The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Measures
2.2.1. Functioning Score of WHODAS 2.0-36-Item
2.2.2. The Definition of the Urbanization
2.3. Data Analysis
3. Results
3.1. The Characters of Our Participators
3.2. The Relationship between Urbanization, Impairments, and Performance of Functioning
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
ID | Intellectual Disability |
CCI | Concomitant Communicative Impairment |
DEDS | Disability Eligibility Determination System |
FUNDES- Adult | Functioning Scale of the Disability Evaluation System- Adult version |
ICF | International Classification of Health, Functioning, and Disability |
WHODAS 2.0 | World Health Organization Disability Assessment Schedule 2.0 |
ASD | Autism Spectrum Disorders |
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Variables | Content | The Data Sources |
---|---|---|
1. Demography characters | Gender, birthday, the date of test, work status, living status, address of living, etc. | Self-report |
2. Disease and Disability | ICD code, the type of disability, the severity of disability, etc. | To be diagnosed by the physicians |
3. The activity and participation functioning | (1) Cognition (6 items), by assessing communication and thinking activities such as concentrating, remembering, problem-solving, learning and communicating; (2) Mobility (5 items), by assessing activities such as standing, moving around inside the home, getting out of the home and walking a long distance; (3) Self-care (4 items), assessing activities such as hygiene, dressing, eating and staying alone; (4) Getting along (5 items), by assessing interactions with other people and any difficulty experienced due to health conditions; (5) life activities (8 items-pertaining to the household, school, or work), by assessing any difficulty experienced with day-to-day activities (activities that people perform on most days) which are associated with domestic responsibilities, leisure, work and school; and (6) Participation (8 items), | The evaluations were carried out by physicians and other professionals such as occupational therapists (OTs), physical therapists (PTs), speech therapists (STs), social workers, psychologists, and nurses. |
Variables | ID n = 4455 | Autism n = 670 | Concomitant Communicative Impairment (CCI) n = 110 | Combination of ID/Autism/CCI n = 139 |
---|---|---|---|---|
Age (Mean ± SD) *** | 30.67 ± 13.27 | 23.19 ± 7.73 | 47.56 ± 16.32 | 22.66 ± 7.31 |
Gender *** | ||||
Male | 2459 (55.2) | 590 (88.1) | 74 (67.3) | 110 (79.1) |
Female | 1996 (44.8) | 80 (11.9) | 36 (32.7) | 29 (20.9) |
Work status *** | ||||
No | 2640 (59.4) | 262 (39.5) | 49 (44.5) | 82 (59.0) |
Yes | 965 (21.7) | 99 (14.9) | 37 (33.6) | 18 (12.9) |
