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Program logic of a service collaboration to support parents with intellectual disability 支持智障父母的服务合作计划逻辑。
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-16 DOI: 10.1111/jar.13249
Elizabeth Jane Doery, Jay Varcoe, Michelle Benstead, Matin Ghayour-Minaie, Rebecca Sheils, Siobhan Kavanagh, Keriann Little, Allie Pert, John W. Toumbourou

Background

This article describes the Steps to Confident Parenting (SCP) program, developed by an Australian family service consortium. The SCP integrates home-based and case-management services to enhance the skills of parents with a diagnosed or suspected intellectual disability/cognitive impairment and to prevent child protection interventions.

Method

‘Program explication’ methodology documented the components/activities, and underpinning evidence for this practitioner designed service through interviews with nine agency staff. A literature review evaluated evidence for the implicit program benefit theory.

Results and Conclusion

The SCP comprised five logically consistent components—Targeted Referral, Assessments, Initial Consultation, Program Delivery, Closure and Follow-up. Components generally had ‘some’ supportive evidence, however there was a ‘lack of’ evidence for Closure and Follow-up. In the context of a partnership seeking to build the evidence for the SCP, it was recommended that a protocol for a randomised trial evaluation with longer term follow-up be drafted by the consortia.

背景介绍本文介绍了澳大利亚家庭服务联盟开发的 "自信为人父母的步骤"(SCP)计划。方法:"计划阐释 "方法通过对九名机构工作人员的访谈,记录了这项由从业人员设计的服务的组成部分/活动和基本证据。文献综述评估了隐性计划效益理论的证据:SCP 由五个逻辑上一致的部分组成--目标转介、评估、初步咨询、项目实施、结束和跟踪。各组成部分一般都有 "一些 "支持性证据,但 "结束 "和 "后续行动 "则 "缺乏 "证据。在伙伴关系寻求为 SCP 建立证据的背景下,建议由联合体起草一份进行长期跟踪的随机试验评估规程。
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引用次数: 0
School-based targeted prevention for children with mild intellectual disabilities or borderline intellectual functioning and behaviour problems: A pilot implementation study 针对轻度智障或边缘智力功能和行为问题儿童的校本定向预防:试点实施研究。
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-16 DOI: 10.1111/jar.13250
E. Kühl, M. Deković, S. Thomaes, I. Koning, J. M. Liber

Background

We examined the implementation and potential effectiveness of a school-based targeted prevention programme addressing behaviour problems, adapted for children with mild intellectual disabilities or borderline intellectual functioning.

Method

Thirteen children participated. The intervention was implemented in schools. We examined intervention dosage, reach, responsiveness, satisfaction, and comprehension, using questionnaires completed by children and trainers. We assessed child- and teacher-reported behaviour problems before and after the intervention.

Results

Trainers selected both children who did and did not meet the intervention eligibility criteria, suggesting problems in intervention reach. Intervention dosage, responsiveness, satisfaction, and comprehension were satisfactory. There were group-level behaviour problem decreases (i.e., Cohen's d). Individual-level behaviour problem changes (i.e., Reliable Change Indices) showed large heterogeneity and little reliable change.

Conclusions

The results provide initial evidence that the intervention has potential for successful implementation in schools, but the current evidence for intervention effectiveness is inconclusive.

背景:我们研究了针对行为问题的校本定向预防计划的实施情况和潜在效果,该计划针对轻度智障或边缘智力功能儿童进行了调整:13名儿童参加了该项目。干预措施在学校实施。我们使用儿童和培训师填写的问卷调查了干预的剂量、覆盖面、响应度、满意度和理解力。我们还对干预前后儿童和教师报告的行为问题进行了评估:结果:培训师既选择了符合干预资格标准的儿童,也选择了不符合干预资格标准的儿童,这表明在干预到达率方面存在问题。干预的剂量、响应度、满意度和理解力都令人满意。群体层面的行为问题有所减少(即 Cohen's d)。个人层面的行为问题变化(即可靠变化指数)显示出很大的异质性,几乎没有可靠的变化:研究结果提供了初步证据,表明该干预措施有可能在学校成功实施,但目前有关干预效果的证据尚不确定。
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引用次数: 0
The use of proxy measurement of internal states in people with intellectual disability: A scoping review 智障人士内心状态替代测量法的使用:范围综述。
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-15 DOI: 10.1111/jar.13241
Kristen Webb, Monica Cuskelly, Ceridwen Owen

Background

The measurement of internal states of people with an intellectual disability is challenging. Given these difficulties, proxy respondents are sometimes used. However, the literature provides some caution about the validity of the use of proxy respondents.

