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What Approaches Described in Research Literature Enhance the Engagement of Children and Young People With Severe or Profound and Multiple Learning Disabilities? A Systematic Literature Review 研究文献中描述的哪些方法能够提高严重或极度多重学习障碍儿童和青少年的参与度?系统性文献综述
IF 1.5 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-09-16 DOI: 10.1111/bld.12619
Dominic Fitzpatrick, Richard Parker
BackgroundChildren and young people (CYP) with severe or profound and multiple learning disabilities are more likely to experience difficulties engaging for long periods. Finding ways to facilitate their engagement is crucial in promoting their social and emotional development and their mental well‐being, particularly as they are more vulnerable to difficulties with mental well‐being compared to their peers.MethodsWe undertook a systematic literature review (SLR) to identify approaches described within peer‐reviewed research literature that enhance the engagement of these children. Data from seven relevant studies were qualitatively synthesised. Thematic networks were then developed to visually present global, organising and basic themes identified within data.FindingsA global theme derived from organising themes across studies indicated that the quality of space is an important consideration in enhancing engagement. This included the extent to which space adhered to prescribed knowledge or afforded practitioners with opportunities to follow their intuition and deviate from such ideas.ConclusionsQuality of space may be important to the engagement of these CYP and consequently to their mental well‐being. This may involve consideration of the extent to which formal learning environments for them are organised and informed by dominant theory and discourse (abstract space), prescribed (spatial) practice and the extent to which environments provide conditions for ‘lived spaces’ that are potentially more facilitative of their engagement and so their mental well‐being.
背景患有严重或深度多重学习障碍的儿童和青少年(CYP)更有可能在长期参与活动方面遇到困难。找到促进他们参与的方法对于促进他们的社交和情感发展以及心理健康至关重要,尤其是与同龄人相比,他们更容易在心理健康方面遇到困难。方法我们进行了一项系统性文献综述(SLR),以确定同行评审研究文献中描述的可提高这些儿童参与度的方法。我们对七项相关研究的数据进行了定性综合。研究结果从各项研究的组织主题中得出的一个总体主题表明,空间质量是提高参与度的一个重要考虑因素。这包括空间在多大程度上遵循了规定的知识,或为实践者提供了遵循直觉和偏离这些想法的机会。这可能需要考虑为他们提供的正规学习环境在多大程度上是由主流理论和话语(抽象空间)、规定(空间)实践组织和提供的,以及在多大程度上环境为 "生活空间 "提供了条件,而 "生活空间 "可能更有利于他们的参与,从而更有利于他们的心理健康。
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引用次数: 0
Staff Perceptions of Mental Health Relapse Prevention Support in a Specialist Mental Health Service in an Intellectual Disability Setting 智障人士专科心理健康服务机构员工对心理健康复发预防支持的看法
IF 1.5 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-09-10 DOI: 10.1111/bld.12617
Shannon Sinnott, Cliodhna O'Donovan, Suzanne Guerin
BackgroundThe present study investigated staff perspectives on supporting individuals with intellectual disabilities with mental health relapse prevention.MethodsEight staff with experience working with or supporting individuals engaged with a specialist mental health in intellectual disability (MHID) service (team member = 2, management roles = 2, nursing/social care = 4; average years' experience = 16 years, SD = 13.7) completed semi‐structured interviews and thematic analysis was conducted on the resulting data.FindingsParticipants held mostly positive views of MHID supports and described being actively involved in individualised and person‐centred mental health supports. There was variation in awareness and recognition of relapse prevention between MHID and other (frontline) staff. Although frontline staff generally did not express explicit knowledge of relapse prevention, there was implicit staff awareness surrounding ongoing mental health supports, managing risk and coping strategies. Frontline staff also reported a lack of knowledge of the discharge process from the MHID service. Staff questioned the nature of discharge in mental health intellectual disability supports.ConclusionThis study identifies a gap in frontline staff's explicit knowledge of mental health relapse prevention, while also highlighting the importance of ongoing mental health support for individuals with intellectual disabilities.
