RESUMO
BACKGROUND: People with intellectual disabilities face attitudinal and service barriers when attempting to form intimate relationships. To date, their experiences and views are under-represented in the existing evidence base. METHOD: The aim of this study was to carry out an interpretative phenomenological analysis exploring the experience of intimate relationships for nine adults with intellectual disabilities. RESULTS: Four main themes were identified: desiring relationships; expressing sexuality; having relationships; and who has control? Together these themes demonstrated that intimate relationships were desired and important to all participants, fulfilling a variety of their needs. In addition, participants faced a number of challenges related to intimate relationships. CONCLUSION: The findings raise questions about how best to support people with intellectual disabilities with sexuality and intimate relationships. Implications for caregivers and services are discussed.
Assuntos
Deficiência Intelectual/psicologia , Relações Interpessoais , Comportamento Sexual/psicologia , Adulto , Atitude Frente a Saúde , Emoções , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parceiros Sexuais/psicologiaRESUMO
BACKGROUND: Creative use of legislation can produce positive change in the lives of people with intellectual disabilities. This may be 'bottom-up' or 'top-down' or at multiple levels and with multiple stakeholders. METHOD: Using a human rights-based approach (HRBA), four initiatives to improve services for people with intellectual disabilities in the UK are described. RESULTS: The first example explains the process of co-producing a DVD and board game to enable people with intellectual disabilities to understand their human rights. The second example considers the impact of organizational culture in the process of embedding a pilot evaluation of practical, human rights-based risk assessment and management tools. A third pilot project examines how the guiding principles of Mental Health Act (MHA) (2007) for England and Wales can be operationalized using an HRBA. Finally, improving equitable access to health care through a 'top-down' process of change involving the Green Light Toolkit is reported. CONCLUSION: The authors consider how to approach the process and where to focus in the system, to realize meaningful change.
Assuntos
Política de Saúde , Direitos Humanos/legislação & jurisprudência , Deficiência Intelectual , Serviços de Saúde Mental/organização & administração , Participação do Paciente , Medicina Estatal/organização & administração , Adulto , Atitude do Pessoal de Saúde , Internação Compulsória de Doente Mental/legislação & jurisprudência , Internação Compulsória de Doente Mental/normas , Inglaterra , Jogos Experimentais , Acessibilidade aos Serviços de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/normas , Humanos , Serviços de Saúde Mental/legislação & jurisprudência , Serviços de Saúde Mental/normas , Cultura Organizacional , Inovação Organizacional , Educação de Pacientes como Assunto/métodos , Pessoas com Deficiência Mental/psicologia , Projetos Piloto , Gestão de Riscos/organização & administração , Medicina Estatal/legislação & jurisprudência , Medicina Estatal/normas , País de GalesRESUMO
The aim of the meta-synthesis was to determine any difficulties experienced by caregivers relating to the sexuality of people with intellectual disabilities and how they address those difficulties. A qualitative meta-synthesis was used to integrate the findings from 17 papers about these topics. The synthesis produced five concepts: 'Fear and Uncertainty', 'Impact of Perceptions of Sexuality', 'The Same and Different', 'Balancing the Roles of Protector and Facilitator' and 'Conditional Sexuality: Conditional Support'. The findings suggest key issues for caregivers in relation to addressing the sexual needs of people with intellectual disabilities and highlight the possible implications of caregivers own views on their practice. These issues are discussed and in conclusion the review offers explanations about what the difficulties for caregivers are and how they might be addressed, as well as recommendations for future research.
Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Cuidadores , Deficiência Intelectual/enfermagem , Sexualidade , Humanos , Pesquisa Qualitativa , Comportamento SexualRESUMO
OBJECTIVE: We examined the sensitivity of the Evaluation of Social Interaction (ESI) as a measure of the overall quality of social interaction in children as they engage in social exchanges in a natural context with typical social partners. METHOD: We compared the ESI measures of 23 children with disabilities with those of 23 children without disabilities, matched by age and gender. RESULTS: Paired t-test analysis revealed a statistically significant difference, t(22) = -4.065, p = .001, in the quality of social interaction for the two groups of children, indicating sensitivity of the ESI. CONCLUSION: The results support the use of the ESI to measure quality of social interaction in a natural context.