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Gur A, Bina R. Facilitators of Sense of Belonging Among People With Intellectual and Developmental Disabilities: A Systematic Review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:516-538. [PMID: 35271785 DOI: 10.1177/17446295211068424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Background: This review synthesizes the available literature regarding factors which facilitate a sense of belonging in people with intellectual and developmental disabilities, and provide a comprehensive integrative view of the subject. Methods: Four electronic databases were searched, and 13 studies met inclusion criteria for review. The "standard quality assessment criteria for evaluating primary research papers from a variety of fields" indicated satisfactory quality. Factors which facilitate a sense of belonging in people with intellectual and developmental disabilities were analyzed into themes. Results: Sense of belonging is enhanced by feeling respected, accepted, and valued (Subjectivity). These experiences are more likely to be achieved in a familiar and safe environment (Dynamism), and with access to platforms for social interactions (Groundedness), where a sense of relatedness and connectedness achieved by shared experiences with others (Reciprocity). Sense of belonging is associated with committed action of people with disability, taking assertive action or being agentic (Self-determination). Conclusion: Sense of belonging is a unique concept that should be addressed in disability research and practice.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Kiryat Shmona, Israel
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Rena Bina
- Social Work Department, Tel-Hai College, Kiryat Shmona, Israel
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
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Gijzel SMW, Rector J, van Meulen FB, van der Loeff RS, van de Leemput IA, Scheffer M, Olde Rikkert MGM, Melis RJF. Measurement of Dynamical Resilience Indicators Improves the Prediction of Recovery Following Hospitalization in Older Adults. J Am Med Dir Assoc 2019; 21:525-530.e4. [PMID: 31836428 DOI: 10.1016/j.jamda.2019.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/07/2019] [Accepted: 10/16/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Acute illnesses and subsequent hospital admissions present large health stressors to older adults, after which their recovery is variable. The concept of physical resilience offers opportunities to develop dynamical tools to predict an individual's recovery potential. This study aimed to investigate if dynamical resilience indicators based on repeated physical and mental measurements in acutely hospitalized geriatric patients have added value over single baseline measurements in predicting favorable recovery. DESIGN Intensive longitudinal study. SETTING AND PARTICIPANTS 121 patients (aged 84.3 ± 6.2 years, 60% female) admitted to the geriatric ward for acute illness. MEASUREMENTS In addition to preadmission characteristics (frailty, multimorbidity), in-hospital heart rate and physical activity were continuously monitored with a wearable sensor. Momentary well-being (life satisfaction, anxiety, discomfort) was measured by experience sampling 4 times per day. The added value of dynamical indicators of resilience was investigated for predicting recovery at hospital discharge and 3 months later. RESULTS 31% of participants satisfied the criteria of good recovery at hospital discharge and 50% after 3 months. A combination of a frailty index, multimorbidity, Clinical Frailty Scale, and or gait speed predicted good recovery reasonably well on the short term [area under the receiver operating characteristic curve (AUC) = 0.79], but only moderately after 3 months (AUC = 0.70). On addition of dynamical resilience indicators, the AUC for predicting good 3-month recovery increased to 0.79 (P = .03). Variability in life satisfaction and anxiety during the hospital stay were independent predictors of good 3-month recovery [odds ratio (OR) = 0.24, P = .01, and OR = 0.54, P = .04, respectively]. CONCLUSIONS AND IMPLICATIONS These results highlight that measurements capturing the dynamic functioning of multiple physiological systems have added value in assessing physical resilience in clinical practice, especially those monitoring mental responses. Improved monitoring and prediction of physical resilience could help target intensive treatment options and subsequent geriatric rehabilitation to patients who will most likely benefit from them.
