Disabilities In Rural Areas Research Articles

EdTPA: Assisting Rural Special Education Teacher Candidates to Incorporate Self-Regulation Skills in Planning and Instruction

Forty-one states and 928 teacher preparation programs across the United States are using the Teaching Performance Assessment (edTPA) as an evaluation tool to determine teacher readiness and/or meet licensure requirements. Nationwide, pre-service special education teachers struggle to demonstrate proficiency in specific areas of the edTPA (i.e., plan assessments to monitor and support student learning, analyze teaching effectiveness, and incorporate learner feedback into future learning goals). A commonality across these areas is the incorporation of self-determination skills (e.g., self-regulation) into student learning. Assisting pre-service special education teachers to help students become more self-determined may increase these lower scores on the edTPA. More importantly, increasing self-determination is particularly important for students with disabilities in rural areas who often face challenges related to poverty, decreased opportunities for post-school employment, and underemployment due to geographic location and isolation. This article provides a description of how a special education department sought to assist pre-service special educators in embedding self-regulatory behaviors within lesson plans to better promote self-determination for their students in rural communities across eastern North Carolina.

Mothers Who Take Care of Children with Disabilities in Rural Areas of a Spanish Region.

The purpose of this research is to describe how the mothers of children with disabilities in rural areas of Extremadura perceive care tasks and the subjective impact that these tasks have on their daily life and health, as well as the subjective assessment that these mothers make of the benefits and services of the Spanish welfare policy. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method. Three topics have been extracted from the findings of the analysis: (1) extensive care responsibilities, (2) impacts upon well-being and daily life, and (3) resources that “barely” help. The care tasks performed by mothers of children with disabilities in rural areas have an enormous impact on their daily life and health. This involvement in caregiving generates a significant occupational imbalance which has an impact on their mental health, and which causes economic and social problems.

Policy and Practice of Disability in Rural Zones of Southern Peru and Coastal Ecuador

This study investigates the sociopolitical realities for individuals with disabilities in rural zones of Ecuador and Peru. Chapter One defines disability within global, national, and local contexts with regards to La Ley Orgánica de Discapacidades of Ecuador and Law No. 29973 of Peru, laws enacted to protect individuals with disabilities in each respective country. Chapter Two describes two case studies based on short term ethnographic fieldwork in 2017 and 2018 among disabled populations in San Migos, Ecuador. These narratives contribute to a general understanding of how access to medical professionals and quality diagnoses are determined by geographic situation, economic ability, and familial situation. This inequitable system contributes to the lack of political support for individuals in rural zones, such as San Migos, Ecuador. Chapter Three focuses on case studies taken in 2018 from Rio Mar, Peru and discusses structural limitations, such as education, familial support, and economic abilities, that make it difficult for individuals with disabilities to claim rights and recognition by the Peruvian government. Chapter Four compares case studies in Ecuador and Peru and makes suggestions for disability practices in each respective country. The situation for people with disabilities in rural areas of ​​Rio Mar, Peru and San Migos, Ecuador is neither equitable nor efficient. We must increase research in this area to improve the system.

Care of Children With Disabilities in Rural Areas: Meanings and Impact on Everyday life and Health. Study Protocol

The general objective of this study is to describe and analyze the meanings that participants gave to the experience related to maternal caregiving activities of children with disabilities in the rural context and their impact on daily life and health. In order to achieve this general objective, the following specific objectives were established: (1) To describe the meanings given to experiences related to caregiving activities of children with disabilities; (2) To analyze the impact on daily life and health that these mothers attribute to those activities; (3) To describe how they experience the support provided by the social and healthcare system in rural areas. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method.

Reaching People With Disabilities in Underserved Areas Through Digital Interventions: Systematic Review.

