Supported socialization for people with psychiatric disabilities: Lessons from a randomized controlled trial

Two hundred and sixty people with psychiatric disabilities who were socially isolated and withdrawn were randomly assigned to one of three conditions to facilitate their engagement in social and recreational activities: They were (a) not matched with a volunteer partner (N = 70), (b) matched with a volunteer partner who had a personal history of psychiatric disability (N = 95), or (c) matched with a volunteer partner with no history of psychiatric disability (N = 95). Participants and volunteers received a $28 stipend each month to cover the expenses of their activities. Comprehensive assessments of symptoms, functional impairment, self‐esteem, and satisfaction were made at baseline, after 4 months, and after 9 months. While all participants appeared to improve in terms of symptom reduction and increases in functioning and self‐esteem, differences between conditions were found only when participants' degree of contact with their partner was considered. While participants assigned to the nonconsumer volunteer partner condition improved in terms of their social functioning and self‐esteem when meeting with their partners, those who were assigned to consumer partners only improved when they did not. Findings highlight the important role of participants' expectations and perceptions in designing and evaluating psychosocial interventions for people with psychiatric disabilities. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 453–477, 2004.     

Adaptive Morse code recognition using variable degree variable step size LMS for persons with disabilities

In this paper, we applied variable degree, variable step size LMS algorithm to adaptive Morse code recognition for persons with impaired hand coordination and dexterity. The automatic recognition of Morse code by the disabled is difficult because they cannot maintain a stable typing rate. Therefore, a suitable adaptive automatic recognition method is needed. In this adaptive Morse code recognition method, three processes are involved: character separation, character recognition, and adaptive processing. Statistical analyses demonstrated that the proposed method resulted in a better recognition rate compared to alternative methods from the literature.     

Psychological community integration among people with psychiatric disabilities and nondisabled community members

This study examined individual and neighborhood predictors of the psychological community integration of people with psychiatric disabilities and nondisabled community members. One hundred twenty‐three adults (60 psychiatrically disabled, 63 general community residents), completed measures of sense of community, life satisfaction, psychiatric symptoms, and perceptions of neighborhood. Mental health consumers living in independent scatter‐site apartments did not differ from other community members in either sense of community or life satisfaction. Among mental health consumers, neither symptoms nor demographic variables predicted sense of community, whereas objective neighborhood characteristics did. Conversely, among community members, age and symptoms predicted sense of community while objective neighborhood characteristics did not; perceived neighborhood characteristics predicted sense of community in both samples. Findings suggest that consumers living in independent housing may achieve levels of psychological community integration comparable to other community members, and that neighborhood factors impact degree of community integration in this population. © 2011 Wiley Periodicals, Inc.     

Patient satisfaction with the information provided at a psychiatric emergency unit

OBJECTIVE: Evaluation of patient satisfaction with information at a psychiatric emergency unit. DESIGN: Patient survey. SETTING: Psychiatric patients assessed information provided by staff on illness, symptoms, treatment alternatives, treatment design, medication, time schedule for treatment and the expected therapeutic response. PARTICIPANTS: The sample included 100 subjects (63% response rate). OUTCOME MEASURE: Patient satisfaction. RESULTS: 59% were women. Mean age was 43 years. 87% were Swedish. 30% had psychotic, 35% bipolar and 35% anxiety disorders. 87% were admitted voluntarily. Almost 80% were satisfied with the patient-staff relationship. Questions on information, except medication, scored low. Patients with non-psychotic disorder were more satisfied with information on symptoms, treatment alternatives and treatment design, and voluntary patients with information about medication. Patients born in Sweden and voluntary patients awarded influence on treatment planning higher scores. CONCLUSIONS: Psychiatric patients requiring emergency care did understand information. The staff provided satisfactory information only when knowledgeable.     

Universal design of research: inclusion of persons with disabilities in mainstream biomedical studies

Although persons with disabilities of all kinds have as wide a range of health conditions as the general population, they are profoundly underrepresented in mainstream health research. Such underrepresentation might contribute to the health disparities in this population. We propose the concept of Universal Design of Research (UDR), which would promote routine inclusion of persons with disabilities in mainstream biomedical and psychosocial studies, without the need for adaptation or specialized design. Elements of UDR include the use of multisensory formats for recruiting participants, presenting research instruments and interventions, and data gathering from participants and should promote the inclusion of participants with a wide range of abilities, thus enhancing the generalizability of results.     

