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Rousseau MC, Hamouda I, Aim MA, Anzola AB, Maincent K, Lind K, Felce A, Auquier P, De Villemeur TB, Baumstarck K. Health status of individuals with polyhandicap across a 5-year follow-up period. Sci Rep 2024; 14:23197. [PMID: 39369038 PMCID: PMC11455907 DOI: 10.1038/s41598-024-74102-3] [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] [Received: 11/06/2023] [Accepted: 09/23/2024] [Indexed: 10/07/2024] Open
Abstract
The present longitudinal study examined a large sample of individuals with PIMD/Polyhandicap to: (i) describe the evolution over time of the health status in terms of severity, (ii) identify the potential predictors of health status change. This study used the data of the French national EVAL-PLH cohort. Inclusion criteria were: individuals with PIMD/Polyhandicap; age > 3 years at the time of inclusion; age at onset of cerebral lesion younger than 3 years old. The definition of the change in health status over the 5-year period was derived from the Polyhandicap Severity Scale. Among the 875 individuals included in 2015-2016, 492 (56.2%) individuals were assessed in 2020-2021. According to the definition, 68.8% (n = 309), 64.7% (n = 310), and 80.2% (n = 368) of the individuals presented with a worsened or stable severity status based on the global score, the abilities score, and the comorbidities score, respectively. Compared with the individuals with a non-worsened health status (global score), the individuals with a stable or worsened health status were more likely to receive care in specialized rehabilitation centres, more likely to have an antenatal or progressive aetiology, and more likely to have a higher dependency level. The current study provides a robust perspective of the worsened health among persons with PIMD/Polyhandicap over time.
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Affiliation(s)
- Marie-Christine Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap, San Salvadour Hospital, University Hospital of Paris, 4312 Rte de l'Almanarre, Hyères, France
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Ilyes Hamouda
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Marie-Anastasie Aim
- UR 849, LPS - Social Psychology Laboratory, Aix-Marseille University, 29 Av. Robert Schuman, Aix-en-Provence, France
| | - Any Beltran Anzola
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Kim Maincent
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées, CESAP, 62 Rue de La Glacière, Paris, France
| | - Katia Lind
- Union Générale Caisse Assurance Maladie (UGECAM), 26-50 Avenue du Professeur-André-Lemierre, Paris, Ile de France, France
| | - Agnès Felce
- Hôpital Marin d'Hendaye, route Corniche, Hendaye, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pascal Auquier
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France
| | - Thierry Billette De Villemeur
- Clinical Research Group GRC ConCer-LD, Sorbonne University & Pierre-et-Marie-Curie University, 4, Place Jussieu, Paris, France
- Department of Neuropediatrics Armand-Trousseau Hospital, 26 Av. du Dr Arnold Netter, Paris, France
| | - Karine Baumstarck
- EA 3279, CEReSS - Research Centre on Health Services and Quality of Life, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France.
- Epidemiology and Health Economy Department, Aix Marseille University, 27, Boulevard Jean-Moulin, Marseille, France.
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2
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Long C, Plenn E, Acri S, Richardson C. The Impact of Living Situation on Healthcare Encounters for Individuals With Intellectual Disability. Cureus 2023; 15:e51156. [PMID: 38283523 PMCID: PMC10811741 DOI: 10.7759/cureus.51156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The living situation of individuals with intellectual disabilities (ID) has evolved throughout the years and ranges from living at home with family caregivers to group homes to independent living arrangements. Living situations can affect access to care and thus healthcare utilization seen by healthcare encounters for individuals with ID. Methods The researchers conducted a chart review of 112 patients to assess demographics, living situations, and healthcare encounters between 2019 and 2021. Living situation categories included independent, biological family, group home, home with other support, and others. Statistical analyses were conducted using R version 4.2.1 (The R Foundation for Statistical Computing, Vienna, Austria). Univariable analyses consisted of the Shapiro-Wilk test of normality, Kruskal-Wallis rank sum test, and pairwise Wilcoxon rank sum test with multiple comparisons correction using the Bonferroni method. Statistical testing for multivariable analysis included the Kruskal-Wallis rank sum test, Spearman's rank correlation, and the negative binomial model. Results Results showed a statistically significant difference in median total encounter value between independently living individuals with ID compared to all other living situations, Χ2 = 4.230, df = 1, p-value = 0.040. Additionally, there is a significant association between medication count and total encounter count, rho = 0.341, S = 154322, p-value < 0.001. Conclusion The study showed that individuals with ID who live independently have fewer healthcare encounters compared to all other living situations. This may be due to various factors such as increased autonomy and free choice, increased barriers to healthcare, or better overall health requiring less medical attention in independently living individuals with ID.
