Challenges faced by physically challenged women's in donning and doffing of bra
BACKGROUND 8,223,753 2.03%
10,408,168 2.43%
3,600,602 1.98%
26,810,557
Source: Census of India 2011
4,578,034 2.34%
ource: Census of India 2011
5,032,463 19.8%
5,071,007 20.9% 1,998,535 7.5%
5,436,604 22.3%
5,043,498 21% 2,228,450 8.3%
Disabled Population by Type of Disability India : 2011
Type of Disability
Persons
%
Males
%
Females
%
Total
26,810,557
100.0
14,986,202
100.0
11,824,355
100.0
In Seeing
5,032,463
18.8
2,638,516
17.6
2,393,947
20.2
In Hearing
5,071,007
18.9
2,677,544
17.9
2,393,463
20.2
In Speech
1,998,535
7.5
1,122,896
7.5
875,639
7.4
In Movement
5,436,604
20.3
3,370,374
22.5
2,066,230
17.5
Mental Retardation
1,505,624
5.6
870,708
5.8
634,916
5.4
722,826
2.7
415,732
2.8
307,094
2.6
Any Other
4,927,011
18.4
2,727,828
18.2
2,199,183
18.6
Multiple Disability
2,116,487
7.9
1,162,604
7.8
953,883
8.1
Mental Illness
Source: Census of India 2011
Data on population of female with physical disability in Delhi
9.42%
5.79%
17.36% - 30,124
19.89% 38.84%
Seeing Hearing - 34,499 Speech - 15,094 Movement - 67,383 Mental retardation - 16,338 Mental illness - 10,046
8.70%
Source: (State UT wise Persons with Disability)
Types of Disability in movement: • • • • • • •
Arthritis Multiple sclerosis Fibromyalgia Torn rotator cuf Limited upper arm mobility Paralytic persons Limited hand dexterity
• • • •
Those who crawl Those who are able to walk with the help of aid Have acute and permanent problems of joints/muscles Have stifness or tightness in movement or have loose, involuntary movements or tremors of the body or have fragile bones Have difficulty balancing and coordinating body movement Have loss of sensation in body due to paralysis, Leprosy, etc. Have deformity of body like hunch back or are dwarf. Arthritis is the major disease in India which restrict joins and it cause disability in movement.
• • • •
Source: Census of India 2011
Chart showing proportion of female arthritis patient population in respective age group Proportion of disabled population in respective age group India: 2011
Age Group All ages 0-4 5-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ Age not stated Source: Census of India 2011
Females 2.01 1.11 1.44 1.67 1.70 1.77 1.97 2.47 3.89 6.19 8.48 8.85 2.91
Women of the age 40 and above are more afected by Arthritis.
Types of Arthritis Osteoarthritis: degradation of joints including articular cartilage and subchondral bone. Rheumatoid arthritis: autoimmune disease, many tissues and organs Septic arthritis: purulent invasion of a joint by an infectious agent which produces arthritis. Gout and pseudo-gout: debilitating illnesses in which pain and joint inflammation are caused by the formation of crystals within the joint space Juvenile idiopathic arthritis: seen in childhood, self limited or chronic Still’s disease: afects 16-35 year, a ‘salmon pink’ rash appears on joints which causes pain. Ankylosing spondylitis: It mainly afects joints in the spine Source: Wiese AD1, Griffin MR2, Stein CM1, Mitchel EF Jr1, Grijalva CG2. (2016 Feb). Opioid Analgesics and the Risk of Serious Infections Among Patients With Rheumatoid Arthritis: A Self-Controlled Case Series Study. Arthritis Rheumatol .
Population of Rheumatoid arthritis female patient in India
Population of Delhi – 18,00,000 in 2011 • In India, per 1,00,000 there is 7535 Rheumatoid arthritis female patient above 40 yrs. •So, the no. of female RA patients in India over the age of 40 years come out to be 1,35,630 (approx.)
