Understanding the experiences of service users and staff in the promotion of responsive practices within the context of Health and Social Care

  • Madeleine Fitzpatrick

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Positive Behaviour Support and the reduction of Restrictive Physical Interventions for people with Intellectual Disability and Autism Spectrum Disorder: A Systematic Review. 
Positive Behaviour Support (PBS) has been effective in the reduction of challenging behaviour (MacDonald and McGill, 2013). However, research is only beginning to address the extent to which PBS is effective in the reduction of Restrictive Physical Interventions (RPI) within Intellectual Disability (ID) and Autism Spectrum Disorder (ASD) populations. The purpose of this review was to ascertain if an evidence base exists to suggest that elements of PBS reduce the need for RPI for people with ID and ASD, and the extent to which PBS is defined within this evidence base. To the author’s knowledge no other published reviews on PBS and the reduction of RPI within this population exist. Method: The PRISMA guidelines for systematic reviews were utilised and a search strategy was developed to identify studies that reported PBS and RPI outcomes. Studies were evaluated against inclusion and exclusion criteria. Eight studies were identified for review. A narrative analysis was then conducted. Findings: Results indicated that PBS may reduce the use of RPI, however these results need to be treated with caution due to methodological weaknesses. Results also highlighted the need for PBS to be more clearly defined within the evidence base. Clinical implications: This review has clinical implications for service users, staff and at an organisational level. However, future research is needed to expand the evidence base. Value: This review adds to the existing evidence base, highlighting the elements of PBS utilised in the reduction of RPI, as well as the need for clearer definitions of PBS.

Parenting through adversity: An exploration of the lived experiences of same-sex adoptive parents within Northern Ireland:An Interpretative Phenomenological Analysis.
Purpose: The current research aimed to explore the experiences of same-sex adoptive parents within the context of Northern Ireland (N.I.). Within N.I. the ban allowing same-sex couples to adopt was removed in 2013, bringing N.I. into line with the rest of the UK (Goldberg & Gartrell, 2014). To date same-sex parents are largely undocumented within official N.I. adoption statistics and the meaning of this populations’ experience is unexplored. Methodology: 10 participants were recruited; 4 gay fathers and 6 lesbian mothers. Semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis (IPA). Results: Data analysis highlighted three master themes: (1) Catalysts and considerations, (2) Roadblocks and (3) ‘Circumventing the opposition’.Discussion: The current research demonstrated that the journey of same-sex adoptive parenthood within N.I. is both challenging and rewarding for parents and has provided a better understanding of the same-sex parent experience within N.I. These findings however may not be representative of all same-sex parent groups, as all participants were well educated with medium-high incomes. However, these findings provide a new and valuable contribution to the existing evidence base and they have the potential to influence future adoption training and assessment frameworks, as well as peer support within clinical practice.
Date of AwardMay 2018
LanguageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorKatrina McLaughlin (Supervisor), Lesley Storey (Supervisor) & Michael Kavanagh (Supervisor)

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