What is the gap in activity and participation between people with disability and the general population in Taiwan?

Abstract

BackgroundIn 2010, the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed, based on the concept of the International Classification of Functioning, Disability and Health (ICF). The ICF provides a common language and framework for health and health-related status and attempts to integrate the biopsychosocial model as a multidimensional perspective in understanding functioning. Activities and participation (AP) is one salient component of the ICF refers to the execution of a task by an individual, and how such tasks are involved in their daily life. It is essential to examine the gap between the general adult population and adults with disabilities. This gap may be attributed to health status, personal factors, and natural and social environments, which include social and health services and policies. The purposes: (1) To develop a normative activity and participation (AP) value for the adult population and people with disabilities; and (2) to compare the gap in AP normative values between the two groups in Taiwan.MethodsWe use the WHODAS 2.0 to survey and develop a normative AP value for the general adult population, and used secondary data from National Disability Eligibility Determination System (NDEDS) of Taiwan to describe the AP functioning distribution of adult with disability. There were 1100 participants, selected by stratified proportional sampling from two cities. There were also 144,850 participants who were adults with disability, selected from the secondary database in Taiwan.Results and conclusionsThe AP curve for the disabled population increased rapidly at the beginning. The summary score was 13.21 in the performance at 90 percentile for the general population and 82.61 score for disabled adults that the similar gap in every domain, its means that there are significant functioning difference and health equality in general adults population and adults with disabilities. This presents a substantial challenge for both the government and the whole population of Taiwan, to begin considering how to reduce the gap in AP functioning and promote equality for people with disabilities, using social welfare policy. It is important to make sure disabled people have the same rights to be included in society as anybody else and better access to things in all areas of life that are according to Convention on the Rights of Persons with Disabilities (CRPD).

Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations

“…For children and adolescents, the estimates of those meeting the PA guidelines in HIC vary from 25 to 42%, while no systematic data exist for children and youth estimates in LMICs [ 49 , 50 , 51 , 52 ]. These contrast with PA prevalence estimates among children/adolescents and adults without disabilities in both HIC and LMIC of 40% to 60% and 50% to 80%, respectively [ 38 , 39 , 40 , 45 , 47 , 48 , 49 , 53 ]. The known efforts to measure PA and disability among children, adolescents, and adults concurrently across the globe in both HIC and LMIC are summarized in Table 2 .…”

The World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0): remarks on the need to revise the WHODAS

“…With WHO's endorsement, WHODAS 2.0 has had its use spread gradually and quickly throughout the world in clinical and research settings 26 . As a result of this, the literature has shown some examples of its use as in the assessment of functioning in aged population in Poland 33 ; in the check for the association between disability and common mental disorders 20 ; in the research of the symptoms of depression and anxiety 34 ; in the description of the gap in activities and participation between people with and without disabilities 35 ; in the analysis of the participation of colorectal cancer survivors 36 ; relating educational level and disability in people with dementia 37 ; in the investigation of disability in people with HIV 38 ; among others. Several papers with clinical approach can also be found.…”

Structural Validity of an ICF-Based Measure of Activity and Participation for Children in Taiwan’s Disability Eligibility Determination System

“…Domain 2, neighborhood and community participation, has 4 items (item 7-10) to assess activities including social, play, or leisure activities; structured events; moving around; and communicating with others in community; Domain 3, school participation, has 5 items (item 11-15) to assess activities including educational (academic) activities; social, play, or leisure activities; moving around; and using educational material in schools. Domain 4, home and community living activities (HCLA), has 5 items (item [16][17][18][19][20] to assess activities including household tasks, shopping and managing money, managing schedule, using transportation to get around, and work activities and responsibility in home and in the transition to community [15].…”

“…The present study was approved by the Research Ethics Committee of the Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation (IRB104-04-A;IRB107-46-B) and Joint Institutional Review Board Taipei Medical University (TMU-Joint Institutional Review Board), Taiwan. The deidentified data were retrieved from the Taiwan Databank of People with Disabilities, which included 14,835 children and youth (aged 6.0-17.9 years) who received the DEDS assessment in 201 authorized hospitals from November 2013 to January 2015 [3,12,16,17,20]. All children and youth were assigned a diagnosis with specific codes of the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) (http://www.cdc.gov/nchs/icd/icd9cm.htm) to be eligible for the DEDS.…”

“…Psychometric properties have been examined in previous FUNDES-Child versions [ 12 , 13 , 16 , 17 , 18 ]. Internal consistency of the independence and frequency dimensions were adequate to excellent for the total score of the participation section of FUNDES-Child (Cronbach’s alpha = 0.81–0.96) [ 13 ].…”