Adults With IDD in Supported Accommodation During COVID-19 Lockdown: The Families' Perspective.

The present study aims to understand and describe family caregivers' perceptions and experiences regarding contact and relationships with their adult relatives with intellectual and developmental disabilities (IDD) living in supported accommodation during the COVID-19 lockdown. A qualitative phenomenological approach was applied in which 19 Israeli family caregivers (parents and siblings) were interviewed. Inductive thematic analysis revealed themes at the microsystem level (the resident, the caregiver, and their relationship), and at the mesosystem level (the caregivers' interactions with service providers and other residents' families). The findings highlight the pivotal role of family caregivers in times of uncertainty and the need to develop explicit policies and mechanisms to facilitate family engagement in the residents' lives.

"I'm a good mother; I play with her; I love her": The motherhood experience of women with intellectual disabilities from empowering and intersectional approaches.

BACKGROUND: Despite the growing recognition of the right of women with disabilities to become mothers, this right remains significantly under-fulfilled among women with intellectual disabilities (ID). Whereas the voice of mothers with ID has begun being heard in research, most studies still focus on the barriers to motherhood and the difficulties associated with childrearing. OBJECTIVE: The study aims to understand and describe the subjective experiences of mothers with ID, focusing on positive aspects from empowering and intersectional approaches. METHOD: Semi-structured interviews were conducted with 11 mothers with ID who live in the community and raise their children. RESULTS: Four themes emerged from the interviews: (1) A dream that came through; (2) Motherhood as an empowering process; (3) The intersection between the disability identity and the motherhood identity; (4) Family involvement as a resource and a challenge. CONCLUSIONS: The findings highlight the need to meet the mothers' twofold identity in an empowering way by constructing a more positive disability identity and further cultivating their motherhood identity. They also highlight the important role of the family in supporting mothers with ID. A positive disability identity and family support are needed to increase these women's emotional well-being and overall quality of life.

Burden and Growth during COVID-19: Comparing Parents of Children with and without Disabilities.

The COVID-19 pandemic and the measures taken to contain it have had a disproportionate impact on families with young children, especially with disabilities. This study examined factors associated with burden and growth among parents of young children in Israel, while comparing parents of children with and without disabilities. We hypothesized that the association between family functioning, informal social support, and perceived adequacy of educational services and burden and growth would be moderated by disabilities. An online questionnaire was completed by 675 parents of young children, 95 of them with disability. The moderating effect of disability on burden and growth was examined using PROCESS. Compared to parents of children without disabilities, greater burden was found among parents of children with disabilities, but levels of growth were similar. External support was lacking for both parent groups. Educational services were perceived as severely inadequate. Lower perceived adequate educational services were associated with greater burden. On the other hand, higher levels of family functioning (i.e., family cohesion and adaptability) and greater adequacy of educational services were associated with growth. The results show that while burden was greater for parents of children with disabilities, growth during the COVID-19 period was possible for parents of both groups. The findings also pointed to the importance of the family system for sustaining the wellbeing of its members in lockdown situations. Put together, the findings highlight the importance of planning for such national and global emergencies.

"Together in a pressure cooker": Parenting children with disabilities during the COVID-19 lockdown.

BACKGROUND: COVID-19 has had a disproportionate and unprecedented impact on children with disabilities, their parents and families. This impact has been particularly evident during periods of lockdowns and severe restrictions. OBJECTIVE: This study employed the social model of disability to illuminate negative and positive experiences of Israeli parents of children with disabilities during the first COVID-19 lockdown, as well as the way social environments, particularly educational and welfare services, shape that experience. METHODS: The study draws upon thematic analysis of written responses of 80 Israeli parents to open-ended questions. RESULTS: Three main themes were found: (1) lack of responsiveness of both informal and formal supports to family needs, mainly in the educational and welfare systems; (2) juggling multiple roles and tasks along with the parents' routinely intensive caregiving role; and (3) the impact on the family's wellbeing and relationships. CONCLUSION: These results are discussed in light of the social model of disability, showing how social restrictions and barriers affect both negative and positive experiences of these families. Also discussed are practical implications for future crises.