背景本研究调查了工作人员对支持智障人士预防精神疾病复发的看法。方法八名具有智障人士精神健康(MHID)专业服务工作或支持经验的工作人员(团队成员 = 2,管理角色 = 2,护理/社会关怀 = 4;平均工作年限 = 16 年,SD = 13.7)完成了半结构式访谈,并对所得数据进行了主题分析。研究结果参与者对 MHID 支持大多持积极态度,并描述了积极参与个性化和以人为本的精神健康支持的情况。心理健康援助和其他(一线)工作人员对预防复发的意识和认识存在差异。尽管一线工作人员一般都没有明确表示对复发预防的认识,但他们对持续的心理健康支持、风 险管理和应对策略有隐性的认识。前线工作人员还表示,他们对精神健康干预服务的出院程序缺乏了解。结论:本研究发现了一线工作人员在心理健康复发预防方面的明确知识缺口,同时也强调了为智障人士提供持续的心理健康支持的重要性。
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引用次数: 0
Item reduction of the “Support Intensity Scale” for people with intellectual disabilities, using machine learning 利用机器学习减少智障人士 "支持强度量表 "的项目
IF 1.5 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-08-19 DOI: 10.1111/bld.12616
Félix González‐Carrasco, Felipe Espinosa Parra, Izaskun Álvarez‐Aguado, Sebastián Ponce Olguín, Vanessa Vega Córdova, Miguel Roselló‐Peñaloza
BackgroundThe study focuses on the need to optimise assessment scales for support needs in individuals with intellectual and developmental disabilities. Current scales are often lengthy and redundant, leading to exhaustion and response burden. The goal is to use machine learning techniques, specifically item‐reduction methods and selection algorithms, to develop shorter and more efficient scales.MethodsA data set of 93 participants was analysed using the Supports Needs Scale. Five feature‐selection algorithms were evaluated to create a shortened questionnaire. For each algorithm, a Random Forest model was trained, and performance was assessed using metrics like accuracy, precision, recall and F1‐score to measure how well each model predicted support needs.FindingsThe "Select from Model" algorithm successfully identified key items that could predict the level of Support Needs using the Random Forest model. Only 51 variables, out of the original 147, were needed to maintain predictive accuracy. The reduced questionnaire maintained good reliability and internal consistency compared to the original instrument, with a strong F1 score indicating excellent predictive performance.ConclusionsThe study demonstrates that machine learning techniques are effective in reducing the length of support needs questionnaires while preserving their psychometric properties. These methods can help institutions provide more efficient access to information about support needs without compromising validity or reliability, potentially leading to better resource allocation and improved care for individuals with intellectual disabilities.
背景这项研究的重点是需要优化智力和发育障碍人士的支持需求评估量表。目前的量表通常冗长而多余,会导致疲惫和回答负担。我们的目标是利用机器学习技术,特别是项目缩减方法和选择算法,开发出更简短、更高效的量表。我们对五种特征选择算法进行了评估,以制作出更简短的问卷。对每种算法都训练了一个随机森林模型,并使用准确率、精确度、召回率和 F1 分数等指标对性能进行评估,以衡量每个模型预测支持需求的效果。在原来的 147 个变量中,只需要 51 个变量就能保持预测的准确性。与原始问卷相比,缩减后的问卷保持了良好的可靠性和内部一致性,强大的 F1 分数表明问卷具有出色的预测性能。这些方法可以帮助机构更有效地获取有关支持需求的信息,同时又不会影响有效性或可靠性,从而有可能改善资源分配和对智障人士的护理。
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引用次数: 0
Culturally adaptive healthcare for people with a learning disability from an ethnic minority background: A qualitative synthesis 为少数民族背景的学习障碍者提供文化适应性医疗保健服务:定性综述
IF 1.5 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-08-12 DOI: 10.1111/bld.12614
Christina Roberts, Nicola Ditzel, Nicola Cooper‐Moss, Katie Umbleby, Umesh Chauhan
