Physical Disabilities Research Articles

Inferiority feelings mediate the impact of subjective social support on anxiety/depression symptoms in individuals with physical disabilities

BackgroundPersons with physical disabilities are more likely to suffer from psychological symptoms and inferiority feelings, and social support plays an important role in improving those symptoms. However, the interaction between psychological symptoms, inferiority feelings and social support is yet to be understood.MethodsA cross-sectional study was conducted to investigate anxiety, depression, and inferiority feelings among individuals with physical disabilities in a Chinese sample. The questionnaire included the Generalized Anxiety Disorder 7, Patient Health Questionnaire 9, Self-designed Disability Questionnaire, and Social Support Rating Scale including three dimensions: subjective social support, objective social support and utilization of social support.ResultsOut of the 1,453 respondents with physical disabilities, 49.7, 60.4, and 62.5% reported experiencing anxiety, depression, and inferiority feelings, respectively. Factors such as time since identification of physical disabilities, comorbidities, daily travel, social interaction, internet use, subjective social support, and inferiority feelings were found to be associated with anxiety or depression symptoms among physically disabled individuals. Subjective social support was found to be associated with inferiority feelings, which partly mediated the effect of subjective social support on anxiety symptoms by 37.4% and depression symptoms by 28.7%.ConclusionThis study highlights the importance of addressing the psychological well-being of physically disabled individuals in addition to their physical rehabilitation. Psychological intervention strategies should focus on improving subjective social support and reducing inferiority feelings, particularly among vulnerable groups.

Development of a Lightweight Powered Wheelchair for Persons with Physical Disabilities Using a Participatory Action Design

Development of a Lightweight Powered Wheelchair for Persons with Physical Disabilities Using a Participatory Action Design

SRPK3 Is Essential for Cognitive and Ocular Development in Humans and Zebrafish, Explaining X-Linked Intellectual Disability.

Intellectual disability is often the outcome of neurodevelopmental disorders and is characterized by significant impairments in intellectual and adaptive functioning. X-linked intellectual disability (XLID) is a subset of these disorders caused by genetic defects on the X chromosome, affecting about 2 out of 1,000 males. In syndromic form, it leads to a broad range of cognitive, behavioral, ocular, and physical disabilities. Employing exome or genome sequencing, here we identified 4 missense variants (c.475C > G; p.H159D, c.1373C > A; p.T458N, and c.1585G > A; p.E529K, c.953C > T; p.S318L) and a putative truncating variant (c.1413_1414del; p.Y471*) in the SRPK3 gene in 9 XLID patients from 5 unrelated families. To validate SRPK3 as a novel XLID gene, we established a knockout (KO) model of the SRPK3 orthologue in zebrafish. The 8 patients ascertained postnatally shared common clinical features including intellectual disability, agenesis of the corpus callosum, abnormal eye movement, and ataxia. A ninth case, ascertained prenatally, had a complex structural brain phenotype. Together, these data indicate a pathological role of SRPK3 in neurodevelopmental disorders. In post-fertilization day 5 larvae (free swimming stage), KO zebrafish exhibited severe deficits in eye movement and swim bladder inflation, mimicking uncontrolled ocular movement and physical clumsiness observed in human patients. In adult KO zebrafish, cerebellar agenesis and behavioral abnormalities were observed, recapitulating human phenotypes of cerebellar atrophy and intellectual disability. Overall, these results suggest a crucial role of SRPK3 in the pathogenesis of syndromic X-linked intellectual disability and provide new insights into brain development, cognitive and ocular dysfunction in both humans and zebrafish. ANN NEUROL 2024;96:914-931.

‘I just want to show that I am living a normal life’. Young People with Physical Disabilities on Social Media

‘I just want to show that I am living a normal life’. Young People with Physical Disabilities on Social Media

Jazz Musicians and Their Disabilities: Django Reinhardt, Les Paul, and Michel Petrucciani.

