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Mestre TD, Lopes MJ, Mestre DM, Ferreira RF, Costa AP, Caldeira EV. Impact of family-centered care in families with children with intellectual disability: A systematic review. Heliyon 2024; 10:e28241. [PMID: 38560242 PMCID: PMC10981057 DOI: 10.1016/j.heliyon.2024.e28241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
Background Family-Centered Care (FCC) is an approach to healthcare planning, delivery and evaluation, based on beneficial partnerships between health professionals, patients and families. FCC may be particularly relevant for families with children with intellectual disability (ID), given their needs of continuum care. Objective To identify which components of the FCC are practiced and which health outcomes are considered effective in families with children with ID. Method A systematic review guided by the PRISMA STATEMENT 2020 approach and the STROBE reporting guidelines was performed on specific databases through the EBSCOhost Web platform: MEDLINE with Full Text, CINAHL PLUS with Full Text, Academic Search Complete and Psychology and Behavioral Sciences Collection. Peer-reviewed articles published in English or Portuguese languages from 2018 to September 2023 were retrieved. Methodological quality was established using the Quality Assessment Tool for Observational, Cohort and Cross-Sectional Studies - NHLBI, NIH. Results Ten studies met the eligibility criteria and were synthetized. The results revealed nine components, reflecting the way FCC was developed: shared decision-making; family education; respect for culture; family engagement; recognition of the family's needs, characteristics and interests; specialized care support; social and emotional support; family functionality; and family seen as a unit. The health outcomes demonstrate effective gains in improving children's health through family satisfaction with health services. Also achieved psychological and social benefits, with improved family well-being and quality of life, favoring family empowerment. Conclusions The evidence suggests that FCC components involves an effective partnership between the family and health professionals as the main key in developing care plans, as well as the experience that the family unit brings to the delivery of care. FCC approach include all family members as decision-makers, providing emotional, physical and instrumental levels of support. Health outcomes emerged in three strands; for children with ID, families and health services.
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Affiliation(s)
- Teresa Dionísio Mestre
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre [CHRC], Portugal
- University of Évora – Health Department, Portugal
| | | | - Rogério Ferrinho Ferreira
- Comprehensive Health Research Centre [CHRC], Portugal
- Polytechnic Institute of Beja – Health Department, Portugal
| | - Ana Pedro Costa
- Comprehensive Health Research Centre [CHRC], Portugal
- Local Health Unit of Lower Alentejo [ULSBA], Beja, Portugal
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Hande V, Jayan P, Kishore MT, Bhaskarapillai B, Kommu JVS. Development of a scale to assess the determinants of positive coping in parents of children with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:156-169. [PMID: 35125025 DOI: 10.1177/17446295211056824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Identifying the determinants of positive coping is a critical step in empowering the parents of children with intellectual disability. In this context, this study aims to develop a scale to assess the determinants of positive coping. Accordingly, culturally relevant items were pooled, got validated by experts and refined. The scale was administered to 150 parents of children with intellectual disability. Factor analysis done through polychoric correlation helped reduce the items. Cronbach's alpha coefficients were established for reliability testing. The validity of the new scale was examined with the subjective wellbeing on a visual analogue scale and Family Interview for Stress and Coping in Mental Retardation. The new scale has a Cronbach's alpha of 0.71 and an intraclass correlation of 0.64. After factor analysis, 12 items were retained in the final version. This study also identified specific factors associated with positive coping. The new scale can be used with parents of children with intellectual disabilities to identify the determinants of positive coping.
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Affiliation(s)
- Vasudha Hande
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Parvathy Jayan
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - M Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - John Vijay Sagar Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Mbada CE, Onilude AT, Oyewole OO, Olorunmoteni OE, Fatoye C, Ogundele AO, Fatoye F. Exploração qualitativa do itinerário terapêutico de crianças com deficiência física na Nigéria usando análise de conteúdo temática. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Explorar o itinerário terapêutico na busca de cuidados para crianças com deficiências físicas pelos cuidadores. Métodos Um plano qualitativo descritivo que recrutou nove cuidadores de crianças com deficiência física, com consentimento, que frequentavam um Hospital Universitário Nigeriano. Foi utilizado um guia de entrevista semi-estruturado para coletar dados sobre o itinerário terapêutico, que foi definido como os caminhos percorridos pelos indivíduos para resolver o seu problema de saúde. As entrevistas foram gravadas em áudio e transcritas literalmente. Os dados foram analisados utilizando a análise do conteúdo temático. Resultados os temas emergentes revelaram que os cuidadores iniciaram o itinerário terapêutico para os respetivos filhos após a observação de quaisquer deficiências que vão para além de doenças casuais. A falta de capacidade dos hospitais privados, que servem como ponto inicial de entrada na busca de cuidados, encorajou a procura por cuidados nos hospitais públicos, lares espirituais, e clínicas tradicionais. A entrada na fisioterapia dependia de auto-referências, referências por parentes e médicos. Cuidar de crianças com deficiência física prejudicou de modo significativo a vida social, as finanças, o trabalho do cuidador; e expectativas não alcançadas de que a criança melhorasse o mais cedo possível encorajaram um pluralismo contínuo. Conclusão e implicações para a prática O fato de ter crianças com deficiências e de ter havido atraso nos progressos levou os cuidadores a práticas múltiplas e complexas na busca de cuidados de saúde.
