Identifying Risk of Depressive Symptoms in Adults With Physical Disabilities Receiving Rehabilitation Services: Propensity Score Approaches

OBJECTIVE: To compare the risk of depressive symptoms in adults with physical disabilities between rehabilitation-receivers and non-receivers. METHODS: A total of 3,568 adults with physical disabilities were retrieved from the 2014 Korean National Survey on People with Disabilities database. Four covariate adjustment methods (a multivariable regression model, inverse probability of treatment weighting [IPTW] adjusted for normalized weight, IPTW with stabilized weight, and greedy algorithm with 1:1 propensity score matching) were used to estimate the odds of having depressive symptoms. The dependent variable was depressive symptoms and the independent variable was the use of rehabilitation services. Baseline covariates were 19 demographic variables and 10 chronic condition variables. RESULTS: The four covariate adjustment methods revealed that adults with physical disabilities receiving rehabilitation services had a higher risk of depressive symptoms than those who did not receive these services (adjusted odds ratio, 1.191–1.294). CONCLUSION: Our findings suggest that adults with physical disabilities receiving rehabilitation services have higher risk of developing depressive symptoms. Therefore, rehabilitation professionals need to pay attention to depressive symptoms and establish therapeutic strategies that can reduce such risk in rehabilitation settings.

Evaluating Korean Personal Assistance Services Classification System

OBJECTIVE: To evaluate the utility of using the Personal Assistance Services classification system (PAS-CS) that examines individuals with disabilities for services and government funding. To this end, this study also tests for significant differences in PAS-CS scores across disability grades and disability types. METHODS: A retrospective analysis was conducted using the 2014 National Survey on People with Disabilities (NSPD) data set. We selected patients with three types of disabilities (physical disabilities, brain lesions, and visual impairments). We compared the average PAS-CS scores of patients with different disability types and grades using general linear models with multiple comparisons. RESULTS: A total of 4,810 patients were included in the analysis. Patients with brain lesions had the highest average PAS-CS scores in activities of daily living (ADL) and instrumental activities of daily living (IADL) domains. Patients with visual impairments had the highest average scores in ‘Disease-specific disability’ and ‘Social-environment’ domains. For patients with physical disabilities and visual impairments, no PAS-CS domains were significantly different between patients with disability grade III and those with disability grade IV (p>0.05). CONCLUSION: The PAS-CS scores of disability grades were not equivalent among individuals with different disability types. The Korean Ministry of Health and Welfare currently only considers certain disability grades for PAS preeligibility, as a result disregarding the characteristics of different disability types. Thus, the current PAS-CS requires modifications.

A Pilot Study on the Validity and Reliability of the Korean Version of the Oswestry Disability Index in a Farming Community / 대한산업의학회지

OBJECTIVES: The Korean version of the Oswestry Disability Index (ODI) is the most widely used tool validated instrument for measuring and the level of disability associated with low back disorders. We wanted to validate use of the Korean version of the ODI in Korean farmers with low back pain. METHODS: The object of this study was to examine the reliability and validity of the Korean version of the ODI. The Korean version was tested on 53 farmers (62.3+/-10.3 years of age) with low back-related disorders. We investigated the Test-retest reliability, internal consistency, and construct validity of the ODI. The Test-retest reliability was assessed in 30 farmers within a time interval of approximately 14 to 18 days. Differences between the Korean version of the ODI and the Short Form 12 (SF-12), which includes 8 domains (general health, physical functioning, role-physical limitation, bodily pain, role-emotional limitation, mental health, vitality, social functioning) were analyzed for construct validity. The correlation of the Korean version of the ODI with the SF-12 was analyzed, as well. RESULTS: The intra-class correlation coefficient of test-retest reliability was 0.854. Reliability estimated by the internal consistency reached a Cronbach's alpha of 0.879. The correlation between 7 domains of the SF-12 except for the mental health domain and the Korean version of the ODI was statistically significant (p<0.05). Four domains (general health, physical functioning, role-physical limitation, bodily pain) that measured physical status all showed high correlations (p<0.01), as did a domain that measured mental status (role-emotional limitation) (p<0.01). CONCLUSIONS: The results showed that the Korean version of the ODI is a reliable and valid instrument to measure the level of disability in Korean farmers with low back-related disorders. The use of this instrument is recommended for future clinical trials in Korea.