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Efron D, Fowler J, Cull E, Noakes K, Wilkin C, Haslam R. A novel model of care for paediatric patients with developmental disabilities and associated behaviours of concern. J Paediatr Child Health 2024. [PMID: 39014899 DOI: 10.1111/jpc.16615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/24/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
AIM Children and adolescents with autism spectrum disorder and/or intellectual disability often present to emergency departments with behaviours of concern: irritability, aggression and self-injurious behaviour. The objective of this study was to design, implement and evaluate a new model of care to support these patients and their families following presentation to reduce the need for re-presentation. METHODS We designed and evaluated a new model of care for these patients, comprising consultations with a developmental paediatrician and a child psychiatrist, referral to a specialist behavioural service and 6 weeks of care coordination by a clinical nurse consultant. Using a quality improvement framework, iterative improvements were made to the model via a series of plan-do-study-act cycles. Re-presentation rates were compared with a control group of patients who presented with behaviours of concern but were not recruited into the study. Participating families and treating clinicians were surveyed at 2 and 6 weeks post-enrolment to gather qualitative feedback about their experience of the model. RESULTS A total of 31 families participated in the study. Three- and 6-month re-presentation rates were 48.7% and 36.3% lower than the control group. Qualitative evaluation of the model by both families and clinicians was positive. The model was feasible and acceptable. Families reported feeling heard and understood, and that the intervention was helpful and provided a positive path forwards. CONCLUSIONS The findings suggest that a simple model of care can be successfully implemented and provide meaningful benefits for families of children with behaviours of concern, including reduced crisis-oriented help-seeking.
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Affiliation(s)
- Daryl Efron
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - James Fowler
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Emergency Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Emily Cull
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Kirsten Noakes
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Claire Wilkin
- Department of Emergency Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ric Haslam
- Department of Mental Health, The Royal Children's Hospital, Melbourne, Victoria, Australia
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Slade K, Shaw RL, Larkin M, Heath G. Care-giving experiences of parents of young people with PMLD and complex healthcare needs in the transition to adulthood years: a qualitative poetic synthesis. Arts Health 2023:1-18. [PMID: 38018798 DOI: 10.1080/17533015.2023.2288058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To synthesise qualitative research exploring the care-giving experiences of parents of young people with profound and multiple learning disabilities (PMLD) and complex healthcare needs, in the transition to adulthood years. METHOD Four databases were systematically searched: Scopus, WoS Core Collection, Medline and SciELO. Included papers were assessed for quality and thematically synthesised. Findings are presented in the form of free-verse poems. RESULTS Nineteen papers from eight countries were included. Analysis generated three themes: interdependency of parent and child, where parents retained responsibility for their child's care; apprehension regarding sharing and shifting responsibility between parents and professionals; an uncertain future in terms of care provision. CONCLUSIONS Parents are concerned about the future care of their children. Training professionals in alternative and effective communication is fundamental to successful transition. Encouraging discussions about advanced care planning may also alleviate parental concerns and ensure good outcomes for young people with PMLD.