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Affiliation(s)
| | | | | | | | - Clara Fatoye
- Manchester Metropolitan University, United Kingdom
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Nuri RP, Aldersey HM, Ghahari S. Needs of families of children with cerebral palsy in Bangladesh: A qualitative study. Child Care Health Dev 2019; 45:36-44. [PMID: 30304759 DOI: 10.1111/cch.12624] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/11/2018] [Accepted: 10/07/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Families of children with disabilities often have needs related to the care of their child with a disability. Although there has been extensive exploration of family needs in high-income contexts, there is little known about this issue in low and middle-income countries like Bangladesh. In this study, we explored the needs of families of children with cerebral palsy in Bangladesh. Such understanding is important as it will help to improve services for children with disabilities and their families. METHODS We used a qualitative approach and interviewed 20 family members of children with cerebral palsy who visited the Centre for the Rehabilitation of the Paralysed, Bangladesh. We thematically analyzed data from semistructured interviews. RESULTS Five different themes were found on needs of families with children with disabilities: (a) financial needs, (b) needs for disability-related services, (c) needs for family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial needs were their highest priority. CONCLUSION Needs of families of children with disabilities must be considered in rehabilitation services to improve children's outcomes. Further studies are required to explore needs of families of children with disabilities who do not have access to rehabilitation services.
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Affiliation(s)
| | | | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Jaiswal SV, Subramanyam AA, Shah HR, Kamath RM. Psychopathology and coping mechanisms in parents of children with intellectual disability. Indian J Psychiatry 2018; 60:312-317. [PMID: 30405257 PMCID: PMC6201664 DOI: 10.4103/psychiatry.indianjpsychiatry_259_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Raising a child with intellectual disability (ID) can add to parenting stress significantly. This stress can manifest into psychopathologies such as anxiety and depression. The aims of the study were to assess psychopathology and coping mechanisms in parents of children with ID. MATERIALS AND METHODS A total of 100 consecutive consenting parents of children with ID were interviewed from child psychiatry outpatient department of a municipal-run tertiary care teaching hospital. A semi-structured pro forma, symptom checklist 90 revised (SCL90R) and Mechanism of Coping Scale (MOCS) were used for assessment. RESULTS Mean age for the parents was 37.02 (±7.35) years, and for the children, it was 8.29 (±3.11) years. There were 60 mothers and 61 parents of a male child among sample. Eighty-five of parents considered their child's ID to be a major concern in their life. Depression had highest mean among psychopathologies. Mothers had higher score for depression and Interpersonal-sensitivity. Parental psychopathology did not differ significantly with severity of ID of child. Global severity index of SCL90R correlated negatively with age of parents (P = 0.015) and positively with fatalism (P = 0.004), expressive-action (P < 0.000) and passivity (P = 0.001) coping mechanisms. CONCLUSION Depression is the most common psychopathology especially among mothers of child with ID. Psychopathology is independent of severity of ID and worsens with coping mechanisms like fatalism, expressive-action, and escape-avoidance. A child with ID should be seen and treated as a family unit giving enough attention to parent's psychological needs as well.
