scholarly journals Men with severe learning disabilities and challenging behaviour in long-stay hospital care

2006 ◽  
Vol 188 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Jane Hubert ◽  
Sheila Hollins
Keyword(s):  
Learning Disabilities ◽  
Participant Observation ◽  
Mental Healthcare ◽  
Social Identities ◽  
Challenging Behaviour ◽  
Community Based ◽  
Healthcare Needs ◽  
Health And Social Care ◽  
Past Experiences ◽  
Stay Hospital

BackgroundCommunity-based health and social care professionals have little knowledge of the past experiences of people with severe learning disabilities and challenging behaviour who are living in institutions.AimsTo gain a greater understanding of the experiences and needs of men who are living in a locked ward.MethodThe study sample consisted of 20 men who were living in a locked ward of a long-stay institution. Qualitative (ethnographic) methods were used, involving participant observation (for around 250 hours) on the ward. All traceable families were interviewed. The analysis used grounded theory, and material was fed back into the resettlement process throughout.ResultsThe men's lives were emotionally, socially and physically deprived. Their individual, gender and social identities were not recognised, and their general health and mental healthcare needs were inadequately addressed.ConclusionsPeople who live in long-stay institutions, segregated from society, lose their individual and social identity, which complicates the presentation of mental health and behavioural problems, and raises important adult protection issues.

scholarly journals Food and the Social Identities of People with Learning Disabilities

2007 ◽  
Vol 27 (3) ◽  
Author(s):  
Charlotte Aull Davies
Keyword(s):  
Learning Disabilities ◽  
Young Adults ◽  
Food Consumption ◽  
Participant Observation ◽  
Social Identities ◽  
Appropriate Behavior ◽  
Adult Identity ◽  
Adults With Learning Disabilities ◽  
Age Appropriate ◽  
Food Provision

The behaviors surrounding food provision and consumption provide subtle, yet fundamental ways of defining social identities and structuring social relationships. The food consumption patterns of young adults with learning disabilities, and the control over their food consumption exercised by others, define them as 'children' even though they are physically and chronologically adults. These food-based behaviors contribute to the difficulties they face in achieving full social adulthood and thereby accentuate stigmatizing aspects of their social identities. Unsurprisingly, in some cases food becomes an area of conflict between these young people and their caregivers. Food provision also highlights a dilemma of the philosophy of care based on normalization theory, namely that actions taken to encourage age-appropriate behavior, and hence promote social adulthood in one sphere, may undermine adult identity in another. The paper is based on 18 months of participant observation and interviews with young adults with learning disabilities and their caregivers.

scholarly journals Digital Divide Magnified for Older Veterans Living Off the Grid

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 119-120
Author(s):  
Kathryn Nearing ◽  
Camilla Pimentel ◽  
Eileen Dryden ◽  
Laura Kernan ◽  
Lauren Moo
Keyword(s):  
Digital Divide ◽  
National Sample ◽  
Social Determinant ◽  
Community Based ◽  
Moral Imperative ◽  
Healthcare Needs ◽  
Digital Divides ◽  
Unmet Healthcare Needs ◽  
Past Experiences ◽  
Social Determinant Of Health

Abstract Compared to urban Veterans, rural Veterans are more likely to be older (55-74), not employed, have less education, more service-related disabilities and unmet healthcare needs. Interviews with a national sample of community-based outpatient clinic providers described highly-rural Veterans who are “off the grid.” These Veterans, by choice and/or circumstance, do not have access to reliable internet, associated devices or knowledge/skills. Providers described the difficulties of connecting with these Veterans even by phone. The healthcare shift to virtual telehealth modalities in response to COVID-19 highlights the digital divide as a social determinant of health. For “off-the-grid” Veterans, past experiences and present-day circumstances converge to perpetuate and exacerbate inequalities in accessing healthcare. Their situation underscores that telehealth is not a panacea for increasing access to care and confronts us with the moral imperative to reach those with whom it may be most difficult to connect to span social, geographic and digital divides.

scholarly journals Clinical and cost evaluation of intensive support team (IST) models for adults with intellectual disabilities who display challenging behaviour: a comparative cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043358
Author(s):  
Angela Hassiotis ◽  
Athanasia Kouroupa ◽  
Rebecca Jones ◽  
Nicola Morant ◽  
Ken Courtenay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Intellectual Disabilities ◽  
Online Survey ◽  
Service Use ◽  
Cost Evaluation ◽  
Challenging Behaviour ◽  
Health And Social Care ◽  
Adults With Intellectual Disabilities

IntroductionApproximately 17% of adults with intellectual disabilities (ID) living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy inpatient stays in England. We have identified two models of ISTs (model 1: enhanced provision and model 2: independent provision). This study aims to investigate the clinical and cost-effectiveness of the two models of ISTs.Methods and analysisA cohort of 226 adults with ID displaying behaviour that challenges who receive support from ISTs from each model will be recruited and assessed at baseline and 9 months later to compare the clinical and cost-effectiveness between models. The primary outcome is reduction in challenging behaviour measured by the Aberrant Behaviour Checklist-Community (ABC-C). The mean difference in change in ABC score between the two IST models will be estimated from a multilevel linear regression model. Secondary outcomes include mental health status, clinical risk, quality of life, health-related quality of life, level of functioning and service use. We will undertake a cost-effectiveness analysis taking both a health and social care and wider societal perspective. Semistructured interviews will be conducted with multiple stakeholders (ie, service users, paid/family carers, IST managers/staff) to investigate the experience of IST care as well as an online survey of referrers to capture their contact with the teams.Ethics and disseminationThe study was approved by the London–Bromley Research Ethics Committee (REC reference: 18/LO/0890). Informed consent will be obtained from the person with ID, or a family/nominated consultee for those lacking capacity and from his/her caregivers. The findings of the study will be disseminated to academic audiences, professionals, experts by experience and arm’s-length bodies and policymakers via publications, seminars and digital platforms.Trial registration numberClinicalTrials.gov Registry (NCT03586375).

scholarly journals The Current Status and Problems with the Implementation of Interprofessional Education in Japan.

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Sachiko Ogawa ◽  
Yoshinori Takahashi ◽  
Misako Miyazaki
Keyword(s):  
Community Development ◽  
Interprofessional Education ◽  
Social Care ◽  
Current Status ◽  
Future Research ◽  
Clinical Settings ◽  
Community Based ◽  
Social Settings ◽  
Health And Social Care ◽  
Key Issues

Background: Although interprofessional education (IPE) has come to be considered essential in health and social care education programs, most IPE programs in Japan focus on clinical settings. However, following the 2011 Great East Japan Earthquake, IPE programs are considered essential for community development, especially in disaster-affected areas. To identify key issues for the development of IPE, we aimed to clarify the current status of IPE programs and problems in their implementation using an original questionnaire. Methods and Findings: The targets were 865 undergraduate courses that qualify students to take national registered health/social care examinations. Effective responses were received from 284 targets. Of these 284 respondents, 103 respondents had already implemented an IPE program and 181 respondents had not. Among the 103 respondents who had already implemented an IPE program, we found a tendency to collaborate with partners in clinical settings or in social settings. Furthermore, respondents who had implemented or were planning to implement an IPE program had difficulty with ‘interdisciplinary and/or extramural collaboration’ and ‘educational factors’. Conclusions: These difficulties could be considered barriers to developing effective IPE programs for community-based collaboration between health and social care professionals. Future research should investigate more specific solutions to these problems.

scholarly journals Access and participation: What factors influence the provision and utilisation of health care services by children with learning disabilities?

2017 ◽  
Vol 41 (S1) ◽  
pp. S452-S452
Author(s):  
A. Rebowska
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Young People ◽  
Intellectual Disabilities ◽  
Health Care Services ◽  
Healthcare Services ◽  
Children And Young People ◽  
Care Services ◽  
Healthcare Needs ◽  
Wide Range

