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Folch A, Gallo D, Miró J, Salvador-Carulla L, Martínez-Leal R. Mirror therapy for phantom limb pain in moderate intellectual disability. A case report. Eur J Pain 2021; 26:246-254. [PMID: 34464481 DOI: 10.1002/ejp.1859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/30/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Phantom limb pain (PLP) is a common problem after limb amputation. There is mounting evidence supporting the use of mirror therapy (MT) in the treatment of individuals with PLP. However, there is no research studying the effects of MT on PLP in individuals with intellectual developmental disorders (IDD). The aim of this study was to increase our understanding of MT when used with adults with IDD and PLP through a case study approach. METHODS Here, we describe the use of MT with a 53-year-old female with moderate IDD and PLP, related to her left leg being amputated after ulcer complications. The study followed an A-B-A-B design (baseline-treatment-withdrawal of treatment-re-introduction of treatment), lasting 2 years, which included a long-term follow-up. RESULTS The data showed that the PLP sensation decreased after the MT treatment, with a raw change of 3.92 points and a 48% decrease in mean pain intensity ratings from pre- to post-treatment. CONCLUSIONS This is a unique case-report on the use of MT with an individual with IDD suffering from PLP. The findings show that MT helped to significantly reduce the intensity of the PLP in this patient. SIGNIFICANCE This is a case-report that illustrates how mirror therapy can be applied to people with intellectual developmental disorders and phantom limb pain. The results showed that phantom limb pain decreased after the mirror therapy, with a raw change of 3,92 points and a percent change of 48%.
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Affiliation(s)
- Annabel Folch
- UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundació Villablanca, IISPV, Institut d'Investigació Sanitària Pere Virgili, CIBERSAM, Centro de Investigación Biomédica en Red, Departament de Psicologia, Universitat Rovira i Virgili, Reus, Spain
| | - Daniel Gallo
- UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundació Villablanca, IISPV, Institut d'Investigació Sanitària Pere Virgili, CIBERSAM, Centro de Investigación Biomédica en Red, Departament de Psicologia, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Miró
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Institut d'Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australia.,Menzies Centre for Health Policy, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rafael Martínez-Leal
- UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundació Villablanca, IISPV, Institut d'Investigació Sanitària Pere Virgili, CIBERSAM, Centro de Investigación Biomédica en Red, Departament de Psicologia, Universitat Rovira i Virgili, Reus, Spain
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Lonchampt S, Gerber F, Aubry JM, Desmeules J, Kosel M, Besson M. Pain interventions in adults with intellectual disability: A scoping review and pharmacological considerations. Eur J Pain 2020; 24:875-885. [PMID: 32060971 DOI: 10.1002/ejp.1547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/31/2020] [Accepted: 02/09/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Having to deal on a daily routine with prescriptions in adults with intellectual disability (ID), we systematically reviewed the literature on the specificities of pain interventions in that population, focusing on medication and trying to gather practical information on appropriate pain treatments. Given the scarcity of the literature on the topic, we also discussed the pharmacological considerations to be taken into account when prescribing analgesic drugs in that vulnerable population. DATABASES AND DATA TREATMENT Articles on pain and ID were searched in the Medline and Google scholar electronic databases using the key words "Intellectual Disability," "Developmental Disability" and specific keywords for pharmacological and non-pharmacological pain interventions. Preset outcomes about pharmacological treatment specificity, efficacy and safety were then collected. RESULTS One hundred and fifty-two articles were found and 16 were retained based on our inclusion and exclusion criteria. Of the 16 articles, five were topical reviews. Among the 11 remaining articles, five discussed pharmacological interventions, four considered non-pharmacological interventions and two discussed both. As anticipated, the literature matching our specific outcomes about the pharmacological treatment of pain was scarce and for the most part not designed to answer the questions of specificity, efficacy and safety of pain treatment in adults with ID. CONCLUSION The specificity of analgesic treatments in adults with ID is a totally unexplored domain. In the absence of clinical guidelines, pharmacological facts-such as inter-individual variability in drug response, pharmacokinetic and pharmacodynamic interactions, frequent co-morbidities and ease of administration-must be systematically integrated, when prescribing in the population of adults with ID. SIGNIFICANCE This review synthesizes the state of research on pain interventions in adults with ID and is one of the rare articles addressing the specificities of analgesic prescriptions in this population.
