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When work and satisfaction with life do not go hand in hand: health barriers and personal resources in the participation of people with chronic physical disabilities
- Authors:
- van CAMPEN Cretien, CARDOL Mieke
- Journal article citation:
- Social Science and Medicine, 69(1), July 2009, pp.56-60.
- Publisher:
- Elsevier
People with chronic physical disabilities participate less in both paid and voluntary work and are less satisfied with their lives than people without health problems. Governments and scientists have suggested that participation in employment is the main road to well-being. National survey data was on the participation in work and satisfaction with life was analysed, comparing people with a chronic illness and a physical disability (n = 603) to people with a chronic illness but without a physical disability (n = 1199) and the general population (n = 6128) in the Netherlands. The results show that the relationship between happiness and work is different for people with a chronic illness and a physical disability, as compared to the other two populations. Fewer people with a chronic illness and disability were categorized as ‘satisfied people with work’ (i.e. participating in work and satisfied with their life), while most people belonged to a group of ‘satisfied people without work’ and, surprisingly, not to the expected group of ‘dissatisfied people without work’. In order to explain this exceptional distribution the authors modelled satisfied participation in work as an outcome of a balance between personal resources and barriers. By means of discriminant regression analysis, the severity of motor disability was identified as the main barrier, and education level and age, as the main resource factors that distinguish between ‘satisfied people with work’ and others among the group of people with a chronic illness and a physical disability.
CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? examining the WHO ICF disability domains as mediators of this relationship
- Authors:
- SEXTON E., et al
- Journal article citation:
- Aging and Mental Health, 19(7), 2015, pp.622-633.
- Publisher:
- Taylor and Francis
Objectives: The effect of chronic disease status on quality of life (QoL) has been well established. However, less is known about how chronic diseases affect QoL. This article examines impairment in three domains of the WHO International Classification of Functioning, Health and Disability (ICF) – body function, activity and participation, as well as affective well-being, – as potential mediators of the relationship between chronic disease and QoL. Method: A cross-sectional sample (n = 4961) of the general Irish community-dwelling population aged 50+ years was obtained from the Irish Longitudinal Study of Ageing (TILDA). The CASP measure of QoL was examined as two dimensions – control/autonomy and self-realisation/pleasure. Structural equation modelling was used to test the direct and indirect effects of chronic disease on QoL, via variables capturing body function, activity, participation and positive affect. Results: A factor analysis showed that indicators of body function and activity loaded onto a single overall physical impairment factor. This physical impairment factor fully mediated the effect of chronic disease on positive affect and QoL. The total effect of chronic disease on control/autonomy (−0.160) was primarily composed of an indirect effect via physical impairment (−0.86), and via physical impairment and positive affect (−0.45). The decomposition of effects on self-realisation/pleasure was similar, although the direct effect of physical impairment was weaker. The model fitted the data well (RMSEA = 0.02, TLI = 0.96, CFI = 0.96). Conclusion: Chronic disease affects QoL through increased deficits in physical body function and activity. This overall physical impairment affects QoL both directly and indirectly via reduced positive affect. (Publisher abstract)
Outcomes for disabled service users
- Authors:
- HARRIS Jennifer, et al
- Publisher:
- Social Policy Research Unit. University of York
- Publication year:
- 2005
- Pagination:
- 4p.
- Place of publication:
- York
Often, younger disabled people require support that is more flexible, or of a different type than that which social service can offer. For example people may require assistance with making decisions concerning work, both paid and voluntary, or in parenting. This research briefing reports on a study which aimed to see whether these areas of assistance could be incorporated into assessments and reviews. In the study these areas were named 'outcomes', which meant goals that service users wished to achieve. The researchers synthesised findings from previous work with disabled service users into the outcomes framework. This was incorporated into assessment and review practices and used by a multi-disciplinary team of professionals from one Social Services Department in England. The researchers then evaluated the processes of change and their impact on professionals and service users. The majority of staff from all professional groups found the outcome-focused approach and documents to be useful, workable and an improvement on the original system. Most believed that the outcomes approach and documents were applicable and appropriate to their work and suited their professional role.
Ranking the criteria for assessing quality of life after disability: evidence for priority shifting among long-term spinal cord injury survivors
- Authors:
- WEITZENKAMP D.A., et al
- Journal article citation:
- British Journal of Health Psychology, 5(1), February 2000, pp.57-69.
