Despite the efforts of mainstreaming in sports, inclusive participation of people with Intellectual Disabilities (ID) in sports remains challenging. In sports settings, the social environment may influence the motivation of athletes and promote (or restrict) inclusive sports participation of athletes with ID. Thus, this study aims to explore the motivations of athletes and coaches and to investigate the role of the social environment in sports participation of athletes with and without ID. Coaches who coach athletes with ID (n = 11), athletes without ID (n = 13) and both groups (n = 2) were involved in semi-structured interviews. From the inductive thematic analysis three themes were identified for the sports motivations of athletes with ID (Sport-related Progression, Social Interaction, Positive Emotions), two for their coaches’ motivations (Help others, Personal and Professional Development) and four for coaching practices toward athletes with ID (Psychological and Life skills development, Building Meaningful Relationships, Behaviour adaptations and Participation-focused). Moreover, ‘Teammates and Opponents’ and ‘Family’ were classified as social agents that influence the sport participation of athletes with ID. Coaches of athletes without ID reported additional themes about their athletes’ motivations (Health-related Reasons), their coaching motivations (Career aspirations) and their coaching practices towards athletes without ID (Performance-focused). The motivations of athletes and the practices of coaches could promote sports participation of athletes with ID, but more work is needed to address athletes’ sports motivations and overcome the able-ist attitudes and the social oppression that may make their inclusion in sports more challenging. These sports participation barriers and facilitators could provide direction to stakeholders for developing inclusive sports pathways to people with ID.
ObjectiveThe COVID-19 pandemic has had a major impact on the delivery of psychological treatment. Due to social distancing requirements, the provision moved to videoconferencing psychotherapy (VCP). There is a paucity of empirical data supporting the efficacy of EMDR therapy as a VCP. This stage 1 pilot study tested an EMDR therapy scripted protocol, such as Virtual Blind 2 Therapist (VB2Tr), on frontline mental health workers as a VCP regarding fitness for purpose, distinctiveness, relevance, and efficiency.MethodsA total of 24 participants were recruited for the study. The design included a one-session treatment intervention with pre, post, 1-month, and 6-month follow-up (FU) measurements. This treatment session used a “Blind 2 Therapist” EMDR therapy scripted protocol as videoconference psychotherapy that involves non-disclosure of traumatic memory. The research explored the treatment effect on the core characteristics of trauma memory, including subjective disturbance, belief systems, memory intensity (MI), vividness, and levels of emotionality. Additionally, the research explored participants’ experiences of adverse and benevolent childhood experiences (ACEs/BCEs) during their childhood.ResultsRegarding the four tests, namely, fitness for purpose, distinctiveness, relevance, and efficiency, results are favourably suggesting potential clinical benefits of using EMDR as videoconference psychotherapy. Although this is a proof-of-concept study showing positive results, no clinical population or control group was used. The purpose of the study is to explore the potential for scalability toward a larger clinical trial. The treatment intervention was achieved irrespective of either ACEs/BCEs during childhood.ConclusionThe research tentatively supports the case for EMDR therapy as a credible treatment when used as video conference psychotherapy and in using the Blind 2 Therapist protocol. However, more research is needed to scale toward a clinical trial.Clinical Trial RegistrationClinical Trial Registration:https://www.isrctn.com/ISRCTN12099530, identifier ISRCTN12099530.
