Ebook Neural tube defects: Part 2
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Ebook Neural tube defects: Part 2
____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2dical University, Syracuse, New York, U.S.A.rhe past is never dead; it’s not even past.—William Faulkner, Requiem for a Nun, Act I. Scene iiiINTRODUCTIONAdults who have spina bifida carry the past with them, both personally and culturally. Their personal past includes their abilities, physical impai Ebook Neural tube defects: Part 2rments, coping strategics, and social skills. These affect their well-being and functioning as adults. As reviewed in earlier chapters of this book, iEbook Neural tube defects: Part 2
mpairments and disabilities that occur with spina bifida include nonverbal and verbal learning disabilities as well as problems with attention; and ex____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2ally have limited mobility with paraplegia and may have impaired fine motor skills. They may have problems accessing transportation. They may have recurrent medical problems such as urinary tract infection, skin breakdown, and ventricular shunt malfunction that can limit them from participating in s Ebook Neural tube defects: Part 2chool or work for an extended time. They may have urinary or fecal incontinence, which can affect social interactions and self-esteem. For each of theEbook Neural tube defects: Part 2
se challenges, they possess coping skills, with some individuals being more resilient than others.117118LiptakIn addition, they carry their cultural h____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2ess to knowledgeable menial health professionals (1) as well as the inability of part-time employees to obtain adequate health insurance. If a job that they can manage physically (e.g., a part-time job) docs not offer them adequate insurance coverage, they may be better oil’ financially remaining un Ebook Neural tube defects: Part 2employed and relying on governmental assistance like Medicaid. The physical and cultural factors that they bring with them to adulthood affect their mEbook Neural tube defects: Part 2
ental health and well-being as well as their ability to participate in society.THEORETICAL BASESThe World Health Organization (WHO) has developed a mo____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2 health. Functioning is described as the interaction among three dimensions: body functions/structures, activity/participation, and environmental/personal factors. Every component is subdivided into domains that encompass anatomical or physiological systems (body functions and structures), life area Ebook Neural tube defects: Part 2s (activity and participation), and physical. social, and attitudinal environment (environmental and personal factors). Figure 1 illustrates the ICF mEbook Neural tube defects: Part 2
odel as applied to some issues faced by an adult with spina bifida. For example, if a child with spina bifida has hydrocephalus and a small corpus cal____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2ealth Organization International Classification of Functioning. Disability, and Health applied to some issues of adults with spina bifida and hydrocephalus. Source: From Ref. 2.Adults Who Have Spina Bifida119idioms (activities). They likely will not do as well in school, and will not he able to obta Ebook Neural tube defects: Part 2in a rewarding job when they arc adults (participation). (This has been called a chain of adversity.) However. (/) providing remediation (additional iEbook Neural tube defects: Part 2
nstructional time or different instructional approaches to “fix” a certain area of weakness and build strength in a particular area to facilitate pote____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2 the desired level of performance! in the school, (/7) having parents who help the child with homework (environment), and (Hi) having a child who has a persistent temperament (personal factor) can ameliorate the adverse effects of the impairments and lead to better outcomes.Erikson (3) has argued th Ebook Neural tube defects: Part 2at an individual has to master certain stages in order to develop a healthy personality. During elementary school, children need to develop a sense ofEbook Neural tube defects: Part 2
industry. During adolescence, the teen develops a sense of identity (the identity crisis). During adullhcxxl. the individual must develop a sense of ____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2 these crises adversely affect mental health. These issues (crises) do not completely disappear as the person ages but continue in different manifestations throughout development.Bandura (4) hypothesized as part of his Social Learning Theory that individuals develop a sense of self-efficacy, which i Ebook Neural tube defects: Part 2s related to self-concept and selfesteem. This is defined as people’s belief in their ability to successfully perform specified tasks, expend greaterEbook Neural tube defects: Part 2
effort, and persevere in the face of adversity. If people arc subjected to repeated failures, for example, people with learning disabilities in a clas____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2have no control over a situation. This feeling of helplessness occurs because of repeated failures in similar situations. It causes individuals to think that they should not even try. because they believe they will not be successful. Learned helplessness has been linked to depression (5).Finally, Ev Ebook Neural tube defects: Part 2ans and Stixldard developed a model to explain the determinants of individual health. Figure 2 illustrates this model in terms of depression in an indEbook Neural tube defects: Part 2
ividual with spina bifida (6). The physical and social environments, genetic endowment, and prosperity affect health and well-being in addition to the____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2ucted. The ones that have been published often arc descriptive and limited by small or nonrepresentative samples. How ever, the picture they paint of the life of an adult w ith spina bifida is not bright. For example, in a study of 53 adults who had spina bifida, lived in Kentucky, and had a mean ag Ebook Neural tube defects: Part 2e of 27.8 years at interview, 86% completed al least 12 years of school, but 80% earned less than $ 10,000 per120LipỉakSource: From Ref. 6.year, and 8Ebook Neural tube defects: Part 2
2% had been on Supplemental Security income for an average of nine years. Ninety-three percent had never been married. 24% were currently sexually act____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2 talking on the telephone. Only 16% made all their monetary decisions on their own. 66% were using intermittent catheterization for bladder continence, only 51% were using a bowel program, and only 41% were continent of stool (7). In a study from Ireland, McDonnell and McCann found that only 36% of Ebook Neural tube defects: Part 2adults with spina bifida were employed, 33% were regular drivers, 17% were married or engaged, and 8% were parents (8). Secondary medical conditions tEbook Neural tube defects: Part 2
hat interfere with functioning occur commonly. For example, a group of 98 adults with spina bifida accounted for 353 admissions to Johns Hopkins Medic____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2nfections, renal calculi, pressure ulcers, and osteomyelitis (9).WORKCurrent StatusWork is a major way in which adults participate in society. As shown in Figure 1, impairments that affect body functions and structures, as well as activities, impactAdults Who Have spina Bifida121the ability to work Ebook Neural tube defects: Part 2(i.e., participation in society). On the basis of Figure 2, work is critical for prosperity, which in turn affects the physical and social environmentEbook Neural tube defects: Part 2
, and has direct effects on health and well-being. Work loo helps give individuals a sense of identity (as discussed by Erikson earlier), which is an ____________________8_______________________Adults Who Have Spina Bifida: Work and Mental HealthGregory s. LiptakDepartment of Pediatrics, Upstate Med Ebook Neural tube defects: Part 2ther earlier but ongoing process).Very few studies relating to work in individuals who have spina bifida have been published. The few studies of adults with physical disabilities in general that have been done confirm the importance of work. The life goals of adults who have disabilities include the Ebook Neural tube defects: Part 2 same ideals as those of adults without disabilities. In general terms, they include being independent, living on one’s own terms, and feeling that liEbook Neural tube defects: Part 2
fe is meaningful (10). In more specific terms, they include having adequate financial status, leisure activities (which often require adequate financeGọi ngay
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