- Publisher:
- Wiley
Reports on research to identify the criteria spinal cord injury (SCI) survivors use in assessing their quality of life and to examine the concept of priority shifting following SCI. Main outcome measurements used were Flanagan's Quality of Life and Individual Needs Questionnaire, which ranks 15 life priorities in terms of importance and how well personal needs are met in each area. Results found SCI men differed from non-disabled people in how they ranked the determinants of their quality of life. Unlike non-disabled people, for the SCI men neither health nor work were highly correlated to their perceived quality of life. Concludes that SCI men do change the criteria they use in assessing their quality of life and may in fact devalue less attainable goals while increasing the importance of areas in which they might be successful.
Factors associated with frailty in chronically ill older adults
- Author:
- HACKSTAFF Lynn
- Journal article citation:
- Social Work in Health Care, 48(8), November 2009, pp.798-811.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
An ex post facto analysis of a secondary dataset examined relationships between physical frailty, depression and the self-perceived domains of health status and quality-of-life in older adults. The randomised sample included 992 community-dwelling, chronically ill and functionally impaired adults age 65 and older who received care from a Southern California Kaiser Permanente medical centre between 1998 and 2002. The purpose of the study was to identify possible intervention junctures related to self-efficacy of older adults in order to help optimise their functionality. Multivariate correlation analyses showed statistically significant positive correlations between frailty level and depression (r = .18; p = < .05), number of medical conditions (r = .09; p = < .05), and self-rated quality-of-life (r = .24; p = < .05). Frailty level showed a statistically significant negative correlation with self-perceived health status (r = -.25; p = < .05). Notably, no statistically significant correlation was found between age and frailty level (r = -.03; p = < .05). In linear regression, self-perceived health status had a partial variance with frailty level (part r = -.18). The significant correlations found support further research to identify interventions to help vulnerable, older adults challenge self-perceived capabilities so that they may achieve optimum functionality through increased physical activity earlier on, and increased self-efficacy to support successful adaptation to ageing-related losses.
Report of the task and finish group on care pathways for long term neurological conditions
- Author:
- WALES. Welsh Assembly Government. Task and Finish Group on Care Pathways for Long Term Neurological Conditions
- Publisher:
- Wales. Welsh Assembly Government
- Publication year:
- 2010
- Pagination:
- 11p.
- Place of publication:
- Cardiff
This report by the Welsh Neuroscience Expert Group Care Pathways sub-group outlines a process for the development of care pathways to support children, young people and adults with long term neurological conditions. The aim of these pathways is to help people with long term neurological conditions manage their condition, maintain independence and achieve the best possible quality of life through an integrated process of education, information sharing, assessment, care planning and service delivery. It is suggested that this would be as delineated in the National Service Framework for Long Term Conditions for England. Areas addressed are: early recognition, diagnosis and treatment; acute care; early specialist rehabilitation; community and longer term rehabilitation; transitions; vocational and educational rehabilitation; equipment and accommodation; personal care and support for the sufferer, their families and carers; palliative care, care within hospital and other health or social care settings; quality assurance, audit and development.
Grass roots promotion of community health and human rights for people with disabilities in post-communist Central Europe: a profile of the Slovak Republic
- Author:
- HOLLAND Daniel
- Journal article citation:
- Disability and Society, 18(2), March 2003, pp.133-143.
- Publisher:
- Taylor and Francis
Individuals living with a disability or chronic illness in post-communist Central and Eastern Europe face significant challenges to quality of life. The government-supported health care infrastructures in the post-communist countries of Central and Eastern Europe remain highly centralised and institutional, which poses particular obstacles to people with disabilities who wish to live independently in their communities. A partial solution to this difficulty has been the development of innovative grass roots organisations that provide community-based support to individuals with disabilities or chronic illness. These disability organisations provide services and advocacy that allow individuals to receive needed support outside of the biomedical institutions, facilitating independent living in the community. They do so, however, in a political and economic environment of immense change, and one with varying degrees of support for non-governmental organisations and a Civil Society. The following article profiles this grass roots development in one particularly interesting post-communist Central European country, the Slovak Republic.