TY - JOUR
T1 - Does Moral Case Deliberation Change Current Views on Restrictions?
T2 - Staff Perceptions on Restrictions
AU - van der Meulen, Anne P.S.
AU - Taminiau, Elsbeth F.
AU - Hertogh, Cees M.P.M.
AU - Embregts, Petri J.C.M.
N1 - Publisher Copyright: © 2021 The Authors. Journal of Policy and Practice in Intellectual Disabilities published by International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background: In the care of people with intellectual disability, support staff apply restrictions to people with moderate intellectual disabilities (ID) in several domains of daily life, such as restrictions on bedtimes or on the amount of food intake. Support staff may experience moral dilemmas applying these restrictions. In this respect, moral case deliberation (MCD) is used as an instrument for support staff to jointly reflect on dilemmas in care and is considered a form of ethical support. MCD also seems to broaden the perspective of their participants. Specific Aims: This study examined to what extent MCD led to changes in support staff's perspectives with regard to daily life restrictions placed upon people with moderate ID. Consequently, this study examined to what extent support staff's perspectives on these restrictions were broadened as a result of their participation in the study. Method: Prior to and following a series of three MCD sessions on moral dilemmas commonly encountered in daily life care, interviews were held with 12 support staff across two teams. Participants were asked what they considered to be good care in the given dilemmas. To systematically compare all of the answers given in the interviews prior to and following the MCDs, the same interview-guide was used in both instances. Interviews were analyzed inductively. Findings: Following the MCD sessions, the respondents tended to hold onto their perspective to restrict clients to provide them with structure, clarity and rest, as expressed prior to the MCD. However, some respondents adapted their perspective on restrictions and were willing to provide people with moderate ID more freedom after the MCD. Discussion: This study contributed to the evidence underlying MCD in healthcare and in providing insights into MCD with regard to daily life restrictions in the care of people with moderate ID. Partly, MCD leads to a broadening of perspective on restrictions applied in the daily life of people with moderate ID.
AB - Background: In the care of people with intellectual disability, support staff apply restrictions to people with moderate intellectual disabilities (ID) in several domains of daily life, such as restrictions on bedtimes or on the amount of food intake. Support staff may experience moral dilemmas applying these restrictions. In this respect, moral case deliberation (MCD) is used as an instrument for support staff to jointly reflect on dilemmas in care and is considered a form of ethical support. MCD also seems to broaden the perspective of their participants. Specific Aims: This study examined to what extent MCD led to changes in support staff's perspectives with regard to daily life restrictions placed upon people with moderate ID. Consequently, this study examined to what extent support staff's perspectives on these restrictions were broadened as a result of their participation in the study. Method: Prior to and following a series of three MCD sessions on moral dilemmas commonly encountered in daily life care, interviews were held with 12 support staff across two teams. Participants were asked what they considered to be good care in the given dilemmas. To systematically compare all of the answers given in the interviews prior to and following the MCDs, the same interview-guide was used in both instances. Interviews were analyzed inductively. Findings: Following the MCD sessions, the respondents tended to hold onto their perspective to restrict clients to provide them with structure, clarity and rest, as expressed prior to the MCD. However, some respondents adapted their perspective on restrictions and were willing to provide people with moderate ID more freedom after the MCD. Discussion: This study contributed to the evidence underlying MCD in healthcare and in providing insights into MCD with regard to daily life restrictions in the care of people with moderate ID. Partly, MCD leads to a broadening of perspective on restrictions applied in the daily life of people with moderate ID.
KW - ethics
KW - intellectual disability
KW - practice
KW - restrictions
UR - http://www.scopus.com/inward/record.url?scp=85115433689&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jppi.12394
DO - https://doi.org/10.1111/jppi.12394
M3 - Article
SN - 1741-1122
JO - JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES
JF - JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES
ER -