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Affiliation(s)
- Katharine Slade
- Institute of Health & Neurodevelopment Aston University Birmingham United Kingdom of Great Britain and Northern Ireland
| | - Rachel L Shaw
- Institute of Health & Neurodevelopment Aston University Birmingham United Kingdom of Great Britain and Northern Ireland
| | - Michael Larkin
- Institute of Health & Neurodevelopment Aston University Birmingham United Kingdom of Great Britain and Northern Ireland
| | - Gemma Heath
- Institute of Health & Neurodevelopment Aston University Birmingham United Kingdom of Great Britain and Northern Ireland
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Gudka R, Kelman C, Bryant E, Farooq B, Berry V, Bjornstad G, Martin F, Glover SL, Russell A. Parent-carer experiences using a peer support network: a qualitative study. BMC Public Health 2023; 23:2007. [PMID: 37845646 PMCID: PMC10577900 DOI: 10.1186/s12889-023-16666-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/30/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Parent-carers of children and young people (CYP) with mental health problems are at greater risk of poor outcomes, such as poor physical and mental health. Peer interventions for parent-carers of CYP with disabilities may improve parent-carer outcomes. This qualitative study investigates parent-carer experiences of using Parental Minds (PM), a multi-component peer support service for parent-carers of CYP with disabilities. METHODS Twelve current service-users and four staff/volunteers at PM participated in one-to-one semi-structured interviews. All participants were white females, except for one service-user who was male. All interviews were recorded and transcribed verbatim. Thematic analysis of results was used to explore perceived benefits and disadvantages of PM and possible behaviour change mechanisms. RESULTS Three themes and eight subthemes were identified. Participants identified that internal and external factors influence their self-concept. The identification of themselves as a priority, and empowerment by reassurance and affirmation lead to improved parent-carer self-efficacy and agency to better care for their CYP. Participants described the difficulty of speaking honestly with friends and family about what they experience because it is perceived as different to what "normal" parents experience. From participant accounts, PM enables the construction of a support network and links external services to help manage family circumstances rather than offer curative treatment/intervention. Proactive and immediate advice which is constantly and consistently available was valued by participants. Participants expressed the need for a flexible range of service components which provide holistic support that encompasses both health and social care. CONCLUSIONS PM was perceived to be beneficial as a multi-component peer support service which increases parenting self-efficacy and empowerment, reduces isolation, improves access to services, and is tailored to individual needs. Parent-carers reported benefits in parenting and wellbeing practices. The development of a refined logic model will inform a future study of the effectiveness of PM on parent-carer outcomes.
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Affiliation(s)
- Rebecca Gudka
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Charlotte Kelman
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Eleanor Bryant
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Vashti Berry
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | - Gretchen Bjornstad
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK
| | | | | | - Abigail Russell
- Children and Young People's Mental Health Research Collaboration, University of Exeter, Exeter, UK.
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Celik P, Kara Uzun A. Stressful experiences and coping strategies of parents of young children with Down syndrome: A qualitative study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023. [PMID: 37100435 DOI: 10.1111/jar.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/26/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Previous studies have focused mostly on the negative experiences of parents of children with Down syndrome. We aimed to explore both the stressful experiences and coping strategies of parents from a non-Western country. METHODS Twenty-six parents of children aged 8-48 months with Down syndrome were included. Semi-structured interviews were conducted, and the data were analysed using thematic analysis. RESULTS The main themes of the stressful experiences were emotional burdens, caregiving burdens, struggle against stigma and discrimination, concerns about the future, challenges related to health, education, and financial issues. Parents used a variety of coping strategies to overcome the challenges by seeking support and help, searching for information, accepting and adapting, and adopting optimistic attitudes. CONCLUSION Although being a parent of a child with Down syndrome has many challenges, most parents effectively used coping strategies and adapted their lives to their new parental roles in their child's early years.
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Affiliation(s)
- Pelin Celik
- Department of Pediatrics, Ankara Yildirim Beyazit University, Ankara, Turkey
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Aysun Kara Uzun
- Division of Social Pediatrics, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences Turkey, Ankara, Turkey
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Tekola B, Kinfe M, Girma Bayouh F, Hanlon C, Hoekstra RA. The experiences of parents raising children with developmental disabilities in Ethiopia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:539-551. [PMID: 35757938 DOI: 10.1177/13623613221105085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT The experiences of parents raising children with developmental disabilities have been widely researched, although most of this research comes from Western, high-income countries. In comparison, little is known about the lived experiences of parents of children with developmental disabilities in low- and middle-income countries and in Africa in particular. We interviewed 14 mothers and 4 fathers in Addis Ababa and the rural town of Butajira to explore what life is like for parents caring for children with developmental disabilities in Ethiopia. Cultural and religious beliefs played a role in the types of delays or differences in their child's development that parents noticed early and the kinds of support they sought. Parents experienced stigma and lack of understanding from others. Their experiences regarding some of the challenges they faced such as lack of appropriate services varied based on where they lived (urban or rural). Single mothers especially were faced with multiple struggles including poverty, stigma, and lack of social support. Implications for future research and interventions that aim to increase knowledge about developmental disabilities, tackle stigma and improve the lives of children and their families are discussed.
