Majority and Minority Ethnic Family Carers of Adults with Intellectual Disabilities: Perceptions of Challenging Behaviour and Family Impact

Factors Associated with the Anxiety, Subjective Psychological Well-Being and Self-Esteem of Parents of Blind Children

The objective was to examine the connection of the personal, social and family context, educational variables with the levels of anxiety, subjective psychological well-being and self-esteem in a sample of 61 parents of blind children. Results suggest that parents present less anxiety when they have only one child, possess a technical degree, receive remuneration for their work, their child’s visual impairment is not progressive, their knowledge about their child’s disability is appropriate, and their leisure and labour possibilities have not been affected. Their psychological well-being is higher when they are married in first nuptials and perceive that their health is good. Their well-being is negatively related to reduced leisure, and self-esteem is lower when labour possibilities have been affected. In order for these families to achieve a more pleasant life, with greater psychological well-being, lower anxiety and higher self-esteem, professionals should be aware of the aspects with a negative impact.

Developing resources to facilitate culturally-sensitive service planning and delivery - doing research inclusively with people with learning disabilities

PLAIN ENGLISH SUMMARY

(Please see www.Toolsfortalking.co.uk for an easy read summary of the project.) The Tools for Talking are a set of resources that were developed through collaboration between Black, Asian and minority ethnic people with learning disabilities and researchers at the University of Birmingham. The resources were designed to be used by people with learning disabilities and service providers to facilitate culturally-sensitive communication and information sharing, service planning and delivery. They comprise illustrative videos and exploratory activities relating to five topics, namely, culture, activities, support from staff, important people, choices and independence. These topics emerged as important to people with learning disabilities during the 'Access to Social Care-Learning Disabilities' (ASC-LD) study which involved interviews with 32 adults with learning disabilities from Black, Asian and minority ethnic communities. The results of the ASC-LD study were used to develop a set of draft resources which were then co-developed through collaboration with people with learning disabilities and service providers. A 'Partnership event' was convened to involve stakeholders in the development of the resources. This paper describes the refinement of these materials by people with learning disabilities from Black, Asian and minority ethnic backgrounds in cooperation with a range of other stakeholders.

ABSTRACT

Background Black, Asian and minority ethnic people with learning disabilities face inequities in health and social care provision. Lower levels of service uptake and satisfaction with services have been reported, however, this is largely based on the views of carers. The 'Access to Social Care: Learning Disabilities (ASC-LD)' study sought to explore the views and experiences of social support services among adults with learning disabilities from Black, Asian and minority ethnic communities. Interviews with 32 Black, Asian and minority ethnic adults with learning disabilities were conducted to explore participants' cultural identities, their understanding and experience of 'support'. The views and experiences expressed in the ASC-LD study were used in the 'Tools for Talking project' to develop a suite of resources designed to facilitate culturally-sensitive communication and information-sharing, service planning and delivery through improved mutual understanding between providers and users of services. This paper describes the Tools for Talking project which sought to co-develop the resources through a partnership event. Methods An inclusive approach was adopted to address issues that are important to people with learning disabilities, to represent their views and experiences, and to involve Black, Asian and minority ethnic people with learning disabilities in the research process. Partnerships were developed with provider organisations and service users who were invited to a 'Partnership Event'. Collaborators at the partnership event were asked to comment on and evaluate draft resources which included a series of videos and activities to explore topics that emerged as important in the ASC-LD study. Their comments were collated and the tools developed as they suggested. Results Using the results from the ASC-LD study helped to ensure that the draft resources were relevant to service users, addressing topics that were important to them. The partnership event was an effective method to collaborate with a relatively large number of stakeholders. However, the event was resource intensive and required substantial planning to ensure active and meaningful participation. Considerations, such as inviting stakeholders, developing the programme and selecting a venue are discussed. Conclusions The partnership approach has led to the development of a set of five illustrative videos and accompanying activities that address issues that emerged from the collaborative process including: culture, activities, support from staff, important people, choices and independence. These resources are freely available at: www.Toolsfortalking.co.uk. They are designed to be used by users and providers of services, but may also be useful in other settings.

