Perceptions of the impact of disability and impairment on health, quality of life and capability.
Ontology highlight
ABSTRACT: Objective
The impact of impairment and disability on quality of life can be considerable, however advances in assistive technology can help to optimise physical and psychosocial functioning. Little is known about how impairment and subsequent adaptation influences health state perceptions, particularly amongst the general public. The aim of this pilot project was to examine student perceptions of what it would be like to live with a physical or sensory impairment, and how adaptation influences health and quality of life.Results
In total 151 undergraduate Psychology students were invited to participate in a questionnaire-based survey. Ethical approval was granted by an academic ethics committee. The survey included a range of validated outcome measures relating to illness perceptions and quality of life, including the B-IPQ, EQ-5D-3L and ICECAP-O. Surveys were divided into two parts: firstly, participants were asked to self-report their own health; and secondly participants were asked to estimate the health impacts of a range of hypothetical states of impairment. Severe adapted impairments were perceived to have less impact on health status than moderate un-adapted impairments. Hearing impairment was perceived to have the least impact on health status, whilst mobility impairment was perceived to have the largest impact on health status.
SUBMITTER: Bray N
PROVIDER: S-EPMC6534923 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Background and objectiveUnderstanding the socioeconomic burden of multiple sclerosis (MS) is essential to inform policymakers and payers. Real-world studies have associated increasing costs and worsening quality of life (QoL) with disability progression. This study aims to further evaluate the impact of cognition, fatigue, upper and lower limb function (ULF, LLF) impairments, and disease progression per Expanded Disability Status Scale (EDSS) level, on costs and QoL.MethodsThis was a cross-sectional cohort study including 20,988 patients from the German NeuroTransData MS registry from 2009 to 2019. QoL analyses were based on EQ-5D-5L. Cost analyses included indirect/direct medical and non-medical costs. Eight subgroups, ranging from 439 to 1812 patients were created based on presence of measures for disease progression (EDSS), cognition (Symbol Digit Modalities Test [SDMT]), fatigue (Modified Fatigue Impact 5-Item Scale [MFIS-5]), ULF (Nine-Hole Peg Test [9HPT]), and LLF (Timed 25-Foot Walk [T25FW]). Multivariable linear regression assessed the independent effect of each test's score on QoL and costs, while adjusting for EDSS and 12 other confounders.ResultsLower QoL was associated with decreasing cognition (p < 0.001), worsening ULF (p = 0.025), and increasing fatigue (p < 0.0001); however, the negative impact of LLF worsening on QoL was not statistically significant (p = 0.54). Higher costs were associated with decreasing cognition (p < 0.001), worsening of ULF (p = 0.0058) and LLF (p = 0.049), and increasing fatigue (p < 0.0001). Each 1-scale-step worsening function of SDMT, MFIS-5, 9HPT, and T25FW scores resulted in €170, €790, €330, and €520 higher costs, respectively. Modeling disability progression based on SDMT, MFIS-5, 9HPT, and T25FW scores as an interaction with EDSS strata found associations with lower QoL and higher costs at variable EDSS ranges.ConclusionsDisease progression in MS measured by 9HPT, SDMT, and MFIS-5 had a significant negative impact on QoL and broad socioeconomic costs independent of EDSS. T25FW had a significant negative association with costs. Cognition, fatigue, ULF, and LLF have stronger impact on costs and QoL in patients with higher EDSS scores. Additional determinants of MS disability status, including SDMT, MFIS-5, 9HPT, and T25FW, should be considered for assessing cost effectiveness of novel therapeutics for MS.
