-
[show abstract]
[hide abstract]
ABSTRACT: Consequences of major burn injuries often include losing the ability to engage in basic life functions such as work or employment. As this is a developing area of importance in burn care, the goal of this study was to perform a systematic review of the burn literature to ascertain a comprehensive view of the literature and identify return to work (RTW) factors where possible. A search was conducted and peer-reviewed studies that investigated predictors and barriers of returning to work of those with burn injuries, published since 1970 and written in English, were examined. From the 216 articles initially identified in the search, 26 studies were determined to meet inclusion criteria. Across studies, the mean age was 33.63 years, the mean TBSA was 18.94%, and the average length of stay was 20 days. After 3.3 years (41 months) postburn, 72.03% of previously employed participants had returned to some form of work. Important factors of RTW were identified as burn location, burn size, treatment variables, age, pain, psychosocial factors, job factors, and barriers. This systematic review suggests multiple conclusions. First, there is a significant need for attention to this area of study given that nearly 28% of all burn survivors never return to any form of employment. Second, the RTW literature is in need of coherent and consistent methodological practices, such as a sound system of measurement. Finally, this review calls for increased attention to interventions designed to assist survivors' ability to function in an employed capacity.
Journal of burn care & research: official publication of the American Burn Association 12/2011; 33(1):101-9. · 1.37 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To validate a single item self-report of satisfaction with participation in two groups with differing patterns of symptoms and disease progress, multiple sclerosis (MS) and spinal cord injury (SCI).
Community-dwelling adults with MS (N = 1,271) or SCI (N = 620) completed a battery of self-report questionnaires covering demographic information, disease specific measures, symptoms, psychological distress, social-environmental issues, and overall well-being. They were also asked to rate satisfaction with participation: How satisfied are you with your ability to take part in activities that are important to you: not satisfied, somewhat satisfied, satisfied, or very satisfied. Kendall's tau rank correlation coefficient and χ(2) tests were used to examine the strength and direction of associations between demographic and symptom variables and responses to the participation item.
Although the demographics of the MS and SCI differed in predictable ways, younger participants and those employed report more satisfaction with participation. Ratings of satisfaction with participation were also consistently associated with a number of variables including less fatigue, pain, depression, stress, anxiety, as well as higher overall measures of well-being across the two populations.
More research is needed to better understand the multiple dimensions that comprise participation and to develop robust and sensitive measurement tools. A global rating of satisfaction with participation using one item has a number of potentially useful applications including description of case mix in clinical trials.
Disability and Rehabilitation 10/2011; 34(9):747-53. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This article serves as an introduction to this issue of the Archives of Physical Medicine and Rehabilitation that is devoted to current research findings of the Spinal Cord Injury Model Systems (SCIMS) program. The SCIMS program began in 1970, with funding from the National Institute on Disability and Rehabilitation Research in the U.S. Department of Education, to demonstrate a comprehensive care system for spinal cord injury (SCI) and also to conduct research to improve the health and quality of life of persons with SCI. Over the last 20 years, similar collaborative efforts for the dissemination of SCIMS research outcomes have produced conference proceedings in 1990, a book in 1995, and dedicated journal issues in 1999 and 2004. The collection of 24 articles in this issue shows the depth and breadth of work being carried out by the SCIMS investigators, from descriptive epidemiology to a randomized controlled trial, from neurologic recovery to community reintegration, and from health services utilization to assistive technology for mobility. Herein, we provide a brief overview of the SCIMS program, highlight the research initiatives currently underway, and describe the important findings of the original research articles contained in this issue.
Archives of physical medicine and rehabilitation 03/2011; 92(3):329-31. · 2.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To examine the experiences of people with chronic disabling conditions as they communicate with health care providers about pain and fatigue.
Twenty-three adults with a variety of chronic disabling conditions participated in 5 focus groups. The following issues were raised: tell me about your pain/fatigue; what things go along with pain/fatigue? how do you talk about pain/fatigue with your health care provider (HCP)? What should your HCP know that they do not ask you about?
