The involvement matrix as a framework for involving youth with severe communication disabilities in developing health education materials

PPIE in a technical research study: Using public involvement to refine the concept and understanding and move towards a multidimensional concept of disability

BACKGROUND

Disability is often an essentialised and oversimplified concept. We propose refining this while incorporating the multidimensional nature of disability by increasing the use of existing survey questions and their corresponding data to enrich, broaden and inform understandings of disability.

METHODS

We combined patient and public involvement and engagement (PPIE) with focus groups and concept mapping to collaboratively map disability survey questions into conceptual models of disability with six members of the public with lived experiences of disability.

RESULTS

Using reflexive thematic analysis, we identified three qualitative themes and eight subthemes through a series of four PPIE activities: (1) understanding concepts of disability based on individual experience, subthemes: 1.1-preference for the biopsychosocial model, 1.2-'Reviewing' instead of mapping survey questions and 1.3-comparing questions to real life; (2) consistency between understanding needs and implementing adjustments, subthemes: 2.1-connecting preparation and operation, 2.2-inclusivity and adjustments in activities and 2.3-feedback for improving activities and (3) real-world applications-targeted awareness raising, subthemes: 3.1-who, where, what and how to share activity findings and results, 3.2-sharing with human resource and equality, diversity and inclusion professionals.

CONCLUSION

Members of the public who collaborated in these activities felt empowered, engaged and supported throughout this study. This approach offers a model for other researchers to cede power to the public over the research aspects typically reserved for researchers.

PATIENT OR PUBLIC CONTRIBUTION

We involved members of the public with lived experience throughout this study-co-design, co-facilitation, collaboratively mapping the disability or disability-related survey questions into conceptual models of disability, evaluation of the activities, co-analysis and co-authorship.

The Sustainable Development Goals: A framework for addressing participation of persons with complex communication needs in South Africa

BACKGROUND

Participation in society is the cornerstone to living a meaningful, connected, and healthy life. Persons with complex communication needs, however, often have restricted opportunities to participate in everyday contexts and situations. Reasons for this include societal attitudinal barriers, as well as limited knowledge and skills about augmentative and alternative communication (AAC) to enhance participation. Enhancing participation of persons with complex communication needs requires a holistic and multi-faceted approach. The 17 Sustainable Development Goals (SDGs) with their disability-inclusive agenda provide an impetus for shaping the approach of the Centre for Augmentative and Alternative Communication (CAAC) in enhancing participation of persons with complex communication needs in South Africa.

PURPOSE

This paper aims to provide a reflective description and application of the work conducted by the CAAC in addressing the SDGs in South Africa.

RESULT

Research and training conducted by the CAAC is shown to be aligned to five SDGs, namely zero hunger (SDG 2), good health and well-being (SDG 3), quality education (SDG 4), decent work and economic growth (SDG 8) and peace, justice, and strong institutions (SDG 16), with a focus on reaching these goals in order to benefit persons with complex communication needs.

CONCLUSION

The paper demonstrates that, despite some gains in addressing the SDGs, research and clinical practice still needs to be on these and the remaining SDGs. Furthermore, there is a need to also find ways to integrate the SDGs to ensure participation of persons with complex communication needs in major life activities and society.

Co-Design of an Intervention to Increase the Participation in Leisure Activities Including Adolescents with Cerebral Palsy with GMFCS Levels IV and V: A Study Protocol

The participation of adolescents with cerebral palsy (CP) within the community is reduced compared to their peers and is a barrier to their socialization, self-determination and quality of life. Patient and Public Involvement (PPI) is a key strategy for successful interventions, especially when involvement of the stakeholders takes place at all stages of the research. Co-design can be crucial for success as researchers, patients with CP and their families work together to bring the necessary elements to the interventions to be designed. The objectives will be: (1) To co-design an intervention aimed at improving the participation of adolescents with significant motor disabilities within the community in partnership with adolescents with CP, families and rehabilitation professionals. (2) To assess the feasibility of the co-design process in partnership with interested parties. The study will be based on Participatory Action Research (PAR) and will be held in Spain and Brazil. In both countries, the study will be carried out remotely with nine adolescents aged 12 to 17 years with CP, Gross Motor Function Classification System (GMFCS) levels IV-V, their families and six health professionals (physiotherapists and occupational therapists). Different dialogue groups will be created to involve adolescents, families and health professionals to the research's project. To manage their involvement in the co-design process, the Involvement Matrix (IM) will be used, and according to the IM phases, four steps will be included in the research: (1) Preparation; (2) Co-design; (3) Analysis: results of the intervention protocol and the study's feasibility and (4) Dissemination of results. Partnering with the public to design an intervention to improve participation can bring better results compared to protocols designed only by health professionals. In addition, it will allow for knowing the needs of adolescents with CP in terms of participation within the community. The study will also explore which roles were chosen by all participants and how they felt while actively participating in the process of co-designing an intervention protocol and their own perspectives on the use of the involvement matrix.

