Research

19 pages, 414 KiB

Open AccessArticle

Gender Identity, Disability, and Unmet Healthcare Needs among Disabled People Living in the Community in the United States

by Abigail Mulcahy, Carl G. Streed, Jr., Anna Marie Wallisch, Katie Batza, Noelle Kurth, Jean P. Hall and Darcy Jones McMaughan

Int. J. Environ. Res. Public Health 2022, 19(5), 2588; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052588 - 23 Feb 2022

Cited by 13 | Viewed by 4963

Abstract

Disabled adults and transgender people in the United States face multiple compounding and marginalizing forces that result in unmet healthcare needs. Yet, gender identity among disabled people has not been explored, especially beyond binary categories of gender. Using cross-sectional survey data, we explored [...] Read more.

Disabled adults and transgender people in the United States face multiple compounding and marginalizing forces that result in unmet healthcare needs. Yet, gender identity among disabled people has not been explored, especially beyond binary categories of gender. Using cross-sectional survey data, we explored the rates of disability types and the odds of unmet healthcare needs among transgender people with disabilities compared to cisgender people with disabilities. The rates of disability type were similar between transgender and cisgender participants with two significant differences. Fewer transgender participants identified physical or mobility disability as their main disability compared to cisgender participants (12.31%/8 vs. 27.68/581, p < 0.01), and more transgender participants selected developmental disability as their main disability compared to cisgender participants (13.85%/9 vs. 3.67%/77, p < 0.001). After adjusting for sociodemographic characteristics, the odds of disabled transgender participants reporting an unmet need were higher for every unmet need except for preventative services. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

13 pages, 1031 KiB

Open AccessArticle

Traditional Korean Medicine Home Care for the Older Adults during the COVID-19 Pandemic in South Korea

by Soo-Hyun Sung, You-Sang Baik, Ji-Eun Han, Eun-Jin Lee, Jihye Kim, Minjung Park, Ji-Yeon Lee, Jang-Kyung Park, Jung-Youn Park and Eunkyung Lee

Int. J. Environ. Res. Public Health 2022, 19(1), 493; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010493 - 03 Jan 2022

Cited by 2 | Viewed by 2636

Abstract

Objectives: The aim of this study was to examine the status of community care services regarding traditional Korean medicine (TKM) for older adults and raise awareness on current opinions and services of TKM institutions. Methods: The National Development Institute of Korean Medicine conducted [...] Read more.

Objectives: The aim of this study was to examine the status of community care services regarding traditional Korean medicine (TKM) for older adults and raise awareness on current opinions and services of TKM institutions. Methods: The National Development Institute of Korean Medicine conducted a survey of 16 local governments by sending official letters through an electronic document system from October 2020 to November 2020. The survey items included basic demographic information and information about TKM service. Results: Eleven (68.8%) of the 16 local governments provided TKM home care services. A total of 136 TKM clinics provided home care services for 598 older adults with musculoskeletal disorders. The number of TKM services provided in five or more local governments were cupping 11 (100.0%), acupuncture 11 (100.0%), education and consulting 10 (90.9%), and moxibustion 9 (81.8%). Moreover, pain (recorded on visual analogue scale) and quality of life significantly improved following TKM services (p < 0.001). Conclusions: Covered under medical policy, TKM homecare services could function as a viable alternative for continued medical care disrupted during the coronavirus disease 19 pandemic. In addition, standardisation and legalisation of these services could ensure and improve their efficiency. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

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13 pages, 344 KiB

Open AccessArticle

The Social Course of Fibromyalgia: Resisting Processes of Marginalisation

by Nicole Brown

Int. J. Environ. Res. Public Health 2022, 19(1), 333; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010333 - 29 Dec 2021

Cited by 2 | Viewed by 2497

Abstract

This sociological article reports an empirical study into the lived experience of fibromyalgia. It includes 28 participants (26 women, 2 men) with a formal diagnosis of fibromyalgia. Data collection consisted of the completion of an identity box project and subsequent interviews. Data analysis [...] Read more.

This sociological article reports an empirical study into the lived experience of fibromyalgia. It includes 28 participants (26 women, 2 men) with a formal diagnosis of fibromyalgia. Data collection consisted of the completion of an identity box project and subsequent interviews. Data analysis followed the principles of iterative, inductive, semantic thematic analysis, and led to the identification of four major themes: the role of the social in making sense of the experience, the process of redefining lifegoals, the refusal to accept fibromyalgia as a diagnosis, and the consideration of identifying as a patient. These themes in turn demonstrate four forms of resistance against processes of marginalisation amongst those who have been diagnosed with fibromyalgia: (1) the incorporation of societal expectations and norms into their life-stories; (2) the re-making the lifeworld at a cerebral level through redefining reality and creating a new, socially acceptable reality; (3) the active rejection of the fibromyalgia diagnosis; and (4) the employment of active and pro-active countermeasures to assuming the sick role. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

