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PubMed1994

Predicting depression and psychological distress in persons with spinal cord injury based on indicators of handicap.

This study examined whether experiences of handicap influence levels of depression and distress among persons with spinal cord injury (SCI) during the years after initial discharge from rehabilitation. SCI outpatients (163), who had received inpatient treatment at one of two rehabilitation centers in Michigan and who were between 2 to 7 years since injury, participated in the study. Measures of depression, of psychological distress and of handicap were collected during 2 consecutive years utilizing the Zung Self-Rating Scale, the Brief Symptom Inventory and the Craig Handicap Assessment and Reporting Technique (CHART) in conjunction with the Perceived Handicap Questionnaire (PHQ), respectively. According to the study's findings, depressed/distressed SCI subjects reported spending more hours in bed (P < 0.01), fewer days out of the house (P < 0.03) and receiving more paid personal care assistance (P < 0.02) than did other subjects. They also expended more for general medical expenses (P < 0.001) and reported less access to readily available transportation (P < 0.003). CHART total scores, reflecting a simple objective measure of handicap as described by Whiteneck et al. (Whiteneck GG, Charlifue SW, Gerhart KA, Overholser JD, Richardson GN: Guide for Use of the CHART: Craig Handicap Assessment and Reporting Technique. Craig Hospital, CO, 1988) were significantly associated with both distress and depression as measured during the second year of data collection. Other significant predictors of depression and distress included subjects' self-perceived handicap (measured by the PHQ), gender, marital status and age.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMedDate not supplied

The relationship between audiometric and self-report measures of hearing handicap.

In 430 individuals with adult onset hearing loss, relationships were explored between definitions of handicap based on a number of arithmetic formulas applied to audiometric data and definitions of handicap based on two self-report questionnaires (the Denver Scale of Communication Function and the Social Hearing Handicap Index). Resulting linear correlations were very low with the highest relationship--between better ear pure-tone average and perceived handicap--being only 0.38. Of the standard hearing handicap formulas, the 1947 American Medical Association calculation and the 1980 Ohio State formula showed the highest correlations with perceived handicap (0.33 and 0.28, respectively). The results highlight the difference between audiometrically calculated and self-reported hearing handicap.

Adolescent↗
PubMed1981

Psychological and dynamic aspects of handicaps.

Within a research program on the functional approach of the handicap we have realized a psychological survey in order to test the relationship between the functional approach and the desires of the disabled. 72 handicapped persons, fairly representative of the general population of our area, were included into the study. A coded interview, a projection test and a connotation test were carried out and their result computerized and statistically analyzed. The results show clearly that the handicap, if it modifies the daily life of the subjects, has no repercussion on personality tendencies. The emotional repercussion of experienced situations is independent of the characteristics of the handicap. The perception of his body is, for the handicapped, in reference to the others. Confrontation favors the integration of handicapped people. The experience of being handicapped in daily life exists only in situations where the others are involved.

Activities of Daily Living↗
PubMed1993

Is there only one type of male handicap?

The handicap principle has been one of the most important developments in sexual selection theory. Numerous theoretical papers have considered whether extreme male ornaments could have arisen through female choice by being handicaps to the male. These models have been defined as belonging to one of three categories: (i) Zahavi's (J. theor. Biol. 53, 205 (1975)); (ii) the revealing; or (iii) the condition-dependent handicap. Here I discuss whether the division is still helpful for empirical purposes, or whether handicaps are not best considered as being condition dependent. I argue that in fact the revealing and condition-dependent handicaps are indistinguishable empirically, and that the 'Zahavi' handicap models arose due to a misunderstanding of what Zahavi originally proposed, which was in fact a condition-dependent handicap.

Animals↗
PubMed1988

Stigma and the self-concept of people with a mild mental handicap.