Digital Community Inclusion of Individuals With Serious Mental Illness: A National Survey to Map Digital Technology Use and Community Participation Patterns in the Digital Era.

BACKGROUND: Despite the growing interest in developing and using mobile health (mHealth) and digital technologies in mental health, little is known about the scope and nature of virtual community inclusion. OBJECTIVE: The overarching goal of this study was to understand and conceptualize virtual community inclusion of individuals with serious mental illness (SMI). Specific objectives of this study were as follows: (1) mapping the prevalence, trends, and experiences related to mHealth and digital technology use among individuals with SMI; (2) comparing patterns of technology use by individuals with and those without SMI; and (3) examining whether use of mHealth and digital technologies predicts recovery among individuals with SMI. METHODS: A web-based survey of technology use and virtual participation was developed and distributed among adults with and those without SMI via social media, national email discussion lists, nonprofit organizations, and advocacy groups. RESULTS: A total of 381 adults aged 18 years or older participated in the survey, of whom 199 (52%) identified as having a SMI. Participants with SMI reported significantly greater access to technology and significantly fewer days of face-to-face participation in community activities than those without SMI. Among participants with SMI, greater technology use was positively associated with positive emotions and significantly predicted recovery. CONCLUSIONS: This study is the first to explore, map, and conceptualize virtual community inclusion among adults with SMI. Our findings indicate a gap in the literature and research on community inclusion and participation, and emphasize the need for virtual community inclusion, particularly during the COVID-19 pandemic and its future implications.

Romantic relationship and psychological wellbeing: the experiences of young individuals with visual impairment.

PURPOSE: The sense of vision plays a dominant role in entering a romantic partnership. However, the romantic experiences of individuals with visual impairment have received scant research attention. The study aimed to describe the lived romantic experiences of young adults with visual impairment from various cultural backgrounds and to understand the implications of these experiences on their psychological wellbeing. METHOD: The study was conducted in the Israeli multicultural society. We conducted in-depth semi-structured interviews with 24 Jewish and Arab adults (aged 18-40 years) with visual impairment about their romantic experiences and the meanings they attribute to these experiences. We used an inductive thematic analysis. RESULTS: Singlehood seemed to be a distressing situation for the Muslim female participants compared to the Jewish participants. Having a romantic partner contributed to the participants' self-acceptance and psychological well-being, especially for Muslim individuals. CONCLUSIONS: The findings demonstrate the intersection of lifelong disability, gender, and culture in the context of romantic relationships. The findings also highlight the need to support the romantic opportunities and experiences of young individuals with visual impairment, especially those from Arab society.IMPLICATIONS FOR REHABILITATIONYoung adults with visual impairment often face physical and social barriers in entering and maintaining a romantic relationship.Having a romantic partner contributes to the self-acceptance and psychological wellbeing of young adults with visual impairment.Rehabilitation practitioners should take into consideration personal and environmental factors, such as gender and cultural background, when providing support in a romantic and intimate relationship, for individuals with lifelong disabilities.Rehabilitation practitioners should also engage family members, especially from religious families, to support their relatives with visual impairment in developing a romantic relationship.

Staying connected during COVID-19: Family engagement with adults with developmental disabilities in supported accommodation.

BACKGROUND: Enduring family engagement and informal support is crucial to the health and well-being of adults with developmental disabilities (DD) residing in supported accommodation. The COVID-19 pandemic and restrictive measures enforced in residential settings have resulted in changes in daily routine and modified the ways families can interact with and provide support to residents. Yet, the impact of these changes has not been empirically explored. AIM: Explore how family caregivers have interacted with and supported their relatives with DD residing in supported accommodation during the pandemic. METHODS: Changes in frequencies of communication modes and types of informal support were measured through a cross-sectional and anonymous online survey which completed by 108 family caregivers of adults with DD. RESULTS: Most family caregivers adopted remote communication technologies; however, these were not perceived to be effective in filling the gap created by reduced face-to-face contact. While families were able to provide emotional support and advocacy using digital technologies, they were limited in their ability to provide significant social support. CONCLUSIONS: Findings may help key stakeholders develop and implement novel strategies and policies to accommodate the changing circumstances and to ensure continuity of family engagement and informal support in the context of COVID-19.