Aims

This review aims to identify the available evidence regarding the use of proxy respondents in the measurement of internal states of people with intellectual disabilities.

Method

The Arksey and O'Malley scoping review framework was used for this review, refined with the Joanna Briggs Institute Methodology.

Results

Results indicate there are some differences in the findings reported with respect to the efficacy of the use of proxy respondents. These may be due to a number of inconsistencies and weaknesses in examinations of their utility.

Conclusions

If proxy-reports are to be useful in understanding the internal states of people with intellectual disability, researchers need to address the shortcomings revealed by this review.

背景:测量智障人士的内心状态具有挑战性。鉴于这些困难,有时会使用代理受访者。目的:本综述旨在确定有关在测量智障人士内心状态时使用代理受访者的现有证据:本综述采用 Arksey 和 O'Malley 的范围综述框架,并根据 Joanna Briggs 研究所的方法进行了改进:结果表明,在使用代理受访者的有效性方面,报告的结果存在一些差异。这可能是由于对其效用的研究存在一些不一致和不足之处:如果要使代理报告有助于了解智障人士的内心状态,研究人员就需要解决本综述所揭示的不足之处。
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引用次数: 0
How do people with intellectual disabilities understand friendship? A systematic meta-synthesis 智障人士如何理解友谊?系统性元综合
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-11 DOI: 10.1111/jar.13244
Isabel Jackson, Dave Dagnan, Laura Golding, Kelly Rayner-Smith

Background

Previous systematic reviews of the relationships of people with intellectual disabilities have included consideration of intimate relationships. In this paper, we report a systematic review of papers describing friendship only.

Method

A systematic qualitative meta-synthesis of the research exploring experiences of friendship as reported by people with intellectual disabilities.

Results

Seven papers met the inclusion criteria for analysis. Three superordinate themes were identified. (1) Reciprocity, ‘Someone who helps me, and I help them’. (2) The building blocks of friendships, ‘I can tell her some secrets’. (3) Managing friendship difficulties, ‘In real life it's much harder’.

Conclusion

People with intellectual disabilities value friendship and actively engage in reciprocal exchanges. We explore the strengths and limitations of current research, clinical implications, and directions for future research.

背景以往对智障人士人际关系的系统性综述都包括对亲密关系的考虑。在本文中,我们对仅描述友谊的论文进行了系统性综述。 方法 对探讨智障人士所报告的友谊经历的研究进行系统的定性元综合。 结果 七篇论文符合纳入分析的标准。确定了三个首要主题。(1) 互惠,"有人帮助我,我也帮助他们"。(2) 友谊的基石:"我可以告诉她一些秘密"。(3) 处理友谊遇到的困难,"在现实生活中,这要难得多"。 结论 智障人士重视友谊,并积极参与互惠交流。我们探讨了当前研究的优势和局限性、临床影响以及未来研究的方向。
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引用次数: 0
Barriers to physical activity participation for adults with intellectual disability: A cross-sectional study 智障成人参加体育活动的障碍:一项横断面研究。
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-08 DOI: 10.1111/jar.13242
Henriette Michalsen, André Henriksen, Gunnar Hartvigtsen, Monica Isabel Olsen, Erlend Refseth Pedersen, Erik Søndenaa, Reidun Birgitta Jahnsen, Audny Anke

Background

Identifying barriers that can be modified to promote physical activity is important for informing health interventions for adults with intellectual disabilities.

Objectives

Exploring participation in physical activity considering age, sex, living conditions, and health conditions. Further, identifying barriers significantly associated with sedentary activity after adjustment for physical activity correlates.

Methods

A cross-sectional study including physical activity and barrier questions from the POMONA-15 health indicators. Multivariate logistic regression analysis with sedentary activity level as dependent variable.

Results

Among 213 participants with intellectual disabilities, 36% reported predominately sedentary activities, 53% light and 11% moderate/vigorous physical activity. Barriers related to sedentary activity after adjustment were transportation, health conditions, mobility impairment, and lack of activities at the day activity centre.

