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Bitektine E, Hintermayer MA, Chen A, Ko A, Rodriguez C. Medical students' perceptions on preparedness and care delivery for patients with autism or intellectual disability. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:37-47. [PMID: 38528903 PMCID: PMC10961132 DOI: 10.36834/cmej.76338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Introduction To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education. Methods We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level. Results We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning. Discussion/Conclusions This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.
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Affiliation(s)
- E Bitektine
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - M A Hintermayer
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
- Montreal Neurological Institute, McGill University, Quebec, Canada
| | - A Chen
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - A Ko
- Department of Medicine and Dentistry, McGill University, Quebec, Canada
| | - C Rodriguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
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Thalen M, van Oorsouw WM, Volkers KM, Embregts PJ. Support needs of older people with intellectual disabilities: An exploratory study among psychologists in the Netherlands. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:266-277. [PMID: 35533301 PMCID: PMC9940125 DOI: 10.1177/17446295211062399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Information regarding the common-daily support needs of older people with intellectual disabilities remains scarce, despite the necessity of such knowledge to the provision of adequate support. This exploratory study aims to identify the most important support needs. METHOD A mixed-method design was conducted, in which 11 semi-structured interviews were held with psychologists to gain insight into the support needs of older people with intellectual disabilities. RESULTS The data provide an overview of the support needs of older people with intellectual disabilities in all quality-of-life (QoL) domains. Physical well-being, emotional well-being, interpersonal relationships and self-determination were identified as the most important domains for older people with intellectual disabilities. CONCLUSIONS The findings of this study may guide the development of a specific training for support staff and constitute a valuable contribution to raising awareness among support staff concerning the broad range of support needs existing among older people with intellectual disabilities.
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Affiliation(s)
- Marloes Thalen
- Tranzo, 120694Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
- Philadelphia Care Foundation, Amersfoort, Netherlands
| | - Wietske Mwj van Oorsouw
- Tranzo, 120694Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Petri Jcm Embregts
- Tranzo, 120694Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, Netherlands
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Nicholson E, Doherty E, Guerin S, Schreiber J, Barrett M, McAuliffe E. Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:442-453. [PMID: 35285998 PMCID: PMC9310956 DOI: 10.1111/jir.12927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 01/25/2022] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Health disparities for children with intellectual disabilities can be challenging to measure due to many other factors that can impact health and healthcare use. The aim of the current study was to use longitudinal cohort data to compare children with intellectual disability (ID) in Ireland between 2006 and 2014 on healthcare utilisation and unmet need, at ages 9 and 13, using a propensity score matching (PSM) approach. METHODS Using data from the Growing up in Ireland study, PSM was used to identify an appropriate control sample to compare with a sample of children with ID (n = 124). Participants were matched on variables that are known to influence healthcare utilisation to reduce the impact of confounding variables between groups so that differences between the groups can be estimated. Logistic regression was used to estimate effects at ages 9 and 13. RESULTS Children with ID were no more likely to have visited a general practitioner or emergency department in the past 12 months than children without ID. They did have a greater likelihood of visiting a doctor in a hospital in the past 12 months and of having an overnight stay in hospital by age 9. Primary caregivers of children with ID were more likely to report unmet health needs at ages 9 and 13. CONCLUSIONS This approach is a novel means of comparing healthcare use in this population by balancing the impact of other factors that may result in inequities, to which children with ID may be more vulnerable.
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Affiliation(s)
- E. Nicholson
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS)UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural SciencesDublinIreland
- School of Psychology, Faculty of Science and HealthDublin City UniversityGlasnevin CampusDublin 9Ireland
| | - E. Doherty
- J.E. Cairnes School of Business & EconomicsNational University of Ireland GalwayGalwayIreland
| | - S. Guerin
- UCD Centre for Disability StudiesUCD School of Psychology, University College DublinDublinIreland
| | - J. Schreiber
- School of NursingDuquesne UniversityPittsburghPAUSA
| | - M. Barrett
- Children's Health Ireland (CHI) at CrumlinDublinIreland
- UCD School of MedicineUCD College of Health and Agricultural SciencesDublinIreland
| | - E. McAuliffe
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS)UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural SciencesDublinIreland
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Dickson D. Multilevel Governance and the Implementation of Inclusion Policy for Older Adults With Intellectual and Developmental Disabilities in Canada. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12397] [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)
- Daniel Dickson
- Department of Political Science Concordia University Montreal QC Canada
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P. Albuquerque C. Needs of older people with intellectual disabilities: variables influencing inter-respondent (client vs staff) agreement. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:256-264. [PMID: 37025327 PMCID: PMC10071974 DOI: 10.1080/20473869.2021.1952825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 06/19/2023]
Abstract
Background: The importance of understanding the needs of older people with intellectual disabilities (IDs) is obvious, but the research available is limited. This study identifies the self-reported needs of older adults with IDs and compares them with staff reported needs regarding the same older adults with ID, therefore specifying and explaining agreements and disagreements. Method: The needs of 96 older adults with IDs were assessed through the Inventory of Identification of Needs (informant and self-report versions). Results: Both older people with IDs and staff reported quite diverse needs related to all the domains assessed by the IIN: physical health, literacy, information, meaningful activity, participation in the community, mental health, basics needs and accommodation. All the mean scores of the informant version of the IIN were higher than the ones of the self-report version. Agreement amongst informants was influenced by the prominence of needs, the accessibility to and the subjectivity of the information, and social desirability. Conclusions: A consumer-driven approach implies that services should be based on the needs identified.
