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Taylor B, Thompson J, Ryan T. 'Moving on' for Adults With a Learning Disability and Their Families: A Constructivist Grounded Theory Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241232360. [PMID: 38437864 DOI: 10.1177/10497323241232360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Ending familial co-residence, termed 'moving on' by participants, is an increasingly relevant life transition for people with a learning disability due to increasing life expectancy and policy developments. Nevertheless, there is an absence of research exploring this transition experience in a United Kingdom (UK) context. This constructivist grounded theory study therefore aimed to explore, conceptualise, and theorise the 'moving on' experiences of adults with a learning disability and their families. This article reports the experiences of five adults with a learning disability and nine family members in England, UK. Narrative interviews and creative storybook methods were used to collect data between April 2015 and May 2016. Constant comparative methods, theoretical sampling, and memo writing were used throughout data collection and analysis. Participants with a learning disability presented personal growth and greater life fulfilment over the course of the transition; they flourished. In parallel, family members relinquished their care responsibilities. Importantly, the iterative and reciprocal relationship between flourishing and relinquishing shows that ongoing family member involvement is crucial during and following relocation. Family members identified factors that potentially inhibit relinquishing: pressure to 'let go', different perceptions of independence between family members and service providers, inadequate future investment, and rapport with professional carers. These novel insights led to the generation of the first known mid-range theory concerning this transition, entitled 'Moving on: flourishing and relinquishing'. Findings will guide future research in this field and facilitate the design of appropriate support for people with a learning disability and their families.
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Affiliation(s)
- Bethany Taylor
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Tony Ryan
- Health Sciences School, University of Sheffield, Sheffield, UK
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Hermsen M, Simons R, van Veen H, Prudon A, Rooijackers L, Otten R, Koordeman R. Building high-quality interpersonal staff-client relationships with people with severe to profound intellectual disabilities and challenging behavior: Insights of professionals and relatives. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:17-34. [PMID: 36198498 DOI: 10.1177/17446295221131443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background: Staff-client relationships impact the quality of support and life of people with severe to profound intellectual disabilities and challenging behavior, but are challenging to build due to clients' intense, complex and varying support needs. The present study explores the perspectives of professionals and relatives on what affects these interpersonal relationships. Method: 17 professionals and 11 relatives participated in focus groups and interviews. Data collection and analysis was performed in collaboration with a co-researcher. Data were synthesized thematically. Results: Interpersonal relationships constituted equivalence, striving for mutual understanding, trust and exploring clients' potential. The combination of staff characteristics (enthusiasm/passion, patience, resilience, creativity/humor, flexibility) and expertise (knowledge, vulnerability/sincerity, self-reflection) enabled staff to build these relationships. The importance of involving relatives was addressed. Contextual influences included the team (cooperation, flexibility, culture), organization (cooperation, boundary conditions) and setting (predictability, interior/atmosphere). Conclusions: The findings make practical knowledge explicit and scientifically underpinned for this specific population.
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Affiliation(s)
| | - Rianne Simons
- Pluryn, Netherlands
- Radboud University Nijmegen, Netherlands
| | | | | | | | - Roy Otten
- Pluryn, Netherlands
- Radboud University Nijmegen, Netherlands
- Arizona State University, Tempe, AZ, USA
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Tournier T. "Connectedness" between people with intellectual disabilities and challenging behaviour and support staff: Perceptions of psychologists and support staff. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:121-137. [PMID: 35086364 PMCID: PMC9941799 DOI: 10.1177/17446295211056820] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 06/14/2023]
Abstract
The tacit practical knowledge of psychologists and support staff to foster a real connection between support staff and people with intellectual disabilities and challenging behaviour was explored. Therefore, six dyads comprising individuals with intellectual disabilities and challenging behaviour and their support staff were video recorded during joint engagement in an activity. To tap into the implicit knowledge of professionals about when staff have 'a real connection' with a person with an intellectual disability, 10 psychologists and 10 support staff were asked to pinpoint these moments in the pre-recorded video compilation. They also shared their interpretations about what they considered to be a real connection. The results displayed that participants designated real connections as occurring when they noticed concrete interactions taking place. Based on thematic analysis of the data, four themes were identified that encapsulated what professionals deemed to be a real connection. In conclusion: joint engagement in an activity appears to be a context that fosters opportunities for real connection. Furthermore, support staff should adopt a sensitive attitude and create a safe atmosphere, to establish real connections.
