Personal assistance, independent living, and people with disabilities: An international systematic review (2013-2023).

BACKGROUND: The article discusses the contribution of personal assistance for the independent living of people with disabilities. This right is evolving at different speeds internationally, presents controversial aspects, and is under continuous debate. OBJECTIVE: To synthesize the evidence relating to the promotion of self-determination and independent living through personal assistance. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published was conducted during March 2023 across nine databases. The findings of the included studies were coded and analyzed via inductive content analysis. RESULTS: 26 articles were included, mostly qualitative, from four different continents. The analysis revealed six different key themes. The social framework highlighted the influence of international agreements and disability activism on cultural shifts in understanding disability. Secondly, healthy relationships and life or service expectations were emphasized. Key agents included users, personal assistants, family members, service providers, and other professionals. Personal assistants' work context explored ethical dilemmas, training, and working rights. Decision-making about personal assistance involved factors like lack of information, access requirements, and funding. Lastly, the implications underscored the positive impact of personal assistance on independent living, while identifying threats, and best practices for improvement. CONCLUSIONS: This systematic review was the first to explore the promotion of independent living of people with disabilities through personal assistance schemes and highlights the need for governments to prioritize and coordinate efforts to ensure access for all, emphasizing the ethical imperative to progress toward social justice.

Aspectos éticos de la asistencia personal, una visión desde el Trabajo Social / Ethical Aspects of Personal Assistance, a View from Social Work

El propósito de este estudio es, desde la óptica del Trabajo Social, identificar los principales problemas éticos que se le presentan a las profesionales de la asistencia personal al desarrollar sus funciones de ayuda o apoyo a las personas con discapacidad, así como detectar si las profesionales consideran necesaria una mayor formación ética. Para ello, se optó por un procedimiento mixto mediante la aplicación de dos cuestionarios ad hoc. El primero, de preguntas abiertas, se dirigió a 31 profesionales en activo de la asistencia personal en España en la fase de recogida de información. El segundo, de preguntas cerradas o respuesta breve, se dirigió a 52 profesionales con experiencia previa en dicha figura profesional. Mediante el análisis de su discurso se corroboró la necesidad de afrontar diferentes conflictos y problemas éticos durante la prestación del servicio de asistencia personal en distintos ámbitos y situaciones. Podemos concluir que la formación ética de las profesionales es insuficiente para el desarrollo de sus funciones en condiciones de calidad y respecto a la dignidad y la autonomía personal de las personas usuarias. (AU)

The purpose of this study is, from the point of view of Social Work, to identify the main ethical problems that personal assistance professionals face when developing their functions of helping or supporting people with disabilities, as well as detecting whether professionals consider that greater ethical training is necessary. To do this, a mixed method was chosen through the application of two ad hoc questionnaires. The first, with open questions, was addressed to 31 active personal assistance professionals in Spain in the information collection phase. The second, with closed questions or short answers, was addressed to 52 professionals with previous experience in said professional figure. Through the analysis of their speech, the need to face different conflicts and ethical problems during the provision of the personal assistance service in different areas and situations was corroborated. We can conclude that the ethical training of professionals is insufficient for the development of their functions in quality conditions and with respect to the dignity and personal autonomy of the users. (AU)

Psychometric properties of the Maslach Burnout Inventory - Human Services in Social Work professionals in Spain.

The burnout syndrome has traditionally been identified in the service sector professions, among which is Social Work. In order to determine this syndrome, different measuring instruments have emerged, including the Maslach Burnout Inventory. The main objective of this study was to evaluate the psychometric properties of this instrument and to find evidence of its validity (corroborating the original factorial structure and its convergent validity) and reliability (internal consistency). The Spanish adapted version of the Maslach Burnout Inventory was used. Four hundred social workers participated, randomly divided into two samples of 200 individuals (Sample 1: M = 43.06, SD = 9.04 and Sample 2: M = 40.89, SD = 8.78). We carried out principal components exploratory factor analysis with Varimax rotation. The results identified a factorial structure with four factors (Emotional Exhaustion, Depersonalization, Personal Realization, and Interpersonal Psychological Stress) (χ2 /df = 1.73, CFI = 0.929, NNFI = 0.859, SRMR = 0.069, RMSEA = 0.061), different from that of the original questionnaire, which indicated three dimensions. The data also show a high internal consistency (α = 0.882). The four factors were directly and moderately associated with each other (r between 0.328 and 0.534). In conclusion, this study provides new data of a valid and reliable tool for evaluating professional burnout or exhaustion.