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Affiliation(s)
- Cristina P. Albuquerque
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, Faculty of Psychology and Educational Sciences, Coimbra, Portugal
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Ratnayake I, Shooshtari S, Chateau D, Kristjanson M. Complete physical examinations in Manitoba adults with an intellectual or developmental disability: A retrospective cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1582-1591. [PMID: 34196454 DOI: 10.1111/jar.12908] [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: 09/05/2020] [Revised: 04/26/2021] [Accepted: 05/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Complete physical examinations (CPE) can identify health disparities in persons with intellectual or developmental disabilities. The objective of this study was to determine and compare rates of CPE among Manitoba adults with and without intellectual or developmental disabilities over time and to identify factors that were associated with receiving a CPE. METHOD A retrospective cohort study using linked administrative health and non-health data from 1995 to 2015 was conducted. Poisson and logistic regression were used to calculate CPE rates and examine factors associated with CPE. RESULTS The rates of CPE are decreasing over time and are higher among Manitobans with an intellectual or developmental disability. Characteristics such as being male, living rurally, low socioeconomic status, and high continuity of care led to lower odds of receiving a CPE. CONCLUSIONS The current state of CPE provision to adults with intellectual or developmental disabilities in Manitoba is encouraging but needs improvement.
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Affiliation(s)
- Iresha Ratnayake
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Shahin Shooshtari
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Dan Chateau
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Mark Kristjanson
- Department of Family Medicine, University of Manitoba, Winnipeg, Canada
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Kim MA, Yi J, Bradbury L, Han KM, Yang J, Lee J. A Photovoice Study: The life experiences of middle-aged adults with intellectual disabilities in Korea. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:852-865. [PMID: 33686721 DOI: 10.1111/jar.12870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND As adults with intellectual disabilities approach older adulthood, they face unique physical and psychosocial challenges. This study explored the lived experiences of middle-aged adults with intellectual disabilities living in their community. METHOD Six sessions of Photovoice were conducted with a purposeful sample of six middle-aged adults with intellectual disabilities in South Korea. Participants were involved with the theme selection, taking photographs related to the themes, group discussion of photo stories and sharing Photovoice outcomes. RESULTS Thematic analysis yielded 11 subthemes under the five major themes selected by the participants: health, free time, time in the centre, family and my future in old age. CONCLUSIONS The study findings showed complex issues middle-aged adults with intellectual disabilities may face in later life, including bereavement and healthy lifestyle concerns. It is important to create a space for meaningful social support and social interactions without stigma.
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Affiliation(s)
- Min Ah Kim
- Department of Social Welfare, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaehee Yi
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Laura Bradbury
- College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Ki-Myung Han
- Department of Gerontology, Graduate School of East-West Medical Science, Kyung Hee University, Gyeonggi, Republic of Korea
| | - Jieun Yang
- Therapy Center for Children with Emotional and Behavioral Issues, I-Zone in Seodaemun, Seoul, Republic of Korea
| | - Jinseung Lee
- Woori Daycare Center, Gyeonggi, Republic of Korea
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Albuquerque CP, Carvalho AC. Identification of Needs of Older Adults With Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Ana Cristina Carvalho
- Faculty of Psychology and Educational SciencesUniversity of Coimbra Coimbra Portugal
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Baumbusch J, Moody E, Hole R, Jokinen N, Stainton T. Using Healthcare Services: Perspectives of Community-Dwelling Aging Adults With Intellectual Disabilities and Family Members. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Elaine Moody
- Schools of Nursing and Occupational Therapy; Dalhousie University; Halifax Nova Scotia Canada
| | - Rachelle Hole
- UBC School of Social Work; Kelowna British Columbia Canada
| | - Nancy Jokinen
- UBC School of Social Work; Kelowna British Columbia Canada
- University of Northern British Columbia; Prince George British Columbia Canada
| | - Tim Stainton
- UBC School of Social Work; Kelowna British Columbia Canada
- University of British Columbia; Vancouver British Columbia Canada
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Abstract
ABSTRACTUnderstanding the nature and extent of unmet need for social care among older people is a critical policy priority in the United Kingdom and beyond, as national governments juggle the provision of adequate social care for a growing older population with competing funding priorities. Several factors can heighten the experience of unmet need among older people, for instance their family environment, and their health and socio-economic status. This paper contributes empirical evidence on the patterns of unmet need for social care among older people in England today, focusing on the individual characteristics associated with experiencing unmet need in relation to mobility tasks, activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The results show that about 55 per cent of older individuals with an ADL difficulty had unmet need, compared to 24 per cent of those with an IADL difficulty and 80 per cent of those with a mobility difficulty. Characteristics reflecting greater vulnerability were more strongly associated with the risk of experiencing unmet need for ADLs, and such vulnerability was greater for particular ADLs (e.g. bathing), and for a higher number of ADLs. The findings reaffirm the complexity of conceptualising and empirically investigating unmet need in later life, and add to our understanding of the challenges of providing adequate and appropriate social care to older people.
