Nancy Salmon

We Just Stick Together: How Disabled Teens Negotiate Stigma to Create Lasting Friendship.

BACKGROUND Friendship is a crucial relationship offering practical support, enjoyment and improved health. When disability is added into the mix, the permutations of friendship shift. Despite the presence of inclusive social policies many disabled teens continue to experience stigma and social isolation, yet some teens are able to establish long-term friendships. METHODS A nuanced understanding about how disabled teens navigate stigma to create lasting friendships was constructed through this qualitative study. Seven boys and seven girls between the ages 15 to 20 years who experienced disability engaged in research interviews and participant observation sessions. Nine adults were also interviewed. A critical approach to data analysis was complimented by coding in Atlas.ti. RESULTS This article describes the strategies used by these disabled teens to make and keep friends: disrupting norms about friendship, coming out as disabled, connecting through stigma and choosing self-exclusion. CONCLUSION Disabled teens in this study felt a greater sense of belonging when with peers who shared the disability experience, thus self-exclusion was a viable strategy for creating sustainable friendships in the context of oppression. Social policy informed by the experiences of disabled youth in the current study will more effectively promote social inclusion by first acknowledging and then disrupting ableism.

Bladder dysfunction and quality of life for people with multiple sclerosis

Abstract Purpose: Bladder dysfunction affects 75% of people with multiple sclerosis (MS). People with MS are reluctant to seek treatment for this distressing symptom. This is the first-known study to explore in depth how bladder dysfunction interferes with quality of life for people with MS. Methods: Nineteen individual semi-structured interviews were conducted (M = 8, F = 11). Participants had a definite diagnosis of MS, aged between 37 and 64 years and had at least one bladder dysfunction symptom. The audio-recorded interviews lasted up to 90 min and were transcribed verbatim. Results: Thematic analysis within NVivo10 yielded two key themes: (1) Disruptions and loss and (2) ways of knowing. “Disruptions and Loss” explores how bladder dysfunction interrupted daily living activities and how this contributed to experiencing loss. “Ways of knowing” portrays the types of knowledge that existed around bladder dysfunction. Participants described using their experiential knowledge to self-manage bladder symptoms without advice from healthcare providers. Conclusions: Bladder dysfunction imposes major disruptions on daily life. People with MS attempt to self-manage their bladder symptoms, despite current barriers to navigating existing healthcare infrastructure. Understanding these barriers and the individual strategies employed by people with MS are the first steps in facilitating independent management of bladder dysfunction. Implications for Rehabilitation Each individual’s experience of bladder dysfunction is unique. Healthcare professionals must be prepared to discuss all disruptions and losses associated with bladder dysfunction for people with MS. People with MS have a vast range of knowledge in relation to their own bladder symptoms and healthcare professionals need to explore their existing self-management strategies during assessment. People with MS and healthcare professionals need to be educated on the wider health implications relating to bladder dysfunction.

Harried by Harding and Haraway: student–mentor collaboration in disability studies

Exploring the friendships of disabled youth in forthcoming doctoral research raised many unsettling questions. Members of academic and disability communities thoughtfully asked how the researcher could legitimately understand, interpret and represent the experiences of disabled youth. The initial impulse was to rely on nearly two decades of clinical practice with children and youth with disabilities; however, the futility of this strategy quickly surfaced. Uncertainty about how to proceed arose. A colleague and mentor suggested that a careful reading of Sandra Harding, Donna Haraway and Mats Alvesson and Kaj Sköldberg might provide the conceptual tools required to address these concerns. This paper presents a student’s stumbling, hesitant and sometimes ‘harried’ attempts to grapple with their unfamiliar arguments while simultaneously exploring tentative connections with disability studies. The evolutionary cycle of queries, responses and reflections from a series of e‐mails demonstrate a transition in thinking about research and representation.

Schools as sanctuaries: A systematic review of contextual factors which contribute to student retention in alternative education

Early school leaving is an international concern. Previous research indicates that the school context contributes to early school leaving. This systematic review is aimed to gather marginalised young peoples’ perceptions concerning contextual factors that contributed to and interfered with their decisions to stay in alternative education. Twenty-three databases and reference lists of reviews were searched, eliciting 1586 studies, which were then screened. Data from 24 mixed-methods studies that met the inclusion criteria were extracted and synthesised. Findings suggested that alternative schools which provided a sanctuary for students increased student engagement. Schools were sanctuaries when they offered physical, emotional and psychological safe spaces; fostered a sense of community; enabled students to affirm their racial/ethnic pride and employed flexible behavioural supports. Implications for practice and research are discussed.