Results of qualitative analysis suggested two major themes. The first theme was labeled "Putting it in words" and suggests that both pain and fatigue are described in many ways, including the dimensions of type, intensity, level of interference and temporal aspects. Participants reported difficulty with responding to a single question that asked them to assign a number to their level of pain or fatigue. The second theme was labeled, "Let's talk about it" and suggested that participants wanted HCPs "to listen and believe me when I describe my experience". They wanted to be asked about how pain or fatigue interferes with life and about compensatory strategies rather than being asked to rate symptom intensity. Participants wished to be viewed as experts and to be actively involved in decisions about their health care.
Pain and fatigue were viewed as having many facets that are associated in complex ways with other aspects of the health/disability condition. From the participants' perspective, assignment of a pain intensity rating does not represent the complexity of their pain experience. Suggestions are provided for HCPs when communicating about pain and fatigue with people with chronic conditions.
Quality of Life Research 03/2010; 19(2):243-51. · 2.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: As part of the planning process for a larger survey study to examine factors affecting employers' intention to hire and hiring of people with disabilities, a series of three semi-structured focus groups were held with key hiring decision makers, such as Human Resources directors, Chief Operating Officers (COOs), or Chief Executive Officers (CEOs) of small, medium, and large Seattle area companies.
The chief goals of the focus groups were to elicit and refine the participants' beliefs, normative influences, and perceived control relative to hiring workers with disabilities.
Narrative data obtained from the focus group discussion were examined using the Theory of Planned Behavior (TPB) to identify themes expressed by the focus group participants within the context of company size.
Themes did vary by company size, but a prevailing concern across all companies related to questions about the efficiency/effectiveness of contact with vocational rehabilitation agencies. For both small- and mid-sized companies, there was a belief that people with disabilities could not do the work or were somehow less qualified. For large companies, convincing departmental and team managers that outreaching workers with disabilities would be a worthwhile hiring practice remained a challenge.
The themes derived from this study can be used to help occupational rehabilitation professionals develop educational and marketing interventions to improve employers' attitudes toward hiring and retaining individuals with disabilities.
Journal of Occupational Rehabilitation 11/2009; 20(4):420-6. · 2.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To determine the information needs, level of Internet access, and current and preferred formats and sources of information of adults with spinal cord injuries (SCIs). Individuals with SCIs have a high lifetime risk for medical complications and other health conditions secondary to their injury. Many secondary conditions can be prevented or mitigated through appropriate self-care and/or self-management. People with SCIs need timely, high-quality information about health and medical issues after discharge and throughout their lifetime to improve self-care and maximize quality of life.
A survey was administered as part of the third time point of a longitudinal research study on individuals with SCI.
A total of 80.2% of the 277 respondents reported having Internet access. The most frequently selected format used currently and preferred by respondents for receiving SCI information was "Web pages/Internet". The top-ranked current and preferred source of SCI information was from a "Physician: SCI Expert/Rehabilitation Specialist". Respondents reported needing information on medical issues the most. Significantly higher percentages of individuals identified as "white" and with higher education levels had access to the Internet and ranked the selection of Web pages/Internet as their top choice.
Results confirm that, although people with SCI prefer to receive SCI information from SCI experts, the Internet is a more accessible and more currently used source. Educational level and race predicted current and preferred use of the Internet for obtaining SCI information, suggesting that Internet distribution of SCI information will exclude subgroups.
The journal of spinal cord medicine 01/2009; 32(5):545-54. · 2.11 Impact Factor
-
3rd International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2009, London, UK, April 1-3, 2009; 01/2009
-
Proceedings of the 11th International ACM SIGACCESS Conference on Computers and Accessibility, ASSETS 2009, Pittsburgh, Pennsylvania, USA, October 25-28, 2009; 01/2009
-
[show abstract]
[hide abstract]
ABSTRACT: Investigate change in prevalence rates for mental and substance abuse disorders between early and mid-adolescence among a cohort of indigenous adolescents.
