Bigby C, Clement T, Mansell J, Beadle-Brown J
School of Social Work and Social Policy, LaTrobe University, Melbourne, Australia.
J Intellect Disabil Res. 2009 Apr;53(4):363-76. doi: 10.1111/j.1365-2788.2009.01154.x. Epub 2009 Jan 21.
The level of resident's adaptive behaviour and staff facilitative practices are key sources of variation in outcomes for residents in community-based residential services. The higher the resident support needs the poorer their outcome. Although substantial investment has been made in values-based training for staff, their attitudes and the impact of these on practice is largely unexplored.
The first study used ethnographic and action research methods to examine the daily lives of 25 residents with severe and profound intellectual disabilities (ID), who lived in five small group homes, and the attitudes of the staff supporting them. Thematic analysis of the data led to a proposition that although staff accept principles of inclusion, choice and participation for people with ID in general, they do not consider it feasible to apply these to the people with severe and profound ID to whom they provide support. The findings from a second study that used a group comparison design and administered a short questionnaire about staff attitudes to 144 direct-care staff and first-line managers working in disability services confirmed this hypothesis.
The study suggests more focused attention is needed to staff understanding the values embedded in current policies and their application to people with more severe disabilities.
在社区寄宿服务中，居民的适应性行为水平和工作人员的促进性做法是影响居民服务结果差异的关键因素。居民的支持需求越高，其服务结果就越差。尽管已在基于价值观的员工培训方面投入了大量资金，但他们的态度及其对实践的影响在很大程度上仍未得到探究。
第一项研究采用人种志和行动研究方法，对居住在五个小型集体之家的25名重度和极重度智力残疾居民的日常生活以及支持他们的工作人员的态度进行了考察。对数据的主题分析得出一个观点，即虽然工作人员总体上接受智力残疾者的包容、选择和参与原则，但他们认为将这些原则应用于他们所支持的重度和极重度智力残疾者是不可行的。第二项研究采用组间比较设计，并向144名从事残疾服务的直接护理人员和一线管理人员发放了一份关于员工态度的简短问卷，其结果证实了这一假设。
该研究表明，需要更加关注工作人员对现行政策所蕴含价值观的理解以及这些价值观在更严重残疾者中的应用。