BackgroundPeople with a learning disability face health inequality. Those from ethnic minority backgrounds with a learning disability face ‘double discrimination’ as members of two marginalised groups.MethodsThis codesigned review consolidated the evidence on the healthcare experiences of individuals and their carers from ethnic minority backgrounds with a learning disability. Three electronic databases were searched for UK studies from January 1990 to June 2022. Qualitative data from 28 studies were analysed using thematic framework analysis.FindingsThere was an overarching theme of ‘culture, choice and conflicts of control’, which related to the variable preferences for involvement in healthcare decisions. Cultural and individual factors impacted upon experience, with themes relating to ‘misunderstanding and mistrust’, ‘discrimination and stigma’, ‘isolation’, ‘feelings of shame and blame’, ‘burdens of care’ and ‘carer wellbeing’. Factors associated with healthcare‐seeking and care provision are described in the themes ‘triangles of care’, ‘community networks’ and ‘adaptive communication’.ConclusionsPeople from ethnic minority backgrounds with learning disability experience complex barriers which influence their healthcare experiences. Recognising and understanding discrimination can be difficult for people with a learning disability. Carers face challenges which influence their own wellbeing. Services need to be responsive to individual cultural contexts, while addressing potential conflicts of control.
背景有学习障碍的人面临着健康不平等。作为两个边缘化群体的成员,来自少数民族背景的学习障碍者面临着 "双重歧视"。方法本研究整合了来自少数民族背景的学习障碍者及其照顾者的医疗保健经历的相关证据。我们在三个电子数据库中搜索了 1990 年 1 月至 2022 年 6 月期间的英国研究。研究结果 "文化、选择和控制冲突 "是一个总的主题,与参与医疗决策的不同偏好有关。文化和个人因素对体验产生了影响,主题涉及 "误解和不信任"、"歧视和耻辱"、"孤立"、"羞耻感和自责"、"护理负担 "和 "护理者福祉"。与寻求医疗保健和提供护理相关的因素在 "护理三角"、"社区网络 "和 "适应性交流 "等主题中进行了描述。对于有学习障碍的人来说,认识和理解歧视是一件困难的事情。照顾者面临着影响其自身福祉的挑战。服务需要对个人的文化背景做出回应,同时解决潜在的控制冲突。
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引用次数: 0
Bridging the digital divide for individuals with intellectual disabilities: Implications for well‐being and inclusion 缩小智障人士的数字鸿沟:对福祉和包容的影响
IF 1.5 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-07-25 DOI: 10.1111/bld.12613
Esther Murphy, Orla Shiels, Sara Fiori, Darren McCausland, Helena Bergström, Raphael Koster, Hanna Noorlandt, Ida Korfage, Eva Flygare Wallén
BackgroundDevelopments in digital technologies have transformed how people interact with the world, offering employment, education, communication, health benefits and entertainment. Research has shown that not everyone can easily access digital content, particularly people with intellectual disabilities. Despite internet access being recognised as a human right in the United Nations' Conventions on the Rights of Persons with Disabilities, this group faces significant disadvantages.MethodsA thematic analysis of quantitative and qualitative findings was conducted with data from focus groups and interviews with 200+ participants across Ireland, Sweden, France, and the Netherlands on how people with intellectual disabilities are using technology at this time and access facilitators and barriers.FindingsThe pandemic exacerbated the digital divide between people with intellectual disabilities and their neurotypical peers, impacting physical and mental well‐being. Growing demand for accessible digital skills training underscores the need to bridge this gap.ConclusionAddressing these digital access disparities is crucial to ensure that individuals with intellectual disabilities can enjoy the benefits of the digital age and maintain their well‐being. By identifying priority topics in our interview data, researchers also pinpointed critical accessibility barriers and facilitators to support codesigning activities for future digital skills education content within the Digi‐ID project.
背景数字技术的发展改变了人们与世界互动的方式,为人们提供了就业、教育、交流、健康和娱乐。研究表明,并非每个人都能轻松获取数字内容,尤其是智障人士。尽管联合国《残疾人权利公约》将使用互联网视为一项人权,但这一群体仍面临着巨大的不利因素。研究方法通过对爱尔兰、瑞典、法国和荷兰的 200 多名参与者进行焦点小组讨论和访谈,对定量和定性结果进行了专题分析,以了解智障人士目前是如何使用技术的,以及使用技术的促进因素和障碍。研究结果大流行加剧了智障人士与神经正常的同龄人之间的数字鸿沟,影响了他们的身心健康。对无障碍数字技能培训日益增长的需求凸显了弥合这一鸿沟的必要性。结论要确保智障人士能够享受数字时代的益处并保持身心健康,解决这些数字访问方面的差距至关重要。通过确定访谈数据中的优先主题,研究人员还指出了关键的无障碍障碍和促进因素,以支持 Digi-ID 项目中未来数字技能教育内容的编码设计活动。