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Gore N, Bradshaw J, Hastings R, Sweeney J, Austin D. Early positive approaches to support (E-PAtS): Qualitative experiences of a new support programme for family caregivers of young children with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:889-899. [PMID: 35289031 PMCID: PMC9311085 DOI: 10.1111/jar.12993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Early Positive Approaches to Support (E-PAtS) is a co-produced and co-facilitated group programme that aims to provide early years support to family caregivers of children with Intellectual and Developmental Disabilities. METHOD Thirty-five caregivers who had attended E-PAtS groups took part in individual interviews or focus groups. Caregiver experiences concerning attendance of E-PAtS were explored, in relation to process variables and perceived outcomes. Interviews were thematically analysed. RESULTS Three major themes were identified: our group, evolving emotions, and positive approaches. Being with and being supported by other families was very important to caregivers. Families reported increased confidence and greater realisation of the need for self-care. Children were reported to show fewer behaviours that challenge and increases in adaptive skills. Findings corresponded to mechanisms and outcomes in the E-PAtS logic model. CONCLUSION E-PAtS shows promise as one way families and children with Intellectual and Developmental Disabilities can access early years support.
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Affiliation(s)
- Nick Gore
- Tizard Centre, Cornwallis North East, University of Kent, Canterbury, Kent, UK
| | - Jill Bradshaw
- Tizard Centre, Cornwallis North East, University of Kent, Canterbury, Kent, UK
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Carollo A, Bonassi A, Lim M, Gabrieli G, Setoh P, Dimitriou D, Aryadoust V, Esposito G. Developmental disabilities across the world: A scientometric review from 1936 to 2020. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104031. [PMID: 34333315 DOI: 10.1016/j.ridd.2021.104031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental disabilities have been largely studied in the past years. Their etiological mechanisms have been underpinned to the interactions between genetic and environmental factors. These factors show variability across the world. Thus, it is important to understand where the set of knowledge obtained on developmental disabilities originates from and whether it is generalizable to low- and middle-income countries. AIMS This study aims to understand the origins of the available literature on developmental disabilities, keeping a focus on parenting, and identify the main trend of research. METHODS AND PROCEDURE A sample of 11,315 publications from 1936 to 2020 were collected from Scopus and a graphical country analysis was conducted. Furthermore, a qualitative approach enabled the clustering of references by keywords into four main areas: "Expression of the disorder", "Physiological Factors", "How it is studied" and "Environmental factors". For each area, a document co-citation analysis (DCA) on CiteSpace software was performed. OUTCOMES AND RESULTS Results highlight the leading role of North America in the study of developmental disabilities. Trends in the literature and the documents' scientific relevance are discussed in details. CONCLUSIONS AND IMPLICATIONS Results demand for investigation in different socio-economical settings to generalize our knowledge. What this paper adds? The current paper tries to provide insight into the origins of the literature on developmental disabilities with a focus on parenting, together with an analysis of the trends of research in the field. The paper consisted of a multi-disciplinary and multi-method review. In fact, the review tried to integrate the analysis of the relation between developmental disabilities with a closer look at the scientific contributions to the field across the world. Specifically, the paper integrates a total of 11,315 papers published on almost a century of research (from 1936 to 2020). An initial qualitative analysis on keywords was combined to a subsequent quantitative approach in order to maximize the comprehension of the impact of almost a century of scientific contributions. Specifically, documents were studied with temporal and structural metrics on a scientometric approach. This allowed the exploration of patterns within the literature available on Scopus in a quantitative way. This method not only assessed the importance of single documents within the network. As a matter of fact, the document co-citation analysis used on CiteSpace software provided insight into the relations existing between multiple documents in the field of research. As a result, the leading role of North America in the literature of developmental disabilities and parenting emerged. This was accompanied by the review of the main trends of research within the existing literature.