| S-EPMC11362420 | biostudies-literature
Project description:BackgroundMigraine is the leading cause of days lost due to disability in the world among people less than 50 years of age. There is a paucity of evidence on the impact of migraine and other headache disorders and the cost and productivity losses in the workplace.MethodsEmployee population survey assessed prevalence, characteristics, and disability of headache disorders at a Japanese information technology company. This study was supported by the World Health Organization Western Pacific Region Office and International Headache Society.Results2458 (1963men, 495 women) out of 2494 responded to the survey that utilized ICHD-3 beta criteria. Among these, 13% (205 male/123 female) had migraine (M), 53% (1093 male/207 female) had tension-type headache (TTH) and 4% (61 male/27 female) had migraine and TTH (M/TTH). The number of days when productivity at work was reduced by half or more because of headache was significantly higher in migraine compared to TTH. The norm-based scoring of SF-12v2 was significantly lower in M/TTH and M than TTH. The economic loss due to absenteeism for migraine was calculated to be $ 238.3US$/year/person for day-off and 90.2US$/year/person for half-day off using migraine disability assessment score (MIDAS). The economic loss due to presenteeism for migraine was calculated to be $ 375.4US$/year/person using MIDAS and 2217US$/year/person using work productivity and activity impairment questionnaire (WPAI). Furthermore, estimated cost of productivity loss associated with presenteeism using WPAI was calculated at 21.3 billion US$/year in Japan as a whole.ConclusionsThis study revealed a high prevalence and disease burden among employees with migraine that is associated with substantial losses in productivity and employer cost. These results support the development and implementation of workplace programs to improve migraine management in the workplace and reduce the burden and costs associated with lost workplace productivity.
| S-EPMC8061063 | biostudies-literature
Project description:Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide and creating substantial financial and health burdens. Obesity has a negative impact on health-related quality of life (HRQoL) with reference to physical and mental health status, social relationships, and economic factors. The aim of the present study is to investigate the association of number of comorbidities, psychological status, and disability level with HRQoL in a sample of subjects with obesity. METHODS:A total of 273 subjects with obesity (199 women and 74 men) were recruited. Medical history and anthropometric measurements were carried out. The Italian version of the Laval questionnaire, the TSD-OC (SIO test for obesity-related disabilities), and SCL-90 (Symptom Checklist-90) tests were administered. The association between HRQoL (global and different domains scores of the Laval questionnaire - dependent variable) and age, body mass index (BMI), comorbidity, TSD-OC, and SCL-90 was analysed using a stepwise linear regression model. RESULTS:BMI, disability (TSD-OC global score), and psychological symptoms (SCL-90 global severity index) were found to be the main determinants of HRQoL. Single domains of HRQoL (symptoms, activity/mobility, personal hygiene/clothing, emotions, social interaction, and sexual life) showed different patterns of associations with each domain of the Laval questionnaire. BMI, pain, and social life disruptions were found to be significantly associated with most of the HRQoL domains while age, comorbidities, psychological problems (depression, interpersonal symptoms, somatization), and disability were associated with only some domains of the Laval questionnaire. Education, psychological symptoms (obsessive-compulsive, anxiety, hostility, phobic anxiety, paranoid ideation), and disability domains (stiffness, housework, outdoor activities, occupational activities) were not associated with any of the dimensions of the Laval questionnaire. DISCUSSION/CONCLUSION:The present study identified key determinants of QoL in subjects with obesity, which could help in refining the multidimensional diagnostic assessment of obesity as well as designing more effective interventions to improve HRQoL in these patients.
| S-EPMC7250341 | biostudies-literature
Project description:BACKGROUND: Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends. METHODS: Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females. RESULTS: All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: -18.10 (-20.95,-15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability. CONCLUSIONS: Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases.
| S-EPMC4222819 | biostudies-other
Project description:BackgroundThe quality of life (QoL) of informal caregivers of people with Parkinson's disease (PD) (PwP) can be affected by the caring role. Because of cognitive symptoms and diminished activities of daily living, in addition to the management of motor symptoms, carers of PwP and cognitive impairment may experience increased levels of burden and poorer QoL compared with carers of PwP without cognitive impairment. This study aimed to investigate the impact of cognitive impairment in PD upon QoL of carers.MethodsApproximately 36 months after diagnosis, 66 dyadic couples of PwP and carers completed assessments. PwP completed a schedule of neuropsychological assessments and QoL measures; carers of PwP completed demographic questionnaires and assessments of QoL. Factor scores of attention, memory/executive function and global cognition, as derived by principal component analysis, were used to evaluate cognitive domains.ResultsHierarchical regression analysis found lower Montreal Cognitive Assessment was a significant independent predictor of poorer carer QoL, in addition to number of hours spent caregiving, carer depression and PD motor severity. Attentional deficits accounted for the largest proportion of variance of carer QoL. Carers of PwP and dementia (n = 9) had significantly poorer QoL scores compared with PwP and mild cognitive impairment (n = 18) or normal cognition (n = 39) carers (p < 0.01).ConclusionsAttentional deficits were the strongest predictor of carer QoL compared with other cognitive predictors. Carers for those with PD dementia reported the poorest QoL. Interventions such as respite or cognitive behavioural therapy to improve mood and self-efficacy in carers may improve carer QoL. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.
