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Furukawa S, Nawa N, Yamaoka Y, Fujiwara T. Concerns and needs of people with intellectual disabilities and their caregivers during the COVID-19 pandemic in Japan. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:137-156. [PMID: 36286242 PMCID: PMC9606640 DOI: 10.1177/17446295221135274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Background: People with intellectual disabilities (IDs) and their caregivers face difficulties during the COVID-19 pandemic. However, limited studies have comprehensively investigated their challenges, especially in Japan. We aimed to clarify the concerns and needs of people with IDs and their caregivers during the COVID-19 pandemic in Japan. Method: From March to August 2021, 27 in-depth interviews were conducted with principal caregivers of people with moderate to profound IDs in Japan. We then transcribed the interviews and conducted deductive coding using predetermined codes focused on their daily life difficulties. Inductive coding was used to ensure that no important themes were overlooked. Results: We found four concerns and four needs among people with IDs and their caregivers as significant themes. Conclusions: Our results provide useful information for supporting people with IDs and their caregivers, especially among those who need medical or social care in accordance with the infection control and social-distancing policies.
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Affiliation(s)
- Sawako Furukawa
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutoshi Nawa
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yui Yamaoka
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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Mimmo L, Hodgins M, Samir N, Travaglia J, Woolfenden S, Harrison R. 'Smiles and laughter and all those really great things': Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability. J Adv Nurs 2022; 78:2933-2948. [PMID: 35451515 PMCID: PMC9544709 DOI: 10.1111/jan.15256] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/11/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
AIM To understand what constitutes a good experience of care for inpatient children and young people with intellectual disability as perceived by nursing staff. DESIGN Interpretive qualitative study. METHODS Focus groups with clinical nursing staff from speciality neurological/neurosurgical and adolescent medicine wards across two specialist tertiary children's hospitals in Australia were conducted between March and May 2021. Data analysis followed interpretative analysis methods to develop themes and codes which were mapped to a conceptual model of safe care. RESULTS Six focus groups with 29 nurses of varying experience levels were conducted over 3 months. Themes and codes were mapped to the six themes of the conceptual model: use rapport, know the child, negotiate roles, shared learning, build trust and relationships, and past experiences. The analysis revealed two new themes that extended the conceptual model to include; the unique role of a paediatric nurse, and joy and job satisfaction, with a third contextual theme, impacts of COVID-19 pandemic restrictions. With the perspectives of paediatric nurses incorporated into the model we have enhanced our model of safe care specifically for inpatient paediatric nursing care of children and young people with intellectual disability. CONCLUSION Including perceptions of paediatric nurses confirmed the position of the child with intellectual disability being at the centre of safe care, where care is delivered as a partnership between nursing staff, child or young person and their parents/family and the hospital systems and processes. IMPACT The enhanced model offers a specialized framework for clinical staff and health managers to optimize the delivery of safe care for children and young people with intellectual disability in hospital.
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Affiliation(s)
- Laurel Mimmo
- Clinical Governance UnitThe Sydney Children's Hospitals NetworkSydneyNSWAustralia
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Michael Hodgins
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Nora Samir
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Joanne Travaglia
- Centre for Health Services ManagementFaculty of HealthUniversity of Technology SydneySydneyNSWAustralia
| | - Susan Woolfenden
- Population Child Health Research GroupSchool of Women's and Children's HealthFaculty of MedicineUniversity of New South WalesSydneyNSWAustralia
| | - Reema Harrison
- Centre for Health Systems and Safety ResearchAustralian Institute of Health InnovationFaculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
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Nicholson E, Conlon C, Mimmo L, Doherty E, Guerin S. Unscheduled healthcare for children with intellectual disabilities: A systematic scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:736-751. [PMID: 35322908 PMCID: PMC9314007 DOI: 10.1111/jar.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Abstract
Background The provision of unscheduled healthcare for children with intellectual disability is less researched than that focused on hospital settings or for adult services. The aim of the scoping review was to map the evidence base in this area and identify areas for future study. Method A five‐stage scoping review framework was adopted. CINAHL, PubMed, SCOPUS, PsycINFO, Embase, ProQuest Dissertation & Theses and Google Scholar were searched. Studies published in English after 1/1/2000 were considered eligible for inclusion. Results A total of 3158 titles and abstracts were screened, 137 full‐text articles were reviewed, and 25 papers met the inclusion criteria. Descriptive themes focused on inequities, needs and experiences of families', poor GP training, and limitations of existing evidence. Conclusion Describing trends in healthcare utilisation by this population is valuable for monitoring quality of healthcare, however, addressing observed inequities will require approaches that recognise specific issues within the health system that result in inequities.
