1
|
Gilliand M, Perrenoud B, Lecerf T, Serex M, Breaud A, Larkin P. Behavioral pain indicators for adults with an intellectual disability: a scoping review protocol. JBI Evid Synth 2023; 21:254-263. [PMID: 36000781 PMCID: PMC10467817 DOI: 10.11124/jbies-21-00434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This scoping review aims to identify and map the behavioral pain indicators observed when adults with an intellectual disability experience pain. INTRODUCTION Adults with an intellectual disability have more health problems than the general population. The likelihood that this population will experience pain is high, but intellectual disability can obstruct the verbal expression of pain. Adults with an intellectual disability express pain via behavioral pain indicators; however, because no behavioral pain scale exists for this population, observers may misinterpret the pain experienced by adults with an intellectual disability. INCLUSION CRITERIA The review will examine literature about behavioral pain indicators for adults with any type of intellectual disability who are suffering from any type of pain in any country or care setting. METHODS The review will be conducted according to the JBI recommendations for scoping reviews. A preliminary search focusing on the concepts of intellectual disability and pain measurement was conducted for PubMed and CINAHL in March 2022. Once the protocol is validated, searches will also be carried out in Embase, JBI EBP Database, the Cochrane Database of Systematic Reviews, ProQuest Dissertations and Theses, PsycINFO, Web of Science Core Collection, ERIC, Google Scholar, MedNar, and the websites of relevant professional associations. Titles and abstracts, and then full-text studies, will be selected independently by 2 researchers and assessed against the inclusion criteria. Relevant information will be imported into a data chart. Any behavioral pain indicators identified will be classified into 14 behavioral categories. REVIEW REGISTRATION NUMBER Open Science Framework osf.io/8xckf.
Collapse
Affiliation(s)
- Morgane Gilliand
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Béatrice Perrenoud
- Bureau d’Echange des Savoirs pour des praTiques exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
- Lausanne University Hospital (CHUV), Lausanne, Switzerland
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Thierry Lecerf
- Faculty of Psychology and Educational Sciences, Geneva University, Geneva, Switzerland
| | - Magali Serex
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Anne Breaud
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Philip Larkin
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland
- Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
2
|
|
3
|
Reppermund S, Srasuebkul P, Dean K, Trollor JN. Factors associated with death in people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 33:420-429. [DOI: 10.1111/jar.12684] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 10/09/2019] [Accepted: 10/24/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Simone Reppermund
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing School of Psychiatry UNSW Sydney Sydney NSW Australia
| | - Preeyaporn Srasuebkul
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
| | - Kimberlie Dean
- School of Psychiatry UNSW Sydney Sydney NSW Australia
- Justice Health & Forensic Mental Health Network Sydney NSW Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry School of Psychiatry UNSW Sydney Sydney NSW Australia
- Centre for Healthy Brain Ageing School of Psychiatry UNSW Sydney Sydney NSW Australia
| |
Collapse
|
4
|
Dahm MR, Georgiou A, Bryant L, Hemsley B. Information infrastructure and quality person-centred support in supported accommodation: An integrative review. PATIENT EDUCATION AND COUNSELING 2019; 102:1413-1426. [PMID: 31010602 DOI: 10.1016/j.pec.2019.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/11/2019] [Accepted: 03/16/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To integrate findings on the information infrastructure for people with intellectual or developmental disability (I/DD) living in supported accommodation, to understand how documentation use impacts person-centred support. METHODS We conducted an integrative literature review. Following screening by two independent reviewers, we included English language peer-reviewed empirical studies (n = 34) on documentation use for people with I/DD in domestic-scale supported accommodation. We appraised quality and extracted information for iterative comparative thematic and content analysis. RESULT All studies reported written documentation regarding either the person with disability or the residence. Eighteen studies focused on health-specific information. We identified three key themes impacting on the person-centred support; 1) level of inclusion and independence of people with I/DD, 2) the culture of support within group homes, and 3) the quality use of information. CONCLUSIONS Information infrastructure is closely aligned with the support culture in residences and can affect whether and to what extent key stakeholders (i.e., people with I/DD, family members) are involved in making decisions about healthcare and support needs. PRACTICE IMPLICATIONS Surveying local service health information infrastructure can provide crucial insights which can be leveraged to improve the safety and quality of supports provided for people living in supported accommodation.