Musicians with physical disabilities who achieved stardom are part of the lore of popular music. Guitarist Django Reinhardt contrived alternate fingering patterns necessitated by burn contractures of his left hand. Les Paul, a legend in the development of the solid body electric guitar and multitrack recording, mangled his right arm in a car wreck so severely that his elbow was set permanently at 90° so he could continue to play guitar. Michel Petrucciani suffered from osteogenesis imperfecta, a condition that stunted his growth to the point where he used a special attachment to reach the sustaining pedals of his piano. Their stories show the force of human genius in music.

Impact of Siponimod on Clinical and Radiological Parameters of Secondary Progressive Multiple Sclerosis: A Real-World Prospective Study.

Secondary progressive multiple sclerosis (SPMS) presents with a challenging clinical phenotype, and siponimod has a potential to treat the active clinical phenotype of this disease. This single-center longitudinal study aimed to determine the therapeutic effects of siponimod in patients with active SPMS over 12 months. The clinical and radiological parameters of 50 patients with active SPMS treated using siponimod were assessed at baseline and after a 1-year follow-up period using the annual relapse rate (ARR), the Expanded Disability Status Scale (EDSS), the occurrence of gadolinium-enhanced lesion (GdE+), the Modified Fatigue Impact Scale (MFIS), and the Symbol Digit Modalities Test. The urine bladder postvoid residual (PVR) volume was also measured in a subcohort of 39 participants. Participants with an EDSS score ≥5.0 at baseline were finally assessed separately in prespecified subgroup analyses. There were significant reductions in ARR (p<0.001), GdE+ (p<0.001), and MFIS score (p=0.001) during the follow-up period. The progression of physical and cognitive disabilities remained stable (p>0.05). The PVR-volume analysis revealed a significant decrease in urine bladder PVR volume (p<0.001). These observations were consistent for the subgroup with EDSS score ≥5.0. Siponimod demonstrated efficacy in reducing ARR, GdE+, fatigue levels, and PVR volume, while maintaining stability in the cognitive and physical disability statuses of patients with SPMS. Similar findings were documented in the subgroup with EDSS score ≥5.0.

Students’ safety culture at tertiary level academic institutes in Bangladesh: A cross-sectional study

This study aims to investigate the safety culture of tertiary-level students in Bangladesh and identify the factors that influence it. A cross-sectional survey was conducted among 1676 students from 16 universities and medical colleges in Bangladesh to gather data. The survey consisted of a paper-based structured questionnaire with three scales: a 17-item safety beliefs and values scale, a 10-item safety perception and awareness scale, and a 14-item safety attitudes scale. The results showed that tertiary-level students generally exhibit moderate levels of safety beliefs and values, safety perception and awareness, and safety attitudes. Female students had better safety perception and awareness [β = -0.083; 95%CI = -0.140, -0.025] and safety attitudes [β = -0.173; 95%CI = -0.230, -0.117], while male students had stronger safety beliefs and values [β = 0.047; 95%CI = 0.005, 0.089]. Students with physical disabilities and those who had experienced accidents had significantly higher levels of safety perception and awareness, as well as safety attitudes, compared to their peers. Additionally, students in private institutions had lower levels of safety perception and awareness [β = -0.130; 95%CI = -0.189, -0.070] as well as safety attitudes [β = -0.058; 95%CI = -0.116, -0.001], than public institution students. Age, gender, and type of institute were significantly associated with all three components of safety culture. Accident experience was also significantly linked to safety perception and awareness [β = 0.054; 95%CI = 0.002, 0.105], and safety attitudes [β = -0.093; 95%CI = -0.143, 0.043]. Based on these findings, it is recommended that tertiary educational institutions in Bangladesh develop intervention strategies that consider the age, gender, and physical disability of students to enhance their safety culture.