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Affiliation(s)
- Sanne M W Gijzel
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Environmental Sciences, Wageningen University, Wageningen, the Netherlands
| | - Jerrald Rector
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Fokke B van Meulen
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rolinka Schim van der Loeff
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Marten Scheffer
- Department of Environmental Sciences, Wageningen University, Wageningen, the Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - René J F Melis
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
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Carbó-Carreté M, Guàrdia-Olmos J, Peró-Cebollero M, Giné C. Impact of the intellectual disability severity in the Spanish Personal Outcomes Scale. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1221-1233. [PMID: 31115999 DOI: 10.1111/jir.12634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 03/14/2019] [Accepted: 04/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The interest in measuring quality of life (QoL) in persons with intellectual disability (ID) has brought about a number of QoL measurements for this population. These measurements need to address two issues that have contributed to enhancing the current instruments. First, the necessity to develop measures with adequate psychometric properties, which has been discussed in recent studies, and second, the agreement between experts in analysing objective and subjective perspectives, as well as the use of self-report to include the participation of the person with ID. The question that we set out to investigate in this paper is whether the measurements function properly for the person with ID, independent of their level of severity. We used the Spanish version of the Personal Outcomes Scale, as it is a psychometrically sound instrument and includes three sources of information (the person with ID, a professional and a family member). METHOD The sample was composed of 529 persons with ID (296 men, representing 55.95% of the total sample, and 233 women, with Mage = 35.03, SD = 10.82) from several regions of Spain, along with their professional of reference and a family member. The severity variable was estimated for each item based on estimations of differential item functioning. RESULTS The results showed that several items were undervalued by the assessments if the severity of the ID was greater. Mainly, this difference was observed in the assessments by professionals and in the dimensions of rights, personal development and self-determination. CONCLUSIONS This paper focuses on the uses and interpretations of the results of the QoL measurements in the Personal Outcomes Scale. The results indicate that, in our sample, when people with high levels of ID are assessed, the functioning of some items are affected by the severity of this disability. For correct use, these items must be interpreted on the basis of the results obtained. Additionally, it is necessary to thoroughly review the QoL indicators for persons with severe or profound ID.
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Affiliation(s)
| | - J Guàrdia-Olmos
- Faculty of Psychology, Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Spain
| | - M Peró-Cebollero
- Faculty of Psychology, Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Spain
| | - C Giné
- Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Spain
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Delle Fave A, Bassi M, Allegri B, Cilia S, Falautano M, Goretti B, Grobberio M, Minacapelli E, Pattini M, Pietrolongo E, Valsecchi M, Amato MP, Lugaresi A, Patti F. Beyond Disease: Happiness, Goals, and Meanings among Persons with Multiple Sclerosis and Their Caregivers. Front Psychol 2017; 8:2216. [PMID: 29326635 PMCID: PMC5742493 DOI: 10.3389/fpsyg.2017.02216] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 12/07/2017] [Indexed: 01/07/2023] Open
Abstract
The experience of persons with multiple sclerosis (MS) and their caregivers is usually investigated in terms of emotional distress and health-related quality of life, while well-being indicators remain largely underexplored. In addition, findings are often interpreted from the clinical perspective, neglecting socio-cultural aspects that may crucially contribute to individuals' functioning. At the methodological level, most studies rely on scaled instruments, not allowing participants to freely express their needs and resources. Based on the bio-psycho-social perspective endorsed by the International Classification of Functioning, well-being indicators were investigated among 62 persons with MS (PwMS), their 62 caregivers and two control groups, matched by age and gender. Participants completed the Positive Affect Negative Affect Schedule (PANAS), the Satisfaction with Life Scale (SWLS), and the Eudaimonic and Hedonic Happiness Investigation instrument (EHHI). EHHI provides information on participants' happiness, goals and meanings through scaled and open-ended questions, contextualized within major life domains. No relevant differences emerged among PwMS and caregivers, compared with the respective control groups, as concerns life domains associated with happiness, goals and meaning. Participants across groups prominently mentioned family, highlighting its intrinsic value and its relevance as a sharing context; health did not represent a major theme for PwMS; community, society and religion/spirituality issues were substantially neglected by all participants. PwMS and caregivers reported lower levels of positive affect than their control groups, while no substantial differences emerged for negative affect, happiness and meaningfulness levels in life and across most domains. Results suggest that the experience of MS is associated with well-being in relevant life domains, such as family and close relationships. Although PwMS and caregivers identified a lower number of goals and meaning-related opportunities compared to control groups, they showed a positive adjustment to disease through the development of personal and family resources. These assets are often undervalued by health professionals and social institutions, while they could be fruitfully exploited through the active involvement of PwMS and their families as expert and exemplary informants in initiatives aimed at promoting the well-being of individuals and communities
