Keywords
rehabilitation research, people with disabilities, demographics, caregivers, Chile
This article is included in the Health Services gateway.
rehabilitation research, people with disabilities, demographics, caregivers, Chile
Approximately 2.41 million people worldwide could benefit from rehabilitation services, which mean that one in three people will need this service at some point in their lives because of an illness or injury.1 Rehabilitation services were estimated to become more necessary as the population ages because of the increase in people with chronic diseases2 and the emergence of increasingly efficient medical treatments.3
The World Health Organization (WHO) defines rehabilitation as “a set of measures that help people who have or are likely to have a disability to achieve and maintain optimal functioning in interaction with their environment”.4 Recent definitions broaden its application beyond the clinical field, relating it to social, occupational, and educational interventions, independent of its location, i.e., it can be applied in hospitalized or ambulatory patients.5 Furthermore, rehabilitation aims to achieve independence, minimize pain and distress, and improve the ability to adapt and respond to circumstantial changes.6 For a person with disability, access to health services, including rehabilitation services, is essential to improve quality of life.7
The WHO indicates that approximately 15% of the world’s population has some disabilities, which is more prevalent in women and older people from low-income countries.7 A descriptive study based on an analysis of disability surveys in Latin America conducted between 2001 and 2009, which used the methodology of the International Classification of Functioning, Disability, and Health (ICF), estimated a higher prevalence of disability in Brazil with 14.5%, followed by Chile with 12.9%.8
Access to rehabilitation services for people with disabilities depends on various factors, such as personal and environmental factors.7 Likewise, disability is associated with several inequity factors that push the person to a situation of social, individual, and family exclusion.9 To reduce these inequities, the WHO created a strategy called “community-based rehabilitation” (CBR), which provides rehabilitation services in the community with equal opportunities and social inclusion and training to people with disabilities, their families, and community members. CBR aims to ensure the maximum social inclusion for these people and the whole exercise of their rights. This strategy has five components, namely, health, education, labor, and social and community strengthening. In Chile, it was implemented between 2004 and 2015, with the objective that 10% of the people served in community rehabilitation centers achieve social inclusion. However, a study using data from all community rehabilitation centers up to December 2016 indicated that the strategy had not been appropriately adopted. This study found that although all centers had physical and occupational therapists, less than half had professionals from other rehabilitation areas such as speech therapists, nurses, psychologists, or nursing technicians, which impedes the correct implementation of CBR due to a lack of trained human resources.9 Likewise, the study found that the implementation of CBR focused on the “health” component, neglecting the other four; the study recommended adequate implementation of the five components so that the target population is duly benefited.8
Thus, it is necessary to understand the situation in Chile, where the prevalence of people with disabilities is the second highest in Latin America.9 Although the CBR was maintained for 11 years, the objective was not achieved, and inequality in access to rehabilitation services was not reduced.10 The present study aimed to determine the factors associated with the use of rehabilitation services by persons with disabilities in Chile in 2015. In addition, few studies in Latin America have evaluated the determinants that could influence access to rehabilitation services. Thus, this would be one of the first studies whose results would have national representativeness. For this reason, this study will contribute to reducing the gaps in access to rehabilitation for people with disabilities in Chile.
This analytical cross-sectional study analyzed secondary data from Chile’s 2015 Second National Disability Study (ENDISC II).10 The study population consisted of residents of urban and rural areas of the 135 communes of the 15 regions of Chile. ENDISC II was conducted between June 30 and September 5, 2015.11
ENDISC II is a population-based survey that aims to “determine the prevalence and characterize disability at the national level, identifying the main gaps in access to persons with disabilities”.10 It was conducted jointly by the Ministry of Social Development (MDS) and the National Statistics Institute (INE) and supervised by the National Disability Service (SENADIS) of Chile.11
ENDISC II used a probabilistic sampling in two phases. The first phase used a list of households from a previous survey (Case 2013), and the second phase systematically selected households within the strata (communes and rural–urban areas). The final selection unit was the dwelling. ENDISC II’s design allows its results to be nationally and regionally representative because it covers 80% of the total number of households in Chile. Data collection was conducted through personal interviews with paper questionnaires. The surveys were applied to 12,015 dwellings, which included 12,265 people aged ≥18 years. Details of the sample design can be reviewed in their methodology book.10
For this study, we included persons with disabilities aged >18 years of both sexes and excluded records with missing or inconsistent data on the variables of interest.