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Affiliation(s)
- T Tournier
- T Tournier, Tranzo, Tilburg School of
Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, Tilburg 5000
LE, The Netherlands.
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Chiang YJ, Lee LH, Chen SL, Yang CI. Healthcare workers' experiences of caring for patients diagnosed with intellectual disability co-occurrent with psychiatric disorders. J Psychiatr Ment Health Nurs 2022; 29:842-851. [PMID: 34854163 DOI: 10.1111/jpm.12811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Intellectual disability (ID) involves problems with general mental abilities and affects intellectual functioning and adaptive functioning. People diagnosed with ID present higher levels of functional disability, which means they usually have difficulty or the inability to independently perform basic activities of daily living. Little to no attention has been paid to the issues of the mental health of people diagnosed with ID. Specifically, healthcare workers' experiences of caring for patients with IDPD have been neglected. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The findings increase our understanding and partially address the knowledge gap regarding the situations and circumstances faced by healthcare workers in caring for patients diagnosed with intellectual disability co-occurrent with psychiatric disorders (IDPD). In cases of insufficient staffing, healthcare workers may be forced to ignore the individualized needs of patients so as to facilitate management. Healthcare workers may also feel frustrated by not being able to anticipate or deal with patients' unexpected problem behaviours or accidents. They adapt by adjusting their expectations of their patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Healthcare administrators need to understand the difficulties faced by staff in caring for patients diagnosed with IDPD, arrange appropriate in-service education to increase the healthcare workers' knowledge and skills in caring for patients diagnosed with IDPD, and create warm and supportive environments for them. The government department responsible for the management of ID patient care institutions should be able to regularly monitor the overall staffing and quality of care in these institutions. ABSTRACT: Introduction When intellectual disability co-occurs diagnosed with psychiatric disorders (IDPD), the impact of the burden of illness on the affected individuals, their caregivers, their family and friends, and the services that provide for them is particularly high. The issues of the mental health of people diagnosed with ID have received little, if any, attention. One specific area of neglect is healthcare workers' experiences of caring for patients diagnosed with IDPD. Aim The aim of this study was to understand healthcare workers' experiences of caring for patients diagnosed with IDPD. Methods A qualitative descriptive research approach and semi-structured interviews were used in this study. We interviewed 15 participants who had experience in caring for patients diagnosed with a dual diagnosis of IDPD. Findings Four themes were found, as follows: (1) Negative impacts of insufficient staffing on the quality of care, (2) Constantly worrying about harmful incidents, (3) Discovering effective ways to provide individual patient care and (4) Adjusting expectations and attitudes towards patients. Participants' experiences revealed that they perceived the importance and effectiveness of providing individualized care for IDPD patients. However, when staffing is insufficient, they may be forced to ignore the individualized needs of patients so as to facilitate management. They may also feel frustrated by not being able to anticipate or deal with patients' unexpected problem behaviours or accidents. In addition, they adapt by adjusting their expectations of the patients. Discussion The findings from this research help to fill the knowledge gap in our understanding of healthcare workers' experiences of and their perspectives on caring for patients diagnosed with IDPD. Implications for Practice Healthcare administrators need to understand the difficulties faced by staff in caring for patients diagnosed with IDPD, arrange appropriate in-service education to increase the healthcare workers' knowledge and skills in caring for patients diagnosed with IDPD, and create warm and supportive environments for them. The government department overseeing the management of institutions providing ID patient care should be empowered to conduct regular monitoring of the overall staffing and quality of care in such institutions.