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Affiliation(s)
- Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences "L.Sacco", Università degli Studi di Milano, Milan, Italy
| | - Beatrice Allegri
- Neurology Unit, Multiple Sclerosis Centre, Ospedale di Vaio-Fidenza, Fidenza, Italy
| | - Sabina Cilia
- Ospedale Policlinico Universitario G. Rodolico, Catania, Italy
| | - Monica Falautano
- Neurological Department, San Raffaele Hospital (IRCCS), Milan, Italy
| | | | - Monica Grobberio
- Laboratory of Clinical Neuropsychology, ASST Lariana, Como, Italy
| | | | - Marianna Pattini
- Neurology Unit, Multiple Sclerosis Centre, Ospedale di Vaio-Fidenza, Fidenza, Italy
| | - Erika Pietrolongo
- Department of Neurosciences, Imaging and Clinical Science, Università degli Studi 'G. d'Annunzio' Chieti - Pescara, Chieti, Italy
| | | | - Maria Pia Amato
- Department of NEUROFARBA, University of Florence, Florence, Italy
| | - Alessandra Lugaresi
- Department of Biomedical and Neuromotor Sciences, Università di Bologna, Bologna, Italy
| | - Francesco Patti
- Ospedale Policlinico Universitario G. Rodolico, Catania, Italy
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Guàrdia-Olmos J, Carbó-Carreté M, Peró-Cebollero M, Giné C. Item response theory analysis applied to the Spanish version of the Personal Outcomes Scale. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:1021-1033. [PMID: 28833804 DOI: 10.1111/jir.12407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 07/11/2017] [Accepted: 07/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The study of measurements of quality of life (QoL) is one of the great challenges of modern psychology and psychometric approaches. This issue has greater importance when examining QoL in populations that were historically treated on the basis of their deficiency, and recently, the focus has shifted to what each person values and desires in their life, as in cases of people with intellectual disability (ID). Many studies of QoL scales applied in this area have attempted to improve the validity and reliability of their components by incorporating various sources of information to achieve consistency in the data obtained. The adaptation of the Personal Outcomes Scale (POS) in Spanish has shown excellent psychometric attributes, and its administration has three sources of information: self-assessment, practitioner and family. The study of possible congruence or incongruence of observed distributions of each item between sources is therefore essential to ensure a correct interpretation of the measure. The aim of this paper was to analyse the observed distribution of items and dimensions from the three Spanish POS information sources cited earlier, using the item response theory. METHOD We studied a sample of 529 people with ID and their respective practitioners and family member, and in each case, we analysed items and factors using Samejima's model of polytomic ordinal scales. RESULTS The results indicated an important number of items with differential effects regarding sources, and in some cases, they indicated significant differences in the distribution of items, factors and sources of information. CONCLUSIONS As a result of this analysis, we must affirm that the administration of the POS, considering three sources of information, was adequate overall, but a correct interpretation of the results requires that it obtain much more information to consider, as well as some specific items in specific dimensions. The overall ratings, if these comments are considered, could result in bias.
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Affiliation(s)
- J Guàrdia-Olmos
- Faculty of Psychology, Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain
| | - M Carbó-Carreté
- Faculty of Psychology, Education and Sport Sciences, Blanquerna, Ramon Llull University, Barcelona, Spain
| | - M Peró-Cebollero
- Faculty of Psychology, Institute for Brain, Cognition and Behaviour (IR3C), University of Barcelona, Barcelona, Spain
| | - C Giné
- Faculty of Psychology, Education and Sport Sciences, Blanquerna, Ramon Llull University, Barcelona, Spain
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Simões C, Santos S. Comparing the quality of life of adults with and without intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:378-388. [PMID: 26806030 DOI: 10.1111/jir.12256] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 11/05/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Quality of life (QOL) is an important issue for all citizens, comprising equity, equality, inclusion and participation of each person in society. The research purposes driving this investigation were (1) to compare QOL among people with and without intellectual disability (ID) and (2) to examine the predictors of QOL in both groups of participants. METHODS Data were collected from 1929 adults, including 1264 individuals with an ID and the remainder (n = 665) were participants without a disability. QOL was assessed by the Portuguese version of the Personal Outcomes Scale. RESULTS The findings supported significantly higher QOL for adults without ID. Furthermore, QOL is influenced by individual and environmental variables, stressing that the health status was the highest mutual predictor of QOL among those with and without ID. CONCLUSION The gaps among both groups of participants should be addressed in service provision and policies. Taking into account the research findings, the personalised supports should enable the full inclusion and participation of adults with ID in community-based settings.