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Wark S, Hussain R, Müller A, Ryan P, Parmenter T. Challenges in providing end‐of‐life care for people with intellectual disability: Health services access. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:1151-1159. [DOI: 10.1111/jar.12408] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Stuart Wark
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Rafat Hussain
- ANU Medical School & Research School of Population HealthAustralian National University Canberra ACT Australia
| | - Arne Müller
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Peta Ryan
- School of Rural MedicineUniversity of New England Armidale NSW Australia
| | - Trevor Parmenter
- Centre for Disability StudiesSydney Medical SchoolUniversity of Sydney Sydney NSW Australia
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Shooshtari S, Temple B, Waldman C, Abraham S, Ouellette-Kuntz H, Lennox N. Stakeholders’ Perspectives towards the Use of the Comprehensive Health Assessment Program (CHAP) for Adults with Intellectual Disabilities in Manitoba. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:672-683. [DOI: 10.1111/jar.12261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Shahin Shooshtari
- Faculty of Health Sciences; Department of Community Health Sciences; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Beverley Temple
- Faculty of Health Sciences; College of Nursing; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Celeste Waldman
- Faculty of Health Sciences; College of Nursing; St. Amant Research Centre; University of Manitoba; Winnipeg MB Canada
| | - Sneha Abraham
- Faculty of Health Sciences; Department of Community Health Sciences; University of Manitoba; Winnipeg MB Canada
| | | | - Nicholas Lennox
- The Queensland Centre for Intellectual and Developmental Disability; School of Medicine; South Brisbane QLD Australia
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Wark S, Hussain R, Edwards H. The training needs of staff supporting individuals ageing with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2014; 27:273-88. [PMID: 24436133 DOI: 10.1111/jar.12087] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The issue of ageing within the cohort of people with intellectual disabilities has been an increasing focus for research. However, the training needs of the staff who support them has not been subject of extensive examination. MATERIALS AND METHODS A multiround Delphi project was conducted focusing upon the impact ageing issues have on the support provided by disability workers, and what training is required to address the identified areas. RESULTS Three rounds of the Delphi identified twenty-six separate important issues. A thematic analysis identified five main themes including Generic Training Issues; Medical Issues; Emerging Ageing Issues Requiring Changing Support; Mental Health Issues; and Quality of Life. CONCLUSIONS The study identified a series of training priorities for staff assisting people ageing with an intellectual disability. It would appear possible for many training programmes to be developed and delivered with minimal cost impacts even within rural localities.
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Affiliation(s)
- Stuart Wark
- School of Rural Medicine, University of New England, Armidale, NSW, Australia; The Ascent Group, Armidale, NSW, Australia
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Brown M, Karatzias T, O'Leary L. The health role of local area coordinators in Scotland: a mixed methods study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2013; 17:387-402. [PMID: 24166152 DOI: 10.1177/1744629513509795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The study set out to explore whether local area coordinators (LACs) and their managers view the health role of LACs as an essential component of their work and identify the health-related activities undertaken by LACs in Scotland. A mixed methods cross-sectional phenomenological study involving local authority service managers (n = 25) and LACs (n = 40) was adopted. Quantitative data from LACs were obtained using online and postal questionnaires. Qualitative data from local authority service managers and LACs were collected using one-to-one interviews and focus groups. Thematic analysis was undertaken of the qualitative data. The results indicate that there is a need to develop further the wider public health role of LACs to incorporate health-related activities focused on broader community-based outcomes such as empowerment and community integration. By adopting a public health role, LACs will be able to contribute to the reduction of health inequalities in people with learning disabilities.
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Affiliation(s)
- Michael Brown
- Edinburgh Napier University, UK, and NHS Lothian, UK
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