Conclusions

The findings highlight the need to enhance physical activity opportunities at day activity centres, tailor programmes for wheelchair users, and improve access to physical activity facilities for adults with intellectual disabilities.

背景:找出可以改变以促进体育锻炼的障碍对于为智障成人的健康干预提供信息非常重要:根据年龄、性别、生活条件和健康状况,探索参与体育活动的情况。此外,在对体育活动相关因素进行调整后,确定与久坐不动活动有明显关联的障碍:方法:一项横断面研究,包括 POMONA-15 健康指标中的体力活动和障碍问题。以久坐活动水平为因变量进行多变量逻辑回归分析:结果:在213名智障参与者中,36%的人称主要从事久坐不动的活动,53%的人称从事轻度体力活动,11%的人称从事中度/剧烈体力活动。经过调整后,与久坐不动有关的障碍包括交通、健康状况、行动不便以及日间活动中心缺乏活动:研究结果突出表明,有必要增加日间活动中心的体育活动机会,为轮椅使用者量身定制活动计划,并改善智障成人使用体育活动设施的情况。
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引用次数: 0
Treating traumatized children with intellectual disabilities: Tailoring Trauma-Focused Cognitive Behaviour Therapy for a vulnerable population 治疗受创伤的智障儿童:为弱势人群量身定制创伤认知行为疗法。
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-05-08 DOI: 10.1111/jar.13243
Daniel W. Hoover, Tabitha C. Fleming, Maria Khan

Background

Children with intellectual disabilities are at heightened risk for traumatization, though underserved due to silos of care, diagnostic overshadowing, and lack of adapted treatment. Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), an evidence-based childhood trauma therapy, is described with recommended adaptations for use with children who have intellectual disabilities.

Method

We present a suggested theoretical and clinical guide for treating children with mild to moderate intellectual disabilities. We explicate key functional domains of intellectual disabilities—comprehension, executive functions, and generalization—as the basis for tailoring the treatment model.

Results

Therapy recommendations are organized into a heuristic ‘matrix’ of resources and adaptations to TF-CBT components, based on clinical experience and research literature, illustrated with composite case vignettes.

Conclusion

Children with intellectual disabilities are a uniquely vulnerable population historically excluded from clinical trauma interventions and research but can respond to adapted care. Considerations for future research and dissemination are discussed.

背景:智障儿童遭受心理创伤的风险较高,但由于医疗机构各自为政、诊断不明确以及缺乏适应性治疗等原因,这些儿童的心理创伤得不到充分治疗。创伤认知行为疗法(TF-CBT)是一种以证据为基础的儿童创伤疗法,本文介绍了该疗法,并建议将其调整用于智障儿童:方法:我们提出了治疗轻度至中度智障儿童的理论和临床指南建议。我们阐述了智障的关键功能领域--理解力、执行功能和概括能力,以此作为调整治疗模式的基础:根据临床经验和研究文献,我们将治疗建议组织成一个启发式 "矩阵",其中包含了TF-CBT的资源和调整内容,并通过综合案例进行了说明:智障儿童是一个独特的弱势人群,历来被排除在临床创伤干预和研究之外,但他们可以对经过调整的护理做出反应。本文讨论了未来研究和传播的注意事项。
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引用次数: 0
Perceived barriers and enablers to utilising the Australian National Disability Insurance Scheme for adults with an intellectual disability and their families: A scoping review 智障成人及其家庭在使用澳大利亚国家残疾保险计划时遇到的障碍和推动因素:范围审查
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-04-23 DOI: 10.1111/jar.13240
Alice Zubrinich, Gideon de Jong, Nasim Salehi, Richard Lakeman

Background

The introduction of the National Disability Insurance Scheme (NDIS) in Australia in 2013 promised significant improvements in the lives of adults with intellectual disabilities. Although the scheme enables support, there are challenges associated with establishing eligibility and administering funds. This scoping review explored perceived barriers and enablers to effectively utilising the NDIS for adults with intellectual disabilities and their families.

Method

A scoping review of the empirical literature on the NDIS and intellectual disabilities included nine studies in this review. These papers were subjected to thematic analysis and the findings were presented as a narrative synthesis.