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Affiliation(s)
- C Simões
- University of Lisbon, Faculty of Human Kinetics, Lisbon, Portugal
| | - S Santos
- University of Lisbon, Faculty of Human Kinetics, Lisbon, Portugal
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Luijkx J, Ten Brug A, Vlaskamp C. Does the severity of disability matter? The opinion of parents about professional support in residential facilities. Child Care Health Dev 2016; 42:8-15. [PMID: 26482821 DOI: 10.1111/cch.12297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 08/25/2015] [Accepted: 09/06/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Researchers have shown that the characteristics of a person with an intellectual disability (ID), in particular the severity of the disability, are related to the outcomes of professional support. Hardly any studies have asked parents and/or legal guardians for their own opinion about the quality of support given to their child/family member with ID. Therefore, this study examined the relationship between the severity of a person's disability and the opinions voiced by the parents and/or other legal guardians of that person concerning several aspects of the quality of support received in residential care. METHOD Questionnaires were completed by 1058 parents and/or legal guardians of people with ID living in residential facilities. A multiple covariance analysis was conducted to explore the relationship between the severity of the disability and the parents' and/or legal guardians' opinions. RESULTS Only small differences in the opinions about the quality of support were observed between parents and/or legal guardians of people with mild to moderate ID and those of people with severe to profound ID. CONCLUSION This study showed that there are differences in parental opinions about the quality of support, but that most of these differences are not related to the severity of disability. The only significant difference related to the severity of disability is on the leisure activities domain. Parents and/or legal guardians of a person with severe/profound ID were less satisfied with leisure activities than parents and/or legal guardians of persons with mild/moderate ID. It is important to determine to what other factors parental opinions are related, as these opinions concerning the quality of support are important measures alongside client self-reports and measures of the facility itself. The quality of support should be measured using a combination of methods for different stakeholders.
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Affiliation(s)
- J Luijkx
- Department of Special Needs Education and Child Care, University of Groningen, Groningen, Netherlands
| | - A Ten Brug
- Department of Special Needs Education and Child Care, University of Groningen, Groningen, Netherlands
| | - C Vlaskamp
- Department of Special Needs Education and Child Care, University of Groningen, Groningen, Netherlands
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Gray JA, Abendroth M. Perspectives of US Direct Care Workers on the Grief Process of Persons with Intellectual and Developmental Disabilities: Implications for Practice. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:468-80. [DOI: 10.1111/jar.12189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Jennifer A. Gray
- School of Nursing and Health Studies; Northern Illinois University; DeKalb IL USA
| | - Maryann Abendroth
- School of Nursing and Health Studies; Northern Illinois University; DeKalb IL USA
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Fianco A, Sartori RDG, Negri L, Lorini S, Valle G, Delle Fave A. The relationship between burden and well-being among caregivers of Italian people diagnosed with severe neuromotor and cognitive disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 39:43-54. [PMID: 25666898 DOI: 10.1016/j.ridd.2015.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/22/2014] [Accepted: 01/19/2015] [Indexed: 05/15/2023]
Abstract
In studies on caregiving, high levels of perceived burden are commonly considered as synonymous with poor well-being. This study aimed at better disentangling the relationship between burden and well-being dimensions through their joint investigation. To this purpose, perceived well-being and social resources were evaluated among caregivers reporting different levels of burden. Participants were 91 caregivers (mean age=50.4; SD=9.6), parents of people diagnosed with severe neuromotor and cognitive disorders. Participants completed a semi-structured interview and a set of scaled questionnaires: Caregiver Burden Inventory (CBI), Satisfaction with Life Scale, Positive and Negative Affect Schedule, Depression Anxiety Stress Scale, Eudaimonic and Hedonic Happiness Investigation, Resilience Scale for Adults, and Multidimensional Scale of Perceived Social Support. Participants were divided into two groups according to their perceived burden level, assessed through CBI. In both groups, the subjective components of burden accounted for the major fraction of the total burden level. Participants perceiving high burden reported higher levels of depression related emotions, lower life satisfaction and lower resilience than participants perceiving low burden. No group difference emerged in perceived meaningfulness and social support. A regression analysis showed that the best predictor of perceived burden was life satisfaction, followed to a lesser extent by resilience, while depression related emotions did not provide significant contribution. Findings suggest that the joint assessment of burden and well-being dimensions, that are co-existing in caregivers' experience, allow for the identification of personal and relational resources that can be usefully included in interventions addressed to caregivers.
