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Why am I still in hospital? Evaluation of delayed discharges from two learning disability assessment and treatment units in England 为什么我还在医院?英国两个学习障碍评估和治疗单位延迟出院的评估
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2023-06-22 DOI: 10.1108/tldr-07-2022-0015
Daisy Alicia Gibson, Holly Eick, Susanne Meddings, Ceri Woodrow
PurposeThis paper aims to examine the prevalence and reasons for delayed discharge from two regional assessment and treatment units (ATUs) for people with learning disabilities, in line with the transforming care agenda.Design/methodology/approachThis is a retrospective evaluation of 44 admissions and discharges from two ATUs from February 2019 to March 2022.FindingsOf 44 admissions who were discharged during the included period, 20 experienced delays in their discharge. Delayed discharges occurred despite the two ATUs meeting standards for length of assessment and treatment as specified by the Learning Disability Professional Senate. The most prevalent reasons for discharge delays were identification of a new placement, recruitment of care staff and building work.Originality/valueThis paper offers an in-depth evaluation of recent delayed discharges from two regional ATUs, highlighting the most common reasons for delays and offering suggestion for reducing delays in future.
目的探讨两个区域学习障碍评估和治疗单位(ATUs)延迟出院的患病率及其原因,以配合转型护理议程。设计/方法/方法这是对2019年2月至2022年3月两个ATUs的44例入院和出院的回顾性评估。研究发现,在研究期间出院的44名住院患者中,有20人在出院时遇到了延误。尽管两个ATUs达到了学习障碍专业参议院规定的评估和治疗时间标准,但仍发生了延迟出院。延迟出院的最普遍原因是确定新的安置地点、征聘护理人员和建筑工作。原创性/价值本文对两个区域ATUs最近的延迟排放进行了深入评估,突出了延迟的最常见原因,并提出了未来减少延迟的建议。
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引用次数: 2
What can a Family Liaison Service offer families of children with disabilities and/or developmental difficulties? 家庭联络服务能为残疾及/或有发展困难儿童的家庭提供什么服务?
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2023-06-22 DOI: 10.1108/tldr-11-2022-0024
B. Collins, Nicole A. McGrath, S. Maguire
PurposeFamilies of children with disabilities experience many challenges, which Sparkle’s Family Liaison Service (FLS) aims to alleviate. The purpose of this study was to evaluate the impact of the service.Design/methodology/approachQualitative interviews with ten families who had accessed the FLS and 14 professionals working with children with disabilities were conducted in 2020. Interview transcripts were analysed using inductive and deductive thematic analysis.FindingsFamilies valued an accessible service and a neutral individual who could empathise with them. Professionals highlighted the FLS relieving pressure they felt to provide informal support for families they work with, resulting in considerable time saving.Originality/valueTo the best of the authors’ knowledge, this is the first evaluation of the novel FLS meeting the unmet needs of families of children with disabilities. The service equips and empowers caregivers to enhance their own lives and the lives of their children and family.
目的残疾儿童的家庭面临许多挑战,耀辉的家庭联络服务(FLS)旨在减轻这些挑战。本研究的目的是评估这项服务的影响。设计/方法/方法在2020年对10个使用过残疾儿童服务的家庭和14名从事残疾儿童工作的专业人员进行了定性访谈。访谈记录分析采用归纳和演绎主题分析。调查结果:家庭看重的是无障碍的服务和能与他们感同身受的中立人士。专业人士强调,外联服务减轻了他们为合作家庭提供非正式支持的压力,从而节省了大量时间。原创性/价值据作者所知,这是第一次对小说《残疾儿童》满足残疾儿童家庭未满足需求的评价。这项服务为护理人员提供了装备和能力,使他们能够改善自己及其子女和家人的生活。
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引用次数: 0
Diversity and inclusion policies in publicly traded New Zealand companies: inclusion of people with intellectual disabilities 新西兰上市公司的多样性和包容性政策:智障人士的包容性
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2023-06-21 DOI: 10.1108/tldr-07-2022-0016
Dhammika (Dave) Guruge
PurposeThis study aims to evaluate employment opportunities for people with intellectual disabilities in publicly traded companies in New Zealand.Design/methodology/approachThe diversity and inclusion (DI) policies of 163 publicly traded companies listed on the New Zealand equity market were examined and compared to the Global Reporting Initiative (GRI) reporting standards using content analysis with Leximancer software.FindingsOnly 1.84% of publicly traded companies met all of the GRI reporting standards and disclosed information about the proportion of employees with disabilities in their DI policies.Originality/valueTo the best of the researcher's knowledge, disclosure of inclusion of people with intellectual disabilities in publicly traded companies in New Zealand has not been studied. This study provides insights into the level of DI in the New Zealand equity market companies related to people with intellectual disabilities.