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Affiliation(s)
- Calista Long
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Eion Plenn
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Samantha Acri
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
| | - Cheryl Richardson
- Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA
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Gómez LE, Morán ML, Solís P, Pérez‐Curiel P, Monsalve A, Navas P. Health care for people with intellectual disability in Spain. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2023. [DOI: 10.1111/jppi.12455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- L. E. Gómez
- Department of Psychology University of Oviedo Oviedo Spain
| | - M. L. Morán
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Solís
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Pérez‐Curiel
- Department of Psychology and Sociology University of Zaragoza Zaragoza Spain
| | - A. Monsalve
- Department of Psychology University of Oviedo Oviedo Spain
| | - P. Navas
- INICO, Department of Personality, Assessment & Psychological Treatments University of Salamanca Salamanca Spain
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Park SM, Kim SY, Yeob KE, Shin DW, Han JH, Park JH, Park JH. Disparities in the Diagnosis and Treatment of Bile Duct Cancer in People with Disabilities: A National Cohort Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16625. [PMID: 36554502 PMCID: PMC9779117 DOI: 10.3390/ijerph192416625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
We aimed to evaluate the impacts of disability on the diagnosis, treatment, and prognosis of bile duct cancer (BDC) according to the severity and type of disability. Patients diagnosed with BDC were selected from an age- and sex-matched population (1:3 ratio) with or without disabilities from the National Disability Database, the Korean Central Cancer Registry, and the Korean National Health Insurance claims database. The cohort included 15,065 patients with BDC, with a significantly lower rate in those with severe disabilities than in people without or with mild disabilities (110.6 vs. 136.5 vs. 147.6 per 105 persons, respectively). People with severe disabilities were diagnosed with BDC at an earlier age but were less likely to undergo surgery (adjusted odds ratio (aOR) = 0.52, 95% confidence interval (CI): 0.45-0.61) or chemotherapy (aOR = 0.76, 95% CI: 0.61-0.95) compared to those without disabilities. This trend was more evident in patients with mental disabilities. The overall and cancer-specific mortality rates were higher in patients (especially women) with disabilities than in those without. There needs systemic approach to ensure equal access to quality cancer care for people with disabilities.
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Affiliation(s)
- Seon Mee Park
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
- Division of Gastroenterology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - So Young Kim
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, Korea
| | - Kyoung Eun Yeob
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, Korea
| | - Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul 06351, Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 03063, Korea
| | - Joung-Ho Han
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
- Division of Gastroenterology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju 28644, Korea
| | - Jong Heon Park
- Big Data Steering Department, National Health Insurance Service, Wonju 26464, Korea
| | - Jong Hyock Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju 28644, Korea
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Bernal-Celestino RJ, León-Martín A, Martín-López MM, Ruiz-García J, Muñoz-Romera S, Lozano-Diaz AI. Evaluating and Handling the Pain of People With Intellectual Disability. Pain Manag Nurs 2021; 23:311-317. [PMID: 34493439 DOI: 10.1016/j.pmn.2021.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 05/30/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
Anecdotal reports have suggested people with intellectual disabilities experience more pain than the general population due to additional co-morbidities and secondary conditions. This multicenter comparative cross-sectional study aimed to evaluate the prevalence, factors, and treatment modalities in people with intellectual disabilities (PID) as observed by their caregivers and reported through distributed questionnaires. The study sample included 130 PID users of centers in Ciudad Real (Spain). Variables related to sociodemographic characteristics, health problems, problem behaviors, and pain were collected. Among participants, 78 (60%) of PID were males, and their mean age was 43.8 years (SD = 13.57). Pain was identified in 29 PID (22.3%; 95% confidence interval [CI] 14.99-29.81), and drugs for pain were administered to 33 PID (26.4%; 95%CI 19-34). The prevalence of pain in the sampled PID, its severity, and the analgesic administration rate were lower than those in the general population. This situation may be aggravated for PID with communication problems.
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Affiliation(s)
- Rubén J Bernal-Celestino
- Gerencia de Atención Integrada de Ciudad Real, Supervisor of the Teaching and Training Research Area, Ciudad Real, Spain.
| | - Alberto León-Martín
- Public Health Technician, Quality Unit, Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, Spain
| | - María Mairena Martín-López
- Professor, Department of Inorganic and Organic Biochemistry, Faculty of Chemistry, Regional Center for Biomedical Research, University of Castilla, La Mancha, Spain
| | - Jacinto Ruiz-García
- Mental Health Nursing Supervisor, Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, Spain
| | - Silvia Muñoz-Romera
- Mental Health Specialist. Residential Center for People with Intellectual Disabilities, "Guadiana" Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, Spain
| | - Ana Isabel Lozano-Diaz
- Mental Health Specialist. Residential Center for People with Intellectual Disabilities, "Guadiana" Gerencia de Atención Integrada de Ciudad Real, Ciudad Real, Spain
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Rousseau M, Dagois J, Lausecker C, Humbertclaude E, Dominique A, Hamouda I, Auquier P, Billette de Villemeur T, Baumstarck K. Healthcare of Persons With Complex Developmental Disabilities From Three European Experiences: France, Italy, and Norway. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Marie‐Christine Rousseau
- Fédération des Hôpitaux de Polyhandicap et Multihandicap Hôpital San Salvadour Assistance Publique Hôpitaux de Paris France
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Jean‐Francois Dagois
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées Paris France
| | - Claire Lausecker
- Comité d'Études, d'Éducation et de Soins Auprès des Personnes Polyhandicapées Paris France
| | - Eric Humbertclaude
- Fédération du polyhandicap de l'Assistance Publique des Hôpitaux de Paris France
| | - Alain Dominique
