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Background: The ageing of people with intellectual disabilities, involving consequences like dementia, creates a need for methods to support care staff. One promising method is Dementia Care Mapping (DCM). This study examined the effect of DCM on job satisfaction and care skills of ID-care staff. Methods: We performed a quasi-experimental study in 23 group homes for older people with intellectual disabilities in the Netherlands. Among staff, we assessed job satisfaction and care skills as primary outcomes and work experience measures as secondary outcomes (N = 227). Results: Dementia Care Mapping achieved no significantly better effect than care as usual (CAU) for primary outcomes on job satisfaction (MWSS-HC) and working skills (P-CAT). Effect sizes varied from -0.18 to -0.66. We also found no differences for any of the secondary outcomes. Conclusion: Dementia Care Mapping does not increase job satisfaction and care skills of staff caring for older people with intellectual disabilities. This result differs from previous findings and deserves further study.

Although most clients on work disability benefits face multiple problems, most traditional interventions for (re)integration focus on a single problem. The aim of this study was to evaluate the "Comprehensive Approach to Reintegrate clients with multiple problems" (CARm), which provides a strategy for labour experts to build a relationship with each client in order to support clients in their needs and mobilize their social networks. This study is a stratified, two-armed, non-blinded randomized controlled trial (RCT), with a 12-month follow-up period. Outcome measures were: having paid work, level of functioning, general health, quality of life, and social support. We included a total of 207 clients in our study; 97 in the intervention group and 110 in the care as usual (CAU) group. The clients' mean age was 35.4 years (SD 12.8), 53.1% were female, and 179 (86.5%) reported multiple problems. We found the CARm intervention to have no significant effects superior to those of the CAU group on all outcomes. As we found no superior effect of the CARm intervention compared to CAU, we cannot recommend widespread adoption of CARm. A process evaluation will give more insight into possible implementation failure of the intervention. Most traditional interventions for (re)integration into the labour market are problem-centred, i.e., focusing on a single problem, and have limited effectiveness in persons with multiple problems. A strength-based intervention may be suitable for vocational rehabilitation and disability settings, since it contains many elements (e.g., being strength-based, focused on clients' wishes and goals, and involving activation of the social environment) also likely to improve chances of re-employment of persons with multiple problems. In this study a strength-based intervention did not show a superior effect on paid employment and functioning within one year follow-up compared to care as usual in people with multiple problems on a work disability benefit. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the reliability and discriminant validity of the Dutch version of the life satisfaction questionnaire (Lisat-9 DV) to assess patients with an acquired brain injury. The reliability study used a test-retest design, and the validity study used a cross-sectional design. The setting was the general rehabilitation centre. There were 159 patients over 18 years of age, with an acquired brain injury, in the chronic phase. The main outcome measures were weighted [kappa] of test and retest data on the nine questions of the Lisat-9 DV and significance levels of differences between subgroups of patients who are expected to differ in terms of Lisat-9 scores, on the basis of other instruments. The results were as follows: the reliability was moderate, with the weighted [kappa] ranging from 0.41 to 0.64. In terms of validity, subgroups of patients who were expected to differ in terms of the Lisat-9 domains did indeed differ significantly, except for the difference in the Lisat score for "contact with friends and acquaintances" between subgroups defined by higher or lower scores on the corresponding domain of the Frenchay Activities Index. As there was a plausible explanation for not finding a significant difference between subgroups defined by one of the Frenchay Activities Index domains and significant differences were found between the subgroups defined by other instruments corresponding to the same domain, we conclude that the discriminant validity is good. The reliability was not clearly affected by cognitive disorder or aphasia. The conclusions were that the reliability of the Lisat-9 DV for patients with an acquired brain injury was moderate; the discriminant validity was good.

Background: The number of reliable and valid instruments to measure the effects of therapy in apraxia of speech (AoS) is limited. Aims: To evaluate the newly developed Modified Diadochokinesis Test (MDT), which is a task to assess the effects of rate and rhythm therapies for AoS in a multiple baseline across behaviours design. Methods: The consistency, accuracy and fluency of speech of 24 adults with AoS and 12 unaffected speakers matched for age, gender and educational level were assessed using the MDT. The reliability and validity of the instrument were considered and outcomes compared with those obtained with existing tests. Results: The results revealed that MDT had a strong internal consistency. Scores were influenced by syllable structure complexity, while distinctive features of articulation had no measurable effect. The test-retest and intra- and inter-rater reliabilities were shown to be adequate, and the discriminant validity was good. For convergent validity different outcomes were found: apart from one correlation, the scores on tests assessing functional communication and AoS correlated significantly with the MDT outcome measures. The spontaneous speech phonology measure of the Aachen Aphasia Test (AAT) correlated significantly with the MDT outcome measures, but no correlations were found for the repetition subtest and the spontaneous speech articulation/prosody measure of the AAT. Conclusions & Implications: The study shows that the MDT has adequate psychometric properties, implying that it can be used to measure changes in speech motor control during treatment for apraxia of speech. The results demonstrate the validity and utility of the instrument as a supplement to speech tasks in assessing speech improvement aimed at the level of planning and programming of speech. (Contains 8 tables and 1 note.)

INTRODUCTION Aboriginal people in Canada are urbanizing along with other Canadians and, in fact, the global human population. (2) Empirical research suggests that Aboriginal people thrive in the urban environment. [...]

Facial palsy rehabilitation therapy plays an essential role in treating facial palsy. This study aimed to gain insight into therapists' perceptions and attitudes toward facial palsy rehabilitation therapy and to examine whether therapists could be categorized into distinct groups based on these attitudes and perceptions. Thirteen semi-structured, in-depth interviews were conducted in a purposive sample of therapists. Interviews were analyzed using thematic analysis. Next, a questionnaire containing questions about therapists' characteristics and perceptions and attitudes toward facial palsy rehabilitation therapy was sent to all facial palsy rehabilitation therapists in the Netherlands and Flanders (n = 292). Latent class analysis (LCA) was performed to identify and analyze distinct groups of therapists. Seven themes were derived from the interviews: treatment goals, therapy content, indications, measurement instruments, factors influencing success, emotional support, and cooperation with colleagues. The questionnaire was filled out by 127 therapists. A 2-group structure consisting of a positive class and a negative class was found to fit the questionnaire data best. No distinction could be made regarding therapists' characteristics. Considerable variation in stated treatment practices was present among therapists. Therapists could be classified into 2 groups. This study raises several hypotheses that require further study. [ABSTRACT FROM AUTHOR]