BackgroundPeople with disabilities need rehabilitation interventions to improve their physical functioning, mental status, and quality of life. Many rehabilitation interventions can be delivered electronically ("digitally") via telehealth systems. For people with disabilities in underserved areas, electronically delivered rehabilitation interventions may be the only feasible service available for them.ObjectiveThe objective of this study was to evaluate the current status of digital interventions for people with disabilities in remote and underserved areas.MethodsA systematic review was conducted on this topic. Keyword searches in multiple databases (PubMed, CINAHL, and Inspec) were performed to collect articles published in this field. The obtained articles were selected based on our selection criteria. Of the 198 identified articles, 16 duplicates were removed. After a review of the titles and abstracts of the remaining articles, 165 were determined to be irrelevant to this study and were therefore removed. The full texts of the remaining 17 articles were reviewed, and 6 of these articles were removed as being irrelevant to this study. The 11 articles remaining were discussed and summarized by 2 reviewers.ResultsThese 11 studies cover a few types of disabilities, such as developmental disabilities and mobility impairments as well as several types of disability-causing disorders such as stroke, multiple sclerosis, traumatic brain injury, and facio-scapulo-humeral muscular dystrophy. Most of these studies were small-scale case studies and relatively larger-scale cohort studies; the project evaluation methods were mainly pre-post comparison, questionnaires, and interviews. A few studies also performed objective assessment of functional improvement. The intervention technology was mainly videoconferencing. Moreover, 10 of these studies were for people with disabilities in rural areas and 1 was for people in urban communities.ConclusionsA small number of small-scale studies have been conducted on digital interventions for people with disabilities in underserved areas. Although the results reported in these studies were mostly positive, they are not sufficient to prove the effectiveness of telehealth-based digital intervention in improving the situation among people with disabilities because of the small sample sizes and lack of randomized controlled trials.

Barriers to health care utilization for older adults with functional disabilities in rural areas

의료서비스를 이용하려는 농촌에 거주하는 노인은 건강 관련 개인적인 요인과 인력과 자원이 부족한 농촌의 특성으로 서비스 접근에 어려움을 겪는다. 그래서 이 연구는 지역과 기능장애의 상호작용에 관심을 가지고, 기능장애와 지역적 특성 그리고 의료서비스 이용과의 관계를 분석하였 다. 이 연구는 2014년 노인실태조사에서 지역사회 거주 65세 이상 노인을 연구 대상으로 하였다. 의료서비스 이용 관련 요인을 분석하기 위해 로지스틱 회귀분석이 사용되었고, 기능장애와 농촌지 역의 상호작용을 분석하였다. 일상생활에 지장이 없는 농촌노인은 도시노인에 비해 의료서비스를더 높은 확률로 이용하는 것으로 나타났지만, 기본적 일상생활에 어려움이 있는 농촌노인은 통계적 으로 유의미하게 의료서비스 이용확률이 낮게 나타났다. 농촌과 기능장애의 상호작용 효과를 고려 하지 않는다면 농촌노인의 서비스 접근성이 잘못 해석될 수 있다. 이 결과는 도시와 농촌의 건강불 평등이 기능장애 노인에게는 심화될 수 있음을 의미한다.Rural older adults with functional disabilities may experience barriers in regard to using health care services due to the lack of health services and professionals in rural areas and the difficulty they experience in accessing such services. This study explored the relationships among functional disabilities, geographical characteristics, and health care use, focusing on the interaction effects of functional disabilities and rural areas on health care use. Using 2015 Living Profiles of Older People Survey, cross-sectional analyses were employed. Community-residing older adults aged 65 and older were extracted from the database. Logistic regressions were conducted to identify the influencing factors of health care service use. Next, interaction terms between functional disabilities and rural areas were included into the model. Rural older adults without difficulties in activities of daily living (ADL and IADL) were more likely to use health care services than their urban counterparts. However, rural older adults with difficulties in ADL were significantly less likely to use health care services than their counterparts. Without considering interaction effects between functional disabilities and geographic area, results might be misinterpreted as suggesting better accessibility of rural older adults to health care services. The results imply that health disparities between rural and urban older adults should be addressed by considering functional disability.

A Qualitative Analysis of the Employment Needs and Barriers of Individuals With Intellectual and Developmental Disabilities in Rural Areas

In this article we present the results of a needs assessment evaluating the employment-based needs of individuals with intellectual and developmental disabilities (IDD), from the perspectives of self-advocates, their families and care givers, and IDD service providers in a primarily rural state. Participants were recruited through statewide distribution of a questionnaire about key issues and barriers to employment. A total of 467 adults participated. Employment was identified as a top concern across the groups. An inductive thematic analysis approach was used to analyze the qualitative comments provided by respondents about their employment needs. The results were generally consistent with prior research among Americans with IDD, in that employer expectations, transportation barriers, disability benefits, limited opportunities to develop employment skills, and broader economic factors influencing the community were identified as key issues. However, the results demonstrate the magnified impact of these barriers in rural areas, particularly rural areas facing economic challenges. The results of this needs assessment are discussed in terms of the broad national implications, and in terms of the local process of engaging multiple stakeholder groups to identify potential solutions.