The data are from a lagged, sequential study of 651 indigenous adolescents from a single culture in the northern Midwest United States and Canada. At waves 1 (ages 10-12 years) and 4 (ages 13-15 years), one adult caretaker and one tribally enrolled adolescent completed a computer-assisted personal interview that included Diagnostic Interview Schedule for Children-Revised assessment for 11 diagnoses. Multivariate analyses investigate effects of wave 1 adolescent diagnosis and wave 1 biological mother diagnosis (University of Michigan Composite International Diagnostic Interview) on wave 4 diagnostic outcomes.
The findings show a increase in prevalence rates for substance abuse disorders and conduct disorders between ages 10 and 12 years and 13 and 15 years among indigenous adolescents, with these disorders affecting more than one fourth of the children. The rate of lifetime conduct disorder is about twice that expected in general population studies (23.4% versus 5%-10%), and the rate of lifetime substance abuse disorder (27.2%) is three times that reported in the 2004 National Survey on Drug Use and Health (9.4%) for individuals 12 years or older. Prevalence rates for any single mental or substance use disorder (44.8 lifetime) for the 13- to 15-year-olds are similar to the lifetime prevalence rates reported in the National Comorbidity Survey-Replication (46.4%) for individuals 18 years and older.
A mental health crisis exists on the indigenous reservations and reserves that participated in this study. Current service systems are overwhelmed and unable to meet the demands placed upon them.
Journal of the American Academy of Child and Adolescent Psychiatry 07/2008; 47(8):890-900. · 4.98 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Assistive technology for wayfinding will significantly improve the quality of life for many individuals with cognitive impairments. The user interface of such a system is as crucial as the underlying implementation and localisation technology. We studied the user interface of an indoor navigation system for individuals with cognitive impairments.
We built a system using the Wizard-of-Oz technique that let us experiment with many guidance strategies and interface modalities. Through user studies, we evaluated various configurations of the user interface for accuracy of route completion, time to completion, and user preferences. We used a counter-balanced design that included different modalities (images, audio, and text) and different routes.
We found that although users were able to use all types of modalities to find their way indoors, they varied significantly in their preferred modalities. We also found that timing of directions requires careful attention, as does providing users with confirmation messages at appropriate times.
Our findings suggest that the ability to adapt indoor wayfinding devices for specific users' preferences and needs will be particularly important.
Disability and rehabilitation. Assistive technology 02/2008; 3(1):69-81.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate a modified version of the Roland-Morris Disability Questionnaire for differential item functioning (DIF) related to several covariates.
DIF occurs in an item when, after controlling for the underlying trait measured by the test, the probability of endorsing the item varies across groups.
Secondary data analysis of two studies of participants with back pain (total n = 875). We used a hybrid item response theory/ logistic regression approach for detecting DIF. We obtained scores that accounted for DIF. We evaluated the impact of DIF on individual and group scores, and compared scores that ignored or accounted for DIF in terms of the strength of association with SF-36 subscale scores.
DIF was found in 18/23 items. Salient scale-level differential functioning was found related to age, education, and employment. Overall 24 participants (3%) had salient scale-level differential functioning. Mean scores across demographic groups differed minimally when accounting for DIF. The strength of association of scores with SF-36 scores was similar for scores that ignored and scores that accounted for DIF.
The modified version of the Roland-Morris Disability Questionnaire appears to have largely negligible DIF related to the covariates assessed here.
Quality of Life Research 09/2007; 16(6):981-90. · 2.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: PROMIS (Patient-Reported Outcome Measurement Information System) is developing a set of tools for collecting patient reported outcomes, including computerized adaptive testing that can be administered using different modes, such as computers or phones. The user interfaces for these tools will be designed using the principles of universal design to ensure that it is accessible to all users, including those with disabilities. We review the rationale for making health assessment instruments accessible to users with disabilities, briefly review the standards and guidelines that exist to support developers in the creation of user interfaces with accessibility in mind, and describe the usability and accessibility testing PROMIS will conduct with content experts and users with and without disabilities. Finally, we discuss threats to validity and reliability presented by universal design principles. We argue that the social and practical benefits of interfaces designed to include a broad range of potential users, including those with disabilities, seem to outweigh the need for standardization. Suggestions for future research are also included.