Prevalencia del burnout en el Sistema de Servicios Sociales: estudio transversal en servicios sociales comunitarios / Prevalence of burnout in the Social Services System: cross-sectional study in community social services

Objetivo principal: evaluar la prevalencia del síndrome de burnout en las trabajadoras sociales que ejercen su actividad laboral en los servicios sociales comunitarios. Metodología: diseño de enfoque descriptivo y transversal, utilizando el cuestionario Maslach Burnout Inventory. Dicho cuestionario mide tres dimensiones relacionadas con el burnout: Agotamiento emocional, Despersonalización y Realización personal. La recogida de datos se realizó a través de una aplicación de encuestas, entre trabajadoras sociales colegiadas. Resultados: participaron 209 trabajadoras sociales, de las cuales el 92,8% son mujeres y un 7,2% hombres; sus edades están comprendidas entre los 23 y los 64 años. Los datos de prevalencia arrojan unos resultados elevados en los factores que componen el constructo de burnout, especialmente en la dimensión de Agotamiento Emocional. Conclusiones: el síndrome de burnout se encuentra presente en un porcentaje elevado de trabajadoras sociales del Sistema de Servicios Sociales. (AU)

Objective: to assess the prevalence of burnout syndrome in the professional group of social workers who perform their work in the community social services. Methods: a descriptive and cross-sectional design was proposed, using as the main instrument the Maslach Burnout Inventory. This inventory measures three dimensions related to burnout: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Data collection was carried out through a survey among the social workers registered. Results: 209 social workers participated in the study, of which 92.8% of the population under study are women and 7.2% are men; their ages ranging between 23 and 64 years. The study prevalence data yields high results in the factors that make up the burnout construct, especially in the Emotional Exhaustion dimension. Conclusions: burnout syndrome is present in a high percentage of social workers in the social services system. (AU)

Síndrome de burnout en el Sistema de Salud: el caso de las trabajadoras sociales sanitarias / Burnout syndrome in the Health System: the case of social health workers

OBJETIVO: El objetivo general de esta investigación es medir la prevalencia del síndrome de burnout en el colectivo profesional de trabajadoras sociales sanitarias que ejercen su actividad laboral en los diferentes servicios y centros del Servicio Público de Salud de Galicia (España). MÉTODO: Se ha planteado un diseño de enfoque cuantitativo-analítico y transversal, utilizando como instrumento principal el cuestionario Maslach Burnout Inventory, versión Human Services Suvey. Dicho cuestionario mide tres dimensiones relacionadas con el burnout: Agotamiento emocional, Despersonalización y Realización personal. La recogida de datos se realizó a través de una aplicación de encuestas entre las trabajadoras sociales colegiadas en el Colegio Oficial de Trabajo Social de Galicia. RESULTADOS: El 86,2% de la población objeto de estudio son mujeres y un 13,8% hombres, y sus edades están comprendidas entre los 23 y los 63 años. Los datos de prevalencia del estudio arrojan unos resultados elevados, especialmente en la dimensión de Agotamiento Emocional donde más de la mitad de la población objeto de estudio presenta una puntuación considerada alta. CONCLUSIÓN: Al igual que otros colectivos profesionales que ejercen su actividad laboral en el sistema de salud, como es el caso de Enfermería y Medicina, las trabajadoras sociales sanitarias presentan índices elevados de burnout, siendo el Agotamiento Emocional la dimensión más afectada