Learning disabilities: Interventions and clinical issues

Learning disabilities: Interventions and clinical issues

Planning for the future: Exploring the experiences of older carers of adult children with a learning disability

Accessible summary There are a large number of adults with learning disabilities who live with and are cared for by their parents. There is a need for interventions to support older carers with their caring role and to plan for a time when they can no longer continue caring. This research looked at a local support service in England that aimed to support carers over 55 who had an adult child with a learning disability living at home. Twelve carers were interviewed individually. The study highlights the unmet needs of older family carers and shows the value of support from a carer perspective. AbstractBackgroundThere are a significant number of adults with a learning disability who live with and are cared for by their parents. There is a pressing need for interventions to support older parent carers with their role and to plan for a time when they can no longer continue caring. This article reports on the experiences of older parent carers who have been in receipt of an intervention to support future planning, in a rural part of England, delivered to older carers of their adult children with learning disabilities.MethodsSemi‐structured carer interviews (n = 12) were conducted and analysed thematically.ResultsFour themes were identified (a) emotional needs of carer, (b) future planning, (c) accessing other services and resources and (d) links to adult care services. Carers welcomed the flexibility of the intervention and its focus on support for them, relieving their sense of isolation.ConclusionsThe research highlights the unmet needs of older family carers and shows the value of tailored support from a carer perspective. The findings have implications for national social care provision delivered to carers of adult children with learning disabilities in rural areas.

Disability Transitions and Health Expectancies among Elderly People Aged 65 Years and Over in China: A Nationwide Longitudinal Study.

Disability has become a critical issue among elderly populations, yet limited large-scale research related to this issue has been conducted in China, an aging society. This study explored sex and urban-rural differences in disability transitions and life expectancies among older adults in China. Data were collected from the Chinese Longitudinal Health Longevity Survey (CLHLS), which enrolled people aged 65 and older and was conducted in randomly selected counties and cities across 22 provinces in China. Disability was diagnosed based on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Several individual characteristics were assessed, including sociodemographic factors (age, sex and region, etc.) and health behaviors (currently smoking, currently drinking, etc.). Multistate models were applied to analyze the transition rates among 4 states: no disability, mild disability, severe disability and death. The transition rates from disabled states to the no-disability state were found to decrease markedly with age. The rates of recovery from mild disability in rural areas were higher than those in urban areas. Rural elderly individuals lived shorter lives than their urban counterparts, but they tended to live with better functional status, spending a larger fraction of their remaining life with less severe disability. Based on these findings, devoting more attention and resources to rural areas may help less severely disabled people recuperate and prevent severe disability. The study provides insights into health plan strategies to help guide the allocation of limited resources.

‘When I don't have money to buy the drugs, I just manage.’—Exploring the lived experience of persons with physical disabilities in accessing primary health care services in rural Ghana

The United Nations Convention on the Rights of Persons with Disabilities recognizes the rights of persons with disabilities' access to health care, including primary health care (PHC). However, growing evidence indicates that individuals in rural areas generally experience health access issues, and these issues are even worse for those with physical disabilities. Knowledge about such experiences is critical for policy design and clinical practice to promote PHC access for persons with physical disabilities in rural areas. This study seeks to explore the experiences of persons with physical disabilities in accessing PHC services in the predominantly rural Upper West Region of Ghana. We conducted semi-structured interviews with 18 participants living with physical disabilities, and used both deductive and inductive approaches to analyze the data. Participants shared experiences at three broad levels: the health system level, individual level and health-seeking behaviors level. Within the health system level, we identified three main categories: service availability (presence of health facilities, deficient drug supply and lack of providers), acceptability (positive and negative attitudes of providers and perceived high and low quality of care) and accommodation (inaccessible health facilities and equipment). The experiences at the individual level included financial constraints and mobility to health care facilities. Health-seeking behaviors related to how the individual reacted and responded to access barriers, which included searching for traditional healing, resorting to self-medication, making sacrifices in managing their conditions and relying on spiritual means. The information provided in this study is potentially important to policy makers and PHC providers as it presents evidence on the barriers and facilitators to PHC access in a rural setting. In particular, understanding individuals' experiences and how they develop health-seeking behaviors to overcome access barriers will be critical for policy design and client-centered service delivery in rural Ghana and potentially other low- and middle-income countries.

Using Teleconferencing to Meet the Needs of Children, 0 to 3 Years Old, With Disabilities in Rural Areas

Serving families who live in rural communities can be a challenge for early intervention programs. Factors, such as travel, family needs, and limited program and community resources, have been identified as ongoing barriers for this population. Technology, specifically teleconferencing, can be a solution to provide equitable services compliant with Part C of Individuals With Disabilities Education Act (IDEA; 2004) mandates and professional practices. This article will discuss how to determine whether teleconference technology is a good fit and how to individualize, plan, and implement technology to support families in rural communities. It will also discuss legal and practical considerations that must be taken into account when using teleconferencing to discuss service delivery.

