Health care providers' perceptions of the vulnerability of persons with disabilities: Sociological frameworks and empirical analyses

In this study, we explored health care providers' perceptions about their professional responsibility for persons with disabilities. We examined the providers' perceptions of the vulnerability of persons with disabilities to sexual exploitation. We also elicited the professionals' assumptions about the consequences of such exploitation to the persons with disability and the professionals working with them. Our analyses indicated that these professionals perceived that different categories of disability pose different risk of sexual exploitation. Populations with forms of cognitive impairment were considered most vulnerable. In terms of professional responsibility for the care of persons who might have experienced sexual exploitation, respondents reported least confidence in their ability to detect instances of exploitation. In contrast, respondents expressed greater confidence in their ability to report and conduct follow-up of abuse. The professionals anticipated providing emotional support to persons who experienced exploitation. We discuss the study's implications for training and policy formation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45566/1/11195_2005_Article_BF01102394.pd

Social disadvantage in the international classification of impairments, disabilities, and handicap

The revision process of the international classification of impairments, disabilities and handicaps (ICIDH) is now in progress. Major changes are being considered which question one of the main fields, that of handicap, or social disadvantage. The scope of these changes goes beyond simple technical adjustments. It reaches the level where fundamental positions are adopted regarding the mainspring of public health policies. The purpose of this article is to review and discuss the main criticisms that have appeared in the literature about the dimension of handicap, including a study of the consequences that may result from keeping this dimension or from leaving it out. We suggest that the definition of handicap as a disadvantage has been overlooked, so that discussion has mainly taken place about the environment. Our opinion is that each criticism is based upon the emphasis given to a choice of strategy for preventing or reducing disablement. For some experts, the emphasis is on health care. For others, it is on social change. We share this interest in strategy. This is why we suggest that the conceptual framework is meant only for description, that it does not and should not include choices of strategy. We argue that it is the best way to promote appropriate description and therefore appropriate choice of strategies. Finally, we state that social disadvantage is a major dimension of the consequences of disorders and related problems, and should therefore remain in the framework, in order to provide appropriate information for better choices in strategy.handicap disablement ICIDH social disadvantage

A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly

Objective: To develop a simple clinical screening tool for community-dwelling older adults.Study Design and Setting: A prospective multicenter cohort study was performed among healthy subjects of 65 years and older, examined in 10 health examination centers for the French health insurance. Falls were ascertained monthly by telephone for 12-month follow-up. Multivariate analyses using Cox regression models were performed. Regression coefficients of the predictors in the final model were added up to obtain the total score. The discriminative power was assessed using the area under the curve (AUC). Results: Thousand seven hundred fifty-nine subjects were included. The mean age was 70.7 years and 51% were women. At least one fall occurred among 563 (32%) participants. Gender, living alone, psychoactive drug use, osteoarthritis, previous falls, and a change in the position of the arms during the one-leg balance (OLB) test were the strongest predictors. These predictors were used to build a risk score. The AUC of the score was 0.70. For a cutoff point of 1.68 in a total of 4.90, the positive predictive value and negative predictive value were 72.0% and 72.7%, respectively. Conclusion: A screening tool with five risk factors and the OLB test could predict falls in healthy community-dwelling older adults. (C) 2011 Elsevier Inc. All rights reserved