目的本研究旨在评估新西兰上市公司中智障人士的就业机会。设计/方法/方法研究了163家在新西兰股市上市的上市公司的多样性和包容性(DI)政策,并使用内容分析将其与全球报告倡议(GRI)的报告标准进行了比较使用Leximancer软件。调查结果只有1.84%的上市公司符合GRI的所有报告标准,并在DI政策中披露了残疾员工比例的信息。独创性/价值据研究人员所知,尚未对新西兰上市公司中智障人士的披露进行研究。这项研究深入了解了新西兰股票市场公司与智障人士相关的DI水平。
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引用次数: 0
Commentary on “Why am I still in hospital? Evaluation of delayed discharges from two learning disability assessment and treatment units in England” “为什么我还在医院?”英国两个学习障碍评估和治疗单位延迟出院的评估
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2023-06-19 DOI: 10.1108/tldr-05-2023-0013
R. Shankar
PurposeThis commentary explores the challenges and themes enumerated by the associated article “Why am I still in hospital? Evaluation of delayed discharges from two learning disability assessment and treatment units in England”. This commentary broadens and outlines the research’s background, premise and potential impact. This paper aims to critically examine the evidence on this subject.Design/methodology/approachThis commentary considers the attitudes to inpatient care for people with learning disabilities in the past decade and outlines a possible compact for the future.FindingsContrary to popular and emotive beliefs that using specialist inpatient psychiatric settings for people with learning disabilities is universally a poor practice, there are defined occasions when such settings are needed and imperative in the clinical pathway. If people with learning disabilities can access inpatient settings at the right time for the right reason, psychiatric outcomes could be improved. Timely discharge is imperative and currently lacking due to a lack of suitable engagement mechanisms between inpatient settings and the community. Thus, evidence-based outcome tools are essential to facilitate appropriate discharge.Originality/valueThere is an ongoing debate on the value and utility of specialist inpatient psychiatric units for people with learning disabilities. This commentary provides a balanced, evidence-based insight into this discussion.
本评论探讨了相关文章“为什么我还在医院?”英国两个学习障碍评估和治疗单位延迟出院的评估。这篇评论拓宽并概述了研究的背景、前提和潜在影响。本文旨在批判性地考察关于这一主题的证据。设计/方法/方法本评论考虑了过去十年中对学习障碍患者住院治疗的态度,并概述了未来可能的契约。研究结果与流行的、情绪化的观点相反,人们普遍认为,对有学习障碍的人使用专门的住院精神病学设置是一种糟糕的做法,在某些特定的情况下,这种设置在临床途径中是需要和必要的。如果有学习障碍的人能够在正确的时间因为正确的原因进入住院环境,精神治疗的结果可能会得到改善。及时出院是必要的,但由于住院环境和社区之间缺乏适当的参与机制,目前缺乏及时出院。因此,基于证据的结果工具对于促进适当出院至关重要。独创性/价值关于为有学习障碍的人设立精神科专科住院病房的价值和效用,一直存在争论。这篇评论为这一讨论提供了一个平衡的、基于证据的见解。
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引用次数: 0
Commentary on “Diversity and inclusion policies in publicly traded New Zealand companies: inclusion of people with intellectual disabilities” 对“新西兰上市公司的多样性和包容政策:包容智障人士”的评论
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2023-06-15 DOI: 10.1108/tldr-02-2023-0007
Alex Cockain
PurposeThis commentary reflects upon the article entitled “Diversity and inclusion policies in publicly traded New Zealand companies: Inclusion of people with intellectual disabilities”.Design/methodology/approachThis narrative commentary critically reflects upon the Global Reporting Initiative (hereafter, GRI) itself and what the numbers reported in Guruge’s (2023; this issue) article say, paying attention to what we might think and do about such standards and scenarios.FindingsThis commentary does not present a definitive assessment of the GRI. This is because it is marked by undecidability. Nevertheless, it reads some of the figures, or “data”, which register organisational uptake of GRI standards (or the lack thereof), together with other “data”, to contrive a more stable account.Originality/valueThis commentary strives to avoid presenting a reductive reading of “data” and, instead, highlights the complex multifaceted dimensions of societies, sustainability, social inclusion, disability and possibilities for inclusive practices.
本评论对题为“新西兰上市公司的多样性和包容性政策:包容智障人士”的文章进行了反思。设计/方法/方法这篇叙述性评论批判性地反思了全球报告倡议组织(以下简称GRI)本身以及古鲁格(2023;这期文章说,关注我们对这些标准和场景的想法和做法。这篇评论并不是对GRI的最终评估。这是因为它具有不可预测性。然而,它读取了一些数字或“数据”,这些数字或“数据”记录了组织对GRI标准的接受(或缺乏),以及其他“数据”,以设计一个更稳定的账户。原创性/价值本评论力求避免对“数据”进行简化解读,而是强调社会、可持续性、社会包容、残疾和包容性实践可能性的复杂多面性。
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引用次数: 0
A STOMP-focused evaluation of prescribing practices in one assessment and treatment unit for people with intellectual disabilities 以STOMP为重点的对一个智力残疾患者评估和治疗单位的处方实践的评估
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2022-12-14 DOI: 10.1108/tldr-04-2022-0008
J. Painter, Winola Chio, L. Black, D. Newman
PurposeThis study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.Design/methodology/approachThis service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.FindingsMost people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.Originality/valueThis study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.
