Purpose: Worldwide, disability systems are moving away from congregated living towards individualized models of housing. Individualized housing aims to provide choice regarding living arrangements and the option to live in houses in the community, just like people without disability. The purpose of this scoping review was to determine what is currently known about outcomes associated with individualized housing for adults with disability and complex needs. Methods: Five databases were systematically searched to find studies that reported on outcomes associated with individualized housing for adults (aged 18-65 years) with disability and complex needs. Results: Individualized housing was positively associated with human rights (i.e., self-determination, choice and autonomy) outcomes. Individualized housing also demonstrated favourable outcomes in regards to domestic tasks, social relationships, challenging behaviour and mood. However, outcomes regarding adaptive behaviour, self-care, scheduled activities and safety showed no difference, or less favourable results, when compared to group homes. Conclusions: The literature indicates that individualized housing has favourable outcomes for people with disability, particularly for human rights. Quality formal and informal supports were identified as important for positive outcomes in individualized housing. Future research should use clear and consistent terminology and longitudinal research methods to investigate individualized housing outcomes for people with disability. ä IMPLICATIONS FOR REHABILITATIONIndividualized housing models can foster self-determination, choice and autonomy for adults with disability and complex needs. Having alignment between paid and informal support is important for positive outcomes of individualized housing arrangements. A more substantial evidence base regarding individualized housing outcomes, in particular long-term outcomes, and outcomes for people with an acquired disability, is required.
Background For people with acquired neurological disabilities and complex needs, general practitioners (GPs) play an important role in health management and early intervention for the prevention of comorbidities and health complications. People with disability are a vulnerable group who need and have the right to, quality general practice services. It is therefore important to understand the health needs and service use of this group. The aim of this review was to identify the healthcare needs and general practice utilization of people with acquired neurological disabilities and complex needs. Methods A scoping review methodological framework was utilized. Six databases (MEDLINE, PsycInfo, CINAHL, Scopus, Embase and the Cochrane Library) were searched. Articles were included if they reported on general practice service utilization of people with acquired neurological disabilities and complex needs aged between 18 and 65. Articles were required to be peer‐reviewed, written in English and published between 2010 and 2021. Results Thirty‐one articles were included in the review. Studies originated from Canada (9), the United States (8), Australia (4), Switzerland (4), the United Kingdom (2), England (1), Norway (1), France (1) and Denmark (1). For many people, GPs were the main healthcare provider. People with disability consult multiple healthcare providers and navigate complex healthcare systems. Commonly presented healthcare needs were bladder, bowel and skin problems, pain and chronic pain, medication needs and mental health concerns. Conclusions People with acquired neurological disabilities and complex needs were vulnerable to receiving suboptimal healthcare. The literature highlighted issues regarding the accessibility of services, the fragmentation of health services and inadequate preventative care. GPs were challenged to offer adequate disability‐related expertise and to meet the mental health needs of people with disability within time constraints. Patient and Public Involvement This manuscript was prepared in collaboration with a GP, who is one of the authors. A person with lived experience of acquired neurological disability was engaged to check the alignment of the findings with their personal experience and provide feedback.
(2020) A scoping review to explore the experiences and outcomes of younger people with disabilities in residential aged care facilities,
Findings showed that elements from self-determination theory and dual process models relate to incidental physical activity behaviour. Specifically, autonomous motivation and certain implicit processes contributed to incidental physical activity engagement. This study provides an important first step towards understanding the psychological mechanisms that contribute to incidental physical activity. Statement of contribution What is already known on this subject? Motivation and implicit processes individually contribute to incidental physical activity behaviour. Autonomous motivation, rather than controlled motivation, primarily contributes to physical activity behaviour. What does this study add? Motivational and implicit processes together contribute to predicting levels of incidental physical activity. Both autonomous and controlled motivation contribute to levels of incidental physical activity. Certain implicit processes also play a role in incidental physical activity engagement.
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