Disabilities In Finland Research Articles

Construction of discretion-related characters in social work with persons with disabilities in Finland

ABSTRACT This study explores characterisation regarding discretion in social work with persons with disabilities (PWD) in Finland. Discretion is conceptualised as a relational and institutional practice that is connected to narratives and conducted through relationships. The writings of six social workers and 36 clients about discretion in social work with PWD were analysed through characterisation. The research question was as follows: How do social workers and clients construct discretion-related characters for each other in their writings? Based on the findings, the characters were constructed regarding desired and undesired attributes. The discretion-related characters with desired attributes were a client at the centre of everything and a social worker advocating for a client, while the characters with undesired attributes were a social worker promoting the system and a client in inappropriate services. This study argues that the construction of characters is conducted through available material and narrative resources that matter for both the relationships and the discretion in social work with PWD.

Ethnic background as a risk factor for permanent brachial plexus birth injury: A population-based study.

Brachial plexus birth injury is the most common birth injury causing permanent disability in Finland. This study aimed to assess risk factors of a permanent brachial plexus birth injury and calculate the incidence. This is a retrospective population-based study including all deliveries between 2006 and 2022 in Southern Finland. The number of children born, obstetric data, and migrant status were gathered from the registries of the Finnish Institute for Health and Welfare, and Statistics Finland. Race of the mothers of children with a permanent brachial plexus birth injury was recorded. The severity of permanent brachial plexus birth injury was assessed using the 3-month Toronto test score. A lower score was indicative of a more severe injury (scored 0-10). One hundred of the 298 428 children born during the 17-year study period sustained a permanent brachial plexus birth injury (0.34 per 1000). Mothers of children with a permanent brachial plexus birth injury had a higher body mass index (29 vs. 24 kg/m2) and their pregnancies were more often complicated by diabetes (28% vs. 12%), shoulder dystocia (58% vs. 0.3%), and/or assisted deliveries (45% vs. 10%) compared with all other mothers (p < 0.001). Thirty two of the 52 725 children born to migrant mothers had a permanent brachial plexus birth injury (0.61 per 1000). The incidence of permanent brachial plexus birth injury was 5.7 times higher among children of Black migrants from Africa (18/11 738, 1.53 per 1000) compared with children of native mothers (0.27 per 1000). Black mothers had a higher body mass index at the start of pregnancy (29 vs. 26 kg/m2, p = 0.02) compared with Caucasians. Children of Black mothers had a more severe injury compared with all others (p = 0.007) with a mean 3-month Toronto test score of 4.2 (range 0.0-6.5, SD ±1.6) vs. 5.6 (range 0.0-9.3, SD ±2.2). Shoulder dystocia and assisted delivery are the most important risk factors for a permanent brachial plexus birth injury. Black race was associated with a higher rate and a more severe permanent brachial plexus birth injury.

Relational discretion in social work with persons with disabilities. Intersecting relations between legal, professional and organizational discourses

ABSTRACT This study examines discretion in social work with persons with disabilities in Finland based on texts written by social workers. Discretion is understood as relational and discursive institutional practice. The research question is: What kind of discourses and relations between them are involved in discretion in social work with persons with disabilities? The social workers’ writings are analysed using critical discourse analysis. The findings show how discretion is manifested as relational discretion influenced by a legal, a professional, and an organizational discourse. Discretion is expressed in various ways in the discourses. The discourses are complementary, but highlight tensioned power relationships. The intersecting relations of the discourses form an image of extensive and complex discretion in social work with persons with disabilities, which requires relational agency and relational expertise from social workers.

The labour market participation of persons with disabilities and related policies

This study provides a comparative analysis of policies related to the labour market position of persons with disabilities in Finland and Italy, countries with a relatively small employment gap between persons with and without disabilities. This research examining policies improving the labour market position of persons with disabilities was based on existing literature and expert interviews. The comparative analysis shows that these countries employ different policy approaches. In Finland, benefits are relatively high and policies emphasise prevention. However, there is a lack of activation measures for disability benefit recipients. In Italy, policies focus on activation. The Italian quota law requires companies to hire persons with disabilities. Moreover, social cooperatives provide employment for persons with disabilities. The findings suggest that efforts to ensure adequate compensation and activation measures, combined with processes created to build an inclusive society, may help to improve the labour market situation for persons with disabilities.

