调查的见解。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-12-03 DOI: 10.1016/j.dhjo.2024.101763

Danielle Xiaodan Morales

Background

Natural disasters pose global challenges, with their frequency and severity increasing annually, impacting communities worldwide. People with disabilities are disproportionately vulnerable to experiencing adverse mental health outcomes in the aftermath of such events, yet this critical issue remains inadequately studied.

Objective

This paper examines the impact of natural disasters on people with disabilities, focusing on their displacement patterns and mental well-being, to enhance our understanding of health vulnerabilities and the specific needs in emergency response.

Methods

Data from the nationally representative 2024 Household Pulse Survey were analyzed to assess the duration of displacement and the severity of mental distress among individuals with and without disabilities following natural disasters. Generalized Estimating Equations were employed to predict post-disaster outcomes, adjusting for demographic characteristics, socioeconomic factors, and household structure.

Results

Individuals with vision disabilities (CI: 0.024–0.137) and those with multiple disabilities (CI: 0.020–0.068) experienced significantly longer periods of displacement compared to non-disabled people. Additionally, people with cognitive disabilities reported significantly higher levels of mental distress than their non-disabled counterparts (CI: 0.149–0.236).

Conclusion

Findings from this study demonstrate the need for specialized disaster response protocols that prioritize accessibility, mental health support, and targeted assistance for different disability types. Future emergency preparedness policies should incorporate disability-specific considerations, including enhanced evacuation planning, accessible mental health services, and strengthened community support systems. Disaster response frameworks must evolve to address these documented vulnerabilities, ensuring equitable support for all community members during and after natural disasters.

背景：自然灾害构成了全球性挑战，其频率和严重程度每年都在增加，影响着全世界的社区。在这些事件发生后，残疾人尤其容易遭受不良心理健康后果的影响，但这一关键问题仍未得到充分研究。目的：本文考察了自然灾害对残疾人的影响，重点关注他们的流离失所模式和心理健康，以增强我们对健康脆弱性和应急响应中的具体需求的理解。方法：分析来自具有全国代表性的2024年家庭脉搏调查的数据，以评估自然灾害后残疾人和非残疾人流离失所的持续时间和精神痛苦的严重程度。采用广义估计方程预测灾后结果，调整人口特征、社会经济因素和家庭结构。结果：视力障碍者（CI: 0.024-0.137）和多重障碍者（CI: 0.020-0.068）比非障碍者经历了更长的位移期。此外，有认知障碍的人报告的精神痛苦水平明显高于没有残疾的人（CI: 0.149-0.236）。结论：本研究的结果表明，需要制定专门的灾害响应协议，优先考虑无障碍、心理健康支持和针对不同残疾类型的有针对性的援助。未来的应急准备政策应纳入针对残疾人的考虑，包括加强疏散规划、提供无障碍精神卫生服务和加强社区支持系统。灾害应对框架必须不断发展，以解决这些记录在案的脆弱性，确保在自然灾害期间和之后为所有社区成员提供公平的支持。

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引用次数: 0

Intersectional inequities in maternal mortality: Examining the compounded risks for black birthing individuals with physical disabilities 产妇死亡率的交叉不平等：检查身体残疾的黑人生育个体的复合风险。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-12-03 DOI: 10.1016/j.dhjo.2024.101765

Ilhom Akobirshoev , Sarah Jerome , Jonathan M. Snowden , Jaime Slaughter-Acey , Anne Valentine , Willi Horner-Johnson , Monika Mitra

Background

People who are Black and have physical disabilities likely face a dual burden of risk for maternal mortality due to enduring systemic oppression rooted in racism and ableism.

Objective

To investigate maternal mortality risks among Black birthing individuals with physical disabilities in the United States and assess the potential compounding effect when these marginalized identities intersect.

Methods

We conducted a historical cohort study using the 2004–2021 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. The study included 8,263,997 delivery hospitalizations. We used modified Poisson regression to estimate unadjusted and adjusted relative risks (RR) of maternal mortality by race and physical disability status. We calculated the Relative Excess Risk due to Interaction (RERI) and Attributable Proportion (AP) to assess additive interaction between Black race and physical disability status.