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引用次数: 0
Umbrella review of hospital passports: Their use and improvements 对医院护照的全面审查:使用和改进
IF 1.2 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-07-17 DOI: 10.1111/bld.12612
Jennifer Jackson, Jessica Sinyor, Hayley Trower
<div> <section> <h3> Background</h3> <p>The hospital or health passport is widely acknowledged as a central element in making reasonable adjustments for patients with intellectual disabilities. Historically, the health passport has been used exclusively for patients with intellectual disabilities; however, it has wider applications for any patient requiring additional support. Commonly, it documents past medical history, communication needs and a person's means of expressing pain. There are, however, significant barriers to their use, meaning patients are unable to access adjustments to improve their experiences in a healthcare system that already marginalises and discriminates against people with intellectual disabilities. This umbrella review aims to establish whether the passport is an effective reasonable adjustment, identify barriers to its use and make recommendations to alleviate these barriers.</p> </section> <section> <h3> Methods</h3> <p>Database and citation searches informed a synthesis of international evidence to address these aims. Following the removal of duplicates and screening, nine review papers originating from the United Kingdom, Australia and Ireland were identified for inclusion. Seven focus on the use of passports for patients with intellectual disabilities, one on the use of passports for autistic people, and one exploring the use of passports for patients with dementia.</p> </section> <section> <h3> Findings</h3> <p>The results demonstrated that the passports are effective in improving care for patients with intellectual disabilities. However, there are barriers to its routine use. We identified three main issues with the current use of the hospital passport. First, there is a need for greater managerial support to implement reasonable adjustments. Second, standardisation of the passports at a national level will make them more accessible to healthcare professionals and will ensure that information is not ‘buried’; the development of a standardised passport must involve consultation of patients, carers and staff to meet the needs of all stakeholders. Finally, education for all healthcare staff to raise awareness of the passport and ensure it is utilised appropriately will ultimately pave the way for positive, long-lasting change.</p> </section> <section> <h3> Conclusions</h3> <p>Passports can be an effective means of communicating reasonable adjustments. Addressing a lack of awareness of its utility, ensuring managerial commitment to implementing reasonable adjustments and making the passport accessible through a standard
背景医院或健康护照被广泛认为是为智障病人提供合理调整的核心要素。从历史上看,健康护照只用于智障病人,但它对任何需要额外支持的病人都有更广泛的应用。通常情况下,它可以记录患者的既往病史、沟通需求和表达疼痛的方式。然而,这些工具的使用却存在着巨大的障碍,这意味着患者无法在已经边缘化和歧视智障人士的医疗保健系统中获得调整,以改善他们的就医体验。本综述旨在确定护照是否是一种有效的合理调整,识别使用护照的障碍,并提出减少这些障碍的建议。在删除重复内容并进行筛选后,确定了九篇来自英国、澳大利亚和爱尔兰的综述论文供纳入研究。其中七篇侧重于智障患者护照的使用,一篇侧重于自闭症患者护照的使用,还有一篇探讨了痴呆症患者护照的使用。但是,护照的常规使用还存在一些障碍。我们发现,目前医院护照的使用主要存在三个问题。首先,在实施合理调整方面需要更多的管理支持。其次,在全国范围内实现通行证的标准化将使医护人员更容易使用通行证,并确保信息不会被 "埋没";标准化通行证的开发必须征求患者、护理人员和员工的意见,以满足所有利益相关者的需求。最后,对所有医护人员进行教育,提高他们对护照的认识,并确保其得到合理使用,这将最终为积极、持久的变革铺平道路。解决对其效用缺乏认识的问题,确保管理者致力于实施合理的调整,并通过标准化的格式使患者能够使用护照,这将增强患者参与自身护理的能力。
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引用次数: 0
Big ideas that changed the world of disability: Exploring theory with self-advocates 改变残疾世界的伟大思想:与自我倡导者一起探索理论
IF 1.2 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-07-17 DOI: 10.1111/bld.12611
Nicola Grove, Simon Richards, Simon Rice, Claudia Magwood, Bryan Collis, Steffen Martick, Saskia Schuppener, Gertraud Kremsner, Elizabeth Tilley, Jan Walmsley

