Obesity in people with intellectual disabilities: the impact of nurse-led health screenings and health promotion activities

BACKGROUND: Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. AIM: Firstly, to follow-up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. METHODS: A clinic led by two learning disability nurses was held for all people aged 10 years and over (n = 464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organized health promotion classes for 20 people over a 6- or 8-week period. FINDINGS: The health screen identified 64% of adults and 26% of 10-19-year olds as being overweight or obese. Moreover, those aged 40-49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow-up questionnaire sent after 3 months suggested that of the 122 people identified for weight reduction, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. CONCLUSIONS: Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabilities to create more active lifestyles.     

Rehabilitation interventions for children living with HIV: a scoping review

Abstract

Purpose: To report the extent (how many), range (variation) and nature (qualities) of rehabilitation interventions for children living with HIV. Method: Electronic databases, reference lists of included articles, and grey literature were searched. Title and abstract and full text review were completed independently by two reviewers. Each study’s location, research methodology, interventions, the age of the participants, whether participants were receiving antiretroviral therapy (ART), the health professions delivering the interventions, when the study was conducted and the composition of the research team were documented. The nature of the intervention goals was organized into qualitative categories. Results: The 17 included studies were conducted in seven countries. Seven rehabilitation professions were involved with the interventions. The age of the participants ranged from 3 months to 24 years. The year in which the study was conducted and whether children were receiving ART were rarely specified. Studies focused on impairments. There were no studies on activity limitations and only two studies on participation restrictions. Alternative and complementary therapies were the most common interventions. Conclusions: Research in this area is limited. More rehabilitation research is needed especially in areas where the burden of the disease is highest and for those children receiving ART.

• Implications for Rehabilitation

• Many low-and-middle-income countries (LMICs) struggle with an undersupply of trained rehabilitation professionals.

• Due to the large number of children living with HIV in LMICs, and as more continue to receive life-saving treatment, the need will grow for more rehabilitation professionals to work with this population to address HIV-related disability.

• This scoping review indicates that there is a dearth of research on interventions provided by allied health professionals, including physiotherapists, occupational therapists and speech language pathologists for children living with HIV.

• There is a moderate literature base supporting the use of alternative and complementary therapies for children living with HIV.

     

A systematic review of self-management interventions for children and youth with physical disabilities

ABSTRACT

Purpose: Evidence shows that effective self-management behaviors have the potential to improve health outcomes, quality of life, self-efficacy and reduce morbidity, emergency visits and costs of care. A better understanding of self-management interventions (i.e. programs that help with managing symptoms, treatment, physical and psychological consequences) is needed to achieve a positive impact on health because most children with a disability now live well into adulthood. Method: A systematic review of self-management interventions for school age youth with physical disabilities was undertaken to assess their effectiveness. Comprehensive electronic searches using international web-based reference libraries were conducted for peer-reviewed and gray literature published between 1980 and January 2012. Eligible studies examined the effectiveness of self-management interventions for children and youth between 6 and 18 years of age with congenital or acquired physical disabilities. Studies needed to include a comparison group (e.g. single group pre/post-test design) and at least one quantifiable health-related outcome. Results: Of the 2184 studies identified, six met the inclusion criteria; two involved youth with spina bifida and four with juvenile arthritis. The majority of the interventions ran several sessions for at least 3 months by a trained interventionist or clinician, had one-to-one sessions and meetings, homework activities and parental involvement. Although outcomes varied between the studies, all of the interventions reported at least one significant improvement in either overall self-management skills or a specific health behavior. Conclusions: While self-management interventions have the potential to improve health behaviors, there were relatively few rigorously designed studies identified. More studies are needed to document the outcomes of self-management interventions, especially their most effective characteristics for children and youth with physical disabilities.

• Implications for Rehabilitation

• There is some evidence to suggest that self-management interventions for children and youth with spina bifida and arthritis can improve self-management behaviors and health outcomes.

• Parents’ involvement should be considered in encouraging self-management behaviors at different stages of their child’s development.

• Much work is needed to explore the longer term implications of self-management interventions for youth with physical disabilities as well as the impact on health care utilization.

     

智力和发展性残疾儿童青少年身体活动效益：基于ICF的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建智力和发展性残疾儿童青少年身体活动效益系统综述的范畴和PICO架构,探讨智力和发展性残疾儿童和青少年参加身体活动的健康效益。     

Communicating about obesity and weight-related topics with children with a physical disability and their families: spina bifida as an example

Purpose: The purpose of this study was to explore the experiences of children with spina bifida (SB), their families and healthcare professionals (HCPs) when discussing weight-related topics. Method: In-depth qualitative interviews were conducted with HCPs from Canadian outpatient SB clinics (n?=?13), children aged 6–18 years with SB (n?=?17) and their parents (n?=?20). Data were analyzed using a phenomenological approach within an interpretative paradigm. Results: Many HCPs were not confident talking about weight, concerned that they would damage relationships with children and families. Parents wanted routine weight surveillance, but were worried about their children’s self-esteem if their weight was discussed. They wanted HCPs to acknowledge the challenges of weight management in children with a physical disability and provide specialized solutions. Children wanted a positively framed and tailored approach to weight discussions, although this had generally not been their experience. Conclusions: Stakeholders describe therapeutic relationships that are currently disconnected around the issue of weight and obesity. However, children, parents and HCPs all believed that discussing this topic was critical. Positively framed, strengths-based and tailored approaches to weight-related discussions are warranted.

