Acute rehabilitation hospitals assist brain injury patients and families who face a life- changing event to achieve greater independence and quality of life. During the acute rehabilitation phase of recovery, care is focused on the patient; however, there is a nationwide movement to implement patient- and family-centered care because caregivers experience grief and uncertainty about how to care for their loved one during hospitalization and upon discharge. The purpose of this staff education project was to educate rehabilitation staff on how to identify and to meet the needs of family members of brain injury patients in an acute rehabilitation center in the western United States. The patient- and family-centered care theoretical framework and Knowles's theory of adult learning supported the development and implementation of the educational program. The project site stakeholders identified educational opportunities to assist staff to meet caregiver needs and improve outcomes. Thirty-two staff including registered nurses, licensed vocational nurses, patient care technicians, and nurse managers, received education for the support of caregivers for patients with brain injuries. The program was evaluated using a 5-point Likert type questionnaire. After receiving the education all participants agreed or strongly agreed that content increased their knowledge, skills, and confidence in caring for family caregivers of brain injury patients. Implications of this project for social change include the potential to improve patient outcomes through caregiver knowledge and skills to provide care to patients with brain injury.

The school to post-school transition has been identified as a time when young people with Additional Support Needs (ASN) need extra support. This thesis focuses on the school to post-school transition planning and preparation process for young people with ASN in Scotland. In particular, the author scrutinised the collaborative planning and preparation that takes place amongst professionals to support young people with ASN and their families during this transition. The author also examined the influence of the Education (Additional Support for Learning) (Scotland) Act 2004 upon the process. A mixed-methods research design was used to undertake three studies. Study 1 was a national on-line survey of professionals involved in post-school transition planning and preparation. Study 2 was a longitudinal study in which professionals involved in transition planning and preparations from one local authority were interviewed at 2 time periods (2004 before the implementation of the Education (Additional Support for Learning) (Scotland) Act 2004 and 2010). Minutes of transition meetings from both periods were also examined. Study 3 was a case study of a further education college undertaken in the same local authority as Study 2, to understand the experiences of transition planning and preparation from the perspectives of the young people with ASN who had experienced post-school transition and their families, along with school and college professionals. Participants (young people, parents and professionals) were interviewed. Visual resources were developed by the author to support the interviews with the young people. Data in all the studies were analysed using a thematic analysis approach. Finally, the findings of the three studies are presented and discussed. These include the perception that transition planning and preparation has become more young person centred since the Act was introduced. Implications for policy makers, practitioners, and future research are also discussed.

Individualised needs based approaches are increasingly being utilised to fund disability support services. Frequently, standardised assessments such as adaptive behaviour scales and, more recently, measures of support needs are used for determining level of need. The aim of this thesis is to understand the relationship between adaptive behaviours and support needs and to investigate factors that impact functional capacity and need for supports for individuals with an intellectual disability. Although a conceptually attractive approach to assessment, concern exists regarding the adequacy of the theoretical framework for guiding the development of support needs instruments. Though possessing theoretical similarities, adaptive behaviour and support needs scales are considered to measure different, albeit related constructs, prompting investigation into the nature of the relationship and the structure of the support needs construct. Accordingly, in Study 1 the Supports Intensity Scale (SIS), the Adaptive Behaviour Scale–Residential and Community (ABS-RC:2), and the Inventory for Client and Agency Planning (ICAP) were used to examine this relationship (N = 80). Dimensionality of the SIS (Section 1) was examined in reference to the three areas of conceptual, social, and practical skills, considered as comprising the adaptive behaviour construct. Factor analysis offered support for measurement of a common underlying construct. When considered in terms of the three adaptive behaviour skill areas, the support needs construct related predominantly to conceptual skills. Unlike adaptive behaviour scales, little is reported about the properties of support needs measures or factors that impact on an individual’s need for supports. Study 2 examined factors likely to influence adaptive behaviours and need for supports; in particular, the presence of coexisting disabilities. Using a measure of adaptive behaviour (i.e., ICAP) and two support needs scales (i.e., SIS and the Service Need Assessment Profile, SNAP), the extent to which adaptive and challenging behaviours and support needs (including medical) were impacted by the number and severity of disabilities was examined (N = 83). Results showed adaptive behaviours and support needs (including medical) were meaningfully related to the number and severity of disabilities present, whereas this was not so for challenging behaviours. Profiles for challenging behaviour measures did not support a linear association with number and severity of additional disabilities, raising the possibility that the profiles were influenced more by the nature of the additional disabilities present. Study 3 investigated the impact of the nature of the additional disabilities present on adaptive and challenging behaviours, support and medical needs using the same instruments utilised in Study 2. Each scale discriminated skills and needs associated with the presence of additional physical and speech disabilities. The support needs subscales of SNAP and SIS were more sensitive to the needs of individuals with coexisting neurological and sensory disabilities. SNAP was the only instrument to identify unique needs associated with the presence of a psychiatric disability but SIS was the only instrument to discriminate needs associated with the presence of a vision disability. Underlying this finding may be the importance of the person-environment interaction intrinsic to contemporary models of disability and support approach to assessment. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1349602 / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2009

