Disability and Health Journal最新文献

{"title":"Exploring menstrual symptom frequency and impact on people with neurodevelopmental conditions","authors":"Laura St. John ,&nbsp;Emma Osness ,&nbsp;Anmol Panech ,&nbsp;Yona Lunsky ,&nbsp;Patricia K. Doyle Baker","doi":"10.1016/j.dhjo.2025.101914","DOIUrl":"10.1016/j.dhjo.2025.101914","url":null,"abstract":"<div><h3>Background</h3><div>Menstruation can be a physically, mentally and emotionally challenging time, especially for individuals who have neurodevelopmental disabilities. Sensory impairments, emotional dysregulation and challenges communicating pain can make managing menstruation challenging for this population.</div></div><div><h3>Objective</h3><div>To describe common symptoms and the effect of symptoms on those with neurodevelopmental disabilities.</div></div><div><h3>Methods</h3><div>A mixed methods study design was employed. Qualitative data regarding symptom experience were collected through a semi-structured interview, while quantitative data were collected using the Menstrual Symptom Questionnaire.</div></div><div><h3>Results</h3><div><span>Participants described debilitating cramping which often impacted activities of daily living. Participants also discussed challenges with emotional dysregulation, with many experiencing extreme </span>moods swings and/or depressive episodes during menstruation.</div></div><div><h3>Conclusion</h3><div>For the participants in this study, their periods were physically and emotionally taxing and had significant impacts on their day to day lives. Future research is needed to explore why those with neurodevelopmental disabilities may be experiencing such extreme menstrual symptoms.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101914"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental barriers to participation for people with spinal cord injury. The case of Ecuador","authors":"Ana Oña ,&nbsp;Andrea Pacheco Barzallo ,&nbsp;Jaime Toaquiza ,&nbsp;Diana Pacheco Barzallo","doi":"10.1016/j.dhjo.2025.101929","DOIUrl":"10.1016/j.dhjo.2025.101929","url":null,"abstract":"<div><div>This study assesses the environmental barriers faced by people with spinal cord injury (SCI) in Ecuador. Using cross-sectional data from the International Spinal Cord Injury Survey (InSCI), we analyzed responses from 510 participants across 23 provinces. We calculated the total environmental barrier index using the Nottwil Environmental Factor Inventory (NEFI) and applied regression analysis to identify key influencing factors. We also examined the severity of barriers by region, comparing rural and urban areas.</div><div>Our findings reveal significant disparities. Individuals with lower incomes, those with tetraplegia, and those without a partner reported higher levels of environmental barriers. Rural residents were disproportionately affected. While both urban and rural participants cited long-distance travel and limited public access as top barriers, finances ranked higher in urban settings, whereas home access was more critical in rural areas.</div><div>This is the first national study to map modifiable environmental barriers for people with SCI in Ecuador. The results point to clear spatial and economic inequalities, highlighting the need for targeted policies that improve public infrastructure to promote social inclusion.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101929"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work from home and job Satisfaction: Differences by disability status among healthcare workers","authors":"Yana van der Meulen Rodgers ,&nbsp;Lisa Schur ,&nbsp;Flora M. Hammond ,&nbsp;Renee Edwards ,&nbsp;Jennifer Cohen ,&nbsp;Douglas Kruse","doi":"10.1016/j.dhjo.2025.101931","DOIUrl":"10.1016/j.dhjo.2025.101931","url":null,"abstract":"<div><h3>Background</h3><div>Many workers with disabilities face negative stereotypical attitudes, pay gaps, and a lack of respect in the workplace, contributing to substantially lower job satisfaction compared to people without disabilities. Work from home may help to increase job satisfaction for people with disabilities.</div></div><div><h3>Objective</h3><div>This study analyzes how different measures of job satisfaction vary between people with and without disabilities, and the extent to which working from home moderates the relationship between disability and job satisfaction.</div></div><div><h3>Methods</h3><div>We use multivariable regression analysis to examine if the ability to work from home moderates the relationship between disability and indicators related to job satisfaction. The dataset draws on a novel survey of healthcare professionals.</div></div><div><h3>Results</h3><div>Results show that people with disabilities have relatively greater turnover intentions, lower sense of organizational commitment and support, weaker perceptions of openness and inclusion in the workplace, and worse relations with management and coworkers. Regressions indicate that working from home helps to improve most perceptions of work experiences but does so more for people without disabilities than for people with disabilities.