Results

The key themes identified were: (1) Limited understanding of the NDIS process; (2) Language use and capacity assumptions; (3) Unrealistic goals and progress, and difficulty utilising plans; (4) Expectations of families and associated workloads; (5) Opening up opportunities not previously available; (6) Knowledgeable planners who actively seek to involve adults and their families.

Conclusion

Although qualitative studies demonstrate that adults with an intellectual disability and their families are largely satisfied with the increased opportunities the NDIS has afforded them, there are various areas in which accessibility to services can be improved. In order for the NDIS to continue to improve, the results from this scoping review underline the need for adults with an intellectual disability and their support systems to have their voices heard and be utilised.

背景 澳大利亚于 2013 年推出国家残疾保险计划(NDIS),承诺大幅改善智障成人的生活。尽管该计划能够提供支持,但在确定资格和管理资金方面仍存在挑战。本范围界定综述探讨了智障成人及其家庭在有效利用 NDIS 时所遇到的障碍和推动因素。 方法 对有关 NDIS 和智障的实证文献进行的范围界定审查将九项研究纳入了本审查。对这些文献进行了主题分析,并以叙述性综合报告的形式介绍了分析结果。 结果 确定的关键主题有(1) 对 NDIS 程序的理解有限;(2) 语言使用和能力假设;(3) 不切实际的目标和进展,以及利用计划的困难;(4) 家庭的期望和相关的工作量;(5) 提供以前没有的机会;(6) 积极寻求成人及其家庭参与的有知识的规划者。 结论 尽管定性研究表明,智障成人及其家人对 NDIS 为他们带来的更多机会基本满意,但仍有许多方面可以改进服务的可及性。为了使 NDIS 继续得到改善,本次范围界定审查的结果突出表明,有必要倾听智障成人及其支持系统的意见并加以利用。
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引用次数: 0
The feasibility of an adapted virtual mindfulness intervention for Special Olympics athletes and their caregivers 针对特奥会运动员及其护理人员的改编虚拟正念干预的可行性
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-04-21 DOI: 10.1111/jar.13229
Brianne Redquest, Chris A. Clark, Hangsel Sanguino, Yona Lunsky, Sue Hutton, Jonathan Weiss, Tom Davies, Carly A. McMorris

Background

Virtual mindfulness may be helpful for individuals with intellectual disabilities in the context of COVID-related disruptions of in-person programming, such as Special Olympics (SO). This study examined the feasibility of a virtual mindfulness intervention for SO athletes and their caregivers.

Method

SO athletes (n = 44) and their caregivers (n = 29) participated in a 6-week adapted virtual mindfulness intervention. Athletes completed mindfulness and well-being questionnaires prior to, immediately following, and 3-months post-intervention. Caregivers completed questionnaires assessing their own stress, mindfulness, and well-being, as well as athlete mental health. Exit interviews were conducted immediately following the intervention.

Results

The intervention was feasible in terms of demand, implementation, acceptability, and limited testing efficacy. There were significant improvements in athlete well-being and mental health, and caregiver stress and mindfulness post-intervention.

Conclusions

Adapted virtual mindfulness groups may be an effective intervention in improving the well-being of adults with intellectual disabilities and their caregivers.

背景 虚拟正念可能有助于智障人士在与 COVID 相关的情况下中断特奥会(SO)等现场活动。本研究探讨了针对特奥会运动员及其照顾者的虚拟正念干预的可行性。 方法 特奥会运动员(44 人)及其照顾者(29 人)参加为期 6 周的虚拟正念干预。运动员在干预前、干预后和干预后 3 个月填写正念和幸福感问卷。护理人员则填写了评估自身压力、正念和幸福感以及运动员心理健康的问卷。干预结束后立即进行了离职访谈。 结果 该干预措施在需求、实施、可接受性和有限的测试效果方面都是可行的。干预后,运动员的幸福感和心理健康以及照顾者的压力和正念均有明显改善。 结论 经调整的虚拟正念小组可能是改善智障成人及其照顾者福祉的有效干预措施。
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引用次数: 0
Understanding experiences of ‘Gig Buddies’: A befriending scheme for people with intellectual disabilities 了解 "Gig Buddies "的经历:智障人士结交计划
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-04-16 DOI: 10.1111/jar.13232
Fiona Brand, Katrina Scior, Alana Loewenberger

Background

Research into befriending for people with intellectual disabilities is limited. This study aimed to explore the impact, mechanisms of change, and limitations of a befriending scheme for adults with intellectual disabilities and/or autism.

