Search

Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised. Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services. Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes. Aboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed. An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers. A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare. Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

The delivery of family‐centred practice (FCP) within Early Childhood Intervention Services (ECISs) for young children with a disability or development delay conceptualises that children's learning environments, parenting, family and community supports intersect to have the greatest impact on the developing child. The transdisciplinary key worker model is considered a best‐practice approach within ECISs whereby staff work collaboratively across disciplinary boundaries to plan and implement services for children and their families. Research suggests families who have a key worker have better relationships with services, fewer unmet needs, better morale, more information about services, higher parental satisfaction and more parental involvement than those not receiving this service. Using a phenomenological qualitative design this study sought to understand transdisciplinary key workers' perspectives regarding the strengths and challenges to undertaking their role in providing services to children and families accessing an ECIS at a major disability service organisation, in light of the changing policy reform during the roll out of the National Disability Insurance Scheme in Australia. Purposive sampling was used to recruit key workers (n = 13) to participate in semi‐structured interviews during 2015. Data were analysed using an inductive, thematic approach. Results revealed four main themes that impact on the effectiveness of key workers' service provision. These are broadly categorised as (a) Engagement with the workplace, (b) Engagement with clients, (c) Professional capacity and (d) Staff Wellbeing. The findings aligned with previous studies identifying sources of support and stress for disability services staff. They also provided new insights into key workers' lack of confidence in addressing parental mental health issues, despite operating under a family‐centred approach. These findings informed the development of an intervention trial and evaluation to improve support for parent and staff wellbeing within a Victorian Disability Service with the aim of building their capacity to support children with a disability. [ABSTRACT FROM AUTHOR]

Purpose:Many adults aged less than 65 years with high-care needs resulting from acquired disabilities are unable to access age-appropriate housing and support, and reside in residential aged care or live with family members who may struggle to navigate the disability support system. This qualitative study aimed to investigate the experiences of adults with high-care needs and their family members regarding pathways related to housing and support. Method:Two in-depth semi-structured interviews were conducted six months apart with 21 people aged 18 to 65 with high-care needs of varying etiology and living in different housing settings. Nineteen family members involved in decision-making about housing and supports were also interviewed. Results:Thematic data analysis yielded five themes: (1) Traveling in different directions; (2) “the fight, the battle and the war”; (3) willing but wanting; (4) uncertainty and vulnerability; and (5) redefining social roles and relationships. Conclusions:Current disability policy is not satisfying the housing and support requirements of adults with high-care needs and their families. The findings provide rigorous, empirical evidence which indicate the urgent need to improve access to affordable, individualized housing and support packages, including financial, practical and informational support for family members involved in caring roles. Implications for RehabilitationIndividual preferences are an important consideration in housing and support arrangements for younger people with high-care needs alongside needs-based solutions.Individualized funding approaches may provide flexibility of care and choice in housing and support for people with disability.Family members willingly provide substantial informal care, support and advocacy for younger people with high needs but perceive their role as a constant “battle”.Payment of family members in recognition of caring work was perceived as a solution to relieve family hardship and ensure optimal care. [ABSTRACT FROM AUTHOR]

Background: Transition is a common experience; yet, there is a lack of understanding about how transition impacts middle-aged adults with a longstanding disability. Methods: Qualitative methods were used within a needs analysis design. Narrative data were collected via an online or postal written survey and phone or face-to-face interviews, which were transcribed verbatim. Data were inductively analysed and categorised to form descriptions of types of transition experienced, and what enabled or impeded the participants adapting to changes. Findings: Five types of transition were identified: deterioration of the health of a person with disability; deterioration of the health or death of a primary carer/s; change to living situation; change to daily activities; and seeking change. Five factors that influenced the outcome of transition were discovered: knowledge and understanding; time; attitudes; environments; and support and services. Conclusions: Adults with a longstanding disability may experience multiple and complex transitions as they age. Rehabilitation and therapy staff can support people with disability to adjust to change by providing information, helping and encouraging others to be accepting and supportive, allowing people time to accommodate to change, and providing a range of flexible and accessible services. [ABSTRACT FROM AUTHOR]