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Report of a mixed methods systematic review of literature to inform the development of ‘sustainable safe staffing’ improvement resource in learning disability (LD) services for NHS Improvement
- Authors:
- MAFUBA Kay, GATES Bob, SIVASUBRAMANIAN Madhini
- Publisher:
- University of West London
- Publication year:
- 2016
- Pagination:
- 76
- Place of publication:
- Middlesex
Summarises the best evidence available on sustainable safe staffing levels for multi-disciplinary learning disability teams in order to inform the development of setting-specific sustainable safe staffing guidance for the NHS Improvement National Safe Sustainable Staffing Guidance Programme Board for England. No empirical evidence was located that directly relate to sustainable safe staffing. Three core themes emerged from the review. The first theme, service models, is underpinned by three categories (service design and implementation strategies; clarity of professional roles and service collaboration / integration mechanisms; stakeholder and service user engagement). Four categories underpin the second theme, standards of care (understanding of the context of care; delivering effective care; ensuring effective communication; ensuring high standards of care). The third theme, resources, is made up of three categories (processes for managing resources; developing professional competence; values-based recruitment and retention practices). (Edited publisher abstract)
Systematic reviews of the health or health care of people with intellectual disabilities: a systematic review to identify gaps in the evidence base
- Authors:
- ROBERTSON Jane, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 28(6), 2015, p.455–523.
- Publisher:
- Wiley
Background: Systematic reviews are important in evaluating evidence concerning the health of people with intellectual disabilities. This study conducts a systematic review to identify strengths and gaps in this evidence. Method: Electronic literature searches and email requests identified systematic reviews published in English from 2008 to 2013 on the health or health care of people with intellectual disabilities. Reviews were categorized using ICD-10 chapter headings and information extracted regarding methods, number of studies reviewed and findings. Results: Ninety-four reviews were identified: 52 related to ICD-10 Chapter V: Mental or behavioural disorders, 28 to Chapter XXI: Factors influencing health status and contact with services, and 14 related to other chapters or encompassed multiple chapters. Nine reviews were ‘empty’. No reviews were found for many ICD-10 chapter headings. Conclusions: Systematic reviews are heavily weighted towards mental health, with little coverage of several areas important to the health and mortality of people with intellectual disabilities. (Publisher abstract)
The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review
- Authors:
- JENNINGS Caroline, HEWITT Olivia
- Journal article citation:
- Tizard Learning Disability Review, 20(2), 2015, pp.54-64.
- Publisher:
- Emerald
Purpose: This paper is to identify, outline and evaluate current research on the effectiveness of cognitive behavioural therapy (CBT) for depression for people with a learning disability. The clinical, service and research implications are considered. Design/methodology/approach: A systematic search was conducted on the databases AMED, MEDLINE, PsychINFO and CINAL. Five relevant articles were identified for critical review. Findings: There is a limited but promising evidence base for the use of CBT for depression with people with learning disabilities. Research limitations/implications: The current review identified a number of methodological issues and future research should attempt to overcome these (e.g. small sample sizes and lack of controls). In particular, research should focus on determining the relative contribution of cognitive and behavioural techniques in producing a change in depressive symptoms. Practical implications: Services (including those provided as part of Improving Access to Psychological Therapies) should be offering CBT-based interventions for people with learning disabilities who are experiencing depression. (Edited publisher abstract)
Systematic review of restraint interventions for challenging behaviour among persons with intellectual disabilities: focus on effectiveness in single-case experiments
- Authors:
- HEYVAERT Mieke, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(6), 2014, pp.493-510.
- Publisher:
- Wiley
Background: This article, the first in a two-part series, focuses on the effectiveness of restraint interventions (RIs) for reducing challenging behaviour (CB) among persons with intellectual disabilities. The second article focuses on experiences with RIs for CB among people with intellectual disabilities. Methods: A mixed-methods research synthesis involving statistical meta-analysis and qualitative meta-synthesis techniques was applied to synthesize 76 retrieved articles. This first article reports on the meta-analysis of 59 single-case experiments on effectiveness of RIs for CB among people with intellectual disabilities. Results and Conclusions: The RIs reported on in the single-case experiments were on average highly effective in reducing CB for people with intellectual disabilities, and this reduction in CB was statistically significant. However, the effects vary significantly over the included participants, and the published data and reported outcomes are rather unrepresentative of the everyday use of RIs among persons with intellectual disabilities. (Edited publisher abstract)
Evaluating staff training: taking account of interactions between staff and clients with intellectual disability and challenging behaviour
- Authors:
- OORSOUW Wietske M. W. J. van, EMBREGTS Petri J.C.M., BOSMAN Anna M.T.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 38(4), 2013, pp.356-364.
- Publisher:
- Taylor and Francis
Background: Three aspects in the training of staff who serve clients with mild to moderate intellectual disability and challenging behaviour (CB) have been emphasised: Staff attitudes, self-awareness, and clients' perspectives. This study investigates whether programmes include these aspects. Method: A systematic search yielded 11 relevant articles. Results: Generally, all programmes aimed to improve staff knowledge and skills. Client variables concerned frequencies and severities of CB. None of the studies included clients' perspectives or staff attitudes and self-awareness. Conclusions: The fact that staff attitudes and awareness or clients' perspectives were not among the main goals of the training studies suggests that recent views of effective treatment of CB are not yet the object of scientific study. Given the acknowledgment of these aspects, it is warranted that future research focuses upon these recent insights. (Publisher abstract)
Parent training support for intellectually disabled parents: protocol information
- Authors:
- COREN Esther, et al
- Publisher:
- Campbell Collaboration
- Publication year:
- 2010
- Pagination:
- 16p., bibliog.
