Hasil untuk "Vocational rehabilitation. Employment of people with disabilities"

Surona J. Visagie, Christopher M. Likando

Background: The World Health Organization (WHO) published ‘Standards for Prosthetics and Orthotics’ to improve these services globally. Research that compares services to the standards assists in developing a baseline against which future development can be measured and identifies areas needing improvement. Objectives: This article aims to describe prosthetic services in Namibia and compare them to the 60 WHO standards. Method: A mixed-methods exploratory design was employed. Qualitative data were collected through semi-structured interviews with purposively selected participants, including managers (n = 2), service providers (n = 9) and users (n = 16). The data were analysed using content analysis. In the quantitative phase, cross-sectional surveys were administered to managers (n = 2), service providers (n = 10) and users (n = 120). The data were analysed descriptively. Qualitative and quantitative data were triangulated to determine Namibia’s adherence to the standards. Results: The triangulated data showed adherence to 14 standards, partial adherence to 24 and non-adherence to 22 standards. As per the standards’ requirements, the government directed the provision of prosthetic services, and a range of prosthetic products was provided free of charge at all levels of care. Funding challenges, no national prosthetics committee, and no databases as well as lacklustre support of providers’ careers and professional development, indicated areas of non-adherence. Conclusion: A systems-based approach, utilising a people-centred conceptual framework, can aid Namibia and similar countries in implementing the standards. Contribution: This study is the first to provide information on implementing WHO prosthetic standards in an African setting.

Stefanie Köb, Frauke Janz, Paula-Marie Mühlstädt

Inclusive education aims to ensure not only academic development but also social participation among students with intellectual disabilities. However, research consistently shows that students with intellectual disabilities are prone to social exclusion in secondary school settings. While theoretical frameworks increasingly highlight the importance of contextual and systemic factors—particularly classroom social dynamics—empirical studies on teachers’ practices for fostering participation remain scarce. This qualitative study investigates how secondary school teachers in inclusive classrooms perceive and enact their role in promoting social participation. Semi-structured interviews were conducted with 30 teachers from various German secondary schools. The data were analyzed using qualitative content analysis based on the social dynamics management (SDM) framework, which distinguishes between universal, selected, and indicated intervention levels. The results reveal that teachers use a wide range of strategies across all three levels. In addition to the categories proposed by the SDM framework, two further areas were identified inductively: (1) teachers’ pedagogical beliefs and (2) internal and external cooperation. These findings suggest a need to expand the SDM model and provide guidance for the professional development of teachers aiming to promote inclusive classroom environments.

Takayasu Fukuma

Background Despite recent policy initiatives promoting disability employment, employees with disabilities in Japan often face considerable adaptation challenges during the early stages of their careers. Issues such as role ambiguity, low self-efficacy, and difficulties with emotional regulation can heighten stress levels and increase turnover risk, particularly within highly regulated employment settings. Objective This study aimed to identify and categorize workplace adaptation challenges experienced by employees with disabilities during their first five years of employment in Japanese special-purpose subsidiaries. Methods Semi-structured interviews were conducted with six employees with psychiatric, developmental, intellectual, or visual disabilities. Data were thematically analyzed to uncover key adaptation challenges, guided by organizational socialization, supportive relationship, and self-efficacy theories. Findings were then interpreted through Schlossberg's 4S model (Situation, Self, Support, Strategy) to propose evidence-based support strategies. Results Eleven distinct adaptation challenges emerged, classified as either organizational socialization issues (e.g., reality shock, unclear expectations) or disability-specific issues (e.g., reduced self-efficacy, emotional stress). These challenges negatively affected participants’ psychological well-being and underscored the need for individualized support measures. Conclusions The 4S model provided a valuable framework for understanding early workplace adaptation and designing targeted interventions. Findings highlight the importance of structured onboarding, mentoring, and inclusive HR practices to promote retention, mental health, and long-term employment sustainability for employees with disabilities.