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Affiliation(s)
- Ya-Ju Chiang
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Li-Hung Lee
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
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Ee J, Kroese BS, Lim JM, Rose J. What do specialist mental health professionals think of the mental health services for people with intellectual disabilities in Singapore? JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:972-989. [PMID: 34427139 PMCID: PMC9608008 DOI: 10.1177/17446295211030094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This research aimed to investigate the views and experiences of specialist mental health professionals working with adults with intellectual disabilities and mental health problems in Singapore in order to gain insight into the functioning of the local specialist intellectual disability mental health service and how it may be improved. METHODS Eight staff members from specialist service were interviewed. The transcriptions of the interviews were analysed using thematic analysis. RESULTS Analysis revealed four themes (1) Identifying their roles; (2) Ensuring continuity of care; (3) Disempowerment of service users and (4) Improving clinical practice. CONCLUSIONS Participants identified the challenges they faced working with this population. They highlighted the importance of building therapeutic relationships during the treatment process and discussed the stigma that people with intellectual disabilities face in the community. Recommendations and implications are discussed in relation to service provision, improving staff knowledge and recruiting more staff to work in this field.
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Affiliation(s)
- Jonathan Ee
- Jonathan Ee, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Navallo K. “Let my hands be your hands”: Constructions of intimacy among Filipina migrants in the care of the elderly in Japan. GENDER WORK AND ORGANIZATION 2022. [DOI: 10.1111/gwao.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Katrina Navallo
- Graduate School of Asian and African Area Studies Kyoto University Kyoto Japan
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Simons R, Koordeman R, de Looff P, Otten R. Physiological Measurements of Stress Preceding Incidents of Challenging Behavior in People With Severe to Profound Intellectual Disabilities: Longitudinal Study Protocol of Single-Case Studies. JMIR Res Protoc 2021; 10:e24911. [PMID: 34287220 PMCID: PMC8339975 DOI: 10.2196/24911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 01/29/2023] Open
Abstract
Background Clients with severe to profound intellectual disabilities (SPID) and challenging behavior (CB) and the professional caregivers that support them are vulnerable to high stress levels, which negatively impact their well-being and the quality of care. CB is thought to result from an increase in the intensity and frequency of clients’ stress experiences. In turn, staff members experience stress in dealing with this behavior, and stressed staff members might behave in ways that increase clients’ stress levels, contributing to the origin and maintenance of CB. Research into these dyadic interactions between clients and staff is scarce for people with SPID, especially in real-life situations. The barriers of studying stress in this population include clients’ difficulties in communicating stress experiences and the lack of an objective continuous measure of stress. Objective This paper presents a protocol for studying patterns of physiological stress in 15 client-caregiver dyads in the 30 minutes preceding incidents of CB compared to control periods without CB and the interplay between the stress levels of clients and professional caregivers. Methods We will conduct 15 single-case studies to assess patterns of physiological stress in dyads of clients with SPID and professional caregivers prior to CB in several Dutch residential institutes. Client-caregiver dyads will wear the Empatica E4 wristband for 20 sessions of 3 to 8 hours without interruptions of daily routines while caregivers report clients’ CB. The physiological measures obtained will be electrodermal activity (microsiemens) and heart rate (beats per minute). A multilevel model with repeated measures at the incident level nested within the person level will be applied, employing separate models for electrodermal activity and heart rate to compare stress levels in the 30 minutes prior to incidents with control epochs. Covariates in the models include movement, temperature, and gender. In addition, cross-recurrence quantification analyses will be performed to study the synchronization between the stress levels of clients and professional caregivers. Results The Ethics Committee of the Radboud University (NL-number: NL71683.091.19) approved the study on February 12, 2020. In total, 15 organizations have declared their commitment to participate in the study. The first result is expected in the spring of 2022. Conclusions Study results will demonstrate whether changes in patterns of electrodermal activity and heart rate are apparent in the 30 minutes preceding an incident of CB compared to baseline levels when the client does not engage in CB. The synchronization between caregivers’ and clients’ physiological stress levels will be explored with cross-recurrence quantification analyses. Insights into the physiological stress levels of clients and caregivers may contribute to a reduction of CB and an improvement of both clients’ and caregivers’ safety and well-being. International Registered Report Identifier (IRRID) DERR1-10.2196/24911