Family caregivers' and professionals' stigmatic experiences with persons with early-onset dementia: a qualitative study.

OBJECTIVES: Recently, research has focused on understanding the needs of persons with early-onset dementia and their family caregivers who often experience stigmatic beliefs. However, to date, research has not provided a thorough and deep understanding of the stigma formation process and its implications for this population. Thus, the aim of the present study was to explore the stigma formation process as experienced by family members as informal caregivers of persons with early-onset dementia, and professionals as formal caregivers who are involved in the development, management and provision of services. METHOD: We conducted three focus groups with 16 participants, including spouses of a person with early-onset dementia and professionals. The focus groups' transcripts were analysed following a thematic analysis procedure. RESULTS: Results indicated that both family members and professionals encounter stigmatic experiences because of their association with younger persons with dementia. Lack of knowledge emerged as the main antecedent and emotional burden as the main consequence of stigma. CONCLUSION: Stigmatic experiences emerged as a pervasive and complex phenomenon among formal and informal caregivers of persons with early-onset dementia, suggesting the need to developing a comprehensive and integrated approach to reduce them at the individual, professional and societal levels.

The impact of disability type and visibility on self-concept and body image: Implications for mental health nursing.

WHAT IS KNOWN ON THE SUBJECT?: Physical appearance, as in the case of individuals with physical disabilities who use a cane, walker or wheelchair, also influence others' reactions and as a result, may lead to one's negative or positive feelings and thoughts. A disability that is not observable by others, as in the case of individuals with psychiatric disabilities (mental illnesses), may also have a negative impact on one's feelings and thoughts, due to stigma associated with psychiatric disabilities. To date, research has mainly focused on the way persons with a noticeable type of disability think about themselves. It is also important to evaluate the impact of disability type on ones' feelings and thoughts, and compare persons with visible and invisible disabilities. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We asked 119 adults (over the age of 18 years) with different types of disabilities to complete a set of questionnaires and found that those who had a disability that was not observable by others (a psychiatric disability) felt more negative about themselves and their body than those who had a disability that was observable by others (a physical disability). The study extends the current knowledge on the impact of disability type and its visibility on the way persons with disabilities think about themselves. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The findings suggest that healthcare services should be modified to address the psychological needs of people with different types of disability. Mental health nurses should identify practices in the community that will improve the feelings and thoughts of consumers with disabilities, and especially those who cope with a psychiatric disability. Abstract Introduction Individuals with disabilities often face stigma and discrimination, which may negatively affect their self-concept. To date, research has mainly focused on the psychological implications of living with a noticeable physical disability. Less attention has been given to individuals with invisible psychiatric disabilities as a stigmatized subgroup in the disability community. Aim To evaluate the impact of disability type and its visibility on the self-concept and body image. Method A cross-sectional quantitative study design was implemented to compare the self-concept and body image of individuals with visible physical disabilities and individuals with invisible psychiatric disabilities (n = 119). Pearson correlations, ANOVA and multiple linear regression models were performed. Results Individuals with invisible psychiatric disabilities reported lower levels of self-concept and body image compared to individuals with visible physical disabilities. Gender, family status and the severity level of the disability were found to be associated with self-concept and body image. Discussion The study extends the current knowledge by showing that disability visibility might play a protective role for persons with physical disabilities compared to persons with psychiatric disabilities. Implications for Practice Mental health nurses should apply practices to enhance the self-concept and body image of consumers with invisible psychiatric disabilities.

Information and communication technologies: where are persons with intellectual disabilities?

Individuals with disabilities are entitled to equal access to information and communication technologies (ICT), including the Internet. The study to which this commentary refers has shown that over time (between 2003 and 2015), Internet access by persons with disabilities has increased, but a gap still exists between people with and without disabilities. One population that has been excluded from this study is that of individuals with intellectual disabilities. This is unfortunate because these individuals may face an even greater gap than others in access to the Internet. In this commentary we review the state of ICT use specifically by individuals with intellectual disabilities, and make a few recommendations for future ICT research and for reducing this gap.

