Health Promotion for Persons with Disabilities: Moving beyond Rehabilitation

1988 ◽  
Vol 2 (4) ◽  
pp. 29-44 ◽  
Author(s):  
Michael Marge
Keyword(s):  
Health Promotion ◽  
Significant Risk ◽  
Disabled Persons ◽  
Rehabilitation Program ◽  
Persons With Disabilities ◽  
Rehabilitation Process ◽  
Effective Components ◽  
Increased Risk ◽  
Comprehensive Health ◽  
Quality Programs

Persons with disabilities are at significant risk for additional or secondary disabilities. Because of this increased risk, especially for persons suffering from the “disuse syndrome,” it is important that a comprehensive health promotion component is included in the rehabilitation program for disabled individuals. Current concepts of disability are discussed as well as the distinctions between primary and secondary disabilities. Specific types and causes of disabilities are identified and described. Each type of secondary disability is assessed in terms of its “preventability.” Examples and characteristics of quality programs for health promotion for disabled persons are presented. Recommendations for further research and study are discussed to include the need for determining effective components of successful programs and ways to encourage the field of rehabilitation to incorporate health promotion into the rehabilitation process for its disabled clients.

To the question about problems in the fi eld of vocational rehabilitation of the disabled

2020 ◽  
pp. 12-23
Author(s):  
Y. A. Kulikova ◽  
A. V. Kornienko ◽  
G. V. Jukevich
Keyword(s):  
Vocational Rehabilitation ◽  
Russian Federation ◽  
Social Protection ◽  
Disabled Persons ◽  
Rehabilitation Program ◽  
The State ◽  
Disabled People ◽  
Persons With Disabilities ◽  
The Disabled ◽  
The Russian Federation

The article deals with issues related to the problem of vocational rehabilitation of disabled people. The competence of the Russian Federation in the fi eld of rehabilitation of disabled persons in the person of its Federal authorities and management, subjects of the Russian Federation and local self-government bodies is specifi ed. The content of such concepts as "services for professional rehabilitation of disabled people" in accordance with the state standard GOST R 53873-2010 Rehabilitation of disabled people is disclosed. Professional rehabilitation services for the disabled; "professional rehabilitation program" and "options for professional rehabilitation". Despite the fact that professional rehabilitation and adaptation in the workplace is an integral part of the state policy in the fi eld of social protection of persons with disabilities, there are many unresolved problems and diffi culties in this area.

scholarly journals Physicians' Perceptions of Barriers to Equal Access to Reproductive Health Promotion for Women with Mobility Impairment

2018 ◽  
Vol 7 (1) ◽  
pp. 62-100 ◽  
Author(s):  
Meera Joseph ◽  
Sujen Saravanabavan ◽  
Jeff Nisker
Keyword(s):  
Health Promotion ◽  
Reproductive Health ◽  
Information Provision ◽  
Disabled Persons ◽  
Physician Attitudes ◽  
Pap Smears ◽  
Mobility Impairment ◽  
Additional Time ◽  
Persons With Disabilities ◽  
Lack Of Information

In Canada, 15% of women report having a disability, most frequently mobility-related. Research with women with disabilities has for decades brought attention to barriers to reproductive health promotion. Research with physicians regarding why these barriers exist and how they can be dissolved has not occurred. Physicians were recruited through email and pamphlets to participate in 30-45 minute in-person interviews, audiotaped and transcribed verbatim.  Charmaz-based qualitative analysis was supported by NVivo10TM software. Twenty-five interviews were conducted before theoretical sufficiency. Six themes were co-constructed: I-Physicians’ Perceptions of Barriers; II-Physicians' Perceptions of Consequences of Barriers; III-Resolving Barriers; IV-Physicians’ Sub-Understanding of Legal Right to Accommodation; V-Obligation of Physicians to Advocate for Accommodation; and VI-Language Suggesting Physicians’ Lack of Understanding of How Persons with Disabilities See Themselves and Want to be Seen. Physicians identified physical access barriers previously identified in critical disability studies literature, but did not identify the barriers of physician attitudes and lack of information provision as reported in this literature. Physicians perceived their additional time for pap smears and other surveillance strategies as barriers, particularly when not remunerated. Physicians were unaware of their legal obligation to accommodate under human rights codes, perceiving that taking extra time to provide accommodation was doing so out of the "goodness of your heart". Physicians used language illustrating many were unaware of how disabled persons see themselves and want to be seen. Education regarding disability rights and culture must be introduced immediately and prominently into all levels of medical education, with the educators being people with disabilities. 

scholarly journals Aspects of rehabilitation of disabled elderly persons in the Russian Federation