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Affiliation(s)
- Rianne Simons
- Department of Research and Development, Pluryn, Nijmegen, Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Renske Koordeman
- Department of Research and Development, Pluryn, Nijmegen, Netherlands
| | - Peter de Looff
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Specialized and Forensic Care, Wier (SGLVG Treatment Center), Den Dolder, Netherlands.,Specialized and Forensic Care, De Borg National Expertise Center, Den Dolder, Netherlands
| | - Roy Otten
- Department of Research and Development, Pluryn, Nijmegen, Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Research and Education Advancing Children's Health Institute, Department of Psychology, Arizona State University, Tempe, AZ, United States
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Simons M, Koordeman R, Willems A, Hermsen M, Rooijackers L, Otten R. Factors facilitating or hindering meaningful staff-client interactions in people with intellectual disabilities and challenging behaviour: A systematic mixed studies review using thematic synthesis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:446-458. [PMID: 33219605 PMCID: PMC7894474 DOI: 10.1111/jar.12830] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Interactions with professional caregivers affect the quality of support and life of people with intellectual disabilities and contribute to the occurrence of challenging behaviour. The present literature review provides an overview of factors facilitating or hindering meaningful staff-client interactions in people with borderline to profound intellectual disabilities and challenging behaviour. METHOD Database searches, reference list and citation screening, and expert consultations were undertaken. A thematic synthesis of 28 studies was performed. RESULTS Factors were identified at the client (i.e. behaviour, emotions and (dis)abilities), staff (i.e. interactive principles, knowledge, psychological resources, attributions, attitudes and (coping with) emotions) and context levels (i.e. group size, team and organization). CONCLUSIONS The present overview provides insights into factors that facilitate or hinder meaningful staff-client interactions with people with intellectual disabilities and challenging behaviour. The results support the need to combine client, staff and contextual factors when considering staff-client interactions in research and practice.
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Affiliation(s)
- M.A.G. Simons
- Research and DevelopmentPlurynNijmegenThe Netherlands
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| | - R. Koordeman
- Research and DevelopmentPlurynNijmegenThe Netherlands
| | | | - M. Hermsen
- Research Centre for Social Support and Community CareNijmegenThe Netherlands
| | | | - R. Otten
- Research and DevelopmentPlurynNijmegenThe Netherlands
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
- REACH InstituteArizona State UniversityTempeAZUSA
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McCausland D, McCallion P, Carroll R, McCarron M. The nature and quality of friendship for older adults with an intellectual disability in Ireland. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:763-776. [DOI: 10.1111/jar.12851] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 10/07/2020] [Accepted: 11/30/2020] [Indexed: 01/07/2023]
Affiliation(s)
- Darren McCausland
- Centre for Ageing and Intellectual Disability School of Nursing & Midwifery Trinity College Dublin Dublin 2 Ireland
| | | | - Rachael Carroll
- Centre for Ageing and Intellectual Disability School of Nursing & Midwifery Trinity College Dublin Dublin 2 Ireland
| | - Mary McCarron
- Centre for Ageing and Intellectual Disability School of Nursing & Midwifery Trinity College Dublin Dublin 2 Ireland
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10
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Gil-Llario MD, Morell-Mengual V, Fernández-García O, Castro-Calvo J, Ballester-Arnal R. Development and psychometric properties of an instrument for the Assessment of Sexual Behaviour and Knowledge of people with Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 35:976-987. [PMID: 33103331 DOI: 10.1111/jar.12823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/06/2020] [Accepted: 09/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND This paper presents psychometric properties of an instrument for the Assessment of Sexual Behaviour and Knowledge of people with Intellectual Disability (ASBKID), other-reported by professionals who are in daily contact with them. METHODS AND PROCEDURES Assessments of 236 individuals with intellectual disability were obtained from 100 professionals. RESULTS Confirmatory factor analysis revealed a four-factor structure: concern about the user's inappropriate or uninhibited sexual behaviour; perception of the user's knowledge about privacy and social norms; perception of the user's knowledge about sexuality; and concerns about the user's sexuality. A multi-group CFA was also conducted in men and women, confirming the adequacy of this four-factor structure by gender. The reliability of the factors ranged from 0.74 to 0.92. CONCLUSIONS The psychometric results obtained support the use of the ASBKID as a valid and reliable measure for the assessment of sexual behaviour and knowledge in both men and women with intellectual disability.