Results

After adjusting for covariates, compared to their White birthing individuals, their Black peers experienced about 2.5 times (RR = 1.48,95%CI:2.08–2.96) the risk of maternal mortality. Compared to birthing individuals without physical disabilities, those with physical disabilities experienced nearly 11 times the (RR = 10.72,95%CI:8.15–14.10) risk of maternal mortality. Our adjusted additive interaction analysis revealed a significant super-additive effect (RERI = 11.3; AP = 0.47); suggesting that the combined effect of having both marginalized identities was greater than the sum of the individual effects of each identity.

Conclusions

Our findings provide evidence for substantial inequities in maternal mortality by Black race and physical disability status, with evidence of a compounding effect when these marginalized identities intersect. These results underscore the urgent need for intersectional approaches in maternal health interventions and policies.

背景：由于种族主义和残疾歧视的系统性压迫，身体残疾的黑人可能面临孕产妇死亡风险的双重负担。目的：调查美国黑人残疾产妇的孕产妇死亡风险，并评估这些边缘化身份交叉时的潜在复合效应。方法：我们使用2004-2021年医疗成本和利用项目全国住院患者样本进行了历史队列研究。该研究包括8,263,997例分娩住院病例。我们使用修正泊松回归来估计种族和身体残疾状况下未调整和调整的产妇死亡率相对风险（RR）。我们计算了相互作用的相对超额风险（Relative Excess Risk due to Interaction， RERI）和归因比例（Attributable ratio， AP），以评估黑人种族和身体残疾状况之间的附加相互作用。结果：调整协变量后，与白人分娩个体相比，黑人分娩个体的孕产妇死亡率风险约为2.5倍（RR = 1.48,95%CI:2.08-2.96）。与没有身体残疾的分娩个体相比，身体残疾的产妇死亡率风险几乎是其11倍（RR = 10.72,95%CI:8.15-14.10）。经校正的加性相互作用分析显示了显著的超加性效应(RERI = 11.3；ap = 0.47)；这表明拥有两种边缘化身份的综合影响大于每一种身份的个人影响的总和。结论：我们的研究结果为黑人种族和身体残疾状况在孕产妇死亡率方面的重大不平等提供了证据，并证明当这些边缘化身份交叉时，会产生复合效应。这些结果强调迫切需要在孕产妇保健干预措施和政策方面采取交叉方法。

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引用次数: 0

Social validity of Research Ethics for All: Social-behavioral research ethics education for community research partners with developmental disabilities 面向全体的研究伦理的社会效度：发展性残疾社区研究伙伴的社会行为研究伦理教育。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-28 DOI: 10.1016/j.dhjo.2024.101762

Ariel E. Schwartz , Katherine McDonald

Background

Training in research ethics supports community research partners with developmental disabilities to take on additional research responsibilities. We worked with an academic-community partnership to develop an accessible research ethics training tailored to the roles of community research partners with developmental disabilities that leads to certification: Research Ethics for All.

Objective

We evaluated the social validity of the educational activities and certification process.

Methods

We shared the training via a webinar and gathered feedback from attendees using polls (138 attendees; 92 respondents). In addition, four research teams composed of academic researchers and community research partners with developmental disabilities completed Research Ethics for All. Teams provided feedback on a series of surveys as they prepared to use the training, completed each of the 5 learning units, and after completing the training. We calculated descriptive statistics and used a pragmatic content analysis approach to analyze open-ended data.

Results

Teams were satisfied with the training and felt it supported learning. They endorsed the videos and learning activities but thought videos should be shorter. 68.5% of webinar attendees felt that Research Ethics for All covers essential information in social-behavioral research ethics. Several IRBs have approved the use of Research Ethics for All.

Conclusions

Research Ethics for All is an acceptable research ethics training that may support community research partners with developmental disabilities to take on important research responsibilities in social-behavioral research.

