Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review
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2019Author:
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McCarron M, Lombard-Vance R, Murphy E, May P, Webb N, Sheaf G, McCallion P, Stancliffe R, Normand C, Smith V, O?Donovan MA, Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review, BMJ Open, 2019Download Item:
Abstract:
Objective: To review systematically the evidence on how
deinstitutionalisation affects quality of life (QoL) for adults with
intellectual disabilities.
Design: Systematic review.
Population: Adults (aged 18 years and over) with
intellectual disabilities.
Interventions: A move from residential to community
setting.
Primary and secondary outcome measures: Studies
were eligible if evaluating effect on QoL or life quality, as
defined by study authors.
Search: We searched MEDLINE, PsycINFO, CENTRAL,
CINAHL, EconLit, Embase and Scopus to September 2017
and supplemented this with grey literature searches. We
assessed study quality using the Critical Appraisal Skills
Programme suite of tools, excluding those judged to be of poor
methodological quality.
Results: Thirteen studies were included; eight quantitative
studies, two qualitative, two mixed methods studies and
one case study. There was substantial agreement across
quantitative and qualitative studies that a move to community
living was associated with improved QoL. QoL for people
with any level of intellectual disabilities who move from any
type of institutional setting to any type of community setting
was increased at up to 1year postmove (standardised mean
difference [SMD] 2.03; 95%CI [1.21 to 2.85], five studies, 246
participants) and beyond 1year postmove (SMD 2.34. 95%CI
[0.49 to 4.20], three studies, 160 participants), with total
QoL change scores higher at 24 months comparative to 12
months, regardless of QoL measure used.
Conclusion Our systematic review demonstrated a
consistent pattern that moving to the community was
associated with improved QoL compared with the institution. It
is recommended that gaps in the evidence base, for example,
with regard to growing populations of older people with
intellectual disability and complex needs are addressed.
Author's Homepage:
http://people.tcd.ie/pemayhttp://people.tcd.ie/odonovm3
http://people.tcd.ie/esmurphy
http://people.tcd.ie/normandc
http://people.tcd.ie/smithv1
http://people.tcd.ie/mccarrm
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Author: May, Peter; Mc Carron, Mary; O'Donovan, Mary-Ann; Normand, Charles; Murphy, Esther; Smith, Valerie
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Journal ArticleSeries/Report no:
BMJ OpenAvailability:
Full text availableKeywords:
Deinstitutionalisation, Adults with intellectual disabilities, Community care - Adults with intellectual disabilitiesSubject (TCD):
Inclusive Society , INTELLECTUAL DISABILITYDOI:
http://dx.doi.org/10.1136/bmjopen-2018-025735Metadata
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