Co-design and delivery of a relational learning programme for nursing students and young people with severe and complex learning disabilities

BACKGROUND

National Health Service (NHS) staff in the UK are required to undergo training about learning disabilities at the appropriate level for their role. However, this requirement does not apply to nurses in training and student nurses report fear and anxiety about caring for people with intellectual learning disabilities (ILDs). Young people with intellectual disabilities report feeling scared of nurses and parents feel staff do not listen to them or involve them in care.

OBJECTIVES

(i) For a university and special school for young people with server and complex ILDs to work in partnership to co-design a programme for nursing students, young people, their teachers, and parents. (ii) To deliver the programme online as part of the university's existing nursing courses.

DESIGN

The partnership between the university and the special school focused on co-design of an interactive programme, parent involvement, safeguarding, and the design of accessible learning resources to support young people with severe and complex ILDs' engagement. The programme was informed by relational inquiry, service user and transformative pedagogies, and parents and teacher's knowledge and views about the young people. Delivery of the programme was designed to fit into existing nursing courses and enable students on placement and young people at home or in hospital to participate. A rights-based ethnographic evaluation was designed to support participant feedback and programme development.

SETTING

The Heritage2Health Virtual Arts and Drama Programme was piloted with nursing students at one UK university and young people with severe and complex ILDs from one special school, their parents and teachers.

PARTICIPANTS

15 nursing students (BSc Year 2 = 10, Year 3 = 3, MSc = 2) and 7 young people with severe and complex learning disabilities (age 11-14 yrs). Other participants were parents/guardians of young people (7), arts/drama facilitators (2), academic lecturers (2), special needs teachers (2), registered nurse (1).

METHODS

An 8-week dynamic programme of arts and drama. Sessions included 30-min start-up/presencing, 45-min storytelling/drama with young people and parents, 30-min reflection/close. Sessions were facilitated by 2 arts and drama specialists. The story of 'Ubuntu the Lion with the Long, Long, Mane' (by TNP) was used to explore difference and ways of being. The evaluation methods were participant observation, semi-structured interviews (2-6 weeks post) and thematic analysis.

RESULTS

Participation in the programme was a challenging, creative, and reflective experience that was transformative for all. Nurses and young people's fears and anxieties about each other were revealed and addressed by participating in arts and drama activities together. Nursing students learnt how to adopt a relational orientation to young people and their parents and teachers.

CONCLUSIONS

A co-designed programme for nursing students and young people with severe and complex ILDs can benefit student knowledge and skills and reduce fears and anxieties between nurses and young people with ILDs. With adequate planning and resources, the programme could be adopted by multidisciplinary partnerships between other universities and special schools.

Health information and education needs for youth with complex communication needs during the Covid-19 pandemic: rehabilitation professionals' perspectives

PURPOSE

The worldwide Covid-19 pandemic has highlighted inequities faced by persons with complex communication needs (CCN) in accessing health information and education. This study reports on the perspectives of South African rehabilitation professionals regarding access to health information and education for youth with CCN.

MATERIALS AND METHODS

Two asynchronous online written focus groups were conducted with 15 rehabilitation professionals. Participants' contributions were thematically analysed.

RESULTS

Participants reported that youth with CCN faced a variety of challenges when accessing health information, related, amongst others, to the format and quality of the information. Participants reported on strategies they had successfully used to support comprehension of health information and the youth's communication during healthcare encounters. Participants suggested various Covid-19-related and general health topics of value to youth, as well as a variety of multimodal and multilingual presentation formats to make health information accessible. This information was used in the development of accessible health information resources that are now freely available on the authors' institutional website.

CONCLUSIONS

The results confirmed that there is an urgent need to make accessible health information available in order to include South Africans with CCN in health services during the pandemic and beyond. Implications for rehabilitationHealth information and education (including information and education provided with respect to the Covid-19 pandemic) has often not been accessible to youth with complex communication needs (CCN).South African rehabilitation professionals reported on a variety of challenges that youth with CCN face when attempting to access health information and education, but also reported on strategies that had helped to support them in this.They also highlighted Covid-19-related and general health topics that would be of value to youth, and suggested a variety of information formats and strategies to make health information more accessible.This information can assist in the design of appropriate and accessible health information resources for youth with CCN and other individuals who experience communication challenges.