Medical Care 06/2007; 45(5 Suppl 1):S48-54. · 3.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The study examined risk factors for having ever contracted sexually transmissible infections (STI) among a high-risk sample in midwestern USA.
A cross sectional survey was conducted among 428 homeless youth aged 16-19 years. Assessed correlates included child maltreatment, street exposure, sexual histories, street experiences and substance use.
Multivariate analyses revealed that males were 86% less likely to have had STI compared with females (adjusted odds ratio [AOR] = 0.14; 95% confidence interval [CI] = 0.06-0.31). Blacks were almost four times more likely (AOR = 3.71; 95% CI = 1.80-7.63) and other races were over two times more likely (AOR = 2.25; 95% CI = 1.08-4.67) to have had STI compared with whites. For every one unit increase in the number of times youth ran away, there was a 3% increase in the likelihood of ever having had an STI (AOR = 1.03; 95% CI = 1.01-1.06). For every one unit increase in frequency of condom use there was a 61% decrease in the likelihood of an STI (AOR = 1.39; 95% CI = 1.10-1.76). Finally, youth who traded sex were approximately 2.5 times more likely to have had STI compared with youth who did not trade sex (AOR = 2.36; 95% CI = 1.04-5.34). None of the remaining correlates approached multivariate significance.
The amount of time youth spend on the street, their sexual practices, and their subsistence strategies are important correlates of STI and females and non-whites are particularly vulnerable among this high-risk population.
Sexual Health 04/2007; 4(1):57-61. · 1.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We studied an indoor wayfinding application for individuals with cognitive impairments using Wizard-of-Oz techniques. This gave us insights into the technological considerations for the location system underlying such an application. We have abstracted these into generally desirable properties for location-aware systems for wayfinding. In addition to general requirements for accuracy and robustness, we discuss what other information about the environment should be provided that supports wayfinding. Our work showed that combining rich environment information with user location is key to making indoor wayfinding applications feasible
Pervasive Health Conference and Workshops, 2006; 01/2007
-
[show abstract]
[hide abstract]
ABSTRACT: This study reports prevalence and comorbidity of five DSM-III-R diagnoses (alcohol abuse, alcohol dependence, drug abuse, major depressive episode, and generalized anxiety disorder) among American Indian and Canadian First Nations parents/caretakers of children aged 10-12 years from the Northern Midwest United States and Canada. Lifetime prevalence rates were compared to adults in the National Comorbidity Survey (NCS) and Southwest and Northern Plains cultures from the AI-SUPERPFP study.
Native interviewers used computer-assisted personal interviews to administer the University of Michigan Composite International Diagnostic Interview (UM-CIDI) to 861 tribally enrolled parents and caretakers (625 females; 236 males) of 741 tribally enrolled children aged 10-12 years. Fathers/male caretakers ranged in age from 21 years to 68 years with an average age of 41 years; mothers/female caretakers ranged in age from 17 years to 77 years with an average of 39 years.
About three-fourths (74.6%) of the adults met lifetime criteria for one of the five disorders; approximately one-third (31.6%) met lifetime criteria for two or more of the five disorders. Prevalence of the substance use disorders was higher than those in the general population (NCS); prevalence of internalizing disorders (major depressive disorder and generalized anxiety disorder) was very similar to those in the general population. Prevalence rates for alcohol abuse among the Northern Midwest adults were higher than those reported for Southwest and Northern Plains Tribes, but rates of alcohol dependency were very similar across cultures.