Retire/students/house wife | 836 (18.8) | 302 (45.6) | 24 (21.8) | 39 (28.1) |
The severity of disability *** | ||||
Mile | 1281 (40.9) | 423 (63.1) | 60 (54.5) | 17 (12.2) |
Moderate | 1853 (41.6) | 159 (23.7) | 22 (20.0) | 55 (39.6) |
Severe | 592 (13.3) | 66 (9.9) | 9 (8.2) | 40 (28.8) |
Profound | 189 (4.2) | 22 (3.3) | 19 (17.3) | 27 (19.4) |
Urban Type of Living City (Urbanization) *** | ||||
Metropolitan | 724 (16.3) | 199 (29.7) | 32 (29.1) | 33 (23.7) |
Tertiary industry city | 929 (20.9) | 256 (38.2) | 19 (17.3) | 39 (28.1) |
New developed city | 1333 (29.9) | 143 (21.3) | 24 (21.8) | 33 (23.7) |
Traditional industry city | 513 (11.5) | 24 (3.6) | 17 (15.5) | 13 (9.4) |
Less developed country | 701 (15.7) | 34 (5.1) | 17 (15.5) | 17 (12.2) |
Aging country | 182 (4.1) | 9 (1.3) | 0 (−) | 4 (2.9) |
periphery country | 73 (1.6) | 5 (0.7) | 1 (0.9) | 0 (−) |
Living status *** | ||||
Living in community $ | 4172 (94.4) | 624 (94.3) | 107 (97.3) | 120 (86.3) |
Living in an institution | 249 (5.6) | 38 (5.7) | 3 (2.7) | 19 (13.7) |
Income Status of Households *** (n = 1657) | ||||
Low income households | 176 (12.3) | 5 (3.4) | 2 (7.4) | 11 (22.9) |
Middle-income households | 97 (6.8) | 4 (2.7) | 0 (−) | 1 (2.6) |
General households | 116 (85.5) | 140 (94.0) | 25 (92.6) | 36 (75.0) |
Domain | ID n = 4455 | Autism n = 670 | CCI n = 110 | Combination of ID/Autism/CCI n = 139 |
---|---|---|---|---|
Do1 Cognition *** | 42.02 ± 25.39 | 34.96 ± 23.87 | 30.45 ± 29.89 | 52.63 ± 29.42 |
Do2 Mobility *** | 10.84 ± 19.60 | 6.70 ± 14.43 | 22.27 ± 28.54 | 11.06 ± 18.57 |
Do3 Self-care *** | 11.85 ± 19.23 | 9.69 ± 17.06 | 13.73 ± 25.80 | 21.94 ± 26.26 |
Do4 Get along *** | 44.62 ± 29.67 | 49.56 ± 28.11 | 45.53 ± 33.42 | 60.91 ± 30.53 |
Do5-1 Life activities: Work and school task *** | 40.32 ± 31.55 | 34.10 ± 31.37 | 32.09 ± 38.72 | 54.03 ± 35.50 |
Do5-2 Life activities: Household *** | 56.31 ± 44.41 | 48.07 ± 41.16 | 45.13 ± 46.87 | 67.37 ± 39.91 |
Do6 Participation *** | 31.84 ± 23.32 | 32.41 ± 23.06 | 38.41 ± 27.85 | 39.06 ± 26.60 |
Summary Scores *** | 34.76 ± 20.54 | 31.28 ± 19.08 | 34.12 ± 25.70 | 43.75 ± 22.68 |
Variables: Age, Domain and Urbanization | ID n = 4455 | Autism n = 670 | CCI n = 110 | Combination of ID/Autism/CCI n = 139 |
---|---|---|---|---|
After adjust age | 29.88 | |||
Domain 1 | ¥ F = 1.38 p = 0.228 | F = 1.345 p = 0.243 | F = 2.814 * p = 0.020 | F = 2.391 * p = 0.041 |
Metropolitan | 43.65 ± 0.91 | 37.17 ± 1.74 | 13.68 ± 4.33 | 53.30 ± 4.25 |
Tertiary industry city | 41.32 ± 0.80 | 37.02 ± 1.54 | 10.70 ± 5.62 | 52.76 ± 3.91 |
New developed city | 40.93 ± 0.67 | 42.17 ± 2.05 | 20.39 ± 5.00 | 55.62 ± 4.25 |
Traditional industry city | 41.63 ± 1.07 | 43.58 ± 4.98 | 23.98 ± 5.94 | 50.55 ± 6.77 |
Less developed country | 40.89 ± 0.92 | 40.31 ± 4.18 | 41.16 ± 5.93 | 70.78 ± 14.08 |