Twelve people with a mild mental handicap, their mothers and members of staff of Adult Training Centres were interviewed to explore their views on the subjects of stigma and handicap, and to establish the facts about the social life and autonomy of people with a mental handicap. It was found that all participants with a mental handicap were aware of the stigma attached to them. A minority of three conceived of themselves as 'essentially different' from non-handicapped people, while the majority of nine conceived of themselves as 'essentially the same'. In contrast, the majority of mothers viewed their sons and daughters as 'essentially different' from non-handicapped people. These findings do not support the claim of the social constructionist theory of the self that people's self-concepts are primarily determined by the ways in which they are treated by the significant others. Rather, people with a mental handicap are aware of their own agency and clearly express their socio-emotional needs.

Adult↗
PubMed1978

Dental health education for the mentally and physically handicapped.

Dental disease is one of the most common health problems of Americans. It is one of the many health problems that handicapped children have in common with their non-handicapped peers. Research indicates that handicapped children have significantly more decayed and missing teeth than non-handicapped students. Methods of improving the dental health of handicapped children were explored. These methods included teacher education, development of special instruments, development of a directory of dentists who would treat the handicapped, and the role that parents should play in the dental health program. The plight of dental health care in the handicapped will continue unabated until health educators become more active in health education for all segments of the school population.

Adolescent↗
PubMed2004

Blindness, low vision, and other handicaps as risk factors attached to institutional residence.

AIMS: To estimate the risk of living in an institution and being visually impaired. METHODS: Two national surveys were pooled: (1) 2075 institutions (for children or adults with handicaps, old people, and psychiatric centres) were selected randomly, in 18 predefined strata, from the French health ministry files. From these institutions, 15 403 subjects were selected randomly and handicap was documented by interview in 14 603 (94.9%) of them; (2) level of handicap was documented in a randomised, stratified sample of 356 208 citizens living in the community; from this sample, 21 760 subjects were further selected at random and 16 945 people were interviewed. Data on handicaps (visual, auditory, speech, brain, visceral, motor, and other) and activities of daily living (ADL) were extracted. The odds ratio (OR) of living in an institution was estimated, using stepwise logistic regressions with age, geographical area, handicaps, and ADL as co-variables. RESULTS: Subjects in institutions, compared to those living at home, were, respectively, more often female (64.3% v 52.4%) and older (68.7 v 38.0 years); they more often had handicaps (ORs: speech, 6.59; brain, 10.17; motor, 8.86; visceral, 3.49; auditory, 2.66; other, 1.53); and were less often able to perform their ADL (46.2% v 97.1%) without assistance. Below 80 years, blind people were more often in institutions (ORs 0.239 to 0.306); whereas in older people the association was reversed (OR: 3.277). Low vision was always significantly associated with institutional residence (ORs from 0.262 to 0.752). CONCLUSION: Visual handicap was associated with institutional residence. The link persisted after adjustment for known confounding factors.

Activities of Daily Living↗
PubMed1998

Diagnostic assessment and treatment goals in logopedics: impairments, disabilities and handicaps.

This study was aimed to investigate to what extent impairments, disabilities and handicaps are used as diagnostic assessments and treatment goals in logopedics. Traditionally, logopedists are mainly concerned with impairments. These days, increasing attention is demanded for disabilities and handicaps as well. A survey study was carried out on 1,567 patients in logopedic practices in the Netherlands to provide an empirical quantitative description of diagnostic assessments and treatment goals, formulated in terms of impairments, disabilities and handicaps. Results show that logopedists indeed often indicate impairments as diagnostic assessments and as treatment goals, particularly language development impairments and phonetic/phonological articulation impairments. Interestingly, also large numbers of diagnostic assessments and treatment goals were indicated at the level of disabilities and handicaps; the most important being disability in expressing communication and occupational handicap. These results demonstrate that disabilities and handicaps may serve an important function in logopedics, in that they may guide assessment as well as therapy. It is concluded that disabilities and handicaps should be considered in the future development of the profession of logopedics.