Individualised needs based approaches are increasingly being utilised to fund disability support services. Frequently, standardised assessments such as adaptive behaviour scales and, more recently, measures of support needs are used for determining level of need. The aim of this thesis is to understand the relationship between adaptive behaviours and support needs and to investigate factors that impact functional capacity and need for supports for individuals with an intellectual disability. Although a conceptually attractive approach to assessment, concern exists regarding the adequacy of the theoretical framework for guiding the development of support needs instruments. Though possessing theoretical similarities, adaptive behaviour and support needs scales are considered to measure different, albeit related constructs, prompting investigation into the nature of the relationship and the structure of the support needs construct. Accordingly, in Study 1 the Supports Intensity Scale (SIS), the Adaptive Behaviour Scale–Residential and Community (ABS-RC:2), and the Inventory for Client and Agency Planning (ICAP) were used to examine this relationship (N = 80). Dimensionality of the SIS (Section 1) was examined in reference to the three areas of conceptual, social, and practical skills, considered as comprising the adaptive behaviour construct. Factor analysis offered support for measurement of a common underlying construct. When considered in terms of the three adaptive behaviour skill areas, the support needs construct related predominantly to conceptual skills. Unlike adaptive behaviour scales, little is reported about the properties of support needs measures or factors that impact on an individual’s need for supports. Study 2 examined factors likely to influence adaptive behaviours and need for supports; in particular, the presence of coexisting disabilities. Using a measure of adaptive behaviour (i.e., ICAP) and two support needs scales (i.e., SIS and the Service Need Assessment Profile, SNAP), the extent to which adaptive and challenging behaviours and support needs (including medical) were impacted by the number and severity of disabilities was examined (N = 83). Results showed adaptive behaviours and support needs (including medical) were meaningfully related to the number and severity of disabilities present, whereas this was not so for challenging behaviours. Profiles for challenging behaviour measures did not support a linear association with number and severity of additional disabilities, raising the possibility that the profiles were influenced more by the nature of the additional disabilities present. Study 3 investigated the impact of the nature of the additional disabilities present on adaptive and challenging behaviours, support and medical needs using the same instruments utilised in Study 2. Each scale discriminated skills and needs associated with the presence of additional physical and speech disabilities. The support needs subscales of SNAP and SIS were more sensitive to the needs of individuals with coexisting neurological and sensory disabilities. SNAP was the only instrument to identify unique needs associated with the presence of a psychiatric disability but SIS was the only instrument to discriminate needs associated with the presence of a vision disability. Underlying this finding may be the importance of the person-environment interaction intrinsic to contemporary models of disability and support approach to assessment. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1349602 / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2009