Background

Inclusive research has sidelined discussion of theoretical issues with researchers with intellectual/learning disabilities. This is a situation which the Big Ideas initiative sought to change. Between 2021 and 2023, the Open University, Leipzig University and the University of Koblenz organised nine workshops to explore influential theories in disability research. The objective was to share a theory (Big Idea) that sheds light on disability with self-advocates and discuss how it relates to their experience. By making theories accessible and discussing how they relate to lived experience, we aimed to inform self-advocates and activist researchers about key concepts in disability, deepen their capacity for research and campaigning, and better equip them to activate for change.

Methods

The online workshops were evaluated by observers. These observations were used by an inclusive group of activist researchers as the basis for an overall evaluation of the project.

Findings

People with learning disabilities can engage with complex theories if these are presented accessibly alongside opportunities for reflective discussion. Input from self-advocates helps to broaden and deepen theoretical understanding.

An unanticipated but important finding was that the Big Ideas workshops created a new space in which academics and self-advocates could learn together as equals.

Conclusions

Making theory accessible and easier to understand is both possible and valuable.

背景全纳研究忽视了与智力/学习障碍研究人员讨论理论问题。而 "大创意 "计划正是要改变这种状况。2021 年至 2023 年期间,开放大学、莱比锡大学和科布伦茨大学组织了九次研讨会,探讨残疾研究中具有影响力的理论。目的是与自我倡导者分享揭示残疾问题的理论(大构想),并讨论该理论与他们的经历有何关联。通过使理论易于理解并讨论其与生活经验的关系,我们旨在让自我倡导者和积极的研究人员了解残疾领域的关键概念,加深他们的研究和运动能力,使他们能够更好地推动变革。研究结果如果能将复杂的理论与反思性讨论的机会结合起来,学习障碍者就能理解这些理论。一个意料之外但却很重要的发现是,"大创意 "研讨会创造了一个新的空间,让学者和自我倡导者可以平等地共同学习。
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引用次数: 0
Editorial: The case for more action and more research into healthcare provision and health inequalities for people with intellectual disabilities 社论:对智障人士的医疗保健服务和健康不平等问题采取更多行动和开展更多研究的理由
IF 1.2 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-06-24 DOI: 10.1111/bld.12610
Hazel M. Chapman, Martin McMahon, Alexandra Kaley, Kay Mafuba, Mary-Ann O'Donovan
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引用次数: 0
Don't put us away: Memories of a man with learning disabilities By  Richard Keagan-Bull, forward by Mel Giedroyc, Critical Publishing.  2022. pp. 184. £18.99. 别把我们关起来:一个有学习障碍的人的回忆》,理查德-基根-布尔著,梅尔-吉德罗伊茨作序,临界出版社。2022年,第184页。£18.99.
IF 1.2 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-06-14 DOI: 10.1111/bld.12608
Nathaniel Lawford
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引用次数: 0
Working it out together: Lessons and insights into inclusive research in an arts context 共同努力:艺术领域包容性研究的经验与启示
IF 1.2 4区 医学 Q3 EDUCATION, SPECIAL Pub Date : 2024-06-11 DOI: 10.1111/bld.12609
Matthew Reason, Kelsie Acton, Daniel Foulds

Background

I'm Me is a creative research project co-created between York St John University and Mind the Gap, investigating learning disabled and autistic artists’ understandings of identity, representation and voice.

Methods

In this paper, we use Walmsley and Johnson's criteria for inclusive research to reflect on the involvement of people with learning disabilities and autism in I'm Me.

Findings

Researchers need to carefully reflect on who benefits from research. Long-term relationships allow genuine allyship and for research design to emerge in an inclusive manner. Taking the time to develop access and clear structures for decision-making can support people with learning disabilities’ participation and control over research. Part of access is sharing our findings in accessible ways, in this case, by using plain language and artistic outputs.

Conclusions

Working out how people with learning disabilities and autism should be involved in research has involved establishing structures, reflecting and responding to create as much involvement and enable as much decision-making as possible.

我是我 "是约克圣约翰大学(York St John University)与 "缩小差距 "组织(Mind the Gap)合作开展的一个创意研究项目,旨在调查学习障碍者和自闭症艺术家对身份、代表性和话语权的理解。在本文中,我们采用沃姆斯利(Walmsley)和约翰逊(Johnson)提出的包容性研究标准,对 "我是我 "中学习障碍者和自闭症患者的参与情况进行反思。研究人员需要仔细思考谁能从研究中获益。长期的合作关系可以建立真正的盟友关系,并以包容性的方式进行研究设计。花时间开发决策通道和明确的决策结构,可以支持学习障碍者参与和控制研究。如何让学习障碍者和自闭症患者参与到研究中来,这涉及到建立结构、反思和回应,以创造尽可能多的参与机会并促成尽可能多的决策。
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引用次数: 0
期刊
British Journal of Learning Disabilities
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