Foodwork among people with intellectual disabilities and dietary implications depending on staff involvement

The food provision for people with intellectual disability (ID) in Sweden is organized within their own households. The aim of this study was to describe how foodwork – planning for meals, shopping for food and cooking – is performed in different social contexts in community settings involving people with ID, staff or both. Dietary intake in the main meals in relation to foodwork practice was also studied. Four different foodwork practices could be distinguished. For some participants only one kind of foodwork practice was found, but for most of them two or more different practices. There was a tendency that food items and dishes chosen and used differed depending on what foodwork practice was performed, which, in turn, affected the nutrient intake. More attention needs to be directed to these everyday matters as a means to increase the quality of support in food for people with ID

Food Related Activities and Food Intake in Everyday Life among People with Intellectual Disabilities

The aim of this thesis was to study food, eating and meals in the everyday life of 32 women and men with intellectual disabilities (IDs) who require varying levels of supervision. They lived in supported living (rather independently) or group homes in community-based home-like settings. Observations during 3 days, assisted food records and anthropometric measurements were used to collect data. Dietary intake on the group level showed a varied diet and sufficient intake of all micronutrients, but a low dietary fibre intake. On the individual level, inadequate intake of micronutrients was observed, with many participants being obese, overweight or underweight. Everyday support with food, eating and meals was seen in four praxis: foodwork by oneself for oneself, foodwork in co-operation, foodwork disciplined by staff and foodwork by staff. These four practices resulted in large variations in dietary intake. The first praxis entailed more convenience food and less vitamins, the second and third, more fresh ingredients and high energy intake, and the fourth, low energy intake but rather high intake of vitamins. Sharing of meals was least common in supported living and more common in group homes and daily activity centres. The participants’ social eating spheres consisted mostly of other people with ID and staff members, and seldom other people. Whereas some preferred solitary eating, many participants considered eating together as important, but required staff support in establishing commensality. However, disturbing behaviour, as determined by the staff, could result in solitary eating. In conclusion, supporting the group rather than the individual sometimes created less favourable dietary, eating and meal outcomes. This problem needs to be addressed in order to establish food security at the individual level. In addition, actions should be taken to ensure that people with intellectual disabilities receive sufficient support to meet their individual needs and aspirations

Food Related Activities and Food Intake in Everyday Life among People with Intellectual Disabilities

The aim of this thesis was to study food, eating and meals in the everyday life of 32 women and men with intellectual disabilities (IDs) who require varying levels of supervision. They lived in supported living (rather independently) or group homes in community-based home-like settings. Observations during 3 days, assisted food records and anthropometric measurements were used to collect data. Dietary intake on the group level showed a varied diet and sufficient intake of all micronutrients, but a low dietary fibre intake. On the individual level, inadequate intake of micronutrients was observed, with many participants being obese, overweight or underweight. Everyday support with food, eating and meals was seen in four praxis: foodwork by oneself for oneself, foodwork in co-operation, foodwork disciplined by staff and foodwork by staff. These four practices resulted in large variations in dietary intake. The first praxis entailed more convenience food and less vitamins, the second and third, more fresh ingredients and high energy intake, and the fourth, low energy intake but rather high intake of vitamins. Sharing of meals was least common in supported living and more common in group homes and daily activity centres. The participants’ social eating spheres consisted mostly of other people with ID and staff members, and seldom other people. Whereas some preferred solitary eating, many participants considered eating together as important, but required staff support in establishing commensality. However, disturbing behaviour, as determined by the staff, could result in solitary eating. In conclusion, supporting the group rather than the individual sometimes created less favourable dietary, eating and meal outcomes. This problem needs to be addressed in order to establish food security at the individual level. In addition, actions should be taken to ensure that people with intellectual disabilities receive sufficient support to meet their individual needs and aspirations