| S-EPMC5724657 | biostudies-literature
Project description:ImportanceMost studies use impaired functioning alone to specify populations with disabilities. However, some people with functional impairments do not identify as disabled. With functional status-based definitions, studies have shown disparate care quality for people with disabilities.ObjectiveTo examine whether impairment and disability identity have different associations with perceived health care experiences and explore factors associated with disability identification.Design, setting, and participantsThis cross-sectional study used a nationally representative survey of US adults conducted from April 20 through May 31, 2021, and analyzed between June 1 and August 31, 2022. Survey participants were 1822 English- or Spanish-speaking adults responding either online or via telephone.ExposuresUsing 8 survey questions, participants were grouped according to presence of impairment and disability identity.Main outcomes and measuresLikert scale measures of trust, respect, and fairness (henceforth, procedural justice measures) were dichotomized. Sociodemographic characteristics and rates of procedural justice responses were compared across groups. Multivariable logistic regressions adjusting for baseline characteristics were performed to (1) estimate associations of impairment and disability identity with perceptions of procedural justice and (2) explore factors associated with disability identification. Analyses applied survey weights.ResultsOf 6126 individuals invited to participate, 1854 (30.3%) completed the survey. Thirty-two were excluded due to unreportable gender, for a final analytic sample of 1822 participants. Participants with impairments (n = 816; mean [SD] age, 48.1 [17.0] years; 51.2% women, 48.8% men) had worse perceptions on 7 of 10 procedural justice measures (crude) compared with those without impairments (n = 1006; mean [SD] age, 49.6 [18.1] years, 55.1% female, 44.9% male). Among respondents with impairments, those who did (n = 340) vs did not (n = 476) identify as disabled gave better ratings for clinician communication efforts (a lot of effort, 38.8% vs 31.0%) and having health goals understood (understood very or fairly well, 77.2% vs 70.1%) but gave worse ratings for respect (almost never felt inferior or talked down to, 66.1% vs 59.1%). Disability identification was associated with more reports of unfair treatment (31.0% vs 22.4%; adjusted odds ratio, 1.65; 95% CI, 1.12-2.42) and of being unafraid to ask questions or disagree (50.5% vs 40.1%; adjusted odds ratio, 1.51; 95% CI, 1.04-20.19). Income and employment were associated with disability identification.Conclusions and relevanceIn this cross-sectional survey study of US adults, health care perceptions differed between groups defined by impairment status and disability identity. These findings suggest that, alongside functional measures, health systems should capture disability identity to better address disparities for people with impairments.
| S-EPMC10517379 | biostudies-literature
Project description:BackgroundThe emphasis on treating rheumatoid arthritis (RA) intensively reduces disease activity but its impact in routine care is uncertain. We evaluated temporal changes in disease activities and outcomes in a 10-year prospective observational cohort study of patients in routine care at one unit.MethodsThe Guy's and St Thomas' RA cohort was established in 2005. It involved most RA patients managed in this hospital. Clinical diagnoses of RA were made by rheumatologists. Patients were seen regularly in routine care. Each visit included measurement of disease activity scores for 28 joints (DAS28), health assessment questionnaire scores (HAQ) and EuroQol scores. Patients received intensive treatments targeting DAS28 remission.ResultsIn 1693 RA patients mean DAS28 scores fell from 2005 to 15 by 11% from 4.08 (95% CI: 3.91, 4.25) in 2005 to 3.64 (3.34, 3.78); these falls were highly significant (p?<?0.001). DAS28 components: swollen joint counts fell by 32% and ESR by 24%; in contrast tender joint counts and patient global assessments showed minimal or no reductions. The reduction in DAS28 scores was predominantly between 2005 and 2010, with no falls from 2011 onwards. Associated with falls in mean DAS28s, patients achieving remission increased (18% in 2005; 27% in 2015) and the number with active disease (DAS28?>?5.1) decreased (25% in 2005; 16% in 2015). In 752 patients seen at least annually for 3?years, persisting remission (68 patients) and intermittent remission (376 patients) were associated with less disability and better health related quality of life. Over time biologic use increased, but they were used infrequently in patients in persistent remission.ConclusionsOver 10?years an intensive management strategy in a routine practice setting increased combination DMARD and biologic use: disease activity levels declined; this association is in keeping with a causal relationship. Patients who achieved remission, even transiently, had better functional outcomes than patients never achieving remission.