To measure the prevalence of disability, ENDISC II applied a methodology based on the Model Disability Survey (MDS) used by the WHO in the II World Report on Disability, which measures three aspects, namely, functioning, health status, and environmental factors.10 The MDS was developed after the review of 179 health and disability surveys from around the world, following the implementation of the ICF in 2001.12 The application of this methodology in the Americas is novel because it is different from surveys that use few questions to identify persons with disabilities, such as those of the Washington group.13 This methodology is based on the item response theory and uses a metric scale that places different questions associated with greater or lesser disability. Thus, it is possible to identify the degrees of difficulty and adequately estimate the total prevalence of disability.13
The outcome variable was rehabilitation services in the previous year for persons with disabilities. This variable is of a nominal qualitative type and was measured with the question, “In the last 12 months, did you receive any rehabilitation services?” The response categories were yes and no.
The exposure variables were sex (male and female), age group (18–29, 30–44, 55–59, and 60+), educational level (no education, elementary, middle, and high school), marital status (married/cohabiting, widowed/separated/divorced, and single), origin (urban and rural), indigenous identification (no and yes), current job (no and yes), health insurance system (FONASA, FFAA, and Order, ISAPRE, none or private, and other/does not know), chronic diseases (which included diabetes, hypertension, arthritis/arthrosis, heart diseases, respiratory diseases, migraine, and AIDS/HIV diagnosed by a doctor; “Has a doctor ever told you that you have [name of disease/health condition]?” no and yes; mental illness (which included persons with physician-diagnosed anxiety and depression; “Have you ever been told by a doctor that you have [name of disease/health condition]?” no and yes), recreational activities (“During the past 6 months, did you engage in or attend the following activities or places?” no and yes), physical activity (“In the past month, did you play sports or engage in physical activity outside of your work schedule, for 30 min or more?” no and yes), caregiver assistance (“Because of your health, do you have someone to help you at home or outside your home, including family and friends, to perform the following activities?” no and yes), and perceived discrimination “In the past 12 months, have you felt discriminated against (i.e., been prevented from doing something, bothered, or made to feel inferior?” no and yes).
Self-reporting bias may increase the prevalence of disability.14 However, surveys and population censuses have widely used self-reported questions to measure this condition. For example, the Washington Group questions measure disability quickly, effectively, and economically and have been used in more than 69 national censuses worldwide.15 ENDISC II also uses self-report questions through an interview conducted by trained enumerators and has already been applied in 10 countries, Chile being the first in Latin America.12
The data were downloaded from the SENADIS web page and analyzed with STATA version 16 (Stata Corporation, College Station, TX, USA). To select the subgroup of people with disabilities aged >18 years, the variable disc_adult was used through the sub pop command. Frequency distribution tables and weighted percentages with their 95% confidence intervals (95% CI) were prepared. In the bivariate analysis, to evaluate differences in the characteristics of people with disabilities who use or do not use rehabilitation services, the chi-square test was corrected with the F statistic for survey design. In the multivariate analysis, Poisson regression was used to estimate prevalence ratios (PR) with their 95% CI. A crude model was developed, and variables having a p-value <0.25 were included in the adjusted model. All results were weighted according to the complex sample design of the ENDISC II. A p-value of p <0.05 was assumed to be statistically significant. The possible multicollinearity among the variables of the adjusted model was also checked through the manual calculation of the variance inflation factor (VIF).16 A VIF ≥10 was an indication of collinearity. We did not perform any stratification according to sex, as previous studies have not shown that this variable is associated with the use of rehabilitation services in people with disabilities.17
The ENDISC II database is publicly accessible and available on the SENADIS website. Data are coded and do not allow the identification of participants. The Human Medicine career approved the present secondary analysis of the Universidad Científica del Sur. It was exempted from review by the institutional ethics committee according to resolution N° 407-DACMH-DAFCS-U. CIENTIFICA-2022, issued on August 1, 2022.