Yes / We interviewed people with dementia and carers from the IDEAL cohort to find out how the COVID-19 lockdown and continuing restrictions affected those living with dementia. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement. What might be helpful for people with dementia? • Reablement to help regain or maintain skills • Personalised health advice regarding managing COVID-19 risk and the opportunity to ask questions. • Identification of people with dementia who live alone and an assessment of their needs. What might be helpful for carers? • Needs assessment in regard to respite. • Novel forms of respite care that incorporate social distancing. What might be helpful for both carers and people with dementia? • Access to COVID-safe outdoor spaces. • Continuation and expansion of ‘just checking’ services. • Support to get online and use the internet. • Communication and information through non-digital means. • Community COVID-19 ‘dementia awareness’ initiatives. What might be helpful for people from Black and minority ethnic groups? • Addressing concerns about their increased risk of COVID-19. • Directing information and support through existing community and faith groups. / This report presents independent research funded by the National Institute for Health Research Policy Research Unit in Older People and Frailty.

The focus of this qualitative study is the professional environment where post-school transitions take place. It seeks to identify some possible means for improving outcomes for young people with low educational achievement, dyslexia, social, emotional and behavioural difficulties as they move on from school. The study picks up a recommendation made by Ward and Thomson (1997), following their Scotland-wide survey, that further investigation is needed into post-school transitions of such ‘unrecorded’ young people. Taking ahead this task brings together different areas of knowledge, for example, inclusive education, youth transitions and social theory. To orient the research, initial data were gathered through a questionnaire completed by 14 educational professionals and in structured interviews with 16 youngsters, mostly recently enrolled at college, and their families. Ideas occurring here were then used to inform the main data gathering process. This was conducted in 17 semi-structured audio-recorded interviews, each approximately one hour’s duration, with school teachers, college lecturers and other professionals associated with transition. The methodology utilised a critical friends group to shape the research as it progressed. The thematic analysis of the data produced information about dissimilar models of transition support, varying constructions of young people and difficulties in partnership working. The ensuing discussion considered the roles of trusted signals of youth’s value, of careership based on transformations of identity and aspects of social capital on transitions of young people with additional support needs. The conclusion sets out areas for improvement and asks that greater consideration be given to the constraining factors within the professional environment of the post-school transitions of young people with additional support needs.

Studiens syfte är att undersöka hur socialsekreterare konstruerar klienter med missbruksproblematik samt deras stödbehov. Syftet är även att undersöka om socialsekreterare förhåller sig olika till kvinnliga kontra manliga klienter med missbruksproblematik. För att besvara syftet är studiens fokus att klarlägga vad som påverkar socialsekreterares bedömningar samt eventuella skillnader mellan män och kvinnor. Urvalet består av åtta socialsekreterare som arbetar med bedömningar avseende stödinsatser för missbrukande kvinnor och män i Sverige. Datamaterialet har insamlats med hjälp av vinjett och semistrukturerad intervju. Resultatet visar att socialsekreterarens bedömning påverkas av manualstyrt arbete, klientens livssituation, socialsekreterarens egna värderingar samt lagar och samhälleliga normer. Resultatet visar också att när det kommer till val av insats erbjuder socialsekreteraren olika insatser utifrån om klienten är kvinna eller man. Bedömningsarbetet utgår från individuella förutsättningar, men valet av insats styrs av föreställningen om att missbrukande kvinnor och män har olika behov. För att klienter ska erbjudas rätt hjälp är det av vikt att socialsekreterare och klienter utbyter kunskaper med varandra. / The aim for this study is to examine how social workers construct clients with substance abuse problems and their support needs. The aim is also to investigate the impact of the client’s gender towards the social workers. In order to answer the aim, the study’s focus is to clarify what affects social workers assessments as well as any differences between men and women. The selection of the study consists of eight social workers who work with assessments regarding support needs for men and women with substance abuse problems in Sweden. Data has been collected using a vignette and semi-structured interview. The findings show that assessments are affected by manual work, client’s life situation, social workers own values, laws and norms of society. The findings also show that social workers offer different assistance depending on whether the client is female or male. The assessments are based on individual conditions, but the choice of assistance is determined by expectations that men and women have different needs. For clients to be offered the right help, it is important that social workers and clients exchange knowledge with each other.