Dietitians’ challenges when consulting to adults with intellectual disabilities

Purpose: The purpose of this paper is to investigate registered dietitians' (RDs) experiences in consulting to adults with intellectual disabilities (ID) in Sweden. Design/methodology/approach: A descriptive study using a study-specific web-based questionnaire was administered, comprising both multiple-choice questions with a space for comments and open-ended questions. The open-ended answers and comments from 53 respondents were analysed with systematic text condensation. Findings: Four categories were identified: RDs' experiences from the first meeting; explanations for late initial contact; the actions taken by RDs; and necessary measures for more sustainable nutrition care. Ten sub-categories described the challenges that RDs experience in more detail. Practical implications: It is necessary to provide adults with ID and their supporting staff with individually tailored nutritional information. Individuals with ID must be actively involved in lifestyle changes that affect their everyday life. The RD must be included in the interdisciplinary team supporting adults with ID. If a new practice is to be implemented, it should be compatible with the existing values of adults with ID and their staff and must be feasible to implement in the everyday life of the individual. Originality/value: This paper identified several barriers that should be overcome in relation to the preparation of RDs for consultation with adults with ID about nutritional health issues. A systematic structure, knowledge about nutrition and knowledge about adults with ID and their living situations are needed. An assessment instrument may meet health promotion needs and facilitate longitudinal follow-ups of nutritional problems

Significant others’ perspectives on experiences of meal-oriented support and diet counselling for adults with intellectual disabilities who live in supported housing

The quality of meal-oriented support for people with intellectual disabilities is important for their health. The aim of the present study was to explore the experiences of meal-oriented support and diet counselling for adults with intellectual disabilities living in supported housing, from the perspective of housing staff and mothers. Five focus group interviews, including nine supporting staff members and nine mothers, were conducted. The interviews were analyzed using systematic text condensation. Five themes appeared; Extensive needs of the individual, Staff skills determine the food intake, Informal caregivers make up for shortage of support, Effective collaboration with a registered dietitian is needed and Responsibility of the organization state that professionalization of staff is needed. Lacking resources, such as time and nutritional knowledge, insufficient considerations of individual needs, and high staff turnover influence the meal-orientated services negatively. This study brings to the fore, staff working practices and the complexity of providing meal-oriented support for people with intellectual disabilities. Staff need skills to perform individually tailored support. This is best accomplished through effective collaboration between housing staff and relatives underpinned by knowledge from a registered dietitian. The working practices must be structured at the organizational level of the services

Omgivningens hjälp eller stjälp? : Dokumentation av personers med psykisk funktionsnedsättning erfarenheter av användning av elektroniska planeringshjälpmedel

Vuxna personer med psykisk funktionsnedsättning har ofta problem med sin kognitiva förmåga, vilket leder till problem med att hantera vardagslivets komplexitet. Med behovsanpassade kognitiva hjälpmedel och individuellt stöd från kunnig personal finns möjlighet för personen att få ordning på sitt ofta kaotiska vardagsliv. Dock finns studier och klinisk erfarenhet som påvisar att hjälpmedel inte används i den utsträckning som förväntats. Antaganden finns om att komplexa faktorer i omgivningen interagerar med hjälpmedelsanvändning. Syftet med studien var att dokumentera erfarenheter av underlättande och hindrande omgivningsfaktorer som personer med psykisk funktionsnedsättning har av användningen av elektroniska planeringshjälpmedel. Metod: tolv personer med psykisk funktionsnedsättning och med erfarenhet av elektroniska planeringshjälpmedel rekryterades efter informerat samtycke via förskrivare och besök vid dagliga verksamheter. En studiespecifik frågeguide med öppna frågor med ett innehåll som täcker omgivningsfaktorer enligt Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) användes i de inspelade intervjuerna. Materialet bearbetades med kvalitativ, induktiv innehållsanalys. Resultatet utmynnade i sex kategorier och två teman formade till en modell med underlättande eller hindrande faktorer som inverkar på användning av elektroniska planeringshjälpmedel enligt deltagarna. Kategorierna benämndes: Insikt om funktionsnedsättning/behov; Medveten social omgivning; Egen kontroll och hanterbarhet av hjälpmedel; Nytta av och brister i hjälpmedlets funktion; stöd av kunnig personal; och Tydligt och lättbegripligt myndighetsutövande. Teman benämndes: Tydlig önskan om delaktighet och Nödvändig individuell anpassning. Åtgärder för att förebygga eller förhindra omgivningens negativa inverkan på hjälpmedelsanvändning är angelägen.Adults with mental disabilities often have problems with their cognitive ability, leading to problems in dealing with everydaylife's hindrancecomplexity. With the needs-based cognitive assistive technology and individual support from knowledgeable staff it is possible for the person to bring order to their often chaotic daily life. However, there are studies and clinical experience which indicate that assistive technology is not used to the extent expected. Assumptions are that complex environmental factors interact with use of the assistive technology. The purpose of this study was to document the experiences of facilitating or hindrance environmental factors that people with mental disabilities have of using electronic planning devices. Method: Using prescribers and at visits to community activity centres twelve adult persons with mental disabilities and own experience of useing electronic planning devices were, after informed consent, recruited. A study-specific interview guide with open questions, with a content that covers environmental factors according to International Classification of Functioning, Disability and Health (ICF) was used in the recorded interviews. The material was analysed by using qualitative inductive content analysis. Result: From the interviews six categories and two themes emerged, wich were molded to a model of facilitating or impeding factors affecting the use of electronic planning devices. The categories were named: Insight of disability/needs; Cognisant social environment; Self control and manageability of the device; Benefits and shortcomings of using the device; Assistance of skilled personnel and Clear and simple exercise of authority. The themes are named: A clear desire for participation and Necessity of individual adaption of the device. Measures to prevent or eliminate ambient negative impact of the device use is keen