Vulnerability, Disability, and Agency: Exploring Structures for Inclusive Decision-Making and Participation in a Responsive State

By unpacking some of the dichotomies inherent in the concepts of vulnerability and disability, the article problematises some of the current legal approaches to disability in Finland. It argues that where used to single out population groups or individuals due to their embodied characteristics, the vulnerability paradigm can be seen to create binaries both among the persons with disabilities, and between the “vulnerable” persons with disabilities and the perception of a rational, self-standing and autonomous human being. To mitigate such binaries, the article explores an agency-centred discourse of vulnerability, one that recognises the co-existence of agency and vulnerability and sees agency as dynamic and responsive to the societal support structures that surround all of us. One of the central arguments of the article is that generalised approaches do, however, not suffice to make agency a reality for all persons with disabilities. Given the extensive diversity of intra-group variations between persons with disabilities, individualised solutions are needed for agency to be possible for all. To overcome objectification and de-agencification – and to enhance agency – this diversity of situations, needs and contexts of lived-in realities of individuals also needs to be expressly reflected in the legal language in addressing disability.

Differences in Unfavorable Lifestyle Changes during the COVID-19 Pandemic between People with and without Disabilities in Finland: Psychological Distress as a Mediator.

We investigated whether people with disabilities—cognition, vision, hearing, mobility, or at least one of these disabilities—report more COVID-19-related negative lifestyle changes than those without disabilities, and whether psychological distress (MHI-5) mediates the association between disabilities and negative lifestyle changes. Information about COVID-related lifestyle changes among people with disabilities is scarce. We analyzed population-based data from the 2020 FinSote survey carried out between September 2020 and February 2021 in Finland (n = 22,165, aged 20+). Logistic regressions were applied to investigate the effect of the COVID-19 pandemic and related restrictions on negative lifestyle changes—sleeping problems or nightmares, daily exercise, vegetable consumption, and snacking. To test for a mediation effect of psychological distress, the Karlson–Holm–Breen method was used. People with all disability types reported increased sleeping problems or nightmares, and decreased vegetable consumption during the pandemic more frequently than those without. People with mobility and cognitive disabilities more frequently reported decreased daily exercise. People with cognitive disabilities more often reported increased snacking. Psychological distress mediated associations between disabilities and negative lifestyle changes, with the highest association between cognitive disabilities and increased sleeping problems or nightmares (B = 0.60), and the lowest between mobility disabilities and decreased daily exercise (B = 0.08). The results suggest that strategies to promote healthy lifestyles should consider people with disabilities. Alleviating their psychological distress during crisis situations could be one approach.

Experiences from the harmonization of Finnish national population-based health survey data.

Aims: There are several advantages to pooling survey data from individual studies over time or across different countries. Our aim is to share our experiences on harmonizing data from 13 Finnish health examination surveys covering the years 1972–2017 and to describe the challenges related to harmonizing different variable types using two questionnaire variables – blood pressure measurement and total cholesterol assessment – as examples. Methods: Data from Finnish national population-based health surveys were harmonized as part of the research project ‘Projections of the Burden of Disease and Disability in Finland – Health Policy Prospects’, including variables from questionnaires, objective health measurements and results from the laboratory analysis of biological samples. The process presented in the Maelstrom Research guidelines for data harmonization was followed with minor adjustments. Results: The harmonization of data from objective measurements and biomarkers was reasonably straightforward, but questionnaire items proved more challenging. Some questions and response options had changed during the covered time period. This concerned, for example, questionnaire items on the availability and use of medication and diet. Conclusions: The long time period – 45 years – made harmonization more complicated. The survey questions or response options had changed for some topics due to changes in society. However, common core variables for topics that were especially relevant for the project, such as lifestyle factors and certain diseases or conditions, could be harmonized with sufficient comparability. For future surveys, the use of standardized survey methods and the proper documentation of data collection are recommended to facilitate harmonization.

Governing citizenship for students with learning disabilities in everyday vocational education and training

In recent decades, disability policy programmes and conventions have been underlining how improving educational opportunities, especially for post-compulsory education, improve the employability and independence of disabled people, and thus their position in society and as citizens. However, little attention has been paid to actual educational practices and how they relate to these policy objectives. This article focuses on post-compulsory education for students with learning disabilities in Finland, more precisely on a vocational training programme called Preparatory Education for Work and Independent Living (PEWIL). In our ethnographic study of the programme, we scrutinise how daily educational practices govern citizenship for its students. We argue that even though these students are perceived as ‘trainable’ mainly in sheltered work and as only able to live in an institutionalised setting—thus reproducing their marginalisation—they have internalised the idea of a neoliberal labour market citizen with an emphasis on independence and employability. Points of interest The subject of this article is a vocational education and training programme for young people with learning disabilities. The aim of the programme is to give students skills for working and independent living in mainstream society. We are interested in how citizenship is understood on the programme. The first author participated in the everyday life of the programme and interviewed students. We found that the programme prepares students to work in sheltered workshops and to live in group homes. In interviews, the students said they want to have regular paid jobs and live independently in their own flats.

