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Intellectual disability and autism in adults influence psychological treatments for mental health comorbidities 成人智力残疾和自闭症影响心理健康合并症的心理治疗
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-04-13 DOI: 10.1108/amhid-12-2021-0050
Rachel Mills, R. Nathan, Paul Soper, Felix Michelet, A. Stewart, S. Jaydeokar
PurposeThe purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.Design/methodology/approachA cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.FindingsThere was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.Research limitations/implicationsNot having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.Originality/valueThis large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.
目的:本研究的目的是检查在提供非药物干预方面是否存在基于智力残疾水平和是否存在自闭症的差异。在智力残疾的成年人中,心理健康状况往往没有得到充分的诊断,而且并不总是按照国家卫生和保健研究所优秀指南的建议接受心理干预。为了实现英国国家计划的目标,即阻止智障人士过度使用药物,重要的是让这些人能够获得适当的非药物干预。作者研究了个体智力残疾水平与自闭症存在与否之间的关系,并从专业的社区智力残疾服务中获得相关的非药物干预。设计/方法/方法对2019年英格兰西北部四家专业智障服务机构的成年人进行的横断面研究。研究发现精神疾病的发病率很高,自闭症成年人的患病率更高。然而,研究人群中接受心理干预的比例相对较小。最常见的非药物干预是积极的行为支持计划,无论是否伴有精神疾病。研究局限/影响无法获得治疗精神疾病的心理干预措施可能导致健康结果不佳,并加剧健康不平等。这项研究强调了发展心理干预的必要性,特别是对那些有中度到重度智力残疾的人以及那些有相关自闭症的人。原创性/价值本大样本研究通过获取心理干预来检验智力残疾水平与自闭症存在之间的关系。
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引用次数: 0
Examining the relationship of age with fears among adolescents and young adults with and without intellectual disabilities 研究有和没有智力残疾的青少年和年轻人的年龄与恐惧的关系
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-04-12 DOI: 10.1108/amhid-10-2022-0037
L. Barnard‐Brak, Kagendo Mutua, J. Burnham
PurposeThis paper aims to examine for differences in potentially productive fear versus all other fear scores comparing adolescents and young adults with intellectual disabilities versus their typically developing peers without intellectual disabilities while statistically controlling for chronological age.Design/methodology/approachThe authors examined for differences in potentially productive fear scores versus all fear scores comparing adolescents and young adults with intellectual disabilities versus their typically developing peers without intellectual disabilities.FindingsResults of the current study highlight the importance of examining and statistically acknowledging the form of the relationship between age and fear. As previous research has indicated the relationship of age with fear, this form of the relationship should be acknowledged in subsequent analyses. Results also present a conceptualization of fear with some fears being considered as potentially productive fears as it relates to independent living.Research limitations/implicationsAs previous research has indicated the relationship of age with fear, this form of the relationship should be acknowledged in subsequent analyses. Finally, results present a conceptualization of fear with some fears being considered as potentially productive fears as it relates to independent living as an outcome.Practical implicationsThe current study presents a conceptualization of fear with some fears being considered as potentially productive fears as it relates to independent living as an outcome.Originality/valueResults support that potentially productive fears can be considered fears that can be used to promote learning that leads to independent living outcomes such as safety and security.