背景：研究伦理方面的培训支持有发育障碍的社区研究伙伴承担更多的研究责任。我们与一个学术社区伙伴关系合作，为有发育障碍的社区研究伙伴的角色量身定制了一种无障碍的研究伦理培训，从而获得了认证：人人享有研究伦理。目的：评价教育活动和认证过程的社会效度。方法：我们通过网络研讨会分享培训，并通过民意调查收集与会者的反馈(138名与会者；92受访者)。此外，由学术研究人员和有发育障碍的社区研究伙伴组成的四个研究小组完成了《全民研究伦理》。团队在准备使用培训、完成5个学习单元中的每一个单元以及完成培训后，对一系列调查提供反馈。我们计算了描述性统计数据，并使用了实用的内容分析方法来分析开放式数据。结果：团队对培训感到满意，并认为它支持学习。他们支持视频和学习活动，但认为视频应该更短。68.5%的与会者认为《全民研究伦理》涵盖了社会行为研究伦理的基本信息。几个内部审查委员会已经批准了《全民研究伦理》的使用。结论：面向所有人的研究伦理是一种可接受的研究伦理培训，可以支持有发育障碍的社区研究伙伴在社会行为研究中承担重要的研究责任。

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引用次数: 0

Rural disability, self-reliance, and the utilization of mental health services 农村残疾、自力更生和利用精神卫生服务。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-26 DOI: 10.1016/j.dhjo.2024.101761

Luke Santore , Catherine Ipsen , Gilbert Gimm

Background

The intersection of rurality, disability, self-reliance values, and utilization rates of mental health services (MHS) is under-researched.

Objective

To better understand the differences between unmet need and no perceived need for MHS between noncore, micropolitan, and metropolitan adults with disabilities.

Methods

We conducted logistic regression analyses of the 2022 National Survey on Health and Disability (NSHD) to identify associations between demographic characteristics and odds of reporting unmet need for MHS or no perceived need for MHS.

Results

Living in a noncore area, being male, lower educational attainment, older age, vision disability, and ambulatory disability were significantly associated with increased odds of reporting no perceived need for MHS. Being LGBTQIA+, poor transportation access, and cognitive disability were significantly associated with decreased odds of reporting no perceived need for MHS.

Cognitive disability, cohabitation, and poor transportation access were significantly associated with increased odds of reporting unmet need for MHS. Conversely, being male, having some college and/or a two-year degree were significantly associated with decreased odds of reporting unmet need for MHS. There were not significant differences in unmet need for MHS across rural indicators.

Conclusion

No perceived need of MHS is an underexplored factor among rural and urban adults with disabilities. Solutions include policies to expand MHS access, tailored public health outreach, and provider communication training.

背景：农村、残疾、自力更生价值观与心理健康服务（MHS）使用率的交叉关系研究不足。目的：更好地了解非核心、小城市和大城市残疾成人MHS未满足需求和无感知需求之间的差异。方法：我们对2022年全国健康与残疾调查（NSHD）进行了logistic回归分析，以确定人口统计学特征与报告未满足MHS需求或没有感知到MHS需求的几率之间的关联。结果：居住在非核心地区、男性、受教育程度较低、年龄较大、视力障碍和行动障碍与报告不需要MHS的几率显著相关。LGBTQIA+、交通不便和认知障碍与报告不需要MHS的几率显著降低相关。认知障碍、同居和交通不便与报告未满足MHS需求的几率增加显著相关。相反，作为男性，拥有一些大学和/或两年制学位与报告未满足MHS需求的几率显著降低相关。各农村指标未满足的卫生保健需求没有显著差异。结论：在农村和城市残疾成人中，没有感知到MHS需求是一个未被充分研究的因素。解决方案包括扩大MHS准入的政策、量身定制的公共卫生外展以及提供者沟通培训。

{"title":"Rural disability, self-reliance, and the utilization of mental health services","authors":"Luke Santore , Catherine Ipsen , Gilbert Gimm","doi":"10.1016/j.dhjo.2024.101761","DOIUrl":"10.1016/j.dhjo.2024.101761","url":null,"abstract":"<div><h3>Background</h3><div>The intersection of rurality, disability, self-reliance values, and utilization rates of mental health services (MHS) is under-researched.</div></div><div><h3>Objective</h3><div>To better understand the differences between <em>unmet need</em> and <em>no perceived need</em> for MHS between noncore, micropolitan, and metropolitan adults with disabilities.</div></div><div><h3>Methods</h3><div>We conducted logistic regression analyses of the 2022 National Survey on Health and Disability (NSHD) to identify associations between demographic characteristics and odds of reporting <em>unmet need</em> for MHS or <em>no perceived need</em> for MHS.</div></div><div><h3>Results</h3><div>Living in a noncore area, being male, lower educational attainment, older age, vision disability, and ambulatory disability were significantly associated with increased odds of reporting <em>no perceived need</em> for MHS. Being LGBTQIA+, poor transportation access, and cognitive disability were significantly associated with decreased odds of reporting <em>no perceived need</em> for MHS.</div><div>Cognitive disability, cohabitation, and poor transportation access were significantly associated with increased odds of reporting <em>unmet need</em> for MHS. Conversely, being male, having some college and/or a two-year degree were significantly associated with decreased odds of reporting <em>unmet need</em> for MHS. There were not significant differences in <em>unmet need</em> for MHS across rural indicators.</div></div><div><h3>Conclusion</h3><div><em>No perceived need</em> of MHS is an underexplored factor among rural and urban adults with disabilities. Solutions include policies to expand MHS access, tailored public health outreach, and provider communication training.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 2","pages":"Article 101761"},"PeriodicalIF":3.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755727","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