Loneliness in life stories by people with disabilities

This study investigates loneliness in life stories by people with disabilities. By approaching loneliness from a relational perspective, this study attempts to illustrate how loneliness and disability are intertwined in the life course. The research question was as follows: How do people with disabilities understand loneliness in their life stories? Life story data ‘Life of Disabled Persons in Finland 2013–2014’ was analysed with a narrative life course approach. Loneliness was narrated in accordance with normative life course expectations. People with disabilities narrated loneliness as unbelonging in childhood, disjointed youth and disaffiliation to normative institutions in adulthood. This study suggests that relation between loneliness and disability concern the conditions of inclusion that is the conditions of living and telling. Points of Interest Loneliness involves both unwanted emotions and social isolation. In many societies, both loneliness and disability bear a stigma. This so-called double stigma affects the lives of people with disabilities. This study explores loneliness and disability in life stories by people with disabilities in Finland from a life course perspective. Although scholars have widely studied loneliness in Finland, they have not studied loneliness in people with disabilities in any great depth. Loneliness in life stories by people with disabilities was narrated in relation to a sense of bodily difference and occurred as a disconnection from a socially ‘standard’ life course. Loneliness was located within three main phases: childhood, youth and adulthood. Negative attitudes towards disability feed social isolation and emotional loneliness. Further research on disability and loneliness throughout the life course as well as more discussion about the conditions of inclusion and the emotional patterns of social relations are needed.

Comparison of Physical Activity between Children and Adolescents with and without Disabilities in Finland

Comparison of Physical Activity between Children and Adolescents with and without Disabilities in Finland

Predictors of completion of upper secondary education of young adults with severe physical and multiple disabilities in Finland

ABSTRACT Prior studies have shown that young adults with severe physical and multiple disabilities are less likely to complete upper secondary education. This study aimed to identify whether these students’ type of multiple disability, gender, location and literacy skills were associated with completion of upper secondary education. The participants were 74 young adults with severe physical disabilities (aged 19–22, M age = 20.2, SD = 1.16), of whom 39 (52.70%) had multiple disabilities. The data was gathered via the healthcare professionals’ instrument, Severely Disabled Youth’s Life Situation and Functioning of Service Systems in Finland. The results of chi-squared tests of independence indicated that having severe physical disability (other than cerebral palsy) with intellectual disability, location, and literacy skills were associated with completion of upper secondary education. The binary logistic regression showed that urban location and moderate or good literacy skills predicted completion of upper secondary education.

Protocol of a research project ‘Projections of the burden of disease and disability in Finland – health policy prospects’ using cross-sectional health surveys and register-based follow-up

IntroductionWith the rapid ageing of the population in Europe, reliable estimates of the future development of the disease and disability burden as well as healthy life years in the older...

Indigenous Persons with Disabilities: The Quest for Legal Recognition of Intersectionality and the Prohibition of Multiple Discrimination using the Example of the Sámi People in Finland

Indigenous peoples have attracted a lot of attention in international legal and political instruments during the last couple of decades. Only very recently, however, have international institutions started to address the situation of minorities within minorities that often experience multiple discrimination. This article focuses on the vulnerable situation and the rights of Sámi persons with disabilities in Finland as the case study to demonstrate the inadequacy of different legal regimes to recognise and thus help to prevent and overcome the multiple discrimination of persons with disabilities who also belong to the indigenous community. The article calls for an intersectional approach to law, in order to recognise that persons with multiple identities may need legal protection that recognises the problem of multiple discrimination, and thereby adequately protects their rights and equality.

Creating capabilities for societal participation in times of welfare state change? Experiences of people with disabilities in Finland

Societal participation is central for disability policies throughout the world. In a Finnish setting, it is firmly anchored in the welfare state's commitment to create equal capabilities, but it is also dependent on other prerequisites, such as an inclusive labour market. However, these commitments have become both increasingly important through efforts of strengthening the rights of people with disabilities as well as increasingly challenged by crumbling growth and recurrent austerity measures in social policy. This article explores societal participation of people with disabilities in Finland in times of the recent ratification process of the UN CRPD and welfare cuts, and investigates the subjective experiences of societal participation in a changing welfare state context. The data consists of 13 individual qualitative interviews among working-age people with different kinds of disabilities. The findings highlight the importance of state commitment for creating equal capabilities for societal participation and for removing barriers standing in its way. They also suggest that this commitment is becoming both strengthened by the UN CRPD and weakened by the economic crisis and austerity measures and that this may have an undermining effect upon capabilities for persons with disabilities to participate in society.