目的本文旨在检验潜在的生产性恐惧与所有其他恐惧评分的差异,将有智力残疾的青少年和年轻人与他们通常发展中的无智力残疾同龄人进行比较,同时对按时间顺序排列的年龄进行统计控制。设计/方法/方法作者比较了有智力残疾的青少年和年轻人与他们通常发展中的无智力残疾同龄人在潜在生产性恐惧评分与所有恐惧评分之间的差异。发现当前研究的结果强调了检查和统计承认年龄和恐惧之间关系形式的重要性。正如先前的研究表明年龄与恐惧的关系一样,这种关系应该在随后的分析中得到承认。研究结果还提出了恐惧的概念,一些恐惧被认为是潜在的生产性恐惧,因为它与独立生活有关。研究局限性/含义正如先前的研究表明年龄与恐惧的关系一样,这种形式的关系应该在随后的分析中得到承认。最后,研究结果提出了恐惧的概念,一些恐惧被认为是潜在的生产性恐惧,因为它与作为结果的独立生活有关。实际含义当前的研究提出了恐惧的概念,一些恐惧被认为是潜在的生产性恐惧,因为它与作为结果的独立生活有关。独创性/价值结果支持,潜在的生产性恐惧可以被视为恐惧,可以用来促进学习,从而获得独立的生活成果,如安全和保障。
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引用次数: 0
Informed consent with people judged incapable of legally consenting 被判定为无法律能力的人的知情同意书
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-04-06 DOI: 10.1108/amhid-10-2022-0040
Amy Bittick, Ryan Holliman
PurposeThe purpose of this study is to consider informed consent with those who may be legally judged incapable of consent. Frequently individuals with traumatic brain injuries and intellectual disabilities may fall into this category. This paper seeks to consider aspects of guardianship, moral and legal implications and best practices for mental health professionals.Design/methodology/approachThis practice piece reviews literature regarding informed consent, as well as pertinent issues in the professional literature regarding types of guardianship as well as the occurrence of “Lucid intervals.” Furthermore, literature from moral philosophy and current legal research was examined to fully provide readers with a grasp of the legal and ethical landscape of this issue.FindingsThe paper finds that treating consent as a one-time binary event is lacking in both practicality and nuance. Moral philosophy and issues regarding paternalism are raised, as well as practice approaches to assessment of capability and how to engage in therapy in meaningful ways.Originality/valueThis paper provides insight into providing dignity-affirming therapy with a population that is often not considered in the literature of mental health ethics. When it is considered, the suggestions are so vague as to be of limited use. This manuscript provides nuance and practical applications to be a therapist that promotes dignity in those who might have varying levels of capacity to consent.
目的本研究的目的是考虑那些可能在法律上被判定没有知情同意能力的人的知情同意。通常,患有创伤性脑损伤和智力残疾的人可能属于这一类。本文旨在考虑监护方面,道德和法律的影响和最佳做法的精神卫生专业人员。设计/方法/方法:这篇实践文章回顾了关于知情同意的文献,以及关于监护类型的专业文献中的相关问题,以及“清醒间隔”的出现。此外,从道德哲学和当前的法律研究文献进行了审查,以充分为读者提供这个问题的法律和伦理景观的把握。本文发现,将同意视为一次性二元事件既缺乏实用性,也缺乏细微差别。道德哲学和关于家长作风的问题被提出,以及评估能力和如何以有意义的方式参与治疗的实践方法。原创性/价值这篇论文提供了对在心理健康伦理学文献中通常不考虑的人群提供尊严肯定治疗的见解。经过考虑,这些建议非常模糊,用途有限。这个手稿提供了细微差别和实际应用,作为一个治疗师,促进那些可能有不同程度的同意能力的人的尊严。
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引用次数: 0
Staff views on reflective practice groups in an inpatient assessment and treatment unit for people with intellectual disabilities 工作人员对智障人士住院评估及治疗单位的反思实践小组的意见
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-03-21 DOI: 10.1108/amhid-11-2022-0045
Corinne A. Green, Reed Cappleman
PurposeAlthough it is recommended that reflective practice groups (RPGs) are used to support staff in inpatient intellectual disability (ID) services, there is to date no research on their effectiveness or how staff perceive RPGs in these settings. This paper aims to evaluate staff perceptions of the RPGs in an assessment and treatment unit for people with ID and to ascertain the nature of any barriers for staff in attending the group.Design/methodology/approachThirteen staff completed questionnaires ascertaining their views on the purpose, process and impact of the RPG run within the service. Questionnaires included a version of the clinical supervision evaluation questionnaire (CSEQ; Horton et al., 2008) adapted for this context and a questionnaire designed by the authors examining barriers to attending the group.FindingsStaff responses indicated that they valued the group and perceived it as improving their clinical practice and their self-awareness. Staff did not always perceive group sessions as having clear aims and did not perceive the group as enhancing their well-being or their awareness of gaps in their skills. RPGs may be most effective if they form part of a service-wide approach to staff support and development.Originality/valueTo the best of the authors’ knowledge, this is the first evaluation of RPGs in inpatient ID services. The adapted CSEQ was found to be an easily implemented method of evaluating RPGs in an inpatient ID setting.