Collapse
Affiliation(s)
- Maria R Dahm
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Andrew Georgiou
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Lucy Bryant
- Graduate School of Health, University of Technology, Sydney, Australia.
| | - Bronwyn Hemsley
- Graduate School of Health, University of Technology, Sydney, Australia.
| |
Collapse
|
5
|
Dahm MR, Georgiou A, Balandin S, Hill S, Hemsley B. Health Information Infrastructure for People with Intellectual and Developmental Disabilities (I/DD) Living in Supported Accommodation: Communication, Co-Ordination and Integration of Health Information. HEALTH COMMUNICATION 2019; 34:91-99. [PMID: 29068261 DOI: 10.1080/10410236.2017.1384431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
People with intellectual and/or developmental disability (I/DD) commonly have complex health care needs, but little is known about how their health information is managed in supported accommodation, and across health services providers. This study aimed to describe the current health information infrastructure (i.e., how data and information are collected, stored, communicated, and used) for people with I/DD living in supported accommodation in Australia. It involved a scoping review and synthesis of research, policies, and health documents relevant in this setting. Iterative database and hand searches were conducted across peer-reviewed articles internationally in English and grey literature in Australia (New South Wales) up to September 2015. Data were extracted from the selected relevant literature and analyzed for content themes. Expert stakeholders were consulted to verify the authors' interpretations of the information and content categories. The included 286 sources (peer-reviewed n = 27; grey literature n = 259) reflect that the health information for people with I/DD in supported accommodation is poorly communicated, coordinated and integrated across isolated systems. 'Work-as-imagined' as outlined in policies, does not align with 'work-as-done' in reality. This gap threatens the quality of care and safety of people with I/DD in these settings. The effectiveness of the health information infrastructure and services for people with I/DD can be improved by integrating the information sources and placing people with I/DD and their supporters at the centre of the information exchange process.
Collapse
Affiliation(s)
- Maria R Dahm
- a Centre for Health Systems and Safety Research, Australian Institute of Health Innovation , Macquarie University
| | - Andrew Georgiou
- a Centre for Health Systems and Safety Research, Australian Institute of Health Innovation , Macquarie University
| | - Susan Balandin
- b School of Health and Social Development , Faculty of Health, Deakin University
| | - Sophie Hill
- c Centre for Health Communication and Participation, School of Psychology and Public Health , La Trobe University
| | - Bronwyn Hemsley
- d School of Humanities and Social Science, Faculty of Education and Arts , The University of Newcastle
| |
Collapse
|
6
|
Wallace RA. National Disability Insurance Scheme, health, hospitals and adults with intellectual disability. Intern Med J 2018; 48:351-359. [PMID: 29512328 DOI: 10.1111/imj.13671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 10/08/2017] [Accepted: 10/08/2017] [Indexed: 11/28/2022]
Abstract
Preventable poor health outcomes for adults with intellectual disability in health settings have been known about for years. Subsequent analysis and the sorts of reasonable adjustments required in health and disability support settings to address these health gaps are well described, but have not really been embedded in practice in any significant way in either setting. As far as health is concerned, implementation of the National Disability Insurance Scheme (NDIS, the Scheme) affords an opportunity to recognise individual needs of people with intellectual disability to provide reasonable and necessary functional support for access to mainstream health services, to build capacity of mainstream health providers to supply services and to increase individual capacity to access services. Together these strands have potential to transform health outcomes. Success of the Scheme, however, rests on as yet incompletely defined operational interaction between NDIS and mainstream health services and inherently involves the disability sector. This interaction is especially relevant for adults with intellectual disability, known high users of hospitals and for whom hospital outcomes are particularly poor and preventable. Keys to better hospital outcomes are first, the receiving of quality person-centred healthcare from physicians and hospitals taking into account significance of intellectual disability and second, formulation of organised quality functional supports during hospitalisation. Achieving these require sophisticated engagement between consumers, the National Disability Insurance Agency, Commonwealth, State and Territory government leaders, senior hospital and disability administrators, NDIS service providers and clinicians and involves cross fertilisation of values, sharing of operational policies and procedures, determination of boundaries of fiscal responsibility for functional supports in hospital.