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Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Peipei Setoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Dagmara Dimitriou
- Sleep Research and Education Laboratory, UCL Institute of Education, London, United Kingdom
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Chauke T, Poggenpoel M, Myburgh CPH, Ntshingila N. Experiences of parents of an adolescent with intellectual disability in Giyani, Limpopo province, South Africa. Health SA 2021; 26:1538. [PMID: 33936787 PMCID: PMC8063545 DOI: 10.4102/hsag.v26i0.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/25/2021] [Indexed: 11/04/2022] Open
Abstract
Background Parents of adolescents with intellectual disability experienced stress caused by challenges that come from having such adolescents. Those challenges affected the parents physically and emotionally, depending on the severity of the adolescent’s intellectual disability. Having an adolescent with an intellectual disability becomes a burden if the challenges were not resolved. Aim This study aimed to explore and describe the experiences of parents of adolescents with intellectual disability in Giyani. Setting This study was conducted at the participants’ homes in Giyani, Limpopo province, South Africa. Methods A qualitative, exploratory, descriptive and contextual design was utilised. The main question was ‘How is it to have an adolescent with intellectual disability?’ Eight purposively sampled parents participated, and data were collected through in-depth interviews, observations and field notes. Data were analysed by means of thematic coding and an independent coder was consulted. Results Four themes were identified. The study revealed that parents of adolescents with intellectual disability experienced negative emotional responses. Most parents reported a lack of support from family members and the community. They also reported caring challenges, yet some showed positive coping mechanisms. Conclusion Parents of adolescents with intellectual disability experienced various challenges in caring for these children. A collaborative approach from relevant stakeholders could have a positive impact in supporting the parents of adolescents with intellectual disabilities.
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Affiliation(s)
- Tsakani Chauke
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Marie Poggenpoel
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Chris P H Myburgh
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Johannesburg, South Africa
| | - Nompumelelo Ntshingila
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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Day JJ, Hodges J, Mazzucchelli TG, Sofronoff K, Sanders MR, Einfeld S, Tonge B, Gray KM. Coercive parenting: modifiable and nonmodifiable risk factors in parents of children with developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:306-319. [PMID: 33506597 DOI: 10.1111/jir.12813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/18/2020] [Accepted: 11/30/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Parents of children with developmental or intellectual disabilities tend to report greater use of coercive parenting practices relative to parents of typically developing children, increasing the risk of adverse child outcomes. However, to date, there is limited research exploring the role and relative contribution of modifiable and nonmodifiable risk factors in parents of children with a disability. The present study aimed to explore the role of various modifiable and nonmodifiable parenting, family and sociodemographic factors associated with the use of coercive parenting practices in parents of children with a disability. METHODS Caregivers (N = 1392) enrolled in the Mental Health of Young People with Developmental Disabilities (MHYPeDD) programme in Australia completed a cross-sectional survey about their parenting and their child aged 2-12 years with a disability. Measures covered a range of domains including relevant demographic and family background, use of coercive parenting practices, intensity of child behavioural difficulties and questions relating to parent and family functioning such as parental self-efficacy, adjustment difficulties and quality of family relationships. RESULTS Parents of older children, those who were younger at the birth of their child, and parents who were co-parenting or working reported more use of coercive parenting practices. Greater intensity of child difficulties, poorer parental self-efficacy and parent-child relationships, and more parental adjustment difficulties were also significantly associated with more use of coercive parenting. Examination of the relative contribution of variables revealed parent-child relationship was a key contributing factor, followed by intensity of child behaviour problems, parent adjustment and parent confidence. CONCLUSIONS These findings highlight a range of factors that should be targeted and modified through upstream prevention programmes and further inform our understanding of how coercive practices may be influenced through targeted parenting interventions.