For children with juvenile idiopathic arthritis (JIA), the quality of life (QoL) emotional component is influenced by numerous factors: the arthritis subtype, disease duration, and activity, patient’s treatment, patient’s physical condition, and pain level, also his age, and sex. However, it’s important to determine the emotional component in the structure of QoL in children with different JIA subtypes (polyarthritis, oligoarthritis, and uveitis-associated arthritis) and features of psychological adaptation in modern conditions. Purpose - to determine both the emotional component of QoL in patients with JIA and their emotional condition considering the disease subtype, its duration, and the therapy complex. Materials and methods. The study was carried out at the SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine», Kharkiv, from November 2020 to November 2021. The assessment was provided by JADAS27, functional state by CHAQ, QoL according to PedsQLTM 4.0 Generic Core Scales, and emotional state according to the Montgomery-Asberg scale (MADRS) for depression assessment and clinical indicators. Statistical processing of the material was carried out using parametric and non-parametric methods, the critical level of significance for statistical testing hypotheses comparing groups was set at 0.05. Results. The 118 patients with JIA were examined, of them 47 patients with polyarticular, 43 patients with oligoarticular, and 28 patients with JIA-u subtypes. The study involved 77 girls and 41 boys aged 2 to 18 years (133.3±4.6 months). The majority (112 patients) received methotrexate therapy, 30 of them - methotrexate in combination with immunobiological therapy, 6 - sulfasalazine. The overall QoL in the group of children with JIA was at the level of 70.9±1.4 points for the last month and 72.6±1.4 points for the last week without significant difference, and the emotional component in the group as a whole was significantly higher for the last month - 73.1±1.6 points, while during the hospital stay it decreased to 66.3±1.7 points (p≤0.05). According to the results of the assessment of emotional state by the MADRS questionnaire, children aged 8 years and older did not have a depressive episode - 6.02±0.72 points. No significant differences were observed for HRQoL and emotional component in groups with different variants of arthritis and depending on age. However, certain results with a decrease in QoL and emotional state were observed in children with polyarthritis and uveitis-associated variant of JIA. The duration of the disease and treatment affected the QoL and emotional state, especially in the first year (QoL = 62.5±3.8 points for the last month). Correlations between MADRS and emotional state according to PedsQL were indirect and strong both for the last week and for the last month (r=-0.821; r=-0.784; p≤0.05). MADRS and total PedsQL scores also had indirect, medium strength correlations for the study periods (r=-0.558; r=-0.528; p≤0.05). Conclusions. At the beginning of the disease children with JIA have the reduction of QoL indicators with the emotional component. Such results depend on the course of JIA, which predicts the formation of emotional depressive disorders in some of them. The first year of the disease is the most vulnerable for children with polyarthritis, and for children with JIA-u increased disease duration enhances symptoms of emotional disturbances. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
Summary. Juvenile idiopathic arthritis is a severe chronic childhood disease that affects not only the joints but is also accompanied by various comorbid conditions, among which eye damage (uveitis) is the most common. In addition to a significant impact on the general condition of the child, this disease also affects the main indicators of quality of life: physical activity, emotional activity, activity in educational institutions, and the social sphere. During the period of active study of Juvenile idiopathic arthritis patients quality of life, a decrease in its overall level is noted due to almost all components, but physical activity shows the lowest values in some studies, which is associated with joint damage, activity, and duration of the disease. Objective. To determine the state of physical functioning and assess the overall level of quality of life in patients with JIA, considering the subtype of the disease duration and the therapy complex. Materials and Methods. The study was carried out at SI "Institute for Children and Adolescents Health Care of the NAMS of Ukraine", Kharkiv, from November 2020 till November 2021. There 118 patients with juvenile idiopathic arthritis were examined, including 47 with polyarticular, 43 with oligoarticular, 28 with uveitis-associated subtypes. The investigation involved 77 girls and 41 boys in age from 2 till 18 years old. The therapy by methotrexate was provided in 111 patients, among them 30 had methotrexate with immunobiological therapy (29 adalimumab, 1 – tocilizumab), 6 – sulfasalazine. The disease duration due to disease subtype was in children with polyarthritis – (49,2±6,7), oligoarthritis – (35,4±4,2), uveitis-associated subtypes of juvenile idiopathic arthritis – (76,8±10,2) months. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score 27-joint reduced count questionnaire, functional state according to he Child Health Assessment Questionnaire and quality of life according to PedsQLTM 4.0 Generic Core Scales. Results. It was found that high juvenile idiopathic arthritis activity was observed in 31 (26.2%) patients, equally often in all subgroups of children. Index functional state did not show a significant decrease either in the whole group or in each of the arthritis subgroups. The overall indicator of quality of life in children with juvenile idiopathic arthritis was reduced in the whole group (71.2±1.4 and 72.9±1.4 per week and month). There was no significant difference between the quality of life indicators of boys and girls. at the same time, physical activity indicators were the lowest in the group with polyarticular juvenile idiopathic arthritis, regardless of gender and age of children, and especially low in children with polyarthritis in the first year of the disease. They also turned out to be worse in children with uveitis-associated subtypes of juvenile idiopathic arthritis with the disease from one to three years. The highest level of the physical component of quality of life was observed in children with oligoarthritis older than 14 years and in children under 8 years of age in the uveitis-associated subtypes of juvenile idiopathic arthritis group. There was no significant effect on the physical indicators of quality of life of the start treatment timing. (р≤0,05). Conclusions. A decrease in quality of life and its physical component is typical for children with different types of juvenile idiopathic arthriti (oligoarticular, polyarticular, and uveitis-associated subtypes of juvenile idiopathic arthritis). It has been established that children with polyarticular subtype of arthritis have the greatest decrease in quality of life and physical functioning.
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