目的尽管建议使用反思性实践小组(RPG)来支持住院智障(ID)服务的工作人员,但迄今为止,还没有研究其有效性或工作人员在这些环境中如何看待RPG。本文旨在评估工作人员对身份证患者评估和治疗单位RPG的看法,并确定工作人员参加该小组的任何障碍的性质。设计/方法/方法13名工作人员完成了问卷调查,确定了他们对RPG在服务中运行的目的、过程和影响的看法。问卷包括一份适用于这一背景的临床监督评估问卷(CSEQ;Horton等人,2008年),以及一份由作者设计的调查参加小组障碍的问卷。FindingsStaff的回答表明,他们重视这个团队,并认为它提高了他们的临床实践和自我意识。工作人员并不总是认为小组会议有明确的目标,也不认为小组会议提高了他们的幸福感或他们对技能差距的认识。如果RPG是全服务员工支持和发展方法的一部分,那么它们可能是最有效的。创意/价值据作者所知,这是首次对住院ID服务中的RPG进行评估。改进后的CSEQ被发现是一种在住院ID环境中评估RPG的简单方法。
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引用次数: 0
Spanish validation of the Glasgow depression scale for people with intellectual disabilities (GDS-LD) and of the Glasgow depression care supplement scale (GDS-CS) 格拉斯哥智力残疾人抑郁量表(GDS-LD)和格拉斯哥抑郁护理补充量表(GDS-CS)的西班牙验证
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-02-10 DOI: 10.1108/amhid-10-2022-0042
Mercedes H. Nuñez-Polo, Elena M Lorenzo-Llamas, M. Alonso-Rodríguez, J. Ayuso-Mateos, A. Martorell
PurposeThis study aims to validate a Spanish version of the Glasgow Depression Scale for Learning Disability (GDS-LD) and of the Glasgow Depression Care Supplement Scale (GDS-CS).Design/methodology/approachThe GDS-LD was administered to 120 adults with mild and moderate intellectual disabilities and the GDS-CS to the staff from their occupational workshops (n = 120) to detect symptoms of depression. Internal consistency, inter-rater reliability, test-retest reliability, criterion validity, construct validity and the feasibility and applicability of both scales were analysed.FindingsBoth scales showed an adequate internal consistency (GDS-LD, a = 0.86) (GDS-CS, a = 0.88). Exploratory factor analysis revealed four well-defined factors in GDS-LD and three in GDS-CS. Pearson correlation analysis data has also been carried out with both tools for test-retest and inter-rater, showing good correlations.Research limitations/implicationsIn terms, of limitations, the participants were recruited from the same centre, so this could be a problem in terms of generalisation. In addition, the GDS-LD and GDS-CS scales were developed for people with mild and moderate ID; it would be worth it to develop a version for people with severe and profound disabilities.Practical implicationsFrom its clinical perspective, it will be possible to have a specific tool that assesses the symptoms of depression in the Spanish population with ID. Furthermore, as it is a user-friendly scale; it can be administrated by both mental health and other professionals working in the field of disability.Originality/valueThe Spanish version of the GDS-LD and GDS-CS showed adequate rates of feasibility and reliability to assess symptoms depression among Spanish speaking adults with mild and moderate ID.
目的本研究旨在验证西班牙语版格拉斯哥学习障碍抑郁量表(GDS-LD)和格拉斯哥抑郁护理补充量表(GDS-CS)。设计/方法/方法对120名轻中度智力残疾成人和120名职业车间工作人员分别进行GDS-LD和GDS-CS检测抑郁症状。分析了两种量表的内部一致性、量表间信度、重测信度、量表效度、量表结构效度以及量表的可行性和适用性。结果两种量表均表现出足够的内部一致性(GDS-LD, a = 0.86) (GDS-CS, a = 0.88)。探索性因素分析显示GDS-LD有4个明确的因素,GDS-CS有3个因素。Pearson相关分析数据也与test-retest和inter-rater两种工具进行了比较,显示出良好的相关性。研究的局限性/意义就局限性而言,参与者是从同一中心招募的,因此这可能是概括方面的问题。此外,还编制了GDS-LD和GDS-CS量表。为严重残疾的人开发一个版本是值得的。实际意义从临床角度来看,有可能有一种特定的工具来评估西班牙ID人群的抑郁症状。此外,由于它是一个用户友好的规模;它可以由精神卫生和在残疾领域工作的其他专业人员管理。西班牙语版本的GDS-LD和GDS-CS显示出足够的可行性和可靠性来评估轻度和中度ID的西班牙语成人抑郁症症状。
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引用次数: 0
Evaluating workforce needs for higher specialist training for psychiatry of intellectual disability in Kent, Surrey and Sussex: a workforce scoping service evaluation 评估肯特郡、萨里郡和苏塞克斯郡智力残疾精神病学高级专业培训的劳动力需求:劳动力范围服务评估
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-02-02 DOI: 10.1108/amhid-10-2022-0041
R. Mukherjee, Mary Ondrusz
PurposeWhilst recruitment and retention of high-quality staff is vital to providing a good service, at the time of the evaluations, Kent, Surrey and Sussex (KSS) was the only area of the UK without a Higher Specialist Training (HST) scheme in intellectual disability (ID). The purpose of this project was to identify barriers to recruitment and support the need for change.Design/methodology/approachThis evaluation included conducting interviews with 16 practitioners in the region with links to ID to consider the gaps in training and find solutions.FindingsFour themes were identified, namely, good experiences are important to recruiting people into the ID field; bad experiences or lack of exposure to people with ID are likely to prevent engagement with this field; there is an ongoing need for specialist psychiatrists in ID services; and there is a developing need for specialists in neurodevelopmental disorders. Finally, the challenge means we need to think differently about developing a workforce. Seven recommendations to support workforce delivery in KSS were developed.Originality/valueThis paper highlights an important rationale for ongoing need for HST in ID work and also reasons to engage people in this field. This has not been undertaken in the ID field in this way previously.