Driving evaluation methods for able-bodied persons and individuals with lower extremity disabilities: a review of assessment modalities

Assessing the driving abilities of individuals with disabilities is often a very challenging task because each medical condition is accompanied by physical impairments and because relative individual functional performance may vary depending on personal characteristics.We identified existing driving evaluation modalities for able-bodied and lower extremity-impaired subjects (spinal cord injury patients and amputees) and evaluated the potential relationships between driving performance and the motor component of driving.An extensive scoping review of the literature was conducted to identify driving assessment tools that are currently used for able-bodied individuals and for those with spinal cord injury or lower extremity amputation. The literature search focused on the assessment of the motor component of driving. References were electronically obtained via Medline from the PubMed, Ovid, Web of Science and Google Scholar databases.This article compares the current assessments of driving performance for those with lower extremity impairments with the assessments used for able-bodied persons. Very few articles were found concerning “Lower Extremity Disabilities,” thus confirming the need for further studies that can provide evidence and guidance for such assessments in the future. Little is known about the motor component of driving and its association with the other driving domains, such as vision and cognition. The available research demonstrates the need for a more evidenced-based understanding of how to best evaluate persons with lower extremity impairment.     

Nature and prevalence of learning disabilities in a child psychiatric population

The protocols of over 500 children from a psychiatric hospital were evaluated to determine the nature and prevalence of learning disabilities in this population. The Wechsler Intelligence Scale for Children‐Revised (WISC‐R), the Wide Range Achievement Test (WRAT), and the revised form (WRAT‐R) were used in our analysis. The distribution of IQ and achievement scores in this population, unlike other studies of psychiatric patients, was within normal limits, and therefore, comparable to a nonpsychiatric school age population. The prevalence of learning disabilities in this group, however, is relatively high as compared to a nonpsychiatric population. The proportion of reading achievement disabilities was significantly lower than the proportion of children with arithmetic achievement disabilities. In fact, the modal achievement profile in this child psychiatric setting was reading achievement greater than arithmetic. Neither IQ nor academic achievement nor the discrepancy between the two varied as a function of severity of illness. However, chronicity of illness was associated with lower IQ and lower academic achievement. In this psychiatric population, similar to studies of specific learning disability populations, verbal IQ (VIQ) was the major predictor of academic achievement. Surprisingly, the VIQ/performance IQ (PIQ) discrepancy was irrelevant in predicting achievement or psychiatric status.     

Effective treatment relationships for persons with serious psychiatric disorders: the importance of attachment states of mind.

Participants were 54 clients with serious psychiatric disorders and 21 clinical case managers. Clients' serious psychiatric disorders included Axis I diagnoses, such as schizophrenia and bipolar disorder. This study examined how attachment states of mind of both clients and case managers influenced the effectiveness of therapeutic relationships and client functioning. Client and case manager attachment states of mind interacted in predicting the working alliance and client functioning. Specifically, clients who were more deactivating with respect to attachment had better alliances and functioned better with less deactivating case managers, whereas clients who were less deactivating worked better with more deactivating case managers. These findings highlight the importance of clinicians and clients being matched in ways that balance their interpersonal and emotional strategies.     

The effect of relocation on the satisfaction of psychiatric inpatients

Fifty-one psychiatric inpatients were tested on a 36-item satisfaction scale before and after a reorganization at Harlem Valley Psychiatric Center. Patients were divided into three groups (Low, Medium, and High Stress) on the basis of whether they experienced no change as a result of the reorganization, environmental change only (different building), or environmental and social change (different building, different staff, different fellow patients). Patients in the three groups were matched on the basis of chronological age, length of hospitalization, and sex. Results indicated that there were no reliable differences among the satisfaction scores of the groups as a result of the relocation. This finding supports the hypothesis that the involuntary relocation of chronic psychiatric patients to another institutional treatment environment results in few demonstrable effects.     

Healthy living does not reduce life satisfaction among physically handicapped persons

Smoking, drinking, over-eating and sedentary living may be regarded as ways of compensating for losses inflicted by physical handicaps. Therefore, promoting healthy life-styles among physically handicapped persons may amount to reducing their life satisfaction. This article examines the life-style and life satisfaction of all self-reported somatically handicapped respondents 25-50 years of age in a mid-Norwegian county. Persons with physical handicaps had more unhealthy habits than the general population. But life-style was not related to degree of physical handicap. And quality of life among the physically handicapped was not associated with life-style. Efforts to promote healthy living may not threaten the quality of life of physically handicapped persons.     