2016 ◽  
Vol 19 (3) ◽  
pp. 116-122 ◽  
Author(s):  
S. N Puzin ◽  
Marina A. Shurgaya ◽  
M. A Shkurko ◽  
I. A Krasnomyasova ◽  
S. N Khristophorov ◽  
...  
Keyword(s):  
Russian Federation ◽  
Social Protection ◽  
Care Home ◽  
Disabled Persons ◽  
Rehabilitation Program ◽  
Elderly Persons ◽  
Evaluation Tool ◽  
Persons With Disabilities ◽  
Disabled Patients ◽  
The Russian Federation

The article presents the results of the study of recommendations both for the rehabilitation of citizens, recognized primary and re-examination as disabled patients in the Russian Federation (2014). A positive result of the implementation of individual rehabilitation program was achieved in 45.1% of persons with disabilities, with the most significant recovery rates being at the level of 51.7% (integration of disabled persons in the family and society) and 50.8% (achievement of a partial compensation of lost functions). Disturbed functions were partially restored in 28.6% ofpersons with disabilities. As a result of the analysis of questionnaires of the evaluation tool (308forms), performed in the Care Home of Labor Veterans number 17, the Department of Labor and Social Protection of Moscow, there was revealed the medical and social status of persons with disabilities staying in this institution. The gender structure ofpersons with disabilities is characterized by a slight predominance ofwomen (59.7%) versus 40.3% of men. Among of all persons with disabilities there are dominated people aged of 75-89 years (51.9%). In the implementation of the comprehensive rehabilitation of disabled patients the need in drug therapy accounts of 100%, in the physiotherapy treatment - 89.6%, and physical therapy methods are used in 99.4% ofpersons with disabilities. With bearing in mind medical indications there are applied methods of socio-environmental, social and domestic, socio-psychological, sociocultural (art therapy, library therapy and adaptive physical education). For the creation of a barrier-free environment patients with disabilities are provided with the technical means of Rehabilitation. At the end of 2014 16.0 thousand people stand on the waiting list for the admission in stationary social care institutions for adults in the Russian Federation. With taking into account of demographical situation of an aging of the population and the gain in the demand for stationary establishments [2] intended for living of the older generation of people who cannot take care of themselves independently and need constant assistance, the further development of the social service system is feasible and has an important medical health value.

A Health Promotion Strategy for Persons with Disabilities

1994 ◽  
Vol 25 (2) ◽  
pp. 3-6
Author(s):  
Henry D. Wong ◽  
Ann Neulicht
Keyword(s):  
Health Promotion ◽  
Rehabilitation Counseling ◽  
Rehabilitation Program ◽  
Promotion Strategy ◽  
Persons With Disabilities ◽  
Rehabilitation Professionals ◽  
Health Promotion Strategy ◽  
Promotion Strategies

Rehabilitation professionals have focused little attention on health promotion strategies for persons with disabilities. The purpose of this article is define and identify components of a health promotion strategy which may be incorporated into a rehabilitation program. The application and utility of integrating health promotion is discussed, and recommendations are provided for rehabilitation counseling.

Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Cun-Xian Jia ◽  
Lin-Lin Wang ◽  
Ai-Qiang Xu ◽  
Ai-Ying Dai ◽  
Ping Qin
Keyword(s):  
Risk Factor ◽  
Family Income ◽  
Rural China ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Health Condition ◽  
Physical Illness ◽  
Rural Residents ◽  
Increased Risk ◽  
Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

scholarly journals The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Katarina Bremme ◽  
Sonja Honkanen ◽  
Iva Gunnarsson ◽  
Roza Chaireti
Keyword(s):  
Caesarean Section ◽  
Lupus Nephritis ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Premature Birth ◽  
Renal Involvement ◽  
Significant Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

Association between Pre-Existing Coronary Artery Disease and 5-Year Mortality in Stroke Patients with High-Grade Carotid Artery Stenosis

2020 ◽  
pp. 1-7
Author(s):  
Ching-I Wu ◽  
Chia-Lun Wu ◽  
Feng-Chieh Su ◽  
Shun-Wen Lin ◽  
Wen-Yi Huang
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Carotid Artery ◽  
Carotid Artery Stenosis ◽  
Significant Risk ◽  
Cox Proportional Hazards Model ◽  
Artery Stenosis ◽  
High Grade ◽  
Increased Risk ◽  
Artery Disease

