Kim Myoungsuk, Ho Seung Hee, Kim Hayeon, Park Jaemin
Program in Public Health, Korea University Graduate School, Seoul, Republic of Korea.
National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, Republic of Korea.
Brain Behav. 2025 May;15(5):e70454. doi: 10.1002/brb3.70454.
People with physical disabilities inevitably experience barriers to social participation, including physical limitations, health issues, stigma, discrimination, policies, and socio-environmental factors. Although this is a critical public health issue, no multidimensional, comprehensive, evidence-based intervention has previously addressed the specific factors affecting social participation in people with physical disabilities. This study explores the various factors influencing social participation, which contribute to health inequalities for people with physical disabilities. In particular, the physical and mental health, socio-environmental factors, and quality of life (QoL) among people with physical disabilities are examined.
The study used health data from surveys and clinical examinations conducted in 2021 and 2022 for 301 participants with physical disabilities in Korea. An observational, cross-sectional analysis was performed using 47 independent variables to analyze the risk factors affecting social participation.
Crude analysis revealed 29 variables in demographic characteristics, disability characteristics, health behaviors, health status, mental health, socio-environmental factors, and QoL that correlated significantly with social participation. The adjusted analysis revealed that difficulties in social participation were influenced in the following order: poor subjective health, lower QoL, inability to freely use public buildings in the community, lack of necessary income sources, difficulty in using transportation, selective eating habits, increased depression, and experiences of discrimination. The explanatory power of the regression model is 46.4%.
To strengthen social participation, it is necessary to develop community programs that integrate rehabilitation treatment for managing physical disabilities and secondary health conditions with psychological and emotional support. In addition, social discrimination and health inequalities should be addressed through raising awareness and education about disabilities and participation.
身体残疾者不可避免地会面临社会参与的障碍，包括身体限制、健康问题、耻辱感、歧视、政策以及社会环境因素。尽管这是一个关键的公共卫生问题，但此前并没有多维、全面、基于证据的干预措施来解决影响身体残疾者社会参与的具体因素。本研究探讨了影响社会参与的各种因素，这些因素导致了身体残疾者的健康不平等。特别是，对身体残疾者的身心健康、社会环境因素和生活质量（QoL）进行了研究。
该研究使用了2021年和2022年对韩国301名身体残疾参与者进行的调查和临床检查的健康数据。使用47个独立变量进行观察性横断面分析，以分析影响社会参与的风险因素。
粗分析显示，人口统计学特征、残疾特征、健康行为、健康状况、心理健康、社会环境因素和生活质量方面的29个变量与社会参与显著相关。调整分析显示，社会参与困难受以下因素影响，顺序依次为：主观健康状况差、生活质量较低、无法自由使用社区公共建筑、缺乏必要收入来源、交通使用困难、选择性饮食习惯、抑郁增加以及遭受歧视经历。回归模型的解释力为46.4%。
为了加强社会参与，有必要制定社区项目，将管理身体残疾和继发性健康状况的康复治疗与心理和情感支持相结合。此外，应通过提高对残疾和参与的认识及教育来解决社会歧视和健康不平等问题。