Inclusive research: An Irish perspective

Background: The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) (United Nations, 2006) sets the expectation that people with disabilities be involved in research that affects their lives. Inclusive research moves people with intellectual disabilities away from being research subjects, towards powerbalanced research collaborations that can create individual and societal

Our Homes: An inclusive study about what moving house is like for people with intellectual disabilities in Ireland

Background: Supporting people with intellectual disabilities to live well in communities they choose is deinstitutionalisation’s central aim and endorsed by the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (UN, 2006). This study focused on the experiences of people with intellectual disabilities in Ireland when moving home using an inclusive research approach. Method: This inclusive research project employed a qualitative approach. Participants included 19 men and 16 women (total n = 35) with ages ranging from 22 to 77 years. Structured interviews attended to the experience of moving home and the supports accessed during and after the transition to community living. Results: Thematic analysis yielded four themes: “expressing choice” in the moving process; “feeling connected or isolated when moving”; “accessing supports during and after the move”; and finally, participants’ reflections on “experiencing vulnerability and feeling safe” while resettling. Conclusions: This is the first study about people with intellectual disabilities moving home to be collaboratively designed and completed by an inclusive research team. Although much is understood about the long‐term benefits of engaging in meaningful choices about housing and supports, concerns remain about the extent to which the will and preferences of people with intellectual disabilities in Ireland are respected when moving home.

Interventions to improve adherence to exercise therapy for falls prevention in community-dwelling older adults: systematic review and meta-analysis

BACKGROUND exercise therapy is highly recommended for falls prevention in older adults; however, poor exercise adherence may limit treatment effectiveness. OBJECTIVE to assess the effectiveness of interventions to improve exercise adherence for community-dwelling adults (aged over 65 years), at risk of falling. METHODS eight databases were searched to identify randomised/quasi-randomised trials. The Capability, Opportunity, Motivation model of behaviour (COM-B) was used to categorise the identified adherence interventions. Studies with similar interventions that provided adherence outcome data per group were analysed to establish pooled intervention effect. Protocol registration with Propsero: (CRD42016033677). RESULTS of the 20 trials included (n = 4419), five provided data per group for adherence outcome. Meta-analysis of four studies (n = 482), containing interventions exploring the way exercise is delivered, demonstrated significantly better adherence in the intervention group (n = 166 experimental, n = 161 control Fixed effects model (FEM), SMD = 0.48 95% CI [0.26-0.70] P < 0.0001 I2 = 0%, very low GRADE evidence). Within this limited evidence base, interventions using telecommunication and the integration of exercise into activities of daily living appear most promising when delivering exercise at home. Meta-analysis to explore the effect that these interventions to improve adherence had on balance (n = 166 experimental, n = 161 control Random-effects model (REM), SMD = 0.82, 95% CI [-1.20-2.84] P = 0.43 I2 = 52%) and gait (n = 59 experimental, n = 56 control REM, SMD = 0.29, 95% CI [-1.62-2.20] P = 0.77 I2 = 48%), found no statistically significant effect. CONCLUSIONS adherence to exercise can be positively influenced; however, insufficient data exists to support any single intervention that also achieves effective outcomes for balance and gait.

How Beliefs About Bladder Dysfunction Among Health-Care Professionals Influence Clinical Practice Development

BACKGROUND Bladder dysfunction can affect up to 75% of people with multiple sclerosis (MS) on several important life domains. It is a multifaceted problem that remains underdiagnosed by health-care professionals. The aims of this study were to understand the perceptions of Irish health-care professionals regarding bladder dysfunction and to explore current service provision for people with MS. METHODS Two focus groups, three dyadic interviews, and one semistructured interview with 14 health-care professionals lasting up to 90 minutes were audio-recorded. Participants included eight physiotherapists, two occupational therapists, three nurses, and one clinical case manager from acute and community settings. RESULTS Thematic analysis of transcripts yielded two key themes. The first theme involves the underlying beliefs of health-care professionals, their clinical practice, and experiential knowledge in the model of clinical practice development in relation to bladder management. The second theme addresses the pivotal points in this model where change can be implemented to optimize bladder management. The first element of change encompasses the interaction between clinical practice and experiential knowledge of health-care professionals. The second element of change incorporates how acknowledgment of individual beliefs of health-care professionals can further inform clinical practice and experiential knowledge. CONCLUSIONS These findings suggest that health-care professionals need to be aware of their beliefs in relation to bladder dysfunction. Examining these beliefs may influence how people with MS access health service provision for this disabling symptom. This type of reflexive practice may facilitate changes to existing perceptions and reduce the reluctance to discuss bladder symptoms.