The database had information on 2,618 persons with disabilities. We excluded eight due to a lack of data on the variables of interest (2 in educational level, 2 in indigenous identification, and 4 in the health insurance system). Finally, we included 2610 persons with disabilities, of whom 64.3% were women, and 47.3% were 60 or older. A total of 39.3% had elementary education, and 54% reported being married or cohabiting. Most were from urban areas and did not identify with indigenous populations (86.5% and 92.6%, respectively). Most of the participants (66.6%) did not have a job at the time of the survey, and 84 (8%) had the National Health Fund (NASA) as their healthcare provider. Likewise, 74.2% and 68.2% reported having a chronic illness and mental illness, respectively. In addition, 75% were engaged in recreational activities, and 17% were physically active. Moreover, 41.2% had a caregiver, and 23.7% had perceived discrimination. Finally, 19.1% admitted that they had used some rehabilitation service in the last 12 months (Table 1).
Variables | n | %a | 95% CI |
---|---|---|---|
Sex | |||
Male | 801 | 35.7 | 33.0–38.4 |
Female | 1,809 | 64.3 | 61.6–67.0 |
Age group | |||
18–29 | 173 | 8.3 | 6.8–10.1 |
30–44 | 356 | 12.8 | 11.1–14.7 |
55–59 | 758 | 31.6 | 29.2–34.2 |
60+ | 1,323 | 47.3 | 44.5–50.1 |
Educational level | |||
No education | 191 | 7.5 | 6.2–9.0 |
Elementary | 1,077 | 39.3 | 36.6–42.2 |
Middle | 986 | 38.2 | 35.7–40.7 |
High school | 356 | 15.0 | 13.0–17.3 |
Marital status | |||
Married/cohabiting | 1,181 | 54.0 | 51.4–56.5 |
Widowed/separated/divorced | 841 | 24.8 | 22.6–27.2 |
Single | 588 | 21.2 | 19.1–23.5 |
Origin | |||
Urban | 2,176 | 86.5 | 84.2–88.6 |
Rural | 434 | 13.5 | 11.4–15.8 |
Indigenous identification | |||
No | 2,388 | 92.6 | 91.2–93.9 |
Yes | 222 | 7.4 | 6.2–8.9 |
Current job | |||
No | 1,778 | 66.6 | 63.9–69.2 |
Yes | 832 | 33.4 | 30.7–36.1 |
Health insurance system | |||
FONASA | 2,225 | 84.8 | 82.8–86.7 |
FFAA, and order | 60 | 1.8 | 1.3–2.5 |
ISAPRE | 168 | 8.2 | 6.7–10.0 |
None or private | 95 | 3.0 | 2.3–4.0 |
Other/does not know | 62 | 2.2 | 1.5–3.0 |
Chronic diseasesb | |||
No | 633 | 25.8 | 23.4–28.3 |
Yes | 1,977 | 74.2 | 71.7–76.6 |
Mental illnessc | |||
No | 1,784 | 68.2 | 65.4–70.8 |
Yes | 826 | 31.8 | 29.2–34.6 |
Recreational activities | |||
No | 639 | 25.3 | 22.9–27.8 |
Yes | 1,971 | 74.7 | 72.2–77.1 |
Physical activity | |||
No | 2,165 | 82.9 | 80.8–84.9 |
Yes | 445 | 17.1 | 15.1–19.2 |
Caregiver assistance | |||
No | 1,560 | 58.8 | 55.9–61.6 |
Yes | 1,050 | 41.2 | 38.4–44.0 |
Perceived discrimination | |||
No | 1,965 | 76.3 | 74.0–78.6 |
Yes | 645 | 23.7 | 21.3–26.2 |
Rehabilitation | |||
No | 2,107 | 80.9 | 78.7–82.9 |
Yes | 503 | 19.1 | 17.1–21.3 |
In the bivariate analysis, a higher prevalence of the use of rehabilitation services was found in persons with disabilities who had a provisional health system, mainly in those who received care in Social Security Health Institutions (ISAPRE), with 28.9% (p < 0.028). Similarly, in persons with disabilities and mental illness, the prevalence of rehabilitation services was 27.6% compared with persons with disabilities who did not have a mental illness, with 15.1% (p < 0.001). A higher prevalence of the use of rehabilitation services was also found in persons with disabilities who had a caregiver (23.3%) compared with those without a caregiver (16.2%) (p = 0.001) (Table 2).