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Affiliation(s)
- Emma Nicholson
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.,School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland
| | - Ciara Conlon
- Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Laurel Mimmo
- School of Public Health & Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Edel Doherty
- J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Suzanne Guerin
- UCD Centre for Disability Studies, UCD School of Psychology, University College Dublin, Dublin, Ireland
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Don A, O'Byrne P. Exploring how the diagnostic process stratifies children with intellectual disability navigating the service system in Ontario, Canada. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:50-69. [PMID: 32909868 DOI: 10.1177/1744629520954765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Children with intellectual disability experience a higher prevalence of dental disease, obesity, challenging behaviours, and mental health disorders compared to children without intellectual disability. Children with intellectual disability concurrently face health and social service navigational barriers that are associated with unresolved health needs and hospital admissions, and parent burnout and employment interruptions. In this study, we explored the knowledge gap of how carers and governmental agencies, providing services, understand intellectual disability using discourse analysis, and a theoretical framework applying Deleuze and Guattari's concepts of the rhizome and stratification. We found that children with intellectual disability were stratified into eligible or ineligible service recipients through the diagnostic process that prioritized specified characteristics. Carers did not perceive that their children's unique characteristics and needs were accounted for within the diagnostic process and expressed feelings of being dismissed by clinicians and providers in decision-making about priority needs and services.
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Affiliation(s)
- Anna Don
- 6363University of Ottawa, Canada
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Arnhart C, Neale M, Collins C, Chesher T, Coffey S, Rogers TC, Ottwell R, Hartwell M. The Use of Person-Centered Language in Scientific Research Articles Focused on Autism. J Dev Behav Pediatr 2022; 43:63-70. [PMID: 35132042 DOI: 10.1097/dbp.0000000000001038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Individuals with developmental conditions, such as autism, experience stigma, which is reflected in derogatory language and labels. To limit stigma associated with disabilities, government agencies and medical organizations have adopted the use of person-centered language (PCL). This study investigated adherence to PCL guidelines among peer-reviewed research publications focused on autism. In addition, we investigated the co-occurrence of stigmatizing language in articles using person-first language (PFL) and identity-first language (IFL) styles. METHODS We performed a systematic search of PubMed for autism-focused articles from January 2019 to May 2020. Articles from journals with more than 20 search returns were included, and a random sample of 700 publications were screened and examined for inclusion of prespecified, non-PCL terminology. RESULTS Of the 315 publications, 156 (49.5%) were PCL compliant. Articles frequently used PCL and non-PCL terminology concomitantly, and 10% of publications included obsolete nomenclature. A logistic regression model showed the odds were more likely that publications using IFL were more likely to include other stigmatizing terminology than publications using PFL (odds ratio = 2.03, 95% confidence interval: 1.15-3.58). CONCLUSION Within medical research, the language to describe individuals and populations needs to be used with intentionality and acknowledges that individuals are more than the diagnosis under study. This may reduce the structural stigma that may be implied otherwise. Our study showed that when PFL is used when addressing individuals with autism, other more stigmatizing language is often avoided and is in line with medical education and clinical practice.
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Affiliation(s)
- Chelsea Arnhart
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Monika Neale
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
- College of Osteopathic Medicine, Kansas City University, Joplin, MO; and
| | - Claire Collins
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Tessa Chesher
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Sara Coffey
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - T Calli Rogers
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK
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Ceglio K, Rispoli MJ, Flake EM. Training Medical Professionals to Work with Patients with Neurodevelopmental Disorders: A Systematic Review. Dev Neurorehabil 2020; 23:463-473. [PMID: 32543301 DOI: 10.1080/17518423.2020.1777217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Patients with neurodevelopmental disorders are not always provided the quality of medical care they deserve. Medical personnel report limited preparation and education in caring for patients with neurodevelopmental disorders. Aim: The purpose of this systematic review is to summarize the research on medical personnel training programs, identify effective training methods, and provide directions for future application and research. Methods: Thirty-four studies met inclusion criteria. The studies were summarized in terms of training components, the medical personnel trained, and the effectiveness of the training in achieving target outcomes. Results: Seventy-nine percent of studies demonstrated improvement in target outcomes. A variety of training components were used in combination throughout the studies, demonstrating a possibility of significant change to medical personnel's abilities for and attitudes about working with patients with neurodevelopmental disorders. Conclusion: Further research is needed to determine specifically which types of training can affect which target outcomes.
