A Conceptual Model for Identifying, Preventing, and Managing Secondary Conditions in People With Disabilities

Rimmer, James H.; Chen, Ming‐De; Hsieh, Kelly

doi:10.2522/ptj.20100410

Cited by 114 publications

(101 citation statements)

References 30 publications

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“…Besides the risk of low HRQoL (pain and low general health) with high BMI or increase in BMI over time, overweight status and obesity increase the risk of several serious diseases [9]. It is well-known that obesity, as well as other conditions such as depression, social isolation, pain, and fatigue, are secondary conditions to several disabilities [29-31]. Although these secondary conditions exist among people without mobility disability as well as among people with mobility disability, the frequency is much higher for people with mobility disability [31].…”

Section: Discussionmentioning

confidence: 99%

Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

et al. 2014

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BackgroundIncreasing obesity in adults with mobility disability has become a considerable health problem, similar to the increasing trend of obesity in the general population. The aims of this study were to investigate the association of mobility disability with overweight status and obesity in a large population-based Swedish cohort of adults, and to investigate whether mobility disability, high body mass index (BMI), and increasing BMI over time are predictors of health-related quality of life and participation in society after 8 years of follow-up.MethodsThe study cohort included 13,549 individuals aged 18–64 years who answered questions about mobility disability, weight, height, health-related quality of life and participation in society in the Stockholm Public Health Survey 2002 and 2010. The cohort was randomly selected from the population of Stockholm County, and divided into six subgroups based on data for mobility disability and overweight status. Multiple binary logistic regression analyses were performed to assess the likelihood for low health-related quality of life and lack of participation.ResultsRespondents with mobility disability had a higher mean BMI than those without mobility disability. Respondents both with and without mobility disability increased in BMI, but with no significant difference in the longitudinal changes (mean difference: 0.078; 95% CI: -0.16 - 0.32). Presence of mobility disability increased the risk of low health-related quality of life and lack of participation in 2010, irrespective of low health-related quality of life and lack of participation in 2002. The risk of pain and low general health (parts of health-related quality of life) increased for every 5 units of higher BMI reported in 2010. In respondents without low general health at baseline, the risk of obtaining low general health increased for every 5 units of higher BMI in 2010 (OR:1.60; CI: 1.47 - 1.74).ConclusionsThe greatest risk of low general health after 8 years was observed for respondents with both mobility disability and high BMI. These results indicate the importance of working preventively with persons with mobility disability and overweight status or obesity based on the risk of further weight gain.

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Section: Discussionmentioning

confidence: 99%

Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

et al. 2014

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“…[1][2][3] The Institute of Medicine defines secondary condition as, 'a condition that is causally related to a disabling condition (that is, occurs as the result of a primary disabling condition) and that can either be a pathology, an impairment, a functional limitation or an additional disability (p.214). 4 In addition, clinicians and researchers have noted that many individuals with physical disabilities-including individuals with SCI-show evidence of earlier onset of some health conditions usually associated with aging (for example, diabetes and cardiovascular disease), as well as a steeper slope with respect to the increase in severity or frequency of a number of health conditions in individuals with SCI relative to nondisabled age-matched peers.…”

Section: Introductionmentioning

confidence: 99%

Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review

et al. 2013

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Study design: Scoping review. Objectives: To gain a better understanding of the prevalence, course and association with age of secondary health conditions in individuals with spinal cord injury (SCI). Setting: Seattle, Washington, USA. Methods: We performed searches of electronic databases for studies published from 1986-2011 that provided information regarding the prevalence, course or associations with age and duration of secondary health conditions in individuals with SCI. Results: Ninety-two studies were included. The findings indicate that: (1) individuals with SCI experience a number of secondary health conditions, many of which occur at a higher rate in those with SCI than the normative population; (2) the most common conditions or symptoms are pain, bowel and bladder regulation problems, muscle spasms, fatigue, esophageal symptom and osteoporosis; (3) a number of conditions, including cardiovascular disease, diabetes, bone mineral density loss, fatigue and respiratory complications or infections, occur with higher frequency in older individuals or those with longer SCI duration, relative to younger individuals or those with shorter SCI duration; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in individuals aging with SCI. Conclusions: The findings support the conclusion that individuals with SCI show signs of 'premature aging' in different organ systems. Longitudinal research is needed to understand when problems are most likely to emerge, and to develop and test the efficacy of interventions to prevent these health conditions and their negative impact.

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“…These results are not surprisingly as they correspond with previous research reporting about health care professionals' inadequate clinical knowledge on the specific disability, secondary conditions and associated (to be expected) behavior, as well as insecurities about strategies to respond to DP and their 'peculiar' behavior. [13][14][15][16][17][18][32][33][34] As research of Emerson et al reports, prevalence of challenging behavior varies depending on the study, from 5% up to 15% of people with an intellectual disability. [35] Research of van Schrojenstein et al states a point prevalence of 41% in people with an intellectual disability with the most prevalent type being problem behavior.…”

Section: Discussionmentioning

confidence: 99%

Care, communication and educational needs of primary care nurses to treat disabled patients

Claes

Storms

Moermans

2016

JNEP

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Introduction: In the northern part of Belgium, 21,518 of 129,021 disabled patients (DP) were waiting to receive residential care. Due to waiting lists for DP, Belgian government promotes a shift towards primary care. This shift results in specific needs for primary care professionals (general practitioners, primary care nurses [PCN] and informal caregivers). The objective of this research was to detect nursing care, communication and educational needs of PCN to treat their DP and their informal caregivers. Methods: A questionnaire was constructed by a multidisciplinary team of primary care professionals (4 general practitioners and 20 PCN) in different consensus meetings. Disabilities are defined as physical and/or intellectual impairment. The questionnaire was sent electronically to participants. Analysis is performed using SPSS 22.0. Results: 1547 questionnaires were mailed, 617 PCN responded (response rate = 40%). PCN are delivering care to 16 patients (+/-10) of which 5 DP (+/-6). 408 PCN have contact with at least half of informal caregivers. Most PCN (n = 582) report overburdening of informal caregivers due to an overload of tasks (72%). Personal hygiene and administering medication are most frequent administered care. Communication with DP and primary health care professionals is evaluated as very good. Most reported educational needs are dealing with behavioral problems (84%), functional loss (84%) and acquired brain injury (74%). There is no significant difference in educational needs of PCN nursing exclusively at home versus at least in residential care facilities. Conclusion: PCN prefer education on dealing with behavioral problems, which corresponds to previous studies. An educational program can be designed to ensure PCN have necessary skills to ensure high quality care for DP and a reduced overburdening of informal caregivers.

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A Conceptual Model for Identifying, Preventing, and Managing Secondary Conditions in People With Disabilities

Cited by 114 publications

References 30 publications

Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

Impacts of mobility disability and high and increasing body mass index on health-related quality of life and participation in society: a population-based cohort study from Sweden

Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review

Care, communication and educational needs of primary care nurses to treat disabled patients

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