Methods

Participants were recruited using convenience sampling. Thirteen individuals with intellectual disabilities and/or autism were interviewed and data thematically analysed.

Results

Four themes were generated: ‘Something fun for me’; ‘A good connection’; ‘Increasing independence’; and ‘A life less quiet’. Befriending had direct benefits through the activities undertaken and the befriending relationships themselves being fun and reducing isolation. Befriending facilitated belonging, improved access to mainstream activities, and fostered independence by providing safety and support. The importance of shared interests and external support for the relationship was highlighted.

Conclusions

Positive outcomes of befriending were found, supporting existing literature and revealing new information from the voices of participants with intellectual disabilities themselves.

背景 对智障人士结交朋友的研究十分有限。本研究旨在探讨智障和/或自闭症成人结伴计划的影响、变化机制和局限性。 方法 采用便利抽样法招募参与者。对 13 名智障人士和/或自闭症患者进行了访谈,并对数据进行了主题分析。 结果 得出了四个主题:为我带来乐趣"、"良好的联系"、"增强独立性 "和 "生活不再平淡"。结伴活动的直接益处在于所开展的活动以及结伴关系本身的趣味性和减少孤独感。结交朋友有助于增强归属感,增加参加主流活动的机会,并通过提供安全和支持来培养独立性。共同的兴趣和外部支持对这种关系的重要性得到了强调。 结论 结交朋友的积极成果支持了现有的文献,并从智障参与者自己的声音中揭示了新的信息。
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引用次数: 0
Preliminary translation of ‘Reducing Disability in Alzheimer's Disease’ among individuals with intellectual disabilities and caregiver dyads 减少阿尔茨海默病致残率 "在智障人士和照护者中的初步翻译
IF 2.4 3区 医学 Q1 Social Sciences Pub Date : 2024-04-15 DOI: 10.1111/jar.13239
Lauren T. Ptomey, Kelli Barton, Emma Swinford, Amy Bodde, Amanda George, Anna M. Gorczyca, C. Michelle Niedens, Susan C. Sprague, Amy Yeager, Brian Helsel, Linda Teri, Eric D. Vidoni, Jaime Perales-Puchalt

Background

The Reducing Disability in Alzheimer's Disease in Kansas City (RDAD-KC) intervention has been shown to improve the health of individuals with dementia and caregiver dyads. This manuscript reports the results of implementing the RDAD among individuals with intellectual disabilities and caregiver dyads.

Methods

Nine community agencies deployed the 12-week intervention. We assessed changes in individuals with intellectual disabilities' behavioural symptom related severity and physical activity, and caregivers' behavioural symptom-related distress, unmet needs, and caregiver strain.

Results

Forty-four dyads enrolled, and 23 (~60 years, 48% female) completed ≥75% of the intervention. We observed decreases in behavioural symptom related severity (p = .07) and increases in physical activity (p = .20) among individuals with intellectual disabilities. We also observed decreases in behavioural symptom related distress (p = .14), unmet needs (p = .50), and caregiver strain (p = .50) among caregivers.

Conclusions

The RDAD-KC intervention showed promising, although statistically non-significant, benefits among individuals with intellectual disabilities and their caregivers.

背景 堪萨斯城减少阿尔茨海默病致残干预(RDAD-KC)已被证明可以改善痴呆症患者和照护者二人组的健康状况。本手稿报告了在智障人士和照护者二人组中实施 RDAD 的结果。 方法 九个社区机构部署了为期 12 周的干预措施。我们评估了智障人士行为症状相关严重程度和体育活动的变化,以及照护者行为症状相关困扰、未满足需求和照护者压力的变化。 结果 44 个二人组参加了干预,其中 23 个(约 60 岁,48% 为女性)完成了≥75% 的干预。我们观察到,智障人士的行为症状相关严重程度有所下降(p = .07),体育活动有所增加(p = .20)。我们还观察到,在照顾者中,与行为症状相关的痛苦(p = .14)、未满足的需求(p = .50)和照顾者的压力(p = .50)均有所减少。 结论 RDAD-KC 干预在智障人士及其照顾者中显示出良好的效果,尽管在统计上并不显著。
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引用次数: 0
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Journal of Applied Research in Intellectual Disabilities
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