Subjective quality of life among youth with severe physical disabilities during the transition to adulthood in Finland

Purpose: This study examined the subjective quality of life among youth with severe physical disabilities during the transition to adulthood.Method: A purposive sample of 74 youths (mean age 20.19) with severe physical disabilities completed World Health Organization Quality of Life – Brèf (WHOQOL-BREF) to measure the quality of life; the Severely Disabled Youths’ Life Situation and Functioning of Service Systems in Finland to measure health issues. The data were analyzed using one-sample and independent-samples t-tests, and sequential multiple regression analysis.Results: Compared to youth without disabilities, the study youth scored lower values in physical, social, and environmental quality of life. No gender differences were found in the quality of life among youth with severe physical disabilities. Age, gender, and intensity of pain were associated with quality of life.Conclusions: This evidence-based knowledge can be used to provide guidance for policy issues such as providing health and social services for youth with severe physical disabilities in Finland.

Psychological and physical violence towards children with disabilities in Finland and Sweden.

This article describes psychological aggression and physical violence by Swedish and Finnish mothers ( N = 3420) towards their 0- to 12-year-old children with disabilities ( N = 286) by comparing such behaviour with the mothers of children without disabilities ( N = 3134). The survey data are based on representative samples from Finland and Sweden of mothers' reports of their behaviour towards their child in conflict situations. Mothers of children with disabilities reported more psychological aggression towards their child than did mothers of children without disabilities. Mothers used psychological aggression, especially towards children with neurological/psychological disabilities. However, the only significant difference regarding physical violence was repetitive use of mild physical violence. Overall, the analysis suggests that children with neurological/psychological disabilities are more exposed to both psychological and physical violence than children without disabilities or children with somatic/developmental disabilities.

The daily life of people with disabilities: experience of Lappeenranta

The article is devoted to the experience of social services in South Karelia (region of Finland) in respect of different types of urban support for disabled people in the areas of employment, housing and hobbies. The article describes the work of institutions providing assistance to people with disabilities and the services which are being provided by social service Eksote in Lappeenranta, Imatra and Parikkale. The article describes the work of centers round the clock monitoring and employment for the day, as well as the daily lives of people with Down syndrome, severe autism, intellectual disabilities. The attention is focused on the best practices in Finland, enabling the disabled child to engage in open employment. The article informs about the kinds of financial support for disabled people in Finland and assistance from the National Insurance Institute Kela, including the payment of rental housing. This article describes the features and differences of the centers around the clock care for people with disabilities in South Karelia: Houses “Petyayamyaki” and Private accommodation center “Villa of Karelia “for people requiring intensive care. The article describes the features of the day centers of employment for people with disabilities in Finland: the Center for Independent Living Support “Arttu” and Center “Valtsy.” According to the official position of the Government of Finland, persons with disabilities have the same rights as all other citizens of the country, and they have possibility to make decisions about their own lives. The Finnish system of medical and social rehabilitation of people with disabilities deserves the attention and replication in Russia.

Mortality in individuals with intellectual disabilities in Finland.

ObjectivesThis study aimed at ascertaining the standardized mortality ratios (SMR) for those with an intellectual disability (ID) in Finland.Materials and MethodsWe used the statistical database of the national insurance institution of Finland and Statistics Finland's mean population figures. We determined the number of individuals who received benefits (disability allowance, disability pension, or care allowance for pensioners) due to an ID diagnosis and the number of those whose benefit had been terminated due to death during the years 1996–2011.ResultsSMR for females with a mild ID (IQ 50–69) was 2.8 (95% CI: 2.60–3.01) and for males 2.0 (95% CI: 1.88–2.14), and for females with a severe ID (IQ <50) 5.2 (95% CI: 4.99–5.50) and for males 2.6 (95% CI: 2.48–2.72).ConclusionThis significant difference in the SMR figures between males and females with ID warrants further research.

The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study

ObjectiveThe association between obesity and disability may differ between high-income and low-income/middle-income countries but there are no studies comparing this association between these settings. The aim of the study was...

Lines of development in social research on disability in Finland between the years 1970–2010

Abstract This article reviews the development of social research on disability conducted in Finland during the 40-year period from 1970 until 2010. The main focus is the connection of the research with the socioeconomic development of the country. The review starts from the emergence of a new disability service paradigm during the late 1960s. This new paradigm centred around the concept of rehabilitation, and had its roots in the birth of a postmodern welfare state during the same decade. The second shift began during the 1980s and was characterized by the precedence of human rights issues. Both of these changes paralleled international developments, but equally had their roots in the Finnish post-war society. Along with these changes the predominant metaphor of a disabled person shifted from a criminal to a sick person, and finally, to a citizen, manifesting three successive service paradigms. Based on extensive screening on the available databases, the article reviews typical studies from different time...