16 pages, 390 KiB

Open AccessArticle

Living in Roma Settlements in Greece: Self-Perceived Health Status, Chronic Diseases and Associated Social Determinants of Health

by Ioanna Petraki, Natasa Kalpourtzi, Agapios Terzidis, Magda Gavana, Apostolos Vantarakis, Georgios Rachiotis, Argiro Karakosta, Vana Sypsa, Giota Touloumi and Hprolipsis Study Group

Int. J. Environ. Res. Public Health 2021, 18(16), 8403; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168403 - 09 Aug 2021

Cited by 2 | Viewed by 2067

Abstract

We aimed to assess the self-perceived health status and the presence of chronic diseases of adult Roma living in settlements in Greece, and to explore associated social determinants of health. Data were derived from the Hprolipsis Health Survey. Multivariable regression models were applied. [...] Read more.

We aimed to assess the self-perceived health status and the presence of chronic diseases of adult Roma living in settlements in Greece, and to explore associated social determinants of health. Data were derived from the Hprolipsis Health Survey. Multivariable regression models were applied. In total, 534 adults, 287 women, and 247 men were recruited from twelve Roma settlements in four prefectures. Although 62% of the participants perceived their health status as good/very good, about half of them had been diagnosed with at least one chronic disease. Several structural and intermediary social determinants of health were found to be significantly associated with the health outcomes; prefecture, settlement type, sex, age group, living with a partner, presence of depression symptoms, food insecurity, and alcohol consumption were associated with self-perceived health status; settlement type, sex, age group, presence of anxiety symptoms, food insecurity and number of persons living in the house with the presence of a chronic disease. This is one of the few studies assessing the self-perceived health status and presence of chronic diseases in Roma settlements in Greece and investigating the associated social determinants of health in the world. Community-based participatory action research and health literacy programs are needed to mitigate health inequalities in Roma settlements. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

11 pages, 752 KiB

Open AccessArticle

A Nurse-Led Education Program for Pneumoconiosis Caregivers at the Community Level

by Cheung Kin, Chun Yuk Jason Tsang, Lillian Weiwei Zhang and Sandy Kit Ying Chan

Int. J. Environ. Res. Public Health 2021, 18(3), 1092; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031092 - 26 Jan 2021

Cited by 2 | Viewed by 2717

Abstract

Pneumoconiosis is an irreversible chronic disease. With functional limitations and an inability to work, pneumoconiosis patients require support from family caregivers. However, the needs of pneumoconiosis caregivers have been neglected. This study aimed to evaluate the effectiveness of a nurse-led education program, which [...] Read more.

Pneumoconiosis is an irreversible chronic disease. With functional limitations and an inability to work, pneumoconiosis patients require support from family caregivers. However, the needs of pneumoconiosis caregivers have been neglected. This study aimed to evaluate the effectiveness of a nurse-led education program, which involved four weekly 90-min workshops led by an experienced nurse and guided by Orem’s self-care deficit theory. A single-group, repeated-measure study design was adopted. Caregivers’ mental health (Hospital Anxiety and Depression Scale, HADS, four single items for stress, worriedness, tiredness, and insufficient support), caregiving burdens (caregiving burden scale, CBS), and unmet direct support and enabling needs (Carer Support Needs Assessment Tool, CSNAT) were measured at the baseline (T0), immediately after (T1), and one month after intervention (T2); 49, 41, and 28 female participants completed the T0, T1, and T2 measurements. Mean age was 65.9 years old (SD 10.08) with a range between 37 and 85 years old. The program improved the caregivers’ mental wellbeing, and reduced their caregiving burdens and their unmet support and enabling needs, both immediately (T1) and one-month after the intervention (T2). In particular, the intervention improved the caregivers’ mental wellbeing significantly, specifically depression symptoms, stress, and tiredness immediately after the intervention; and reduced most of their unmet support needs and unmet enabling needs one-month after the intervention. This was the first nurse-led program for pneumoconiosis caregivers and should serve as a foundation for further studies to test the program with robust designs. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

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10 pages, 2919 KiB

Open AccessArticle

Influence of Living Alone or with a Spouse Only on the Short-Term Prognosis in Patients after an Acute Ischemic Stroke

by Yohei Ishikawa, Toru Hifumi and Mitsuyoshi Urashima

Int. J. Environ. Res. Public Health 2020, 17(21), 8223; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218223 - 06 Nov 2020

Cited by 5 | Viewed by 1942

Abstract

Background—This study aimed to explore whether living alone or with a spouse only affects the short-term prognosis of acute ischemic stroke patients. Methods—We conducted a retrospective cohort study of patients with a diagnosis of acute ischemic stroke from April 2014 to February 2019 [...] Read more.