</div></div><div><h3>Conclusions</h3><div>The findings suggest that (a) some accommodations typically viewed as exceptions to meet the needs of people with disabilities have even greater benefits for the workforce at large and (b) because workers without disabilities also benefit from remote work, we cannot expect this accommodation to close job satisfaction gaps caused by inequities.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101931"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needs assessment of training midwifery, nursing, and medical students in sexual and reproductive health care for people with disabilities in Tanzania","authors":"Kristen P. Mark ,&nbsp;Stella E. Mushy ,&nbsp;Marguerite Puchner-Hardman ,&nbsp;Lucy R. Mgopa ,&nbsp;Gift G. Lukumay ,&nbsp;B.R. Simon Rosser ,&nbsp;Agnes F. Massawe ,&nbsp;Dorkasi L. Mwakawanga ,&nbsp;Victor Z. Chikwala ,&nbsp;Emmanuel I. Sumari ,&nbsp;Ally A. Lyimo ,&nbsp;Gudrun Kilian ,&nbsp;Maria E. Trent ,&nbsp;Michael W. Ross ,&nbsp;Charlotta Löfgren ,&nbsp;Jennifer J. Connor ,&nbsp;Rashid H. Mfinanga ,&nbsp;Dickson A. Mkoka","doi":"10.1016/j.dhjo.2025.101919","DOIUrl":"10.1016/j.dhjo.2025.101919","url":null,"abstract":"<div><h3>Background</h3><div>Tanzania has a sexual and reproductive health<span> (SRH) crisis, a particularly vulnerable population of people with disabilities (PWD), and a need for healthcare providers trained in PWD-focused SRH care. However, SRH services are limited, and the inclusion of PWD in SRH efforts is rare in Tanzania. The current study examined the feasibility and acceptability of addressing this critical gap by training future healthcare professionals in SRH for PWD.</span></div></div><div><h3>Objective</h3><div>To determine the feasibility and acceptability of a PWD-focused SRH training to be delivered to healthcare students attending Muhimbili University of Health and Allied Science (MUHAS) in Dar es Salaam, Tanzania.</div></div><div><h3>Methods</h3><div>A mixed methods design via a survey taken by 409 medical, nursing, and midwifery<span> student participants was employed to determine the feasibility and acceptability of a new curriculum focused on the SRH needs of PWD. Data were assessed using descriptive statistics and reflexive content analysis.</span></div></div><div><h3>Results</h3><div>Data indicate that 83.6% and 97.6% of medical, nursing, and midwifery students believe that an SRH training centered on the needs of PWD is feasible and acceptable, respectively. Moreover, findings indicated that 50.4% of medical, nursing, and midwifery students at MUHAS receive little to no training in SRH for PWD. Participants’ qualitative responses indicated that the training would improve the quality of life for PWD, address their vulnerability and healthcare neglect, and benefit society.</div></div><div><h3>Conclusion</h3><div>MUHAS students find a PWD-focused SRH training to be feasible, acceptable, and needed, presenting an opportunity for great impact.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"19 1","pages":"Article 101919"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet educational accommodation needs and mental health outcomes in adults with disabilities: A machine learning approach","authors":"Bryan R. Christ,&nbsp;Lucie Adams,&nbsp;Benjamin Ertman,&nbsp;Paul B. Perrin","doi":"10.1016/j.dhjo.2025.101849","DOIUrl":"10.1016/j.dhjo.2025.101849","url":null,"abstract":"<div><h3>Background</h3><div>No research has yet determined exactly what accommodation needs are unmet for disabled students and how those needs being unmet predict psychosocial outcomes many years later.</div></div><div><h3>Objective</h3><div>To address this research gap, we seek to explore the potentially long-term associations of unmet educational accommodation needs and demographic characteristics with the mental health of adults with disabilities (n = 409).</div></div><div><h3>Methods</h3><div>To explore these associations, we use modern the machine learning technique of Random Forest feature importance.</div></div><div><h3>Results</h3><div>While 52.3 % of the sample reported having had one or more unmet accommodation needs while going to school, 57.2 % displayed current clinically elevated symptoms of depression and 48.4 % clinically elevated symptoms of anxiety. The machine learning approaches had 65.9 % and 60.0 % accuracy in correctly classifying clinically elevated depression and anxiety symptoms, respectively. For the models predicting clinically elevated depression symptoms using mean decrease in impurity (MDI) and permutation importance, unmet accommodation needs ranked fifth and fourth, respectively, in feature importance after age, disability severity<span>, high school GPA, and individual income (for MDI). For the MDI model predicting clinically elevated anxiety symptoms, unmet academic accommodation ranked third in feature importance behind disability severity and age, while for permutation importance, unmet academic accommodation need ranked fourth behind age, urbanicity, and disability severity.</span></div></div><div><h3>Conclusion</h3><div>Unmet academic accommodations may result in reduced psychological adjustment and quality of life potentially many years into adulthood.