Adherence to long-term medical follow-up: A qualitative, experience-focused study of people with spinal cord injury.

Background: Scientific evidence indicates the presence of secondary conditions (such as pressure injuries) after spinal cord injury (SCI). Treatment methods focusing on the management of paraplegia and tetraplegia include systematic preventive follow-up. These advances have significantly improved the functional and vital prognosis of people with SCI, but some people may not have access to these specialized organizations or may not adhere closely to this medicalized vision.

The functioning of social support in long-term prevention after spinal cord injury. A qualitative study.

Background: The impact of social support on the long-term condition after a spinal cord injury (SCI) varies across studies mainly involving self-report questionnaires.

Objective: We aimed to establish the common factors associated with social support leading individuals with an SCI to the effective prevention of secondary complications, including via adherence to medical follow-up.

Methods: Inclusion criteria were a history of acquired SCI of any etiology, wheelchair use, and age≥18 years at the time of the study.

Contribution of chronic diseases to educational disparity in disability in France: results from the cross-sectional "disability-health" survey.

Background: This study aimed 1) to assess whether the contribution of chronic conditions to disability varies according to the educational attainment, 2) to disentangle the contributions of the prevalence and of the disabling impact of chronic conditions to educational disparities.

Methods: Data of the 2008-09 Disability Health Survey were examined ( = 23,348). The disability indicator was the Global Activity Limitation Indicator (GALI).

Methods to assess the contribution of diseases to disability using cross-sectional studies: comparison of different versions of the attributable fraction and the attribution method.

Background: This study aims to illustrate the differences between approaches proposed for apportioning disability to different diseases in a multicausal situation, i.e. the unadjusted attributable fraction (AF), the adjusted AF, the average AF and the attribution method (AM).

Risk of pressure ulcers in tetraplegic people: a French survey crossing regional experience with a long-term follow-up.

Background: Pressure ulcer risk assessment provides an indicator of quality of care in French health establishments. The reliability and validity of assessment tools have been shown to be lower for people with spinal cord injury (SCI). We hypothesized that skin complications would be less frequent in people with traumatic SCI and tetraplegia (TSCIt), who were initially managed in French regions with a high level of specialized SCI rehabilitation experience.

Disability, residential environment and social participation: factors influencing daily mobility of persons living in residential care facilities in two regions of France.

Background: Despite the context of individualization of public policies and promotion of independent living, residential care facilities (RCFs) (called "établissements medico-sociaux" in France) still represent the main system used by disabled people. Through a study of their daily mobility, this article proposes a geographical approach to the examination of factors influencing the social participation of disabled persons with motor impairments who live in residential care facilities.

Methods: The data were collected in three stages from several sources.

Risk Analyses of Pressure Ulcer in Tetraplegic Spinal Cord-Injured Persons: A French Long-Term Survey.

Objective: To identify the long-term clinical, individual, and social risk factors for the development of pressure ulcers (PUs) in traumatic spinal cord-injured persons with tetraplegia (TSCIt).

Design: Cohort survey with self-applied questionnaires in 1995 and 2006.

Setting: Thirty-five French-speaking European physical medicine and rehabilitation centers participating in the Tetrafigap surveys.

The burden of musculoskeletal conditions.

Objective: Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability.

Methods: Data on disabilities associated with RMDs were extracted from the national 2008-2009 Disability-Health Survey of 29,931 subjects representative of the population in France.

Respective contribution of chronic conditions to disability in France: results from the national Disability-Health Survey.

Background: Representative national data on disability are becoming increasingly important in helping policymakers decide on public health strategies. We assessed the respective contribution of chronic health conditions to disability for three age groups (18-40, 40-65, and >65 years old) using data from the 2008-2009 Disability-Health Survey in France.

Methods: Data on 12 chronic conditions and on disability for 24,682 adults living in households were extracted from the Disability-Health Survey results.

[Definition, classification and epidemiology of disability].

How can we define disability and handicap? What are their different forms? What are the figures for the persons concerned? This paper reviews the key conceptual advances and classification developments as well as new French nationwide surveys on disability. Any attempt at defining what is handicap gives rise to heated debates. This layman word initially originating from the turf language has been prevailing in the medico-social field for the last fifty years.

Toll motorway accessibility for wheelchair users: a survey.

Objective: To identify difficulties encountered by wheelchair users who travel on toll motorways, with the goal of defining areas for improvement.

Design: Survey. After observing a wheelchair user travelling on a toll motorway and using the associated services, we designed a self-questionnaire on perceptions by wheelchair users of toll motorway accessibility.

Knee arthroplasty: disabilities in comparison to the general population and to hip arthroplasty using a French national longitudinal survey.

Background: Knee arthroplasty is increasing exponentially due to the aging of the population and to the broadening of indications. We aimed to compare physical disability and its evolution over two years in people with knee arthroplasty to that in the general population. A secondary objective was to compare the level of disabilities of people with knee to people with hip arthroplasty.

Demographics of wheelchair users in France: results of national community-based handicaps-incapacités-dépendance surveys.

Objective: To highlight the prevalence of manual and/or powered wheelchair use within the general French population living at home or in institutions, to describe the users and to identify factors determining wheelchair use.