Subjective Psychological Well-Being in Families with Blind Children: How Can We Improve It?

The aim of this work was to examine family well-being in a sample of Spanish families with blind children. Sixty-one participants reported their perceived economic status, the level of job satisfaction, and state-anxiety symptoms. The participants of our study scored higher on state-anxiety and lower on material well-being than the normative sample, although these differences did not reach statistical significance. They also scored higher on job satisfaction and family satisfaction than the general population. A negative correlation was found between state-anxiety and material well-being (r = - 0.62, p = 0.001) and between state-anxiety and family satisfaction (r = - 0.57, p = 0.001). A positive correlation was found between material well-being and job satisfaction (r = 0.40, p = 0.001), and between material well-being and family satisfaction (r = 0.41, p = 0.001). Higher levels of material well-being, job satisfaction, and family satisfaction were associated with lower levels of anxiety in these families. However, no statistically significant correlation was found between family satisfaction and job satisfaction. Our results suggest that the family experience of having a disabled child is evolving, and this implies achieving greater job and family satisfaction than the normative samples, although anxiety scores continue to be higher and material well-being scores remain lower. On the whole, our results confirm that it is necessary to provide these families with more economic resources, which would have a positive impact on their subjective psychological well-being, decreasing their state-anxiety, and increasing their satisfaction with life.

The Challenges of Providing Culturally Competent Care Within a Disability Focused Team

Purpose: The study explored how service providers address the challenges of providing culturally competent care within disability services in the United Kingdom. Design/Method: Focus groups and interpretative phenomenological analysis were used to explore the experiences of 20 service providers from a range of professions, working with South Asian families. Results/Findings: Two superordinate themes emerged. The first concentrated on difficulties with language and communication and the challenges posed by the use of interpreters. The second included five subthemes that broadly described a five-stage process of dealing with barriers and engagement to service delivery, followed by reflections on the effort made to provide culturally competent care in the face of limited resources and training. Discussion/Conclusion: The study makes recommendations for cultural competency within health and social care services.

Raising a child with disability and dealing with life events: a mother's journey

Intellectual disability services recognise people with intellectual disability as a family member and aim to provide effective support that facilitates family cohesion. However, the needs of families and individuals within the family should be addressed in a holistic manner to ensure a seamless service. This article outlines a mother's reflections on her experience of raising a child with autism spectrum disorder and its impact on her life. The article focuses on one mother's feelings, coping or lack of coping and growth during a time of sadness. This article written by a mother, nurse and academic through their shared interest in supporting families of children with a disability all came together to tell this story. It is hoped that this article will assist professionals understand a mother's perspective when raising a child with intellectual disability and support professionals to recognise the importance of listening, coordinated support and working in partnership.

Stigma, public awareness about intellectual disability and attitudes to inclusion among different ethnic groups

BACKGROUND

Attitudes to the inclusion of people with intellectual disabilities (IDs) have been studied extensively, yet evidence on public awareness about ID and stigma is limited. The relationship between attitudes, knowledge and stigma associated with ID is poorly understood. The present study examined these factors and the relationships between them in the context of a multicultural society.

METHOD

UK residents of working age (n = 1002) were presented with a diagnostically unlabelled vignette of someone with a mild ID. They were asked to label the difficulties presented and to complete measures of social distance and attitudes to the inclusion of people with IDs.

RESULTS

While attitudes to the inclusion of people with IDs were relatively positive overall, social contact was viewed with ambivalence. Inclusion attitudes and social distance were only moderately correlated. Across the whole sample 28% recognised typical symptoms of mild ID. Recognition of ID was associated with lower stigma and more positive attitudes than attribution of the difficulties presented to other causes. White Westerners showed increased knowledge, lower stigma and favoured inclusion more than participants from ethnic minorities. Among the latter group, Asians showed lower stigma and attitudes more in line with inclusion policies than participants of Black African/Caribbean backgrounds. Once a host of contextual factors were considered jointly, only contact was consistently associated with the variables measured.