Objective of study To understand the difficulties and challenges faced by patient of Rheumatoid arthritis in donning and doffing of bra
What is Rheumatoid Arthritis (RA)? • •
RA is an autoimmune disease Body’s immune system which protects its health by attacking foreign substances like bacteria and viruses mistakenly attacks the joints Immune system incorrectly targets your own tissues and organs
Antibodies form and attack cells
Inflammation/Swelling
Damage/Disease
RA attacks tissues near joints and sometimes other body parts also
Stages of Rheumatoid arthritis
It can damage cartilage, the elastic tissue that covers the ends of bones in a joint, as well as the bones themselves. Over time, there is loss of cartilage, and the joint spacing between bones can become smaller.
Joints can become loose, unstable, painful and lose their mobility
It resulting in swelling and pain in and around the joints
JOINT DAMAGE CANNOT BE REVERSED
Shoulder RA commonly afects the joints of the hands, feet, wrists, elbows, knees and ankles Elbow
Wrist
RA usually afects joints symmetrically(on both sides equally)
Hands
Knees
Ankles Feet
In most cases joint deformity also occur
Research Methodology Primary Research: • Self administered questionnaire was used • An interview schedule was developed to elicit information about specific clothing needs.
Questionnaire To understand the difficulties and challenges faced by women with Rheumatoid arthritis in donning and doffing of brassier The research is being conducted to analyze the problem and challenges faced by Rheumatoid arthritis patient in donning and doffing of Brassier. The study is purely for academic purpose and thus, all the details are confidential. Name :________________________________________________________________ Age : ______ Occupation : ____________________Location:____________________ Monthly family Income:______________________________________________(INR) 1. Are you aware of the severities of Rheumatoid arthritis? ( ) Yes ( ) No 2. What stage of Rheumatoid arthritis you are sufering from? ( ) Stage 1 ( ) Stage 2 ( ) Stage 3 ( ) Stage 4
3. Do you wear brassiere? ( ) Yes ( ) No 4. How often do you buy your brassiere ? ( ) Once a month ( ) Once in 6 month ( ) More than one time in 6 month ( ) Once a year 5. What is the price of brassiere you buy? __________________ INR 6. Do you face any problem in donning and doffing of Brassiere? ( ) Yes ( ) No 7. Do you need help in adornment of brassier or you can do it yourself? ( ) Need help ( ) Do it yourself
8. Are you using any of the specialised elderly brassiere which is available in the market? ( ) Yes ( ) No 9. What are the problem or difficulties you face with your existing brassiere with respect to the disability: ( ) Skin fit ( ) Hook closure ( ) Zip closers( ) Tight elastic ( ) Donning ( ) Doffing ( ) Both donning & doffing Any other, Please specify _________________________________ 10. Rank the above problems you face the most ( from 1-7, 1 being the problem faced the most & 7 being the least) ( ) Skin fit ( ) Hook closure ( ) Zip closers( ) Tight elastic ( ) Donning ( ) Doffing ( ) Both donning & doffing 11. What price range of brassier would you prefer if it is user friendly with respect to the disability? ( ) Under 500 ( ) 500 – 1,000 ( ) 1,000 – 1,500 ( ) Above 1,500
Findings from Questionnaire
Targeting population – Middle income group Filled by 19 patient and 8 attendants Average age of patient was 52 years Average duration of disease was 11.65 years
Data collection on the basis of Questionnaire Are you aware of the severities of Rheumatoid arthritis?
35.71% No Yes 64.29%
What stage of Rheumatoid arthritis you are suffering from? 10.71%
39.29%
17.86%
32.14%
Stage 1 Stage 2 Stage 3 Stage 4
Do you wear brassiere?
14.29%
Yes No
85.71%
How often do you buy your brassier? 8.33% 8.33%
25.00%
Once in 6 month More than one time in 6 month Once in year Once in two year 58.33%
What is the price of brassiere you buy? 8.33%
16.67% 50.00%
25.00%
Under 500 500 - 1,000 1,000 - 1,500 Above 1,500
Do you face any problem in donning and doffing of Brassiere?
Yes No
41.67% 58.33%
Do you need help in adornment of brassier or you can do it yourself?
29.17% Need help Do it yourselves
70.83%
Are you using any of the specialised elderly brassiere which is available in the market?