- Fédération des Hôpitaux de Polyhandicap et Multihandicap Hôpital San Salvadour Assistance Publique Hôpitaux de Paris France
| | - Ilyes Hamouda
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Pascal Auquier
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
| | - Thierry Billette de Villemeur
- UPMC, GRC ConCer‐LD and AP‐HP, Hôpital Trousseau, Service de Neuropédiatrie ‐ Pathologie du développement Sorbonne Université Paris France
- Centre de référence des déficits intellectuels de causes rares, Inserm U 1141 France
- Hôpital de La Roche Guyon, Service de Polyhandicap Pédiatrique Assistance Publique Hôpitaux de Paris France
| | - Karine Baumstarck
- EA 3279, Self‐perceived Health Assessment Research Unit, School of Medicine Aix Marseille Université Marseille France
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7
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Serra P, Costa R, Almeida N, Baptista A. Visual Status in a Portuguese Population with Intellectual Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217715. [PMID: 33105693 PMCID: PMC7672629 DOI: 10.3390/ijerph17217715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Neurosensory deprivation associated with vision is a well-known fact in people with intellectual disability (ID). This work aims to report the visual status of a population with ID in Portugal. METHODS A vision screening protocol was conducted during two Special Olympics events. The vision protocol included personal medical history, ocular health evaluation, and clinical measures, such as visual acuity (VA), binocular vision, colour vision, refractive error, and intraocular pressure. This protocol was administered to 134 subjects. RESULTS Half of the subjects reported that they had never attended or they did not remember having attended a previous eye exam. Additionally, 10% of them had not attended an eye exam in the immediate past three years. Half the subjects failed the VA test and 13% presented moderate Visual Impairment (VI) (VA worse than 0.5 logMAR in the best eye). Manifest ocular deviation was found in 25% of the subjects and the most common ocular health dysfunction conditions were conjunctiva hyperaemia, meibomian gland dysfunction, and lens anomalies. Refractive error correction allowed a reduction in the level of moderate VI to 3.7%. CONCLUSIONS The population analysed showed a poor eye care attendance rate and vision-related conditions are in agreement with previous reports. The development of national strategies to promote the awareness for routine eye care in people with ID and improving accessibility to eye care services may mitigate many of the most prevalent conditions encountered.
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Affiliation(s)
- Pedro Serra
- Instituto Superior de Educação e Ciências, Alameda das Linhas de Torres, 1750-142 Lisboa, Portugal
| | - Regina Costa
- Novas Olimpiadas Especiais—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - Nuno Almeida
- Opening Eyes Portugal—Special Olympics Portugal, Rua Sítio do Casalinho da Ajuda, 1300-536 Lisboa, Portugal;
| | - António Baptista
- Centre of Physics, Campus Gualtar, School of Sciences, University of Minho, 4710-057 Braga, Portugal;
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8
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Chronic Health Conditions in Aging Individuals with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093126. [PMID: 32365862 PMCID: PMC7246565 DOI: 10.3390/ijerph17093126] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 12/21/2022]
Abstract
Life expectancy of people with intellectual disability (ID) has increased in recent decades. However, there is little evidence of whether these extra years of life are spent in good health. The aim of this study, conducted in Spain, is to obtain information about the prevalence of chronic health conditions in people with ID over the age of 44 and compare it with that of their peers without disability. Twenty health conditions were analyzed in 1040 people with ID and 12,172 people without ID through a study of their prevalence. The findings show that chronic constipation, urinary incontinence, thyroid disorders and obesity are the most prevalent chronic diseases among individuals with ID. In addition, this population group suffers these health conditions more frequently than older adults without ID. Detection and early intervention in these health conditions will improve adequate access to social health services and subsequent treatment of aging adults with ID.
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9
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Pharmacist interventions for persons with intellectual disabilities: A scoping review. Res Social Adm Pharm 2020; 17:257-272. [PMID: 32276871 DOI: 10.1016/j.sapharm.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/07/2020] [Accepted: 03/21/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Persons with intellectual disabilities (ID) often have complex health needs due to the development of multiple comorbidities. Given the higher associated use of problematic medications, such as antipsychotics, and polypharmacy, persons with ID may be particularly vulnerable to adverse side effects. With their medication expertise, pharmacists have the potential to address medication related challenges experienced by this population. OBJECTIVE Explore what is known about the care pharmacists provide to persons with ID. DESIGN Following Arksey and O'Malley's 5-stage framework for scoping reviews, searches of the PubMed (MEDLINE), Ovid EMBASE, Ovid International Pharmaceutical Abstracts, Scopus and APA PsycINFO databases were conducted in January 2019 with no limits on publication date. Studies of participants diagnosed with ID or healthcare providers/caregivers of persons with ID that referenced a pharmacist care intervention were included. Studies with non-human populations and editorials, commentaries, letters to the editor or discussion papers were excluded. RESULTS Twenty-six studies were included in the review. Seventy-six pharmacist care interventions were identified in cognitive pharmacy services (n = 46); educational and advisory services (n = 20); and medication prescription processing (n = 10). Fifty-one outcomes were referenced including drug-related interventions (n = 14), drug related problems (n = 9), cost/time-effectiveness (n = 7), secondary symptoms (n = 6), other outcomes (n = 5), general medication usage (n = 4), caregiver and healthcare team satisfaction levels (n = 3), and educational/knowledge (n = 3). CONCLUSION Pharmacists perform a variety of health care services to persons with ID but the impact of these interventions cannot be accurately measured due to a lack of: 1) universal definitions for ID; 2) reporting of multifactorial conditions contributing to a spectrum of ID severity; and 3) standardized reporting of ID-specific outcomes. Addressing these gaps is necessary for the development of a comprehensive evidence base regarding pharmacist involvement for medication challenges in persons with ID.