目的本研究旨在了解智力障碍患者的精神药物处方是否符合最佳实践指南。设计/方法/方法本服务评估项目是对从智障评估和治疗单位出院的所有36名智障人士的照护记录中常规收集的数据进行回顾性分析,这些数据是在“停止过度用药智障人士和/或自闭症人士”(STOMP)倡议实施的头五年里收集的。数据收集于4个时间点(入院前、出院、6个月和12个月的随访),然后进行分析,以了解具有不同临床特征/特征/诊断的人的精神药物处方是否存在差异。随着时间的变化也被探讨,以确定是否和如何改变处方从入院到出院,并在随后的一年的社区生活。研究发现:大多数智障患者离开评估和治疗部门时,服用的常规精神药物较少,剂量也低于入院时。这些优化方案在出院后12个月仍然明显,表明有效的出院计划和社区护理方案。严重智力残疾的住院患者通常接受更多的抗焦虑药和催眠药,剂量更高。自闭症患者接受的精神类药物总体上更多,累积剂量也更高,这种模式在出院后持续存在。三分之一的样本接受了常规的抗精神病药物治疗,尽管没有相应的精神病诊断,这一比例在出院和进入社区期间保持相对稳定。独创性/价值本研究突出了接受高剂量精神药物风险特别高的智力残疾人群的子集,并为打算进行以stomp为重点的评估的提供者提供了一个可行的模板。
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引用次数: 0
Commentary on “Status quo bias and resistance to positive behaviour support: implications for leaders” 对“现状偏见和对积极行为支持的抵制:对领导者的启示”的评论
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2022-11-28 DOI: 10.1108/tldr-10-2022-0021
Paddy Behan
PurposeThe purpose of this paper is to provide a commentary on “Status quo bias and resistance to positive behaviour support: implications for leaders” and to extend the conversation regarding potential change agents to address resistance.Design/methodology/approachThis commentary provides discussion stimulated by the Ntinas’s (2022) paper regarding resistance to the implementation of positive behaviour support (PBS).FindingsContextual fit is highlighted as a consideration related to the implementation of PBS, with a view to mitigating resistance. A range of factors linked to supporting good contextual fit are discussed.Originality/valueThis paper provides the perspective of a PBS practitioner with experience of implementing PBS across a range of settings. Recognition is given that further empirical evidence is required to confirm the utility of contextual fit to address resistance.
目的本文的目的是对“现状偏见和对积极行为支持的抵制:对领导者的影响”进行评论,并扩展关于潜在变革推动者的对话,以解决抵制问题。设计/方法/方法本评论提供了Ntinas(2022)关于实施积极行为支持(PBS)的阻力的论文所激发的讨论。发现情境适合性被强调为与实施PBS相关的考虑因素,以减轻阻力。讨论了与支持良好的上下文匹配相关的一系列因素。原创性/价值本文提供了一位具有在各种环境中实施PBS经验的PBS从业者的视角。人们认识到,需要进一步的经验证据来证实上下文拟合对解决阻力的效用。
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引用次数: 0
Commentary on “Developing and refining a process to improve teacher engagement with the performance management system in a school setting” 对“发展和完善一个过程以提高教师对学校绩效管理系统的参与”的评论
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2022-11-28 DOI: 10.1108/tldr-10-2022-0022
Manuel Rodriguez
PurposeThe purpose of this paper is to provide a commentary on “Developing and Refining a Process to Improve Teacher Engagement with the Performance Management System in a School Setting” and to extend the conversation around the use of organisational behavioural management in services.Design/methodology/approachThis commentary focuses on the work conducted by Hawkins et al. (2022) in a school for autistic students who are also diagnosed with a learning disability.FindingsThe strengths and limitations of this research study are highlighted, and some suggestions are provided for future research.Originality/valueThis paper offers a valuable account of how organisational behavioural management can be used to help educational services produce better outcomes for the students while also empowering teachers.