目的:虽然招聘和留住高质量的员工对于提供良好的服务至关重要,但在评估的时候,肯特、萨里和苏塞克斯(KSS)是英国唯一一个没有智力残疾(ID)高等专家培训(HST)计划的地区。这个项目的目的是确定招聘的障碍和支持变革的需要。设计/方法/方法本次评估包括对该地区16名与ID有联系的从业人员进行访谈,以考虑培训中的差距并找到解决方案。研究结果确定了四个主题,即,良好的体验对招聘人员进入ID领域很重要;糟糕的经历或缺乏与ID患者的接触可能会阻碍他们参与这一领域;身份识别服务持续需要专业精神病医生;对神经发育障碍专家的需求也在不断增长。最后,这一挑战意味着我们需要从不同的角度来思考如何培养劳动力。提出了七项建议,以支持KSS的劳动力交付。原创性/价值这篇论文强调了在ID工作中持续需要HST的重要理由,以及在这个领域吸引人们的原因。以前在ID字段中没有这样做过。
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引用次数: 0
Caregivers experiences of caring for people with intellectual disability and dementia: a qualitative evidence synthesis 护理人员照顾智障和痴呆患者的经验:定性证据综合
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-01-20 DOI: 10.1108/amhid-08-2022-0027
Daniel Acton, S. Jaydeokar, Steven Jones
PurposeA systematic review of the literature was completed to examine the needs of those who provide care to people with intellectual disability and dementia. The purpose of this paper was to develop an understanding of the complexities, challenges and support available to meet the needs of an ageing population.Design/methodology/approachA qualitative evidence synthesis was used to appraise 12 studies. An evidence synthesis approach was used to better understand the challenges caregivers experience in caring for a person with intellectual disability and dementia. Aggregating and integrating findings from multiple studies allowed to identify inconsistencies, quality, relationships and trends to enhance the awareness of gaps in care provision.FindingsThere were six main domains identified from the available literature which included: gaps in knowledge and skills, early identification of dementia and associated difficulties, managing behaviour, coping, burden of care and Impact on confidence.Originality/valueTo the best of the authors’ knowledge, this is the first paper to use qualitative evidence synthesis to understand the challenges of caring for a person with intellectual disability and dementia.
目的完成对文献的系统回顾,以检查那些为智力残疾和痴呆症患者提供护理的人的需求。本文的目的是加深对满足人口老龄化需求的复杂性、挑战和可用支持的理解。设计/方法/方法采用定性证据综合法对12项研究进行评价。使用证据综合方法来更好地了解照顾者在照顾智力残疾和痴呆症患者时所面临的挑战。通过汇总和整合多项研究的结果,可以确定不一致、质量、关系和趋势,以提高对护理提供差距的认识。发现从现有文献中确定了六个主要领域,包括:知识和技能差距、痴呆症和相关困难的早期识别、管理行为、应对、护理负担和对信心的影响。原创性/价值据作者所知,这是第一篇使用定性证据综合来理解照顾智力残疾和痴呆症患者的挑战的论文。
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引用次数: 1
Investigating the experience of professional carers supporting individuals with intellectual disability who were at risk of admission – a qualitative study 调查专业护理人员支持有入院风险的智障人士的经验-一项定性研究
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-01-19 DOI: 10.1108/amhid-08-2022-0029
Mizla Manandhar-Richardson, Ceri Woodrow, Georgia Cooper-Taylor
PurposeThis study aims to understand the experiences of professional paid carers providing community support to people with intellectual disability “at risk of admission”. This study explores factors that were helpful or lacking in terms of the support the carers received from NHS health services during this time.Design/methodology/approachThis study conducted semi-structured interview with eight participants. Thematic analysis was used to analyse the data.FindingsThree main themes and ten subthemes were identified. The first main theme was “support systems” that were available or lacking for the client and their carers. The second main theme was “training and supervision” available to the carers and their team when the individual they supported needed additional support. The third theme was “change” clients encountered which included changes in the environment as well as changes because of COVID-19 pandemic.Originality/valueTo the best of the authors’ knowledge, this is the first study on experiences of carers during specifically high stress periods, such as when the clients they are supporting are at risk of hospital admission.
