Psychiatric Rehabilitation Programs for Peoples with Disabilities: Literature Review
Leyla Küçük* and Tuba ÇÖmez
Department of Mental Health and Psychiatric Nursing, Istanbul University, Turkey
Submission: June 14, 2017; Published: July 5, 2017
*Corresponding author: Leyla Küçük, Department of Mental Health and Psychiatric Nursing, Istanbul University, Turkey,Tel: 0090-212-440-0000/27074; Email: leylak73@istanbul.edu.tr
How to cite this article: Leyla K, Tuba Ç. Psychiatric Rehabilitation Programs for Peoples with Disabilities: Literature Review. J Yoga & Physio. 2017;1(005 4): 555570. DOI:10.19080/JYP.2017.01.555570
Abstract
Hereditary factors and stigma in disabled people increase the possibilities of unemployment, environmental factors including adverse life experiences and psychiatric problems.Studies have shown that psychiatric problems in disabled people are five times higher than other people in the community. For this reason, besides treatment programs rehabilitation programs that enable psychiatric strengthening are needed to reintegrate disabled people into society and to enable them live their lives on their own or with minimum support. Psychiatric rehabilitation programs were revised through this mini-literature review and it is seen that the programs improved problem solving skills in disabled people, increased perceptions of family communication and social support, increased self esteem and decreased anxiety and depression symptoms.
Keywords: Disability; Disabled person; Psychiatric rehabilitation; Psychoeducation; Evidencebased practices
Introduction
Disability is a phenomenon which is characterized by difficulties in adapting to social life and meeting the needs of daily life because of the loss, by birth or later for any reason, of physical, mental, spiritual, sensory and social skills at various grades and it needs support services such as prevention, care, rehabilitation and counseling [1]. Prenatal, at birth and postnatal causes play a role in the occurrence of disability. It is classified in seven groups as mental, physical, sight, hearing, language and speech, disability due to persistent diseases, and spiritual emotional disability [2]. According to World Health Organization (WHO) 2011 disability data, the rate of disability is accepted as 10% for developed countries and 15.6% for developing countries and it is estimated that 750 million to 1 billion people are disabled worldwide [3]. Disability rates have reached significant numbers all over the world and have recently been a serious issue to raise awareness on. In disabled people; the risk of biological disposition, unsuccessful experiences in social life, stigma perception and the occurrence of the psychiatric problems that are based upon stress effects originating from the individuals in family or in the environment are five times higher than the other individuals in the society [4]. Therefore, besides treatment programs rehabilitation programs that enable psychiatric strengthening are needed to reintegrate disabled people into society and to enable them live their lives on their own or with minimum support. Psychiatric rehabilitation is a comprehensive, coordinated and long-term treatment that is practiced to meet the mental and social needs of individuals with persistent symptoms and functional impairment [5]. In disabled individuals who are treated as private/different groups; this process progresses according to different and group specific needs because they have different problems than usual patients [4,5]. With this mini-literature compilation, it is aimed to review the "psychiatric rehabilitation programs" for disabled people which are a special group.
Methods
Search methodology
The study was carried out by retrospective scanning in the databases of the relevant publications. Studies, between January- March 2017, were scanned via Istanbul University internet access network, with the keywords "psychiatric rehabilitation", "physical handicap", "physical disability", "mental/intellectual handicap-disability-retarded", "deaf", "deafness", "hearing impaired", "visually handicap-disability", "speech and language disability"; in the databases of Ulakbim, Turkish Psychiatry Index, Google Academic, Pubmed, CINAHL, and Cochrane. The thesis studies done on the subject and the leaflets presented in the congresses were not included in the scope of the study.
Selection of studies
The following criteria were taken into consideration in the selection of the articles to be included in the study;
- The practiced psycho-rehabilitation program is towards disabled people,
- Being a research article that can be reachable as a full text,
- Language of the publication is either Turkish or English,
- Being original and quantitative,
- Published in a national/international refereed journal between 2000 and 2017.
In the summarization of the data; a valid and reliable guideline for systematic reviews "A checklist of items that should be taken into account in the reporting of systematic compilation or meta-analysis studies" (Preferred reporting items for systematic reviews and meta-analyses statement -PRISMA-) was taken into account.
Results
When the psychiatric rehabilitation programs for disabled people were examined in the mentioned databases, a total of 7413 studies were reached. When studies were analyzed via the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) scheme by considering the inclusion criteria, 14 studies (Table 1) were considered appropriate and included. When studies are examined, it is seen that there are various cognitive, behavioral and socially supporting programs towards disabled people. Out of 14 studies examined, 7 of them are programs towards children and teenagers with autism, cerebral palsy and sight-disability, 1 of them towards elderly people with sight-disability, 6 of them towards adults with multiple sclerosis, physical or sight disability. In studies examined, it is seen that "Virtual Reality Therapy" (Table 2) practiced on children with cerebral palsy increases spiritual adaptation, "Picture Exchange Communication System (PECS)" practiced on children with autism provides a progress in social communication skills, "Communication-based Intervention Program" practiced on children with both autism and lack of verbal communication makes a significant difference in starting the conversation and "Interpersonal Communication Skills Psycho-Education Program" and "Structured Experience of Group Process" practiced on teenagers with sight disability are effective on increasing the empathetic tendencies and communication skills of teenagers.
In consequence of psychoeducation program practiced on elderly individuals with visual impairment, it is seen that depression and symptoms of anxiety reduce, "Healing Pathways" program practiced on physically disabled women with depression diagnosis decreases the points of depression and reduces its symptoms, "Development Programs of Self Esteem" increases the points of self esteem level significantly. Besides, with the development of technology, as a result of practicing telepsychiatry and telehealthprograms which have been often used recently on physically disabled people, it is seen that breakoff phenomenon and depressive symptoms are reduced in people.
Conclusion
With this mini-literature review, the psychiatric rehabilitation programs were revised and it was seen that the programs improved problem solving skills in disabled people, increased perceptions of family communication, social support, self esteem and decreased mood problems such as anxiety and depression. Besides programs examined, teaching daily life skills, assisted living and employment programs, sensory integration therapies, social skills education, behavioral change (regulation) education and spiritual education of the family towards disabled individuals exist and they are practiced.
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