Intellectual disabilities and risk of cardiovascular diseases: A population-based cohort study 智障与心血管疾病风险：一项基于人群的队列研究。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-17 DOI: 10.1016/j.dhjo.2024.101754

In Young Cho , Hye Yeon Koo , Yoo Jin Um , Yong-Moon Mark Park , Kyung Mee Kim , Chung Eun Lee , Kyungdo Han

Background

While intellectual disability is associated with higher mortality rates due to circulatory diseases, it is unclear whether intellectual disability is associated with higher risk of myocardial infarction (MI) and stroke than the general population.

Objectives

We aimed to analyze the risk of cardiovascular diseases (CVD), specifically myocardial infarction (MI) and ischemic stroke, and death due to circulatory diseases in individuals with disability.

Methods

This retrospective cohort study used data from the National Disability Registration System linked to the Korean National Health Insurance Service database. Individuals who underwent national health examinations in 2009 were followed until 2020. Cox-proportional hazard analyses were performed to estimate the risk of CVD, MI, ischemic stroke, and circulatory disease deaths with adjustment for covariates.

Results

A total of 3642 individuals with intellectual disability (mean [SD] age 39.1 [12.6], 28.8 % female) and 3,889,794 individuals without intellectual disability (mean [SD] age 47.1 [13.9], 45.6 % female) were included. Compared to those without intellectual disability, those with intellectual disability had higher risk of CVD (adjusted hazard ratio [aHR] 1.71, 95 % confidence interval [CI] 1.45–2.02), ischemic stroke (aHR 2.21, 95 % CI 1.81–2.69), and death due to circulatory diseases (aHR 4.20, 95 % CI 3.24–5.45), and a non-significant risk for MI (aHR 1.24, 95 % CI 0.95–1.63) after full adjustment for covariates.

Conclusions

Individuals with intellectual disability were at increased risk of CVD, in particular ischemic stroke, and death due to circulatory diseases. Healthcare professionals should be aware of increased CVD risk in individuals with intellectual disability.

背景：智力残疾与循环系统疾病导致的较高死亡率有关：虽然智力残疾与循环系统疾病导致的较高死亡率有关，但智力残疾是否与心肌梗塞（MI）和中风的风险高于普通人群有关，目前尚不清楚：我们旨在分析智障人士罹患心血管疾病（CVD）的风险，尤其是心肌梗死（MI）和缺血性中风，以及因循环系统疾病导致死亡的风险：这项回顾性队列研究使用的数据来自与韩国国民健康保险服务数据库相连接的国家残疾登记系统。研究人员对 2009 年接受国民健康检查的人进行了跟踪调查，直至 2020 年。在对协变量进行调整后，对心血管疾病、心肌梗死、缺血性中风和循环系统疾病死亡的风险进行了Cox比例危险分析：共纳入 3642 名智障者（平均 [SD] 年龄为 39.1 [12.6]，28.8% 为女性）和 3889794 名非智障者（平均 [SD] 年龄为 47.1 [13.9]，45.6% 为女性）。与非智障者相比，智障者患心血管疾病（调整后危险比 [aHR] 1.71，95 % 置信区间 [CI] 1.45-2.02）、缺血性中风（aHR 2.21，95 % CI 1.81-2.69）和循环系统疾病导致死亡（aHR 4.20，95 % CI 3.24-5.45）的风险较高，在对协变量进行全面调整后，患心肌梗死（aHR 1.24，95 % CI 0.95-1.63）的风险不显著：结论：智障人士罹患心血管疾病（尤其是缺血性中风）和死于循环系统疾病的风险增加。医疗保健专业人员应注意智障人士心血管疾病风险的增加。