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Heutmekers M, Naaldenberg J, Verheggen SA, Assendelft WJJ, van Schrojenstein Lantman-de Valk HMJ, Tobi H, Leusink GL. Health problems of people with intellectual disabilities in Dutch out-of-hours primary care. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:475-481. [DOI: 10.1111/jar.12537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Marloes Heutmekers
- Department of Primary and Community Care; Radboud Institute for Health Sciences; Radboud University Medical Center; Nijmegen The Netherlands
| | - Jenneken Naaldenberg
- Department of Primary and Community Care; Radboud Institute for Health Sciences; Radboud University Medical Center; Nijmegen The Netherlands
| | - Sabine A. Verheggen
- General Practitioner Cooperative Nijmegen and Boxmeer; Nijmegen The Netherlands
| | - Willem J. J. Assendelft
- Department of Primary and Community Care; Radboud Institute for Health Sciences; Radboud University Medical Center; Nijmegen The Netherlands
| | | | - Hilde Tobi
- Biometris; Wageningen University and Research; Wageningen The Netherlands
| | - Geraline L. Leusink
- Department of Primary and Community Care; Radboud Institute for Health Sciences; Radboud University Medical Center; Nijmegen The Netherlands
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11
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Folch-Mas A, Cortés-Ruiz MJ, Salvador-Carulla L, Kazah-Soneyra N, Irazábal-Giménez M, Muñoz-Lorente S, Tamarit-Cuadrado J, Martínez-Leal R. [New considerations on the health of the persons with intellectual developmental disorders]. SALUD PUBLICA DE MEXICO 2018; 59:454-461. [PMID: 29211267 DOI: 10.21149/8201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/12/2017] [Indexed: 11/06/2022] Open
Abstract
Recent literature indicates that people with Disorders of Intellectual Development (DID) experience health disparities in the pathologies that they present, and a worst access to health care. However, current evidence-based knowledge is still sparse outside the Anglo-Saxon countries. The POMONA-I and POMONA-II European projects aimed to collect information on the health status of people with DID in Europe. The POMONA-ESP project in Spain is meant to collect health information in a wide and representative sample of persons with DID. Also, there are studies that claim for the need of specialized services for people with DID at the public health system. There are also studies about the current state of the education and training about DID for students within the health sector. In this paper we review the latest evidences about the health of the persons with DID and we present the main research activities and care initiatives about this issue.
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Affiliation(s)
- Anabel Folch-Mas
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain
| | - María José Cortés-Ruiz
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | | | - Natalia Kazah-Soneyra
- Parc Sanitari Sant Joan de Dèu. Barcelona, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | - Marcia Irazábal-Giménez
- Parc Sanitari Sant Joan de Dèu. Barcelona, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | | | | | - Rafael Martínez-Leal
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
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12
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Folch A, Martínez-Leal R, Vicens P, Irazábal M, Muñoz S, Salvador-Carulla L, Rovira L, Orejuela C, Cortés MJ. The POMONA-ESP project methodology: Collecting data on health indicators for people with intellectual developmental disorders. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:15-22. [PMID: 30009410 DOI: 10.1111/jar.12497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 05/24/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with intellectual developmental disorders have significant health disparities and a lack of proper attention to their health needs. They have been underrepresented in scientific research, and very few studies have been carried out using a representative randomized sample. The aim of this study was to describe the methods used in the POMONA-ESP project to recruit a representative and randomized sample of participants with intellectual developmental disorders. METHODS The POMONA-ESP project is an observational cross-sectional study. It aims to explore the health status of people with intellectual developmental disorders across Spain and the use they make of health services. RESULTS AND CONCLUSIONS The results of the POMONA-ESP project may have a major impact on people with intellectual developmental disorders and society in general. It is the first study to obtain geographically representative epidemiological data from a large sample, information that is fundamental to improving care and healthcare planning for people with intellectual developmental disorders.
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Affiliation(s)
- Annabel Folch
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) - Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Rafael Martínez-Leal
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) - Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain.,Centre of Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain
| | - Paloma Vicens
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain.,Research Center in Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Tarragona, Spain.,Laboratory of Toxicology and Environmental Health, Universitat Rovira i Virgili, Tarragona, Spain
| | - Marcia Irazábal
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.,Faculty of Education, Universitat de Barcelona, Barcelona, Spain
| | | | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Lluís Rovira
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) - Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Carmen Orejuela
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) - Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Maria José Cortés
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) - Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Spain.,Centre of Biomedical Research Network on Mental Health (CIBERSAM), Madrid, Spain
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Grey JM, Totsika V, Hastings RP. Living with family: perceptions of health and subjective well-being of adults with an intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:474-485. [PMID: 29479860 DOI: 10.1111/jir.12479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 11/05/2017] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little is known about the role of living circumstances to the perception of subjective well-being (SWB) and health of adults with intellectual disability (ID). The aim of the present study was to examine whether living circumstances impact differently on the perception of health and SWB and whether potential differences persist after accounting for other variables (e.g. level of support needs and reporting method). METHODS Secondary data analysis was undertaken of a large national survey of adults with an ID in England, aged 16 years and over. Participants were identified as living with family (N = 1528) or living out of home (N = 874). RESULTS The results of t-test and chi-square revealed that levels of health and SWB were perceived as being higher for people living with family than those living in out-of-home settings. Multiple linear regression analyses fitted to explore factors associated with these reported differences revealed that, when controlling for other variables, living with family was highly associated with reports of better SWB. Multiple logistic regression revealed that whilst the health status of people living with families were perceived as better, this was only true when their support needs were low. Poorest health outcomes were found for people with highest support needs who lived with family. CONCLUSIONS On the whole, the health and well-being of adults living with family were perceived more positively than those living out of home. However, potential health disparities exist for those with high support needs who live with family. Further longitudinal research is needed to explore causes and potential solution to these inequalities.