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Affiliation(s)
- Sophie Lonchampt
- Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Psychopharmacology Unit, Geneva University Hospitals, Geneva, Switzerland.,Division of Psychiatric Specialties, Department of Psychiatry and Mental Health, Unit for Intellectual Disabilities and Autism in Adults, Geneva University Hospitals, Geneva, Switzerland
| | - Fabienne Gerber
- Division of Psychiatric Specialties, Department of Psychiatry and Mental Health, Unit for Intellectual Disabilities and Autism in Adults, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Michel Aubry
- Division of Psychiatric Specialties, Department of Psychiatry and Mental Health, Geneva University Hospitals, Geneva, Switzerland
| | - Jules Desmeules
- Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Markus Kosel
- Division of Psychiatric Specialties, Department of Psychiatry and Mental Health, Unit for Intellectual Disabilities and Autism in Adults, Geneva University Hospitals, Geneva, Switzerland
| | - Marie Besson
- Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Psychopharmacology Unit, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Intensive care and Pharmacology, Multidisciplinary Pain Center, Geneva University Hospitals, Geneva, Switzerland
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Cantrell A, Croot E, Johnson M, Wong R, Chambers D, Baxter SK, Booth A. Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
In 2015, approximately 2.16% of adults were recorded as having intellectual disabilities. UK government policy is that adults with intellectual disabilities should access mainstream health services. However, people with intellectual disabilities experience challenges when accessing primary and community health services that can lead to inequalities and shorter life expectancy.
Objectives
To map and review the evidence on access to primary and community health-care services for adults with intellectual disabilities and their carers. To identify influencing factors for gaining access to primary and community health-care services. To determine which actions, interventions or models of service provision improve entry access to these services for people with intellectual disabilities and their carers. Finally, to identify the gaps in evidence and provide implications for health care and recommendations for research.
Data sources
MEDLINE, The Cochrane Library, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC) were searched from 2002 to 2018.
Review methods
The mapping review methodology included an extensive literature search, article selection and data extraction of relevant abstracts. Findings from the mapping review informed the scope of the targeted systematic review. Methodology for the targeted systematic review included an extensive literature search informed by the mapping review, article selection, data extraction, quality appraisal and narrative synthesis.
Results
The mapping review included 413 studies with data extraction completed on abstracts. The targeted systematic review synthesised the evidence from 80 studies reported in 82 publications. During the review process, the team identified three key points at which people with intellectual disabilities potentially interacted with primary and community health-care services: identifying needs, accessing services and interaction during a consultation. In addition, there were a number of papers about interventions or innovations to improve access. Evidence from the studies was synthesised within the four clusters. Influencing factors were identified: staff knowledge/skills, joint working with learning disability services, service delivery model, uptake, appointment making, carer/support role, relationship with staff, time, accessible information and communication. The influencing factors were cross-cutting through the literature, with certain factors having more importance in certain clusters.
Limitations
The main limitation was the weak evidence base. The studies generally had small samples, had study designs that were open to potential biases and measured only short-term outcomes.
Conclusions
Health checks were found to help identify health needs and improve the care of long-term conditions. Important factors for accessing health services for adults with intellectual disabilities were consistency of care and support, staff training, communication skills and time to communicate, and provision of accessible information. Health professionals need to ensure that there is joint working between different services, clear communication and accurate record-keeping. Future research questions centre on the need to develop and value creative study designs capable of addressing the complex issues identified in the findings of the review for this complex population.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 5. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Anna Cantrell
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Elizabeth Croot
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Maxine Johnson
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Ruth Wong
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Duncan Chambers
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Susan K Baxter
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School for Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Segerlantz M, Axmon A, Gagnemo Persson R, Brun E, Ahlström G. Prescription of pain medication among older cancer patients with and without an intellectual disability: a national register study. BMC Cancer 2019; 19:1040. [PMID: 31684896 PMCID: PMC6829972 DOI: 10.1186/s12885-019-6290-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background The longevity for people with intellectual disability (ID) has significantly increased in developed countries during the past decades. Consequently, the incidence of cancer is expected to increase in this group. The aim of the present study was to investigate the prescription of pain medication in older cancer patients with intellectual disability (ID) compared to older patients in the general population, surviving or living with a cancer diagnosis. Methods This Swedish national registry-based study, included people with ID aged 55 years or older in 2012, and alive at the end of that year (ID cohort, n = 7936). For comparisons, we used a referent cohort, one-to-one matched with the general population by year of birth and sex (gPop cohort, n = 7936). People with at least one diagnosis of cancer during 2002–2012 were identified using the Swedish National Patient Register, resulting in 555 cancer patients with ID and 877 cancer patients from the general population. These two cohorts of cancer patients were compared with respect to prescription of pain medication for the period 2006–2012. Outcome data were aggregated so that each patient was categorized as either having or not having at least one prescription of each investigated drug group during the study period, and relative risks (RRs) for prescription were estimated for prescription in the ID cohort vs the gPop cohort. Results Cancer patients with ID were less likely than cancer patients in the gPop cohort to have at least one prescription of COX inhibitors (RR 0.61) and weak opioids (RR 0.63). They were, however, more likely to be prescribed paracetamol (RR 1.16), antidepressants (RR 2.09), anxiolytics (RR 2.84), and “other hypnotics, sedatives, and neuroleptics” (RR 1.39). No statistically significant differences between the two cohorts were found for strong opioids, antiepileptics, tricyclic antidepressants, or hypnotics and sedatives. Conclusion In the studied cohort of older people surviving or living with cancer, prescriptions for pain-treatment was less common in patients with ID compared to the general population. These results may suggest that pain is not sufficiently treated among cancer patients with ID, a situation that most likely would compromise the quality of life in this group.