Omgivningens hjälp eller stjälp? : Dokumentation av personers med psykisk funktionsnedsättning erfarenheter av användning av elektroniska planeringshjälpmedel

Vuxna personer med psykisk funktionsnedsättning har ofta problem med sin kognitiva förmåga, vilket leder till problem med att hantera vardagslivets komplexitet. Med behovsanpassade kognitiva hjälpmedel och individuellt stöd från kunnig personal finns möjlighet för personen att få ordning på sitt ofta kaotiska vardagsliv. Dock finns studier och klinisk erfarenhet som påvisar att hjälpmedel inte används i den utsträckning som förväntats. Antaganden finns om att komplexa faktorer i omgivningen interagerar med hjälpmedelsanvändning. Syftet med studien var att dokumentera erfarenheter av underlättande och hindrande omgivningsfaktorer som personer med psykisk funktionsnedsättning har av användningen av elektroniska planeringshjälpmedel. Metod: tolv personer med psykisk funktionsnedsättning och med erfarenhet av elektroniska planeringshjälpmedel rekryterades efter informerat samtycke via förskrivare och besök vid dagliga verksamheter. En studiespecifik frågeguide med öppna frågor med ett innehåll som täcker omgivningsfaktorer enligt Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) användes i de inspelade intervjuerna. Materialet bearbetades med kvalitativ, induktiv innehållsanalys. Resultatet utmynnade i sex kategorier och två teman formade till en modell med underlättande eller hindrande faktorer som inverkar på användning av elektroniska planeringshjälpmedel enligt deltagarna. Kategorierna benämndes: Insikt om funktionsnedsättning/behov; Medveten social omgivning; Egen kontroll och hanterbarhet av hjälpmedel; Nytta av och brister i hjälpmedlets funktion; stöd av kunnig personal; och Tydligt och lättbegripligt myndighetsutövande. Teman benämndes: Tydlig önskan om delaktighet och Nödvändig individuell anpassning. Åtgärder för att förebygga eller förhindra omgivningens negativa inverkan på hjälpmedelsanvändning är angelägen.Adults with mental disabilities often have problems with their cognitive ability, leading to problems in dealing with everydaylife's hindrancecomplexity. With the needs-based cognitive assistive technology and individual support from knowledgeable staff it is possible for the person to bring order to their often chaotic daily life. However, there are studies and clinical experience which indicate that assistive technology is not used to the extent expected. Assumptions are that complex environmental factors interact with use of the assistive technology. The purpose of this study was to document the experiences of facilitating or hindrance environmental factors that people with mental disabilities have of using electronic planning devices. Method: Using prescribers and at visits to community activity centres twelve adult persons with mental disabilities and own experience of useing electronic planning devices were, after informed consent, recruited. A study-specific interview guide with open questions, with a content that covers environmental factors according to International Classification of Functioning, Disability and Health (ICF) was used in the recorded interviews. The material was analysed by using qualitative inductive content analysis. Result: From the interviews six categories and two themes emerged, wich were molded to a model of facilitating or impeding factors affecting the use of electronic planning devices. The categories were named: Insight of disability/needs; Cognisant social environment; Self control and manageability of the device; Benefits and shortcomings of using the device; Assistance of skilled personnel and Clear and simple exercise of authority. The themes are named: A clear desire for participation and Necessity of individual adaption of the device. Measures to prevent or eliminate ambient negative impact of the device use is keen

Omgivningens hjälp eller stjälp? : Dokumentation av personers med psykisk funktionsnedsättning erfarenheter av användning av elektroniska planeringshjälpmedel