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Affiliation(s)
- Andrea Fianco
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Raffaela D G Sartori
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Luca Negri
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
| | - Saverio Lorini
- IRCCS Fondazione Don Carlo Gnocchi, Centro IRCSS "S. Maria Nascente", Via A. Capecelatro, 66, 20148 Milano, Italy
| | - Giovanni Valle
- IRCCS Fondazione Don Carlo Gnocchi, Centro IRCSS "S. Maria Nascente", Via A. Capecelatro, 66, 20148 Milano, Italy.
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milano, Via F. Sforza, 35, 20146 Milano, Italy.
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The subjective well-being of individuals diagnosed with comorbid intellectual disability and attention deficit hyperactivity disorders. Qual Life Res 2015; 24:1875-86. [PMID: 25676860 DOI: 10.1007/s11136-015-0936-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The present study's aim was to empirically explore subjective well-being (SWB) and its correlates among adults diagnosed with comorbid intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD). This exploration was guided by the Theory of SWB Homeostasis as a conceptual framework for examining determinants and processes underlying the SWB of this understudied population. METHOD A total of 246 adults receiving residential support completed questionnaires measuring their SWB, ADHD symptomatology, functional limitations, and individual internal (self-determination) and external (financial resources, and social support) resources. RESULTS The participants' SWB was found to be within the normative range. ADHD symptomatology directly predicted reductions in SWB; however, according to the theory, this effect was fully mediated by the individual's internal and external resources. CONCLUSIONS The main findings support the applicability of the SWB Homeostasis theory for understanding the SWB of individuals with comorbid ID and ADHD. The study findings shed light on the psychosocial determinants of SWB and highlight the importance of psychosocial resources as buffers of the effect of health and environmental conditions.
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Abstract
AIM To report a concept analysis of family homeostasis. BACKGROUND As family members are a majority of informal caregivers, negative consequences from caregiving duty create a vicious cycle in the family unit resulting in ongoing health crises and care challenges. DESIGN Concept analysis. DATA SOURCES Forty empirical studies published from 1956-2012 were selected by searching five electronic bibliographical databases and by a manual search conducted from 2012-2013. Search terms included 'family homeostasis', 'homeostasis in family', 'homeostatic care' and 'family equilibrium'. Clinical experiences in nursing practice were used for constructing cases and clinical implications. METHODS Walker and Avant's method guided this analysis. RESULTS Family homeostasis is defined as the capacity and mechanisms by which equilibrium is re-established in the family after a change occurs. Five critical attributes are identified: (1) predetermined setpoint; (2) self-appraised antecedents; (3) interdependence; (4) tendency to stability; and (5) feedback mechanisms. Antecedents include any type of causative change beyond the tolerable limit, while consequences encompass intermediate and long-term outcomes as well as equilibrium itself. CONCLUSION Family homeostasis provides a conceptual rationale of family caregiving. While care recipients remain the primary beneficiaries of healthcare provision, homeostatic mechanisms are required to support the family caregiver's valuable contribution in the caring process to enhance family well-being. Further study should expand the definition and settings of family to reflect healthcare needs of diverse types of families and from the perspectives of different healthcare providers.
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Affiliation(s)
- Heejung Kim
- University of Kansas, School of Nursing, Kansas, USA
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Rey L, Extremera N, Durán A, Ortiz-Tallo M. Subjective Quality of Life of People with Intellectual Disabilities: The Role of Emotional Competence on Their Subjective Well-Being. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 26:146-56. [PMID: 23230008 DOI: 10.1111/jar.12015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2012] [Indexed: 11/27/2022]
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Claes C, Vandevelde S, Van Hove G, van Loon J, Verschelden G, Schalock R. Relationship between Self-Report and Proxy Ratings on Assessed Personal Quality of Life-Related Outcomes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2012. [DOI: 10.1111/j.1741-1130.2012.00353.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Geert Van Hove
- Ghent University; Department of Orthopedagogics; Ghent; Belgium
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Bell BG, Clegg J. An Ecological Approach to Reducing the Social Isolation of People With an Intellectual Disability. ECOLOGICAL PSYCHOLOGY 2012. [DOI: 10.1080/10407413.2012.673983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nieboer AP, Cramm JM, van der Meij B, Huijsman R. Choice processes and satisfaction with care according to parents of children and young adults with intellectual disability in The Netherlands. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2011; 36:127-136. [PMID: 21609298 DOI: 10.1080/13668250.2011.573471] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Despite the expressed desire for access to information on care providers and increased availability of this information, the use of available information falls short of expectations. We lack research on the decision-making processes and on how these processes are influenced. A study that employs "real-life" decisions is necessary. METHODS Our experimental study design established the effects of providing decision-support information only (services/quality indicators) and providing a combination of information and personal decision-making support (counselling/peer meetings) on the choice process and satisfaction with care. RESULTS These forms of support affected the choice process, but did not affect satisfaction with care. Decision-support information combined with personal decision-making support led to less frequent switching of care providers and to more satisfaction with choice information. Parents make limited use of online decision-support information, but did use decision counselling. CONCLUSION This population is better supported with an intensified personal approach rather than through the current generic approach using websites.
