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educational programs

Women with Disabilities. educational programs. Why This Curriculum?. 54 million Americans live with disabilities 28.6 million are women (21.3% of all females). An Urgent Healthcare Problem:. Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

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educational programs

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  1. Women with Disabilities educational programs

  2. Why This Curriculum? 54 millionAmericans live with disabilities 28.6 millionare women(21.3% of all females) An Urgent Healthcare Problem: Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  3. Disability Trends in Women From 1990-19941: • <18 years 33% (4.2% to 5.6%) • 18-44 years 16% (8.8% to 10.3%) From 1982-19962: • 65 years 26.8% (26.9 million to 34.1 million) 1LaPlante, M.P, and H.S. Kaye, eds.Trends in Disability and Their Causes: Proceedings of the Fourth National Disability Statistics and Policy Forum. 1998. 2U.S. Department of Health & Human Services. Healthy People 2010. 2001.

  4. Why This Curriculum? • Overweight • Physically inactive • Overstressed Women With Disabilities Are More Likely to be Source: U.S. Department of Health & Human Services. Healthy People 2010. 2001.

  5. Why This Curriculum? Women with Disabilities Report More • Pain • Depression • Anxiety • Sleep problems • Days of low vitality Source: CDC. Morbidity and Mortality Weekly Report 47, no. 7 (1998):134-140.

  6. Why This Curriculum? • Given preventive healthcare services (e.g., Pap test, breast exam, mammogram)1 • Screened for tobacco and alcohol use2 • Asked about sexual activity and need for contraception2 Women With Disabilities Are Less Likely to Be 1U.S. Department of Health & Human Services. Healthy People 2010. 2001.

  7. Why This Curriculum? • All people with disabilities are in poor health • Public health policy should focus only on preventing disabling conditions • Standard definitions of disability and people with disabilities are not needed • Environment plays no role in the disabling process Major Misconceptions Source: U.S. Department of Health & Human Services. Healthy People 2010. 2001.

  8. Leading “Hidden” Causes of Disabilities in Women • Arthritis • Obesity • Chronic health conditions • Aging

  9. Arthritis and Disabilities • Leading cause of disability in U.S.1 • 38% of people with arthritis restrict their daily activities2 • By 2030, 67 million Americans will have arthritis3 1CDC. Morbidity and Mortality Weekly Report 50, no. 7 (1999):120-125. 2CDC. Morbidity and Mortality Weekly Report 55, no. 40 (2006):1089-1092. 3Hootman, J.M., and C.G. Helmick. Arthritis and Rheumatism 54, no. 1 (2006):226-229.

  10. Obesity and Disabilities • Obese people are 2-4 times more likely to limit their daily activities1 • 17% of children and 32% of adults in U.S. are obese2 1Sturm, Roland, et al. Health Affairs 23, no. 2 (2004):199-205. 2Ogden, Cynthia I., et al. Journal of the American Medical Association 295, no. 13 (2006):1549-1555.

  11. What Is a Disability? Occurring at a personal level and is defined as any restriction or lack of ability (from impairment) to perform an activity in the manner or within the range considered normal for a human being World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  12. Disability Models Medical Model • Individual problem • Directly caused by disease Social Model • Does not reside in individual • Created by a non-accommodating environment

  13. International Classification of Functioning, Disability and Health (ICF)* A Person’s Functioning and Disability Is a Dynamic Interaction Between Contextual Factors (environmental and personal) Health Conditions (diseases, disorders, injuries, traumas, etc.) *World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  14. International Classification of Functioning, Disability and Health (ICF)* * World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization, 2001.

  15. ICF Definitions Body functionsPhysiological functions of body systems (including psychological functions) Body structuresAnatomical parts of the body, such as organs, limbs and their components ActivityExecution of a task or action by an individual ParticipationInvolvement in a life situation Source: World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  16. ICF Definitions Environmental factorsThe physical, social and attitudinal environment in which people live and conduct their lives. These are either barriers to or facilitators of the person’s functioning. Personal factors(Not classified) Source: World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  17. International Classification of Functioning, Disability and Health (ICF)* * World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization, 2001.

  18. Activities and Participation (ICF) • Learning and Applying Knowledge • General Tasks and Demands • Communication • Mobility • Self Care • Domestic Life • Interpersonal Interactions and Relationships • Major Life Areas • Community, Social and Civic Life Source: World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  19. Environmental Factors (ICF) • Products and Technology • Natural Environment and Human-Made Changes to Environment • Support and Relationships • Attitudes • Services, Systems and Policies Source: World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  20. International Classification of Functioning, Disability and Health (ICF)* * World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization, 2001.

  21. ICF Definitions Activity limitationsDifficulties an individual may have in executing activities Participation restrictionsProblems an individual may experience in involvement in life situations Source: World Health Organization. International Classification of Functioning, Disability and Health: ICF. 2001.

  22. Who Will You Be Seeing? 46%have more than one disability Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  23. Who Will You Be Seeing? 60%of disabled men are employed 51%of disabled women are employed Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  24. Who Will You Be Seeing? Document source? I put it in the notes section. Source: Jans, L., & Stoddard, S. (1999). Chartbook on Women and Disability in the United States. An InfoUse Report. Washington, D.C.: U.S. National Institute on Disability and Rehabilitation Research.

  25. Source? I inserted in the note section. Who Will You Be Seeing? Females Males

  26. Who Will You Be Seeing? 50% of womenwith activity limitations are currently married 64% of womenwith no activity limitations are currently married 44% of womenwith severe activity limitations are married Source: Jans, L., and S. Stoddard. Chartbook on Women and Disability in the United States. 1999.