J. A. Morales-Camino

This paper provides an analytical connection between Long Covid syndrome, productivity, and its monitoring in occupational health. Long Covid is a medical condition affecting 10-20% of people who had Covid-19 disease. PubMed, Google Scholar, ScienceDirect, The Lancet, NEJM, Nature, CDC Library, WHO COVID-19 research article database. Search terms: ‘Long Covid’, ‘Productivity’, ‘workers impact’. WHO defines long Covid as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. Signs and symptoms linked to Long Covid include fatigue, shortness of breath and cognitive dysfunction. Longest list includes 66 symptoms. Most mentioned symptoms are fatigue, dyspnoea, arthralgia/myalgia, cough, and headache. Some others are related to quality of life: anxiety/depression, Post Exertional Malaise (worsening of symptoms after minor physical or mental exertion), Brain Fog (neurocognitive symptoms including loss of memory and problems focusing, concentrating, and paying attention) a new study has found that these symptoms may be caused by a viral-borne brain injury, and finally sleep/mood disorders. Long Covid medical management is focussed on: COVID-19 vaccination and administration of anti-SARS-CoV-2 monoclonal antibodies. Treatment of patients with COVID-19 with oral nirmatrelvir/ritonavir was associated with a 25% reduction of sequelae. Individuals receiving metformin had a reduced 40% incidence of long COVID. Workers with long COVID have decreased productivity, including presenteeism. In the US, 1.8 to 4.1 million workers with Long Covid were out of work. Time out was influenced by Initial infection severity, type of work, and professional categories (blue vs. white collar workers). Permanent employment loss due to long COVID was between 11%-14%. Some employees took early retirement. Persons with long COVID are less likely to employ themselves full time. Some work despite their symptoms, or RTW too early. Some reduce their workload. Working relationships are not good for workers with long COVID. Estimated prevalence of long COVID cases in EU population is 1.7% in 2021 and 2.9% in 2022, having a negative impact on labour supply of 0.2-0.3% in 2021 and 0.3-0.5% in 2022. Long COVID reduced labour supply by 364,000–663,000 in 2021 and by 621,000-1,112,000 in 2022, with lower productivity, higher sick leaves, lower working hours, and unemployment. This range is close to a recent estimate for the US. Health professionals must look for preventing Long COVID becoming a disabling condition. Helping workers to stay at work or RTW. Look for work accommodations options, access to vocational rehabilitation, facing health challenges. OM physicians must help workers to manage persisting and disabling long COVID symptoms that could affect function at work. Occupational Medicine physicians often do not know how to handle long COVID cases. OM physician must be aware of the WC’s and Disability guidelines for employees with Long Covid, to identify those cases requiring support. Prevalence of long Covid is between 5 and 15%, that means we´ll continue facing a challenge to countries health and health care systems. New approaches will be required to care for patients with long Covid, and these must be based on education, research, and support. Wellbeing interventions are important to avoid work disability.

Maram Alwadi, AlBandary AlJameel, Sarah Baker et al.

The Convention on the Rights of the Child argues for children’s involvement in research. Oral health research frequently excludes children with disabilities and their voices. This study takes a rights-based approach by devising methods to include disabled children in oral health research. This is an ethnographic study. Methods utilized interviews, guided tours, symbols, drawings, pictures, and games. The selection of method depended on the ability and preference of each child. Using pictures and games as prompts enabled child participation. The guided tour activity facilitated the development of relationships with the children. It also increased their ability to chat informally and appeared to reduce power imbalances compared to formal, structured interviewing. Focus group interviews, symbols, and drawings acted as barriers to children’s participation. Involving children with disabilities in oral health research requires using appropriate methodological designs and innovative, pluralistic methods drawn from different disciplines. This promotes a rights-based approach, which recognizes diversity and aims to reduce the discrimination and disempowerment of children with disabilities.

Pakeeza Seemal, Jibran Arshad, Saba Hameed et al.

Objectives: We intend to find out current practice patterns in managing Bell’s palsy among the physiotherapists of Sargodha, Pakistan. Methods: A cross-sectional study was conducted from May to August 2022. Data were obtained from 50 physiotherapists working in various clinical settings of Sargodha with more than 2 years of clinical experience. They were selected using convenient sampling. A self-designed questionnaire was used to gather all necessary information regarding the physical therapy practice patterns of Bell’s palsy. The obtained data were analyzed by using SPSS software, version 20. Results: Proprioceptive neuromuscular facilitation (PNF) was the preferred (42%) neurodevelopmental technique used in current practice patterns to manage Bell’s palsy. The most used therapeutic exercises by the physiotherapists were facial expression coordination exercises (66%). Also, 44% of physiotherapists used electrical muscle stimulation as the preferred electrotherapeutic modality in their current practice. Soft tissue release (54%) was the most preferred manual therapy technique in Bell’s palsy patients. The combination of electrical muscle stimulation, facial exercises, and biofeedback was the most used (54%) among physiotherapists.  Discussion: Current practice for Bell’s palsy treatment includes PNF techniques, facial expression coordination exercises, soft tissue release, and electrical muscle stimulation by most physiotherapists in Sargodha. The most preferred combination was facial exercises, electrical stimulation, and biofeedback.

