International disability studies最新文献

The case dossiers of 950 patients attending a rehabilitation centre were reviewed to permit appraisal of the value of the ICIDH for monitoring changes in disablement status under treatment. The approach was valuable for identifying people in need of rehabilitation services and for evaluating the care dispensed to such individuals. Certain problems in application of the ICIDH in practice are noted.

The components of three different rehabilitation programmes were analysed to determine the factors that influence functional outcomes and prosthetic costs. Age and additional health problems showed little relationship to inpatient activity level while the physical health status score had a significant relationship. The level of expectation in the rehabilitation programmes for walking independently with canes or without aids at discharge was shown to have a strong influence on the activity level attained and the length of rehabilitation stay. The style of socket did not appear to affect fitting success but had some effect on the efficiency of the prosthetic fitting process and the length of stay.

A description of a unique programme designed to train and support hospital-based rehabilitation generalists on remote Pacific islands is presented. The rationale for the training is discussed, the curriculum is described and the outcomes thus far are presented. The programme consists mainly of on-site training of indigenous health personnel centred around mobility aspects of physical rehabilitation. The project has been successful in enhancing local capabilities to deal with the needs of acutely and chronically disabled persons and reducing the need for off-island referrals.

The study (n = 261) focused on employment chances of Swedish visually impaired persons aged 25-45 years at the onset of their visual impairment, and who were employed at that time. It concerned persons who became visually impaired after 1974, the year when the Act on Security of Employment was passed. Although the Act has had an impact on employment opportunities, it is, however, no guarantee per se. Factors in the work environment accounted for improved chances of keeping the pre-disability employment. Individual factors were decisive in a person's chances of obtaining new employment. The least competitive groups of visually impaired were, in spite of the law, 'eliminated' from the labour market.

Objective: to define the use of disablement resettlement officers (DRO) by patients with locomotor disorders.

Design: questionnaire for patients with locomotor disorders potentially handicapping them from obtaining work.

Setting: outpatient clinics.

Patients: 52 patients, capable of work, aged 55 years or less, with a locomotor disorder; 19 had chronic arthritis and 18 back disorders. QUESTIONNAIRE: obtained details of diagnosis, work status, contact with DRO and results of referral.

Results: 21 had seen the DRO and three of these were dissatisfied; 15 were referred to the DRO and only three were placed in employment; 16 did not want referral to the DRO; overall 60% were unemployed.

Conclusions: Many patients are reluctant to see the DRO. Only a minority either attend or find work on referral. A modified system is needed to improve the employment prospects of patients with locomotor disorders.

This paper examines the various ways in which symptoms of chronic illness may be experienced. With particular reference to fatigue in multiple sclerosis, it discusses how the conceptualization of symptoms as discrete entities requiring targeted action (common in much current writing on chronic illness) is only one form in which physical disorder may be recognized by those directly affected, and one which probably applies little in the course of everyday life. The paper draws attention to the significance of personal and social context in symptom definition and to the implications for the measurement of symptoms and for advice to patients on management.

Controversy exists in the literature as to the accuracy of the formulae used in predicting oxygen consumption (VO2) during level walking. The purpose of this study was to develop an equation for use at speeds of 54-130 m min-1. The VO2 and energy expenditure (EE) of 25 healthy subjects were measured while walking on a level, motor-driven treadmill at four varying speeds (54, 81, 107 and 130 m min-1). The regression analyses revealed that a quadratic model was a better predictor (p less than 0.05) of both the VO2 and EE than a linear model. The quadratic equation relating VO2 and EE to walking speed (X) is as follows: VO2 (ml kg-1 min-1) = 17.77 - 0.3023X(m min-1) + 0.0027X2 (R2 = 0.935, SEE = 1.5) EE (kcal min-1) = 6.14 - 0.1076X (m min-1) + 0.00093X2 (R2 = 0.830, SEE = 0.89).

The object of the study was to investigate the frequency of physiological sexual dysfunction in a population of men with spinal cord injury (SCI). A questionnaire-based survey of admissions during 1980-84 was undertaken at a regional spinal cord injury rehabilitation unit. Male patients aged 20-63 years with complete or incomplete tetraplegia or paraplegia living in their own homes were included in the study; 43 complied with inclusion criteria, and 38 answered the questionnaire. Ninety-five per cent of the patients stated that they could obtain an erection, 61% on a purely reflex basis; 66% stated that erection was sufficient for coitus, and 45% that they could obtain ejaculation/emission. More patients with incomplete than complete lesions reported ability to obtain ejaculation/emission. Significantly, more of the patients aged below 30 years reported erection sufficient for coitus (p less than 0.05). Forty-five per cent of the patients experienced complications of sexual activity, mainly in the form of bladder dysfunction and pain or spasms. In conclusion, SCI is usually accompanied by considerable sexual dysfunction, but most patients are still capable of functioning sexually. Thus, in the rehabilitation process after SCI, sexual counselling and information may be valuable.

In Japan, many profoundly handicapped persons and their families are demanding day-care welfare facilities to ensure continued community life. Thus, 'Houmon-no-ie' was organized in 1986 to fulfil these needs. Forty-nine persons are enrolled at this facility; 67% suffer from cerebral palsy, and 43% exhibit very serious physical and mental disability (impossible to sit and IQ below 25). They show many medical problems such as poor general condition, respiratory disorder, etc. We report the purpose of this facility and the effects of day-care programmes.