Do gender stereotype threats have a spillover effect on motor tasks among children? A mixed-model design investigation

ObjectivesThe stereotype threat effect has captivated social and sports psychology researchers for over two decades. However, many questions remain unanswered. This research was designed to explore the spillover effects of stereotype threat in motor tasks. DesignA mixed model design with within-between-subjects was utilized, with soccer performance and throwing scores serving as the dependent variables. MethodForty-two 10-year-old girls without mental or physical disabilities participated in the study and were randomly assigned into two groups: stereotype threat (ST) and nullified stereotype threat (NST). After measuring baseline performance in throwing and soccer tasks, the participants in the ST group received soccer-based stereotype induction. Afterwards, they performed 20 trials of soccer shooting. Half an hour later, the children were asked to perform 10 throws with the non-dominant hand. ResultsOur results indicated that inducing soccer-based stereotypes towards girls led to underperformance in soccer, however, this negative effect did not spill over onto subsequent task (i.e., throwing) which was unrelated to the induced stereotype. ConclusionsOur finding regarding the stereotype threat spillover effect is novel and provides more insight into the range of effects of stereotype threat within the motor domain. The findings encourage the researcher to practice caution regarding the generalizability of the stereotype threat spillover effect, especially in motor tasks.

Challenges Linked to Post-Polio-Paralysis in Khyber Pakhtunkhwa Region

Background: Poliomyelitis is a highly infectious viral disease often causing permanent paralysis. Post-Polio Paralysis (PPP) involves the delayed onset of new or worsening neuromuscular symptoms years after the initial attack. Polio survivors face numerous physical disabilities and significant social, financial, and human rights barriers. Aims: To identify the challenges faced by individuals with PPP in the Khyber Pakhtunkhwa region. Methods: The study employed a cross-sectional survey design with a sample size of n=200, selected through non-probability convenience sampling. Data were collected using the Post-Polio Clinic Questionnaire and analyzed with SPSS 22. Results: The gender distribution was 21.50% female and 78.50% male. New health and physical problems (neurological, arthritis, and physiological) were observed in 64.5% (n=129) of participants. Aggravated previous complications, such as pain, fatigue, and muscular atrophy, were reported by 91.5% (n=183). Difficulty performing heavy tasks was noted by 49.5% (n=99). Using public transport was a challenge for 46.5% (n=93), and driving a car was deemed impossible by 70% (n=140). Using an Indian commode as a toilet was a complication for 58% (n=116) of participants. Conclusion: The study reveals significant health and daily life challenges for polio survivors in Khyber Pakhtunkhwa, including a high prevalence of new and worsening neuromuscular symptoms, aggravated complications like pain and fatigue, and difficulties with heavy tasks, public transport, driving, and using certain toilets. These findings underscore the urgent need for targeted interventions to improve the quality of life for polio survivors by addressing their physical health and social and financial barriers.

What factors attenuate the relationship between childhood neglect and adverse health outcomes? Examining the role of socioeconomic status, health behaviors, and the presence of a protective adult

BackgroundThe detrimental effects of childhood neglect on adult health outcomes are well-recognized; however, less is known about factors that may attenuate this relationship. Objective(1) To examine the associations between childhood neglect and various physical and mental health outcomes in adulthood among those who had not experienced childhood physical or sexual abuse; and (2) To determine whether adjusting for risk and protective factors, including socioeconomic status, health behaviors, and the presence of a trusted adult, attenuates these relationships. Participants and settingData came from the 2021 Behavioral Risk Factor Surveillance System (BRFSS), a representative sample of community-dwelling US adults (n = 41,322). MethodsThe relationships between childhood neglect and health outcomes were investigated using logistic regression analyses. Adjustments were made for demographics, socioeconomic status, health behaviors, and the presence of a protective adult. ResultsChildhood neglect was significantly associated with adverse health outcomes, including health behaviors (e.g., smoking, low physical activity), physical health indicators (e.g., self-reported fair/poor health, stroke, asthma, COPD), disabilities (e.g., hearing impairment, vision impairment, cognitive impairment, difficulty walking or climbing stairs, difficulty bathing), and mental health indicators (e.g., poor mental health/past month, depression) after controlling for demographics. All significant associations indicated small or very small effect sizes. Associations were substantially attenuated when controlling for adult socioeconomic status, and further attenuated when controlling for the presence of a protective adult, with several outcomes becoming non-significant. ConclusionsSocioeconomic status and the presence of a protective adult in childhood considerably diminishes the association between childhood neglect and health outcomes in adulthood.

