Social inclusion of people with intellectual disabilities: the impact of place of residence

Supporting Social Inclusion in Neighbourhoods of Adults with Intellectual Disabilities: Service Providers' Practice Experiences

Deinstitutionalisation has increased the likelihood of adults with intellectual disabilities residing in neighbourhoods either in staff-supported accommodation or in their family home. However, it raises the question of whether national policies on disability have translated into practice actions by service providers that result in positive social inclusion outcomes for individuals. This study examined the practice initiatives supporting social inclusion in neighbourhoods in specialist state-funded service providers for adults with intellectual disabilities. Using a mixed methods design, CEOs/service leaders of 40 organisations completed an online survey. Follow-up interviews were completed with a randomised sample. Shifting towards new service models and strategic links with mainstream organisations were most often mentioned as furthering social inclusion goals. A wide range of service initiatives were reported, with positive outcomes alongside a range of challenges. Service providers play an important role in providing individualised supports that foster local engagement. However, the service context is complex and service leaders have reported many challenges that may impede progress on social inclusion.

Unlimited Surrounding: A Scoping Review on the Impact of the Built Environment on Health, Behavior, and Quality of Life of Individuals With Intellectual Disabilities in Long-Term Care

OBJECTIVES

To identify available literature on the impact of built environments on health, behavior, and quality of life of individuals with intellectual disabilities in long-term care. Additionally, we aimed to map the available literature, (re)frame the overall research situation in this area, and formulate recommendations.

BACKGROUND

Long-term care facilities in the Netherlands are planned without using knowledge from research regarding evidence-based design because it is unclear what evidence is available about the impact of long-term care built environments on individuals with intellectual disabilities receiving 24/7 care.

METHODS

Twelve scientific databases were searched for keyword combinations. After systematically screening 3,095 documents, 276 were included in the analysis.

RESULTS

There is an underrepresentation of research and publications in intellectual disabilities, compared to other user groups living in long-term care facilities. A total of 26 design components were found in all groups; as for intellectual disabilities, research was available on only seven of them. Community care, home-likeness, and variety seem to have a positive effect on health, behavior, and quality of life. There are conflicting results regarding the effects of house size.

CONCLUSIONS

Although individuals with intellectual disabilities live in long-term care facilities, sometimes for life, little research has been conducted on the impact of the built environment on them. In the future, more empirical research should be conducted, addressing all aspects of quality of life and specific design components, with hypotheses based on needs assessments and the use of good research designs. This requires an investment of time and funding.

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

OBJECTIVES

To capture the extent and nature of intellectual disability nursing publications in Ireland.

DESIGN

Scoping review using Arksey and O'Malley approach.

DATA SOURCES

Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020.

ELIGIBILITY CRITERIA

Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education.

DATA EXTRACTION AND SYNTHESIS

Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken.

RESULTS

The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring.

CONCLUSIONS

This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.

Community Involvement of Young Adults with Intellectual Disabilities: Their Experiences and Perspectives on Inclusion

BACKGROUND

Inclusion in the community is essential to enhancing a person's quality of life. Although people with intellectual disabilities have a desire to be more involved in activities, they experience barriers that limit their inclusion.

METHODS

The purpose of this study was to describe the community involvement of young adults with intellectual disability. I interviewed fourteen young adults with intellectual disability to explore their involvement in work, recreation and leisure activities.

FINDINGS

Four themes emerged from the data: vocational endeavours, leisure pursuits, social inclusion and supports. The contexts of their experiences either facilitated or hindered their community involvement.

CONCLUSIONS

The community involvement of young adults with intellectual disability varies depending on the opportunities and supports available to them. Their inclusion in the community may be enhanced by additional transportation options, continuing education in vocational and social skills, personalized guidance from group members and environments that are welcoming to people with disabilities.

The image of people with intellectual disability in Taiwan newspapers

BACKGROUND

There is limited research on the development of newspaper analysis about the images of people with ID in Chinese newspapers. The purpose of this study was: (a) to understand the general image of persons with ID presented in printed newspapers in Taiwan, and (b) to classify the various images of persons with ID and to measure the relative proportions among these classifications.

METHOD

Articles from 2008 from the media databank UDNDATA were analysed by content analysis.

RESULTS

Three main images were portrayed. The greatest number of articles revolved around the "dispirited" image (44.5%), followed by "needy" (32.7%), and "affirmative" (22.8%). Articles focused on families with a member with ID made up 20.8% of the total articles, and 81% of these stories had a negative theme.

CONCLUSION

The pessimistic portrayal of people with ID is popular and newspapers may create stigma for people with ID in Taiwan.

Dispersed or clustered housing for adults with intellectual disability: a systematic review

BACKGROUND

The purpose of this review was to evaluate the available research on the quality and costs of dispersed community-based housing when compared with clustered housing.

METHODS

Searches against specified criteria yielded 19 papers based on 10 studies presenting data comparing dispersed housing with some kind of clustered housing (village communities, residential campuses, or clusters of houses). The studies reported the experience of nearly 2,500 people from four different countries.

RESULTS

In five of eight quality of life domains there were no studies reporting benefits of clustered settings. In respect of interpersonal relations, emotional, and physical well-being, clustered settings had some advantages. However, in many of these cases the better results refer only to village communities and not to campus housing or clustered housing. In terms of costs, clustered housing was usually less expensive because of lower staffing levels. In two of the three studies that examined costs controlling for user characteristics, there was no statistically significant difference.

CONCLUSION

Dispersed housing appears to be superior to clustered housing on the majority of quality indicators studied. The only exception to this is that village communities for people with less severe disabilities have some benefits; this is not, however, a model which can be feasibly provided for everyone. Clustered housing is usually less expensive than dispersed housing but this is because it provides fewer staff hours per person. There is no evidence that clustered housing can deliver the same quality of life as dispersed housing at a lower cost.

Autonomy in relation to health among people with intellectual disability: a literature review

BACKGROUND

Since the 1990s, individualisation, participation, normalisation and inclusion have been the main principles of care for people with intellectual disability (ID). Autonomy has become an important issue for these people. This review of the literature tried to answer the question: how do people with ID exercise autonomy in relation to health?

METHOD

Searches in Cochrane, Medline and PsycINFO were based on the following aspects of autonomy: self-determination, independence, self-regulation and self-realisation.

RESULTS

Thirty-nine of 791 articles met our criteria, including 14 on self-determination, seven on independence, 15 on self-regulation and three on self-realisation.

CONCLUSIONS

In spite of decades of promoting autonomy, the exercise of autonomy in relation to health has so far rarely been an issue in the literature.

Outcomes in different residential settings for people with intellectual disability: a systematic review

Large-scale reviews of research in deinstitutionalization and community living were last conducted about 10 years ago. Here we surveyed research from 1997 to 2007. Articles were included if the researchers based the study on original research, provided information on the participants and methodology, compared residential arrangements for adults with intellectual disability, and were published in English-language peer-reviewed journals. Sixty-eight articles were found. In 7 of 10 domains, the majority of studies show that community-based services are superior to congregate arrangements. These studies provide more evidence of the benefits of deinstitutionalization and community living and continue to indicate variability in results, suggesting that factors other than the basic model of care are important in determining outcomes.