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Affiliation(s)
- María Dolores Gil-Llario
- Department of Developmental and Educational Psychology, Universitat de València, Valencia, Spain
| | - Vicente Morell-Mengual
- Department of Developmental and Educational Psychology, Universitat de València, Valencia, Spain
| | - Olga Fernández-García
- Department of Developmental and Educational Psychology, Universitat de València, Valencia, Spain
| | - Jesús Castro-Calvo
- Department of Personality, Evaluation and Psychological Treatment, Universitat de València, Valencia, Spain
| | - Rafael Ballester-Arnal
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
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Sandjojo J, Eltringham EG, Gebhardt WA, Zedlitz AMEE, Embregts PJCM, Evers AWM. Self-management interventions for people with intellectual disabilities: A systematic review. PATIENT EDUCATION AND COUNSELING 2020; 103:1983-1996. [PMID: 32576421 DOI: 10.1016/j.pec.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/04/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE People with intellectual disabilities (ID) often experience difficulties managing their affairs. This study reviewed self-management interventions for people with mild to moderate ID, studying interventions' effectiveness and applied behavioural change techniques (BCTs). METHODS A systematic literature search was conducted in PubMed, PsychINFO, Web of Science, Embase, Emcare, Cochrane, and ProQuest. Data were extracted on study, intervention, and participant characteristics, and results. RESULTS Of the 681 studies retrieved, 36 met the inclusion criteria. Most studies used case study designs and small samples. There were eight randomised controlled trials and one non-randomised study. Studies were mostly of moderate quality (Mixed Methods Appraisal Tool). Twenty-two interventions targeted a singular practical skill for a specific context. In allinterventions, the provider applied several BCTs; in 13 studies participants were also trained to apply BCTs themselves. In all studies, improvements in self-management were reported, which mostly maintained over time (n = 20). If measured, generalisation to other settings was also found. CONCLUSIONS Future studies should aim for a higher methodological quality and couldconsider targeting more generic self-management and a wider application of BCTs by people with ID themselves. PRACTICE IMPLICATIONS The findings suggest that training can promote self-management in people with ID.
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Affiliation(s)
- Janice Sandjojo
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands; Raamwerk, Noordwijkerhout, the Netherlands.
| | - Emma G Eltringham
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands
| | - Winifred A Gebhardt
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Aglaia M E E Zedlitz
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, the Netherlands
| | - Andrea W M Evers
- Leiden University, Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition (LIBC), Leiden, the Netherlands; Leiden University Medical Center, Department of Psychiatry, Leiden, the Netherlands
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Nouwens PJG, Smulders NBM, Embregts PJCM, van Nieuwenhuizen C. Differentiating care for persons with mild intellectual disability or borderline intellectual functioning: a Delphi study on the opinions of primary and professional caregivers and scientists. BMC Psychiatry 2020; 20:57. [PMID: 32039715 PMCID: PMC7008567 DOI: 10.1186/s12888-020-2437-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/10/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The demand for support for persons with mild intellectual disability or borderline intellectual functioning is growing rapidly. These persons often encounter individual and familial limitations that influence their human functioning, and often have difficulty coping with the demands of modern society. Although in the areas of policy, research and practice, people with mild intellectual disability or borderline intellectual functioning are generally approached as one group, important differences between them have been reported. Current support seems to be both suboptimal and insufficiently differentiated. METHODS In this Delphi study we aimed to explore the need for appropriate and differentiated support for individuals with mild intellectual disability or borderline intellectual functioning. The study was based on five unique profiles of persons with mild intellectual disability or borderline intellectual functioning that are associated with individual and environmental variables. The opinions of expert primary caregivers, professional caregivers and scientists were analysed for potentially appropriate types of support for each of the five profiles. RESULTS A total of 174 statements, divided over the five profiles, were presented to the participants. For 74 statements, consensus was reached between the expert groups. For each profile, these consensual statements represented specific items (e.g. concrete personal goals) and non-specific items (e.g. the attitude towards persons with mild intellectual disability or borderline intellectual functioning, and the coordination of health care) related to the support needs. CONCLUSION This Delphi-based study generated consensual opinions contributing to a more differentiated system of support for individuals with mild intellectual disability or borderline intellectual functioning. Although these findings need additional investigation, they address actions that might enhance the support programmes for these individuals into more personalized support.