Shamim Ghazi, Fatemeh Haresabadi, Toktam Maleki Shahmahmood

Objectives: The present research aims to highlight the impact of hyperammonemia, a common pediatric metabolic disease, on children’s language and feeding skills. This research was conducted through a literature review and the presentation of a 2.5-year-old girl diagnosed with hyperammonemia. Case Presentation: The research was conducted on a 2.5-year-old girl who had been diagnosed with a sudden-onset metabolic disorder that resulted in swallowing, speech, and language problems. The child’s receptive and productive language and feeding history were obtained through interviews with her mother. Formal and informal tests were used to assess the child’s language and feeding skills at two different times after the onset of symptoms. Discussion: This study presents a new and unique case of a child with very high levels of ammonia and severe clinical manifestations of cognitive, language, and motor dysfunctions. Although the child did not receive any direct interventions during the study, a secondary assessment revealed slight improvements in some language and oral motor skills, possibly due to maturation and advice provided by rehabilitation team members.

Perri Campbell, Erin Wilson, Luke John Howie et al.

For workers living with a disability, pathways to sustainable employment in the open labour market are inhibited by barriers operating at different structural and societal levels. The culture of Australia’s government employment services has applied a ‘work-first’ approach that emphasises finding people employment rather than supporting the acquisition of skills and education. The net effect of this approach is the preferencing of short-term employment solutions, with a focus on individual behaviour or so-called resilience and an emphasis on personal responsibility instead of addressing structural issues. In this paper, we explore how people with disability can be supported in finding employment through a shared resilience approach offered by a Work Integration Social Enterprise (WISE). We suggest that WISEs can provide the conditions for shared resilience by developing and sustaining networks needed to generate hybrid pathways to work and by role modelling inclusive work conditions in the open labour market.

Seb M. Prohn, Parthenia Dinora, Kayla Diggs Brody

Community organizations can enhance the intellectual and developmental disability (I/DD) service system’s ability to improve the health, wellness, and participation of people with I/DD. This study added an item about Special Olympics (SO) participation to the 2019-2020 National Core Indicators In-Person Survey to predict active SO participation and to determine whether personal outcomes differed for SO participants. Results of a multinomial logistic regression showed that people who were younger or who did not require mobility aids were more likely to participate in SO. Compared with people who never or formerly participated in SO, current SO athletes had better personal outcomes. Results provide evidence that alignment between service agencies and community organizations may benefit personal outcomes for people with I/DD.

Mfungana M. Shikwambana, Jean V. Fourie

Background: Bardet-Biedl syndrome (BBS) is a rare, systemic, hereditary disorder characterised by obesity, polydactyly, visual and auditory impairment, and cognitive disability. Providing quality education in appropriate schools for children who present with such complex chronic conditions is challenging. Objectives: This study explored the dimensions of psycho-educational support needs for a child with BBS in South Africa to contribute to the improvement of early detection and holistic interventions. Method: A descriptive in-depth qualitative case study of Gezani, an adolescent Tsonga boy diagnosed with BBS, was undertaken. Semi-structured interviews were conducted with his parents and teachers to ascertain the boy’s psycho-educational support needs. Medical reports provided information on the complexities and prognosis of the syndrome. Observations in the classroom corroborated the learner’s symptoms and behaviours. Results: Thematic content analysis revealed the key areas of support needs. Gezani’s cognitive disability required a modified, slow-paced curriculum. His visual impairment required mobility orientation training and learning Braille. His emotional needs were supported with psychotherapy to maintain a sense of well-being. Medical monitoring was recommended with interventions for walking and managing his diet and weight. Speech therapy supported his communication skills. Conclusion: Learners with multiple disabilities require carefully planned, individualised psycho-educational support programmes addressing their unique needs and delays with targeted remedial interventions in appropriate special needs schools. Contribution: This study informs educators about BBS and provides multi-faceted, holistic support. The Department of Basic Education could bring special schools and national policies in tighter alignment for learners presenting with complex disabilities.

Qamar Mahmood

Mortaza Moghari, Zahra Rahemi, Zohreh Sadat et al.

Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions.  Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy.

Fatemeh Pazouki Movakher, Mohammad Saeed Khanjani, Mohammad Ali Hosseini et al.

Objectives: Chronic Obstructive Pulmonary Disease (COPD) impacts the quality of life of the affected patients. The present study aimed to determine the effects of home-based self-care program follow-up on re-hospitalization frequency and quality of life in COPD patients. Methods: This quasi-experimental study was performed on 44 COPD patients at Masih Daneshvari Hospital in Tehran City, Iran, in 2018. For collecting the necessary data, we used demographic data checklist, COPD Assessment Test, and the St. George’s Quality of Life questionnaire. We used SPSS v. 22 for analyzing the obtained data.  Results: The present study revealed that the highest age frequency was in the 61-70 years age group. Moreover, the male gender had the highest frequency and most research participants had elementary school education; the highest frequency regarding the disease duration was >5 years. Besides and the hospitalization frequency was once a year. The present study findings indicated that the provided self-care program follow-up reduced the re-hospitalization frequency and increased the quality of life of the explored COPD patients (P<0.001).  Discussion: The obtained results revealed that implementing a course of home-based follow-up self-care program could reduce re-hospitalization and increase the quality of life of COPD patients; thus, it is suggested that such follow-up programs be included in COPD treatment plans.