Variable | Use of rehabilitation services | P-valuea | |
---|---|---|---|
No, n (%) | Yes, n (%) | ||
Sex | 0,776 | ||
Male | 660 (81.4) | 141 (18.6) | |
Female | 1,447 (80.7) | 362 (19.3) | |
Age group | 0.326 | ||
18–29 | 139 (80.9) | 34 (19.1) | |
30–44 | 305 (85.2) | 51 (14.8) | |
55–59 | 596 (78.4) | 162 (21.6) | |
60+ | 1,067 (81.4) | 256 (18.6) | |
Educational level | 0.063 | ||
No education | 167 (87.5) | 24 (12.5) | |
Elementary | 879 (82.1) | 198 (17.9) | |
Middle | 791 (80.6) | 195 (19.4) | |
High school | 270 (75.3) | 86 (24.7) | |
Marital status | 0.204 | ||
Married/cohabiting | 969 (82.6) | 212 (17.4) | |
Widowed/separated/divorced | 663 (78.5) | 178 (21.5) | |
Single | 475 (79.5) | 113 (20.5) | |
Origin | 0.987 | ||
Urban | 1,744 (80.9) | 432 (19.1) | |
Rural | 363 (80.9) | 71 (19.1) | |
Indigenous identification | 0.087 | ||
No | 1,920 (80.5) | 468 (19.5) | |
Yes | 187 (86.2) | 35 (13.8) | |
Current job | 0.732 | ||
No | 1,420 (80.6) | 358 (19.4) | |
Yes | 687 (81.5) | 145 (18.5) | |
Health insurance system | 0.028 | ||
FONASA | 1,806 (81.5) | 419 (18.5) | |
FFAA, and Order | 47 (82.0) | 13 (18.0) | |
ISAPRE | 118 (71.1) | 50 (28.9) | |
None or private | 82 (86.6) | 13 (13.4) | |
Other/does not know | 54 (87.4) | 8 (12.6) | |
Chronic diseasesb | 0.509 | ||
No | 534 (82.2) | 99 (17.8) | |
Yes | 1,573 (80.4) | 404 (19.6) | |
Mental illnessc | < 0.001 | ||
No | 1,515 (84.9) | 269 (15.1) | |
Yes | 592 (72.4) | 234 (27.6) | |
Recreational activities | 0.747 | ||
No | 514 (81.5) | 125 (18.5) | |
Yes | 1,593 (80.7) | 378 (19.3) | |
Physical activity | 0.670 | ||
No | 1,746 (81.1) | 419 (18.9) | |
Yes | 361 (79.9) | 84 (20.1) | |
Caregiver assistance | 0.001 | ||
No | 1,308 (83.8) | 252 (16.2) | |
Yes | 799 (76.7) | 251 (23.3) | |
Perceived discrimination | 0.102 | ||
No | 1,601 (81.9) | 364 (18.1) | |
Yes | 506 (77.9) | 139 (22.1) |
In the crude model, the variables that were significantly associated with the use of rehabilitation services were primary education (PR 0.72; 95% CI 0.53–0.99, p < 0.043), no education (PR 0.5; 95% CI 0.32–0.80, p < 0.004), marital status (PR 1.24; 95% CI 0.97–1.58, p = 0.078), indigenous identification (PR 0.71; 95% CI 0.47–1.08, p = 0.109), health insurance system in the ISAPRE category (PR 1.56, 95% CI 1.10–2.23, p = 0.015), mental illness (PR 1.83; 95% CI 1.48–2.25, p < 0.001), caregiver assistance (PR 1.44; 95% CI 1.16–1.79, p = 0.001), and perception of discrimination (PR 1.22; 95% CI 0.96–1.55, p = 0.104). Other variables such as sex, age groups, origin, current job, chronic disease, recreational activities, and physical activity were not significantly associated with rehabilitation services (Table 3).