Adolescent↗
PubMed2001

Cross-cultural validation of the London Handicap Scale in Hong Kong Chinese.

STUDY OBJECTIVE: To investigate the cross-cultural validity of London Handicap Scale in Hong Kong Chinese. DESIGN: Ratings of the utility of 10 hypothetical health scenarios were given by groups of HK Chinese subjects. Measured scores were compared with calculated scores from published scale weights of London Handicap Scale, which were based on utility ratings made by UK subjects. SETTING: A rehabilitation hospital in Hong Kong. SUBJECTS: A total of 164 HK Chinese, comprising doctors, medical students, nonmedical hospital staff, geriatric day hospital stroke and nonstroke patients, community day-care centre elderly, old age hostel elderly, young disabled inpatients and young community-dwelling disabled citizens. MAIN RESULTS: There was a close correlation between the mean scores of HK subjects and the calculated scores derived from the published UK scale weights, apart from one scenario (Pearson's correlation coefficient r = 0.87 p = 0.001). The correlations were high for all subgroups, between which there was good consensus. Measured utilities were significantly different between subgroups for only one scenario. For this scenario of moderate to severe handicap in mobility, physical dependence, occupation and social integration, but with excellent orientation and economic self sufficiency: (1) older age groups gave better scores than younger age groups (p < 0.0005); (2) subjects with poor subjective health status gave better scores than those with good subjective health status (p = 0.002); (3) subjects related to the medical or hospital field, i.e. doctors, medical students and nonmedical hospital staff, gave worse scores than other subject groups (p < 0.0005). CONCLUSION: The concept of handicap applies across cultures. Perception of severity of selected real life handicap scenarios by HK Chinese were well estimated using scale weights from UK populations developed for the London Handicap Scale. Significant differences in perception of certain handicap scenarios by different population subgroups deserve further study.

Activities of Daily Living↗
PubMed2003

Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap.

OBJECTIVES: (1) To examine the relationships between measures of impairment and disability for the arm and leg with a measure of handicap and (2) to identify the impairment or disability most strongly related to handicap situations. DESIGN: Prospective cohort study. SETTING: Intensive functional rehabilitation unit and community. PATIENTS: One hundred and two persons who had a stroke. MAIN OUTCOME MEASURES: Arm and leg impairments and disabilities were evaluated with reliable and valid tests at discharge from rehabilitation. Six months later, handicap situations were evaluated with the Assessments of Life Habits (LIFE-H). RESULTS: Arm and leg impairments and disabilities are correlated with handicap situations. Disability of the leg is more strongly associated with handicap than arm disability. Arm and leg disabilities are not statistically more strongly related to handicap than arm and leg impairments. CONCLUSIONS: The high correlations found between handicap situations and the impairment and disability measures of the leg provide new information that support the importance of mobility to promote integration after stroke.

Aged↗
PubMed1995

[Handicaps in twins and triplets].

This study was conducted to investigate the prevalence rates of handicaps in twins and triplets. The subjects were 252 twins and 287 triplets. The following results were obtained. 1) The prevalence rates of the handicapped were 8.7 per 100 triplets, and 4.4 per 100 twins. The risk of producing at least one handicapped child was approximately 22% in triplet pregnancy and 9% in twin pregnancy. This means that one in 4 or 5 sets of triplets had at least one handicapped child, as did one in 11 pairs of twins. 2) Cerebral palsy was the most frequent handicap in twins and triplets. The risks of producing a child with cerebral palsy were 2.0% and 3.1% in twins and triplets, respectively. 3) The prevalence rates of congenital anomalies (congenital heart disease, limb anomalies, and others) were 2.4% in twins and 4.5% in triplets. Approximately 45% of the handicaps in twins and triplets resulted from congenital anomalies. 4) The prevalence rate of the handicapped in twins and triplets was not associated with maternal age, but was associated with the years of delivery in triplets, and was higher in babies with shorter gestation periods.

