Eliciting perceptions of satisfaction with services and supports from persons with intellectual disability and developmental disabilities: a review of the literature

A Program Based on Common Technology to Support Communication Exchanges and Leisure in People With Intellectual and Other Disabilities

The aim of this study was to assess a new smartphone-based program version to allow seven participants with intellectual plus visual and/or motor disabilities and hesitant speech to send out and receive WhatsApp messages, make telephone calls, and access leisure activities. This program version relied on a Samsung A3 smartphone, which was automated through the MacroDroid application and responded to the input of specific cards and miniature objects. During the baseline (i.e., without the program), the participants’ performance was zero or close to zero on communication and leisure. During the use of the program, the participants increased their frequency of WhatsApp messages sent out and received/listened to, and of leisure activities accessed. Their frequency of telephone calls averaged between virtually zero and slightly above one. The implications of the findings are discussed in relation to the technology used for the program and the applicability of the program in daily contexts.

Early intervention and perceived quality: Refinement of the inventory of quality in early intervention centers

The current perspective on early intervention revolves around consideration of the family as a cornerstone, its opinion being essential in providing a quality service. Early intervention centers require an evaluation of the services they perform. The aim of this study was to examine the psychometric properties of the short version of the Inventory of Quality for Early Intervention Centers (IQEIC) and to obtain evidence of its validity and reliability. The sample consisted of 887 families from 21 early intervention centers in Spain, which were randomly divided into 2 groups to conduct a cross-validity analysis: exploratory factor analysis with the first group (n1 = 440), and confirmatory factor analysis with the second group (n2 = 447). A 8 factor structure was obtained in the confirmatory factor analysis that showed a good fit. Both the internal consistency (composite reliability ranging from 0.84 to 0.90) and the convergent (AVE values ranged from 0.12 to 0.50) and discriminant validity were adequate. Lastly, a multigroup analysis (n1 and n2) showed the invariance factorial through the difference in the CFI index. The IQEIC showed satisfactory reliability and validity in this study confirming the proposed model is a valid tool to assess the quality of the service provided in early intervention centers, therefore recommending its application for both research and management.

Patient Satisfaction and Perceived Quality of Care Among Younger Medicare Beneficiaries According to Activity Limitation Stages

OBJECTIVE

To examine the association between activity limitation stages and patient satisfaction and perceived quality of medical care among younger Medicare beneficiaries.

DESIGN

Cross-sectional study.

SETTING

Medicare Current Beneficiary Survey (MCBS) for calendar years 2001-2011.

PARTICIPANTS

A population-based sample (N=9323) of Medicare beneficiaries <65 years of age living in the community.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

MCBS questions were categorized under 5 patient satisfaction and perceived quality dimensions: care coordination and quality, access barriers, technical skills of primary care physician (PCP), interpersonal skills of PCP, and quality of information provided by PCP. Persons were classified into an activity limitation stage (0-IV) which was derived from self-reported difficulty performing activities of daily living (ADL) and instrumental activities of daily living (IADL).

RESULTS

Compared to beneficiaries with no limitations at ADL stage 0, the adjusted odds ratios (95% confidence intervals) for stage I (mild) to stage IV (complete) for satisfaction with access barriers ranged from 0.62 (0.53-0.72) at stage I to a minimum of 0.31 (0.22-0.43) at stage IV. Similarly, compared to beneficiaries at IADL stage 0, satisfaction with access barriers ranged from 0.66 (0.55-0.79) at stage I to a minimum of 0.36 (0.26-0.51) at stage IV. Satisfaction with care coordination and quality and perceived quality of medical care were not associated with activity limitation stages.

CONCLUSIONS

Younger Medicare beneficiaries with disabilities reported decreased satisfaction with access to medical care, highlighting the need to improve access to health care and human services and to enhance workforce capacity to meet the needs of this patient population.

Case series of technology-aided interventions to support leisure and communication in extensive disabilities

Objectives: This study assessed a new technology-aided program to support independent leisure and communication engagement with people with intellectual and motor or sensory-motor disabilities. Methods: Six adults participated. The program relied on the use of a Samsung Galaxy Tab S2 LTE tablet with Android 6.0 Operating System, a NANO SIM card, and the WhatsApp Messenger and MacroDroid applications. The participants were presented with leisure and communication (i.e. text messaging) alternatives, and, based on their choices, with series of steps allowing them to access leisure events or send messages. Results: During baseline, the participants were unable to access leisure events or send messages. During intervention and post-intervention phases, they used the program successfully and spent large percentages of the session time independently engaged in leisure and messaging. Conclusions: A program based on readily available technology may be functional to support leisure and communication in people like the participants of this study.

The complex role of social care services in supporting the development of sustainable identities: Insights from the experiences of British South Asian women with intellectual disabilities

BACKGROUND AND AIMS

Carers and service users with intellectual disabilities from minority ethnic groups have typically been reported to be dissatisfied with the social care services they receive. However, service users themselves have rarely been asked directly about their experiences of social care. This paper aims to understand the meaning of social care services in the lives of South Asian women with intellectual disabilities, in the United Kingdom.

METHOD AND PROCEDURE

10 British South Asian women with mild-moderate intellectual disabilities were interviewed about their experiences of social care services. The transcripts were analysed using interpretative phenomenological analysis.

RESULTS

The analysis produced three super-ordinate themes, which focus on how services facilitate the development of complex identities, how the participants explored their sense of being 'stuck' between cultures as they negotiated their journeys towards independence, and the triple disadvantage which they experienced as a consequence of the intersection between gender, ethnicity and disability. The participants were broadly satisfied with the role which services played in these domains, and appeared to find them valuable and helpful.

CONCLUSIONS

The results suggest that the participants successfully managed complex identity issues, such as acculturation processes, with the support of services. It may be helpful to give more explicit consideration to the positive role which good services can play in supporting people with intellectual disabilities in the development of their identities and goals, alongside the more traditionally 'concrete' objectives of such social care. Engagement with families in 'positive risk-taking' is likely to be an important component of success.

Defining social inclusion of people with intellectual and developmental disabilities: an ecological model of social networks and community participation

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.