Aging and periphery country | 41.94 ± 1.53 | 40.85 ± 6.52 | 40.50 ± 24.39 | 88.94 ± 12.19 |
Domain 2 | F = 3.028N ** p = 0.010 | F = 0.259 p = 0.935 | F = 0.843 p = 0.522 | F = 4.420 *** p < 0.001 |
Metropolitan | 11.71 ± 0.68 | 9.01 ± 1.31 | 13.85 ± 3.27 | 11.36 ± 3.20 |
Tertiary industry city | 11.36 ± 0.60 | 9.76 ± 1.16 | 5.80 ± 4.23 | 11.34 ± 2.95 |
New developed city | 10.36 ± 0.50 | 10.55 ± 1.54 | 20.01 ± 3.77 | 14.21 ± 3.20 |
Traditional industry city | 11.02 ± 0.81 | 7.76 ± 3.76 | 18.65 ± 4.48 | 14.70 ± 5.10 |
Less developed country | 8.41 ± 0.70 | 9.90 ± 3.15 | 14.48 ± 4.47 | 17.33 ± 4.46 |
Aging and periphery country | 9.21 ± 1.15 | 9.40 ± 4.91 | −1.32 ± 18.38 § | 51.71 ± 9.19 |
Domain 3 | F = 2.514 * p = 0.028 | F = 1.158 p = 0.329 | F = 0.883 p = 0.495 | F = 2.089 p = 0.071 |
Metropolitan | 13.00 ± 0.70 | 11.54 ± 1.35 | 11.55 ± 3.37 | 25.72 ± 3.30 |
Tertiary industry city | 12.48 ± 0.62 | 10.35 ± 1.19 | 1.09 ± 4.37 | 20.15 ± 3.04 |
New developed city | 10.42 ± 0.52 | 12.85 ± 1.59 | 7.22 ± 3.88 | 22.01 ± 3.30 |
Traditional industry city | 11.98 ± 0.84 | 10.05 ± 3.87 | 16.68 ± 4.61 | 16.58 ± 5.26 |
Less developed country | 10.93 ± 0.72 | 14.80 ± 3.25 | 5.95 ± 4.60 | 32.68 ± 4.60 |
Aging and periphery country | 12.09 ± 1.19 | 19.06 ± 5.01 | −5.02 ± 18.95 § | 52.60 ± 9.47 |
Domain 4 | F = 1.968 p = 0.08 | F = 0.735 p = 0.597 | F = 3.353 ** p = 0.008 | F = 2.28 p = 0.05 |
Metropolitan | 46.61 ± 1.07 | 52.07 ± 2.04 | 26.91 ± 5.09 | 62.71 ± 4.99 |
Tertiary industry city | 43.30 ± 0.94 | 53.69 ± 1.80 | 30.51 ± 6.60 | 61.75 ± 4.59 |
New developed city | 42.88 ± 0.79 | 53.80 ± 2.40 | 46.12 ± 5.87 | 62.74 ± 4.99 |
Traditional industry city | 45.40 ± 1.27 | 46.62 ± 5.85 | 25.27 ± 7.00 | 55.94 ± 7.95 |
Less developed country | 44.16 ± 1.08 | 60.00 ± 4.92 | 55.37 ± 6.96 | 81.34 ± 6.95 |
Aging and periphery country | 44.80 ± 1.79 | 55.91 ± 7.66 | −9.74 ± 28.65 § | 93.94 ± 14.32 |
Domain 5-1 | F = 0.934 p = 0.458 | F = 1.287 p = 0.268 | F = 1.882 p = 0.104 | F = 2.079 p = 0.072 |
Metropolitan | 41.18 ± 1.15 | 34.65 ± 2.20 | 16.13 ± 5.48 | 55.57 ± 5.37 |
Tertiary industry city | 39.28 ± 1.01 | 38.35 ± 1.94 | 10.68 ± 7.10 | 54.32 ± 4.94 |
New developed city | 38.70 ± 0.85 | 40.24 ± 2.59 | 21.15 ± 6.31 | 62.36 ± 5.37 |
Traditional industry city | 40.64 ± 1.36 | 39.97 ± 6.24 | 25.28 ± 7.50 | 41.83 ± 8.55 |
Less developed country | 40.82 ± 1.16 | 43.84 ± 5.29 | 41.58 ± 7.49 | 69.00 ± 7.42 |
Aging and periphery country | 39.75 ± 1.93 | 51.07 ± 8.23 | −10.43 ± 30.81 § | 97.71 ± 15.40 |
Domain 5-2 | F = 2.751 * p = 0.017 | F = 1.135 p = 0.340 | F = 3.085 * p = 0.012 | F = 0.719 p = 0.610 |
Metropolitan | 52.07 ± 1.59 | 52.30 ± 3.04 | 19.88 ± 7.29 | 78.99 ± 7.43 |