| S-EPMC6390620 | biostudies-literature
Project description:This study examined the predictive ability of the Common-Sense Model to explain psychological outcomes in cervical dystonia, a movement disorder that affects the muscles of the head and neck. Illness Perceptions Questionnaire-Revised, brief COPE, Hospital Anxiety and Depression Scale, Cervical Dystonia Impact Profile and the Post-Traumatic Growth Inventory were completed by 118 people with cervical dystonia. Correlations and hierarchical multiple regression models were conducted. Illness perceptions and coping strategies explained 59% of variance in anxiety, 61% of variance in depression and health-related quality of life and 19% of variance in post-traumatic growth. Illness perceptions and coping strategies are significant factors to consider in terms of psychological adjustment and outcomes in cervical dystonia. Psychological interventions targeting illness perceptions and coping strategies may be beneficial in improving psychological outcomes for people with cervical dystonia.
| S-EPMC10042972 | biostudies-literature
Project description:Background"Better teeth better health" is a guiding dictum for the 21st century that has been well adopted by WHO and emulated world over by numerous health care agencies. Hence its of paramount importance to assess the impact of oral health on the quality of life. Keeping this in mind the present study was done to gauge the impact of prevalence of dental diseases amongst 9-15 year old institutionalized hearing impaired children in districts of Uttarakhand, India.Materials & methodology250 hearing impaired institutionalized 9-15 year old children were examined using WHO type III clinical examination for DMFT/dmft, Traumatic dental injuries using TDI index and dentofacial anomalies using Angle's classification of malocclusion. The Hindi version of the C-OIDP questionnaire was used in this study.ResultsThere was a high dental caries prevalence of 56% with significant male predilection. TDI index was 40.8% and the most common molar relation was class I with 90.4%. With 49.6% crowding was the most common dentofacial anomaly. Deformity of face or mouth has maximum impact on the daily life of these children. The overall oral health related quality of life was less favorable in this group.ConclusionOral health has a significant impact on daily life of these children with hearing impairment and those children having dental diseases showed unfavorable OHRQoL.
| S-EPMC6439272 | biostudies-literature
Project description:BackgroundEnablers for people with Parkinson's disease (PD) participating in aquatic physiotherapy have been identified, and exercise improves health-related quality of life (HRQoL) but it is unclear whether all enablers and barriers for aquatic physiotherapy specific to the PD population have been explored.ObjectiveTo describe HRQoL in people with PD who have undertaken aquatic physiotherapy, and explore their perceptions and attitudes regarding the programme.MethodsTwenty-one participants who participated in a pilot trial on aquatic physiotherapy were included. Participants completed a survey regarding their experiences. The Parkinson's Disease Questionnaire-39 (PDQ-39) and Personal Well-being Index-Adult (PWI) were used to quantify HRQoL, whilst focus groups were conducted to explore their perceptions and attitudes. Descriptive statistics were used to summarize HRQoL scores. Focus group data were analysed using the deductive coding method.ResultsMost participants felt that the aquatic programme was worthwhile (n = 20/21, 95%). However, they had poor overall well-being (mean 41.6, SD 13.5) and HRQoL (mean 31.0, SD 13.2) as measured by the PWI and PDQ-39. Several barriers to aquatic therapy including safety when getting dressed, fatigue and transport were identified although many enablers were also identified, including an improvement in function, less falls and group socialization.ConclusionsAquatic physiotherapy was well-accepted. Participants felt their function improved and felt safe in the water. HRQoL is lower in individuals with PD when compared to Australian norms; thus, interventions to optimize HRQoL need to be explored further.Patient or public contributionPatients participated in the aquatic intervention, survey and focus groups.
| S-EPMC8077086 | biostudies-literature