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Affiliation(s)
- J M Grey
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - V Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), Social Sciences, University of Warwick, Coventry, UK
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Folch-Mas A, Cortés-Ruiz MJ, Vicens-Calderón P, Martínez-Leal R. Health profiles in people with intellectual developmental disorders. ACTA ACUST UNITED AC 2017; 59:400-407. [DOI: 10.21149/8199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/12/2017] [Indexed: 12/16/2022]
Abstract
Objective. To better understand the health profiles of people with intellectual disability (ID), focusing on the variables that are associated with a poorer health status. Materials and methods. Data were collected from the Survey on Disability, Personal Autonomy and Dependency (EDAD 2008) of the Spanish National Statistics Institute (INE). The health data of 2 840 subjects with IDD were analyzed in order to verify the impact of different variables on their health profiles. Results. People with severe and profound levels of IDD presented a higher number of medical diagnoses.At residence centers there was a larger proportion of individuals with a higher prevalence of chronic diseases and more severe conditions; age also was an important factor. Conclusion. The health profiles of individuals with IDD differ depending on the severity level of their IDD and their degree of institutionalization. Further research is needed to provide better health care for people with IDD.
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Ranjan S, Nasser JA, Fisher K. Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:29-38. [DOI: 10.1111/jar.12370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Sobhana Ranjan
- Department of Nutrition Sciences; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
| | - Jennifer A. Nasser
- Department of Nutrition Sciences; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
| | - Kathleen Fisher
- Doctoral Nursing Programs; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
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Dunkley AJ, Tyrer F, Spong R, Gray LJ, Gillett M, Doherty Y, Martin-Stacey L, Patel N, Yates T, Bhaumik S, Chalk T, Chudasama Y, Thomas C, Sadler S, Cooper SA, Gangadharan SK, Davies MJ, Khunti K. Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Alison J Dunkley
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Freya Tyrer
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Rebecca Spong
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Mike Gillett
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Yvonne Doherty
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | | | - Naina Patel
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Sabyasachi Bhaumik
- Learning Disabilities Service, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Thomas Chalk
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Yogini Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Chloe Thomas
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Susannah Sadler
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Ruud MP, Raanaas RK, Bjelland M. Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:202-210. [PMID: 27636155 DOI: 10.1016/j.ridd.2016.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/29/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences. AIMS The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents. METHODS AND PROCEDURES A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions. RESULTS Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators. CONCLUSIONS AND IMPLICATIONS Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers.
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Affiliation(s)
- Marte Pilskog Ruud
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway
| | - Ruth Kjærsti Raanaas
- Section for Public Health Science, Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Science, P.O. Box 5003 NMBU, N-1432 Ås, Norway.
| | - Mona Bjelland
- Department of Nutrition, University of Oslo, P.O. Box 1046 Blindern, N-0317 Oslo, Norway
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Spassiani NA, Sawyer AR, Chacra MSA, Koch K, Muñoz YA, Lunsky Y. "Teaches People That I'm More Than a Disability": Using Nominal Group Technique in Patient-Oriented Research for People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 54:112-122. [PMID: 27028253 DOI: 10.1352/1934-9556-54.2.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Individuals with intellectual and developmental disabilities (IDD) have complex healthcare needs, which are often unmet. Nominal group technique (NGT) uses a mixed-methods approach, which may engage the IDD population in the research process in a person-centered manner and address the shortcomings of traditional research methods with this population. NGT was used with a group of 10 self-advocates to evaluate a series of healthcare tools created by and for individuals with IDD. Participants provided helpful input about the strengths of these tools and suggestions to improve them. NGT was found to be an effective way to engage all participants in the research process.