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Affiliation(s)
- Mikael Segerlantz
- Department of Clinical Sciences, Oncology and Pathology, Institute for Palliative Care, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Palliative Care and Advanced Home Health Care, Primary Health Care Skane, Region Skane, Lund, Sweden
| | - Anna Axmon
- EPI@LUND (Epidemiology, Population studies, and Infrastructures at Lund University), Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Rebecca Gagnemo Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden
| | - Eva Brun
- Department of Clinical Sciences, Oncology and Pathology, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Radiotherapy and Radiophysics, Skane University Hospital, Lund, Sweden
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden.
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Doody O, Bailey ME. Interventions in pain management for persons with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2019; 23:132-144. [PMID: 28514882 DOI: 10.1177/1744629517708679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pain is a multidimensional and subjective experience, and an ideal pain management regime needs to be comprehensive, integrative and involve all relevant persons. Multimodal interventions may include pharmacological, physical, social, psychological and spiritual approaches in order to address pain management at a molecular, functional, behavioural, cognitive and affective levels. Pain management interventions will vary according to pain aetiology, patient characteristics and preferences. In keeping with best practice guidelines for effective pain management, a structured approach incorporating an effective assessment of pain by the healthcare professional, identification of the source and type of pain and accurate documentation is essential. This article focuses on pharmacological and non-pharmacological pain management for individuals with intellectual disability.
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Axmon A, Ahlström G, Westergren H. Pain and Pain Medication among Older People with Intellectual Disabilities in Comparison with the General Population. Healthcare (Basel) 2018; 6:healthcare6020067. [PMID: 29914061 PMCID: PMC6023323 DOI: 10.3390/healthcare6020067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 12/14/2022] Open
Abstract
Little is known about pain and pain treatment among people with intellectual disabilities (IDs). We aimed to describe pain and pain medications among older people with ID compared to the general population. Data on diagnoses and prescriptions were collected from national registers for the period between 2006 and 2012 for 7936 people with an ID and a referent cohort from the general population. IDs were associated with a decreased risk of being diagnosed with headaches, musculoskeletal pain, and pain related to the circulatory and respiratory systems, but they were associated with increased risk of being diagnosed with pain related to the urinary system. Among men, IDs were associated with an increased risk of being diagnosed with visceral pain. People with IDs were more likely to be prescribed paracetamol and fentanyl regardless of the type of pain but were less likely to be prescribed COX(1+2) and COX2 inhibitors and weak opioids. Healthcare staff and caregivers must be made aware of signs of pain among people with IDs who may not be able to communicate it themselves. Further research is needed to investigate whether people with IDs are prescribed paracetamol rather than other pain drugs due to physicians trying to avoid polypharmacy or if there are other reasons not to prescribe a greater range of pain treatments.
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Affiliation(s)
- Anna Axmon
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 00 Lund, Sweden.
| | - Gerd Ahlström
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
| | - Hans Westergren
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
- Department of Pain rehabilitation, Skane University hospital, 222 85 Lund, Sweden.
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de Knegt NC, Lobbezoo F, Schuengel C, Evenhuis HM, Scherder EJA. Self-Reported Presence and Experience of Pain in Adults with Down Syndrome. PAIN MEDICINE 2018; 18:1247-1263. [PMID: 27694149 DOI: 10.1093/pm/pnw226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective The aim was to examine whether the presence of pain (based on physical conditions and participants' report) and self-reported pain experience in adults with Down syndrome (DS) differ from general population controls. Design Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) and 142 age-matched controls (median age = 40.5 years, mean estimated IQ = 105.7) in the Netherlands. Methods File-based medical information was evaluated. Self-reported presence and experience of pain were assessed in rest and after movement during a test session (affect with facial affective scale (FAS: 0.04-0.97), intensity assessed with numeric rating scale (NRS: 0-10). Results Compared with controls, more DS participants had physical conditions that may cause pain and/or discomfort ( p = .004, 50% vs 35%), but fewer DS participants reported pain during the test session ( p = .003, 58% vs 73%). Of the participants who indicated pain and comprehended self-reporting scales ( n = 198 FAS, n = 161 NRS), the DS group reported a higher pain affect and intensity than the controls ( p < .001, FAS: 0.75-0.85 vs 0.50-0.59, NRS: 6.00-7.94 vs 2.00-3.73). Conclusions Not all adults with DS and painful/discomforting physical conditions reported pain. Those who did indicated a higher pain experience than adults from the general population. Research into spontaneous self-report of pain, repeated pain assessment, and acute pain is needed in people with DS for more insight into pain experience and mismatches between self-report and medical information.
