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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Disabilities".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 22352

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Prof. Dr. Thilo Kroll

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School of Nursing, Midwifery and Health Systems, University College Dublin, D04 V1W8 Dublin, Ireland
Interests: disability; health systems; participatory research; environmental and service design
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

An estimated 15% of the global population live with a disability (WHO (2011) World Report on Disabilities). There are substantial variations across world regions, which can be explained by the differences in how disabilities are defined or counted. The number of people with disabilities is likely to increase as a result of ageing trends in many countries. Worldwide, people with disabilities face many barriers in accessing health services. These are the result of a combination of health systems and service characteristics and general social and physical barriers. The United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) adopted in 2006 is a human rights instrument to change attitudes and approaches to disabilities. The Convention is a departure from viewing people with disabilities “as ‘objects’ of charity, medical treatment and social protection towards [ed. regarding them] as “subjects” with rights, who are capable of claiming those rights and making decisions for their lives based on their free and informed consent as well as being active members of society” (https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities.html). Article 25 commits nation states to ensure that people with disabilities enjoy “the highest attainable standard of health without discrimination on the basis of disability. States Parties shall take all appropriate measures to ensure access for persons with disabilities to health services that are gender-sensitive, including health-related rehabilitation. (https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/article-25-health.html)”

As of March 2019, 177 countries have ratified the Convention and committed to the implementation of its objectives. This Special Issue aims to compile success stories and case reports on achieving inclusive and equitable access to health care services. We wish to include critical research on health systems issues, such as the organisation and financing of health services, disability-specific training of healthcare staff, as well as audit and monitoring data systems in this collection. We also welcome reviews on geographic, social, and economic factors preventing or facilitating access and the use of health services by people with disabilities.

Further, we will consider qualitative reports on the experience and consequences of physical and social barriers and facilitators. We invite the evaluation and implementation studies on innovative service models in primary and specialist care, as well as evaluation studies of best practices to mitigate or remove access barriers to general practice and specialist services. Mainly, interventions that directly involve people with disabilities in the development and implementation are of interest.

Furthermore, we invite contributions from all social science and health-related disciplines.

This Special Issue will provide readers with best-practice examples for ensuring inclusive and equitable access to health services for people with disabilities, highlight persistent access barriers, and remind policymakers and practitioners about the need for change.

Prof. Dr. Thilo Kroll
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

disability
access to health care
health systems
United Nations convention on the rights of persons with disabilities

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Published Papers (5 papers)

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11 pages, 358 KiB

Open AccessArticle

A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

by Alexandro Pinto, Luciana Sepúlveda Köptcke, Renata David and Hannah Kuper

Int. J. Environ. Res. Public Health 2021, 18(6), 2953; https://doi.org/10.3390/ijerph18062953 - 13 Mar 2021

Cited by 17 | Viewed by 3367

Abstract

Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws. Full article

(This article belongs to the Special Issue Accessible and Inclusive Health Services for People with Disabilities)

13 pages, 843 KiB

Open AccessArticle

Sounds That People with Visual Impairment Want to Experience

by Rafal Mlynski, Emil Kozlowski and Jan Adamczyk

Int. J. Environ. Res. Public Health 2021, 18(5), 2630; https://doi.org/10.3390/ijerph18052630 - 5 Mar 2021

Cited by 7 | Viewed by 2449

Abstract

This article presents the expectations of visually impaired people with regard to the content of a set of sound exercises planned for implementation, which will mainly enable these people to become familiar with the sounds associated with specific life situations. Consultations were carried out with 20 people with visual impairment, which allowed for the recognition of the needs of these people regarding the sounds with which they wish to become acquainted. The 35 initially proposed sounds were assessed using a five-grade scale. These sounds included those that would be heard in a number of situations in which a person with a visual impairment could potentially be found, both at home and, for example, while in the street or at an office. During the consultations, people with visual impairment usually rated the sounds proposed for inclusion in the set of sound exercises as highly relevant or relevant. In most cases, the assessment was analogous regardless of whether the person had a visual impairment since birth or developed it relatively recently. There were also more than 100 sounds that were proposed for inclusion in the set. The results of the consultation demonstrate how important the information contained in sound is for people with visual impairment. Full article