本文的目的是对“开发和完善一个过程,以提高教师在学校环境中的绩效管理系统的参与”提供评论,并扩大围绕在服务中使用组织行为管理的对话。设计/方法/方法本评论的重点是Hawkins等人(2022)在一所自闭症学生学校所做的工作,这些学生也被诊断为学习障碍。研究结果指出了本研究的优势和局限性,并对今后的研究提出了建议。原创性/价值本文提供了一个有价值的说明,如何组织行为管理可以用来帮助教育服务产生更好的结果,为学生,同时也赋予教师权力。
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引用次数: 0
Commentary on “Vocational training for livelihood and rehabilitation of persons with intellectual disabilities” “智障人士生计及康复职业训练”评论
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2022-11-09 DOI: 10.1108/tldr-10-2022-0019
Ceridwen Evans
PurposeThe purpose of this commentary is to reflect on some of the themes presented in the associated article “Vocational training for livelihood and rehabilitation of persons with intellectual disabilities” and provide considerations for future close-to-practice research in the area of vocational training models and rehabilitation provisions.Design/methodology/approachThis commentary considers the literature in relation to rehabilitation provisions centred around vocation, highlights the need for a person-centred focus and reiterates the potential of vocation as a route to social inclusion and wider social networks.FindingsThe focus on adapting supports and vocational training programmes to fit within the context of low-income areas and country-specific legislation should be afforded particular consideration, alongside ways to achieve high-quality research rigour, which still puts the person supported at the centre of any outcome measures.Originality/valueThis commentary is aimed in part at practitioners working in the field of learning disabilities and employment/vocation, who are keen to conduct close-to-practice research.
本评论的目的是对《智障人士生计与康复职业培训》一文中提出的一些主题进行反思,并为未来在职业培训模式和康复规定方面的密切实践研究提供考虑。设计/方法/方法本评论考虑了与以职业为中心的康复规定有关的文献,强调了以人为本的关注的必要性,并重申了职业作为社会包容和更广泛的社会网络的途径的潜力。应该特别考虑调整支持和职业培训计划以适应低收入地区和国家具体立法的背景,以及实现高质量研究严密性的方法,这仍然将被支持的人置于任何结果衡量的中心。原创性/价值本评论部分针对的是在学习障碍和就业/职业领域工作的从业者,他们热衷于进行近距离的实践研究。
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引用次数: 0
Developing and refining a process to improve teacher engagement with the performance management system in a school setting 开发和完善一个流程,以提高教师在学校环境中的绩效管理系统的参与度
IF 0.6 Q4 EDUCATION, SPECIAL Pub Date : 2022-10-10 DOI: 10.1108/tldr-01-2022-0002
E. Hawkins, Kate Grant, M. Szabó, Kate Hewett
PurposeThe purpose of this study was to review and make changes to the performance management process in place for teachers in a school for autistic children with learning disabilities. The performance management process consisted of line managers setting targets for their staff and points were given for targets met. Targets were related to improving outcomes for the children in the school. Teacher engagement in the performance management process was measured by the number of teachers reporting their points monthly and the number of points earned monthly.Design/methodology/approachThe PDC (Austin, 2000) was conducted to determine changes to the process to improve teacher engagement with the performance management system. These changes to the performance management process consisted of an antecedent and information intervention (flowchart implemented summarising performance management process), equipment and processes interventions (change to graphing requirement, set rolling targets implemented) and consequence interventions (teachers set rolling targets to meet with their line manager regularly and to report on targets met monthly).FindingsThe number of teachers completing and submitting monthly summary forms increased following the changes made to the performance management process. The average number of points received increased significantly during the intervention. The intervention implemented following the use of the PDC led to increased teacher engagement in the performance management process and thus potentially improved the outcomes for the children within the school.Originality/valueThe PDC is a fairly simple tool to use to identify solutions to problems in the workplace. The procedure used herein is replicable across many settings and different workplace issues.
目的本研究的目的是回顾并改变一所有学习障碍的自闭症儿童学校教师的绩效管理过程。业绩管理过程包括部门经理为其工作人员设定目标,达到目标就会得到分数。目标与改善孩子在学校的表现有关。教师在绩效管理过程中的参与度是通过每月报告分数的教师人数和每月获得的分数来衡量的。设计/方法论/方法进行了PDC (Austin, 2000),以确定流程的变化,以提高教师对绩效管理系统的参与度。绩效管理流程的这些变化包括先决条件和信息干预(实施总结绩效管理流程的流程图),设备和流程干预(改变绘图要求,设定实施的滚动目标)和后果干预(教师设定滚动目标,定期与他们的直线经理会面,并每月报告达成的目标)。调查结果在绩效管理流程做出改变后,填写和提交月度总结表格的教师人数有所增加。在干预期间,平均得分显著增加。在使用PDC之后实施的干预措施增加了教师在绩效管理过程中的参与度,从而有可能改善学校内儿童的结果。独创性/价值PDC是一个相当简单的工具,用于确定工作场所问题的解决方案。这里使用的程序可以在许多设置和不同的工作场所问题中复制。
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引用次数: 0
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Tizard Learning Disability Review
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