Understanding Reasons for Participation and Barriers Within Adaptive Sports for Individuals with Physical Disabilities

The importance of participating in physical activity is widely advocated to reduce diseases, especially for individuals with physical disabilities. Adaptive sports have shown a multitude of benefits for those with physical disabilities, but few researchers have determined the benefits of adaptive sports from the perspective of the athletes. The purpose of this research study was to explore (1) reasons that individuals with physical disabilities engage in adaptive sports and (2) why individuals with physical disabilities do not participate in adaptive sports. Using an ethnographic qualitative retrospective design, 104 participant survey and phone interview responses were analyzed. Four themes emerged for reasons for adaptive sports participation including three subthemes, and five themes for barriers to adaptive sports participation. Applications for practice will be discussed for practitioners working with individuals who engage in adaptive sports will be identified.

How can HIV self-testing facilitate increased access to HIV testing among multiply marginalised populations? Perspectives from GBMSM and trans women in England and Wales

Background HIV self-testing (HIVST) may facilitate marginalised populations’ uptake of HIV testing, but whether the extent of marginalisation challenges individual uptake of HIVST remains under-researched. We aim to explore the perspectives of multiply marginalised cis-gender gay, bisexual and other men who have sex with men (GBMSM) and trans women on whether HIVST might increase their uptake of HIV testing. Methods We reanalysed qualitative interview data from SELPHI (the UK’s largest HIVST randomised trial) collected between 2017 and 2020 from marginalised populations, defined as people self-identifying as non-heterosexual, transgender, non-White ethnicity and/or with low educational attainment. Thirty-eight interviews with multiply marginalised individuals were thematically examined using the framework method. We specifically focussed on kit usability (a function of the interaction between blood-based HIVST kits and users), perspectives on how HIVST can improve access to HIV testing and suggestions on need-based scale-up of HIVST. Results HIVST kits were considered usable and acceptable by multiply marginalised GBMSM and trans women. The majority of interviewees highlighted multi-levelled barriers to accessing HIV testing services due to structural and social marginalisation. Their multiply marginalised identities did not impede HIVST uptake but often form motivation to self-test. Three potential roles of HIVST in the HIV testing landscape were identified: (1) alternation of HIVST and facility-based testing, (2) integration of HIVST into sexual health services and (3) substituting facility-based testing with HIVST in the future. Perceived beneficiaries of HIVST included trans communities, individuals with undisclosed sexuality and people with physical disabilities. Discussion HIVST can facilitate marginalised populations’ access and uptake of HIV testing by alternating with, integrating into and substituting for facility-based services in the UK. Marginalised identities did not present challenges but rather opportunities for person-centred scale-up of HIVST. Future implementation programmes should ensure equitable access to HIVST among trans people, men unable to disclose their sexuality, and perhaps people with physical disabilities.

PERCEPTIONS OF KARATE COACHES TOWARDS THE INCLUSION OF ATHLETES WITH PHYSICAL DISABILITIES IN TRAINING SESSIONS

Para-karate is an adaptation of karate sport, including regulation changes so as to facilitate the participation of people with disabilities in karate competitions and to promote inclusion in training settings. The purpose of this study was to examine the attitudes of karate coaches toward the inclusion of people with physical disabilities in common training sessions with athletes without disabilities and to record the coaches’ perceived level of self-efficacy. The importance of this study relates to the lack of corresponding researches regarding the attitudes of coaches in this particular sport. The sample consisted of 68 karate Greek coaches, whereas measurement tools used included the Hammond et al. (2014) Questionnaire measuring coaches’ attitudes towards inclusion and the ‘Physical Education Teacher Efficacy’ questionnaire by Biddle and Goudas (1997). Results showed that karate coaches’ perceptions toward inclusion of participants with physical disabilities and self-efficacy were influenced by education level and relative knowledge of adapted physical activity, external influence of significant others and previous coaching experience either with individuals with disabilities or overall experience as coaches, whereas no differences were noted in terms of coaches’ gender, age and local region, in a country that para-karate is still at the stage of early development. Based on the findings, recommendations were made for future researches using a larger sample of karate coaches.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0735/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Beyond telehealth in heart failure, how a nurse-led mobile team unit improves management and reduces re-admission in elderly patients living in a rural area