CONCLUSIONS

Stigma associated with ID is of concern across all ethnic groups, although it appears to be increased among the public from ethnic minorities. Given that contact and awareness are associated with reduced stigma, they should be considered as prime foci for efforts to tackle ID stigma. The current findings serve as baseline for attempts to increase public awareness and tackle stigma.

Family carers' perspectives on post-school transition of young people with intellectual disabilities with special reference to ethnicity

BACKGROUND

School leavers with intellectual disabilities (ID) often face difficulties in making a smooth transition from school to college, employment or more broadly to adult life. The transition phase is traumatic for the young person with ID and their families as it often results in the loss of friendships, relationships and social networks.

METHOD

The aim of this study was to explore the family carers' views and experiences on transition from school to college or to adult life with special reference to ethnicity. Forty-three families (consisting of 16 White British, 24 Pakistani, 2 Bangladeshi and one Black African) were interviewed twice using a semi-structured interview schedule. The carers were interviewed twice, Time 1 (T1) and Time 2 (T2), T2 being a year later to observe any changes during transition.

RESULTS

The findings indicate that although transition planning occurred it was relatively later in the young person's school life. Parents were often confused about the process and had limited information about future options for their son or daughter. All family carers regardless of ethnicity, reported lack of information about services and expressed a sense of being excluded. South Asian families experienced more problems related to language, information about services, culture and religion.

CONCLUSIONS

The majority of families lacked knowledge and awareness of formal services and the transition process. Socio-economic status, high levels of unemployment and caring for a child with a disability accounted for similar family experiences, regardless of ethnic background. The three key areas relevant for ethnicity are interdependence, religion and assumptions by service providers.

Family beyond parents? An exploration of family configurations and psychological adjustment in young adults with intellectual disabilities

This research explores the family configurations of young adults with intellectual disability. Based on a sample of 40 individuals interviewed two times in a year, we found as many as four types of family configurations, with distinct compositions, and different types of social capital. This diversity is not without consequences for individual psychological adjustment. The results are discussed in the light of the configurational approach to families.

Ethnic factors in mental health service utilisation among people with intellectual disability in high-income countries: systematic review

BACKGROUND

An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed.

AIMS

To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income countries.

METHOD

A systematic review using main databases of studies that consider ethnic influences on mental health utilisation of people with ID. Methodological quality of studies was assessed.

RESULTS

Nine studies that reached selection criteria were identified. Six studies that compared two or more ethnic groups found a variation in levels of mental health service utilisation. The most consistent finding was that South Asian children, adolescents and adults with ID in the UK had lower use of mental health services than White British comparison groups.

CONCLUSION

Ethnic influences on mental health service utilisation were identified. Understanding their significance and potential negative consequences requires further investigation.

The care burden of families with members having intellectual and developmental disorder: a review of the recent literature

PURPOSE OF REVIEW

The aim of this article is to review recent studies on the care burden of families with a member having intellectual and developmental disorder.

RECENT FINDINGS

The family is the core unit for providing care to people with intellectual and developmental disorder, regardless of where they live. Recent research on this issue has been focused on two areas: the lifelong burden itself and its impact on the family. The research has incorporated a range of different approaches and has yielded diverse findings.

SUMMARY

The longevity of people with intellectual and developmental disorder has made caring for older adults with intellectual developmental disorder developing dementia a new challenge. In addition, worldwide deinstitutionalization has made it possible for people with intellectual and developmental disorder to live within their communities and integrate with the general population. Because disabled individuals may become parents themselves, the requirements of family care for children born to persons with intellectual and developmental disorder may be different from previous generations of parents who raised children with IDD.