Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey

BMC Public Health

Jesús de Pedro-Cuesta¹  Enrique Alcalde-Cabero¹  Javier Almazán-Isla¹  Sarah Maierhofer¹ 

[1] Department of Applied Epidemiology, National Centre of Epidemiology-Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Carlos III Institute of Health, Av. Monforte de Lemos 5, 28029 Madrid, Spain

关键词: WHO;    Survey;    Prevalence;    ICF;    Epidemiology;    Disability;    ADL;   

Others  :  1164039
DOI  :  10.1186/1471-2458-11-897

 received in 2011-06-09, accepted in 2011-11-28,  发布年份 2011

【 摘 要 】

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, autonomía 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.

【 授权许可】

   
2011 Maierhofer et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]World Health Organization: World Health Organization International Classification of Functioning, Disability and Health. 2001.
• [2]Cieza A, Ewert T, Ustun TB, Chatterji S, Kostanjsek N, Stucki G: Development of ICF core sets for patients with chronic conditions. J Rehabil Med 2004, 44(Suppl):9-11.
• [3]McDaid D, Cieza A, Gomez AR: Bridging knowledge: reflections on crossing the boundaries between long-term care and support. Int J Integr Care 2009, 9:e60.
• [4]Kostanjsek N: Use of The International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems. BMC Public Health 2011, 11(Suppl 4):S3. BioMed Central Full Text
• [5]Swanson G, Carrothers L, Mulhorn KA: Comparing disability survey questions in five countries: a study using ICF to guide comparisons. Disabil Rehabil 2003, 25(11-12):665-675.
• [6]Mulhorn KA, Threats TT: Speech, hearing, and communication across five national disability surveys: results of a DISTAB study using the ICF to compare prevalence patterns. Int J Speech Lang Pathol 2008, 10(1-2):61-71.
• [7]Madans JH, Loeb ME, Altman BM: Measuring disability and monitoring the UN convention on the rights of persons with disabilities: the work of the Washington group on disability statistics. BMC Public Health 2011, 11(Suppl 4):S4. BioMed Central Full Text
• [8]Good A. Using the ICF in Ireland BMC Public Health 2011, 11(Suppl 4):S5. BioMed Central Full Text
• [9]Nieuwenhuijsen ER: On health, ability and activity: comments on some basic notions in the ICF commentary. Disabil Rehabil 2006, 28(23):1477-1479.
• [10]Stineman MG, Ross RN, Maislin G: Functional status measures for integrating medical and social care. Int J Integr Care 2005, 5:e07.
• [11]Albarrán-Lozano I, Alonso-González P, Fajardo-Caldera MA: Valoración global de la discapacidad. Propuesta de un índice y su aplicación a la población española recogida en la EDDES. Estudios de Economía Aplicada 2007, 25:523-549.
• [12]La Parra D, Masanet E: [Comparison of time spent on unpaid work as measured by the National Health Survey and the time use survey]. Gac Sanit 2011, 25(1):68-71.
• [13]Instituto Nacional de Estadística: Survey on Disabilities, Impairments and Health Status 1999. [http:/ / www.ine.es/ jaxi/ menu%20do?type=pcaxis&path=%2Ft15/ p418&file=inebase&L=1] webciteMadridAccess date: 3 May 2010
• [14]Instituto Nacional de Estadística: Survey on Disability, Personal Autonomy and Dependency situations 2008. [http:/ / www.ine.es/ jaxi/ menu%20do?type=pcaxis&path=%2Ft15/ p418&file=inebase&L=1] webciteMadridAccess date: 3 May 2010
• [15]Abellán A: La discapacidad en España. Rev Mult Gerontol 2001, 11:35-37.
• [16]Instituto Nacional de Estadística: Disabilities, Independence and Dependency Situations Survey (DIDSS). [http://www.ine.es/en/metodologia/t15/t1530418_en.pdf] webciteMethodology Madrid. Spain; 2010. Access date: 2 May 2010
• [17]Instituto Nacional de Estadística: Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia (EDAD). [http://www.ine.es/metodologia/t15/t1530418.pdf] webciteMetodología Madrid. Spain; 2010. Access date: 2 May 2010
• [18]Instituto Nacional de Estadística: Cuestionarios de la Encuesta sobre Discapacidad, Autonomía personal y Situaciones de Dependencia 2008. [http://www.ine.es/daco/daco42/discapa/cues07.htm] webciteMadrid. Spain; 2010. Access date: 3 May 2010
• [19]Instituto Nacional de Estadística: Questionnaires of the Survey on Disability, Personal Autonomy and Dependency situations 2008. [http://www.ine.es/en/daco/daco42/discapa/cues07_en.htm] webciteMadrid. Spain;
• [20]World Health Organization: ICF checklist version 2.1A. Geneva, World Health Organization. 2009.
• [21]Instituto Nacional de Estadística. Padrón municipal: Cifras oficiales de población desde 1996. [http:/ / www.ine.es/ jaxi/ menu%20do?type=pcaxis&path=%2Ft20%2 Fe260&file=inebase&L=] webciteData as at 1 January 2008 for Autonomous Regions and sexAccess date: 2 May 2010
• [22]Donmez L, Gokkoca Z, Dedeoglu N: Disability and its effects on quality of life among older people living in Antalya city center, Turkey. Arch Gerontol Geriatr 2005, 40(2):213-223.
• [23]Virues-Ortega J, de Pedro-Cuesta J, Seijo-Martinez M, Saz P, Sanchez-Sanchez F, Rojo-Perez F, et al.: Prevalence of disability in a composite >/= 75 year-old population in Spain: a screening survey based on the International Classification of Functioning. BMC Public Health 2011, 11:176. BioMed Central Full Text
• [24]Donald IP, Foy C, Jagger C: Trends in disability prevalence over 10 years in older people living in Gloucestershire. Age Ageing 2010, 39(3):337-342.
• [25]Salvador-Carulla L, Garcia-Gutierrez C: The WHO construct of health-related functioning (HrF) and its implications for health policy. BMC Public Health 2011, 11(Suppl 4):S9. BioMed Central Full Text