Roles of General Practitioners in the Provision of Health Care Services for People with Intellectual Disabilities: A National Census in Taiwan

What do specialist mental health professionals think of the mental health services for people with intellectual disabilities in Singapore?

BACKGROUND

This research aimed to investigate the views and experiences of specialist mental health professionals working with adults with intellectual disabilities and mental health problems in Singapore in order to gain insight into the functioning of the local specialist intellectual disability mental health service and how it may be improved.

METHODS

Eight staff members from specialist service were interviewed. The transcriptions of the interviews were analysed using thematic analysis.

RESULTS

Analysis revealed four themes (1) Identifying their roles; (2) Ensuring continuity of care; (3) Disempowerment of service users and (4) Improving clinical practice.

CONCLUSIONS

Participants identified the challenges they faced working with this population. They highlighted the importance of building therapeutic relationships during the treatment process and discussed the stigma that people with intellectual disabilities face in the community. Recommendations and implications are discussed in relation to service provision, improving staff knowledge and recruiting more staff to work in this field.

A scoping analysis of the aspects of primary healthcare physician job satisfaction: facets relevant to the Indonesian system

BACKGROUND

Although there is extensive literature on the different aspects of physician job satisfaction worldwide, existing questionnaires used to measure job satisfaction in developed countries (e.g., the Job Satisfaction Scale) do not capture the aspects specific to Indonesian primary healthcare physicians. This is especially true considering the 2014 healthcare system reform, which led to the implementation of a national social health insurance scheme in Indonesia that has significantly changed the working conditions of physicians. Therefore, the current study aimed to identify aspects of primary care physician job satisfaction featured in published literature and determine those most suitable for measuring physician job satisfaction in light of Indonesia's recent reforms.

METHODS

A scoping literature review of full-text articles published in English between 2006 and 2015 was conducted using the PubMed, Psycinfo, and Web of Science databases. All aspects of primary care physician job satisfaction included in these studies were identified and classified. We then selected aspects mentioned in more than 5% of the reviewed papers and identified those most relevant to the post-reform Indonesian context.

RESULTS

A total of 440 articles were reviewed, from which 23 aspects of physicians' job satisfaction were extracted. Sixteen aspects were deemed relevant to the current Indonesian system: physical working conditions, overall job satisfaction, patient care/treatment, referral systems, relationships with colleagues, financial aspects, workload, time of work, recognition for good work, autonomy, opportunity to use abilities, relationships with patients, their families, and community, primary healthcare facilities' organization and management style, medical education, healthcare systems, and communication with health insurers.

CONCLUSION

Considering the recent reforms of the Indonesian healthcare system, existing tools for measuring job satisfaction among physicians must be revised. Future research should focus on the development and validation of new measures of physician job satisfaction based on the aspects identified in this study.

Perspectives on intellectual disability in Taiwan: epidemiology, policy and services for children and adults

PURPOSE OF REVIEW

The present review examines the most recent published references to epidemiology, healthcare needs and utilization and social and health policy relating to people with intellectual disability in Taiwan.

METHOD

Electronic searches of Medline, PubMed and PsychInfo literature using the key terms of epidemiology, etiology, welfare policy, health policy, health services, intellectual disability, learning disability and mental retardation as well as a thorough manual search for relevant literature.

RECENT FINDINGS

The administrative prevalence of intellectual disability was 0.318-0.396%, and men accounted for a higher percentage of cases than women in Taiwan. Institutionalized care still dominates disability services provided in this society, and the number of institutions and staff working therein has increased steadily in recent years. Many studies also identify the high risk for ill health accompanied by physical/mental diseases in people with intellectual disability, with this group also requiring more healthcare services than the general population in Taiwan. There are still many barriers to accessibility and availability of health and social services confronting people with intellectual disability and their caregivers under the National Health Insurance scheme in Taiwan.

SUMMARY

As a result of this review process, this paper suggests that future study should focus on an evaluation of the efficacy of current health and social policies related to people with intellectual disability, and that supportive health environments be initiated for this group of people living in institutions or in the community.