<b><i>Background:</i></b> The coincidence of coronary artery disease (CAD) and carotid artery stenosis (CAS) was observed. However, the association between pre-existing CAD and ischemic stroke (IS) outcome in patients with high-grade CAS remains unclear. We aimed to investigate the association between pre-existing CAD and outcomes of acute IS patients with high-grade CAS. <b><i>Methods:</i></b> From January 1, 2007, to April 30, 2012, we enrolled 372 acute IS patients with high-grade CAS and prospectively observed them for 5 years. Demographic features, vascular risk factors, comorbidities, and outcomes were compared between patients with and without pre-existing CAD. <b><i>Results:</i></b> Among 372 individuals, 75 (20.2%) patients had pre-existing CAD and 297 (79.8%) patients did not have pre-existing CAD. The prevalence rates of hypertension, congestive heart failure, chronic kidney disease, and gout in patients with pre-existing CAD were significantly higher than in those without pre-existing CAD (<i>p</i> = 0.017, <i>p</i> &#x3c; 0.001, <i>p</i> = 0.002, and <i>p</i> &#x3c; 0.001, respectively). The multivariate Cox proportional hazards model revealed that pre-existing CAD was a significant risk factor for a 5-year all-cause mortality in acute IS patients with high-grade CAS (hazard ratio = 2.26; 95% confidence interval = 1.35–3.79; <i>p</i> = 0.002). <b><i>Conclusion:</i></b> Pre-existing CAD was associated with an increased risk of 5-year mortality in acute IS patients with high-grade CAS. Intensive treatment for the pre-existing CAD may reduce long-term mortality in acute IS patients with high-grade CAS.

scholarly journals The Risk of Necrotizing Enterocolitis following the Administration of Hyperosmolar Enteral Medications to Extremely Preterm Infants

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Faiza Latheef ◽  
Hanna Wahlgren ◽  
Helene Engstrand Lilja ◽  
Barbro Diderholm ◽  
Mattias Paulsson
Keyword(s):  
Clinical Practice ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
Quality Register ◽  
Increased Risk ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Hyperosmolar Solutions

<b><i>Introduction:</i></b> Necrotizing enterocolitis (NEC) is a disease predominantly affecting preterm infants. The administration of hyperosmolar solutions could lead to the development of NEC. The objective of this study was to measure the osmolality of enteral medications used in clinical practice and to assess the risk of NEC following exposure to hyperosmolar medications. <b><i>Methods:</i></b> A retrospective cohort study in extremely preterm infants (gestational age &#x3c;28 weeks) born between 2010 and 2016 at a tertiary neonatal intensive care unit in Sweden. 465 infants were identified via the Swedish Neonatal Quality register. Data relating to enteral administrations received during a two-week period were collected from the medical records. The osmolalities of medications were measured using an osmometer. Logistic regression was used to calculate the odds ratio of developing NEC. <b><i>Results:</i></b> A total of 253 patients met the inclusion criteria. The osmolalities of 5 commonly used medications significantly exceeded the recommended limit of 450 mOsm/kg set by the American Academy of Paediatrics (AAP). Most patients (94%) received at least one hyperosmolar medication. No significant risk of developing NEC could be found. <b><i>Conclusion:</i></b> The medications used in clinical practice can significantly exceed the limit set by the AAP. This study does not indicate an increased risk of developing NEC in extremely preterm infants following exposure to hyperosmolar medications. Further studies in larger cohorts are needed to determine the specific cut-off level of osmolality in relation to the pathogenesis of NEC.

Post-Bariatric Abdominoplasty: Analysis of 406 Cases With Focus on Risk Factors and Complications

2020 ◽  
Vol 41 (1) ◽  
pp. 59-71 ◽  
Author(s):  
Torsten Schlosshauer ◽  
Marcus Kiehlmann ◽  
Diana Jung ◽  
Robert Sader ◽  
Ulrich M Rieger
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Surgical Technique ◽  
Significant Risk ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Wound Healing Problems ◽  
Bariatric Patients

Abstract Background Post-bariatric patients present a surgical challenge within abdominoplasty because of residual obesity and major comorbidities. In this study, we analyzed complications following abdominoplasty in post-bariatric patients and evaluated potential risk factors associated with these complications. Objectives The authors sought to determine the complications and risk factors following abdominoplasty in post-bariatric patients. Methods A retrospective study of patients who underwent abdominoplasty was performed from January 2009 to December 2018 at our institution. Variables analyzed were sex, age, body mass index (BMI), smoking, surgical technique, operative time, resection weight, drain output, and complications. Results A total of 406 patients were included in this study (320 female and 86 male) with a mean age of 44.4 years and a BMI of 30.6 kg/m2. Abdominoplasty techniques consisted of traditional (64.3%), fleur-de-lis technique (27.3%), and panniculectomy without umbilical displacement (8.4%). Overall complications recorded were 41.9%, the majority of these being wound-healing problems (32%). Minor and major complications were found in 29.1% and 12.8% of patients, respectively. A BMI value of ≥30 kg/m2 was associated with an increased risk for wound-healing problems (P = 0.001). The frequency of total complications was significantly related to age (P = 0.007), BMI (P = 0.004), and resection weight (P = 0.001). Abdominoplasty technique tended to influence total complications. Conclusions This study demonstrates in a fairly large sample of post-bariatric patients (n = 406) that abdominoplasty alone can be performed safely, with an acceptable complication rate. Age, BMI, and resection weight are shown to be significant risk factors for total complications. The role of surgical technique needs to be evaluated further. Level of Evidence: 4

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