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Affiliation(s)
- Peter J. G. Nouwens
- grid.12295.3d0000 0001 0943 3265Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | | | - Petri J. C. M. Embregts
- grid.12295.3d0000 0001 0943 3265Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Chijs van Nieuwenhuizen
- grid.12295.3d0000 0001 0943 3265Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,GGzE Centre for Child & Adolescent Psychiatry, Eindhoven, the Netherlands
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Nijs S, Taminiau EF, Frielink N, Embregts PJCM. Stakeholders' perspectives on how to improve the support for persons with an intellectual disability and challenging behaviors: a concept mapping study. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 68:25-34. [PMID: 35173961 PMCID: PMC8843164 DOI: 10.1080/20473869.2019.1690859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/05/2019] [Accepted: 11/05/2019] [Indexed: 06/14/2023]
Abstract
INTRODUCTION People with an intellectual disability (ID) are at risk of developing challenging behavior. Although previous research provided important insights into how to support people with an ID and challenging behavior, it remains unclear what various stakeholders consider to be the most essential aspects to further improve their support. METHOD Statements regarding aspects perceived necessary to improve the support to people with an ID and challenging behavior were collected in focus groups. Afterwards participants individually prioritized and clustered these statements, resulting in concept maps for people with an ID, direct support workers, and psychologists. Since only three relatives participated in the entire concept mapping procedure, no concept map could be composed based on their input. RESULTS Participants generated 200 statements. In the concept map of clients, statements were mentioned regarding relational aspects, providing clarity and structure, characteristics of support staff, and professional attitude of direct support workers. Direct support workers provided statements related to their own personal competencies, the necessity of feeling supported and appreciated, and a physical safe environment. Psychologists provided statements regarding their support for direct support workers, the support for the clients, the perspective on the client, and their role as psychologists. CONCLUSION The results of this study may be a starting point to foster increased evidence based practice for the support for persons with an ID and challenging behavior. Moreover, it provides opportunities to create care founded on mutual attunement, based on listening to each other's ideas and insight into perspectives and needs of various stakeholders.
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Affiliation(s)
- S. Nijs
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - E. F. Taminiau
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - N. Frielink
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - P. J. C. M. Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Sandjojo J, Gebhardt WA, Zedlitz AM, Hoekman J, den Haan JA, Evers AW. Promoting Independence of People with Intellectual Disabilities: A Focus Group Study Perspectives from People with Intellectual Disabilities, Legal Representatives, and Support Staff. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Janice Sandjojo
- Leiden University; Institute of Psychology, Health, Medical and Neuropsychology Unit; Leiden The Netherlands
- Leiden University; Leiden Institute for Brain and Cognition (LIBC); Leiden The Netherlands
- Raamwerk, Noordwijkerhout; The Netherlands
| | - Winifred A. Gebhardt
- Leiden University; Institute of Psychology, Health, Medical and Neuropsychology Unit; Leiden The Netherlands
- Leiden University; Leiden Institute for Brain and Cognition (LIBC); Leiden The Netherlands
| | - Aglaia M.E.E. Zedlitz
- Leiden University; Institute of Psychology, Health, Medical and Neuropsychology Unit; Leiden The Netherlands
- Leiden University; Leiden Institute for Brain and Cognition (LIBC); Leiden The Netherlands
| | - Joop Hoekman
- Leiden University; Institute of Education and Child Studies, Clinical Child and Adolescent Studies; Leiden The Netherlands
| | | | - Andrea W.M. Evers
- Leiden University; Institute of Psychology, Health, Medical and Neuropsychology Unit; Leiden The Netherlands
- Leiden University; Leiden Institute for Brain and Cognition (LIBC); Leiden The Netherlands
- Leiden University Medical Center; Department of Psychiatry; Leiden The Netherlands
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15
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Sandjojo J, Zedlitz AMEE, Gebhardt WA, Hoekman J, den Haan JA, Evers AWM. Effects of a self-management training for people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:390-400. [PMID: 30353637 PMCID: PMC7379658 DOI: 10.1111/jar.12536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/14/2018] [Accepted: 09/19/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND To help people with intellectual disabilities lead a more independent life, it is important to promote their self-management. This study evaluated the effectiveness of a self-management training for people with intellectual disabilities directed at independent functioning in daily life. METHOD In the training, 17 people with intellectual disabilities worked on personal self-management goals covering a wide range of everyday affairs. Primary outcome measures focused on goal attainment, independence and support needs. Moreover, outcomes regarding psychopathological behaviour and quality of life were explored. Data were collected before and at the start of the training, and 3, 6, 9 and 12 months later. RESULTS The training contributed to the attainment of self-management goals and to the reduction in support needs (p < 0.01). There were no changes in independence, psychopathological behaviour and quality of life. CONCLUSIONS Results indicate that the training supports people with intellectual disabilities to self-manage their daily affairs.
