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Marquis S, Marquis NE, Lunsky Y, McGrail KM, Baumbusch J. A retrospective cohort study of prescription drug use among youth with intellectual/developmental disabilities in British Columbia. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38773818 DOI: 10.1111/jir.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/22/2024] [Accepted: 04/24/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND People with intellectual/developmental disabilities (IDD) are known to have high rates of prescription drug use, particularly for psychotropic medications. This is of concern due to the many side effects associated with these medications and because of the risks of polypharmacy. In this paper we compare the most commonly dispensed drugs and all psychotropic medications for youth with IDD compared with youth without IDD. METHODS Using population-level administrative health data over a 10-year period, this study examined medications dispensed to youth with an IDD aged 15-24 years compared with youth without an IDD. The most common medications dispensed and the number of youth they were dispensed to were determined. As well a wide variety of psychotropic medications were examined. RESULTS There were a total of 20 591 youth with IDD and 1 293 791 youth without IDD identified. Youth with IDD had higher odds of being dispensed pain medications, amoxicillin, salbutamol, levothyroxine and all the psychotropic medications (antidepressants, antipsychotics, anxiolytics, anti-adrenergic agents, mood stabilisers and stimulants). For youth with IDD, 6558 (31.85%) were dispensed two or more different psychotropic medications within a year, compared with 75 963 (5.87%) of youth without IDD. DISCUSSION Compared to youth without IDD, youth with IDD had significantly higher odds of being dispensed most of the prescription medications studied, including all of the psychotropic medications. They were also twice as likely to be dispensed two or more medications from different classes of psychotropic drugs within the same year. These findings have important implications for the health of people with IDD and for their health care providers.
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Affiliation(s)
- S Marquis
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Y Lunsky
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada
| | - K M McGrail
- Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - J Baumbusch
- School of Nursing, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada
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Rutherford G, Hussain R, Tait K. Pattern of multimorbidity in middle-aged and older-aged people with mild intellectual disability in Australia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13215. [PMID: 38413378 DOI: 10.1111/jar.13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. METHOD Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (≥60 years, N = 391). RESULTS People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). CONCLUSION There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.
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Affiliation(s)
- Grace Rutherford
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Rafat Hussain
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Kathleen Tait
- Macquarie School of Education, Macquarie University, Sydney, Australia
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Hughes J, Roberts R, Tarver J, Warters-Louth C, Zhang B, Southward E, Shaw R, Edwards G, Waite J, Pearson E. 'It wasn't the strategies on their own': Exploring caregivers' experiences of accessing services in the development of interventions for autistic people with intellectual disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1231-1244. [PMID: 37712611 PMCID: PMC11067391 DOI: 10.1177/13623613231196084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
LAY ABSTRACT Many autistic individuals with intellectual disability experience anxiety, and for those who use few or no words, anxiety may present as behaviour that challenges, such as self-injury and avoiding anxiety-provoking situations. Families report difficulty accessing support from services for autistic individuals experiencing anxiety. Moreover, once receiving support, effective interventions for autistic people with intellectual disability are limited. We completed individual and group discussions with 16 caregivers of autistic people with intellectual disability, to (a) explore their experiences of accessing services for anxiety and/or behaviour that challenges for their child; and (b) understand what matters to caregivers when developing interventions that have been designed for them and the autistic individual with intellectual disability that they support. Caregivers reported that services, in their experience, did not deliver the support that they expected, and that they often needed to 'fight' for support. Caregivers considered services and families working together, the inclusion of peer support, and families being offered interventions that are flexible to individual circumstances to be important. These considerations are valuable for clinicians and researchers developing interventions and aiming to improve outcomes for autistic people with intellectual disability and their families.
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Vijayan SK, Bhattarai B, Narayanan S. Awareness, Knowledge and Practice Patterns of Oral Health and Hygiene among Speech-Language Pathologists in India. Indian J Otolaryngol Head Neck Surg 2024; 76:1862-1873. [PMID: 38566661 PMCID: PMC10982219 DOI: 10.1007/s12070-023-04432-7] [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: 10/19/2023] [Accepted: 12/03/2023] [Indexed: 04/04/2024] Open
Abstract
Individuals with communication and swallowing disorders often exhibit poor oral health and hygiene (OHH), that can lead to further complications. OHH assessment and management is a part of scope of practice of Speech-Language Pathologists (SLPs). The study aims to determine the level of awareness, knowledge and practice patterns of OHH amongst the SLPs in India. A questionnaire with 20-item and three sections was developed to assess the awareness and knowledge regarding OHH among SLPs. A total of 162 participants responded to the survey. 93.2% participants were aware of the importance of OHH, however 42.6% participants did not feel confident enough to assess the same. A majority (82.7%) agreed that poor OHH can lead to different health complications. 38.8% of the participants responded that they assessed oral health only sometimes and 54.3% reported that they never used any standard screening/assessment tools to assess oral health. Only a very small percentage of participants (28.65%) counselled the patients for maintenance of oral hygiene and more than 40% never recommended appropriate OHH practices during management. Though a vast majority were aware of the importance of OHH and consequences of poor OHH, they did not feel confident and consequently did not incorporate OHH during clinical practice. Though the scope of SLP includes oral care assessment and management, Indian SLPs were not practicing this. Hence, the clinical and academic curriculum should focus on topics pertaining to oral health assessment and management, which will improve the quality-of-service delivery of the SLPs.