Adult↗
PubMed1990

[A study on a design guide for detached houses with home-elevators for aged and physically handicapped persons].

The purpose of this paper is to extract the design guide of the detached houses with home-elevator for aged and physically handicapped persons, so, for 4 cases we investigated the composition of living spaces, living activities and dweller's evaluation. The main results are follows: (1) The aged and physically handicapped persons' room generally must be located at the 1st floor, but setting up the home-elevator house planning turns into more free. (2) Setting up the home-elevator, we can locate the aged and physically handicapped persons' room at the highest floor. In the case of town houses having few site areas, the highest floor has often good condition of the exposure to the sun and the view, so the aged and physically handicapped persons prefer the highest floor room. (3) In the aged and physically handicapped persons' houses, the corridor and the sanitary space get cold in winter, because those spaces are wide using the wheel chair and helping. So these houses need the floor heating. (4) In the aged and physically handicapped persons' houses, at the garage going in and out must be free without the difference in level, the space of the elevator hall must be secured fully turning the wheel chair, and at the garage the place of the outdoor wheel chair and the transfer space must be secured fully. (5) In the case of using home-elevator the noise is no problem. In opposition, the family members feel easy to hear the sound of home-elevator, because they can perceive the aged and physically handicapped persons' activities.

Aged↗
PubMed1987

Self-reported disability and handicap in the population in relation to pure-tone threshold, age, sex and type of hearing loss.

A self-administered questionnaire concerning auditory disability and handicap was completed by 1691 subjects who were part of a two-stage random sample of the UK adult population. A principal components analysis of questionnaire replies identified four components. They were interpreted as (a) disability for everyday speech, (b) disability for speech-in-quiet, (c) localisation, and (d) hearing handicap. Components (a) and (d) were the strongest, accounting for 68% of the variance. Subjects also performed pure-tone audiometry amongst other tests. Audiometric information was well described by a two-parameter model characterised by low-to-mid-frequency loss and high-frequency slope. All four components increased progressively with increasing low-to-mid-frequency loss, independent of high-frequency slope. They were best correlated with a binaural average over 0.5, 1 and 2 kHz weighted 4:1 in favour of the better ear, out of several audiometric descriptors examined. Sex and socio-economic group did not generally affect disability or handicap, but people of similar hearing impairment reported less disability and handicap as age increased. This is interpreted as over-compensation for the effects of age in self-report. There were three unexpected findings which may entail some changes in current thinking on the relationship between auditory impairment and self-perceived disability/handicap. Hearing losses incorporating a conductive component in the better ear were more disabling and handicapping than sensorineural losses of equal magnitude. Localisation ability and, to a lesser extent, general hearing handicap were more highly correlated with measures of impairment in the worse ear than in the better ear. There was little evidence for the concept of a 'low fence' in the relationship between impairment and either disability or handicap.

Adolescent↗
PubMedDate not supplied

On the use of the WHO handicap classification in a population study of 73- and 76-year-old men and women.

The WHO ICIDH classification of handicap was used in a population sample studied at 73 (n = 504) and 76 (n = 649) years of age. In the sample, there was either no handicap at all or the degree of handicap was generally low. In most handicap categories, however, the grades increased from 73 to 76 years. The self-rated activity level and the handicap category Occupation showed only low correlation. Good agreement was found between the handicap category Physical independence and assessments of Personal and Instrumental ADL and there was also a correlation between Mobility and maximal walking speed. Correlations were found between the handicap categories and the dimensions in the Nottingham Health Profile (NHP), but r-values were generally rather low. The highest correlation was that with the dimension of Physical mobility. The difference between self-assessed health aspects of quality of life and observer ratings using given norms is stressed.

Activities of Daily Living↗
PubMed1976

[On the problem complex of the new act on the severely handicapped with respect to the workshop for the disabled (author's transl)].