This study focuses on the impact of HIV/Aids on secondary school educators who are affected by the HIV/Aids pandemic. The study seeks to understand how the pandemic has impacted on educators and identify support needs of educators affected by HIV/Aids. Many educators are negatively affected by HIV/Aids due to the fact that their family members, loved ones, friends, learners and colleagues may be ill, dying or affected by HIV and Aids. Educators are personally and professionally affected by HIV/Aids. Personally many educators are emotionally, socially, spiritually and physically affected. Professionally many are negatively impacted as educator absenteeism rises, morale is lowered and professional roles become more complex. There are very few avenues of support for educators who are affected by the HIV pandemic. To determine how high school educators are affected and what their subsequent support needs are, this study followed a phenomenological design. Fourteen high school educators were interviewed. All participants taught at township schools in the Free State and were affected by the HIV pandemic. The data were coded with regard to how these educators were affected by the pandemic and what support they wished for. According to this study's findings, educators in township secondary schools in the Free State are personally and professionally affected. Their experiences are mostly negative. They wish for support from the Department of Education, school management, their colleagues and the community. Examples of requested support include training and counselling programmes, supportive attitudes and additional educators so that they might be assisted to cope with the HIV/Aids pandemic challenges. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2009.

This study focuses on the impact of HIV/Aids on secondary school educators who are affected by the HIV/Aids pandemic. The study seeks to understand how the pandemic has impacted on educators and identify support needs of educators affected by HIV/Aids. Many educators are negatively affected by HIV/Aids due to the fact that their family members, loved ones, friends, learners and colleagues may be ill, dying or affected by HIV and Aids. Educators are personally and professionally affected by HIV/Aids. Personally many educators are emotionally, socially, spiritually and physically affected. Professionally many are negatively impacted as educator absenteeism rises, morale is lowered and professional roles become more complex. There are very few avenues of support for educators who are affected by the HIV pandemic. To determine how high school educators are affected and what their subsequent support needs are, this study followed a phenomenological design. Fourteen high school educators were interviewed. All participants taught at township schools in the Free State and were affected by the HIV pandemic. The data were coded with regard to how these educators were affected by the pandemic and what support they wished for. According to this study's findings, educators in township secondary schools in the Free State are personally and professionally affected. Their experiences are mostly negative. They wish for support from the Department of Education, school management, their colleagues and the community. Examples of requested support include training and counselling programmes, supportive attitudes and additional educators so that they might be assisted to cope with the HIV/Aids pandemic challenges. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2009.

This study focuses on the impact of HIV/Aids on secondary school educators who are affected by the HIV/Aids pandemic. The study seeks to understand how the pandemic has impacted on educators and identify support needs of educators affected by HIV/Aids. Many educators are negatively affected by HIV/Aids due to the fact that their family members, loved ones, friends, learners and colleagues may be ill, dying or affected by HIV and Aids. Educators are personally and professionally affected by HIV/Aids. Personally many educators are emotionally, socially, spiritually and physically affected. Professionally many are negatively impacted as educator absenteeism rises, morale is lowered and professional roles become more complex. There are very few avenues of support for educators who are affected by the HIV pandemic. To determine how high school educators are affected and what their subsequent support needs are, this study followed a phenomenological design. Fourteen high school educators were interviewed. All participants taught at township schools in the Free State and were affected by the HIV pandemic. The data were coded with regard to how these educators were affected by the pandemic and what support they wished for. According to this study's findings, educators in township secondary schools in the Free State are personally and professionally affected. Their experiences are mostly negative. They wish for support from the Department of Education, school management, their colleagues and the community. Examples of requested support include training and counselling programmes, supportive attitudes and additional educators so that they might be assisted to cope with the HIV/Aids pandemic challenges. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2009.