Variables | Crude model | P-value | Adjusted model | P-value |
---|---|---|---|---|
PR (95% CI) | PR (95% CI) | |||
Sex | ||||
Male | Reference | |||
Female | 1.04 (0.80–1.34) | 0.777 | ||
Age group | ||||
18–29 | Reference | |||
30–44 | 0.78 (0.44–1.39) | 0.396 | ||
55–59 | 1.13 (0.70–1.82) | 0.610 | ||
60+ | 0.97 (0.61–1.57) | 0.916 | ||
Educational level | ||||
No education | 0.50 (0.32–0.80) | 0.004 | 0.43 (0.25–0.75) | 0.003 |
Elementary | 0.72 (0.53–0.99) | 0.043 | 0.74 (0.52–1.06) | 0.101 |
Middle | 0.78 (0.57–1.07) | 0.117 | 0.85 (0.62–1.18) | 0.334 |
High school | Reference | Reference | ||
Marital status | ||||
Married/cohabiting | Reference | Reference | ||
Widowed/separated/divorced | 1.24 (0.98-1.57) | 0.078 | 1.22 (0.95–1.56) | 0.126 |
Single | 1.18 (0.88-1.57) | 0.270 | 1.18 (0.88-1.58) | 0.274 |
Origin | ||||
Urban | Reference | |||
Rural | 0.99 (0.76–1.31) | 0.988 | ||
Indigenous identification | ||||
No | Reference | Reference | ||
Yes | 0.71 (0.47–1.08) | 0.109 | 0.81 (0.53-1.24) | 0.338 |
Current job | ||||
No | Reference | |||
Yes | 0.96 (0.75–1.23) | 0.733 | ||
Health insurance system | ||||
FONASA | Reference | Reference | ||
FFAA, and Order | 0.97 (0.53–1.77) | 0.927 | 1.07 (0.59–1.94) | 0.815 |
ISAPRE | 1.56 (1.10–2.23) | 0.015 | 1.41 (0.97–2.07) | 0.074 |
None or private | 0.72 (0.38–1.38) | 0.323 | 0.73 (0.39–1.35) | 0.311 |
Other/does not know | 0.68 (0.29–1.57) | 0.363 | 0.76 (0.34–1.68) | 0.499 |
Chronic diseasesa | ||||
No | Reference | |||
Yes | 1.10 (0.83–1.47) | 0.512 | ||
Mental illnessb | ||||
No | Reference | Reference | ||
Yes | 1.83 (1.48–2.25) | < 0.001 | 1.77 (1.44–2.18) | <0.001 |
Recreational activities | ||||
No | Reference | |||
Yes | 1.04 (0.81–1.33) | 0.748 | ||
Physical activity | ||||
No | Reference | |||
Yes | 1.06 (0.80–1.41) | 0.664 | ||
Caregiver assistance | ||||
No | Reference | Reference | ||
Yes | 1.44 (1.16–1.79) | 0.001 | 1.57 (1.25–1.97) | <0.001 |
Perceived discrimination | ||||
No | Reference | Reference | ||
Yes | 1.22 (0.96–1.55) | 0.104 | 1.17 (0.92–1.48) | 0.208 |
The adjusted model’s associated variables were educational level, mental illness, and caregiver assistance. Persons with disability without education were 57% less likely to use rehabilitation services (PR 0.43; 95% CI 0.25–0.75, p = 0.003) than persons with disability with higher education. Likewise, persons with disability who had a mental illness were 77% more likely to use rehabilitation services than persons with disability who did not have a mental illness (PR 1.77; 95% CI 1.44–2.18, p < 0.001). Persons with disabilities who had caregiver assistance were 57% more likely to use rehabilitation services than persons with disabilities who have no caregiver assistance (PR 1.57; 95% CI 1.25–1.97, p < 0.001), all adjusted for educational level, marital status, ethnic identification, health insurance system, mental illness, assistance of a caregiver, and perception of discrimination (Table 3).