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引用次数: 0

Comparison of the prevalence of metabolic syndrome between individuals with spinal cord injury and the general population based on the cutoff values of abdominal obesity 基于腹部肥胖截断值的脊髓损伤个体与普通人群代谢综合征患病率的比较

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-17 DOI: 10.1016/j.dhjo.2024.101753

Jisun Lim , Hyun-Jin Kim , Onyoo Kim

Background

Metabolic syndrome (MetS) is a cluster of cardiovascular disease (CVD) risk factors. Accurate diagnosis, in spinal cord injury (SCI) patients, is vital for effective CVD prevention.

Objective

This study aimed to identify factors related to MetS prevalence by comparing MetS prevalence trends in SCI and the general population (GP) and to examine differences in MetS prevalence in patients with SCI according to the cutoff reference value for abdominal obesity.

Methods

This retrospective cohort study analyzed data from the National Health Insurance Corporation from 2015 to 2019. MetS was defined using the National Cholesterol Education Program criteria with an adjusted waist circumference of 81.3 cm for patients with SCI. Data were collected on age, gender, smoking, alcohol consumption, BMI, waist circumference, lipid profiles, blood pressure, fasting glucose, and socioeconomic status. Each year, SCI patients (n = 3,140, n = 3,201, n = 3,503, n = 1,590, n = 1544) were matched with GP individuals (m = 31,400, m = 32,040, m = 35,030, m = 15,900, m = 15,440).

Results

Over 5 years, MetS prevalence increased in both groups, consistently higher in the SCI group. Older age and lower income were risk factors in both groups (p < 0.05). Smoking and alcohol intake were significant only in the GP (p < 0.0001). Using the adjusted obesity criterion, MetS prevalence was 1.4 times higher in SCI patients than in the GP (p < 0.0001).

Conclusions

Exclusively relying on GP criteria for diagnosing MetS in patients with SCI may lead to an underestimation of MetS prevalence and overlooked opportunities for CVD prevention. Therefore, the development of diagnostic and preventive strategies for MetS considering SCI characteristics is needed.

背景：代谢综合征（MetS）是一组心血管疾病（CVD）危险因素。在脊髓损伤（SCI）患者中，准确的诊断对于有效预防CVD至关重要。目的：本研究旨在通过比较脊髓损伤（SCI）与普通人群（GP）的MetS患病率趋势，确定与MetS患病率相关的因素，并根据腹型肥胖的截止参考值，探讨SCI患者MetS患病率的差异。方法：回顾性队列研究分析2015 - 2019年国民健康保险公司的数据。根据国家胆固醇教育计划标准，脊髓损伤患者调整后的腰围为81.3 cm。收集的数据包括年龄、性别、吸烟、饮酒、BMI、腰围、血脂、血压、空腹血糖和社会经济地位。每年,SCI患者(n = 3140, n = 3201, n = 3503, n = 1590, n = 1544)是与GP个体(m = 31400米= 32040米= 35030,m = 15900 = 15440)。结果：在5年多的时间里，两组的met患病率都有所增加，SCI组始终较高。年龄较大和收入较低是两组患者的危险因素(p结论：完全依靠全科医生的标准来诊断脊髓损伤患者的MetS可能会导致低估MetS的患病率，并忽视CVD预防的机会。因此，需要发展考虑SCI特征的MetS诊断和预防策略。

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引用次数: 0

Examining the impact of the COVID-19 pandemic among staff and consumers at Florida centers for independent living 研究 COVID-19 大流行病对佛罗里达独立生活中心员工和消费者的影响。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-16 DOI: 10.1016/j.dhjo.2024.101751

Acquel Allen-Mitchell , Nichole E. Stetten , Kashif Basaria , Lauren Cox , Nicole M. Marlow

Background

People with disabilities (PWD) face health disparities due to barriers that limit their access to essential healthcare services. During the COVID-19 pandemic, health disparities among PWD increased as stay-at-home mandates and other safety measures interrupted access to healthcare and social services. Community-based and consumer-driven Centers for Independent Living (CILs) attempt to reduce disparities faced by PWD by providing information and referrals, peer counseling, and advocacy.

