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Journal article

Care staff perceptions of choking incidents: what details are reported?

Authors:
GUTHRIE Susan, LECKO Caroline, RODDAM Hazel
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 28(2), 2015, pp.121-132.
Publisher:
Wiley-Blackwell

Background: Following a series of fatal choking incidents in one UK specialist service, this study evaluated the detail included in incident reporting. This study compared the enhanced reporting system in the specialist service with the national reporting and learning system. Methods: Eligible reports were selected from a national organisation and a specialist service using search terms relevant to adults with intellectual disability and/or mental ill health. Qualitative analysis was completed with comparison of themes identified in both sets of reports. Findings: The numbers of choking incidents identified in national reports suggest under-reporting compared with the specialist service and varying levels of severity. Themes included trends in timing, care setting and food textures as perceived by staff. Conclusions: This study demonstrates paucity of detail in reporting in systems without additional question prompts. Adding these questions requires staff to include greater detail which enables learning and risk mitigation to take place. (Edited publisher abstract)

Journal article

Transforming staff practice through active support

Authors:
RICHES Vivenne C., et al
Journal article citation:
Journal of Intellectual and Developmental Disability, 36(3), September 2011, pp.156-166.
Publisher:
Informa Healthcare

The active support model is being introduced in many residential and respite homes worldwide. It aims to increase the opportunities for the participation of people with intellectual disability (ID) in meaningful activity with appropriate assistance from staff. This article describes the development and delivery of an active support training pilot for staff in a large government organisation that supports people with ID in Australia. A train-the-trainer approach was used in which 5 apprentice trainers were trained to provide active support training to 65 staff associated with 6 group homes. These 5 trainers were then monitored to provide training to 54 staff in another 6 group homes. Staff evaluated their interactive training experiences by completing an anonymous questionnaire. In addition, pre and post outcome data were collected for a small number of service users from group homes, along with staff outcome data regarding residential working practices, group home management, and staffing practices. The findings show that the train-the-trainer model was an effective strategy for training large numbers of staff. The interactive training component was particularly effective and was associated with improvements in service user engagement in domestic tasks and decreased depression levels. Staff job satisfaction increased and significant improvements were recorded in residential working practices.

Journal article

The views of clients with mild intellectual disabilities regarding their working relationships with caregivers

Authors:
ROEDEN John M., MAASKANT Marian A., CURFS Leopard M.G.
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 24(5), September 2011, pp.398-406.
Publisher:
Wiley-Blackwell

A good relationship between the client and his caregiver is a key factor in a positive treatment outcome, with research indicating that the client’s opinion about the quality of the working alliance is a stronger predictor of treatment outcome than the opinion of the professional. Many treatment programmes, including solution focused brief therapy (SFBT), strive to encourage a positive client-caregiver relationship. The aim of this study is to gain insight into what clients with intellectual disabilities feel contributes to a successful working relationship with caregivers. The study participants were 18 clients of an organisation providing support to people with intellectual disabilities. Data was collected using the nominal group technique (NGT), which was modified for use with people with intellectual disabilities. The project demonstrates that the NGT is a valuable instrument in bringing to the fore of the opinions and priorities of clients with intellectual disabilities. The findings revealed that the way in which caregivers deliver their support is important. The specific qualities that are valued are reliability, empathy, and a non-patronising attitude. The particular types of support seem to be less influential in terms of treatment success. Furthermore, the results show that the clients’ preferred ways of receiving help correspond with the basic assumptions in SFBT.

Journal article

Staff beliefs about why people with learning disabilities self-harm: a Q-methodology study

Authors:
DICK Katie, et al
Journal article citation:
British Journal of Learning Disabilities, 39(3), September 2011, pp.233-242.
Publisher:
Wiley-Blackwell

Staff beliefs about why people with learning disabilities self-harm are important because they can affect the way that staff respond to the behaviour. Existing research into staff beliefs about self-harm by people with learning disabilities is limited and restricted to forensic services. This study used Q-methodology to explore staff beliefs about why people with learning disabilities self-harm. Participants included 33 staff from community teams and day services for people with learning disabilities. Five viewpoints were identified: self-harm is individual, complex and emotionally meaningful; self-harm is a means to communicate distress; self-harm is difficult to understand but seems to be a way to modify emotional states; self-harm is a result of having learning disabilities and being different; and self-harm is meaningful within relationships. These viewpoints represent the variety of theories and discussions in the literature. It is proposed that some of these viewpoints may result in more helpful responses to self-harm than others. The authors concluded that it would be useful for staff to receive more training about self-harm. This could improve care for people with learning disabilities who self-harm.

Journal article

Factorial validity and consistency of the Maslach Burnout Inventory among staff working with persons with intellectual disability and dementia

Authors:
CHAO S.F., MCCALLION P., NICKLE T.
Journal article citation:
Journal of Intellectual Disability Research, 55(5), May 2011, pp.529-536.
Publisher:
Wiley

Despite the fact that direct care staff working in the intellectual disabilities (ID) field are thought to be particularly vulnerable to burnout, there has been comparatively little research on their specific situation. This study examined the psychometric properties and applicability to staff in ID services of one of the most widely used burnout measurements - the Human Services Survey version of the Maslach Burnout Inventory (MBI-HSS). A mailed survey was used to gather data from 435 staff delivering direct care and working in out-of-home community placements for persons with ID in New York State. Confirmatory factor analysis supported the MBI-HSS as an acceptable measure for evaluating burnout in ID services staff. However, the reliability statistics obtained for the Depersonalization (DP) sub-scale was much lower than that reported in studies with other staff populations. An exploratory factor analysis suggested that a four-factor solution, dividing the DP sub-scale into two factors, provided a better fit for the sample. The authors conclude that the use of the MBI-HHS as an instrument for measuring burnout among ID workers has attraction but also some limitations. In particular, the DP sub-scale should be used with caution because there appear to be wording issues for staff in ID settings that may lead to inconsistent responses.