In the adjusted model, no evidence of multicollinearity was found among the variables (VIF < 10).
The results of this study show that in 2015, one-fifth of the people with disabilities in Chile used some rehabilitation services in the previous year. In addition, low educational level, mental illness, and caregiver assistance were significantly associated with the use of rehabilitation services.
Approximately 19.1% of people with disabilities in Chile used some rehabilitation services in the previous year. A systematic review that included 77 studies, of which 28 measured access to rehabilitation services in persons with disabilities, found low coverage of rehabilitation in India (5%), Turkey (5%), and Bangladesh (7%) and high coverage in Brazil (80%), Malaysia (76%), Philippines (70%), and South Africa (71%).18 The present study described similar results. A population-based analysis of 13,659 individuals with disabilities in southern Brazil found that only 9.2% of people used rehabilitation services.19 A study in a Ugandan community of 318 randomly selected persons with physical disabilities reported a prevalence of 26.4% of rehabilitation service utilization.17 Another study in Uganda of 284 persons with physical disabilities receiving CBR services found a prevalence of access to rehabilitation services of 41.1%, although only 6.8% had access to physical therapy.20
This variability in the prevalence of rehabilitation services could be explained by the diversity of methodological designs, different instruments used to measure disability, or differences in access to rehabilitation services. As long as methodologies for measuring disability are not standardized, these differences will remain unexplained. Thus, caution should be exercised when comparing similar studies.
People with disabilities with lower educational levels were less likely to use rehabilitation services than those with higher education levels. These results are consistent with studies conducted in Uganda,17 Brazil,21–23 Poland,24 and Peru,25 which indicates that low educational level decreases the use of rehabilitation services. A study in Brazil also found that older adults with low educational level were more likely to have a functional disability.22 In this regard, several population-based studies have shown that educational disparities are associated with a higher incidence of disability26,27; this would be explained by the physical and intellectual demand that is necessary to achieve a higher level of education, and because of their condition, people with disabilities would not reach this level. Moreover, limited economic resources would increase these inequalities.28 The more significant disability in people with lower educational levels would explain our study’s greater need for rehabilitation services.
