Search results

This study aims to investigate the prevalence and characteristics of dysphagia among adults with intellectual disabilities (ID) referred to speech and language therapy for swallow assessment, providing information on the demographic characteristics, referral trends, co-occurring health conditions and reasons for referrals highlighting the complex health-care needs of this population.

This study used a standardised patient data extraction method over a six-month period involving 74 adults with ID referred to speech and language therapy for swallow assessment.

This study revealed a high prevalence of dysphagia among adults with ID referred to speech and language therapy for swallow assessment. Increasing age and severity of ID were associated with an increased likelihood of swallowing difficulties. Co-occurring health conditions such as mobility difficulties, epilepsy and gastrointestinal conditions were prevalent, suggesting that adults with ID and swallowing difficulties are often living with complex health conditions. Choking incidents and hospital admissions were primary reasons for referral.

This study stresses the pressing need for strategies to mitigate risks associated with choking incidents and hospital admission among this vulnerable population. Possible limitations include a reliance on referral and the focus being on a single service over a short period which may limit generalisation to the wider ID population.

This study emphasises the need to understand each person’s unique profile of health needs and the value of a specialised speech and language therapy service.

The importance of increasing awareness among caregivers and medical experts is highlighted.

The findings underscore the importance of tailored assessment, caregiver involvement and heightened interdisciplinary awareness to effectively manage dysphagia in individuals with ID.

There is evidence that quality improvement projects developed with the participation of patients and family members are more likely to result in a sustainable change. To identify the intervening factors is an important step in promoting and supporting patient and family members’ engagement.

A survey was carried out with 90 hospitals. A total of 35 intervening factors were evaluated by the healthcare professionals from the quality area using a Likert scale. Factor analysis was applied to identify the relationship among the factors and cluster analysis and the standardized scores for each new latent variable were obtained to observe the association between them and hospitals profile. Cluster analysis allowed to group the hospitals with similar responses and to analyze whether there was any association with the profile of the institutions.

A total of ten intervening factors are identified: two in the financial dimension, five in the structural and three in the personal and cultural. The standardized scores of latent variables suggest that the financial factors could be affected by the hospital capacity. The structural factors could be impacted by the accreditation status, location (region) and administrative control (ownership). And the personal and cultural factors could be by the location and dominant organizational culture. All of factors are influenced by the performed quality management activities. The cluster analysis allowed the identification of three groups in the financial dimension, and four in the other two dimensions. Except for the accreditation status in the personal and cultural dimension, no evidence of association between the groups and the variables raised to characterize the profile of the hospitals was found.

The study contributed to identify the relationship among the intervening factors turning possible to simplify and reduce them more comprehensively than those originally identified in the literature and at the same time maintaining the representativeness of the original variables.

There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse.

A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement.

The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse.

There is a paucity of research in environmental design for primary care from the patient’s perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed.

The tools are free to download. With adaptation, they have potential applicability across health and care settings.

This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person’s response to sensory stimuli is individual rather than determined by their condition.

A sense of collective free-thinking with tangible goals makes co-creation an enlightening experience. Yet despite the freedom and organic flow of the methodology, there remain barriers to deploying co-creation in the real-world context. The aim was to understand the barriers and solutions to co-creation, reflect on applying co-creation in practice and co-create an applicable framework for co-creation.

These reflections and conceptual developments were completed using a Participatory Action Research Approach through the co-creation of the Erasmus+ funded Co-creating Welfare course.

Results presented are centric to the experiences in the United Kingdom but led to application at an international level. Problem formulation led to solutions devised about who should co-create, what co-creation aims to achieve, how to receive management buy-in, co-creating beyond the local face to face context and evaluation.

The Three Co’s Framework is proposed using the outline of: Co-Define, Co-Design and Co-Refine. Those who take part in co-creation processes are recommended to be called co-creators, with less focus on “empowerment” and more about facilitating people to harness the power they already have. Utilising online and hybrid delivery methods can be more inclusive, especially in response to the COVID-19 pandemic. The use of co-creation needs to be evaluated more moving forwards, as well as the output co-created.

This paper aims to explore examine the therapeutic potential of head-mounted display (HMD)-based Virtual Reality Relaxation Therapy (VRRT) sessions for people individuals with dementia in Jordan.

This cross-sectional survey recruited 75 dementia-diagnosed elderly individuals from three Jordanian care homes. A VRRT intervention comprising 10 tailored RT sessions held over the course of five weeks was administered to the participants. Apathy, cognitive performance, anxiety and depression were evaluated before and after the intervention to determine any changes. The Person-Environment Apathy Rating Scale's (PEARS) Arabic translation's validity and reliability were also evaluated.

The VRRT intervention yielded noteworthy results in reducing apathy, as indicated by a substantial decrease in PEARS scores from 17.20 to 11.15. The findings of the study revealed that the participants demonstrated enhanced cognitive abilities, as evidenced by a significant rise in their Saint Louis University Mental Status ratings, which increased from 15.11 to 19.70. The levels of anxiety and depression exhibited a significant decrease subsequent to the implementation of VRRT, with anxiety levels decreasing from 13.66 to 8.23 and depression levels decreasing from 13.62 to 9.33. Furthermore, a notable 70% of participants demonstrated statistically significant decreases in indifference.