The higher prevalence rates for some mental disorders found for the Northern Midwest are discussed in terms of potential method variance. The Northern Midwest results reflect unique patterns of psychiatric disorders in the ubiquity of substance abuse disorders and the co-occurrence of substance abuse disorders with internalizing disorders. Reducing lifetime occurrences of substance abuse disorders would have an enormous positive impact on the mental health of this population.
Social Psychiatry and Psychiatric Epidemiology 09/2006; 41(8):632-40. · 2.70 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The detrimental effects of alcohol misuse and dependence are well documented as an important public-health issue among American Indian adults. This preponderance of problem-centered research, however, has eclipsed some important resilience factors associated with life course patterns of American Indian alcohol use. In this study, we investigate the influence of enculturation, and each of the three component dimensions (traditional practices, traditional spirituality, and cultural identity) to provide a stringent evaluation of the specific mechanisms through which traditional culture affects alcohol cessation among American Indians.
These data were collected as part of a 3-year lagged sequential study currently underway on four American Indian reservations in the upper Midwest and five Canadian First Nation reserves. The sample consisted of 980 Native American adults, with 71% women and 29% men who are parents or guardians of youth ages 10-12 years old. Logistic regression was used to assess the unique contribution of the indicators of alcohol cessation. Excluding adults who had no lifetime alcohol use, the total sample size for present analysis is 732 adult respondents.
The findings show that older adults, women, and married adults were more likely to have quit using alcohol. When we examined the individual components of enculturation, two of the three components (participation in traditional activities and traditional spirituality) had significantly positive effects on alcohol cessation.
Although our findings provide empirical evidence that traditional practices and traditional spirituality play an important role in alcohol cessation, the data are cross-sectional and therefore do not indicate direction of effects. Longitudinal studies are warranted, in light of the work that concludes that cultural/spiritual issues may be more important in maintaining sobriety once it is established rather than initiating it.
Journal of studies on alcohol 04/2006; 67(2):236-44.
-
[show abstract]
[hide abstract]
ABSTRACT: Work can be defined as an activity performed to accomplish something in the presence of obstacles that may make accomplishing the goal difficult. For individuals with MS, work is not only limited by physical impairments but also by factors such as fatigue and cognitive changes
The aim of this study is to examine the experiences of individuals with mild to moderate MS as they carry out everyday work activities both inside and outside the home.
Eleven women and three men were recruited from the community to participate in a series of semi-structured interviews. Using qualitative research methodology that examined the experiences of the participants, two major themes and seven subthemes emerged.
The first theme, Defining the work, included Priorities: seeing what's important; Plans: learning about resources and requirements; and Perspectives: fixing it yourself. The second theme, Changing how things get done, includes Precipitating factors; Awareness; Constructing the strategies; and Evaluating the strategies.
Individuals with MS develop strategies and utilize resources in order to get the work done. Comparisons are made between existing intervention theories or programmes and the experiences described by participants in this study.
Disability and Rehabilitation 05/2003; 25(8):369-79. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Examined the perceived prestige and status attributed to rehabilitation counselors in medical settings in which a rehabilitation counselor is not on the staff by having 104 physical therapists and occupational therapists complete a scale rating the social standing of rehabilitation counselors with that of other allied health professionals. Rehabilitation counselors ranked below several other occupational groups, including physical and occupational therapists and social workers. (6 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Rehabilitation Counseling Bulletin 02/1986; · 0.48 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVES: Distance from expertise in traumatic brain injury (TBI) is often an impediment to appropriate TBI care from local health care providers, especially in rural areas. To overcome this barrier to care and to support a randomized, controlled trial of telephone follow-up after discharge from acute rehabilitation, we demonstrated the use of a confidential consultation Web site to provide expert recommendations and advice to front-line telephone staff at a different site. CONCLUSIONS: This use of Internet communication proved convenient to all users, improved client confidence, and served as an excellent training tool to less experienced staff. In addition, use of a Web-based consultation method provided for archiving of all discussions for later review.
Journal of Head Trauma Rehabilitation 18(6):504-11. · 3.33 Impact Factor
-