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Affiliation(s)
- Janice Sandjojo
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Raamwerk, Noordwijkerhout, The Netherlands
| | - Aglaia M E E Zedlitz
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Winifred A Gebhardt
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Joop Hoekman
- Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
| | | | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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16
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Sandjojo J, Zedlitz AMEE, Gebhardt WA, Hoekman J, Dusseldorp E, den Haan JA, Evers AWM. Training staff to promote self-management in people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:840-850. [PMID: 29479785 DOI: 10.1111/jar.12440] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disabilities have increasing difficulties managing their daily affairs. This study examined the effectiveness of a staff training, which teaches staff to promote self-management in people with intellectual disabilities. METHOD Effectiveness was assessed with questionnaires addressing clients' (n = 26) independence and self-reliance, support needs and challenging behaviour, using a pre-posttest control group design. Additionally, focus groups were conducted with trained staff members 6 months after the training. RESULTS In the long term, the intervention group showed a significant increase in independence and self-reliance, in contrast to the comparison group. No effect was found on support needs and challenging behaviour. Trained staff members reported limited benefits of the training, but had noticed changes in their attitude and method of working afterwards. CONCLUSIONS Further self-management research is required to investigate how independence and self-reliance can be promoted more effectively in this population. Future trainings should carefully consider their content, format, and implementation.
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Affiliation(s)
- Janice Sandjojo
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Raamwerk, Noordwijkerhout, The Netherlands
| | - Aglaia M E E Zedlitz
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Winifred A Gebhardt
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
| | - Joop Hoekman
- Clinical Child and Adolescent Studies, Institute of Education and Child studies, Leiden University, Leiden, The Netherlands
| | - Elise Dusseldorp
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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17
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Alexandra P, Angela H, Ali A. Loneliness in people with intellectual and developmental disorders across the lifespan: A systematic review of prevalence and interventions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:643-658. [DOI: 10.1111/jar.12432] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 01/06/2023]
Affiliation(s)
| | | | - Afia Ali
- University College London; London UK
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18
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van Asselt-Goverts AE, Embregts PJCM, Hendriks AHC. Social networks of people with mild intellectual disabilities: characteristics, satisfaction, wishes and quality of life. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:450-461. [PMID: 25040897 DOI: 10.1111/jir.12143] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND A supportive social network is crucial for facilitating social inclusion, which can, in turn, contribute to the quality of life (QOL) for people with intellectual disabilities (ID). In this study, we investigate how people with mild ID perceive their social networks and which network characteristics relate to satisfaction with the network and perceived QOL. METHOD Data were gathered from 33 young adults with a mild to borderline ID using structured questionnaires: the MSNA to map the social network, the IDQOL-16 to assess QOL, and a questionnaire to determine satisfaction and wishes with regard to the social network. RESULTS The majority of the participants (73.1%) were satisfied with their social networks. Improvement in the area of strengthening existing ties (e.g. more frequent contact, better contact) was desired as opposed to expansion of the network. Affection--especially towards family and professionals--was most strongly related to perceived QOL. It appears to be essential that relatives live in the same town, can frequently meet up and provide both emotional and practical support. CONCLUSIONS The significance of family and the importance of high-quality interpersonal relationships between professional and client in the lives of young adults with ID cannot be overestimated. Although measures of satisfaction and wishes can have limitations, in actual practice it is considered useful to assess the opinions of clients with respect to their social networks. Interventions can then be tailored to the needs and wishes of the persons themselves.