Abstract Introduction Telehealth plays a crucial role in improving access to healthcare for elderly patients with heart failure (HF), particularly those who live in under-resourced geographic areas, have physical disabilities, or have difficulties with transportation. However, extending and improving telehealth faces significant obstacles, primarily due to its inadequacy to fully assess a patient's clinical status. While some components of HF can be measured remotely, others, such as cardiac and lung examinations, require in-person clinical evaluation. This leads to imprecise assessments of HF severity, excessive medical consultations, and inappropriate emergency transfers or hospitalization. We conducted an evaluation of a specialized mobile team unit (MTU) for HF care in a rural area. The team consisted of nurses trained in performing electrocardiograms (ECGs) and point-of-care ultrasound (POCUS) to extend telemonitoring services to elderly patients with HF in the comfort of their homes. This approach offers a direct and optimal evaluation of the patient's condition. Purpose This study aimed to evaluate the added value of an MTU in assessing and optimizing treatment for HF in elderly patients, ultimately leading to decreased hospitalization or medical request rates. Materials and methods This retrospective analysis examined data from elderly patients diagnosed with HF, who participated in a 6-month telemonitoring program, and received MTU visits. MTU was activated by the telemonitoring team, in patients presenting signs of decompensation, with an imprecise assessment of severity based on digital data only. Results During six months, 165 elderly patients were included in the telemonitoring platform after index HF hospitalization. The mobile team traveled over 3,040 kilometers in a rural area with limited cardiological care. They visited 84 patients (50.9%), offering personalized education and physical assessments to all of the patients, 45% received additional imaging (EKG, POCUS). This resulted in 30% therapeutic adjustments, 90% fewer General practitioner (GP) /Cardiologist consultations and 54% avoided readmissions: 20% of hospitalizations were avoided immediately and 34% likely avoided in the near future, demonstrating the intervention's 80% effectiveness. Conclusion Monitoring heart failure (HF) in elderly patients can be challenging, especially in rural areas with limited access to care, few caregivers, cognitive impairments, or difficulty using e-health platforms. This study emphasizes the benefits of a nurse-led mobile team unit in providing a reliable direct assessment of HF severity. This home intervention provides education, strengthens the decision-making capacity of the remote monitoring platform, assists with patient management, and significantly reduces the readmission rate.

Healthcare access for people with disabilities: a scoping review of COVID-19 policies in Europe

Abstract Introduction The COVID-19 pandemic raised healthcare inequalities, affecting the most vulnerable groups. There is limited evidence of whether the COVID-19 measures and the health system’s preparedness for outbreaks among European countries were sufficient to cover the health access needs of PWDs. Aim To provide a structured overview of the COVID-19 measures and policies addressing access to primary and specialist health services for PWDs during the COVID-19 pandemic in the European Members States (MS) and the United Kingdom (UK), using ten dimensions of healthcare access by Levesque et al. (2013) and the PoliMap taxonomy. Methods This study followed the PRISMA guidelines for Scoping Reviews. A search strategy was employed on PubMed, Embase, Scopus, and Web of Science databases from January 2020 to January 2023. Studies published in peer-reviewed journals in English, Portuguese, and Spanish were included, informing a COVID-19 measure or policy and assessing or providing a rationale with access to primary or special healthcare services. Results The final search strategy yielded 2.076 results, 188 studies were reviewed for full-text analysis, and 74 were included in the final analysis. One hundred twenty-one policies or measures addressing primary or specialist care access were identified. Only thirteen target PWDs, focussing on intellectual or mental disability and addressing mental healthcare services. Results revealed that COVID-19 measures for PWDs were oriented to increase health system response capacity and reduce virus transmission, describing a predominantly negative effect on healthcare access for PWDs. Conclusions The needs of PWDs in access to primary and specialist care were not fully covered by the policies and measures placed during the COVID-19 pandemic among the MS and the UK. One-size approaches focussing on the attendance of COVID-19 infection with stigmatizing measures overlook the specific health necessities of this population. Key messages • Adopting disabled-inclusive measures in the daily healthcare provision and engaging PWDs in the policy cycle is paramount to preparing for the next outbreak and public health crises. • Additional research focusing on primary and specialized healthcare access during outbreaks for PWDs, especially with sensory and physical disabilities, is crucial to furthering health equity.