Journal article

Can attribution theory explain carers' propensity to help men with intellectual disabilities who display inappropriate sexual behaviour?

Authors:
WILLNER P., SMITH M.
Journal article citation:
Journal of Intellectual Disability Research, 52(1), January 2008, pp.79-88.
Publisher:
Wiley

This study examined the responses of care managers and direct care staff working in learning disability services in South Wales to vignettes of inappropriate sexual behaviour by a man with an intellectual disability. The aim was to test the theory that helping behaviour is determined by emotional responses (positive and negative emotional reactions, and optimism), which in turn are determined by causal attributions (respectively: controllability and stability of the incident depicted in the vignette). The vignettes varied in response topography and the age of the victim. Regression analysis was used to examine the relationships between causal attributions, emotional responses, and willingness to invest extra time and effort in the service user's care. No support was found for the pathway: low controllability leads to increased sympathy and/or decreased negative emotions which leads to increased helping. However, strong support was found for the pathway: low stability leads to high optimism which leads to increased helping, particularly in direct care staff. High levels of sympathy were also associated with increased helping, the effect again being mediated by feelings of optimism. The data provide support for one (but not the other) strand of attribution theory as applied to inappropriate sexual behaviour. The discussion considers the discrepancy between the present data and the far less encouraging literature on attribution theory as applied to challenging behaviour.

Journal article

Everyone communicates in some way

Author:
BAMFORTH Tony
Journal article citation:
Community Living, 20(4), 2007, pp.22-23.
Publisher:
Hexagon Publishing

People who are unable to communicate their needs and wishes by speech or signing are in constant danger of being neglected. The author looks at legal and moral obligation of support workers to find ways of communicating with this group.

Journal article

Professional carers’ experiences of caring for individuals with intellectual disability and dementia: a review of the literature

Authors:
CLEARY Josephine, DOODY Owen
Journal article citation:
Journal of Intellectual Disabilities, 21(1), 2017, pp.68-86.
Publisher:
Sage
Place of publication:
London

The number of people with intellectual disability living into old age and developing dementia continues to increase. Dementia presents a wide range of challenges for staff due to progressive deterioration. This article presents the findings from a narrative literature review of professional caregivers’ experiences of caring for individuals with intellectual disability and dementia. Seven electronic databases were searched using Boolean operators and truncation to identify relevant literature. Search results were combined and narrowed to articles relevant to staff working with individuals with intellectual disability and dementia, and 14 articles met the criteria for review. Themes outlined in the review include staff knowledge of dementia, staff training in dementia, caregiving, challenging behaviour, pain management, mealtime support and coping strategies. Overall carers must review and adjust their care delivery and support to people with intellectual disability and dementia, not only in terms of identifying and responding to their health needs but also through collaborative team working within and across services. (Edited publisher abstract)

Journal article

Paid support workers for adults with intellectual disabilities: their current knowledge of hearing loss and future training needs

Authors:
McSHEA Lynzee, FULTON John, HAYES Catherine
Journal article citation:
Journal of Applied Research in Intellectual Disabilities, 29(5), 2016, pp.422-432.
Publisher:
Wiley-Blackwell

Background: People with intellectual disabilities are more likely to have hearing loss than the general population. For those unable to self-advocate, the responsibility of detection and management falls to their caregivers. Methods: This is the first cycle of a project using action research methodology to improve services. Twenty care workers were interviewed to understand their knowledge of hearing loss and hearing aids. Themes were generated using thematic analysis. Findings: This group was better qualified than their peers but received minimal training in hearing loss. They were unable to accurately estimate expected prevalence and had a negative perception of hearing aids. Only 7% of service users were known to have hearing loss. Conclusions: Current training is not sufficient to provide the skills for detection and management of hearing problems. This group had clear ideas on methods of learning. Working in collaboration is necessary to achieve long-term change to practice. (Publisher abstract)

Journal article

Can active support improve job satisfaction?

Authors:
Rhodes Jennifer A., TOOGOOD Sandy
Journal article citation:
Tizard Learning Disability Review, 21(2), 2016, pp.54-60.
Publisher:
Emerald

Purpose: Active support (AS) influences the way staff support people with intellectual disabilities to take part in everyday activities. Changes in work practices may affect job satisfaction. The impact of AS on job satisfaction has not, however, been widely studied. Job satisfaction is linked with levels of staff turnover and the overall quality of services provided to people with intellectual disabilities (Coomber & Barriball, 2007; Hatton et al., 2001). The purpose of this paper is to describe an evaluation of job satisfaction amongst 38 direct care staff working in intellectual disability services before and after AS was implemented. Design/methodology/approach: A single group, repeated-measures design was used. In total, 38 members of direct care staff received AS training. Data on job satisfaction were collected before, and after, AS was implemented. In total, 19 members of staff took part in a follow-up 12 weeks later. Findings: There was a significant increase in reported job satisfaction following the implementation of AS. Subscale analysis revealed that the most significant increases in job satisfaction were related to areas directly targeted by AS, including satisfaction with skill level and satisfaction with amount of time spent with service users. Originality/value: Implementing AS may provide an added benefit for direct care staff, who feel more satisfied at work. While a significant number of papers have been published focusing on the benefits of AS, no papers have specifically looked at the impact that the intervention can have on job satisfaction. (Publisher abstract)

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