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Affiliation(s)
- Suyog Vijay Jaiswal
- Department of Psychiatry, H. B. T. Medical College and Dr. R. N. Cooper Mun. Gen. Hospital, Mumbai, Maharashtra, India
| | - Alka Anand Subramanyam
- Department of Psychiatry, T. N. Medical College and B.Y.L. Ch. Hospital, Mumbai, Maharashtra, India
| | - Henal Rakesh Shah
- Department of Psychiatry, T. N. Medical College and B.Y.L. Ch. Hospital, Mumbai, Maharashtra, India
| | - Ravindra M. Kamath
- Department of Psychiatry, T. N. Medical College and B.Y.L. Ch. Hospital, Mumbai, Maharashtra, India
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Rajan AM, John R. Resilience and impact of children's intellectual disability on Indian parents. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2017; 21:315-324. [PMID: 27329035 DOI: 10.1177/1744629516654588] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Resilience of parents in the context of raising a child with intellectual disability is gaining attention as a mechanism that addresses their inherent strengths to withstand the potential associated strain. Understanding its underlying factors has applications in fostering their resilience. The present study explored the resilience of parents and its relationship with the impact of child's disability. A total of 121 parents were assessed using Connor Davidson Resilience Scale and National Institute for the Mentally Handicapped Disability Impact Scale. The results revealed that parenting a child with intellectual disability posed them with both positive and negative experiences. Their evaluations about the condition of the child significantly influenced their resilience. The positive perceptions about the child's disability operated as a protective element, whereas their negative evaluations acted as a risk element of resilience. The findings have specific importance in designing interventions for families of persons with intellectual disability.
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Menon DK, Kishore MT, Sivakumar T, Maulik PK, Kumar D, Lakhan R, Banerjee R. The National Trust: A viable model of care for adults with intellectual disabilities in India. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2017; 21:259-269. [PMID: 28812964 DOI: 10.1177/1744629517709832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The longevity of people with intellectual disabilities is increasing in developing nations. However, developing nations lack a proper system of care for aging persons with intellectual disabilities. Until now the care has been provided by parents and relatives in the home environment in developing countries, but this scenario is also changing; therefore, there is a strong need to explore a plan of care for this population which is also feasible and replicable. The National Trust is an autonomous body of the Government of India which has developed a comprehensive plan of care for adults with intellectual disabilities. In this article, the National Trust is discussed using a socioecological model. The replicability and suitability of this model for other developing countries are discussed.
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Affiliation(s)
| | | | - T Sivakumar
- National Institute of Mental Health and Neuroscience, India
| | - Pallab K Maulik
- The George Institute for Global Health, India; Oxford University, UK
| | - Devvarta Kumar
- National Institute of Mental Health and Neuroscience, India
| | | | - Ruma Banerjee
- State Nodal Agency Centre-Karnataka Chapter, Bangalore
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Shin JY, Nguyen SD. The Effects of a Home-based Intervention Conducted by College Students for Young Children with Developmental Delays in Vietnam. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2016; 63:110-123. [PMID: 29333265 PMCID: PMC5764180 DOI: 10.1080/20473869.2016.1144316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The project assessed the efficacy of a home-based intervention program for young children (n= 64, ages ranging from 3-6 years) with developmental delays in Vietnam. It was hypothesized that the children in the intervention group would show greater progress in adaptive behavior than the children in the control group. METHODS Assessment of the program efficacy was carried out by comparing children who received services for 6 months and those who did not. Children who were recognized as having developmental delays by teachers in kindergarten programs, and confirmed by trained evaluators based on the Vineland Adaptive Behavior Scale-II (VABS-II), were randomly assigned to intervention and control groups. Twenty student teachers were recruited from a teaching university and were provided with pre-program training and ongoing supervision. RESULTS The outcomes of the program were examined at 0, 3, and 6 months using the VABS-II. The intervention group improved significantly more than the control group in overall adaptive functioning and in the areas of communication, social skills and motor skills. CONCLUSION The project is one of only a few early intervention projects to apply randomized control trials in a low-middle-income country. The results demonstrate the feasibility of carrying out the intervention program using teachers with no prior experience of working with children with delays/disabilities, where professional resources are scarce for this population.
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Affiliation(s)
- Jin Y Shin
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Son Duc Nguyen
- Department of Psychology and Pedagogy, Hanoi National University of Education, Hanoi, Vietnam
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Yang X. No matter how I think, it already hurts: self-stigmatized feelings and face concern of Chinese caregivers of people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:367-380. [PMID: 25801087 DOI: 10.1177/1744629515577909] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
This study used mixed-methods design to explore internalized self-stigma among family caregivers (ISFC) of people with intellectual disability (ID) in China, where face culture and collective emotions are emphasized. A total of 120 primary caregivers of people with ID were assessed for ISFC, face concern and psychological distress at the survey phase. Of these caregivers, 10 participated in sequential interviews to provide elaboration for quantitative results. The results highlighted the role of stigmatized feelings instead of cognitive thoughts in hurting caregivers in the Chinese context. Caregivers with higher face concern were more likely to internalize feelings of shame, self-blame and powerlessness and suffered poorer mental health. Low-socioeconomic status group and onset-before-birth group were particularly vulnerable to stigma that require more attention in future studies. Feelings of being marginalized within the family and shame may be more face culture-related concern. Strategies (i.e. withdrawal, compensation, self-compassion and multiple identities) and recommendations for stigma reduction were discussed.
