Objective: To carry out the first systematic review of the evidence base for lifestyle planning (LP) approaches in adults with learning disability/developmental disorder and to discuss implications for other handicapped/disabled groups.
Method: Exhaustive review of relevant electronic databases, supplemented by appropriate hand-searching of journals and correspondence with key researchers. We gathered information from any papers reporting clear outcome measures. Quantitative and qualitative aspects of relevant studies are appraised.
Results: There are no randomized controlled trials of lifestyle planning in adults with learning disability/developmental disorder. There was one controlled trial. Five studies, with a total of 108 subjects clearly identified, report on some outcome data.
Conclusions: There is surprisingly little evidence to support any form of lifestyle planning or lifestyle planning in general in the learning disability population. No statistically significant findings on positive outcomes with good statistical power exist. Limited data are presented to suggest certain desirable features of some methods of lifestyle planning in terms of process or outcome. However, there may be good ethical reasons for pursuing lifestyle planning with certain patient groups. Suggestions are made as to how further research may add to the evidence base for or against effective outcomes in different forms of lifestyle planning.
Get full access to this article
View all access options for this article.
References
1.
Racino JA, Williams JM. Living in the community: an examination of the philosophical and practical aspects. J Head Trauma Rehabil1994; 9: 35–48.
2.
World Health Organization. ICD-10 Classification of mental and behavioural disorders. Geneva: WHO, 1992.
3.
Brechin A, Swain J. Changing relationships – shared action planning with people with a mental handicap. London: Harper & Row, 1987.
4.
Thornicroft G. The concept of case management for long-term mental illness. Int Rev Psychiatry1991; 3: 125–132.
5.
Gardner J. Interdisciplinary team process and individualized program planning. In: Gardner J ed. Program issues in developmental disabilities. Baltimore: Paul Brooks, 1980: 107–125.
6.
Smull M, Burke-Harrison S. Supporting people with severe reputations in the community. Virginia: National Association of State Directors of Developmental Disabilities Services Inc., 1992.
7.
Mount B. Personal futures planning: finding directions for change. Unpublished DPA dissertation, University of Georgia, 1987.
8.
Yates J. Program design sessions. Stoughton, MA, 1980.
9.
Pearpoint J, O'Brien J, Forest M. PATH: a workbook for planning positive possible futures. Toronto: Inclusion Press, 1991.
10.
Vandercook T, York J. The McGill Action Planning System (M.A.P.S.): a strategy for building vision. J Assoc Severely Handicapped1989. 14: 205–215.
11.
WHO Scientific Group on Treatment of Psychiatric Disorders. Evaluation of methods for the treatment of mental disorders. Geneva: World Health Organization, 1991.
12.
Factor A, Sutton E, Heller T, Sterns H. Impact of person-centred later life planning training program for older adults with mental retardation. J Rehabil1996; 62, 77–83.
13.
Sanderson H. Essential lifestyle planning. BILD Bull1997; 104-104.
14.
Higgins R, Richardson A. Mix and Match. Health Serv J1994; 18August: 24–26.
15.
Shiell A, Wright K, Pettipher C, Raynes N. Resource management in community residential facilities for adults with learning disabilities. Health Serv Manage Res1992; 5: 208–215.
16.
Dagnan D, Look R, Trowe, P, Dennis S. An evaluation of joint training for staff and clients in shared action planning in Solihull. Br J Learning Disabil1995; 23: 98–101.
17.
Beauchamp TL, Childress JE. Principles of biomedical ethics, second edition. Oxford: Oxford University Press, 1983.
18.
Gillon R. Philosophical medical ethics. London: BMJ, 1991.
19.
Marshall M, Lockwood A, Gath D. Social Services case-management for long-term mental disorders: a randomised controlled trial. The Lancet1995; 345: 409–412.
20.
Editorial. Care-management: a disastrous mistake. The Lancet1995; 345: 399–401.
21.
O'Brien CL, O'Brien J, Mount B. Person Centred Planning has arrived... or has it?Ment Retard1997; December: 480–483.
22.
Greasley P. Individual planning with adults who have learning difficulties: key issues–key sources. Disabil Society1995; 10: 353–363.
23.
Carnaby S. What do you think?: a qualitative approach to evaluating individual planning services. J Intellect Disabil Res1997; 41: 225–231.