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Affiliation(s)
- Katherine Ceglio
- Indiana University School of Medicine - Lafayette , West Lafayette, IN, USA
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Abstract
Purpose of Review This review explores recent literature (from 2017 onwards) to identify current developments related to reducing stigma and increasing acceptance for people with Intellectual and Developmental Disabilities (IDD) in their communities across diverse cultures. Recent Findings We identified literature related to experiences of stigma for people with IDD and their families across diverse cultures, as well as current and potential interventions and approaches for promoting acceptance. Summary Although the literature confirms that stigma is still a major barrier to acceptance and inclusion for people with IDD regardless of culture, there appears to be progress in terms of using diverse approaches to support acceptance and belonging. Researchers are also increasingly acknowledging the importance of culture and context in the experience and mitigation of stigma. There remains a need for researchers and practitioners to include people with IDD in identifying and prioritising interventions that promote belonging within their communities.
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Fisher K, Robichaux C, Sauerland J, Stokes F. A nurses' ethical commitment to people with intellectual and developmental disabilities. Nurs Ethics 2020; 27:1066-1076. [PMID: 32228209 DOI: 10.1177/0969733019900310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: This article explores the issues of knowledge deficits of healthcare professionals in meeting the needs of people with IDD throughout the life span, and to identify factors that contribute to these deficits. Although statistics vary due to census results and the presence of a "hidden population," approximately 1%-3% of the global population identify as living with an intellectual or developmental disability. People with intellectual or developmental disability experience health inequities and confront multiple barriers in society, often related to the stigma of intellectual or developmental disability. Disparities in care and service are attributed to a lack of knowledge and understanding among healthcare providers about people with intellectual or developmental disability, despite their increased risk for chronic health problems. The near absence of educational programs in nursing both nationally and internationally contributes to this significant knowledge deficit. In addition, ethical considerations between paternalistic beneficence and idealized autonomy have resulted in a lack of clear direction in working with a population that is often ignored or exploited. Nurses who view people with intellectual or developmental disability as vulnerable without assessing or acknowledging their capabilities may err toward paternalism in an effort to "first do no harm." Likewise, nurses who fail to recognize the challenges and limitations faced by people with intellectual or developmental disability may not provide sufficient protections for a vulnerable person. People with intellectual or developmental disability are not binary, but rather complex individuals with a myriad of presentations. This article seeks to encourage a well-informed model of nursing care. Through an ethical lens, this article explores the nurse's ethical commitments in cases of victimization, access to care, decision making, and the provision of optimal end-of-life care for people with intellectual or developmental disability.
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Ollivier RA, Aston ML, Price SL. Exploring postpartum sexual health: A feminist poststructural analysis. Health Care Women Int 2019; 41:1081-1100. [PMID: 31373883 DOI: 10.1080/07399332.2019.1638923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Postpartum sexual health has historically been viewed and discussed in specific ways, often dominated by biomedical discourse. There is a need to expand understandings of sexual health for postpartum women in the context of interdisciplinary health care. Research surrounding postpartum sexual health is largely focused on physical measures, such as vaginal lubrication or initiation of intercourse, without accounting for the diverse and subjective ways that sexuality and sexual health are experienced during the postpartum period. This critical analysis uses feminist post-structuralism to critique and analyze current health research and practice surrounding postpartum sexual health. Agency, subjectivity, gender and sex considerations, relations of power, and discourse are essential to understanding postpartum sexual health in a more holistic, woman-centered way. This includes awareness of dominant discourses that have shaped how health researchers, practitioners, postpartum women, and health institutions care for, support, and promote postpartum sexual health. There is a need to move beyond physically focused, reductionist, heteronormative understandings of sexual health to better promote overall postpartum health and wellbeing.
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Affiliation(s)
- Rachel A Ollivier
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Megan L Aston
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sheri L Price
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
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