Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey
Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey
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DOI：
10.1186/1471-2458-11-897
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发表时间：
2011-11-28
影响因子：
4.5
通讯作者：
de Pedro-Cuesta, Jesus
中科院分区：
文献类型：
--
作者：
Maierhofer, Sarah;Almazan-Isla, Javier;de Pedro-Cuesta, Jesus
背景：自 1986 年以来，西班牙的残疾研究主要通过国家残疾调查 (NDS) 进行。虽然国际上在功能、残疾和健康国际分类 (ICF) 内构建 NDS 设计的尝试取得了进展，但总的来说，ICF 几乎没有用于 NDS 或流行病学研究。本研究旨在确定最新的西班牙 NDS（2008 年残疾、独立和依赖状况调查（Encuesta sobre discapacidades, autonom a individual y situaciones de Dependencia - EDAD 2008）中与 ICF 活动和参与相关的内容，并估计此类 ICF 框架残疾的患病率。方法：EDAD 2008 方法和问题细读过。在分析的 51 个 EDAD 项目中，有 29 个被反向编码到 ICF 检查表的特定 d2-d7 域，并通过对记录的在有或没有帮助的情况下执行特定任务的难度进行评级，然后将这些分别视为性能和能力。还得出了全球 ICF 分数，尽管缺乏 d1“学习和应用知识”、d8“主要生活领域”和 d9“社区、社会和公民生活”的数据。数据按性别、年龄、居住地和初次阳性筛查进行分组，患病率数据是根据一般人群（使用最初设计的权重）和残疾筛查呈阳性的人群的残疾水平计算的。结果：6岁以上社区居住人群ICF重度/完全残疾和中度残疾粗患病率分别为0.9%-2.2%，收容所居住者重度/完全残疾粗患病率为0.3%。严重/完全残疾的患病率是： 女性高于男性，分别为 0.8% 和 0.4%；随着年龄的增长而增加；在“家庭生活”（3.4%）、“流动性”（1.8%）和“自我护理”（1.9%）等领域尤其高，当通过绩效衡量时，这些领域的患病率有所下降。此外，全球评分表明，在中度残疾群体中，这些相同领域的严重/完全残疾很常见。结论：当涉及活动和参与领域时，2008 年 EDAD 提供的 ICF 框架数据集不足。尽管其有效性未知，但可用 ICF 领域的评级可能适合在功能依赖的 ADL 模型下考虑，这表明大约有 500,000 人患有严重/完全残疾，1,000,000 人患有中度残疾，其中一半在能够受益于技术或个人援助的领域中患有严重残疾。将 EDAD 数据应用于地区和其他亚人群的服务规划意味着必须评估个人帮助的需求，查明未满足的需求，并提高对社会参与和支持的了解，特别是对精神病患者的了解。西班牙和其他国家需要在 ICF 规划和 NDS 使用方面开展国际合作，并得到 WHO 支持。
Background: Since 1986, the study of disability in Spain has been mainly addressed by National Disability Surveys (NDSs). While international attempts to frame NDS designs within the International Classification of Functioning, Disability and Health (ICF) have progressed, in general, the ICF has hardly been used in either the NDS or epidemiological studies. This study sought to identify ICF Activity-and Participation-related content in the most recent Spanish NDS, the 2008 Survey on Disabilities, Independence and Dependency Situations (Encuesta sobre discapacidades, autonom a personal y situaciones de Dependencia - EDAD 2008), and estimate the prevalence of such ICF-framed disability.Methods: EDAD 2008 methods and questions were perused. Of the 51 EDAD items analysed, 29 were backcoded to specific d2-d7 domains of the ICF Checklist and, by rating the recorded difficulty to perform specific tasks with or without help, these were then taken as performance and capacity respectively. A global ICF score was also derived, albeit lacking data for d1, "Learning and applying knowledge", d8, "Major Life Areas" and d9, "Community, Social and Civic Life". Data were grouped by sex, age, residence and initial positive screening, and prevalence figures were calculated by disability level both for the general population, using the originally designed weights, and for the population that had screened positive to disability. Data for institutionalised persons were processed separately.Results: Crude prevalence of ICF severe/complete and moderate disability among the community-dwelling population aged >= 6 years was 0.9%-2.2% respectively, and that of severe/complete disability among persons living in sheltered accommodation was 0.3%. Prevalence of severe/complete disability was: higher in women than in men, 0.8% vs. 0.4%; increased with age; and was particularly high in domains such as "Domestic Life", 3.4%, "Mobility", 1.8%, and "Self-care", 1.9%, in which prevalence decreased when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group.Conclusions: The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed.