Personal and sexual boundaries: the experiences of people with intellectual disabilities.

BACKGROUND: Previous research shows that people with intellectual disabilities have less knowledge about sexual health and are more vulnerable to victimisation. In cases of sexual abuse, they are likely to encounter the criminal justice system as vulnerable witnesses. Several challenges arise when people with intellectual disabilities are in communication with the criminal justice system. We aimed to explore the perceptions, experiences and knowledge of people with intellectual disabilities regarding personal and sexual boundaries in order to identify factors relevant for preventing sexual abuse, to develop future studies. METHOD: The study had a qualitative design. Data were collected from seven people with mild intellectual disabilities (25-40 years; 2 men, five women) through one-to-one interviews in specialised health care services for people with intellectual disabilities (SHCS). The participants lived alone, in group homes and with their families. Many received professional support services. Data were analysed using thematic analysis. RESULTS: The interviews identified that the participants want to be in romantic relationships and that some, consider sex to be unimportant. Many of them have had trouble finding someone to have a romantic relationship with. The participants were unsure about sexual consent related to sexual activity, though many could explain the concept of consent in other contexts. Many participants reported that they had experienced sexual abuse, including online sexual abuse. Those participants who had reported the sexual abuse had positive experiences obtaining assistance from the criminal justice system. The participants who had experienced sexual abuse reported trauma and fear related to their experiences. CONCLUSION: This study highlights the need for information about sexually abusive relationships, risks online and ways to get help. More attention should be given to the impact of trauma, police and mental health treatment following sexual abuse against people with intellectual disabilities.

Becoming data. Patient perspectives on using an eTool in physiotherapy sessions.

The purpose of this investigation was to gain insights into how patients experience using an electronic tool as part of their physiotherapy assessment, goal setting, and treatment planning.The research data were generated through close observation of eight clinical encounters in primary health care, where the electronic tool was used. Observations were followed by interviews with physiotherapists and patients involved. This manuscript elaborates on the patient informants' perspectives. The analyses, inspired by postphenomenological theory and research, sheds light on patients' concerns whether reliance on what they perceive as fragmented and incomplete data generated from PROM tools will obscure health matters rather than provide health benefits.By various means, including translations, adaptions, and editing together with their physiotherapist, patients were often able to manage their data into, for them, an acceptable, recognizable form.The investigation highlights that for patients to have confidence in this technology, and particularly the methodology of PROMs, they need to trust the way data is handled and interpreted.

Physiotherapists' experiences of adopting an eTool in clinical practice: a post-phenomenological investigation.

Background and Purpose: The purpose of this investigation was to gain insights into the experience of adoption and integration of an electronic tool in physiotherapy. Case Description: The research data was generated through close observation of eight clinical encounters in primary health care, where the electronic tool was used, and then the physiotherapists were interviewed in-depth on the experience of adopting and using it. Outcomes: The analysis, inspired by post-phenomenological theory and research, reveals how physiotherapists deploy their clinical reasoning skills in an active, critical appropriation of the eTool. Despite an ambiguous attitude toward the tool, they develop an ownership to the eTool that enables them to balance and combine two modes of practice; that of collecting data for research purposes and that of treating the patient. Discussion: It seems that this ownership development is crucial to stimulate continued use of the eTool.

The significance of social rules in group training sessions.

PURPOSE: To identify what types of social rules are involved in group interventions led by physiotherapists (PTs), and how these rules influence individual recovery. METHODS: Eight patients; six women and two men, which had recently undergone elective hip or knee replacement surgery, were recruited as informants from an intervention group that investigated effect of task specific exercise. The data comprise observational notes from group training sessions and one-on-one semi-structured interviews with the eight patients. Observational notes contributed to the development of the research questions. The interviews were audio-recorded and transcribed, and a theoretically-oriented analytical approach guided by performance theory was conducted to identify the rules. RESULTS: Several implicit rules for behavior when attending this group intervention were identified. The compulsory style enhances recovery in an explicit manner. CONCLUSION: When giving advice and home exercise PTs must acknowledge that the roles patients are subtly exposed to during the actual clinical encounter are probably quite different from the roles the patients can merge into outside the therapy context. This might shed some light on the notion of patient adherence/concordance. The significance of social rules in group training sessions. Implications for Rehabilitation Health professionals should be aware of the implicit social regulations of the clinical encounter. They will influence whether and how patients adhere to advice. By acknowledging that patients have different roles to merge into, depending on context, health professionals may significantly broaden our understanding of patient adherence and compliance. The social rules identified in this study contribute to individual recovery processes. We encourage health professionals to regard "group dynamics" as something that is going on during the group session, and worthwhile taking advantage of when planning and implementing group interventions.