Significant others' perspectives on experiences of meal-oriented support and diet counselling for adults with intellectual disabilities who live in supported housing.

The quality of meal-oriented support for people with intellectual disabilities is important for their health. The aim of the present study was to explore the experiences of meal-oriented support and diet counselling for adults with intellectual disabilities living in supported housing, from the perspective of housing staff and mothers. Five focus group interviews, including nine supporting staff members and nine mothers, were conducted. The interviews were analyzed using systematic text condensation. Five themes appeared; Extensive needs of the individual, Staff skills determine the food intake, Informal caregivers make up for shortage of support, Effective collaboration with a registered dietitian is needed and Responsibility of the organization state that professionalization of staff is needed. Lacking resources, such as time and nutritional knowledge, insufficient considerations of individual needs, and high staff turnover influence the meal-orientated services negatively. This study brings to the fore, staff working practices and the complexity of providing meal-oriented support for people with intellectual disabilities. Staff need skills to perform individually tailored support. This is best accomplished through effective collaboration between housing staff and relatives underpinned by knowledge from a registered dietitian. The working practices must be structured at the organizational level of the services.

Older adults' experiences with mHealth for fall prevention exercise: usability and promotion of behavior change strategies.

Background: With the rapidly growing aging population, older adults need to stay healthy and active for a longer time. Mobile health (mHealth) solutions could help support, prevent, or delay functional decline and falls in old age.Purpose: The aim was to explore older persons' experiences of a mobile application for fall prevention exercise, and to identify what possible behavior change techniques to include in the further development of the application.Methods: Two focus groups were conducted with 12 older adults (seven women and five men) 70 to 83 years of age. A qualitative content analysis was performed.Results: Two main results emerged: 1) external facilitators for using the application; and 2) internal facilitators for using the application and perceived gains, in addition 10 behavior change techniques were identified.Conclusion: With support, an application could be adapted for older adults to manage, motivate, and adhere to fall prevention exercise. To achieve long-term adherence to health behavior changes, behavior change strategies and techniques are recommended to be included in further development of the fallprevention application.

Health-promotion intervention in a group home: Perspectives of residents, staff and rehabilitation professionals.

Promoting healthier lifestyles in people with intellectual disabilities is important in order to improve health and reduce health inequalities. Few studies have explored how health-promotion interventions for people with intellectual disabilities in community-based settings are experienced. The aim of this study was to explore residents', staff members' and rehabilitation professionals' experiences of how a health-promotion intervention affected the habits of people living in a group home regarding eating habits and physical activities and staffs' ways of working. Semi-structured group interviews were conducted with five residents, six staff members and five rehabilitation professionals. The group discussions were analysed with content analysis separately for each group. Four different categories described residents', staff members' and rehabilitation professionals' views respectively. It is suggested that including people with intellectual disabilities as active parties throughout the process would facilitate implementation of a health-promotion profile in community residences.

Are clear boundaries a prerequisite for well-functioning collaboration in home health care? A mixed methods study.

AIM: The aim of this study was to examine whether professional collaboration in home health care is associated with clear boundaries between principals' areas of responsibility and the professions areas of responsibility, respectively. METHODS: Data were derived from a web-based survey that was carried out in one county in the middle of Sweden during spring 2013. Participants were health professionals and managers from the county council and from all the municipalities in the county. Both structured and open-ended questions were utilised. A total of 421 individuals (90% women) answered the structured questions, and 91 individuals (22% of the 421) answered the open-ended questions. Quantitative data were analysed with descriptive statistics methods, tests of independence and of correlation strength. Qualitative data were analysed with content analysis. RESULTS: The results from the structured questions showed that well-functioning collaboration was associated with clear boundaries between principals in the county overall, and for respondents in two of three parts of the county. Association between clear boundaries between professions and well-functioning collaboration was found in the county overall among the municipality population. However, in one part of the county, we did not find any correlations between well-functioning collaboration and clear boundaries between professions or principals, with the exception of home help services. The analysis of the open questions gave similar results as the quantitative analysis, illustrated within three themes: The significance of concepts, trust and interdependence, and collaboration as a means for well-being. CONCLUSION: The results indicate that, recently after an organisational change, clear boundaries between the principals' areas of responsibility and professions' area of responsibility respectively are necessary for effective cooperation between professionals. If the organisation and professionals have previous positive experience of colocated activities, clear boundaries do not share the same importance.

Cognitive assistive technology and professional support in everyday life for adults with ADHD.

PURPOSE: An evaluation of a model of intervention in everyday settings, consisting of cognitive assistive technology (CAT) and support provided by occupational therapists to adults with attention deficit hyperactivity disorder (ADHD). The purpose was to study how professional support and CAT facilitate everyday life and promote community participation of adults with ADHD. METHOD: The intervention was implemented in five steps and evaluated in a 15-month study (March 200 = T1 to June 2007 = T2). One questionnaire and one protocol describe the CATs and provided support. Two questionnaires were employed at T1 and T2 for evaluation of the intervention in everyday settings. RESULTS: The participants tried 74 CATs, with weekly schedules, watches and weighted blankets being most highly valued. Carrying out a daily routine was the most frequent support. More participants were working at T2 than at T1. Frequency of performing and satisfaction with daily occupations as well as life satisfaction were stable over the one-year period. CONCLUSIONS: The results indicate a higher frequency of participating in work but only a tendency of increased subjectively experienced life satisfaction. However, to be of optimal usability, CAT requires individually tailored, systematic and structured support by specially trained professionals. Implications for Rehabilitation Adults with ADHD report an overall satisfaction with the cognitive assistive technology, particularly with low-technological products such as weekly schedules and weighted blankets. Using cognitive assistive technology in everyday settings indicate a higher frequency of participating in work, but only a tendency of increased subjectively experienced life satisfaction for adults with ADHD. Prescription of cognitive assistive technology to adults with ADHD in everyday settings requires individually tailored, systematic and structured support by specially trained professionals.

Support in housing: a comparison between people with psychiatric disabilities and people with intellectual disabilities.

The primary objective of this study was to compare type of housing and support in housing in two groups (people with psychiatric disabilities and people with intellectual disabilities) typically dependent on support in everyday life. A second objective was to examine whether type of housing and support in housing were related to gender within the two groups. Information was obtained by available questionnaire reports provided by staff members. The results indicate unequal accessibility of support in housing in relation to the two groups. Moreover, the findings suggest that type of disability is a more determining factor than gender regarding support in housing.

Comparison of reports by relatives and staff on living conditions of adults with intellectual disabilities.

Proxies typically serve as information providers in studies of persons with intellectual disabilities. However, little is known about the concordance between different proxy categories and how proxy characteristics influence the information provided. We compared 89 pairs of relative and staff reports on the living conditions of persons with intellectual disabilities, using percentage agreement and Cohen's kappa statistics. Results demonstrate differences between relative and staff reports for most of the domains investigated, with moderate agreement for objective items and fair agreement for subjective items. Relative and staff proxies contributed different information related to diverse viewpoints and varying types of information. Thus, we suggest that information provided by proxies should not be treated as being interchangeable but, rather, as complementary.