People with disabilities and mental illnesses such as depression or anxiety were more likely to use rehabilitation services. Depression and disability have a reciprocal association. Several factors, such as social stereotyping, abuse, poverty, environmental barriers, or lack of access to health services, predispose people with disabilities to suffer up to depressive symptoms three times more than their non-disabled peers; moreover, depression can lead to disability.29 This association is clearly described in several studies.30,31 However, there is limited information on depression and its association with the use of rehabilitation services in people with disabilities. Some studies have shown results similar to ours. In 3,568 adults with disabilities in Korea, those who received rehabilitation services had a higher risk of depressive symptoms than those who did not (OR 1.23; 95% CI 1.01–1.50).32 A population-based study of 195,033 Americans found a higher prevalence of depressive symptoms in adults with disabilities who used assistive technologies (30.4%) than those who did not (7.4%).33 Another study in Germany involving 4,020 patients with cancer reported a higher prevalence of depression in those patients coming from cancer rehabilitation centers (28%) compared with inpatients (24%) or outpatients (21%), increasing this probability up to six times.34
According to our findings and the evidence reviewed, there is an increase in depressive symptoms in people who used rehabilitation services. This may be due to situations inherent to the rehabilitation process, such as pain, embarrassment, or frustrations experienced by patients when their rehabilitation takes longer than expected or when the disability is permanent. Information on this topic is limited, but some studies have described this explanation.32
Finally, people with disabilities who have caregiver assistance were more likely to use rehabilitation services. One of the consequences of disability is dependence on performing basic activities, which leads to the need for a caregiver.35 A population-based study in Peru found that 40.5% of people with disabilities were dependent on a caregiver; this function was mainly assumed by female family members.25 The role of the caregiver mainly falls on a family member, either the children or the partner.36 A study in China conducted on informal caregivers of people with intellectual disabilities found that 85% of the caregivers were the parents of the patients.37 Therefore, family members would have an essential role in the decision to access rehabilitation services, especially in those with severe limitations and almost absolute dependence on the caregiver. This explanation has been postulated by Medeiros et al. to justify the high prevalence of rehabilitation services in minors with disabilities.19 The role of the caregiver in the success of rehabilitation is fundamental because the caregiver often becomes the channel of communication between the physician and the patient. In addition, health professionals rely on caregivers to extend the rehabilitation process at home.38
This study has some limitations. First, social desirability and recall biases could alter the prevalence of rehabilitation services in persons with disabilities. Second, certain variables related to the use of rehabilitation services, such as transportation, architectural barriers, or quality of medical care, were not available in the ENDISC II. Third, stratification according to age groups was not performed; in older adults, the associated factors may vary concerning other age groups. Fourth, the use of rehabilitation services only included the last 12 months. Their use before that time is unknown, especially in patients with chronic disabilities. Fifth, some categories of the exposure variables may not have an adequate sample size to show an association with the use of rehabilitation services. Sixth, causality between the main variables cannot be affirmed because of the study’s cross-sectional design. As a strength, ENDISC II is a population-based survey; thus, the results of this study would be representative of people with disabilities in Chile.
In Chile, in 2015, one-fifth of people with disabilities used some rehabilitation service in the previous year. People with lower educational levels were less likely to access this service. Having a mental illness, such as depression, and receiving caregiver assistance significantly increased the likelihood of accessing rehabilitation services. These results should guide rehabilitation professionals in identifying depressive or anxious conditions that may impair compliance and correct performance of therapies. Likewise, it is necessary to encourage the caregiver to participate in the rehabilitation therapies of a person with disability. Finally, future studies should include a more significant number of possible factors that may explain the use of rehabilitation services in persons with disabilities.
ENDISC II data is available on the website of the National Disability Service (SENADIS) of Chile: https://www.senadis.gob.cl/pag/356/1625/base_de_datos .
The data is available in SPSS or Stata form and a codebook is available (Spanish).
figshare: [Extended data] Factors associated with the use of rehabilitation services among people with disabilities in Chile: A population-based study. https://doi.org/10.6084/m9.figshare.21749291. 39
This project contains the following extended data:
• Supplementary material (Table of operationalization of variables – this provides English translations of the relevant column labels/questions in the data file, as well as a data key)
• Stata do-file (Contains the commands used for data analysis)
• The ENDISC II questionnaire (Spanish)
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Partly
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
I cannot comment. A qualified statistician is required.
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Stroke rehab, low cost stroke rehab models, technology in stroke rehab, clinical practice guidelines and protocols, tele-rehabilitation, capacity building models
Is the work clearly and accurately presented and does it cite the current literature?
Partly
Is the study design appropriate and is the work technically sound?
Yes
Are sufficient details of methods and analysis provided to allow replication by others?
Yes
If applicable, is the statistical analysis and its interpretation appropriate?
I cannot comment. A qualified statistician is required.
Are all the source data underlying the results available to ensure full reproducibility?
Yes
Are the conclusions drawn adequately supported by the results?
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Disability, rehabilitation
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | ||
---|---|---|
1 | 2 | |
Version 1 18 Jan 23 |
read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)