4.C. Scientific session: Navigating through complex challenges of responding to outbreaks of multidrug-resistant organisms

Abstract Antimicrobial resistance is one of the top ten global public health threats according to the WHO, contributing to millions of deaths each year. While outbreaks of multidrug-resistant organisms (MDROs) are well studied in hospital and nursing home settings, knowledge gaps exist concerning the complex challenges of outbreaks of MDROs among vulnerable patient populations, such as patients with intellectual disabilities or elderly patients living longer at home with multiple comorbidities. The coordination of such outbreaks requires a multidisciplinary approach as these patients often receive care throughout different healthcare settings, including long-term care and home-based nursing care. We delve into the complexities of coordinating an MDRO outbreak response involving healthcare professionals from various healthcare settings. The challenges inherent to the coordination of multidisciplinary involvement and the use of innovative strategies for outbreak preparedness and surveillance, will be thoroughly examined based on scientific evidence and practice based experiences. Workshop objectives • To exchange experiences on managing cross-institutional outbreaks of MDROs • To foster deeper understanding of the complexities of multidisciplinary involvement during MDRO outbreaks among vulnerable patient populations The workshop structure: - A brief introduction will be provided on the generic challenges in providing long-term care to vulnerable patient populations carrying MDROs. We will subsequently illustrate potential challenges faced during a cross-institutional MDRO outbreak among these patients through a realistic scenario (5 min): A patient with severe intellectual and physical disabilities living in both a long-term care facility as well as with family at home, unexpectedly turns out to be carrying an MDRO after recent hospital admission. As the patient receives nursing care from both from family members and nursing staff in different healthcare settings, a cross-institutional MDRO outbreak has occurred requiring a coordinated response. - Hereafter, individual presenters will address evidence- and experience-based challenges faced in MDRO outbreak responses within the specific healthcare settings covered in the previously presented scenario. We will navigate through the scenario together with the participants, discussing practical and ethical dilemmas, and explore ways for containing the MDRO outbreak while maintaining effective and compassionate healthcare delivery. In addition, we will discuss the use of public health innovations, such as social network analysis as a basis for the development of a stress test exercise to improve preparedness for MDRO outbreaks, and the role of wastewater surveillance in MDRO outbreaks. Discussions will be facilitated by (online) voting tools to invite participants to exchange experiences (40 min). We conclude with an exciting quiz to summarize the key messages of this workshop (10 min). Key messages • Healthcare setting, knowledge, proportionality and well-being of vulnerable patients populations are important to acknowledge during cross-institutional MDRO outbreaks. • Novel stress test exercise and wastewater surveillance are potential methods to improve preparedness and surveillance, respectively, during cross-institutional MDRO outbreak responses.

Erratum: “I’m a bathroom expert”: a qualitative study exploring how students with physical disabilities manage bladder and bowel programs during college

Erratum: “I’m a bathroom expert”: a qualitative study exploring how students with physical disabilities manage bladder and bowel programs during college

An exploratory cross-cultural study of community-based health literacy interventions to promote the mental well-being of disadvantaged and disabled young Africans: a multi-method approach.