OBJECTIVE: The general goal of this research is to measure the prevalence of the burnout syndrome in the professional group of social health workers who perform their work in the diverse services and centers of the Public Health Service of Galicia (Spain). METHOD: A quantitative-analytical and cross-sectional design was proposed, using as the main instrument the Maslach Burnout Inventory, Human Services Survey version. This inventory measures three dimensions related to burnout: Emotional Exhaustion, Depersonalization, and Personal Fulfillment. Data collection was carried out through a survey among the social workers registered in the Official Association of Social Work of Galicia. RESULTS: 86.2% of the population under study are women and 13.8% are men; their ages range between 23 and 63 years. The study prevalence data yields high scores, especially in the Emotional Exhaustion dimension, where more than half of the population under study obtained a high score. CONCLUSION: Like other professional groups that perform their work in the health system, as is the case of Nursing and Medicine, social health workers present high rates of burnout, with Emotional Exhaustion being the most affected dimension

La asistencia personal como nuevo derecho de ciudadanía: una mirada desde el ámbito de los profesionales de la salud / Personal assistance as a new citizens' right: seen from the health professionals' sphere / Assistência pessoal como novo direito de cidadania: um olhar do campo dos profissionais de saúde

OBJETIVO: El objetivo principal de esta investigación es conocer la figura del asistente personal para personas con discapacidad. Asimismo, se pretende exponer la importancia de los cuidados y el acompañamiento profesionalizado frente a los cuidados familiares. MÉTODO: Abordaje de investigación mixto consistente en la revisión de bases de datos oficiales, así como la realización de entrevistas semiestructuradas a 11 profesionales de la enfermería pertenecientes al Servicio Público de Salud de Galicia (España). RESULTADOS: Los resultados apuntan a que la figura del asistente personal continúa sin ser mayoritaria en la prestación de servicios para personas con discapacidad. El personal de enfermería entrevistado considera que las funciones de asistencia personal deben enfocarse hacia una clara profesionalización por sus características específicas. CONCLUSIONES: Los resultados de este estudio, constituyen un marco propio para la reflexión sobre la intervención y acompañamiento en personas con discapacidad. Sin duda, es necesario el trabajo interdisciplinar dentro de un abordaje conjunto de profesionales con formación sanitaria y social

OBJECTIVE: The main objective of this research is to familiarize ourselves with the figure of the personal assistant for disabled people. It also seeks to reveal the importance of professionalized care and accompaniment compared with family care. METHODS: Joint research consisting of the review of official databases, as well as the performance of semi-structured interviews with 11 professional nurses belonging to the Public Health Service of Galicia (Spain). RESULTS: The results suggest that the figure of the personal assistant is still not predominant in the provision of services for people with disabilities. The interviewed nursing staff considered that the functions of personal assistance should be clearly professionalized due to their specific characteristics. CONCLUSIONS: The results of this study constitute a framework for reflection on intervention and support for people with disabilities. No doubt, interdisciplinary work is necessary within a joint approach of professionals with health and social training

OBJETIVO: O objetivo principal desta pesquisa é conhecer a figura do assistente pessoal para pessoas com deficiência. Da mesma forma, pretende-se expor a importância do cuidado e o acompanhamento profissionalizado versus cuidado familiar. MÉTODO: Abordagem de pesquisa mista composta pela revisão de bases de dados oficiais, bem como entrevistas semiestruturadas a 11 profissionais de enfermagem pertencentes ao Serviço de Saúde Pública da Galiza (Espanha). RESULTADOS: Os resultados sugerem que a figura do assistente pessoal continua sem ser uma maioria na prestação de serviços para pessoas com deficiência. A equipe de enfermagem entrevistada considera que as funções de assistência pessoal devem estar focadas em uma profissionalização clara devido às suas características específicas. CONCLUSÕES: Os resultados deste estudo constituem um marco adequado para a reflexão sobre a intervenção e acompanhamento de pessoas com deficiência. Sem dúvida, o trabalho interdisciplinar é necessário dentro de uma abordagem conjunta de profissionais com formação em saúde e social