(This article belongs to the Special Issue Accessible and Inclusive Health Services for People with Disabilities)

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13 pages, 4580 KiB

Open AccessArticle

Access to Dental Care—A Survey from Dentists, People with Disabilities and Caregivers

by Gianmaria D’Addazio, Manlio Santilli, Bruna Sinjari, Edit Xhajanka, Imena Rexhepi, Rocco Mangifesta and Sergio Caputi

Int. J. Environ. Res. Public Health 2021, 18(4), 1556; https://doi.org/10.3390/ijerph18041556 - 6 Feb 2021

Cited by 26 | Viewed by 4682

Abstract

The literature highlights differences in the dental conditions of people with disabilities compared with the general population. The aim of this study was to provide an overview of the dental health of people with disabilities in order to understand if their needs are met and to identify their most critical issues as per dentists. A paper and a Google Form platform were used in conducting a survey in Central Italy (the Abruzzo region), by performing an analysis on different points of view as reported by people with disabilities and dentists. The results showed that only 69.2% of dentists treat persons with disabilities. Of these, 73.5% treat less than 10 patients with physical disabilities per year. However, 54% of dentists do not treat people with cognitive impairment and a poor ability to collaborate during treatment. More than 80% of respondent dentists report that people with disabilities do not have good oral hygiene. On the other hand, 49.1% of people with disabilities (or their caregivers in cases where the patient was unable to answer) report that they rarely or never go to the dental office. Moreover, when they do go, it is mainly for emergencies. Despite this, respondents are well aware of their dental problems. However, they have difficulties in communicating their dental problems to their dentist. The 50% of dentists who treat people with cognitive impairment do not include them in follow-up, while only 20% of these patients reported being regularly recalled. This illustrates the importance of the implementation of follow-up. In addition, training courses could help clinicians to reduce this gap and create barrier-free dental offices. Full article

(This article belongs to the Special Issue Accessible and Inclusive Health Services for People with Disabilities)

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10 pages, 773 KiB

Open AccessArticle

The Effectiveness of a Board Game-Based Oral Hygiene Education Program on Oral Hygiene Knowledge and Plaque Index of Adults with Intellectual Disability: A Pilot Study

by Hsiu-Yueh Liu, Ping-Ho Chen, Wun-Jyun Chen, Shan-Shan Huang, Jen-Hao Chen and Ching-Teng Yao

Int. J. Environ. Res. Public Health 2021, 18(3), 946; https://doi.org/10.3390/ijerph18030946 - 22 Jan 2021

Cited by 11 | Viewed by 3680

Abstract

An oral hygiene board game was designed as an intervention tool and applied to explore the effectiveness for the oral health related knowledge (OHK) score and plaque index (PI) of adults with intellectual disability (ID). This one-group pre/post-test design study was conducted in a residential long-term care facility for 42 participants. The study had one pre-test (baseline) and three post-tests evaluated in both control and intervention stages, respectively. The participants participated in a 60-min oral hygiene board game twice a week during the intervention stage. Total OHK score and PI of the participants were recorded to determine the effectiveness of intervention. There were no differences in OHK score and PI between the two stages at baseline. The results in intervention stage demonstrated a significant gradual increase and reduction in the OHK score when compared with the control stage. A statistically significant improvement in the OHK score and PI (42.29% and −33.28%, respectively) at the end of intervention between two stages was recorded. This study proved a board game is deemed an effective education method applicable to promote the OHK and skills of ID adults. Full article

(This article belongs to the Special Issue Accessible and Inclusive Health Services for People with Disabilities)

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15 pages, 1027 KiB

Open AccessProtocol

The Importance of the Built Environment in Person-Centred Rehabilitation at Home: Study Protocol

by Maya Kylén, Lena Von Koch, Hélène Pessah-Rasmussen, Elizabeth Marcheschi, Charlotte Ytterberg, Ann Heylighen and Marie Elf

Int. J. Environ. Res. Public Health 2019, 16(13), 2409; https://doi.org/10.3390/ijerph16132409 - 6 Jul 2019

Cited by 12 | Viewed by 7318

Abstract

Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This—along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred—will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient’s recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person–environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home. Full article

(This article belongs to the Special Issue Accessible and Inclusive Health Services for People with Disabilities)

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