Multi-adjustable chairs for children with disabilities

There is a growing demand that severely disabled children should be offered a normal-looking, comfortable alternative to highly supportive wheelchair seating to facilitate relaxation and social integration. An evaluation of five chairs, funded by Medical Devices Agency, an executive agency of the Department of Health, was undertaken with potential and actual users of these chairs to investigate the chairs'function with respect to the child's posture, and what features were effective. Twenty-nine children tried five chairs for up to 30 min in each; and a postal survey received 100 responses. The chairs seem to meet many users’ postural needs (78% of postal survey; 31 -72% of short-term evaluation depending on chair); the chairs’ adjustability and availability of special features are important in meeting the needs of this user group; evidence of poor design and its implications are discussed.     

The Worcester development project: general practitioner satisfaction with a new community psychiatric service.

General practitioners in the Worcester development project area were interviewed about their experience of using the new community based psychiatric services. Of those who remembered the previous asylum based services most thought the new services were an improvement in many respects and were satisfied with the care provided for their patients. However, there were difficulties in obtaining emergency admissions, and criticisms of the social work service being slow to respond to requests for help. General dissatisfaction was expressed about feedback, particularly from the community psychiatric nursing service. General practitioners are expected to have a key role in the coordination of community services. However, most general practitioners interviewed had no particular interest or training in psychiatry. This, coupled with the inadequate information they received and the possibility of their workload increasing as more patients move out of hospital, raises questions about how they may be helped to fulfil this coordinating role in community psychiatric services.     

Healthcare transition in persons with intellectual disabilities: general issues, the Maastricht model, and Prader-Willi syndrome

In current healthcare, transitional healthcare is a very important and timely issue. Thanks to the major advances made in medical care and technology, many children with childhood onset diseases and/or genetic syndromes survive to adulthood. These children are at risk of not being provided with adequate healthcare as they reach adulthood. Healthcare transition is an essential part of healthcare provision, referred to as the shift from one type of healthcare to another. In Maastricht, we developed a transition/out clinic led by a medical doctor specialized in persons with intellectual disability (ID), together with a clinical geneticist. We aim to coordinate healthcare issues based on guidelines if available. Also questions concerning living, daily activities, relations, sexuality, and sterilization can be discussed. The aging process of persons with ID has been a topic of interest in recent years. Little is known about the aging process of people with specific syndromes, except for persons with Down syndrome. We present some data of a recent questionnaire study in persons with Prader-Willi syndrome. In only 50% in persons with a clinical diagnosis genetic test results could be reported. The majority of persons were obese. Diabetes mellitus, hypertension, skin problems, sleep apnea, and hormonal problems like osteoporosis and hypothyroidism were common. Psychiatric problems were frequent, especially in the persons with uniparental disomy. Osteoporosis and sleep apnoea seem to be underestimated. Further longitudinal research is necessary for a better understanding of the aging process in PWS.     

Reviewing risk for individuals with developmental disabilities

There are many categories of risky behaviors that are of interest to individuals, agencies, and institutions interested in care for developmentally disabled persons. These include challenging behaviors such as aggression and self-injury, psychiatric diagnoses, medical problems, criminal behaviors, and victimization. The literature in this area is difficult to digest due to a number of methodological problems. This paper reviews the research on one of these behaviors, self-injury, and provides a framework that can be applied to other research on predicting risk. Additionally, it attempts to organize the findings in such a way as to maximize the utility to providers and suggest useful directions for future research.     

SEMG-controlled telephone interface for people with disabilities

This paper proposes the development of a surface electromyographic (SEMG)-controlled telephone interface for the disabled. The system is composed of three major components: (1) a SEMG receiving/signal-processing module; (2) a row-column scanning interface for the telephone dialling pad; and (3) a main controller, the Intel-8951 microprocessor. The design concept was based on the idea of using a SEMG generated by the disabled and converting it into a trigger pulse. This could allow convenient control of the dialing motion in the row-column scanning keys of a telephone dialling pad. People with disabilities are competent for certain kinds of work such as being a telephone operator. The increase of opportunities to perform a job for the disabled would help them live independently.     

Measuring life satisfaction among psychiatric patients: Measurement invariance and validity of the Satisfaction with Life Scale

The main aim of the present study was to evaluate the measurement invariance and the convergent validity of the Satisfaction with Life Scale (SWLS) across clinical and nonclinical samples. A total of 216 psychiatric patients (47.7% females; M_age = 44.56) and 235 participants from the general population (54.5% females; M_age = 43.11 years) were recruited. The measurement invariance was tested by a multi‐group confirmatory factor analysis. Full scalar invariance of the SWLS was supported. Psychiatric patients reported substantially lower life satisfaction than participants from the general population. The SWLS demonstrated good convergent validity in both samples. The present study supported the use of the SWLS as a measure of life satisfaction among psychiatric patients.