This study makes a significant contribution to the advancement of innovative treatment approaches aimed at addressing the needs of the aging population, hence enhancing health outcomes and raising the quality of care in Jordan.

The effectiveness of VRRT in reducing apathy among Jordanian senior citizens residing in nursing homes has not yet been fully investigated. Therefore, this paper seeks to assess the effectiveness of HMD-based VRRT by conducting pre- and post-intervention evaluations. This research aims to provide valuable insights into the applicability and significance of VRRT in the Jordanian context, contributing to the development of culturally appropriate and cutting-edge therapeutic interventions for older individuals in Jordan. Through this study, the authors aim to promote improved health and elevated standards of care for this population.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

Evidence-based practice is a professional standard for occupational therapists, but limited time, resources and knowledge challenge its implementation. This study aims to identify what free evidence summary sources (FESS) can be found through a simple online search, related to child/youth interventions surrounding cerebral palsy (CP), autism spectrum disorder (ASD), developmental coordination disorder (DCD), mental health or attention-deficit/hyperactivity disorder (MH/ADHD). Evidence summaries share research in concise, time-efficient manners.

An internet-based scoping review was conducted between February 2022 and July 2022, using Google, and known evidence summary producers. Evidence summaries meeting the inclusion criteria were located and catalogued. Type of agency, target audiences, purpose and distribution of evidence summaries related to diagnosis were identified for each FESS.

Ten FESS were found, which produced 113 intervention-focused evidence summaries within the past 10 years. These FESS were aimed at a variety of target audiences: service providers, service users, parents/families, researchers and commissioners, and were produced primarily by non-profit/charity organisations (6 of 10) who were trying to fill a gap in evidence. Forty-eight evidence summaries were related to ASD, 34 to CP, 29 to MH/ADHD and two to DCD.

A catalogue of FESS that exist online was produced, to support evidence-based practice for paediatric occupational therapists with limited resources, and may support improved health promotion and informed decision-making for service users. No consistent framework for FESS evidence summaries exists at this time.

Delay in housing adaptation is a major problem, especially in assessing if homes are suitable for the occupants and in determining if the occupants are qualified for the Disabled Facilities Grant (DFG). This paper describes the development of two self-administered intelligent integrated assessment tools from the DFG Adapt-ABLE system: (1) The Home Suitability Assessment Platform, which is a preventive mechanism that allows assessment of the suitability of homes based on occupants’ mobility status and (2) an indicative assessment platform that determines if the applicants are qualified for the DFG to prevent lengthy delays.

The adopted method aligned with a development study approach: a grounded literature review, a severity measurement approach, two stakeholder engagement workshops, four brainstorming sessions and four focus group exercises. The system development relied on Entity–Relationship Diagram (ERD) technique for data structures and database systems design. It uses DFG context sensitivity with alignment with DFG guidance, interlinkages and interoperability between the assessment tools and other platforms of the integrated Adapt-ABLE system.

The assessment tools are client-level outcomes related to accessibility, usability and activity based on the assessment process. The home suitability platform shows the percentage of the suitability of a home with assessment results that suggest appropriate action plans based on individual mobility status. The indicative assessment combines the function of referral, allocation, assessment and test of resources into an integrated platform. This enables timely assessment, decision-making and case-escalation by Occupational Therapists based on needs criteria and the eligibility threshold.

These assessment tools are useful for understanding occupants’ perception of their physical housing environment in terms of accessibility, suitability and usability based on basic activities of daily living and their mobility status. The indicative self-assessment tool will substantially cut down the application journey. The developed tools have been recommended for use in the CSJ Disability Commission report and the UK government Guidance on DFGs for local authorities in England.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

This article expands literature on user innovation by exploring the mechanisms that support user innovations in the context of a public organisation. Research has hitherto documented support mechanisms for user innovation in producer companies, where users contribute in early or temporary innovation phases as external non-employees or lead-users engaged by the producer. Complementarily, this paper explores a lesser known area of support mechanisms, those that support internal user innovations in a public sector setting.

Employing a qualitative study of a Norwegian public hospital at the interface between users (personnel and patients) and organisational support (facilitators who orchestrate user innovations), this article analyses in-house user innovation based on observations, text documentation and interviews over a four-year period.

In this public hospital, holistic organisational facilitation of “public user innovators” formed the key support mechanism built on “people” (facilitating co-creation), “process” (facilitating ideas, project realisation and implementation) and “coordination” (facilitating systems and communication). The findings show that public and producer organisational mechanisms both resemble and differ in many respects, as illustrated by the framework developed to describe these characteristics, such as that producers insource users, while the public organisation outsources production.

The originality of the article lies in the identification and description of “public user innovation”, a new term developed from this study of a public organisation in contrast to the dominant literature on producer companies. This article contributes new insights by differentiating the roles of user innovators and the mechanisms that support such innovations. New implications are drawn from the public side of organisational support in user innovation research.