The impact of exposure to war and terror on individuals with disabilities.

BACKGROUND: Exposure to war or to a terror event is associated with mental health problems among the general population; however, less is known about its impact on people with lifelong disabilities. OBJECTIVE: The aim of the present study was to determine the impact of war and terror on people with lifelong physical and sensory disabilities. METHOD: Self-report questionnaires assessing exposure to war or terror, history of traumatic life events, presence of posttraumatic stress symptoms (PTSS), and depression symptoms were used to compare PTSS and depression symptoms among individuals with lifelong disabilities, who had been exposed to war or to terror events, individuals without disabilities exposed to war or to terror events, and individuals with disabilities without such exposure (N = 438). RESULTS: The findings indicated that individuals with lifelong disabilities, who had been exposed to war or terror events, were at higher risk for developing PTSS (95% CI [-13.189, -6.60]), but not depression symptoms (95% CI [5.007, 13.173]). PTSS was predicted by previous traumatic events, the presence of disability, and exposure to war (R² = .12). In addition, within the disability groups, previous traumatic events did not predict any depressive symptoms. CONCLUSIONS: In times of political threat, a lifelong disability is a risk factor for elevated stress-related symptomatology but not for depressive symptoms. The findings emphasize the need to be aware of the effects of life-threatening situations on vulnerable groups, such as people with lifelong disabilities, and to provide services to reduce the level of distress among this population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A 5-step framework to promote nursing community inclusivity: The example of nurses with disabilities.

AIMS AND OBJECTIVES: To provide a five-step conceptual framework to promote community inclusivity among nurses and nursing students, using the example of nursing student with a disability. BACKGROUND: The value of cultural diversity, including characteristics such as socioeconomic status, ability/disability, sexual affection and ethnicity and/or race, is integrated into bachelor's nursing programmes. Yet, often the focus centres on patient care rather than to fellow nursing students or registered nurses. DESIGN: Discursive paper describing a five-step health promotion course framework to promote inclusion for students with disabilities into the nursing community. METHODS: Using the health promotion course platform, this framework demonstrates the integration of important issues such as well-being to those of cultural diversity, inclusivity and feeling belonging to a community, which are essential prerequisites towards achieving cultural competence. FINDINGS: Health promotion courses provide an optimal platform to teach students about the social environment, well-being and inclusivity, and gives students the opportunity to reflect on the impact of their attitudes and behaviours on social inclusivity in their student community, and later, on their nursing community. CONCLUSIONS: Using the example of nursing students with disabilities, the five-step framework incorporates the concepts of social well-being, health and community inclusivity. Nursing students belong to a culturally diverse community including individuals with disabilities. A single course on community inclusivity is insufficient; the approach of inclusivity must be woven throughout the nursing curriculum. RELEVANCE TO CLINICAL PRACTICE: As approximately 15% of the world's population has a disability, nurses must possess an understanding of individuals with a disability as an aspect of cultural diversity. It is the responsibility of programmes to instil in nursing students, the ability to appreciate and work with culturally diverse student and registered nurses. Such goals not only reflect nursing goals, but also strengthen the cohesion and inclusivity of the nursing community.

Attitudes towards motherhood of women with physical versus psychiatric disabilities.