Collapse
Affiliation(s)
- Robyn A Wallace
- Calvary Health Care Tasmania, Hobart, Tasmania, Australia.,St Helen's Private Hospital, Hobart, Tasmania, Australia.,School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| |
Collapse
|
7
|
Ndengeyingoma A, Ruel J. Nurses’ representations of caring for intellectually disabled patients and perceived needs to ensure quality care. J Clin Nurs 2016; 25:3199-3208. [DOI: 10.1111/jocn.13338] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Assumpta Ndengeyingoma
- Department of Nursing; Université du Québec en Outaouais (University of Quebec in Outaouais); Gatineau QC Canada
| | - Julie Ruel
- Department of Education; Université du Québec en Outaouais (University of Quebec in Outaouais); Gatineau QC Canada
| |
Collapse
|
8
|
Hemsley B, Georgiou A, Carter R, Hill S, Higgins I, van Vliet P, Balandin S. Use of the My Health Record by people with communication disability in Australia: A review to inform the design and direction of future research. Health Inf Manag 2016; 45:107-115. [PMID: 27269277 DOI: 10.1177/1833358316652060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND People with communication disability often struggle to convey their health information to multiple service providers and are at increased risk of adverse health outcomes related to the poor exchange of health information. OBJECTIVE The purpose of this article was to (a) review the literature informing future research on the Australian personally controlled electronic health record, 'My Health Record' (MyHR), specifically to include people with communication disability and their family members or service providers, and (b) to propose a range of suitable methodologies that might be applied in research to inform training, policy and practice in relation to supporting people with communication disability and their representatives to engage in using MyHR. METHOD The authors reviewed the literature and, with a cross-disciplinary perspective, considered ways to apply sociotechnical, health informatics, and inclusive methodologies to research on MyHR use by adults with communication disability. RESEARCH OUTCOMES This article outlines a range of research methods suitable for investigating the use of MyHR by people who have communication disability associated with a range of acquired or lifelong health conditions, and their family members, and direct support workers. CONCLUSION In planning the allocation of funds towards the health and well-being of adults with disabilities, both disability and health service providers must consider the supports needed for people with communication disability to use MyHR. There is an urgent need to focus research efforts on MyHR in populations with communication disability, who struggle to communicate their health information across multiple health and disability service providers. The design of studies and priorities for future research should be set in consultation with people with communication disability and their representatives.
Collapse
|
9
|
Hemsley B, Georgiou A, Hill S, Rollo M, Steel J, Balandin S. An integrative review of patient safety in studies on the care and safety of patients with communication disabilities in hospital. PATIENT EDUCATION AND COUNSELING 2016; 99:501-511. [PMID: 26566195 DOI: 10.1016/j.pec.2015.10.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/29/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To review the research literature on the experiences of patients with communication disabilities in hospital according to the Generic Model of patient safety. METHODS In 2014 and 2015, we searched four scientific databases for studies with an aim or result relevant to safety of hospital patients with communication disabilities. The review included 27 studies. RESULTS A range of adverse event types were outlined in qualitative research. Little detail was provided about contributing or protective factors for safety incidents in hospital for these patients or the impact of the incidents on the patient or organisations involved. CONCLUSION Further research addressing the safety of patients with communication disabilities is needed. Sufficient detail is required to identify the nature, timing, and detection of incidents; factors that contribute to or prevent adverse events; and detail the impact of the adverse events. PRACTICE IMPLICATIONS In order to provide safe and effective care to people with communication disabilities in hospital, a priority for health and disability services must be the design and evaluation of ecologically appropriate and evidence-based interventions to improve patient care, communication, and reduce the risk of costly and harmful patient safety incidents.