• Implications for Rehabilitation

• Rates of overweight and obesity in children and youth with physical disabilities are substantially higher than their typically developing peers.

• Healthcare professionals, children with physical disabilities and families often find weight-related discussions challenging and disconnected.

• Weight-related discussions should be tailored to the child and family’s circumstances and priorities.

• Positively framed and strengths-based approaches to weight-related discussions are warranted.

     

基于ICF-CY残疾儿童青少年运动功能评价量表内容和心理测量指标的Scoping综述

目的 基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法,分析儿童青少年常用运动功能评估工具的内容和心理测量指标。方法 基于ICF-CY分类架构和编码系统,应用ICF编码规则、匹配原则,选择4种儿童青少年常用的功能评估工具,分析其运动功能测量方法和心理测量指标。结果 最终纳入11篇文献,其中英文9篇,中文2篇,来自韩国、西班牙、中国、巴西,主要发表在临床医学、神经科学、公共健康、康复科学等领域期刊,发表时间为2011年至2021年。研究对象的年龄为0～16岁,涉及的总样本量为987,健康情况为痉挛型脑瘫、神经发育障碍等。纳入文献中,采用粗大运动功能测试(GMFM-88) 6篇,精细运动功能测试(FMFM) 2篇,Peabody运动发育评定量表(PDMS-2) 2篇,残疾儿童能力评定量表-功能技能量表(PEDI-FSS) 2篇,残疾儿童能评定量表(PEDI) 3篇;测量方式为客观评估、主观评估、主试观察等;测量次数为2～6次。运动功能测量指标主要涉及两个层面,其中身体活动层面包括粗大运动、精细运动和运动控制能力;活动功能层面主要为日常生活活动能力和功能独立性等。...     

Non-pharmacological rehabilitation interventions for concussion in children: a scoping review

Purpose: To summarise the extent, nature, and quality of current scholarly literature related to non-pharmacological, rehabilitation interventions following concussion, or mild traumatic brain injury in children.

Methods: An electronic search was conducted from 1987 to 24 October 2017. Studies were included if they met the following criteria: (1) full text, peer reviewed, and written in English, (2) original research, (3) diagnosed concussion or mild traumatic brain injury, (4) described the evaluation of an intervention, (5) the outcome was a concussion impairment, and (6) the mean/median age was under 19. Quality assessment using the Down’s and Black criteria was conducted.

Results: Twenty-six studies published between 2001 and 2017 were identified. Interventions included rest, active rehabilitation, exercise, vestibular, oculomotor, cervicospinal therapy, education, early intervention, telephone counselling, mobile health application, Web-based Self-Management program, multimodal physical therapy, cognitive behavioural therapy, transcranial direct current stimulation, and acupuncture. The quality assessments ranged from poor to good.

Conclusions: The literature describing interventions following concussion in children is scarce. While both positive and negative results were obtained, there were methodological concerns in most studies limiting the ability to draw conclusions. Interventions incorporating aerobic exercise show promise as a concussion management strategy.

• Implications for rehabilitation

• Few studies have examined rehabilitation interventions for youth following concussion.

• Research ranging from rest to exercise highlights the uncertainty of the field.

• Low quality research limits the generalizability of results.

• The use of physical activity appears to be an emerging area of interest.

• Individualised, aerobic exercise should be used as part of clinical management.

     

Elements contributing to meaningful participation for children and youth with disabilities: a scoping review

Purpose: To synthesise research literature describing elements of community recreation and leisure activities that create meaningful participation experiences for children and youth with disabilities.

Method: Database searches of Medline, Embase, PsycINFO, ERIC, SportDiscus, CINAHL, Scopus and Web of Science were conducted. Studies describing the experience of participating in a community-based programme or activity from the perspectives of children and youth with a disability aged 0–21 or their parents, and published in English were included. Meta-ethnography was used to synthesise qualitative data, and resulting themes were conceptualised in the International Classification of Functioning, Disability and Health-Child and Youth version. Consultation with stakeholders occurred throughout the review process.

Results: The search identified 9544 articles, of which 20 were included for review. Ten elements contributing to meaningful participation experiences were identified and organised as follows: person-based elements (n?=?5; having fun, experiencing success, belonging, experiencing freedom, developing an identity); environment-focused elements (n?=?4; authentic friendships, the opportunity to participate, role models, family support) and activity-related elements (n?=?1; learning).