BACKGROUND: Women with disabilities may face social negative attitudes with regard to their being mothers. In addition, attitudes toward different disabilities form a hierarchy, with more positive attitudes being displayed toward persons with physical disabilities than toward persons with psychiatric disabilities. OBJECTIVE: Current observational study examined whether the relationship between a woman's type of disability (psychiatric vs. physical) and the social attitude towards her would be moderated by her being presented as a mother. METHOD: University students (N = 100) filled out the Multidimensional Attitudes Scale Toward Persons With Disabilities and the Social Distance Scale, after reading one of six randomly assigned fictitious vignettes. The vignettes consisted of a woman with a physical disability/a woman with a psychiatric disability/a woman without a disability, who either was or was not a mother. RESULTS: Type of disability was found to have a main effect in some attitude domains, suggesting that attitudes toward women with physical disabilities were better than attitudes towards women with psychiatric disabilities. An interaction between type of disability and motherhood was found for the interpersonal distress subscale of the attitudes scale. It was found that when women had physical disabilities, there was no change in attitude towards them regardless of whether they were presented as mothers or not; However, when the target woman had a psychiatric disability, and she was presented as a mother, negative attitudes were generated towards her. CONCLUSIONS: The study demonstrates the existence of a hierarchy of stigmatization and the effect of being a mother on stigmatization.

Leveraging Social Capital of Individuals with Intellectual Disabilities through Participation on Facebook.

BACKGROUND: Participation in social networking sites has considerable potential to leverage the individual's social capital, including persons with intellectual disabilities, whose real-world social networks are fairly limited. METHOD: This study aimed to understand how individuals with intellectual disabilities use Facebook to access social capital benefits, if at all. Qualitative interviews and observations were conducted with 20 adult Facebook users with intellectual disabilities. RESULTS: The online participation enhanced their bonding social capital as well as contributed to their psychological well-being through increasing their online visibility, popularity and sense of belonging. At the same time, they experienced stress and frustration due to usage difficulties, which prevented them from enhancing their bridging social capital. CONCLUSIONS: Participation in social networking sites may also leverage bridging social capital of persons with intellectual disabilities, but they need a more accessible platform and ongoing support to ensure safe and fruitful participation.

Leveraging Social Capital of Persons With Intellectual Disabilities Through Facebook Participation: The Perspectives of Family Members and Direct Support Staff.

This study aimed to understand and describe the views of family members and direct support staff regarding the use of Facebook by persons with intellectual disability (ID) within the context of social capital. In-depth, semistructured interviews conducted with 16 family members and direct support staff of persons with ID who use Facebook revealed that most participants favored Facebook use by persons with ID for bonding and bridging social capital and for normalization. Most participants noted the empowering effect of online activity on persons with ID, yet some reported risks and usage difficulties. Although Facebook use enhances the well-being of persons with ID, findings highlighted the participants' need for formal guidelines regarding social media best-practices for people with ID.

The experiences and needs of individuals with disabilities exposed to chronic political violence.

Purpose The main objective of this study was to understand, describe and map the experiences, challenges and needs of individuals with lifelong disabilities, who have been exposed to chronic politically violent events (terror, war or continuous missile attacks) in Israel. Method The study was conducted within the qualitative-constructivist paradigm. Three focus groups consisting of 18 individuals with lifelong disabilities were conducted; each focus group included a specific disability type (physical, visual and hearing impairment). Results The participants reported encountering environmental barriers, such as inaccessibly of the physical environment and information as well as dependency on others. These barriers limited the participants' functioning during emergency period and thus increased their level of distress. The participants also emphasized their physical, social and psychological needs. Conclusions The needs of individuals with disabilities in emergency situations can be met if they have a safe place to stay in, are with someone else, and plan every daily action in advance. It is also imperative to provide accessible services and information. Furthermore, it is recommended to develop training sessions for individuals with disabilities and for service providers regarding how to locate, communicate with and assist individuals with disabilities during security threat situations. Implications for Rehabilitation Successful coping of individuals with lifelong disabilities with chronic politically violent events depends on personal and organizational accommodations. Besides an accessible physical environment, the information provided should be available and accessible through mass media and assistive technologies. A comprehensive emergency service for various disabilities is needed. Service providers should be trained on how to locate, communicate with, and assist individuals with disabilities during security threat situations.

Attitudes Toward Nursing Students With Disabilities: Promoting Social Inclusion.