Collapse
Affiliation(s)
- Bronwyn Hemsley
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia.
| | - Andrew Georgiou
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Sophie Hill
- Department of Public Health, La Trobe University, Australia
| | - Megan Rollo
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia
| | - Joanne Steel
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia
| | - Susan Balandin
- Faculty of Health, Deakin University, Melbourne, Australia
| |
Collapse
|
10
|
Schoufour JD, Echteld MA, Bastiaanse LP, Evenhuis HM. The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:39-47. [PMID: 25576875 DOI: 10.1016/j.ridd.2014.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 12/01/2014] [Accepted: 12/03/2014] [Indexed: 05/17/2023]
Abstract
Frailty in older people can be seen as the increased likelihood of future negative health outcomes. Lifelong disabilities in people with intellectual disabilities (ID) may not only influence their frailty status but also the consequences. Here, we report the relation between frailty and adverse health outcomes in older people with ID (50 years and over). In a prospective population based study, frailty was measured at baseline with a frailty index in 982 older adults with ID (≥50 yr). Information on negative health outcomes (falls, fractures, hospitalization, increased medication use, and comorbid conditions) was collected at baseline and after a three-year follow-up period. Odds ratios or regression coefficients for negative health outcomes were estimated with the frailty index, adjusted for gender, age, level of ID, Down syndrome and baseline adverse health condition. The frailty index was related to an increased risk of higher medication use and several comorbid conditions, but not to falls, fractures and hospitalization. Frailty at baseline was related to negative health outcomes three years later in older people with ID, but to a lesser extent than found in the general population.
Collapse
Affiliation(s)
- Josje D Schoufour
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Michael A Echteld
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Luc P Bastiaanse
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Ipse de Bruggen, P.O. Box 2027, 2470 AA Zwammerdam, The Netherlands.
| | - Heleen M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| |
Collapse
|
11
|
Howlett S, Florio T, Xu H, Trollor J. Ambulatory mental health data demonstrates the high needs of people with an intellectual disability: results from the New South Wales intellectual disability and mental health data linkage project. Aust N Z J Psychiatry 2015; 49:137-44. [PMID: 24913247 DOI: 10.1177/0004867414536933] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the ambulatory mental health service profile of persons with intellectual disability (ID) in a representative sample of New South Wales (NSW). METHODS A statistical linkage key was used to link the Disability Services Minimum Data Set (DS-MDS) and a community mental health services dataset (MH-COM) for a representative area of NSW for the period 2005-2010. Linkage was undertaken in four NSW local health districts (LHDs), covering 36.7% of the NSW population. The mental health profiles and service use characteristics of people with an ID were compared to mental health service users without an ID. RESULTS Of the 89,262 people in the MH-COM over this 6-year period, 1,459 people (1.6 %) were identified as having an ID. Compared to those without an ID, people with an ID were more likely to have psychotic disorders, developmental disorders and personality disorders, and more than twice as likely to have an 'unknown' diagnosis. Compared to those without an ID, people with an ID were less likely to have depressive disorders, adjustment disorders and other disorders. Service use profiles revealed that people with an ID had 1.6 times more face-to-face contacts, and a total face-to-face contact time which was 2.5 times longer than people without an ID. CONCLUSIONS Ambulatory mental health data from NSW indicates that people with an ID receive care for a distinct range of mental disorders, and experience uncertainty regarding their diagnosis. People with an ID have higher service needs which require recognition and the allocation of specific resources. Such data provide a suitable baseline for future evaluation of the impact of ambulatory mental health reforms for people with an ID.
