Needs of Persons with Severe Intellectual Disabilities: a Q‐Methodological Study of Clients with Severe Behavioural Disorders and Severe Intellectual Disabilities

Abstract

Background A demand-oriented approach is becoming increasingly important in care provision. The purpose of this study was to identify the primary needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. Materials and Methods We used the theory of Social Production Function and Maslow's hierarchy of needs to operationalize different types of needs of clients with Severe Behavioural Disorders and Severe Intellectual Disabilities. A Q-methodological study enabled us to distinguish the needs of 23 clients. Results Two needs prioritizations were found. Physical well-being ultimately weighs most heavily for all clients, but in one of the two groups affection and behavioural confirmation (i.e. social needs) were also found to be important. There were no significant differences in needs between clients whose main behavioural difficulty was aggression and clients whose main behavioural difficulty was self-harm. Conclusions A demand-oriented policy for clients with Severe Behavioural Disorders and Severe Intellectual Disabilities should be targeted at groups with different needs prioritizations, rather than groups with different behavioural problems. That does not mean that the same needs of different clients can be met in exactly the same way. It takes creativity and a person-centred approach to find ways to enable clients to realize their social and physical needs.

Patient Views on Determinants of Compliance with Tuberculosis Treatment in the Eastern Cape, South Africa

“…a one-factor solution). [19] We did not anticipate finding only a single view among both compliers and non-compliers since an important reason for choosing Q-methodology was the desire to explore differences in viewpoint within these two groups. In the course of the analysis, all factor solutions supported by the data were inspected; however, the general finding in both groups was that, in solutions with more than one factor, the same statements dominated the 'most important' side of the composite sorts (figure 2), while a limited number of statements distinguished the 'least important' side of the ranking of statements.…”

“…Qmethodology is a fairly novel method in the field of health services research, but has been well established in other fields in the past 70 years; [9][10][11][12][13] a number of studies using Q-methodology were published in the field of health more recently. [14][15][16][17][18][19][20] The aim of Q-methodology is to access the principal views existing on a certain topic. Typically, participants are presented with a sample of opinion statements about the topic and are asked to rank order these statements according to importance or agreement from their individual perspective.…”

Give me a break!

“…Nonetheless, even though our matching of survey respondents with the caregiver attitudes from the Q-study seems feasible and reliable, it would be worthwhile to explore less complex procedures. With Q-methodology becoming increasingly popular in health services research [31][32][33][34][35][36], such a procedure could promote this logical mix of methods in future research.…”

“I can do perfectly well without a car!”

“…Q-methodology is perhaps fairly novel in transportation research, but it has been around for about 75 years (Stephenson 1935) and is well-established in the political and social sciences (De Graaf 2005;De Graaf and van Exel 2009;Durning 1999;Ellis et al 2007;Niemeyer et al 2005;Steelman and Maguire 1999;Van Eeten 2000) and health services research (Baker 2006;Boot et al 2009;Bryant et al 2006;Cramm et al 2009;Jedeloo et al 2010;Kreuger et al 2008;Risdon et al 2003;Stenner et al 2000;Tielen et al 2008;Van Exel et al 2006, 2007. The number of published Q-studies in transportation research is limited.…”