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1.
Front Psychiatry ; 14: 1328310, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38274435

RESUMO

Introduction: People with intellectual disabilities (ID) are at increased risk for developing Post Traumatic Stress Disorder (PTSD). Emerging evidence indicates that Eye Movement Desensitization and Reprocessing (EMDR) therapy is feasible and potentially effective for this group. However, communication, cognition, stress regulation, and attachment difficulties may interfere with the EMDR process. Adaptation of the EMDR protocol seems therefore required for this population. Aim: This review aims to systematically identify and categorize the difficulties in applying EMDR to people with ID and the adaptations made by therapists to overcome these challenges. Methods: A literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal. Results: After screening, 13 articles remained for further review. The identified difficulties and adaptations were categorized into the three domains of adaptive functioning (i.e., conceptual, social, and practical functioning). Considerable difficulties in applying the EMDR protocol for this group were reported. The adaptations made by therapists to overcome these difficulties were highly variable. They could be divided into three main categories: adaptions in EMDR delivery (e.g., tuning to the developmental level of the client, simplifying language, decreasing pace), involvement of others (e.g., involving family or support staff during or in between sessions), and the therapeutic relationship (e.g., taking more time, supportive attitude). Discussion: The variability of the number of mentioned difficulties and adaptations per study seems to be partly related to the specific EMDR protocol that was used. In particular, when the Shapiro adult protocol was administered, relatively more detailed difficulties and adaptations were described than in publications based on derived existing versions of an EMDR protocol for children and adolescents. A probable explanation is that already embedded modifications in these protocols facilitate the needed attunement to the client's level of functioning. Practical implications: The authors of this review suggest that EMDR protocols for children and adolescents could be adapted for people with an intellectual disability. Further research should focus on the involvement of trusted others in EMDR therapy for people with ID and the therapeutic relationship from an attachment and relational-based perspective.

2.
Front Rehabil Sci ; 3: 848492, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36188891

RESUMO

Objectives: Quality of life (QoL) is a multi-dimensional phenomenon composed of core domains that are influenced by personal characteristics, values, and environmental contributions. There are eight core domains of QoL aligned with both the United Nations and the International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD). The Personal Outcome Scale (POS), is a semi-structured self and proxy instrument that specifically measures these aspects of QoL for people with an intellectual disability. Methods: A total of 85 people with an intellectual disability and their primary keyworker (n = 85) took part in this study. A convenience sample recruitment strategy was employed to recruit participants during the calendar year from January-December 2020. Participants completed the self-report and proxy POS, and clinic-demographic data was also considered. Results: QoL is higher in those who have a dedicated service planner and also for those with a less severe to profound disability. People who were in gainful employment reported significantly higher QoL as did those availing of outreach and residential services, over and above local services. Conclusions: This research shows that there are distinct and specific factors that relate to QoL for people with an intellectual disability community-based services in Ireland. Future research could aim to investigate these longitudinally, and specifically how QoL relates to cognitive and functional outcomes.

3.
BMJ Open ; 12(8): e061736, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35977773

RESUMO

INTRODUCTION: Meaningful activities (MA) have a positive impact on identity, well-being, participation and inclusion. Although people with intellectual disabilities (PID) depend on their direct support professionals (DSPs) to engage in MA, the DSPs need support which could enable them to offer more qualitative care and support. METHODS AND ANALYSIS: To identify DSPs' needs, and to develop a tool/service, an innovative and iterative approach is developed, based on the human-centred design (HCD) process, combined with traditional qualitative and quantitative research methods. In the inspiration phase (needs analysis), in-depth interviews will be conducted in two day care centres in Flanders using an interpretative phenomenological analyses, one with a supply-driven approach and the other with a demand-driven approach, followed by a survey sent to all Flemish day care centres. In the ideation phase, the insights of phase 1 will guide a cocreation process (comprising a World Cafe, brainstorm and prototype sessions) with the DSPs, PID and other stakeholders. In the implementation phase, the solution will be tested in the two day care centres from phase 1 by means of living labs and a realist evaluation. By adopting this protocol, the functionality, quality, usability and acceptance are expected to increase. This protocol adopts all phases of the HCD process and shows the complementarity of HCD with traditional research methods. PID and the DSPs will benefit as the end result is truly grounded in their specific needs and wishes. ETHICS AND DISSEMINATION: Ethical approval by the Ethics Committee of the University Hospital Ghent, Belgium (reference numbers: B670202042983 and PA2021-091). All participants will sign informed consent forms. Results of this study will be submitted for publication in relevant peer-reviewed journals and will be presented at relevant conferences.


Assuntos
Pessoas com Deficiência , Deficiência Intelectual , Bélgica , Humanos , Projetos de Pesquisa , Inquéritos e Questionários
4.
Eval Program Plann ; 67: 53-60, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29197716

RESUMO

Organization transformation is an increasingly important concept and process in human service organizations as they adapt to rapidly changing challenges and opportunities to enhance their effectiveness, efficiency, and sustainability. This article describes a four-component organization transformation model that incorporates transformation pillars, transformation strategies, organization capacity, and organization outputs and outcomes. The article includes examples of the model's use, and concludes with a discussion of valuable lessons learned to date.