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Affiliation(s)
- Xue Yang
- The Chinese University of Hong Kong, Hong Kong
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Lakhan R. Behavioral management in children with intellectual disabilities in a resource-poor setting in Barwani, India. Indian J Psychiatry 2014; 56:39-45. [PMID: 24574557 PMCID: PMC3927244 DOI: 10.4103/0019-5545.124712] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Management of behavioral problems in children with intellectual disabilities (ID) is a great concern in resource-poor areas in India. This study attempted to analyze the efficacy of behavioral intervention provided in resource-poor settings. OBJECTIVE This study was aimed to examine the outcome of behavioral management provided to children with ID in a poor rural region in India. MATERIALS AND METHODS We analyzed data from 104 children between 3 and 18 years old who received interventions for behavioral problems in a clinical or a community setting. The behavioral assessment scale for Indian children with mental retardation (BASIC-MR) was used to quantify the study subjects' behavioral problems before and after we applied behavioral management techniques (baseline and post-intervention, respectively). The baseline and post-intervention scores were analyzed using the following statistical techniques: Wilcoxon matched-pairs signed-rank test for the efficacy of intervention; χ(2) for group differences. RESULTS The study demonstrated behavioral improvements across all behavior domains (P < 0.05). Levels of improvement varied for children with different severities of ID (P = 0.001), between children who did and did not have multiple disabilities (P = 0.011). CONCLUSION The outcome of this behavioral management study suggests that behavioral intervention can be effectively provided to children with ID in poor areas.
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Affiliation(s)
- Ram Lakhan
- Department of Epidemiology and Biostatistics, School of Health Sciences, College of Public Service, Jackson State University, Jackson, MS, USA
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Kishore MT. Disability impact and coping in mothers of children with intellectual disabilities and multiple disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2011; 15:241-51. [PMID: 22158461 DOI: 10.1177/1744629511431659] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Understanding the disability impact on parenting and caregiving is important for intervention. The present study was designed to understand the differences in perceived disability impact and related coping in mothers having children with intellectual disabilities alone compared to those having children with intellectual disabilities and additional disabilities. Accordingly, 30 mothers of children with intellectual disabilities and 30 mothers of children with intellectual and additional disabilities were assessed for disability impact and coping. Group differences for disability impact were present in specific domains but not overall. Despite variations in coping pattern, both positive and negative coping strategies were observed in both groups. The results may imply that the impact of intellectual disability is so pervasive that except in certain domains mothers may not perceive the further impact of additional disabilities. Positive coping does not rule out negative coping strategies. These findings have specific relevance to service delivery in a cultural context.
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Perspectives of intellectual disability in India: epidemiology, policy, services for children and adults. Curr Opin Psychiatry 2010; 23:441-6. [PMID: 20489642 DOI: 10.1097/yco.0b013e32833ad95c] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To provide a panoramic view of the recent developments and current situation in epidemiology, legislation, policies, services, and research in intellectual disability in India. RECENT FINDINGS A wide variation in point prevalence of intellectual disability has been reported, from around 1/1000 to 32/1000, depending on the case definition, methodology, and population selected. There are a number of acts, policies, and programs addressing intellectual disability, but their implementation needs to improve. Services in terms of prevention, early intervention, health services, parent-focused and family-focused interventions, special and inclusion education, vocational training, support for individuals and their families, and community-based rehabilitation services are steadily improving, albeit unevenly across different regions and sub-populations. Genetics of disorders associated with intellectual disability such as primary microcephaly and fragile X syndrome have received research attention. Psychosocial research has focused on family needs, family-focused intervention, early intervention, and comorbid disorders. A positive development has been the organization of parents into parent associations all over India and formation of a national confederation. SUMMARY There has been noticeable progress in addressing the challenges posed by intellectual disability in India on all fronts. However, there is still a long way to go in terms of developing a locally and nationally relevant and reliable database, effective implementation of legislation and policies, and development of effective, accessible, and affordable interventions.
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