One group of the disabled, i.e., the most severely handicapped, will not be able to benefit from the improvements brought about by the new Act on the Severely Handicapped, if the statutory orders of the Federal Government and the provisions of the Federal Employment Office are implemented as planned. In this event it would become extremely difficult for the severely physically handicapped to participate in the life of the community. The article demonstrates how a sheltered workshop for the disabled which, in part, looks after the most severely handicapped needing special care: - will not achieve recognition under 55 of the Act on the Severely Handicapped, - will not benefit from either institutional or individual support provided by the organisations of - the labour administration, - will not obtain contracts from either industrial or public enterprises because the orders cannot be set off against the equalisation payment, - cannot help their disabled employees to become eligible for social security benefits. This development which for the most severely handicapped represents a step backwards must be removed from those who are the most afflicted. It must not happen that efforts made at school to promote and integrate the disabled terminate in segregated facilities (nursing homes), which are run under different subsidy regulations. What is needed is a concept for appropriate care and support of the most severely handicapped and their integration into suitably equipped small groups within workshops for the disabled.

Persons with Disabilities↗
PubMed1992

Differences in dental health observed within a group of non-institutionalised mentally handicapped adults attending day centres.

A group of 350 mentally handicapped adults living in the community and attending three social services day centres were dentally examined in 1989. Although all those examined were collectively classified as a group of people with a mental handicap and therefore "a population group with special needs", great differences were observed in the dental health of the sub-groups attending each of the centres; it was evident that they did not constitute a uniform group of people. Those who were less mentally handicapped had better oral hygiene, less gingival inflammation, more fillings and fewer teeth extracted because of caries. Overall DMFT was similar at all centres but a greater proportion of the less handicapped group had active, untreated caries. Seventy-four per cent of the less mentally handicapped people attended the general dental services, and up to seventy per cent of those with a greater handicap were reported as attending the community dental service. Dental care for non-institutionalised mentally handicapped adults living in the community cannot be planned with the assumption that they are a homogeneous group of people.

Adult↗
PubMedDate not supplied

[Handicap among children in Saudi Arabia: prevalence, distribution, type, determinants and related factors].

We determined the prevalence, distribution and determinants of handicap among children in Saudi Arabia. A field survey was carried out from 1417 to 1420 AH (1997-2000 AD) of 60 630 children under 16 years selected from all regions of the country. Information was collected by questionnaire for all children and those with a handicap, or suspected of having a handicap, were referred for confirmatory diagnosis. Of the total sample, 3838 (6.33%) were recorded as handicapped. The region with the highest proportion of handicapped children was Jazan (9.90%); Riyadh had the lowest (4.36%). Motor disability was the commonest kind of handicap (3.0% of the total sample), followed by learning disability (1.8%). The highest proportion of disability was found among children with handicapped parents, those whose mothers were older at the time of their birth and those whose mothers had not had medical care and necessary vaccination during pregnancy.

Child↗
PubMed1990

The oral health in different groups of adults with mental handicaps attending Birmingham (UK) adult training centres.

The policies of normalisation and integration into the community of people with mental handicap have significant implications for dental care. Before dental services can be planned, the extent of the problem needs to be identified. A total of 382 people with mental handicap living in the community and attending day centres was examined; 52 of these people were edentulous. The mean age of the dentate adults was 30.9 years and the mean DMFT was 9.59. This was low in comparison with data available from national studies but when component parts of the DMF were evaluated it was apparent that far less restorative care had been received by the adults with mental handicap. There were also significant differences in the mean DMFT between mentally handicapped people who had additional handicaps; the mean DMFT for people with Down's syndrome was 10.95, whilst those mentally handicapped people who also had epilepsy had a mean DMFT of 11.19. The oral hygiene and periodontal condition was also poor and there were significant differences between the sub-groups. However, despite people with Down's syndrome having lower levels of plaque, they showed evidence of greater periodontal destruction. When resources are allocated, consideration should be given to raising the oral health of adults with mental handicap up to at least the same level as that of the rest of the population.

Adult↗