Javier Muñoz Bravo, Inés de Araoz Sánchez-Dopico

La pandemia de COVID-19 tuvo en su primera oleada entre marzo y mayo de 2020 un impacto enorme sobre el sistema sanitario español. La saturación del mismo y la escasez de recursos materiales y personales obligaron a tomar decisiones que implicaban la priorización de la atención de unos pacientes sobre otros. La toma de estas decisiones se hizo en la mayoría de los casos sin tomar en consideración las características, las necesidades y los derechos de las personas con discapacidad intelectual y del desarrollo cuando no basadas en sesgos negativos sobre el colectivo. Se analiza la situación creada durante el primer pico pandémico y se extraen conclusiones relevantes para la preservación del derecho a la salud.

Parthenia Dinora, Seb Prohn, Elizabeth P. Cramer et al.

Leadership for Empowerment and Abuse Prevention (LEAP) is an abuse prevention intervention for people with intellectual disability. The purpose of this research was to evaluate the intervention’s efficacy. Findings indicated no significant differences in scenario identification questions depicting acceptable or concerning situations. However, statistically significant improvements were noted in participants’ depth of understanding, including their ability to correctly describe why a scenario was abusive or exploitative and what to do next when confronted with unhealthy situations. Limitations and implications for practice are discussed.

Mirette Elias, M. Tavakoli, Steffen Lohmann et al.

Open Educational Resources are becoming a significant source of learning that are widely used for various educational purposes and levels. Learners have diverse backgrounds and needs, especially when it comes to learners with accessibility requirements. Persons with disabilities have significantly lower employment rates partly due to the lack of access to education and vocational rehabilitation and training. It is not surprising therefore, that providing high quality OERs that facilitate the self-development towards specific jobs and skills on the labor market in the light of special preferences of learners with disabilities is difficult. In this paper, we introduce a personalized OER recommeder system that considers skills, occupations, and accessibility properties of learners to retrieve the most adequate and high-quality OERs. This is done by: 1) describing the profile of learners with disabilities, 2) collecting and analysing more than 1,500 OERs, 3) filtering OERs based on their accessibility features and predicted quality, and 4) providing personalised OER recommendations for learners according to their accessibility needs. As a result, the OERs retrieved by our method proved to satisfy more accessibility checks than other OERs. Moreover, we evaluated our results with five experts in educating people with visual and cognitive impairments. The evaluation showed that our recommendations are potentially helpful for learners with accessibility needs.

Victor McKinney, Seyi L. Amosun

Background: In spite of legislations and policies to ensure an inclusive society in South Africa for the accommodation of people with disabilities, there are reports that they still struggle to move freely within society. Objectives: As part of a larger qualitative exploratory study on the preparation of undergraduate civil engineering students in a local university to contribute to the development of an inclusive society, this article seeks to understand the impact of the lived experiences of people with disabilities in their interaction with the built environment. Method: Four persons with disabilities, considered to be knowledgeable about South African legislations relating to disability, were purposely selected to each share one specific experience whilst interacting with the built environment. The transcribed texts of the interviews were analysed by using the phenomenological–hermeneutic method. Results: The participants exhibited strong desires to participate in society. However, the sense of loss of control and independence as they encountered challenges in the built environment changed the euphoria to disempowerment, rejection, anger and despondency. In spite of their experiences, participants expressed a commitment towards overcoming the challenges encountered in the broader interest of people with disabilities. Conclusion: A deeper understanding of the impact of the experiences of people with disabilities when they participate within the built environment in South Africa revealed a broad spectrum of negative emotions, which may impact the quality of life and well-being of the participants.

T. Kahraman, Asiye Tuba Özdoğar, C. Honan et al.

Secretaría de Redacción SIGLO CERO

Razieh Yousefi, Majid Ghayour Mobarhan, Habibollah Esmaily et al.

Objectives: Hypertension is a global major health challenge and mechanisms related to the risk factors associated with it are poorly understood. Therefore, we used structural modeling to test a hypothesized model to identify factors associated with hypertension. Methods: A cross-sectional population based survey, was performed and the data related to a random representative sample of 9704 subjects of MASHAD study were used. Then, we determined the relationship between risk factors for hypertension using structural equation modeling technique. The data were analyzed using Amos V. 22. Results: The conceptual model was validated by Goodness of Fit Indexes (CFI=0.939, TLI=0.908, NFI=0.935, RMSEA=0.04, SRMR=0.037). Obesity and lack of physical activity had the greatest impact on blood pressure. Discussion: Findings show evidences to confirm the conceptual model considered in the risk factors for hypertension that can be helpful in policies for preventing hypertension and consequently, the disabilities that arise from it.