Journal of Applied Research in Intellectual Disabilities最新文献

Background

Pain recognition and assessment in individuals with profound intellectual disabilities are challenging. Exploring effective methods of addressing this is essential. This study aims to discover current nursing practice in this area of care as the first of a four-phased appreciative inquiry study, to inform further research and practice.

Methods

Data from individual and focus group interviews with co-researching nurses were collated and developed into themes.

Results

Six themes were identified: unconditional positive regard, honouring of relationship, creative best practice, pain through a competing lens, accurate assessment—an impossible task? Medicating pain—oversimplified and undervalued?

Conclusion

Relationship is essential, in recognising pain and distress. There is an understanding of the multifaceted nature of pain in the care of this population; however, physical pain recognition and assessment are prioritised, to prevent serious ill health and death. Formal methods of assessment and communication between professionals are needed.

Background

Services for adults with intellectual disabilities in Hong Kong have a hierarchical staffing structure. Professional social workers, who performed as mid-level employees, work with frontline support workers to deliver services to clients.

Methods

This qualitative study explored social workers' experiences of working with support workers through in-depth interviews with 13 participants.

Findings

The study revealed that social workers perceived a significant variation between themselves and support workers in terms of working motivation, values and attitudes towards clients with intellectual disabilities. Despite the hierarchical relationships, social workers and support workers share the power of service decision-making. Social workers used firm and gentle approaches to facilitate changes in practices to uphold service values. These findings were compared with Western literature on this topic, indicating similarities and differences.

Conclusion

The organisations need to facilitate an effective collaboration between social workers and support workers to enhance the quality of services for adults with intellectual disabilities in Hong Kong.

Background

People with intellectual disabilities commonly experience multiple barriers to ‘going out’.

Aims

This paper explores what barriers prevented people from going out, and if the extent and nature of going out changed over time for people with intellectual disabilities as the COVID-19 pandemic progressed.

Methods

Data are drawn from a wider study that explored, at four time points, the experiences of people with intellectual disabilities through the COVID-19 pandemic in the United Kingdom.

Findings

The number of people leaving the house for almost all reasons increased over time through the pandemic, except for some outdoor participation and exercise. However, there was a significant decrease in outdoor exercise at the final time point of the study. Reliance on other people and a lack of availability of support were identified as barriers.

Conclusion

A combination of factors restricted the extent to which people were going out even after COVID-19 protections were lifted.

Background

This exploratory study aimed to enhance the understanding of practitioners' experiences within LGBTQ+ community organisations when providing interventions for LGBTQ+ individuals with intellectual disabilities. Three specific objectives were outlined: to document the situations and challenges encountered by practitioners; to identify perceived needs among LGBTQ+ individuals with intellectual disabilities and to elicit their suggestions for recommendations to improve services.

Method

A qualitative approach, involving in-depth interviews with 12 Québec-based LGBTQ+ community practitioners, underwent content analysis.

Results

Findings were organised around three themes: perceived support needs of LGBTQ+ people with intellectual disabilities; challenges experienced in intervention and recommendations to improve services. Findings reveal that practitioners frequently face significant challenges when supporting LGBTQ+ individuals with intellectual disabilities, who often struggle with multiple daily challenges and insufficient support.

Conclusions

The study highlights the need to empower LGBTQ+ organisations with essential skills and foster partnerships with public service staff to ensure a more inclusive, intersectional approach.

Background

Walk tests are common gait speed and endurance assessments. Shorter test versions could benefit adults with intellectual disability. Thus, the concurrent validity of shorter tests was studied.

Methods

Thirty-five adults with mild to moderate intellectual disability, aged 21–64 years, were assessed with the 4-m walk test, 10-m walk test for gait speed, 2-min walk test, and 6-min walk test for endurance. Correlation and Bland–Altman plots analyses were used to establish concurrent validity between shorter and standard tests.

Results

Strong positive relationships were found for gait speed tests, r = 0.94, p < 0.001, and endurance tests, r = 0.83, p < 0.001, and differences between shorter and standard tests were within limits of agreement.

Conclusions

The concurrent validity of shorter walk tests was established in this study. This would mean that adults with intellectual disability with lower levels of fitness could be assessed.

Trial Registration: Australian New Zealand Clinical Trial Registry: ACTRN12624000203550.

Background

There is established evidence of complicated grief among people with an intellectual disability. This paper describes the process of adapting complicated grief therapy (CGT) for this population.

Method

Action research documented the adaptation of CGT. Qualitative methods included analysing meeting notes, reflective interviews with two members of the team involved in adapting the materials, and interviews with six professionals working in disability settings who reviewed the adapted materials.

Results

Key processes included adapting the standardised tools that form part of CGT and developing adapted approaches to abstract concepts related to death, dying and bereavement. Key therapeutic components such as imaginal revisiting and the role of significant others required adaptation for implementation with people with intellectual disabilities.

Conclusion

The importance of adapting evidence-based therapies for people with intellectual disabilities is emphasised. This research provides an adapted form of an established therapy for piloting with this population.

Background

People with intellectual disabilities remain disadvantaged in many aspects of everyday life. Capability approach is an underused approach in social care research and has at its core the importance of having capabilities or opportunities to do what we value. We use this approach to explore how people with intellectual disabilities can be supported to lead flourishing lives.

Methods

Interviews and focus groups were conducted with 50 people with intellectual disabilities and 28 family carers. Data were analysed using an adapted template approach and conceptual analysis.

Results

Our analysis led to the identification of one overarching theme; ‘Doing what you love and growing’ and sub-themes; ‘Choice, opportunity and empowerment’, ‘Being out in the world’ and ‘Lowered expectations and static lives’.

Conclusion

People with intellectual disabilities can lead capability-deprived lives. Methodological and practice innovation is needed to better understand what people value and ensure they have capability sets that enable flourishing lives.

Background

Many people view people with intellectual disability primarily as needing help. That perspective limits relationships and can promote discrimination. We sought to better understand social relationships among young adults with intellectual disability.

Method

Seven postsecondary students with intellectual disability participated in a photovoice study, sharing photos and stories about giving and receiving help. They participated in individual interviews, a group meeting, and a photo exhibition, and helped identify results and conclusions.

Results

Participants viewed themselves as helpers and recipients of help. Themes were: foundational importance of families; openness to being helped; personal growth through challenging experiences; and tension between wanting to help and risks of helping others. Participants wanted to raise awareness that people with disabilities can help others, educate them about disability, and contribute to research.

Conclusions

Many young adults with intellectual disability want to contribute to relationships, which are often limited by others' expectations about disability.

Purpose

Understanding the experiences of people with developmental disabilities during the initial period of COVID-19 pandemic.

Methods

Individuals with developmental disabilities and their caregivers completed baseline and up to five follow-up online surveys using the CRISIS-AFAR measures, between July 2020 and September 2021. We used qualitative (thematic analysis) and quantitative (MANOVA) analytic methods.

Results

One hundred and eighteen participants (64 caregivers on individuals 6–62 years, 54 self-reporting individuals aged 17–55 years) completed baseline survey; 46 participants (23 caregivers, 23 self-reporting adults) completed ≥1 follow-up. Qualitative themes included uncertainty, and negative and positive influences on behaviours and routines, daily life and mental wellness. Those experiencing positive impacts did not stably perceive so longitudinally.

Conclusions

Despite both negative and positive influences on individuals with developmental disabilities and their families, the prolonged pandemic had wide-ranging repercussions. Emergency preparedness planning should consider the disruptive effects of public health measures on routine and support for this vulnerable population.