Assuntos
Inovação Organizacional , Desenvolvimento de Programas/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Fortalecimento Institucional , Humanos , Modelos Organizacionais , Países Baixos , Estudos de Casos Organizacionais , Cultura Organizacional , Espanha
5.
Eval Program Plann ; 49: 98-105, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25618817

RESUMO

AIM: This article focuses on employee performance-management practices in the healthcare sector. We specifically aim to contribute to a better understanding of the impact of employee performance-management practices on affective well-being of nurses in hospitals. Theory suggests that the features of employee-performance management (planning and evaluation of individual performances) predict affective well-being (in this study: job satisfaction and affective commitment). METHODS: Performance-management planning and evaluation and affective well-being were drawn from a survey of nurses at a Flemish hospital. Separate estimations were performed for different aspects of affective well-being. RESULTS: Performance planning has a negative effect on job satisfaction of nurses. Both vertical alignment and satisfaction with the employee performance-management system increase the affective well-being of nurses; however, the impact of vertical alignment differs for different aspects of affective well-being (i.e. job satisfaction and affective commitment). CONCLUSION: Performance-management planning and evaluation of nurses are associated with attitudinal outcomes. The results indicate that employee performance-management features have different impacts on different aspects of well-being.


Assuntos
Avaliação de Desempenho Profissional , Recursos Humanos de Enfermagem Hospitalar/psicologia , Avaliação de Desempenho Profissional/métodos , Feminino , Humanos , Satisfação no Emprego , Masculino , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Administração de Recursos Humanos em Hospitais/métodos , Lealdade ao Trabalho , Inquéritos e Questionários
7.
Eval Program Plann ; 45: 110-8, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24762778

RESUMO

The work described in this article focuses primarily on how human service organizations can use an evidence-based, self-assessment approach to organization evaluation to facilitate continuous quality improvement and organization change. Real-life examples are presented, strengths and challenges discussed, and future conceptual and measurement issues identified.


Assuntos
Melhoria de Qualidade/organização & administração , Serviço Social/organização & administração , Benchmarking , Comportamento Cooperativo , Humanos , Inovação Organizacional , Avaliação de Programas e Projetos de Saúde , Serviço Social/normas
8.
Eval Program Plann ; 36(1): 80-7, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22982162

RESUMO

This article describes how evidence-based outcomes (EBOs) can be used to improve clinical, managerial, and policy decisions. As a component of evidence-based practices, EBOs are defined as measures obtained from the assessment of quality of life-related indicators that are based on a cross-culturally validated quality of life conceptual and measurement model, have utility in that they can be used for multiple purposes, and have robustness in reference to reliability and validity of the assessment strategy employed. A 5-component EBO model is described that provides a framework for the activities involved in selecting, developing, and implementing evidence-based outcomes. Three international examples based on the reliable, valid, and standardized assessment of individual quality of life outcomes are presented that demonstrate how EBOs can be used to improve clinical, managerial, and policy decision making. The article concludes with a discussion of guidelines for developing and using EBOs, and the challenges involved in their use.


Assuntos
Prática Clínica Baseada em Evidências/organização & administração , Deficiência Intelectual/reabilitação , Avaliação das Necessidades/organização & administração , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Qualidade de Vida , Tomada de Decisões , Humanos , Formulação de Políticas , Indicadores de Qualidade em Assistência à Saúde , Análise de Sistemas
9.
Intellect Dev Disabil ; 50(5): 426-35, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23025644

RESUMO

In this article, the authors relate the life of Chris through narrative snapshots. Chris asked the authors to tell her story. They decided that it could be used to provide an insight into the different ways people with labels are confronted with professional practices and rituals. Although Chris lived a "tough life," her story is full of resilience and resistance. Chris will be kept in the authors' memory as a strong woman, a teacher, and a friend.


Assuntos
Deficiências da Aprendizagem/psicologia , Narração , Resiliência Psicológica , Feminino , Humanos
10.
Res Dev Disabil ; 33(1): 96-103, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22093653

RESUMO

The concept of quality of life (QOL) is increasingly being used as a support provision and outcomes evaluation framework in the field of intellectual disability (ID). The present study used a hierarchical multiple regression research design to determine the role that available supports strategies, environmental factors, and client characteristics play in assessed quality of life-related personal outcomes. Data were collected in Arduin Foundation in The Netherlands. Participants were 186 individuals with an intellectual disability. Results indicated that QOL-outcomes were significantly impacted by the availability of support strategies, living arrangement, status of employment and level of ID.


Assuntos
Meio Ambiente , Deficiência Intelectual/reabilitação , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Deficiência Intelectual/psicologia , Masculino , Pessoa de Meia-Idade , Países Baixos
11.
Intellect Dev Disabil ; 48(6): 432-53, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21166549

RESUMO

Person-centered planning is a well known and widely used approach to individual program planning in the field of intellectual and developmental disabilities. Its purpose is to develop collaborative supports focused on community presence, community participation, positive relationships, respect, and competence. Because there is little research on its effectiveness, our purpose here was to (a) review the current status of effectiveness research; (b) describe its effectiveness in terms of outcomes or results; and (c) discuss the effectiveness of person-centered planning in relation to evidence-based practices. Analyzed studies suggest that, overall, this planning has a positive, but moderate, impact on personal outcomes for this population. The body of evidence provided in this review is weak with regard to criteria for evidence-based research.


Assuntos
Deficiências do Desenvolvimento/reabilitação , Deficiência Intelectual/reabilitação , Planejamento de Assistência ao Paciente , Assistência Centrada no Paciente , Adulto , Criança , Participação da Comunidade , Medicina Baseada em Evidências , Humanos , Pesquisa , Resultado do Tratamento
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