目的本研究旨在了解专业带薪护理员为“有入院风险”的智障人士提供社区支援的经验。本研究探讨了在此期间护理人员从NHS保健服务中获得的支持有帮助或缺乏的因素。设计/方法/方法本研究对8名参与者进行了半结构化访谈。采用主题分析法对数据进行分析。研究结果确定了三个主题和十个副主题。第一个主题是“支持系统”,即客户及其护理人员可用或缺乏的支持系统。第二个主题是“培训和监督”,当他们所支持的个人需要额外的支持时,护理人员及其团队可以使用。第三个主题是客户遇到的“变化”,包括环境的变化以及COVID-19大流行带来的变化。原创性/价值据作者所知,这是第一次对护理人员在特别高压力时期的经历进行研究,比如当他们所支持的客户有住院的风险时。
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引用次数: 0
Co-design and development of a multi-component anxiety management programme for people with an intellectual disability 为智障人士共同设计和开发多成分焦虑管理计划
IF 1.1 Q4 PSYCHIATRY Pub Date : 2023-01-13 DOI: 10.1108/amhid-04-2022-0017
Daniel Acton, R. Waites, S. Jaydeokar, Steven Jones
PurposeThis paper aims to understand the lived experience of people with intellectual disability of their anxiety and of being co-design partners in developing a multi-component approach to the management of anxiety.Design/methodology/approachThe development of an anxiety manual and programme was part of a service development which allowed existing and established psychological therapies to be adapted for people with intellectual disability. A qualitative approach was used to better understand the views of people who experienced anxiety on a daily basis. The feedback generated was used to make modifications to the manuals and the anxiety management programme.FindingsThe study has demonstrated the value of involving people with intellectual disability in the co-production of an anxiety management programme. Additional findings identified the real-life challenges and experiences of the impact anxiety has on people’s lives.Originality/valueTo our knowledge, this is the first study to involve people with intellectual disability in developing an anxiety management programme as co-production partners. This paper underlines the value of understanding and involving people as co-production partners in developing clinical interventions.
目的本研究旨在了解智障人士焦虑的生活经历,并作为共同设计伙伴开发一种多成分的焦虑管理方法。设计/方法/方法焦虑手册和方案的编写是服务开发的一部分,该服务开发允许对现有和已建立的心理治疗方法进行调整,以适应智障人士。一种定性的方法被用来更好地理解那些每天都经历焦虑的人的观点。所产生的反馈被用来修改手册和焦虑管理程序。研究结果这项研究证明了让智障人士参与到焦虑管理项目的共同制作中的价值。其他的研究结果确定了现实生活中的挑战和焦虑对人们生活的影响。原创性/价值据我们所知,这是第一个让智障人士作为合作伙伴参与制定焦虑管理计划的研究。这篇论文强调了在发展临床干预措施中理解和让人们作为合作伙伴参与的价值。
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引用次数: 2
Guest editorial 客人编辑
IF 1.1 Q4 PSYCHIATRY Pub Date : 2022-10-21 DOI: 10.1108/amhid-07-2022-073
Nigel Beail
In mainstream mental health services, there was a sudden move from face-to-face work to looking at new ways of working so that we could restore services as soon as possible. The problem for most services is that waiting lists were on hold for a while, then we had staff absences due to COVID resulting in a build of the waiting time as is common in all health services. In our service, we also had data previously collected on mental health and wellbeing assessment such as with the Psychological Therapies Outcome Scale ID II (Vlissides et al., 2017), which could be used to evaluate outcomes. [...]this is the body of research on psychological therapies generated by those at the coal face.
在主流心理健康服务中,突然从面对面工作转向寻找新的工作方式,以便我们能够尽快恢复服务。大多数服务的问题是,等待名单被搁置了一段时间,然后我们的员工因新冠肺炎而缺勤,导致等待时间增加,这在所有医疗服务中都很常见。在我们的服务中,我们还收集了以前收集的心理健康和幸福感评估数据,如心理治疗结果量表ID II(Vlissides et al.,2017),可用于评估结果。[…]这是对采煤工作面工作人员产生的心理疗法的研究。
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引用次数: 0
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Advances in Mental Health and Intellectual Disabilities
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