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Affiliation(s)
- J J Day
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
- Family Action Centre, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - J Hodges
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - T G Mazzucchelli
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
- Child and Family Research Group, Brain, Behaviour and Mental Health Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - K Sofronoff
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - M R Sanders
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - S Einfeld
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - B Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - K M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
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Holingue C, Kalb LG, Klein A, Beasley JB. Experiences With the Mental Health Service System of Family Caregivers of Individuals With an Intellectual/Developmental Disability Referred to START. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 58:379-392. [PMID: 33032318 DOI: 10.1352/1934-9556-58.5.379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 04/29/2019] [Indexed: 06/11/2023]
Abstract
People with intellectual and developmental disabilities (IDD) frequently have behavioral or mental health needs, but experience obstacles to treatment. Family caregivers are often responsible for coordinating the care of individuals with IDD. This study examined family caregiver experiences using intake data from a national tertiary crisis intervention model designed for people with IDD and mental health needs. Caregivers (n = 488) completed the Family Experiences Interview Schedule. Less than half of families reported satisfaction with the mental health services received. Notable gaps were in crisis, night and weekend services, choice of services and providers, communication and coordination between providers, and specialized training. Experiences were worse for caregiving fathers and individuals with IDD with co-occurring chronic medical conditions.
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Affiliation(s)
| | - Luther G Kalb
- Luther G. Kalb, Johns Hopkins Bloomberg School of Public Health and Kennedy Krieger Institute
| | - Ann Klein
- Ann Klein and Joan B. Beasley, University of New Hampshire Institute on Disability UCED
| | - Joan B Beasley
- Ann Klein and Joan B. Beasley, University of New Hampshire Institute on Disability UCED
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Schippers A, Berkelaar M, Bakker M, Van Hove G. The experiences of Dutch fathers on fathering children with disabilities: 'Hey, that is a father and his daughter, that is it'. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:442-454. [PMID: 31930638 DOI: 10.1111/jir.12711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Due to a predominant focus on mothers, fathers of children with disabilities are greatly overlooked in research. One could argue that there is a lack of research on the multifaceted nature of fatherhood altogether. Therefore, this study aims to gain insight into the perceived experiences of fathers of children with disabilities. METHODS These perceptions were studied by analysing data generated through semi-structured interviews, which were conducted with 12 Dutch fathers of children or young adults with disabilities. RESULTS Categories found during our data analysis were similar to those illustrated in the 'conceptual framework on responsible fathering' by including role identification, commitment, employment characteristics, cultural expectations and social support. CONCLUSIONS Overall, the fathers in this study reported similar experiences, but this study identified new life perspective as an additional category, which might be specific for fathers of children with disabilities. This new life perspective included a positive attitude, living in the moment, appreciation of the little things and transformation of expectations. Some fathers expressed that their child(ren) has enriched their lives, which positively influenced their fathering experience.