This study explores the impact of community-based health literacy interventions on the health and mental well-being of disadvantaged young Africans in Zambia, Sierra Leone, Rwanda, and South Africa. The pandemic has exacerbated mental health problems amongst children and young people, underscoring the urgent need for equitable access to mental healthcare resources. Emphasizing the importance of equitable access to mental healthcare resources, the research addresses educational and income disparities in low- and middle-income countries (LMICs), particularly amongst young Africans with disabilities or vulnerabilities. The study comprised 1,624 young Africans, of whom 1,592 were surveyed, while 191 later participated in in-depth interviews and focus groups. Additionally, 32 participants exclusively joined focus groups. Participants were recruited to complete the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), WHO-5 Well-being Index, Pandemic Anxiety Scale (PAS), and Self-rating of Happiness, as well as semi-structured interviews or focus groups. The findings highlight the significance of tailored health literacy interventions in addressing mental health challenges and promoting well-being in marginalized African communities. In the sample, 43.1% (686) reported to have at least a physical disability or serious health condition and 51.4% (818) had special educational needs (SENs). Mental health scores were significantly lower in participants with two or more physical disabilities and pre-existing mental health problems. Factors significantly associated with poor mental health included poor health literacy, physical disabilities, and pre-existing mental health problems. Four main themes were generated from the thematic analysis: early childhood trajectories and mental illness experiences; positionality, open communication, and mental illness experience; mental illness experience, emotional honesty, and social stratification; and spirituality, cultural beliefs, and mental illness experience. The study emphasizes the need for context-specific, culturally appropriate health literacy interventions to support the mental health and well-being of young Africans in LMICs. By focusing on the lived experiences of disadvantaged groups, the research contributes to a better understanding of effective strategies for promoting health literacy and addressing health inequalities in African communities during and after health emergencies.

A qualitative study of the barriers and facilitators for women with a disability seeking sexual and reproductive health services in Addis Ababa, Ethiopia

BackgroundThe need to advance the sexual and reproductive health (SRH) and rights of women with a disability is becoming more widely recognized. Regrettably, in low- and middle-income settings like Ethiopia, several barriers impede women with a disability (WWDs) from receiving SRH services and care.ObjectivesThis study aims to explore barriers and enablers for women with a disability to access sexual and reproductive health services in Addis Ababa, Ethiopia.MethodsA qualitative phenomenological study was conducted among the purposively selected reproductive age (18–49) group of WWDs living in Addis Ababa who were members of the Ethiopian National Association of Persons with physical disabilities and the Ethiopian National Association for Blind. Ten in-depth interviews, and 2 focus group discussions, were conducted using an interview guide. The analysis involved the use of both a priori codes (from the theory) and emergent inductive codes (from the question guide).ResultsIn this study, several barriers were identified as keeping participants from accessing SRH services, such as unfavorable community views, organizational barriers in health facilities [HFs], financial limitations, transportation problems, and a lack of knowledge about the SRH programs that are available. The enabling factors that made WWDs access SRH services include social support and networking, access to education, positive providers' attitudes, and women's self-confidence/Assertiveness.ConclusionThe study reveals that financial problems brought on by inadequate health insurance coverage, economic hardship, the expense of transportation to the health facility, and the lack of preferential treatment at the health facility are some of the hurdles that WWDs face while accessing SRH services and care. To address these problems and promote SRH access, measures should be taken to decrease financial barriers, improve physical access, and build strong relationships with the community, the church, and healthcare providers.

Multimorbidity and Multiple Disabilities: Present Status and the Roles of Rehabilitation

The world is aging, and an increasing number of countries are becoming aged or super-aged societies. Japan has already become the world’s first super-aged society, with an aging rate of 29.1% of the entire population of the country. As of 15 September 2021, there were approximately 36.40 million people aged 65 years and over. The advent of the super-aged society has increased the possibility of multimorbidity and multiple disabilities (MMDs) in the elderly population. According to a survey by the Ministry of Health, Labour and Welfare, the percentage of people with multiple disabilities of all people with physical disabilities has fluctuated between 4.0 and 7.0%, but rapidly increased to 8.9% in 2006 and 17.7% in 2016. This review aimed to establish the present status of MMDs and the rehabilitation for MMDs. In rehabilitation settings, patients with MMDs are more common than patients with a single disease or disability; however, evidence on MMD rehabilitation is insufficient. Inexperienced and unconfident medical professionals are overly cautious in providing rehabilitation; therefore, adequate rehabilitation is not provided. Furthermore, to respond to the rehabilitation needs of patients with MMDs, human resources need to be cultivated, and a scientific basis needs to be built. It is expected that MMD guidelines will soon be developed based on various case studies and surveys. In MMD rehabilitation, it is important to provide “wider, earlier, more intimate, and more connected rehabilitation”; for this, the training and cooperation of rehabilitation medical professionals is necessary.