Analysis of health, functioning and disability of rural inhabitants aged 60-80 living in south-eastern Poland - a cross sectional study.

Since the beginning of the 20th century, the aging of the European population has been observed, and the potential long-term social and economic problems have been flagged. The aim of the study was assessment of the level of disability and multidimensional analysis of determining factors among the elderly living in rural areas. The study was conducted in a population of 973 people aged 60-80 living in south-eastern Poland. The research tool used in the study was the WHO Disability Assessment Schedule - WHODAS 2.0. As many as 28.26% of the study group had at least a moderate level of disability; severe disability was observed in 11.51 % of the participants, and extreme disability was experienced by 0.21%. The highest average level of disability in the study group was found in performing activities of daily living (mean = 28.94; SD = 30.04), participation in everyday life (mean = 28.40; SD = 23.29) and mobility (mean = 26.04; SD = 27.57). Statistically significant relationships were observed between age, gender, education level, physical activity and number of chronic diseases. An increase in the level of education and popularization of physical activity may be helpful in reducing the prevalence of disability among the elderly inhabitants of rural areas. Increasing access to health care, aimed at rapid diagnosis of chronic diseases, treatment and rehabilitation, seems to be a reasonable action preventing the disability in rural areas.

Status of elderly disability in 7 cities of China

Objective: This study focused on the proportions of disability in old people of China (rural and urban) and the demographic characteristics of disability. Methods: Random sampling was used that including stratified, multiple-stage, and cluster sampling methods. This research project was conducted in 7 municipalities (north, south) of China, including 6 864 urban and rural people aged 60 and above. Interviewers used unified questionnaire and performed door to door. Basic and related information on disability of the community elderly were gathered. χ2 test was used to compare the differences of rates on the extent of disability among different groups of elderly. Results: Health condition and disability assessment on 6 864 urban and rural elderly living in the communities were analyzed. The overall mean rate of disability in the elderly was 7.0%, with the proportion of disability in women (7.9%) significantly higher than in men (6.0%) (P<0.01). Proportions of disability in rural areas (10.9%) were significantly higher than those in urban areas (4.7%) (P<0.01). Region wise, it was also seen higher in the north (7.6%) than in the south (5.4%) (P<0.01) parts of the country. The rates of disability in cities as Beijing, Chongqing, Haerbin, Chengdu, Xi'an, Changsha, Shanghai were 5.7%, 5.3%, 4.5%, 3.9%, 3.0%, 2.3%, 1.2% (P<0.01) respectively with Beijing being the highest and Shanghai being the lowest, all with statistical significances. Mean disability rates in the age groups of 60-, 65-, 70-, 75- and ≥80 were 2.5%, 4.0%, 5.3%, 9.9% and 25.1% (P<0.01) respectively, with the rising rates of disability parallel to the increase of age. Conclusion: In China, the overall rate of disability in the elderly (urban and rural community) was 7.0%. The rates of disability were significantly higher in women than in men, in rural than in urban areas and higher in the north than in the south parts of the country. The rates of disability were increasing along with age of the elderly.

Pessoas com Deficiência em Áreas Rurais da Metade Sul do RS

O presente artigo analisa dados do Censo de 2010, realizado pelo IBGE, relacionados às pessoas com deficiência em áreas rurais de 8 municípios da Metade Sul do RS. O objetivo está centrado na discussão da metodologia do Censo e a forma como os dados foram gerados, buscando o entendimento acerca do termo deficiência. Para compreender a perspectiva dos levantamentos censitários sobre a incidência ou não de deficiências foi realizada pesquisa documental na legislação federal, o que permitiu concluir que o número de pessoas com deficiência, tanto em áreas rurais quanto urbanas, aumentou em relação aos Censos anteriores, devido à definição utilizada pelo IGBE, baseado na legislação. Analisando a variável gênero, os dados demonstram que o número de mulheres com algum tipo de deficiência é consideravelmente maior que o de homens, tanto em áreas urbanas quanto rurais. Mas no que diz respeito à frequência de pessoas com deficiência, nas áreas rurais os dados são superiores aos números encontrados em áreas urbanas, independente do gênero. Nesse sentido, os resultados indicam que as áreas rurais são mais vulneráveis, elaborando-se reflexões sobre as responsabilidades do poder público na construção de políticas públicas que levem em consideração tais variáveis em prol do desenvolvimento social dessas regiões.

