Abstract
Sexuality in the Lives of People with Learning Disabilities: A Meta-Ethnographic Synthesis of Qualitative StudiesBackground. The normalisation movement calls for more recognition of the sexual rights of people with learning disabilities to challenge classically paradoxical cultural beliefs: ‘hypersexual’ versus ‘asexual’.
Aims. This meta-ethnographic qualitative synthesis aimed to explore the voices of people with learning disabilities in regards to their experiences and perceptions of sexuality using a Coordinated Management of Meaning framework to derive new conceptual understandings of how their sexuality exists within multiple contexts.
Methods and Procedures. A systematic literature search and quality assessment yielded 16 studies that met the inclusion criteria and were synthesized following the method of meta-ethnography.
Outcomes and Results. Four core themes were identified; ‘Sociocultural Norms’; ‘Under Others Power’; ‘Sexual Identity’ and ‘Sexual Experience’.
Conclusions and Implications. Application of the hierarchical Coordinated Management of Meaning model suggested carers contextual beliefs about people with learning disabilities’ sexuality inhibited or facilitated positive expressions of sexuality over and above individual needs and desires. Rights-based cultural messages provided the only context that led to positive sexuality outcomes and research that explores sexuality within this context is much needed. The Coordinated Management of Meaning model identified by this research may act as a framework to support the reflective-practice of carers.
A Different Connection: Young People’s Views of Treatment Sessions delivered by Skype in a Specialist Paediatric Chronic Fatigue Service
Background. There is a lack of local specialist services for children and young people with CFS/ME in the UK. The vast distances some families have to travel to reach specialist services can be a barrier to accessing evidence-based treatment, particularly for children and young people who are fatigued and for whom travelling can be very difficult. Specialist services are therefore harnessing videoconferencing technology such as Skype to deliver sessions remotely.
Method. Qualitative interviews explored the views and experience of 8 young people (age 9 - 16) of follow-up sessions delivered by Skype within a specialist CFS/ME service. Interviews were analysed thematically.
Results. Three main themes were identified; ‘A different connection’: Therapeutic experience and engagement; ‘It was a little chaotic, but it was ok’: Anticipations, preparations and technology use; and ‘It was way easier to access’: Accessibility and the impact of CFS/ME symptoms.
Conclusions. Young people reported they were able to overcome potential barriers (e.g. technology issues, worries and anticipations) to therapeutically engage with treatment through the use of Skype. Although the young people valued face-to-face appointments, the convenience of attending Skype sessions from their own homes reduced the burden of travel, reduced school absence and facilitated a greater sense of control of their environment. A list of recommendations about using Skype was presented to the team and an information leaflet was developed to improve the service the CFS/ME team were able to offer young people and their families.
Discussing Disclosure: A Mixed Method Exploration of Disclosing Mental Health Problems
Individuals who experience mental health problems continually make disclosure decisions based upon assessments of the potential benefits, costs and risks associated with the disclosure. Due to the potential stress some people may feel around disclosure, our research aimed to adapt an existing questionnaire in order to measure disclosure-stress (the cognitive appraisal of disclosure as a stressor measure) and to identify associated-factors. We used a mixed-method design to collect quantitative data (n=831) and qualitative data (n=12) to produce a rich account of factors associated with disclosure-stress. Results indicate the cognitive appraisal of disclosure as a stressor measure to be a reliable measure of disclosure-stress. Lower levels of psychological wellbeing, lower numbers of disclosure, less satisfaction with number of disclosures, being female, and less social support were all found to be associated with higher disclosure-stress. Additional analysis identified that individuals who had experienced a more publically stigmatised mental health problem (personality disorder, bipolar disorder, schizophrenia or psychosis) experienced significantly more self-stigma, disclosure-stress and lower social-support but also higher numbers of disclosure than the rest of the sample. Qualitative analysis highlighted potential benefits, costs and risks that individuals consider when making disclosure decisions. Potential factors that increased disclosure-stress included recent diagnosis, disclosure during an acute episode of the mental health problem and being male. Triangulation of the quantitative and qualitative results allowed for rich interpretations of the findings and conclusions to be drawn about which factors are associated with disclosure-stress. Suggestions for future research and clinical implications are discussed.
| Date of Award | 15 Sept 2017 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Lorna Hogg (Supervisor), Catherine Butler (Supervisor) & Maria Loades (Supervisor) |
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