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Affiliation(s)
- A Schippers
- Department of Medical Humanities, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Disability Studies in Nederland, Amersfoort, The Netherlands
| | - M Berkelaar
- Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - M Bakker
- Department of Medical Humanities, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - G Van Hove
- Department of Orthopedagogics, Ghent University, Ghent, Belgium
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Efron D, Taylor K, Payne JM, Freeman JL, Cranswick N, Mulraney M, Prakash C, Lee KJ, Williams K. Does cannabidiol reduce severe behavioural problems in children with intellectual disability? Study protocol for a pilot single-site phase I/II randomised placebo controlled trial. BMJ Open 2020; 10:e034362. [PMID: 32152170 PMCID: PMC7064134 DOI: 10.1136/bmjopen-2019-034362] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/30/2020] [Accepted: 02/11/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Severe behavioural problems (SBPs) are a common contributor to morbidity and reduced quality of life in children with intellectual disability (ID). Current medication treatment for SBP is associated with a high risk of side effects. Innovative and safe interventions are urgently needed. Anecdotal reports and preliminary research suggest that medicinal cannabis may be effective in managing SBP in children with developmental disabilities. In particular, cannabidiol (CBD) may be a plausible and safe alternative to current medications. Families who are in urgent need of solutions are seeking cannabis for their ID children with SBP. However there is no evidence from randomised controlled trials to support the use of CBD for SBP. This pilot study aims to investigate the feasibility of conducting a randomised placebo-controlled trial of CBD to improve SBP in children with ID. METHODS AND ANALYSIS This is a single-site, double-blind, parallel-group, randomised, placebo-controlled pilot study of 10 participants comparing 98% CBD oil with placebo in reducing SBP in children aged 8-16 years with ID. Eligible participants will be randomised 1:1 to receive either CBD 20 mg/kg/day or placebo for 8 weeks. Data will be collected regarding the feasibility and acceptability of all study components, including recruitment, drop-out rate, study visit attendance, protocol adherence and the time burden of parent questionnaires. Safety outcomes and adverse events will be recorded. All data will be reported using descriptive statistics. These data will inform the design of a full scale randomised controlled trial to evaluate the efficacy of CBD in this patient group. ETHICS AND DISSEMINATION This protocol has received ethics approval from the Royal Children's Hospital ethics committee (Human Research Ethics Committee no. 38236). Results will be disseminated through peer-reviewed journals, professional networks, conferences and social media. TRIAL REGISTRATION NUMBER ACTRN12618001852246.
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Affiliation(s)
- Daryl Efron
- Health Services, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kaitlyn Taylor
- Health Services, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jonathan M Payne
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia
- Neuroscience, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jeremy L Freeman
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
- Neuroscience, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Noel Cranswick
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Melissa Mulraney
- Health Services, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Katherine J Lee
- Clinical Epidemiology & Biostatistics, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Katrina Williams
- Health Services, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- Monash Children's Hospital, Clayton, Victoria, Australia
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Marsh L, Brown M, McCann E. The Views and Experiences of Fathers of Children with Intellectual Disabilities: A Systematic Review of the International Evidence. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Lynne Marsh
- School of Nursing and MidwiferyQueen's University Belfast UK
| | - Michael Brown
- School of Nursing and MidwiferyQueen's University Belfast UK
| | - Edward McCann
- School of Nursing and MidwiferyTrinity College Dublin Republic of Ireland
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Emerson A. ‘Room of Gloom’: Reconceptualising Mothers of Children with Disabilities as Experiencing Trauma. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1658946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Anne Emerson
- School of Education, University of Nottingham, Nottingham, UK
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Band-Winterstein T, Avieli H. The Experience of Parenting a Child With Disability in Old Age. J Nurs Scholarsh 2017; 49:421-428. [PMID: 28692780 DOI: 10.1111/jnu.12305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are growing numbers of older parents providing ongoing care for adults with disabilities. A parent's aging calls for a redefinition of parental care practices and roles in light of his or her own changing needs. PURPOSE The current study aims to highlight the ways in which aging parents perceive and construct their parental role to adult children with disabilities at this point in their lives. METHODS An interpretive phenomenological analysis perspective was used. Data collection was performed through in-depth, semistructured interviews with 20 aging parents of children with developmental disabilities, followed by a content analysis. RESULTS Four patterns of parental identity emerged: "Being happy is his responsibility; I did my part," embracing aging needs; "I can do part-time worrying," a gradual letting go of parental roles; "I'm worn out, but I keep going. What choice do I have?" bearing the brunt; "I'm an old woman changing diapers," full-time parents. CONCLUSIONS The findings enable a deeper understanding of the various ways in which parents cope with aging alongside caring for an adult child with disability. Hence, this study can serve as a framework for developing tailored and differential intervention methods for these families. CLINICAL RELEVANCE As the world's people experience longer life expectancy, of both individuals with disabilities and their parents, nurses' education and practice should be challenged by the double sensitivities of elder's caregiving and address the unique needs of this unique population.