AimsThe aim of this literature review is to explore the range of factors that influence the degree of access to health care services by children and young people with learning disabilities.BackgroundChildren with learning disabilities are at increased risk of a wide range of health conditions comparing with their peers. However, recent reports by UK government as well as independent charities working with children and young people with learning disabilities demonstrated that they are at risk of poor health outcomes as a result of barriers preventing them from accessing most appropriate services.MethodsComprehensive searches were conducted in six databases. Articles were also obtained through review of references, a search of the grey literature, and contacting experts in the field. The inclusion criteria were for studies evaluating access to healthcare services, identification and communication of health needs, organisational aspects impacting on access and utilisation, staff attitudes where they impacted on access, barriers, discrimination in patients with intellectual disabilities age 0–18. The literature search identified a sample of 36 papers. The marked heterogeneity of studies excluded conducting a meta-analysis.ResultsBarriers to access included problems with identification of healthcare needs by carers and healthcare professionals, communication difficulties, the inadequacy of facilities, geographical and physical barriers, organisational factors such as inflexible appointment times, attitudes and poor knowledge base of healthcare staff.ConclusionThe factors identified can serve as a guide for managers and clinicians aiming to improve access to their healthcare services for children and young people with intellectual disabilities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Evaluating the Impact and Effectiveness of Community-Based Health Insurance Policy Among Informal Sector in Lagos State Using Donabedian Model

2021 ◽  
Vol 5 (2) ◽  
pp. 65-80
Author(s):  
Afeez Kolawole Shittu ◽  
Kikelomo Aboyowa Mbada ◽  
Temitayo Isaac Odeyemi
Keyword(s):  
Health Insurance ◽  
Informal Sector ◽  
Urban Areas ◽  
National Level ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Healthcare Needs ◽  
Lagos State ◽  
Donabedian Model ◽  
The Impact

The study used the Donabedian model (process, structure, and outcome) to evaluate the impact and effectiveness of the Community Based Health Insurance Scheme (CBHIS) among informal sector population in rural and semi-urban areas of Lagos State, and the respondents were drawn among the market men and women, motorist, among others. Three hundred and eighty-four (384) respondents were sampled based on the research advisor's sampling size. Lagos State is stratified along with its three senatorial districts and a local government each is purposively selected based on the full implementation of CBHIS. Data were analysed using descriptive and interferential statistics and the result revealed that 55% of respondents attested to the effectiveness of CBHIS in drastically reducing the cost of medical services and enhancing equal accessibility for healthcare needs. On the other hand, the implementation of CBHIS has no significant impact on healthcare service delivery due to the unfriendly attitude of healthcare providers towards the beneficiaries. The study concluded by providing information on the outcomes of CBHIS implementation at the sub-national level of government in Nigeria and suggest ways of improvement.

scholarly journals School absences and exclusions experienced by children with learning disabilities and autistic children in 2016/17 in England

2018 ◽  
Vol 23 (4) ◽  
pp. 207-212
Author(s):  
Chris Hatton
Keyword(s):  
Learning Disabilities ◽  
Educational Needs ◽  
Physical Assault ◽  
Learning Difficulty ◽  
Special Educational Needs ◽  
Autistic Children ◽  
Content Type ◽  
Health And Social Care ◽  
School Absences ◽  
Fixed Period

Purpose The purpose of this paper is to examine data on absences and exclusions from school amongst children with learning disabilities and autistic children in England in 2016/2017. Design/methodology/approach Data were drawn from Department for Education statistics for the school year 2016/2017 on school absences (authorised and unauthorised) and school exclusions (fixed-period and permanent) for children in the primary special educational needs categories of moderate learning difficulty (MLD), severe learning difficulty (SLD), profound and multiple learning difficulty (PMLD) and autistic spectrum disorder (ASD). Findings Authorised school absence rates were higher for all groups of children investigated compared to children without special educational needs, primarily due to illnesses and health-related appointments. Rates of unauthorised school absences were low. Rates of fixed-period and permanent school exclusions were higher for children with MLD and ASD compared to children without SEN, and lower for children with SLD and PMLD. Reasons given for exclusions were similar across children (persistent disruptive behaviour, physical assault against a pupil, verbal abuse against an adult), although physical assault against an adult was also commonly mentioned for children with SLD, PMLD or ASD. Social implications Reducing school absences for children with learning disabilities and autistic children will involve co-ordination of health and social care support arrangements to ensure they are convenient and efficient for children and families. In terms of exclusions, schools need to consider the extent to which they are making reasonable adjustments for children with learning disabilities and autistic children. Originality/value This paper presents in one place statistics concerning school absences and school exclusions for children with learning disabilities and autistic children in England.

Sign in / Sign up

Export Citation Format

Share Document