33.33%
Yes No 66.67%
What are the problem or difficulties you face with your existing brassier with respect to the disability? 8.33%
12.50%
8.33%
Skin fit Hook closure
8.33%
Zip closure 29.17%
Tight elastic Donning
25.00%
Doffing 8.33%
Both donning and doffing
Rank the above problems you face the most ( from 1-7, 1 being the problem faced the most & 7 being the 10 9 Skin fit
8
Hook closure
7
Zip closure
6
Tight elastic
5
Donning
4
Doffing
3
Both donning and doffing
2 1 0
1
2
3
4
5
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
What price range of brassier would you prefer if it is user friendly with respect to the disability? 12.50% 25.00% Under 500 500 - 1,000 1,000 - 1,500 Above 1,500
16.67%
45.83%
Analysis on the basis of Questionnaire •86% preferred wearing bra •14% were not wearing bra •Deformities afected basic functions like dressing, eating, etc. on their own •82% of the patient said RA is adversely afecting their lives •71% of the sample agreed that because of RA they are facing problem in self dressing •Joints making them dependent on others for one of the basic activity that is dressing
Activities which are hampered due to RA in wearing Bra Type of movement
Activities which are hampered due to RA
Fingers
Flexion, Extension
Buttoning, Zipping, Tying and chain pulling
Thumb
Circumduction, Abduction, Adduction, Retropulsion
Buttoning, Zipping, Tying and chain pulling and holding
Wrist
Flexion, Extension, Adduction, Abduction, Circumference
Buttoning, zipping, tying
Elbow
Flexion, extension
Wearing strap of bra
Joints
Analysis drawn on the basis of interview with Dr. Prakash, Occupational Therapist, AIIMS, New Delhi
Problem faced in ready to wear bra
Lack of comfort Unsuitability of design Proper fit Hook closure Tight elastic Zip closure Back closure
Improvement can made by
Changing fabric preferences Additional ease placement Larger opening Better fastener Need device which are hand free Function that require less movement It should have following aspects: • Functional • Structure • Aesthetic
Design Intervention
Option 1 Front view
•Joint strap •Fabric – 40%cotton and 60%Lycra -For better stretch •Very stretchable •No closure •Removable cups •Easy to wear
Side view
Upward back strap
Back
Easy stretchable elastic •Easy to wear- very stretchable, •Patient can wear it easily, no need of closure
Advantage RELIEF FROM TIGHT FITTING BRAS - Fabric is very stretchable and strap is made up of elastic CAN WEAR BRA BY THEMSELVES -Due to no closure and stretchable fabric, a women afected by RA can wear this bra by herself. COMFORTABLE SUPPORT - Under wire is replace by soft plastic for more comfortable support REMOVABLE CUPS
Disadvantage MAY FACE A PROBLEM OF SAGGING -Because of the stretchable fabric
Option 2 Front view
Front closure Detachable strap Removable cups Velcro with and “D” ring Good for everyday wear
Back view
Joint strap
Option 3 Front view
Front closure Detachable strap Big loops for better hold Velcro is used Wide strap for support Good for everyday wear
Back view
Joint strap
Option 4 Front view
Front closure Joint and wide strap Soft padded for support Big hook is used Good for everyday wear
Back view
Joint strap
Option 5 Front view
Front closure Joint strap Soft padded for support Big loop is attached in puller of the chain so that patient can pull chain easily with their finger Good for everyday wear
Back view
Joint strap
Option 6 Front view
Detachable strap Soft padded Loop – For better hold 1 loop on the closure 2 loops on the upper panel 2 loops on the lower panel
Left view
Side closure •Tic tac button •Easy to close/open •1 loop on the upper panel •1 loop on the lower panel
Right view
Velcro, on lower panel •For stability •1 loop on the lower panel
Lower panel
Velcro
Tic tac button
Loop
Loop
Upper panel
Velcro inside
Loop
Back view
Joint strap
Prototype
Choice for prototype : Option 6 Reason
: Better from all other designs - Easy in wearing - Good for any kind of patient sufering from RA - 5 loops, so that patient can wear it by themselves - Can be mass produced - Easy in construction - Can be available in various sizes
Thank you.