Background: Rehabilitation has emerged as a comprehensive approach with a combination of treatment modalities to address the multiple impediments associated with disabilities in intellectually disabled people. Rehabilitation is used to address intellectually disabled peoples’ skill deficits, to improve competencies and to facilitate optimal functioning within the goal of giving the greatest possible measure of social and economic participation, independence, self–reliance and self–determination to intellectually disabled people. The ongoing improvement of rehabilitation services in the public health system therefore remains a continuous challenge; hence the need for further research. Objective: The systematic literature review critically synthesizes and describes the available evidence of the effects of rehabilitation on intellectually disabled people. Method: Literature searches of different electronic databases as well as manual searches of references of primary studies were conducted using selected keywords. The total number of the studies identified from an electronic database search was 1 102. All titles and abstracts were screened for relevance and 40 studies were immediately excluded. From the remaining 1 062 studies, another 993 studies were excluded because they were not relevant to the rehabilitation of intellectually disabled people. The abstracts and titles of the remaining 69 studies were screened for a second time to exclude studies not relevant to actual rehabilitation of intellectually disabled people. Another two studies were excluded as duplicates. The remaining 67 studies were retrieved as full texts; of these, 40 studies were excluded due to them being written in a foreign language. After all abstracts and texts were thoroughly screened for true relevancy to the review question, a further 20 studies were excluded. The remaining seven full–text studies were selected for critical appraisal because they were relevant to the effects of rehabilitation on intellectually disabled people. Results: These identified studies have the potential to inform clinical practice on the basis of their evidenced interventions that resulted in the improvement of outcomes of rehabilitation of intellectually disabled people. Improvement of skills was noted for mildly and moderately intellectually disabled people. Improvement was noted in activities of daily living (ADL), self–care skills, communication skills and cognitive achievements. Conclusions: The study contributes to the comprehensive nursing care of intellectually disabled people by endorsement of the effectiveness of rehabilitation in terms of ADL, self–care skills, communication skills and cognitive achievements. The collected evidence of this study may contribute to the education of more effective nurse practitioners involved in the daily care and rehabilitation of intellectually disabled people. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

Background: Rehabilitation has emerged as a comprehensive approach with a combination of treatment modalities to address the multiple impediments associated with disabilities in intellectually disabled people. Rehabilitation is used to address intellectually disabled peoples’ skill deficits, to improve competencies and to facilitate optimal functioning within the goal of giving the greatest possible measure of social and economic participation, independence, self–reliance and self–determination to intellectually disabled people. The ongoing improvement of rehabilitation services in the public health system therefore remains a continuous challenge; hence the need for further research. Objective: The systematic literature review critically synthesizes and describes the available evidence of the effects of rehabilitation on intellectually disabled people. Method: Literature searches of different electronic databases as well as manual searches of references of primary studies were conducted using selected keywords. The total number of the studies identified from an electronic database search was 1 102. All titles and abstracts were screened for relevance and 40 studies were immediately excluded. From the remaining 1 062 studies, another 993 studies were excluded because they were not relevant to the rehabilitation of intellectually disabled people. The abstracts and titles of the remaining 69 studies were screened for a second time to exclude studies not relevant to actual rehabilitation of intellectually disabled people. Another two studies were excluded as duplicates. The remaining 67 studies were retrieved as full texts; of these, 40 studies were excluded due to them being written in a foreign language. After all abstracts and texts were thoroughly screened for true relevancy to the review question, a further 20 studies were excluded. The remaining seven full–text studies were selected for critical appraisal because they were relevant to the effects of rehabilitation on intellectually disabled people. Results: These identified studies have the potential to inform clinical practice on the basis of their evidenced interventions that resulted in the improvement of outcomes of rehabilitation of intellectually disabled people. Improvement of skills was noted for mildly and moderately intellectually disabled people. Improvement was noted in activities of daily living (ADL), self–care skills, communication skills and cognitive achievements. Conclusions: The study contributes to the comprehensive nursing care of intellectually disabled people by endorsement of the effectiveness of rehabilitation in terms of ADL, self–care skills, communication skills and cognitive achievements. The collected evidence of this study may contribute to the education of more effective nurse practitioners involved in the daily care and rehabilitation of intellectually disabled people. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.

How support workers enable, regulate or constrain the sexual expression of intellectually disabled people who live in service agency group homes is the subject of this thesis. A general literature search of what intellectually disabled people currently experience in their lives, including their experiences in the area of sexuality and intimacy, begins this investigation. Secondly, an extensive literature review of the support role, incorporating an appraisal of past and current issues related to the support position in general and to the area of sexuality support in particular, was completed. What intellectually disabled people themselves would like in relation to sexuality and intimacy support was included in this section. Thirdly, a review of research studies focussing on the operation of the support position within service agency systems was undertaken. These explorations revealed a high degree of reluctance on the part of workers to provide assistance in the sexuality area, despite a proven necessity for support to be made available to the intellectually disabled people they worked with. Review research studies suggested a variety of causal factors in explanation of this reluctance. These suggestions link to two meta-reason positions. Failure to prove support either stemmed from individual worker’s inactions due to ignorance and/or incompetence, or from wider systemic failures on the part of agency services to positively value and support this key service role in this area. However, little if any analysis of the possible influence of the broader social, emotional and cultural contexts, in which the concepts ‘sexuality’ and ‘(intellectual) disability’ are located, could be found in the studies reviewed. Eleven in-depth interviews were conducted with front-line support workers about their sexuality support practice. Preliminary readings of the interview texts revealed a similar reluctance on the part of the workers concerned to assist those they worked with in this area. Interview texts were then subjected to a post-modernist inspired, interpretive discursive analysis. This analysis uncovered and tracked how key power/knowledge effects inherent in the terms ‘(intellectual) disability’, ‘sexuality’, ‘gender’ and ‘desire’ inhering in the concept of an ‘ideal (sexual) couple’ interweave to shape the ‘no support necessary’ practice responses held in worker’s interview talk. From this exploration it is suggested that research studies of workers’ practices as an aspect of the promotion of change in support outcomes in the sexuality support area need to go beyond the parameters of recommendations that stem from considerations of either individual or systemic limitation alone. It remains a convincing point to suggest that poorly performing workers need retraining in this area and the overall value of the support role within service organizations needs reshaping. However, future research recommendations also need to engage more directly and effectively with the effects of the wider social and emotional “ideal (sexual) couple” ambiguities that also influence worker’s lack of assistance in this complex and sensitive support area. The use of a post-modern perspective as a helpful conceptual tool in unpacking the power these ambiguities hold within the support position is offered as a productive way forward for future research and practice development.