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101849"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the International Classification of Functioning, Disability and Health (ICF) in integrated care for people with disabilities: A scoping review using the SELFIE framework","authors":"Hye-Jin Kim ,&nbsp;Bokyoung Choi ,&nbsp;Eunhee Choi ,&nbsp;Haesong Kim ,&nbsp;Soong-Nang Jang ,&nbsp;Jae-Young Lim ,&nbsp;Kim Bulkeley ,&nbsp;Jennifer Smith-Merry","doi":"10.1016/j.dhjo.2025.101854","DOIUrl":"10.1016/j.dhjo.2025.101854","url":null,"abstract":"<div><h3>Background</h3><div>Integrated care addresses system fragmentation, especially for people with disabilities who require support across multiple domains. Most models focus on healthcare, overlooking social and environmental factors that hinder health management for people with disabilities. The International Classification of Functioning, Disability and Health (ICF)'s biopsychosocial approach integrates these broader factors, but its application in integrated care remains underexplored.</div></div><div><h3>Objective</h3><div>This scoping review aimed to explore the application of the ICF in research on integrated care, informed by the SELFIE framework, within the context of disability.</div></div><div><h3>Methods</h3><div>Following Joanna Briggs Institute's guidance and the PRISMA extension for scoping reviews, seven databases were searched from January 2011 to September 2023. Independent screening, selection, and data extraction were performed, with key findings related to integrated care identified deductively using the SELFIE framework.</div></div><div><h3>Results</h3><div>Twenty-six studies were included. These focused on populations with visual impairments, hearing loss, intellectual or developmental disabilities, spinal cord injuries, brain injuries, physical and learning disabilities, psychological impairment, and wheelchair users. Most studies applied the ICF as a conceptual framework rather than a coding system. Key elements of integrated care, such as holistic assessment, service delivery, leadership, governance, and workforce, were emphasized, while components like financing, technology, and research received limited attention.</div></div><div><h3>Conclusions</h3><div>Traditional integrated care models, focusing on disease management, fall short for people with disabilities, who have diverse, often cross-system needs and social barriers. This review highlights the importance of integrating the context of disability, with the ICF's biopsychosocial model playing a crucial role in addressing environmental factors impacting body functions, activities, and participation.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101854"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Information","authors":"","doi":"10.1016/S1936-6574(25)00172-4","DOIUrl":"10.1016/S1936-6574(25)00172-4","url":null,"abstract":"","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101943"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Income effects on travel mode choices among people with and without disabilities: Operationalizing the capability approach","authors":"Jaekyeong Kwon","doi":"10.1016/j.dhjo.2025.101850","DOIUrl":"10.1016/j.dhjo.2025.101850","url":null,"abstract":"<div><h3>Background</h3><div>Income helps low-income individuals reduce their reliance on transit and walking and increase car travel. People with disabilities might face challenges in improving their private vehicle access due to disability-related extra costs.</div></div><div><h3>Objective</h3><div>This study examines whether income has different impacts on travel mode choice based on disability status, disability type, and level of activity limitations.</div></div><div><h3>Methods</h3><div>This study used time diary data from the nationally representative American Time Use Survey to estimate the differences in income effects on the likelihood of using public transit, walking, and traveling in private vehicles as drivers or as passengers between working-age adults with and without disabilities. Confounding variables included socioeconomic, demographic, household, and geographic characteristics.</div></div><div><h3>Results</h3><div>Income was associated with a three-percentage-point (95 % CI: 0, 6) higher likelihood of using private vehicles as passengers for people with disabilities. In addition, people with vision disability were 10 percentage points (95 % CI: 4, 16) more likely to travel as passengers when they had more income. In contrast, people without disabilities were equally likely to travel as passengers regardless of income. Whereas people without disabilities were 10 percentage points (95 % CI: 8, 11) more likely to drive when they had more income, income was not associated with a higher likelihood of driving for people with activity-limiting disability.</div></div><div><h3>Conclusions</h3><div>Income effectively expands transportation options for people with disabilities beyond transit and walking. Personal care assistant programs with high reimbursement rates can ease the financial burden of people with disabilities who pay others to travel as passengers.