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Affiliation(s)
- Nanda C de Knegt
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, the Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies and EMGO+ Institute for Health and Care Research
| | - Heleen M Evenhuis
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Erik J A Scherder
- Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
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Moro TT, Savage TA, Gehlert S. Agency, social and healthcare supports for adults with intellectual disability at the end of life in out-of-home, non-institutional community residences in Western nations: A literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:1045-1056. [PMID: 28585240 DOI: 10.1111/jar.12374] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The nature and quality of end-of-life care received by adults with intellectual disabilities in out-of-home, non-institutional community agency residences in Western nations is not well understood. METHOD A range of databases and search engines were used to locate conceptual, clinical and research articles from relevant peer-reviewed journals. RESULTS The present authors present a literature review of the agency, social and healthcare supports that impact end-of-life care for adults with intellectual disabilities. More information is needed about where people with intellectual disabilities are living at the very end of life and where they die. CONCLUSIONS The support needs for adults with intellectual disabilities will change over time, particularly at the end of life. There are some areas, such as removing barriers to providing services, staff training, partnerships between agencies and palliative care providers, and advocacy, where further research may help to improve the end-of-life care for adults with intellectual disabilities.
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Affiliation(s)
- Teresa T Moro
- College of Nursing, Rush University Medical Center, Chicago, IL, USA
| | - Teresa A Savage
- Department of Women, Children, and Family Health Science, College of Nursing, Chicago, IL, USA
| | - Sarah Gehlert
- E. Desmond Lee Professor of Racial and Ethnic Diversity, George Warren Brown School of Social Work, St. Louis, MO, USA
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Amor-Salamanca A, Menchon JM. Pain underreporting associated with profound intellectual disability in emergency departments. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:341-347. [PMID: 28054733 DOI: 10.1111/jir.12355] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability. METHODS Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge. The results were compared with data obtained from a control group of people with no ID who attended an ED for any reason during the same period. RESULTS Somatic complaints were the main reason for ED attendance among persons with PID (90% of consultations). These complaints were more often related to the central nervous system than was the case among non-ID patients (16 vs. 4.7%), whereas other kinds of non-central nervous system somatic complaint were less common among persons with PID (74 vs. 91%). A diagnosis implying physical pain was given less often to people with PID than to controls (3 vs. 20%). CONCLUSIONS The results suggest that persons with PID are less able to conceptualise and communicate information about their symptoms, especially as regards pain, and that this influences the diagnosis they are given when attending an ED. Professionals working in this environment need to be aware of this possibility so as not to underestimate or overlook such symptoms and the illnesses related to them.
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Affiliation(s)
- A Amor-Salamanca
- Fundación Vallparadís, Department of Psychiatry, Mutua Terrassa University Hospital, Spain
| | - J M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Spain
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Antonsson H, Graneheim UH, Isaksson U, Åström S, Lundström MO. Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design. Issues Ment Health Nurs 2016; 37:734-743. [PMID: 27351080 DOI: 10.1080/01612840.2016.1189636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.
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Affiliation(s)
| | - Ulla Hällgren Graneheim
- b Umeå University , Department of Nursing , Umeå , Sweden , University West , Department of Health Sciences , Trollhättan , Sweden.,c University West , Department of Health Sciences , Trollhättan , Sweden
| | - Ulf Isaksson
- a University of Umeå , Department of Nursing , Umeå , Sweden
| | - Sture Åström
- b Umeå University , Department of Nursing , Umeå , Sweden , University West , Department of Health Sciences , Trollhättan , Sweden.,c University West , Department of Health Sciences , Trollhättan , Sweden
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de Knegt NC, Lobbezoo F, Schuengel C, Evenhuis HM, Scherder EJA. Self-Reporting Tool On Pain in People with Intellectual Disabilities (STOP-ID!): a Usability Study. Augment Altern Commun 2015; 32:1-11. [DOI: 10.3109/07434618.2015.1100677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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