The Effect of Community-Based Rehabilitation Program on Quality of Life of People With Physical Disability in Bostanabad, Tabriz, Iran

Background: Many people with disability are living in developing countries, requiring short- and long-term rehabilitation services. These services are provided by various professionals and are very expensive. Community Based Rehabilitation was developed by World Health Organization to provide the basic rehabilitation services for those are living in remote and poor areas, not having access to hospitals and rehabilitation clinics. Objectives: The aim of this study was to examine the effect of a Community-Based Rehabilitation (CBR) program on Quality of Life (QOL) of people with physical disability in rural areas of Bostanabad, Tabriz, Iran. Patients and Methods: In this descriptive-analytical and comparative study, two groups of participants were selected as the case and control according to their living place. Participants in the case group included 48 people with physical disability, aged between 18 and 50 years old (Mean = 32, SD = 8.78) who lived in the villages covered by the CBR program. On the other hand, participants in the control group included 45 people with physical disability in the close-by villages not covered by the CBR program (Age between 18 and 50 years old; Mean = 33, SD = 9.98). People with other types of disabilities or multiple disabilities were excluded from the study. All participants in this study completed two questionnaires, including demographic and the Short-Form 36 (SF-36) to evaluate QOL. Data were analyzed using t-test for independent groups. Results: Data were analyzed using SPSS software. The results demonstrated a significant difference in QOL between the two groups (P > 0.002). Participants in the CBR program group showed a higher level of QOL compared with the other group. Conclusions: The results of this study show that applying CBR programs in the rural and remote areas can be effective in improving the QOL of people with physical disability.

Factors affecting retention of allied health professionals working with people with disability in rural New South Wales, Australia: discrete choice experiment questionnaire development.

ObjectiveThis paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas.MethodsFocus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison.ResultsSix attributes that may influence AHPs working with people with disability in rural areas to continue to do so were inductively identified: travel arrangements, work flexibility, professional support, professional development, remuneration, and autonomy of practice. The qualitative research information was combined with a policy review to define these retention factors and ensure that they are amenable to policy changes.ConclusionThe use of various qualitative research methods allowed the development of a policy-relevant DCE questionnaire that was grounded in the experience of the target population (AHPs).

Increasing Rural Special Education Teacher Candidates' Ability to Implement Evidence-Based Practices: A Program Description of the Boise State University TATERS Program

The Technology Accentuated Teacher Education for Rural Specialists (TATERS) program aimed to: (a) prepare highly qualified special education teachers across a state comprised of more than 70% rural districts, (b) develop a system of support through a mentor network and institutions of higher education collaboration to address the needs of teacher candidates in rural areas, (c) ground special education teachers in the use of evidence-based practices to improve the instructional services that students with disabilities in Idaho receive, and (d) develop a mechanism to evaluate and provide feedback on teacher candidates' implementation of evidence-based practices. This article describes the application of a special education teacher evaluation system to a teacher preparation program designed to improve special education teachers' ability to implement evidence-based practices for students with disabilities in rural areas. Key program components are described and future directions for continuous improvement are highlighted.

Disability in Rural Areas of Australia

Disability in Rural Areas of Australia

The Determinants of the Rural Disabled Person’s Behavior of Receiving Rehabilitation

People with disabilities in rural areas form a special social group in straitened circumstances. They are suffering from impairments, activity limitations, and participation restrictions, which make their situation more severe. As a basic civil right for the disabled, rehabilitation service is an important approach to the recovery of their health and a great help for them to step into society confidently. The objective of this study is to survey the rural disabled people with regard to the important factors that affect their behavior of receiving rehabilitation. 373 questionnaires were sent out and 360 questionnaires were returned (96.5% return rate). The regression analysis was used to analyze the determinants of receiving rehabilitation. The Binary Logistic Regression Model showed that individual factors, family factors, disability characteristic factors and cognitive factors had significant influence on the choice of rehabilitation for the rural disabled. Among these factors, the variables like level of education (P < 0.01), life not fully providing for oneself (P < 0.05), level of understanding of rehabilitation service (P < 0.01), degree of satisfaction about work on the disabled (P < 0.05), cognition of rehabilitation demand (P < 0.01), and net income of households (P < 0.1) had significantly positive correlation with the choice. While other variables like the number of the disabled in a family (P < 0.01) and congenital disability (P < 0.01) had significantly negative correlation with the choice. Rehabilitation for the people with disabilities could be improved by enhancing the education of the disabled in rural areas, paying more attention to impoverished disabled family, perfecting and enforcing implement of the rehabilitation policies, raising the work efficiency of the relative agents, and advocating the rehabilitation policies more sufficiently.