Effect of unexpected outcomes and causal attributions on key workers' expectancies of goal attainment

Incorporation of Chance Into Career Development Theory and Research

In a climate in which career transitions are increasingly common, chance events may have a greater influence on career development. This article is a review of how well the current theory and research can account for the interaction between chance events and career development. Chance events are characterized as being unpredictable and unplanned to the person who experiences them. However, existing research and theory have largely failed to consider these unique qualities of chance events. Theories based on learning principles such as happenstance learning theory (Krumboltz, 1996, 2009), social cognitive career theory, and cognitive information processing theory of career development provide a framework for understanding the processes that occur when people are affected by or respond to events that are predictable or unplanned. This review considers this potential and concludes with suggestions for possible avenues for future research.

Inclusion in primary care for people with intellectual disabilities: gaining the perspective of service user and supporting social care staff

The aim of this study was to gain service user and social care staff perspectives on the barriers facing people with intellectual disabilities when accessing primary healthcare. A qualitative mixed methods semi-structured approach involved the use of focus groups and individual interviews within the service users' homes. A purposive sampling strategy identified people using primary healthcare in the last 6 months (N = 6) with support from social care staff (N = 19). Three emergent themes were common to service users and carer staff: ;accessing the surgery', ;communication issues' and ;waiting around'. Other themes were unique to each group. Social care staff identified the ;attitudes and behaviour of primary healthcare staff' as sometimes problematic, and the importance of ;knowing the service user'. Service users identified ;feelings about going to the doctor', ;health education' and ;making changes'. Gaining these views is an important first step in improving access to primary healthcare.

Using goal attainment scaling to evaluate a needs-led exercise programme for people with severe and profound intellectual disabilities

The aim of this study was to evaluate whether involvement in a 16 week exercise programme improved goal attainment in areas of behaviour, access to community-based experiences, health and physical competence. Participants were women with severe intellectual disability and associated challenging behaviour (setting A,N = 14) and male/female service users with profound physical and intellectual disabilities (setting B,N = 8). The exercise programme included active and passive exercise, walking, swimming, hydrotherapy, team games and rebound therapy. Significant gains in aggregated goal attainment were demonstrated by week 16. The reliability and validity of our goal attainment procedures were demonstrated with inter-rater reliabilities exceeding 80 percent. Changes in goal attainment were concurrent with global clinical impression scores in a series of single case studies. Continuing care settings should dedicate care staff to provide routinized, continuing exercise programmes.