Conclusions: Elements contributing to meaningful leisure participation are interrelated. This review reveals the substantial contribution that meaningful interactions and relationships have in creating and facilitating positive and engaging experiences. Outcomes of this review may assist professionals in the design of targeted interventions to facilitate leisure participation.

• Implications for Rehabilitation

• Elements identified in this review may operate as core components of interventions that aim to optimise participation outcomes in community-based leisure activities.

• Supportive relationships and the availability of services are specific aspects of the environment that needs to be considered by health professionals to facilitate meaningful participation.

• Understanding the perspectives of the child is critical for assessing needs, preferences and goals relating to leisure participation in the community.

     

残疾儿童青少年身体活动及其健康效果：系统综述的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)构建身体活动对残疾儿童青少年健康效果的范畴及研究架构,系统分析残疾儿童青少年的主要残疾类型、身体活动处方及其健康效果。方法 检索Web of Science、PubMed、EBSCO、中国知网、万方、维普,收集2015年至2022年10月发表的残疾儿童青少年参与身体活动及其健康结局相关的系统综述,进行系统综述。结果 纳入9篇系统综述,来自6个国家,涉及138项随机对照试验和4 878例参与者(3～18岁)。主要来源于康复心理学、医学、运动心理学等相关领域的期刊,发表日期集中在2015年至2022年。涉及的疾病主要有唐氏综合征、脑瘫、运动协调障碍、四肢瘫痪、注意力缺陷多动障碍、焦虑症和抑郁症、情绪障碍、前庭受损、感音神经性听力受损等。有益的身体活动方式包括有氧运动、核心训练、渐进式抗阻运动、高强度间歇训练、注意运动训练、步态训练平衡训练、前庭特异性神经肌肉训练、知觉运动训练、游泳、足球、网球、体操、舞蹈等。推荐活动方案每次5～120 min,活动频率每周1～80次,活动强度为中高强度,持续1～139周。活动情境主要为运动训练,活动场所集中于...     

Literacy of children with physical disabilities: a literature review

The ability to read and write can influence an individual's educational, communication, and vocational opportunities. Occupational therapists can assist children with physical disabilities to achieve literacy skills. By setting priorities and goals for each child, in conjunction with their parent(s), opportunities can be provided and technologies utilized to access literacy material and enhance the child's abilities to read and write. This extensive literature review provides clinicians with information on the factors that influence the development of literacy for children with physical disabilities. The expectations and priorities of parent(s) are critical determinants of whether opportunities will be provided for the child to learn to read and write. This article concludes with recommendations and strategies for the use of technology to help develop literacy skills, and future research questions for considerations.     

Modifying a social problem‐solving program with the input of individuals with intellectual disabilities and their staff

Social problem‐solving programs have shown success in reducing aggressive/challenging behaviors among individuals with intellectual disabilities in clinical settings, but have not been adapted for health promotion in community settings. We modified a social problem‐solving program for the community setting of the group home. Multiple sequential methods were used to seek advice from community members on making materials understandable and on intervention delivery. A committee of group home supervisory staff gave advice on content and delivery. Cognitive interviews with individuals with intellectual disabilities and residential staff provided input on content wording and examples. Piloting the program provided experience with content and delivery. The process provides lessons on partnering with vulnerable populations and community stakeholders to develop health programs. © 2012 Wiley Periodicals, Inc. Res Nurs Health 35:610–623, 2012     

School-based drama interventions in health promotion for children and adolescents: systematic review

Title.  School-based drama interventions in health promotion for children andadolescents: systematic review.
Aim.  The paper is a report of a review of the literature on the effects of school-based drama interventions in health promotion for school-aged children and adolescents.
Background.  Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts.
Data sources.  A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006.
Methods.  A Cochrane systematic review was conducted.
Results.  Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons.
Conclusion.  There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention.     

电竞活动对青少年健康和功能的影响及康复干预的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF),探究电竞活动对青少年的健康影响,并对健康状况和功能、干预策略和康复结局进行系统综述。方法 运用ICF对青少年从事电竞活动的身心健康和功能影响进行系统分析。采用关键词和主题检索的方式,在中国知网、维普、万方数据库、PubMed、Web of Science、EBSCO等数据库检索电竞活动、健康状况、功能、功能康复(干预)和康复结局的相关文献,检索时间为建库至2022年2月。对纳入文献进行筛选、质量评价和综述,采用ICF架构和WHO-FICs编码分析从事电竞活动的健康状况和相关的功能、干预策略以及康复(健康状况和功能)结局。结果与结论 最终纳入文献8篇,来自6个国家,主要涉及临床医学、康复科学、运动康复、运动心理学和康复心理学等研究领域,其发表日期主要集中在2015年之后,物理治疗证据数据库(PEDro)量表平均分为6.88分。根据ICF分类,青少年从事电竞活动面临的主要健康问题涉及身体层面、个体层面和环境层面。身体层面包括精神功能、感觉功能和疼痛、神经肌肉骨骼和运动有关的功能,常见的有认知障碍、情绪障碍、疲劳、睡眠障碍、抑郁和焦虑、肥胖症...