Collapse
Affiliation(s)
- Sophie Howlett
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Tony Florio
- South Eastern Sydney Local Health District, Sydney, Australia
| | - Han Xu
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, The University of New South Wales, Sydney, Australia
| |
Collapse
|
12
|
Evans E, Bhardwaj A, Brodaty H, Sachdev P, Draper B, Trollor JN. Dementia in people with intellectual disability: insights and challenges in epidemiological research with an at-risk population. Int Rev Psychiatry 2013; 25:755-63. [PMID: 24423228 DOI: 10.3109/09540261.2013.866938] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The population with intellectual disability (ID) is ageing, but age-related health concerns such as dementia have received little research attention thus far. We review evidence regarding the prevalence and incidence of dementia in people with ID, and discuss some possible explanations for an increased risk, such as shared genetic risk factors, co-morbid physical and mental disorders, lifestyle factors, trauma, and lowered brain reserve. We discuss practical and theoretical challenges facing researchers in this field, before highlighting the implications of findings to date for future research and clinical care. Research on dementia in this at-risk population has the potential to help us understand dementia in general and to improve services for this group of vulnerable individuals.
Collapse
Affiliation(s)
- Elizabeth Evans
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW
| | | | | | | | | | | |
Collapse
|
13
|
Taua C, Hepworth J, Neville C. Nurses' role in caring for people with a comorbidity of mental illness and intellectual disability: a literature review. Int J Ment Health Nurs 2012; 21:163-74. [PMID: 22034918 DOI: 10.1111/j.1447-0349.2011.00779.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article examines literature on the role of the nurse caring for people with a dual disability (DD) of intellectual disability and mental illness. A search of the literature between 2000 and 2010 resulted in a total of 21 articles that met the inclusion criteria. Seven key categories of the role of the nurse were identified: (i) advocacy/health promotion (including working with family); (ii) assessment/case management; (iii) behavioural interventions; (iv) communication; (v) leadership and the nurse's role within the multidisciplinary team; (vi) functions regarding medication administration; and (vii) safety/risk management. There is a paucity of research about the role of nurses working with people with DD, although a number of opinion-based articles exist. This article identifies a need for the role of the nurse working in DD to be more clearly articulated and for the development of evidence to guide best practice.
Collapse
Affiliation(s)
- Chris Taua
- School of Nursing and Midwifery, The University of Queensland, Brisbane, Queensland, Australia.
| | | | | |
Collapse
|
14
|
Hemsley B, Balandin S, Worrall L. Nursing the patient with developmental disability in hospital: roles of paid carers. QUALITATIVE HEALTH RESEARCH 2011; 21:1632-1642. [PMID: 21734223 DOI: 10.1177/1049732311415289] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Our aim in this narrative inquiry was to understand the roles of paid carers supporting adults with developmental disability and complex communication needs in hospital, from the perspectives of 15 paid carers, 15 adults with developmental disability, and 15 hospital nurses. Results demonstrated that paid carers have an important role in supporting the adult with disability, providing information, delivering basic care, and facilitating communication. Stories reflected paid carer volunteerism; lack of orientation of carers and hospital staff to the paid carers' roles; blurred role boundaries between paid carers, family carers, and nurses; and paid carers being uncertain about their own responsibilities for staff and patient safety. New policies and practice guidelines are needed to guide both health and disability services in clarifying paid carer roles and role boundaries, and to enable paid carers and hospital staff to work together effectively on the ward in the care of adults with developmental disability.
Collapse
Affiliation(s)
- Bronwyn Hemsley
- School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia.