Objective

Despite funding to utilize public health workers to respond to the COVID-19 pandemic and prepare for future crises, the literature currently lacks examinations of the impact of the COVID-19 pandemic on CIL consumers and staff.

Methods

This qualitative study employed a directed content analysis to evaluate 6 consumer focus groups (N = 35) and 4 staff focus groups (N = 14).

Results

Through data analysis, staff themes included Resource Gaps, COVID-19 Concerns, Impact on Independence, Impact on Health, Work Demand Changes, and Work/Life Balance. Among consumers, themes of CIL Service Experiences, CIL Benefits, COVID-19 Concerns of Using CILs, COVID-19 Barriers to Using CILs, Impact on Independence, Impact on Health, Resource Gaps, and Recommendations for CILs were present.

Conclusions

This study demonstrates the diverse experiences among PWD during the COVID-19 pandemic. However, there are similarities in the impact of environmental factors on the severity of disability experienced by consumers and staff. This study highlights the benefits of independent community living resource centers and the need to better understand the experiences of PWD to prepare for future pandemics.

背景：残疾人（PWD）在获得基本医疗保健服务方面受到各种障碍的限制，因而在健康方面面临着差异。在 COVID-19 大流行期间，由于留守在家的规定和其他安全措施中断了获得医疗保健和社会服务的途径，残疾人的健康差距加大。以社区为基础、由消费者驱动的独立生活中心（CILs）试图通过提供信息和转介、同伴咨询和宣传来减少残疾人面临的差距：尽管有资金利用公共卫生工作人员应对 COVID-19 大流行并为未来的危机做好准备，但目前的文献缺乏对 COVID-19 大流行对 CIL 消费者和工作人员的影响的研究：这项定性研究采用了定向内容分析法，对 6 个消费者焦点小组（35 人）和 4 个员工焦点小组（14 人）进行了评估：通过数据分析，工作人员的主题包括资源缺口、COVID-19 关注点、对独立性的影响、对健康的影响、工作需求变化以及工作与生活的平衡。在消费者中，主题包括 CIL 服务体验、CIL 益处、COVID-19 使用 CIL 的顾虑、COVID-19 使用 CIL 的障碍、对独立性的影响、对健康的影响、资源缺口以及对 CIL 的建议：这项研究表明，在 COVID-19 大流行期间，残疾人的经历各不相同。然而，在环境因素对消费者和工作人员所经历的残疾严重程度的影响方面存在相似之处。本研究强调了独立社区生活资源中心的益处，以及更好地了解残疾人经历的必要性，以便为未来的大流行做好准备。

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引用次数: 0

Needs beyond coverage: Health care inequities among children with disabilities of parents with disabilities 覆盖范围之外的需求：残疾儿童或残疾父母之间的医疗保健不平等。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-16 DOI: 10.1016/j.dhjo.2024.101755

Christy Pu , Shu-Fang Shih , Yiing-Jenq Chou

Background

Family aggregation of disability is not uncommon. Research on children with disabilities has often overlooked a specific group facing health disparities: children with disabilities of parents with disabilities.

Objective

To determine whether children with disabilities, whose parents also have disabilities, experience limited access to health care.

Methods

This is a dynamic cohort study. The data used in this study were the 2017–2021 Taiwan's National Disability Registry and the National Health Insurance claims data. All children were matched to their biological fathers and mothers using a unique anonymous identification number to identify the disability status of the children and their parents and the receipt of health care services by the children.

Results

In 2021, a total of 2 834 870 pairs of children and parents were identified, of whom 53,419 were children with disabilities. Of these, 5188 had at least one parent with disabilities. Compared with children whose parents did not have disabilities, those whose parents both had disabilities had 1.71 fewer outpatient visits per year (P = .013). Compared with children whose parents had no disabilities, those whose parents had disabilities had 5.0 and 4.2 fewer general outpatient visits at birth (P < .001) and at the age of 2 years (P < .001), respectively. The magnitude of this effect decreased as the children's age increased.

Conclusions

Children with disabilities whose parents also have disabilities may underutilize health care even in settings such as Taiwan, where universal health coverage is available. Standard health programs do not eliminate health care utilization disparities for such children.

