The Broader Impact of Disability Research: Aligning Public Policy with the Experiences of People with Disabilities and Healthcare Providers

Thesis (Ph.D.)--University of Washington, 2016-07

The general purpose of this three-article dissertation is to investigate public policy issues salient to people with disabilities, their families, and healthcare providers. The studies in this dissertation are united by a conceptual framework and applied policy research methods. The first article in this dissertation, “The Relationship between Psychological Assets and Employment in Individuals with Physical Disabilities,” was designed as a secondary analysis of existing data. Using cross-sectional survey data collected as part of the Rehabilitation Research and Training Center on Healthy Aging and Physical Disability, the purpose of this study was to determine the relative importance of resilience and self-efficacy in explaining employment status for people with physical disabilities after controlling for sociodemographic and disease covariates. Data were analyzed using multiple logistic regression with sequential predictor entry. Results indicate that resilience but not self-efficacy was uniquely predictive of employment status. We found in this study preliminary evidence to suggest that rehabilitation professionals should consider the importance of a client’s psychological resources with respect to employment. The second article in this dissertation, “Durable Medical Equipment Reuse and Recycling: Uncovering Hidden Opportunities for Reducing Medical Waste,” was designed as a basic interpretive qualitative study. The purpose of this study was to investigate the phenomenon of durable medical equipment (DME) reuse and recycling in the context of a healthcare delivery system as a first step in understanding how hospitals manage DME waste and how healthcare providers conceive of their role in preventing DME waste. The findings for this study include descriptions of the process for patients to acquire both new and used DME and environmental sustainability practices for reducing DME waste generated by hospitals. The third and final article in this dissertation, “The Experience of Homecare Providers and Beneficiaries with Enhanced Training Requirements in Washington State,” was also designed as a basic interpretive qualitative study. This study was conducted as the first phase in a potential multiphase study to develop a battery of self-report instruments for evaluating consumers’ satisfaction with their homecare and for assessing health-related quality of life outcomes presumed to improve with quality caregiving. We used exploratory research to identify domains relevant to a new homecare aide training and certification program that was mandated by Washington State Initiative 1163. The findings for this study include a description of the components of person-centered delivery of care and an assessment of the homecare aide training from the perspective of some consumers and homecare aides in Washington State.