| | | | | |
Collapse
|
15
|
Lee L, Rianto J, Raykar V, Creasey H, Waite L, Berry A, Xu J, Chenoweth B, Kavanagh S, Naganathan V. Health and functional status of adults with intellectual disability referred to the specialist health care setting: a five-year experience. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2011; 2011:312492. [PMID: 22295183 PMCID: PMC3263836 DOI: 10.1155/2011/312492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 06/16/2011] [Accepted: 08/09/2011] [Indexed: 05/23/2023]
Abstract
Aims and Method. The Developmental Disability Database in the Department of Rehabilitation Medicine at a metropolitan hospital was audited for observations on adults with Intellectual Disability living in the local region (total population 180,000) who were seen in an identified multidisciplinary specialist clinic, during 2006-2010. Results. There were 162 people (representing half the known number of adults with Intellectual Disability living in the region): 77 females, 85 males, age range 16-86 years. The most common complex disabilities referred to the specialists in this clinic were epilepsy (52%), challenging or changing behavior (42%) and movement disorders (34%). Early onset dementia was a feature of the group (7%). The prevalence of prescription of medications for gastro-oesophageal reflux was high (36%) and similar to the numbers of people taking psychotropic medications. The rates of chronic cardiovascular disease (2%), chronic respiratory disease (10%) and generalised arthritis (11%) were low overall, but did rise with increasing age. Conclusions. Complex neurological disabilities are common, and chronic medical illnesses are uncommon in adults with Intellectual Disability referred to specialist clinicians in this region. A combined, coordinated, multidisciplinary clinic model addresses some of the barriers experienced by adults with Intellectual Disability in the secondary health system.
Collapse
Affiliation(s)
- L. Lee
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
- Developmental Assessment Service, St. George Hospital, Kogarah, NSW 2217, Australia
| | - J. Rianto
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
- Developmental Assessment Service, St. George Hospital, Kogarah, NSW 2217, Australia
| | - V. Raykar
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
| | - H. Creasey
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
| | - L. Waite
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
| | - A. Berry
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
- Developmental Assessment Service, St. George Hospital, Kogarah, NSW 2217, Australia
| | - J. Xu
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
| | - B. Chenoweth
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
- Developmental Assessment Service, St. George Hospital, Kogarah, NSW 2217, Australia
| | - S. Kavanagh
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
- Developmental Assessment Service, St. George Hospital, Kogarah, NSW 2217, Australia
| | - V. Naganathan
- Centre for Education and Research on Ageing, Concord Hospital and Sydney University, Concord, NSW 2139, Australia
| |
Collapse
|
16
|
Webber R, Bowers B, Bigby C. Hospital experiences of older people with intellectual disability: responses of group home staff and family members. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2010; 35:155-164. [PMID: 20695830 DOI: 10.3109/13668250.2010.491071] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND This study reports on the hospitalisation experiences of older adults with intellectual disability living in group homes. METHODS Grounded dimensional analysis was used to guide data collection and analysis. Group home residents were tracked prospectively over a 3-year period. Interviews were conducted with family, group home, and aged care staff and managers, and some residents. RESULTS Findings highlighted the difficulty people with intellectual disability experience in hospital settings. Findings revealed extensive strategies undertaken by family members and group home staff to improve hospital experiences. Ageing of the family members and staffing implications for group homes complicated efforts to improve hospital experiences. CONCLUSIONS The current absence of systems to accommodate the special needs of people with intellectual disability in hospital settings has significant consequences for group homes, family members, hospital staff, and residents. Most hospital systems appear to be poorly designed to care for this vulnerable population.
Collapse
Affiliation(s)
- Ruth Webber
- Quality of Life and Social Justice Research Centre, Australian Catholic University, Victoria, Australia.
| | | | | |
Collapse
|
17
|
Kerr M. Commentary on: "On the need for a specialist service within the generic hospital setting" by Robyn A. Wallace and Helen Beange (2008). JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2008; 33:365-369. [PMID: 18728926 DOI: 10.1080/13668250802259637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Michael Kerr
- Welsh Centre for Learning Disabilities, School of Medicine, Cardiff University, Wales, UK.
| |
Collapse
|
18
|
O'Hara D. Invited commentary on Wallace and Beange (2008): "On the need for a specialist service within the generic hospital setting". JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2008; 33:362-369. [PMID: 18728927 DOI: 10.1080/13668250802259645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- David O'Hara
- Westchester Institute for Human Development, Valhalla, NY 10595, USA.
| |
Collapse
|