Coronavirus disease 2019 (COVID-19) and individuals with intellectual and developmental disabilities in Nigeria

Connecting the experiences of persons with disabilities and social workers in Nigerian care institutions regarding COVID-19 vaccine uptake: a qualitative descriptive-interpretive design

Background

During the COVID-19 pandemic, persons with disabilities (PWDs) have faced additional disadvantages that have exacerbated their physical and mental health challenges. In Nigeria, where cultural, religious, and informational barriers persist, understanding these factors is critical for improving health interventions, including vaccine uptake among PWDs.

Methods

This study employed a qualitative descriptive-interpretive design to explore the perceptions of PWDs regarding the COVID-19 pandemic and the vaccine, alongside social workers' views on their roles in facilitating vaccine uptake. We conducted in-depth semi-structured telephone interviews with 20 participants, comprising 16 PWDs and four social workers in Nigerian rehabilitation homes. Data were analyzed using critical thematic analysis to identify key themes influencing attitudes toward the pandemic and vaccine uptake.

Results

The study uncovered significant barriers to COVID-19 vaccine uptake among PWDs, primarily driven by mistrust in government initiatives, widespread conspiracy theories, and deeply held cultural and religious beliefs. Additionally, while social workers played crucial roles as community surveillance officers, in-house educators, and community referral agents, their interventions lacked specific strategies aimed at increasing vaccine uptake among PWDs. Their efforts were more focused on addressing the psychological impacts of the pandemic rather than fostering behavioral changes toward vaccine acceptance.

Conclusion

To enhance COVID-19 vaccine uptake among PWDs in Nigerian rehabilitation homes, targeted interventions that address the identified barriers are essential. These should include trust-building measures, culturally and religiously sensitive communication strategies, and tailored educational programs by social workers. Moreover, training social workers in specific, evidence-based strategies to increase vaccine uptake is crucial for mitigating the pandemic's impact on this vulnerable population.

Quality of life in adults with Down syndrome: A mixed methods systematic review

BACKGROUND

As the life expectancy of adults (aged ≥ 18 years) with Down syndrome increases for a plethora of reasons including recognition of rights, access, and technological and medical advances, there is a need to collate evidence about their quality of life.

OBJECTIVE

Using Schalock and Verdugo's multidimensional quality of life assessment model, this systematic review aimed to identify, synthesise and integrate the quantitative and qualitative evidence on quality of life in adults with Down syndrome via self-and proxy-reporting.

METHODS

Five databases were systematically searched: MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science to identify relevant articles published between 1980 and 2022 along with grey literature and reference lists from relevant studies. A mixed methods systematic review was performed according to the Joanna Briggs Institute methodology using the convergent integrated approach. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

RESULTS

Thirty-nine studies were included: 20 quantitative, 17 qualitative, and 2 mixed methods studies. The synthesised findings were grouped into the 8 core domains of quality of life: personal development, self-determination, interpersonal relations, social inclusion, rights, emotional, physical and material well-being. Of the 39 studies, 30 (76.92%) reported on emotional well-being and 10 (25.64%) on rights. Only 7 (17.94%) studies reported that adults with Down syndrome have a good quality of life centred around self-determination and interpersonal relations. Most adults with Down syndrome wanted to become more independent, have relationships, participate in the community, and exercise their human rights. Self-reported quality of life from adults with Down syndrome was rated higher than proxy reported quality of life. Discrepancies in quality of life instruments were discovered.

CONCLUSION

This review highlighted the need for a better systematic approach to improving the quality of life in adults with Down syndrome in targeted areas. Future research is required to evaluate self-and proxy-reporting methods and culture-specific quality of life instruments that are more appropriate for adults with Down syndrome. In addition, further studies should consider including digital assistive technologies to obtain self-reported quality of life data in adults with Down syndrome.

INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER

CRD42019140056.