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Affiliation(s)
- Natasha A Spassiani
- Natasha A. Spassiani, Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Amanda R Sawyer
- Amanda R. Sawyer, Megan S. Abou Chacra, Kimberley Koch, Yasmin A. Muñoz, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Megan S Abou Chacra
- Amanda R. Sawyer, Megan S. Abou Chacra, Kimberley Koch, Yasmin A. Muñoz, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Kimberley Koch
- Amanda R. Sawyer, Megan S. Abou Chacra, Kimberley Koch, Yasmin A. Muñoz, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Yasmin A Muñoz
- Amanda R. Sawyer, Megan S. Abou Chacra, Kimberley Koch, Yasmin A. Muñoz, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Yona Lunsky
- Amanda R. Sawyer, Megan S. Abou Chacra, Kimberley Koch, Yasmin A. Muñoz, and Yona Lunsky, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
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19
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Thompson JR, DeSpain S. Community Support Needs. EVIDENCE-BASED PRACTICES IN BEHAVIORAL HEALTH 2016. [DOI: 10.1007/978-3-319-26583-4_7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Blick RN, Saad AE, Goreczny AJ, Roman K, Sorensen CH. Effects of declared levels of physical activity on quality of life of individuals with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 37:223-229. [PMID: 25528082 DOI: 10.1016/j.ridd.2014.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/28/2014] [Indexed: 06/04/2023]
Abstract
Routine physical fitness improves health and psychosocial well-being of individuals with intellectual and developmental disabilities. The current study investigated impact of physical fitness on quality of life by comparing individuals who maintain a physically active lifestyle with those who do not report exercising. We assessed several indicators of quality of life, including inclusion and community participation; satisfaction with professional services, home life, and day activities; dignity, rights, and respect received from others; fear; choice and control; and family satisfaction. Our data suggested that individuals who regularly exercise reported having more frequent outings into the community than did their peers who reported exercising infrequently; regular exercisers were also more likely to live in intermediate care facilities (ICF) as opposed to living independently or with family members. We discuss possible reasons for this as well as ideas for future research needed to expand on this area.
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Salvador-Carulla L, Martínez-Leal R, Heyler C, Alvarez-Galvez J, Veenstra MY, García-Ibáñez J, Carpenter S, Bertelli M, Munir K, Torr J, Van Schrojenstein Lantman-de Valk HMJ. Training on intellectual disability in health sciences: the European perspective. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2015; 61:20-31. [PMID: 25705375 PMCID: PMC4334381 DOI: 10.1179/2047387713y.0000000027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Intellectual disability (ID) has consequences at all stages of life, requires high service provision and leads to high health and societal costs. However, ID is largely disregarded as a health issue by national and international organisations, as are training in ID and in the health aspects of ID at every level of the education system. SPECIFIC AIM This paper aims to (1) update the current information about availability of training and education in ID and related health issues in Europe with a particular focus in mental health; and (2) to identify opportunities arising from the initial process of educational harmonization in Europe to include ID contents in health sciences curricula and professional training. METHOD We carried out a systematic search of scientific databases and websites, as well as policy and research reports from the European Commission, European Council and WHO. Furthermore, we contacted key international organisations related to health education and/or ID in Europe, as well as other regional institutions. RESULTS ID modules and contents are minimal in the revised health sciences curricula and publications on ID training in Europe are equally scarce. European countries report few undergraduate and graduate training modules in ID, even in key specialties such as paediatrics. Within the health sector, ID programmes focus mainly on psychiatry and psychology. CONCLUSION The poor availability of ID training in health sciences is a matter of concern. However, the current European policy on training provides an opportunity to promote ID in the curricula of programmes at all levels. This strategy should address all professionals working in ID and it should increase the focus on ID relative to other developmental disorders at all stages of life.
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Affiliation(s)
- Luis Salvador-Carulla
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Australia
| | - Rafael Martínez-Leal
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Carla Heyler
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Marja Y. Veenstra
- Organisation for Patient Involvement and Active Citizenship, Sittard, The Netherlands
| | - Jose García-Ibáñez
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | | | - Marco Bertelli
- Centro di Ricerca ed Evoluzione AMG (CREA), Firenze, Italy
| | - Kerim Munir
- Developmental Medicine Center, The Children’s Hospital, Boston, Massachusetts, USA
| | - Jennifer Torr
- Centre for Developmental Health Victoria, Monash University, Victoria, Australia
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22
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Hom CL, Touchette P, Nguyen V, Fernandez G, Tournay A, Plon L, Himber P, Lott IT. The relationship between living arrangement and adherence to antiepileptic medications among individuals with developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:48-54. [PMID: 24612032 DOI: 10.1111/jir.12123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Non-adherence to antiepileptic drugs (AEDs) is associated with considerable morbidity and mortality in the general population but little is known about adherence in individuals with intellectual disability (ID). METHOD Using the records of a closed pharmacy billing system over a 30 month period, we examined the medication non-adherence rates for AEDs among 793 individuals with ID. We calculated the medication possession ratio (number of days each participant was in possession of an AED), and defined non-adherence as 25% or more of the exposure days without the possession of an AED. All participants studied had filled prescriptions for AEDs spanning at least 6 months. RESULTS Controlling for age and gender, we found non-adherence rates varied by living arrangement. Compared with those living in group homes, individuals with ID living in family homes or in semi-independent settings were significantly less adherent to AEDs (P < 0.0003). CONCLUSION Non-adherence to AEDs is a potential medical risk for individuals with ID that is significantly impacted by the type of community living arrangement.
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Affiliation(s)
- C L Hom
- Department of Psychiatry and Human Behavior, University of California, Irvine, Orange, CA, USA
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23
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Finlayson J. One avoidable death is one too many. Lancet Psychiatry 2014; 1:486-7. [PMID: 26361291 DOI: 10.1016/s2215-0366(14)00060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Janet Finlayson
- Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, G4 0BA, UK.
