Welsh Centre for Learning Disabilities, School of Medicine, Cardiff University, Cardiff, UK.
J Appl Res Intellect Disabil. 2012 Jan;25(1):60-70. doi: 10.1111/j.1468-3148.2011.00647.x. Epub 2011 Sep 19.
Increased provision of out-of-family residential support is required because of demographic changes within the intellectual disabilities population. Residential support now has to be provided in a climate requiring both financial constraint and high quality service outcomes. The aim was to evaluate the quality of life consequences of living with less intensive staff support, resulting from the introduction of more targeted staff allocation coupled with telecare.
The study comprised 91 participants who lived in 33 settings. The targeted support/telecare intervention was implemented at staggered intervals in 25 of these settings (63 participants). Data on a range of participant and setting descriptors, quality of care, and a range of objective lifestyle indicators were collected at four points in time over 2 years. Impact of the intervention was evaluated using within-group comparisons over time.
Comparison between pre- and post-intervention showed that staffing levels were significantly reduced by 23%, whereas they were constant in the absence of intervention. One health indicator improved in the absence of intervention and another improved following intervention. There were no significant changes in any other lifestyle indicators (safety, money, social and community activity, independence or choice).
A combination of targeted support and telecare had no adverse short-term affect on participants' quality of life, but reduced staff input so it seems that they have a role to play in the strategic development of out-of-family placements for adults with intellectual disabilities. Further research is needed to explore in more detail how efficiency is achieved in practice.
由于智力残疾人群的人口结构变化，需要增加家庭以外的居住支持。现在，居住支持必须在财务限制和高质量服务成果的要求下提供。目的是评估由于更有针对性的员工分配加上远程监护，导致员工支持减少对生活质量的影响。
该研究包括 91 名参与者，他们居住在 33 个环境中。有针对性的支持/远程监护干预措施在其中 25 个环境中（63 名参与者）以交错的时间间隔实施。在 2 年内的 4 个时间点收集了一系列参与者和环境描述符、护理质量以及一系列客观生活方式指标的数据。使用组内随时间的比较评估干预的影响。
干预前后的比较表明，工作人员数量减少了 23%，而在没有干预的情况下则保持不变。在没有干预的情况下，有一个健康指标得到了改善，而在干预后，另一个指标也得到了改善。在任何其他生活方式指标（安全、金钱、社会和社区活动、独立性或选择）方面都没有显著变化。
有针对性的支持和远程监护的组合对参与者的生活质量没有短期不利影响，但减少了员工投入，因此它们在为智力残疾成年人制定家庭以外的安置策略方面具有一定作用。需要进一步研究，更详细地探讨如何在实践中实现效率。