Vuxna personer med psykisk funktionsnedsättning har ofta problem med sin kognitiva förmåga, vilket leder till problem med att hantera vardagslivets komplexitet. Med behovsanpassade kognitiva hjälpmedel och individuellt stöd från kunnig personal finns möjlighet för personen att få ordning på sitt ofta kaotiska vardagsliv. Dock finns studier och klinisk erfarenhet som påtalar att hjälpmedel inte används i den utsträckning som förväntats. Antaganden finns om att komplexa faktorer i omgivningen interagerar med hjälpmedelsanvändning. Syftet med studien var att dokumentera erfarenheter av underlättande och hindrande omgivningsfaktorer som personer med psykisk funktionsnedsättning har av användningen av elektroniska planeringshjälpmedel. Metod: tolv personer med psykisk funktionsnedsättning och med erfarenhet av elektroniska planeringshjälpmedel rekryterades efter informerat samtycke via förskrivare och besök vid dagliga verksamheter. En studiespecifik frågeguide med öppna frågor med ett innehåll som täcker omgivningsfaktorer enligt Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) användes i de inspelade intervjuerna. Materialet bearbetades med kvalitativ, induktiv innehållsanalys. Resultatet utmynnade i sex kategorier och två teman formade till en modell med underlättande eller hindrande faktorer som inverkar på användning av elektroniska planeringshjälpmedel enligt deltagarna. Kategorierna benämndes: Insikt om funktionsnedsättning/behov; Medveten social omgivning; Egen kontroll och hanterbarhet av hjälpmedel; Nytta av och brister i hjälpmedlets funktion; stöd av Kunnig personal; och Tydligt och lättbegripligt myndighetsutövande. Teman benämndes: Tydlig önskan om delaktighet och Nödvändig individuell anpassnnig. Åtgärder för att förebygga eller förhindra omgivningens negativa inverkan på hjälpmedelsanvändning är angelägen.Syftet med projektet var att dokumentera erfarenheter av underlättande och hindrande omgivningsfaktorer när det gäller som personer med psykisk funktionsnedsättning som använder elektroniska planeringshjälpmedel.Rapport från projekt som fått stöd av Hjälpmedel i fokusHjälpmedelsinstitutet fick 2007 i uppdrag av regeringen att informera, utbilda och utveckla bra hjälpmedel för personer med psykiska funktionsnedsättningar. En del i arbetet var att dela ut projektmedel för bland annat utveckling av hjälpmedel och metoder.</p

The Effectiveness of Interactive Methods in Teaching Grammar at Secondary School

Bakalaura darbs ir veltīts interaktīvu metožu efektivitātes izvērtēšanai, mācot gramatiku vidusskolā. Darba teorētiskās daļas pirmajā nodaļā ir apskatīts gramatikas jēdziens, un apspriesti mācīšanas metodoloģija un modeļi. Darba otrajā nodaļā ir definētas interaktīvās metodes, uzsvērta saziņas nozīme, kā arī apskatīti interaktīvo mācību metožu galvenie veidi. Trešā nodaļa ir veltīta dažādu skolēnu īpatnību izklāstam. Darba praktiskās daļas mērķis ir uzsākt eksperimentālo mācīšanu vidusskolā, izmantojot interaktīvās metodes. Iegūtie aptauju un eksperimentālās mācīšanas pētījuma rezultāti liecina, ka interaktīvā metode ir efektīvākā nekā gramatikā tulkošanas metode, mācot gramatiku.. Turklāt, interese un motivācija ir augstāka tiem skolēniem, kuru gramatikas mācīšanas posmā tiek izmantotas interaktīvās metodes. Atslēgas vārdi: gramatikas mācīšana, skolēnu tipi, interaktīvās metodes, gramatikas tulkošanas metode, motivācijaThe present thesis is devoted to the examination of effectiveness of interactive methods in teaching grammar at secondary school. Chapter I of the theoretical part of the thesis focuses on the importance of grammar and discusses the teaching methodology. Chapter II defines interactive methods, emphasizes the importance of communication and discusses some types of interactive activities. Chapter III highlights different peculiarities of the learners. The empirical part of the thesis is aimed at launching the pilot teaching employing interactive methods at secondary school. The data obtained from the questionnaire-based survey and pilot teaching indicate that interactive methods of teaching grammar are more effective than grammar-translation method. Moreover, it was revealed that interest and motivation were higher in the group of the learners where interactive methods were applied. Key words: grammar teaching, learner styles, interactive methods, grammar-translation method, motivatio