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Thompson JR, Schalock RL, Agosta J, Teninty L, Fortune J. How the Supports Paradigm Is Transforming the Developmental Disabilities Service System. ACTA ACUST UNITED AC 2014. [DOI: 10.1352/2326-6988-2.2.86] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
The supports paradigm is based on the premise that the most relevant difference between people with intellectual disability and related developmental disabilities (ID/DD) and the general population is that people with ID/DD need different types and intensities of support to fully participate in and contribute to society. The supports paradigm is changing professional work and public policies in the field of ID/DD by providing a conceptual basis for aligning the work of researchers, policymakers, and professionals at micro (individual), meso (organizational), and macro (jurisdictional) levels. The potential of the supports paradigm to transform the adult service system is discussed.
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Affiliation(s)
- James R. Thompson
- James R. Thompson, Professor, Department of Special Education, Illinois State University
| | | | | | | | - Jon Fortune
- Jon Fortune, Senior Research Specialist, Human Services Research Institute
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Wahlström L, Bergström H, Marttila A. Promoting health of people with intellectual disabilities: Views of professionals working in group homes. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2014; 18:113-128. [PMID: 24595869 DOI: 10.1177/1744629514525133] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Deinstitutionalisation has influenced the life situation for people with intellectual disabilities, whilst the experiences of health promotion in group homes now are limited. This study aimed to explore aspects important to consider when promoting health amongst persons with intellectual disabilities in group homes, from the perspective of professionals. Semi-structured interviews were conducted with seven professionals and were analysed with thematic analysis. The overarching theme 'sense of security' was identified as a prerequisite for health promotion, together with the sub-themes 'resources in the organisation', for example, respectful treatment of the residents, and `resources of the residents', for example, meaningfulness and social connectedness. Findings were discussed from the perspective of health assets which is defined as the factors contributing to maintain and sustain health. The importance of strengthening external assets, that is, resources in the society and the organisation, to promote internal assets, that is, residents' individual resources, and ultimately their health, is emphasised.
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Glasson EJ, Dye DE, Bittles AH. The triple challenges associated with age-related comorbidities in Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:393-398. [PMID: 23510031 DOI: 10.1111/jir.12026] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Major increases in the survival of people with Down syndrome during the last two generations have resulted in extended periods of adulthood requiring specialist care, which in turn necessitates greater understanding of the nature, timing and impact of comorbidities associated with the disorder. METHOD The prevalence of five comorbidities reported as common in adults with Down syndrome, visual impairment, hearing impairment, epilepsy, thyroid disorders and dementia was assessed by decade of life. RESULTS From early adulthood, people with Down syndrome are at enhanced risk of developing new comorbidities and they may present with multiple conditions. Three specific challenges are identified and discussed: are comorbidities detected in a timely manner, is the clinical progress of the disorder adequately understood, and who is responsible for the provision of care? CONCLUSIONS Further detailed investigations into the development and treatment of comorbidities across the lifespan are needed for a successful longitudinal approach to healthcare in people with Down syndrome. Implementation of this approach will better inform healthcare providers to ensure continuity of care with advancing age.
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Affiliation(s)
- E J Glasson
- School of Population Health, The University of Western Australia, Perth, Western Australia, Australia
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Joos E, Mehuys E, Van Bocxlaer J, Remon JP, Van Winckel M, Boussery K. Medication Management in Belgian Residential Care Facilities for Individuals With Intellectual Disability: An Observational Study. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nordstrøm M, Hansen BH, Paus B, Kolset SO. Accelerometer-determined physical activity and walking capacity in persons with Down syndrome, Williams syndrome and Prader-Willi syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4395-4403. [PMID: 24139709 DOI: 10.1016/j.ridd.2013.09.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 09/10/2013] [Indexed: 06/02/2023]
Abstract
In this study we describe by use of accelerometers the total physical activity (PA), intensity pattern and walking capacity in 87 persons age 16-45 years with Down syndrome (DS), Williams syndrome (WS) and Prader-Willi syndrome (PWS). Participants were recruited from all over Norway, and lived either with their parents or in community residences with support. On average the participants generated 294 counts per minute (cpm) or 6712 steps per day, with most of the day spent in sedentary activity, 522 min/day, followed by 212 min/day in light PA, 71 min/day in lifestyle activity and 27 min/day in moderate-to-vigorous physical activity (MVPA). Inactivity was prevalent, as only 12% meet the current Nordic recommendations for PA. When compared, no differences for total physical activity or time in MVPA were observed between the three groups. However, participant with DS spent a mean of 73 min/day less and 43 min/day less in sedentary activities compared to participants with PWS and WS, respectively, (p=0.011, 95% CI: -10.9; -80.1). In addition the DS-group spent a mean of 66 min/day more in light PA than the PWS-group and 41 min/day more than the WS-group, (p<0.001, 95% CI: 29.3; 79.7). Participants with PWS spent on average 30 min/day less in lifestyle activities compared to both participants with DS and WS, (p<0.001, 95% CI: -14.2; -45.4). No association between total PA and BMI were observed. Males were more active than females across all diagnoses. Males accumulated on average 85 counts per minutes more than females, (p=0.002, 95% CI: 33.3; 136.7), 2137 more steps per day, (p=0.002, 95% CI: 778; 3496). The mean walking capacity during six-minutes was 507 m (SD 112 m) for males and 466 m (SD 88 m) for females. Distance walked during testing decreased with 33.6 m when comparing normal or underweight participants to overweight participants, and 78.1 m when comparing overweight to obese participants (p<0.001 95% CI: -40.4; -85.8). When adjusted for BMI no differences in walking capacity between the three genetic conditions were observed.
