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Improving Access Within the Clinic
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
Nicole D. Agaronnik, Lisa I. Iezzoni
Health care is essential for everyone, including people with disabilities. However, many complex factors contribute to the healthcare disparities frequently experienced by people with disability, even inequities in the routine screening and preventive services recommended by the US Preventive Services Task Force. Nearly 61 million Americans have a disability (Okoro et al. 2018), and this population is expected to rise given aging of “baby boomers,” the growing longevity of persons with disabling congenital or early-life impairments, and increasing prevalence of chronic conditions even among younger people. The population of people with disability is diverse, and the nature and extent of healthcare disparities vary across subgroups. Specific healthcare needs also differ depending upon one’s underlying condition(s) and their relationship to functional impairment(s).
Clinical Rehabilitation of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
As the conditions of COVID-19 hospitalized patients vary, the possible dysfunction may also vary. In clinical practice, make comprehensive rehabilitation assessments according to patients’ characteristics and classify them accurately. In a timely manner, detect patients’ functional impairment and its severity, and conduct corresponding comprehensive rehabilitation treatment.
Physical and Mental Health and Other Functional Outcomes in Co-Occurring PTSD and Substance Use Disorders
Published in Anka A. Vujanovic, Sudie E. Back, Posttraumatic Stress and Substance Use Disorders, 2019
Lauren Rodriguez, Tiffany Jenzer, Jennifer P. Read
In conclusion, both PTSD and SUD appear to exert a negative influence on multiple domains of functioning; however, the exact mechanisms have yet to be established. Here, based on the available literature for PTSD and SUD as they occur in isolation, we posited two potential mechanisms that may be especially important. Empirical tests of these and other potential mechanisms are a critical next step toward understanding whether and how those with PTSD/SUD may be at risk for deleterious functional outcomes. Such investigation can facilitate an understanding of the exact pathways that lead to functional impairment and could inform treatment goals to help improve functioning in work and personal domains.
Barriers and Facilitators to the Equitable Access of Psychedelic Medical Care and Research in Alzheimer’s Disease and Related Dementias
Published in AJOB Neuroscience, 2023
Alzheimer’s disease and related dementias disproportionately affect older adults of Latino and Black ethnicity (Aranda et al. 2021). Family members of Black and Latino loved ones living with dementia, have been found to provide higher intensity caregiving, manage increased dementia related behavioral disturbance with more unmet care needs (Aranda et al. 2021). Latino and Black older adults have also been found to have delayed dementia diagnosis, with poorer cognitive functioning at the time of diagnosis (Lin et al. 2021). Latino and Black adults living with dementia are also less likely to be prescribed pharmacotherapy for dementia and more likely to discontinue treatment if it is prescribed, with concern for higher rates of antipsychotic use and lower rates of advance care planning (Aranda et al. 2021). Such health care inequities may contribute to functional impairment and reduced quality of life for patients and families with associated heightened health care costs.
The impact of obstacles to health and rehabilitation services on functioning and disability: a prospective survey on the 12-months after discharge from specialist rehabilitation for acquired brain injury
Published in Disability and Rehabilitation, 2022
Melissa Legg, Michele Foster, Rachel Jones, Melissa Kendall, Jennifer Fleming, Mandy Nielsen, Elizabeth Kendall, David Borg, Timothy Geraghty
This study aimed to: (1) describe and compare obstacles to services reported by people with ABI at 6- and 12-months post-discharge from specialist inpatient rehabilitation; and (2) examine obstacles to accessing health services as moderators of the relationship between functional impairment and activities and participation (Figure 1). Specifically, it was hypothesised that the negative impact of cognitive and physical impairment on activities and participation would be stronger for people who reported greater obstacles to health services than those with lower obstacles. Given the theoretical assumption of causality which underlies research questions about moderation [50], this relationship was examined using a longitudinal design where the predictor and potential moderating variables were measured at 6-months post-discharge and the outcome variables at 12-months post-discharge (Figure 1).
Association between socioeconomic status and prognosis after ischemic stroke in South China
Published in Neurological Research, 2019
Siping Wang, Binyan Shen, Lin Wei, Meiting Wu, Juan Wang
Results of the study showed that a family caregiver was associated with the increased risk of developing a poor prognosis compare with no caregivers, but association between health-care assistant and prognosis was not observed. Patients without caregivers had a slight neurological functional impairment, with a stronger self-care ability in daily life. Therefore, those patients had a good prognosis. The health-care assistant is employed by patients or their relatives to provide daily care or for patients. However, only a small percentage of the population hires health-care assistant to care for patients, depending on their socioeconomic status. If the family is in good socioeconomic condition, they would have the ability to afford additional care costs. On the contrary, patients have to choose their family caregiver to care for them. Family caregiver (relatives or friends) is informal caregiver, which have nature of society and economics [27]. Family culture is very important for Chinese, and a family caregiver is a representative of that culture [28]. Most of the patients with stroke suffer from varying degrees of functional impairment after discharge. Family caregivers take a large amount of responsibilities for stroke survivors at home. A US-based study on the family caregivers of patients with multiple chronic conditions, disability, and cognitive impairment, caregivers play an important role [29]. During long-term care, the presence of psychological distress, depression of family caregivers impacts the quality of care, also indirectly affect the poor prognosis of stroke [30,31].