- Place of publication:
- Oslo
Previous research has suggested that the number of intellectually disabled people with children is increasing. Children of parents with intellectual disabilities may be at increased risk of neglectful care which could lead to health, developmental and behavioural problems, or increased risk of intellectual disability. This document describes the protocol of a research review to assess the effectiveness of parent training interventions for mothers and fathers with intellectual disabilities designed to support parenting, parent-child relations, safe parenting or family environments or to develop parenting skills. The studies to be included will be randomised controlled trials and quasi randomised studies. Studies will be included which compare parent training with other interventions, with usual care or with a control group. This document provides information on: the criteria for considering studies for the review; search methods for identification of studies; and data collection and analysis.
Personal assistance for children and adolescents (0-18) with both physical and intellectual impairments
- Authors:
- MAYO-WILSON Evan, MONTGOMERY Paul, DENNIS Jane
- Journal article citation:
- Campbell Systematic Reviews, 4(1), 2008, pp.1-30.
- Publisher:
- Wiley
This systematic review aimed to assess the effectiveness of personal assistance for children and adolescents with both physical and intellectual impairments, and the impacts of personal assistance on others, compared to other interventions. Personal assistance is defined as paid support of at least 20 hours per week for people with impairments to enable them to participate in mainstream activities. The report focuses and the methodology used in the review; Electronic databases were searched from 1980 to June 2005; reference lists were checked; 345 experts, organisations, government bodies and charities were contacted in an attempt to locate relevant research. The review identified no studies that met the inclusion criteria. (Edited publisher abstract)
Instruments for the detection of depressive symptoms in people with intellectual disabilities: a systematic review
- Authors:
- PEREZ-ACHIAGA N., NELSON S., HASSIOTIS A.
- Journal article citation:
- Journal of Intellectual Disabilities, 13(1), March 2009, pp.55-76.
- Publisher:
- Sage
- Place of publication:
- London
Affective disorders, particularly depression, are common in adults with intellectual disabilities. However the detection of these disorders is hindered by the varied presentation of depressive symptoms across the range of intellectual disability. A systematic review of the available English-language diagnostic instruments for depressive disorders for adults with all levels of intellectual disability was undertaken. Studies were appraised based on the instruments' psychometric properties, sensitivity and specificity. Twenty one of 28 identified studies which contained original data on validity and reliability; the `gold standard' ranged from clinical opinion to other established instruments, some of which had limited validation in people with intellectual disability. In view of the benefits of psychological treatments for common mental disorders, it is important to develop instruments to be used in monitoring cognitive as well as behavioural outcomes for people with intellectual disability and depressive disorders.
Effects of psychosocial interventions for people with intellectual disabilities and mental health problems: a survey of systematic reviews
- Authors:
- GUSTAFSSON Carina, et al
- Journal article citation:
- Research on Social Work Practice, 19(3), May 2009, pp.281-290.
- Publisher:
- Sage
The aim of this study is to provide a survey of systematic reviews that have evaluated the effects of psychosocial interventions for adult people with intellectual disabilities and/or an autistic syndrome with concurrent mental health problems. Reviews for inclusion were identified through searches of 10 electronic databases. The authors found that 3 out of 126 published reviews met the inclusion criteria for interventions, population, and being considered a systematic review. The results imply a weak scientific support for behavioural therapy, cognitive-behavioural therapy, and some forms of integrated care and support. However, the primary studies included in the reviews have several methodological shortcomings. The results suggest future research initiatives in the direction of more effectiveness studies of good quality and reproduction of high-quality systematic reviews.
Abuse of the disabled child: a systematic review of population-based studies
- Authors:
- GOVINDSHENOY N., SPENCER N.
- Journal article citation:
- Child: Care, Health and Development, 33(5), September 2007, pp.552-558.
- Publisher:
- Wiley
Systematic review of population-based studies published between 1966 and January 2006. Medline, Embase, Cinahl, Cochrane library, National Research Register, Social Sciences database and PsychInfo databases were searched for potentially relevant studies. Inclusion criteria: population-based cohort, case–control or cross-sectional studies of children <18 years of age that reported empirical data on the association of abuse with disability. Risk estimates were expressed as odds ratios with 95% confidence intervals (CI) where possible. Meta-analysis was not undertaken because of heterogeneity of studies. Four studies met the inclusion criteria. Two were longitudinal studies, one was a retrospective birth cohort and the remaining study was a cross-sectional survey. Types of disability studied varied widely as did methods used to ascertain abuse and neglect. Two studies accounted for potential confounding. Three studies reported an association between psychological and emotional disabilities and abuse. Two studies reported an association of learning disability with abuse. Only one study examined the association of physical disability (cerebral palsy) with abuse reporting an adjusted odds ratio for all forms of abuse of 1.79 (95% CI 0.96, 3.36) and for physical abuse of 3.00 (95% CI 1.29, 6.78). The evidence base for an association of disability with abuse and neglect is weak. Psychological and emotional problems, and learning difficulties appear to be associated with abuse but this association might arise because these conditions share a common aetiological pathway with abuse. There is limited evidence that physical disability predisposes to abuse.