  27. Major U.S. Disability Systems • Worker’s Compensation • Social Security • Disability Insurance • Federal Employees’ Compensation • Longshore and Harbor Workers’ Compensation Program • Railroad Workers and Seamen • Black Lung Benefits • Veteran’s Disability Programs Source: Katz RT, Rondinelli RD. Major U.S. disability systems graphically compared. Phys Med Rehabil Clin N Am. 2001;12:499-505.

  28. Disability Classifications Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  29. Specific Disabilities Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  30. Percent of Males and Females in U.S. Population That Meet Disability Classifications Source: U. S. Census Bureau. Disability Status: 2000: Census 2000 Brief. 2003.

  31. Questions for Healthcare Providers • Do you know how to safely assist with a transfer for a patient with mobility limitations? • Do you know how to use an alphabet board? • Would you know how to effectively use an interpreter? • Can you identify secondary conditions and define autonomic dysreflexia? • Is your practice accessible to women living with disabilities? • Do you have financial concerns regarding patients who require longer time to receive medical services?

  32. Defining an Individual Woman’s Disability • Ask what accommodations she needs • Don’t assume she’s in poor health • Determine if her emotional distress is linked to environmental barriers

  33. Discussion Social Context • Discuss the societal stigmas and barriers related to gender and disability. • Identify healthcare providers’ biases and stereotyping of women with disabilities. • Discuss the impact of these stigmas, barriers and biases on health care and health outcomes for women with disabilities.

  34. Discussion Quality of Life • Discuss why healthcare providers need to understand that patients decide their own quality of life. • Discuss the difference between self-determination and independence.

  35. Discussion Cultural Competency • Discuss the impact of membership in concurrent cultural groups (ethnic, class, gender, sexual orientation) on the care offered and provided to women with disabilities. • Discuss the impact of membership in concurrent cultural groups on healthcare outcomes.

  36. Discussion Collaborative Care • Describe the importance of education for both healthcare providers and patients in maximizing informed choices. • Discuss the importance of healthcare providers and patients in partnering together.

  37. Discussion Professional Etiquette • Describe the principles of professional etiquette in interacting with women with disabilities

  38. Summary: What’s Needed • Diverse, compassionate healthcare providers • Individualized, whole-person care • Accessible medical facilities • Best evidence-based practices • Empowerment of both patient and provider through knowledge

  39. Learning Modules Current modulesHealth Care Provider Learning Modules • Introduction • Communication Future Modules Health Care Provider Learning Modules • Health and Wellness Reproductive Health • Maximizing independence • Associated medical conditions/Secondary Conditions • Ethical and legal issues • Making user-friendly practice changes (for all users-patients AND clinicians) Patient Educational Outreach Modules: • Reproductive Health • Health and Wellness • Maximizing independence • Associated medical conditions/Secondary Conditions • Ethical and legal issues • Resources

  40. Bibliography • American Medical Association. Guides to the Evaluation of Permanent Impairment, 5th ed. Chicago: American Medical Association, 2001. • Centers for Disease Control and Prevention (CDC). “Health-related Quality of Life and Activity Limitation—Eight States, 1995.” Morbidity and Mortality Weekly Report 47, no. 7 (1998):134-140. • Centers for Disease Control and Prevention (CDC). “Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation—United States, 2003-2005.” Morbidity and Mortality Weekly Report 55, no. 40 (2006):1089-1092. • Centers for Disease Control and Prevention (CDC). “Prevalence of Disabilities and Associated Health Conditions Among Adults—United States, 1999.” Morbidity and Mortality Weekly Report 50, no. 7 (1999):120-125. • Hootman, J.M., and C.G. Helmick. “Projections of US Prevalence of Arthritis and Associated Activity Limitations. Arthritisand Rheumatism 54, no. 1 (2006):226-229. • Jans, L., and S. Stoddard. Chartbook on Women and Disability in the United States. An InfoUse Report. Washington, DC: U.S. National Institute on Disability and Rehabilitation Research, 1999.

  41. Bibliography • Mokdad, Ali H., Earl S. Ford, Barbara A. Bowman, William H. Dietz, Frank Vinicor, Virginia S. Bales, and James S. Marks. “Prevalence of Obesity, Diabetes, and Obesity-Related Health Risk Factors, 2001.” Journal of the American Medical Association 289, no.1 (2003):76-79. • Ogden, Cynthia I., Margaret D. Carroll, Lester R. Curtin, Margaret A. McDowell, Carolyn J. Tabak, and Katherine M. Flegal. Prevalence of Overweight and Obesity in the United States, 1999-2004.” Journal of the American Medical Association 295, no. 13 (2006):1549-1555. • Sturm, Roland, Jeanne S. Ringle, and Tatiana Andreyeva. “Increasing Obesity Rates and Disability Trends.” Health Affairs 23, no. 2 (2004):199-205. • U.S. Census Bureau. Disability Status: 2000: Census 2000 Brief, by Judith Waldrop and Sharon M. Stern. Washington, DC: Government Printing Office, 2003. • U.S. Department of Health & Human Services. Healthy People 2010. Washington, DC: U.S. Government Printing Office, 2001. • Zola, Irving K. "Disability Statistics, What We Count and What It Tells Us: A Personal and Political Analysis." Journal of Disability Policy Studies 4, no. 2 (1993): 9-39.

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