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    Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review.


    McCarron, M. and Lombard-Vance, Richard and Murphy, Esther and May, Peter and Webb, Naoise and Sheaf, Greg and McCallion, Philip and Stancliffe, Roger and Normand, Charles and Smith, Valerie and O'Donovan, Mary-Ann (2019) Effect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic review. BMJ Open, 9. ISSN 2044-6055

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    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.

    Item Type: Article
    Additional Information: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. Cite as: McCarron M, Lombard-Vance R, Murphy E, et alEffect of deinstitutionalisation on quality of life for adults with intellectual disabilities: a systematic reviewBMJ Open 2019;9:e025735. doi: 10.1136/bmjopen-2018-025735 Funding: The study was funded by the Department of Health (Ireland), with commissioning assistance by the Health Research Board (Ireland).
    Keywords: Effect; deinstitutionalisation; quality of life; adults with intellectual disabilities; systematic review;
    Academic Unit: Faculty of Science and Engineering > Psychology
    Item ID: 13658
    Identification Number: https://doi.org/10.1136/bmjopen-2018-025735
    Depositing User: Richard Lombard-Vance
    Date Deposited: 24 Nov 2020 17:24
    Journal or Publication Title: BMJ Open
    Publisher: BMJ Publishing Group
    Refereed: Yes
    Funders: Department of Health (Ireland), Health Research Board (HRB)
    URI:

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