Tertiary industry city | 53.87 ± 1.40 | 51.68 ± 2.68 | 21.44 ± 9.83 | 71.39 ± 6.84 |
New developed city | 55.84 ± 1.17 | 56.59 ± 3.58 | 41.71 ± 8.74 | 69.07 ± 7.43 |
Traditional industry city | 52.53 ± 1.88 | 46.46 ± 8.71 | 10.55 ± 10.38 | 75.80 ± 11.84 |
Less developed country | 57.41 ± 1.61 | 59.02 ± 7.32 | 62.57 ± 10.36 | 66.39 ± 10.35 |
Aging and periphery country | 60.80 ± 2.67 | 72.77 ± 11.40 | 85.91 ± 42.65 | 100.28 ± 21.32 |
Domain 6 | F = 0.839 p = 0.522 | F = 0.607 p = 0.694 | F = 1.412 p = 0.226 | F = 3.749 ** p = 0.003 |
Metropolitan | 32.78 ± 0.84 | 34.59 ± 1.62 | 31.12 ± 4.03 | 39.83 ± 3.95 |
Tertiary industry city | 31.18 ± 0.74 | 35.39 ± 1.43 | 20.54 ± 5.22 | 35.93 ± 3.64 |
New developed city | 31.19 ± 0.62 | 37.45 ± 1.90 | 29.48 ± 4.65 | 43.02 ± 3.95 |
Traditional industry city | 32.11 ± 1.00 | 32.25 ± 4.63 | 25.90 ± 5.52 | 41.27 ± 6.29 |
Less developed country | 30.73 ± 0.86 | 34.02 ± 3.89 | 44.19 ± 5.51 | 52.42 ± 5.50 |
Aging and periphery country | 30.88 ± 1.42 | 42.42 ± 6.06 | 25.23 ± 22.68 | 84.53 ± 11.34 |
Summary Scores | F = 0.961 p = 0.441 | F = 1.018 p = 0.406 | F = 2.086 p = 0.073 | F = 3.228 ** p = 0.009 |
Metropolitan | 35.29 ± 0.72 | 33.69 ± 1.37 | 20.91 ± 3.43 | 46.14 ± 3.36 |
Tertiary industry city | 33.991 ± 0.63 | 34.34 ± 1.21 | 15.54 ± 4.44 | 43.39 ± 3.09 |
New developed city | 33.77 ± 0.53 | 37.07 ± 1.62 | 27.00 ± 3.95 | 47.34 ± 3.36 |
Traditional industry city | 35.25 ± 0.85 | 32.81 ± 3.94 | 22.20 ± 4.69 | 43.70 ± 5.35 |
Less developed country | 33.96 ± 0.73 | 37.30 ± 3.31 | 39.23 ± 4.68 | 55.62 ± 4.67 |
Aging and periphery country | 34.76 ± 1.21 | 41.37 ± 5.15 | 21.61 ± 19.27 | 81.79 ± 9.63 |
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Lin, S.-W.; Chiu, T.-Y.; Liou, T.-H.; Yen, C.-F.; Chen, H.-G. The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan. Int. J. Environ. Res. Public Health 2020, 17, 7553. https://doi.org/10.3390/ijerph17207553
Lin S-W, Chiu T-Y, Liou T-H, Yen C-F, Chen H-G. The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan. International Journal of Environmental Research and Public Health. 2020; 17(20):7553. https://doi.org/10.3390/ijerph17207553
Chicago/Turabian StyleLin, Shyang-Woei, Tzu-Ying Chiu, Tsan-Hon Liou, Chia-Feng Yen, and Hui-Guan Chen. 2020. "The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan" International Journal of Environmental Research and Public Health 17, no. 20: 7553. https://doi.org/10.3390/ijerph17207553
APA StyleLin, S. -W., Chiu, T. -Y., Liou, T. -H., Yen, C. -F., & Chen, H. -G. (2020). The Relationship of Urbanization and Performance of Activity and Participation Functioning among Adults with Developmental Disabilities in Taiwan. International Journal of Environmental Research and Public Health, 17(20), 7553. https://doi.org/10.3390/ijerph17207553