Methods: Data were obtained from national community-based Handicaps-Incapacités-Dépendance surveys on disability and dependency carried out on 2 representative samples of the French population in institutions (n = 15,288) and at home (n = 16,945).

Results: The prevalence of wheelchair use is 62 per 10,000 people living in France.

Association of physical job demands, smoking and alcohol abuse with subsequent premature mortality: a 9-year follow-up population-based study.

This study assessed the relationships of physical job demands (PJD), smoking, and alcohol abuse, with premature mortality before age 70 (PM-70) among the working or inactive population. The sample included 4,268 subjects aged 15 or more randomly selected in north-eastern France. They completed a mailed questionnaire (birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr).

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study.

Background: The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse.

Methods: The sample comprised 6,216 people aged > or 15 years randomly selected from the population in north-eastern France.

Why is rehabilitation not yet fully person-centred and should it be more person-centred?

Aims: It is a generally shared opinion that rehabilitation is not (yet) 'fully person-centred' and that it should be more. For a certain number of authors, this deficit in person-centredness has originated from the important weight of a 'medical framework' within rehabilitation. In this paper, we will discuss this criticism and its corollary: the idea that rehabilitation is bound to choose between a non-medical and a medical paradigm, since there is a fundamental contradiction between medicine and person-centredness.

Evolution of disability in adults with hip arthroplasty: a national longitudinal study.

Objective: To describe disability in individuals with hip arthroplasty and its evolution over 2 years compared with that in the general population, and to compare the degree of disability between subjects with recent and older hip arthroplasty.

Methods: We selected a national representative sample of 16,945 subjects from the 1999 French population census. This sample, interviewed in 1999 and 2001 about their level of disability, included 527 subjects with hip arthroplasty (i.

Socioeconomic differences in the impact of HIV infection on workforce participation in France in the era of highly active antiretroviral therapy.

Objectives: We sought to measure the difference in employment rates between HIV-seropositive and HIV-seronegative persons and to establish whether this difference varied according to the HIV-infected persons' socioeconomic position as defined by education level.

Methods: We used data from the VESPA (VIH: Enquête Sur les Personnes Atteintes) study, a large cross-sectional survey conducted among a nationally representative sample of 2932 HIV-infected patients in France. Age-, gender-, nationality-, and education-standardized employment rates were estimated with the French general population as the reference.

Chronic back problems among persons 30 to 64 years old in France.

Study Design: A national population-based survey focusing on disability.

Objective: To describe the frequency of chronic back conditions among those aged 30 to 64 years, the consequences on their daily lives, their employment status, and source of income. SUMMARY OF BACKGROUND DATA.

Prevalence of sensory and cognitive disabilities and falls, and their relationships: a community-based study.

This study assessed the prevalence of sensory and cognitive disabilities and falls for various age groups, sexes, and socio-occupational categories, and their associations in the Lorraine population. The sample included 6,159 subjects, aged 15 years or more, randomly selected from the Lorraine population. They filled in a mailed questionnaire including socio-demographic characteristics, job, falls with physical injuries at the time of the survey, and sensory and cognitive disabilities.

General practitioners' attitudes towards patients with disabilities: the need for training and support.

Purpose: Some general practitioners (GPs) report discomfort in caring for people with disabilities. These feelings may impede the provision of quality health care to these patients.

Method: A cross-sectional survey interviewed 600 GPs in southeastern France and assessed their personal and professional characteristics, their attitudes and opinions towards people with disabilities, and their knowledge and practices in this field.

Women with disabilities: general practitioners and breast cancer screening.

Background: Because they undergo breast cancer screening (BCS) relatively infrequently, women with physical or mental impairments may be at higher risk of late-stage breast cancer than women without impairments. A panel of 600 general practitioners (GPs) in Provence (southeastern France) provided information from which barriers potentially associated with BCS practices for women with disabilities were evaluated.

Methods: In 2002, a telephone questionnaire collected data about GPs' personal and professional characteristics and their attitudes and practices regarding patients with disabilities.

Social and personal consequences of disability in adults with hip and knee arthroplasty. A French national community based survey.

Objective: To describe and compare participation restrictions and environmental factors of persons with and without hip or knee arthroplasty in a national community based survey: the Handicap, Disability, Dependence Survey.

Methods: During the 1999 French Census, a screening questionnaire was proposed to 417,500 persons, for which the response rate was 86%. A stratified random sample with an overrepresentation of disabled persons was performed to constitute the selected population.

Relationships of job and some individual characteristics to occupational injuries in employed people: a community-based study.

This study assessed the associations of job and some individual factors with occupational injuries among employed people from a general population in north-eastern France; 2,562 workers were randomly selected from the working population. A mailed auto-questionnaire was filled in by each subject. Statistical analysis was performed with loglinear models.

Disability and a sense of community belonging. A study among tetraplegic spinal-cord-injured persons in France.

This article presents a study of the identity of persons with motor impairments with regard to the community of disabled persons. The authors used the Tetrafigap survey on the long-term outcome of Tetraplegic Spinal-cord-injured (TSCI) persons, in France, to study the sense of belonging to the community of disabled persons among 1356 TSCI persons in relation to factors of social participation (both sociological and disability-related) and subjective factors (subjective well-being, social perception of disability, perceived disability). The results show that 44% of TSCI persons felt that disabled persons do not constitute a community (the "no-community" group).