背景：残疾家庭聚集并不罕见。对残疾儿童的研究往往忽视了面临健康差距的一个特定群体：残疾父母的残疾儿童。目的：确定父母也有残疾的残疾儿童获得医疗保健的机会是否有限。方法：这是一项动态队列研究。本研究使用的数据为2017-2021年台湾残障登记和国民健康保险理赔数据。使用唯一的匿名识别号码将所有儿童与其亲生父亲和母亲进行匹配，以确定儿童及其父母的残疾状况以及儿童获得的医疗保健服务。结果：2021年共鉴定儿童及家长2 834 870对，其中残疾儿童53419对。其中，5188人的父母中至少有一人患有残疾。与父母均为残疾的儿童相比，父母均为残疾的儿童每年的门诊次数减少1.71次（P = 0.013）。与父母无残疾的儿童相比，父母有残疾的儿童出生时的普通门诊就诊次数分别减少了5.0和4.2次(P结论：即使在台湾这样的全民健康覆盖地区，父母也有残疾的残疾儿童也可能未充分利用医疗保健。标准的健康计划并不能消除这些儿童的医疗保健利用差距。

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引用次数: 0

Exhibiting lived experiences of disability in a hospital workplace: A qualitative evaluation 在医院工作场所展示残疾人士的生活经历：定性评估。

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal

Pub Date : 2024-11-15 DOI: 10.1016/j.dhjo.2024.101752

Nina Michelle Worthington, Charlotte Grainger

Background

Beyond the Stigma (BTS) was an exhibition of stories about staff with physical and hidden impairments at the Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.

Objective

Evaluative research aimed to examine BTS's long-term impact on participants who publicly shared lived experiences of disability in their hospital workplace. It also sought to discover how arts-based interventions can effectively identify and promote nuanced disability understandings and the wellbeing of disabled people working in healthcare.

Methods

Interpretative Phenomenological Analysis (IPA) interviews were conducted with six hospital staff. Transcripts were analyzed in depth.

Results

Three superordinate themes emerged from the data, Process of Hesitancy and Comfort, Perceptions of Impact and Contribution, and Journeying with Disability Understandings. These captured personal narratives of how it felt to disclose impairment and perceptions of the project's impact. Long-term benefits of taking part in BTS were identified as increased self-confidence, openness, self-acceptance, and empowerment. Shifts in participants' personal disability views pointed to improved quality of life inside and outside the workplace through new awareness of diverse and shared experiences, new ease with disability definitions, language, self-identity, and community participation.

Conclusion

Study findings exposed levels of risk, resilience, and compromise associated with sharing personal experiences of disability, and how these can be managed effectively in the workplace. BTS offers a model for health promotion and community participation across disabled and non-disabled communities that can be repeated and adapted to support employment strategies, shift understandings, and promote notions of disability gain and disability pride across healthcare settings.

背景：英国伯明翰皇家矫形外科医院 NHS 基金信托基金会举办了 "超越耻辱"（BTS）展览：英国伯明翰皇家骨科医院 NHS 基金会信托基金会举办了 "超越耻辱"（BTS）展览，展出了有身体缺陷和隐性缺陷的员工的故事：评估研究旨在考察 "超越障碍 "对在医院工作场所公开分享残疾生活经历的参与者的长期影响。研究还试图发现基于艺术的干预措施如何能够有效识别和促进对残疾的细致入微的理解，以及在医疗保健领域工作的残疾人的福祉：方法：对六名医院员工进行了解释性现象学分析（IPA）访谈。对访谈记录进行了深入分析：结果：从数据中发现了三个首要主题，即犹豫和舒适的过程、对影响和贡献的看法以及对残疾的理解。这些主题反映了个人对披露残障状况的感受以及对项目影响的看法。参加 BTS 的长期益处被认为是增强了自信心、开放性、自我接纳和能力。参与者个人残疾观点的转变表明，通过对不同和共同经历的新认识，对残疾定义、语言、自我认同和社区参与的新适应，工作场所内外的生活质量都得到了改善：研究结果揭示了与分享个人残疾经历相关的风险、复原力和妥协程度，以及如何在工作场所有效管理这些风险、复原力和妥协程度。BTS 为残疾人和非残疾人社区的健康促进和社区参与提供了一种模式，这种模式可以重复使用并加以调整，以支持就业策略、转变理解，并在医疗保健环境中促进残疾收益和残疾自豪感的概念。

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引用次数: 0