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101850"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer inequalities experienced by people with disability: a systematic review","authors":"Yi Yang ,&nbsp;Nina Afshar ,&nbsp;Joanna Butchart ,&nbsp;Alex Sully ,&nbsp;Rebecca J. Bergin ,&nbsp;Anne Kavanagh ,&nbsp;George Disney","doi":"10.1016/j.dhjo.2025.101851","DOIUrl":"10.1016/j.dhjo.2025.101851","url":null,"abstract":"<div><h3>Background</h3><div>People with disability experience worse cancer outcomes than people without disability. One potential pathway is through low screening participation leading to delayed cancer diagnosis and late disease presentation.</div></div><div><h3>Objective</h3><div>To summarise and evaluate evidence quantifying disability-related inequalities in (1) cancer mortality, (2) fatality among cancer patients; and for cervical, breast, colorectal and lung cancers: (3) screening participation and (4) stage at diagnosis.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, Embase, PsycInfo and Scopus up to November 2023 for studies that quantified disability-related inequalities in the four outcomes. Studies were evaluated using the Risk Of Bias In Non-randomized Studies - of Exposures tool.</div></div><div><h3>Results</h3><div>We found 73 eligible articles globally. People with disability had higher cancer mortality compared to those without. This inequality was most pronounced among people with intellectual disability. Evidence showed substantially higher fatality among cancer patients with disability compared to those without consistently across disability groups and cancer types. Screening uptake for breast, cervical and colorectal cancers was consistently lower for people with various disability types in multiple countries. Evidence regarding inequalities in stage at diagnosis for people with disability was limited and inconsistent. The main methodological challenges for future research are: complexity in defining disability, underestimation of inequalities due to over-adjustment of mediating factors, under-representation of people with severe disability in data, and reporting inequalities on relative scales only.</div></div><div><h3>Conclusions</h3><div>Existing evidence reinforces the need for high-quality cancer inequality research for this population, and a multi-pronged, inclusive approach to prioritise people with disability in the whole cancer control pathway.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101851"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New approaches to categorising childhood disability: an international comparative analysis of the UNICEF/Washington Group child functioning module","authors":"Carlo Tramontano ,&nbsp;Claudio Barbaranelli ,&nbsp;Julia Carroll ,&nbsp;Marcella Deluca ,&nbsp;Jodie Enderby ,&nbsp;Nora Groce ,&nbsp;Daniel Mont","doi":"10.1016/j.dhjo.2025.101855","DOIUrl":"10.1016/j.dhjo.2025.101855","url":null,"abstract":"<div><h3>Background</h3><div>The Child Functioning Module (CFM) assesses children's functional difficulties in multiple domains (i.e., sensory, physical, communication, cognitive, psychosocial, and emotional functioning). Cut-off points are defined to identify children with disabilities, for use in international monitoring activities. While appropriate for many uses, the recommended cut-offs limit representation of the patterns of multiple co-occurring difficulties.</div></div><div><h3>Objective</h3><div>This paper proposes a new analytical approach that expands the identification of multiple co-occurring difficulties and tests it, using data from the 6th round of UNICEF-supported MICS in seven African countries.</div></div><div><h3>Methods</h3><div>In each country we implemented: a) Confirmatory Factor Analysis (CFA), to examine the possibility of identifying theoretical functional domains; b) Latent Profile Analysis (LPA) on the functional domains factorial scores to explore whether it was possible to identify groups characterised by specific disability profiles.</div></div><div><h3>Results</h3><div>The posited 6-factor CFA model resulted in adequate goodness of fit across countries. The factorial correlations suggest the co-occurrence of difficulties across domains, except for the emotional functioning factor, which was found to be largely independent. The LPA identified six disability profiles - with a striking degree of replication, both in their nature and frequency - across countries.</div></div><div><h3>Conclusion</h3><div>Findings highlights the value and potential of an alternative approach to analyse CFM data to examine and understand co-occurrences of difficulties which a) provides policymakers with key information to tailor interventions to the specific needs of children with disabilities; b) has important implications for models of developmental disabilities, global health planning and resource allocation.</div></div>","PeriodicalId":49300,"journal":{"name":"Disability and Health Journal","volume":"18 4","pages":"Article 101855"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}