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Affiliation(s)
- Marianne Nordstrøm
- Frambu Resource Centre for Rare Disorders, Sandbakkveien 18, 1404 Siggerud, Norway; University of Oslo, Institute of Basic Medical Sciences, Department of Nutrition, P.O. Box 1046, Blindern, 0317 Oslo, Norway.
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Brehmer-Rinderer B, Zigrovic L, Naue U, Weber G. Promoting Health of Persons With Intellectual Disabilities Using the UN Convention on the Rights of Persons With Disabilities: Early Implementation Assessment in Spain and Hungary. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2013. [DOI: 10.1111/jppi.12018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Lucija Zigrovic
- Doctoral College “Empowerment through Human Rights”; University of Vienna; Vienna Austria
| | - Ursula Naue
- Department of Political Science; University of Vienna; Vienna Austria
| | - Germain Weber
- Faculty of Psychology; University of Vienna; Vienna Austria
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Lucas-Carrasco R, Salvador-Carulla L. Life satisfaction in persons with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1103-1109. [PMID: 22502835 DOI: 10.1016/j.ridd.2012.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 02/03/2012] [Indexed: 05/31/2023]
Abstract
We appraised life satisfaction using the Satisfaction with Life Scale (SWLS), and analysed its psychometric properties in persons with intellectual disability (ID). Ninety-nine persons with ID from four services in Spain participated. A battery of subjective assessments was used, including the SWLS, a Quality of Life measure (WHOQOL-BREF), and health status and sociodemographic information. Psychometric properties of the SWLS were investigated using standard psychometric methods. Overall, our results showed that persons with ID were satisfied with their life (SWLS score 25-29). Internal consistency (Cronbach's alpha) was .79. A factor analysis using principal components method, showed a one factor structure accounting for 55.7% of the variance. Associations, using Spearman's rho correlation coefficients, were confirmed between SWLS with the overall QoL, satisfaction with health and WHOQOL-BREF total score. Regarding 'known group' differences, persons living in residential institutions had lower life satisfaction compared to persons living in community facilities or living at home, though differences were not statistically significant. Student t-tests showed that SWLS scores significantly discriminated between healthy and unhealthy; and those reporting higher satisfaction with their relationships, home environment and their jobs compared to participants with lower satisfaction levels. To our best knowledge, this study is the first to report on the psychometrics properties of the SWLS in persons with ID, both in Spain and internationally. It might be a promising tool to use, with other outcome measures, in appraising persons with ID in different services and types of care; also, it might guide policymakers on the implementation of policies for persons with ID.
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Affiliation(s)
- Ramona Lucas-Carrasco
- Department of Methodology and Behavioural Sciences, University of Barcelona, Barcelona, Spain.
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Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, Dodel R, Ekman M, Faravelli C, Fratiglioni L, Gannon B, Jones DH, Jennum P, Jordanova A, Jönsson L, Karampampa K, Knapp M, Kobelt G, Kurth T, Lieb R, Linde M, Ljungcrantz C, Maercker A, Melin B, Moscarelli M, Musayev A, Norwood F, Preisig M, Pugliatti M, Rehm J, Salvador-Carulla L, Schlehofer B, Simon R, Steinhausen HC, Stovner LJ, Vallat JM, Van den Bergh P, van Os J, Vos P, Xu W, Wittchen HU, Jönsson B, Olesen J. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21:718-79. [PMID: 21924589 DOI: 10.1016/j.euroneuro.2011.08.008] [Citation(s) in RCA: 988] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people. AIMS To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country. METHODS The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010. RESULTS The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US. DISCUSSION This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges. RECOMMENDATIONS Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
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Jackson R. Challenges of residential and community care: 'the times they are a-changin'. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:933-944. [PMID: 21815958 DOI: 10.1111/j.1365-2788.2011.01461.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper seeks to examine a number of issues which relate to the provision of appropriate and high-quality residential and community care for people with an intellectual disability. A number of key themes emerging from this Special Issue of the Journal of Intellectual Disability Research are identified and explored: (1) normalisation; (2) inclusion; (3) choice; and (4) regulation. It is concluded that the research community has an obligation to assume a higher profile at a time when the quality of life of people with an intellectual disability and their families is under threat. This can be done in a number of ways through: (1) the establishment of demonstration projects, either independently or in association with the voluntary and statutory sector, to explore innovative and practical approaches of enhancing the quality of services offered to people with an intellectual disability; (2) looking at ways of improving the quality of training programmes for care staff by moving away from current approaches that emphasise narrow instrumental competencies to strategies that develop essential expressive and relational aspects of care practice; and (3) offering a more considered and rigorous critique of current professional practice and assuming a leadership role at a time when leadership in this field is lacking.
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Affiliation(s)
- R Jackson
- Karl Koenig Institute, Aberdeen, UK.
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