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Affiliation(s)
- A E van Asselt-Goverts
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands; Tranzo, Tilburg University, Tilburg, The Netherlands
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19
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Simplican SC, Leader G, Kosciulek J, Leahy M. Defining social inclusion of people with intellectual and developmental disabilities: an ecological model of social networks and community participation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:18-29. [PMID: 25543997 DOI: 10.1016/j.ridd.2014.10.008] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/02/2014] [Indexed: 06/04/2023]
Abstract
Social inclusion is an important goal for people with intellectual and developmental disabilities, families, service providers, and policymakers; however, the concept of social inclusion remains unclear, largely due to multiple and conflicting definitions in research and policy. We define social inclusion as the interaction between two major life domains: interpersonal relationships and community participation. We then propose an ecological model of social inclusion that includes individual, interpersonal, organizational, community, and socio-political factors. We identify four areas of research that our ecological model of social inclusion can move forward: (1) organizational implementation of social inclusion; (2) social inclusion of people with intellectual and developmental disabilities living with their families, (3) social inclusion of people along a broader spectrum of disability, and (4) the potential role of self-advocacy organizations in promoting social inclusion.
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Affiliation(s)
- Stacy Clifford Simplican
- MSU-DOCTRID (Michigan State University - Daughters of Charity - Technology, Research Into Disability) Research Institute, Hegarty Fellow Program, Michigan State University, USA; Department of Counseling, Educational Psychology and Special Education, Michigan State University, USA
| | - Geraldine Leader
- Department of Psychology, National University of Ireland, Galway, Ireland.
| | - John Kosciulek
- MSU-DOCTRID (Michigan State University - Daughters of Charity - Technology, Research Into Disability) Research Institute, Hegarty Fellow Program, Michigan State University, USA; Department of Counseling, Educational Psychology and Special Education, Michigan State University, USA
| | - Michael Leahy
- MSU-DOCTRID (Michigan State University - Daughters of Charity - Technology, Research Into Disability) Research Institute, Hegarty Fellow Program, Michigan State University, USA; Department of Counseling, Educational Psychology and Special Education, Michigan State University, USA
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20
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Frielink N, Embregts P. Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2013; 38:279-291. [PMID: 24279780 DOI: 10.3109/13668250.2013.809707] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Motivational interviewing is a promising method to increase treatment motivation for people with mild intellectual disability and challenging behaviour. The purpose of the present study was to identify how professionals could adapt motivational interviewing techniques for use with clients. METHOD We conducted semistructured qualitative interviews and focus groups with 26 clients, parents, and professionals. A general inductive approach led to the identification of multiple core themes. RESULTS The authors recommend several modifications to accommodate motivational interviewing for use with clients: adapt to language level, adjust to cognitive abilities, and control for social desirability of responding. In addition, certain characteristics of professionals were also found to be critical for effective motivational interviewing: trustworthiness, engagement, acceptance, empathy, and honesty. CONCLUSIONS Concrete recommendations for the adaptation of the motivational interviewing techniques for use with people with mild intellectual disability and challenging behaviour are identified. Certain characteristics of professionals are also critical for maximising the treatment motivation of clients.
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Affiliation(s)
- Noud Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University , the Netherlands
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