BACKGROUND: Nursing education programs rarely refer to individuals with disabilities as potential nursing students; more often, the assumption is that they are patients. Thus, this study aimed to capture nursing students' perspectives of social inclusion through examination of their attitudes toward nursing student colleagues with disabilities. METHOD: Paper-and-pencil structured surveys containing two validated scales were collected from Israeli nursing students (N = 270). Analyses included measuring associations using Pearson's correlation coefficient and general linear regression models. RESULTS: Nursing students held relatively negative attitudes toward colleagues with disabilities, and these negative attitudes were correlated to attitudes toward people with disabilities in general, even after adjusting for noted confounders. CONCLUSION: Nurse educators and nursing students should be aware of prejudicial attitudes with their respective communities toward nursing student colleagues with disabilities, and they should work toward a better understanding that cultural competence and awareness extends not only to patients but also to one's colleagues. [J Nurs Educ. 2016;55(8):441-449.].

Impact of exposure to potentially traumatic events on individuals with intellectual disability.

This study explored the prevalence of posttraumatic symptomatology (PTS) and functional problems among Israeli individuals with intellectual disability (ID) who live in supported residential care settings and who have been exposed to political violence. The sample included 196 residents exposed to chronic missile attacks and 91 residents with ID who were not exposed. Results showed PTS and functional problems to be higher in the exposed group compared to the nonexposed one, although still low compared to the general exposed population. Exposure was found to be related to PTS and functioning problems suggested individuals with ID are reactive to political violence, though the underlying mechanisms are not clear. Implications for research, caretakers, and policy are discussed.

How to support the needs of mothers with physical disabilities?

PURPOSE: The objectives of this study were: (1) to understand and describe the challenges that women with physical disabilities face during their motherhood process; (2) to understand and describe their strengths, and (3) to produce a list of supports that health professionals and policy makers should apply in order to address the needs of these mothers. METHODS: The study was conducted within the phenomenological-constructivist paradigm. In-depth semi-structured interviews were conducted with 17 mothers age 32-62 with various physical disabilities. RESULTS: The findings revealed both physical and mental challenges that these women have faced during their motherhood. Although these challenges, the women evaluated that motherhood, in the context of disability, helped them to develop positive disability identity, to frame and accept their interdependence and to become resilient. Their disability also influenced the children, i.e. they have learned how to cope with difficulties. The mothers recommended making the environment more accessible for them, providing physical and emotional support, parental guidance, information about their rights, and financial benefits to meet their children's needs. CONCLUSIONS: Mothering with a disability can result in personal growth, but this positive process requires interdependence, creative and collaborative approach applied in rehabilitation practices. IMPLICATIONS FOR REHABILITATION: Supporting mothers with physical disabilities should address not only their physical needs but also their mental and social needs. In particular, mothers with physical disabilities want and need parental guidance as well as accessible recreational activities for them and their children. An interdependence and creative approach should be applied in rehabilitation practices in a way that recognizes the right of women with physical disabilities to become mothers, express their needs and develop solutions in collaboration with health professionals. Health professionals should look for strengths of mothers with physical disabilities and use their strengths to accomplish personal aims within individual rehabilitation programs.

Influence of a support group for young women with disabilities on sense of belonging.

Women and girls with disabilities face obstacles to community participation and social acceptance. Consequently, as adolescent women with disabilities mature into adulthood, they may have difficulty feeling that they belong both in the general community and in the community of all women. The positive impact of peer support groups for young women with disabilities on their sense of belonging has been underinvestigated. We conducted in-depth, semistructured interviews with 9 members of a well-established empowerment support group for young women with disabilities to explore how the group might foster a sense of belonging to the general community as well as a sense of shared womanhood. Results revealed that self-confidence and disability pride stemming from participation in the group were essential in helping the women counteract exclusionary messages from the outside world. The group provided an opportunity to develop a positive disability identity and to gain new information regarding the ability and right to identify as women. Reciprocal bonds with other group members helped cultivate feelings of belonging. In turn, the women communicated their empowered identities and the disability rights information they learned in the group to their friends, family, and community members. The group offered the women various platforms to assert their right to belong and, therefore, to participate in the world as women and as independent members of their broader communities. These results show how peer support groups for young women with disabilities can positively influence their sense of belonging both within the group and in the world outside the group.