Background—This study aimed to explore whether living alone or with a spouse only affects the short-term prognosis of acute ischemic stroke patients. Methods—We conducted a retrospective cohort study of patients with a diagnosis of acute ischemic stroke from April 2014 to February 2019 in Japan. The primary outcome was defined as worsening by at least one grade on the modified Rankin Scale (mRS). The secondary outcome was set as the degree of worsening on the mRS. The outcomes were compared between three groups of patients: (1) those living alone (ALONE), (2) those living with their spouse only (SPOUSE), and (3) OTHERs. Results—In total, 365 patients were included in this study: 111 (30%) ALONE, 133 (36%) SPOUSE, and 121 (33%) OTHERs. Cardiogenic embolisms were observed more frequently in ALONE than in OTHERs. The primary outcome occurred in 88 (79.3%) patients in ALONE and in 96 (72.2%) patients in SPOUSE, both of which were higher than the 72 (59.5%) in OTHERs. After adjusting with 19 variables, the risk of worsening was higher in ALONE (odds ratio (OR): 2.90, 95% confidence interval (CI): 1.50–5.58) and SPOUSE (OR: 1.83, 95% CI: 1.00–3.33) compared with OTHERs. Conclusions—In patients with acute ischemic stroke, not only living alone but also living with a spouse only may be associated with a worse short-term prognosis, independent of other cardiovascular risks. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

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Review

Jump to: Research, Other

26 pages, 545 KiB

Open AccessReview

Conceptual Model of Emergency Department Utilization among Deaf and Hard-of-Hearing Patients: A Critical Review

by Tyler G. James, Julia R. Varnes, Meagan K. Sullivan, JeeWon Cheong, Thomas A. Pearson, Ali M. Yurasek, M. David Miller and Michael M. McKee

Int. J. Environ. Res. Public Health 2021, 18(24), 12901; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182412901 - 07 Dec 2021

Cited by 11 | Viewed by 4607

Abstract

Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of [...] Read more.

Deaf and hard-of-hearing (DHH) populations are understudied in health services research and underserved in healthcare systems. Existing data indicate that adult DHH patients are more likely to use the emergency department (ED) for less emergent conditions than non-DHH patients. However, the lack of research focused on this population’s ED utilization impedes the development of health promotion and quality improvement interventions to improve patient health and quality outcomes. The purpose of this study was to develop a conceptual model describing patient and non-patient (e.g., community, health system, provider) factors influencing ED utilization and ED care processes among DHH people. We conducted a critical review and used Andersen’s Behavioral Model of Health Services Use and the PRECEDE-PROCEED Model to classify factors based on their theoretical and/or empirically described role. The resulting Conceptual Model of Emergency Department Utilization Among Deaf and Hard-of-Hearing Patients provides predisposing, enabling, and reinforcing factors influencing DHH patient ED care seeking and ED care processes. The model highlights the abundance of DHH patient and non-DHH patient enabling factors. This model may be used in quality improvement interventions, health services research, or in organizational planning and policymaking to improve health outcomes for DHH patients. Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

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Other

Jump to: Research, Review

16 pages, 1128 KiB

Open AccessStudy Protocol

Study Protocol for a Randomized Controlled Trial Evaluating the Effectiveness of a Group-Based Self-Determination Enhancement Intervention for Adults with Mild Intellectual Disability and Their Caregivers

by Phyllis King Shui Wong

Int. J. Environ. Res. Public Health 2022, 19(3), 1763; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031763 - 04 Feb 2022

Cited by 1 | Viewed by 1852

Abstract

Self-determination is regarded as an adult outcome for people with an intellectual disability (ID). However, self-determination curricula are rarely available in Hong Kong. This paper outlines a protocol for an experimental study that examines the effectiveness of a group-based self-determination enhancement intervention for [...] Read more.

Self-determination is regarded as an adult outcome for people with an intellectual disability (ID). However, self-determination curricula are rarely available in Hong Kong. This paper outlines a protocol for an experimental study that examines the effectiveness of a group-based self-determination enhancement intervention for adults with mild ID and their caregivers. A randomized controlled trial with pre-test, post-test and three-month follow-up is proposed. A total of 120 participants will be randomly assigned to three conditions: self-determination enhancement group, self-determination enhancement PLUS group (with caregivers in a parallel group) and leisure activity group as a control condition. Five groups will be organized for each of the three conditions. There will be 10 sessions per group covering the core components of self-determination including self-knowledge, goal setting and attaining goals, self-regulating and adjusting plans. Components for caregivers include understanding how self-determination and REACH responding skills can support their children to exercise self-determination through positive interaction. Self-determination competencies and personal well-being will be measured at three points in time. The proposed study is the first evidence-based local study aimed at examining a culturally tailored self-determination enhancement intervention for people with ID and fills a research gap in existing interventions. If the intervention is demonstrated to be effective, it will provide new knowledge for a group-based intervention and will be used with Chinese-speaking people with ID in different parts of the world. (Trial registration: ClinicalTrials.gov: NCT05167929) Full article

(This article belongs to the Special Issue Chronic Disease, Disability, and Community Care)

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