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Affiliation(s)
- Anna P Nieboer
- Institute of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands.
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Vos P, De Cock P, Petry K, Van Den Noortgate W, Maes B. What makes them feel like they do? Investigating the subjective well-being in people with severe and profound disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2010; 31:1623-1632. [PMID: 20547036 DOI: 10.1016/j.ridd.2010.04.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 04/23/2010] [Indexed: 05/29/2023]
Abstract
BACKGROUND Because of the problems measuring subjective well-being in people with severe and profound intellectual disabilities, there are no studies to date which explore the factors contributing to the subjective well-being in these groups. We wanted to explore the client and service characteristics contributing to the subjective well-being of persons with severe and profound intellectual disabilities, as measured by the MIPQ (Ross & Oliver, 2003). MATERIALS AND METHODS The MIPQ was completed for 360 persons with severe or profound intellectual disabilities by a member of the direct support staff. They also provided us with information on client, service and informant characteristics. RESULTS We found that the subjective well-being of persons with profound intellectual disabilities was lower than the subjective well-being of people with mild, moderate or severe intellectual disabilities or people without disabilities. Client and informant characteristics but no service characteristics were found to have an influence on the subjective well-being of people with severe and profound intellectual disabilities. CONCLUSION As it is important for policy making to identify residence service and staff factors related to subjective well-being of persons with severe and profound intellectual disabilities, further research should try to identify these factors, taking in account the client characteristics that are found to be related to subjective well-being in this study.
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Affiliation(s)
- Pieter Vos
- Katholieke Universiteit Leuven, Centre for Parenting, Child Welfare and Disability, Vesaliusstraat 2, P.O. Box 3765, B-3000 Leuven, Belgium.
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Love and emotional well-being in people with intellectual disabilities. SPANISH JOURNAL OF PSYCHOLOGY 2009; 12:204-16. [PMID: 19476233 DOI: 10.1017/s113874160000161x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Love has been a recurrent topic throughout history, and especially, literature. Moreover, there is generalized agreement about its relevance for health emotional well-being, and quality of life. This study was carried out with a sample of 376 persons with ID. The goals of the work were to analyze a theoretical model of love in people with intellectual disabilities by means of the methodology of structural equations, and to analyze their perception of love and of amorous relations with regard to other aspects such as amorous satisfaction, perceived satisfaction, absence of family interference, self-determination, and emotional well-being. The results revealed that (a) the construct under study has three factors: Commitment, stability, and idealization, Passion and physiological excitement, and Intimacy and romanticism; (b) the perception of love in this collective is, in general, idealized and affected by the context; and (c) self-determination and the lack of family interference are relevant variables to explain both love and emotional well-being.
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Dunn MC, Clare ICH, Holland AJ. Substitute decision-making for adults with intellectual disabilities living in residential care: learning through experience. HEALTH CARE ANALYSIS 2008; 16:52-64. [PMID: 18240026 PMCID: PMC2675034 DOI: 10.1007/s10728-007-0053-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2006] [Accepted: 04/20/2007] [Indexed: 10/23/2022]
Abstract
In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, 'strategic substitute decision-making', paralleled the MCA's legal and ethical framework, whilst the second process, 'relational substitute decision-making', was markedly different from these statutory procedures. In this setting, 'relational substitute decision-making' underpinned everyday personal and social interventions connected with residents' daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed.
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Affiliation(s)
- Michael C Dunn
- Learning Disabilities Research Group, Department of Psychiatry (Section of Developmental Psychiatry), University of Cambridge, Douglas House, Cambridge CB2 8AH, UK.
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Ruta D, Camfield L, Donaldson C. Sen and the art of quality of life maintenance: Towards a general theory of quality of life and its causation. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.socec.2006.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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