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Affiliation(s)
| | - Hila Avieli
- Assistant Professor, Department of Criminology, Ariel University, Ariel, Israel
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Douglas T, Redley B, Ottmann G. The need to know: The information needs of parents of infants with an intellectual disability-a qualitative study. J Adv Nurs 2017; 73:2600-2608. [DOI: 10.1111/jan.13321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Tracy Douglas
- School of Nursing and Midwifery; Deakin University; Burwood Vic. Australia
| | - Bernice Redley
- School of Nursing and Midwifery; Deakin University; Burwood Vic. Australia
- Centre for Nursing Research-Deakin University and Monash Health Partnership; Burwood Vic. Australia
| | - Goetz Ottmann
- School of Health and Social Development; Deakin University; Burwood Vic. Australia
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17
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Douglas T, Redley B, Ottmann G. The first year: the support needs of parents caring for a child with an intellectual disability. J Adv Nurs 2016; 72:2738-2749. [DOI: 10.1111/jan.13056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Tracy Douglas
- Deakin University; School of Nursing and Midwifery; Burwood Victoria Australia
| | - Bernice Redley
- Deakin University; School of Nursing and Midwifery; Burwood Victoria Australia
- Centre for Nursing Research - Deakin University and Monash Health Partnership; Burwood Victoria Australia
| | - Goetz Ottmann
- Dr Goetz Ottmann and Associates; Mount Waverley Victoria Australia
- Deakin University; School of Health and Social Development; Burwood Victoria Australia
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18
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Goussé V, Czernecki V, Denis P, Stilgenbauer JL, Deniau E, Hartmann A. Impact of Perceived Stress, Anxiety-Depression and Social Support on Coping Strategies of Parents Having A Child With Gilles de la Tourette Syndrome. Arch Psychiatr Nurs 2016; 30:109-13. [PMID: 26804511 DOI: 10.1016/j.apnu.2015.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Previous reports have indicated that raising a child with Gilles de la Tourette syndrome (GTS) could be considered a stressful experience. Thus our study aimed to assess the impact of perceived stress (i.e. parental cognitive perception of their child's disorder) and social support (number of people surrounding the subject providing support) on coping strategies-defined as processes of restoring balance between excessive demands and inadequate resources-of parents having a child with GTS. METHODS Twenty-eight parents of 21 patients with GTS (aged 6 to 16years) completed questionnaires on perceived stress (ALE Scale), social support (SSQ6), coping strategies (WCC-R) and anxiety-depression (HAD). RESULTS Principal component analysis showed a negative correlation between social support on one side and perceived stress and anxiety/depression on the other. Problem- and emotion-focused coping both correlated with social support, all of them being independent from perceived stress and anxiety/depression. Hierarchical ascendant classification showed three clusters of individuals in our parents' groups: i) those having high scores in perceived stress and anxiety-depression; ii) those having high scores in social support associated with low scores in perceived stress; iii) parents having lower than average scores on both problem- and emotion- focused coping and social support. CONCLUSION Our results reinforce the need for developing training programs for parents with GTS children to better understand and tolerate the disorder to decrease their stress.
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Affiliation(s)
| | - Virginie Czernecki
- Centre de Référence National Maladie Rare « Syndrome Gilles de la Tourette », Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | - Pierre Denis
- Aix-Marseille Université, LPS EA 849, Aix-en-Provence, France
| | | | - Emmanuelle Deniau
- Centre de Référence National Maladie Rare « Syndrome Gilles de la Tourette », Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France
| | - Andreas Hartmann
- Centre de Référence National Maladie Rare « Syndrome Gilles de la Tourette », Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France
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Abstract
Advanced technology combined with improvements in neonatal care have increased the survival rates of low-birth-weight infants and infants born with severe birth defects. These infants are at greater risk for long-term health and developmental problems. The effect of having a child with a disability on the family is described, and emerging interventions and resources available for these families are provided.
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