Main Research ProjectBackground: People with intellectual disability (ID) are more likely to be overweight or obese compared to their peers, which fuels the need for effective healthy weight management programmes targeted at this population. In order to inform such programmes, more evidence is needed relating to how people with ID perceive their bodies. Method: This study uses qualitative and quantitative methodology to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale was used to assess how participants perceived themselves, how they would like to look, and how they conceptualised underweight, healthy-weight and overweight. This rating scale was shown to be a valid and reliable measure when used with this population. Results: Results show that young adults with ID tend to hold positive beliefs about their bodies. Females with ID are likely to perceive their bodies to be smaller than they are and neither males nor females report a desire for an altered body size. The results also suggest that individuals with ID understand what is meant by ‘overweight’, ‘healthy-weight’ and ‘underweight’ although these concepts are qualitatively different compared to those held by people without ID. Furthermore, individuals with ID are unable to apply these body size categories to themselves. Conclusion: It is vital to consider these findings when designing healthy weight management programmes for people with ID. These individuals will need to be supported to understand how concepts of body size apply to themselves before they can move on to make positive choices about their weight management. Service Improvement ProjectThis service improvement project followed the Model for Improvement framework (Langley et al., 2009), comprising two ‘plan-do-study-act’ cycles. The aim of this project was to support NHS staff without specialist psychological therapy skills to provide phase one trauma work to service users with complex post-traumatic stress disorder (C-PTSD). Semi-structured focus groups were used to elicit staff views on what would be helpful to facilitate this work (n= 8). The findings from these focus groups informed the production of a resource pack that staff could use to assist phase one of trauma focussed work, which included psycho-education, stabilisation and emotion regulation training. Questionnaires were used to assess the amount of phase one trauma based work completed and the perceived level of confidence in staff before and after the introduction of the resources. A total of 16 participants provided ratings before the introduction of the resources and nine participants provided ratings following the introduction of the resources. Findings indicated that the use of phase one trauma skills by staff without psychological training had either stayed the same or increased following the introduction of the resources and staff confidence ratings were higher when staff had access to the resources compared to before the resources had been made available. These findings demonstrate that recovery from C-PTSD can potentially be facilitated by developing resources for staff to use with service users.Critical review of the literature There is incontrovertible evidence that domestic abuse is a highly prevalent phenomenon with wide reaching clinical and health implications. Individuals with disabilities are at significant risk of domestic abuse victimisation yet their experiences are often poorly documented and understood. This systematic review builds upon the ecological model of domestic abuse in people with disabilities, which was first outlined almost two decades ago by Bonnie Carlson. At a micro-system level, factors associated with domestic abuse in people with disabilities that were not previously reported by Carlson included being married, being younger, having a low income, being unemployed, having lower levels of education and having unmet health needs. At a meso-system level, additions to the ecological model for domestic abuse in people with disabilities included increased isolation from other carers and restrictions in reporting abuse resulting from the immediate social environment. Finally, additional macro-system factors included a lack of responsiveness by services, which, in part, appears to be influenced by an inadequate understanding of how domestic abuse manifests in people with disabilities. The definition of domestic abuse is examined to explore how this fails to capture the experiences of people with disabilities.
|Date of Award||21 Aug 2016|
|Supervisor||Cathy Randle-Phillips (Supervisor), Chris Gillmore (Supervisor) & Maria Loades (Supervisor)|