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Affiliation(s)
- Syam Krishna Vijayan
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
| | - Biraj Bhattarai
- Speech-Language Pathologist, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
| | - Swapna Narayanan
- Centre for Swallowing Disorders, All India Institute of Speech and Hearing, Mysuru, Karnataka 570006 India
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Nijhof K, Boot FH, Naaldenberg J, Leusink GL, Bevelander KE. Health support of people with intellectual disability and the crucial role of support workers. BMC Health Serv Res 2024; 24:4. [PMID: 38167137 PMCID: PMC10763292 DOI: 10.1186/s12913-023-10206-2] [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: 06/02/2023] [Accepted: 10/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker's role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability. METHOD Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support. RESULTS We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place. CONCLUSION This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs.
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Affiliation(s)
- Kim Nijhof
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands.
| | - Fleur H Boot
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
| | - Kirsten E Bevelander
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Academic collaborative Intellectual Disability and Health - Sterker op Eigen Benen (SOEB), Nijmegen, The Netherlands
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Vukovic V, Banda A, Carneiro L, Dogan S, Knapp P, McMahon M, Milutinovic D, Soylar P, Sykes K, Tosun B, Yava A, Trajkovski V, Wells J, Cuypers M. The importance of cancer prevention policies to inform and guide preventative and screening measures for people with intellectual disabilities: The COST project "Cancer- Understanding Prevention in Intellectual Disabilities". JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231213752. [PMID: 37943033 DOI: 10.1177/17446295231213752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Cancer is a global public health problem, but its exact prevalence in people with intellectual disabilities is still uncertain. This population, with limited health skills and complex health needs, faces many challenges in cancer prevention, screening, timely diagnosis and treatment. Furthermore, they are often underrepresented in general cancer prevention and screening policies across Europe, leading to widened disparities in health outcomes and premature mortality. Thus, unified national and local policies are needed to reduce inequalities and promoting a pan-European inclusion of people with intellectual disabilities. Our goal is to raise public awareness of this issue, including the involvement of people with intellectual disabilities, and promote engagement from relevant stakeholders. The COST Action 'Cancer- Understanding Prevention in Intellectual Disabilities' (CUPID) project will address health inequalities faced by people with intellectual disabilities in relation to cancer, and support the development of policy recommendations specifically tailored to their unique cognitive and healthcare needs, having a positive long-term impact on quality of life.
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Affiliation(s)
- Vladimir Vukovic
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Serbia
- Centre for Disease Control and Prevention, Institute of Public Health of Vojvodina, Serbia
| | - Amina Banda
- Radboud University Medical Center, The Netherlands
| | - Lara Carneiro
- Physical Education Department, College of Education, United Arab Emirates University, United Arab Emirates
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, ISMAI, Portugal
| | - Soner Dogan
- Department of Medical Biology, School of Medicine, Yeditepe University, Türkiye
| | - Peter Knapp
- Department of Health Sciences & the Hull York Medical School, University of York, United Kingdom
| | - Martin McMahon
- School of Nursing & Midwifery, The University of Dublin Trinity College, Ireland; Trinity Centre for Ageing and Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Ireland
| | | | - Pinar Soylar
- Health science faculty, Fırat University, Türkiye
| | - Kate Sykes
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, Northumbria University, United Kingdom
| | - Betul Tosun
- Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Türkiye
| | - Ayla Yava
- Department of Nursing, Faculty of Health Sciences, Hasan Kalyoncu University, Türkiye
| | | | - John Wells
- School of Health Sciences, South East Technological University, Ireland
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van den Bemd M, Cuypers M, Schalk BW, Leusink GL, Bischoff EW. Chronic disease management in patients with intellectual disabilities: a matched study in Dutch general practice. Br J Gen Pract 2023; 73:e744-e751. [PMID: 37666513 PMCID: PMC10498381 DOI: 10.3399/bjgp.2023.0029] [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: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Disease management programmes (DMPs) aim to deliver standardised, high- quality care to patients with chronic diseases. Although chronic diseases are common among people with intellectual disabilities (ID), this approach may be suboptimal for meeting their care needs. AIM To examine differences between patients with and without ID who have a chronic illness in DMP enrolment and disease monitoring in Dutch general practice. DESIGN AND SETTING Observational study utilising the Nivel Primary Care Database (2015-2018) comparing patients with ID and cardiovascular disease, diabetes mellitus, or chronic obstructive pulmonary disease (COPD) with matched (1:5) controls with these conditions but without ID. METHOD Using conditional logistic regression, enrolment in DMP per chronic disease was examined and differences tested between groups in the frequencies of consultations, medication prescriptions, and routine examinations. RESULTS A total of 2653 patients with chronic illness with ID were matched with 13 265 controls without ID. Patients with both diabetes mellitus and ID were more likely than controls to be enrolled in DMP (odds ratio [OR] = 1.44, 95% confidence interval [CI] = 1.27 to 1.64). Independent of DMP enrolment, patients with chronic illness with ID were more likely than controls to have frequent consultations. Patients with both diabetes mellitus and ID and patients with both COPD and ID who were not enrolled in DMPs had more medication prescriptions than non-enrolled patients with diabetes or COPD but without ID (OR = 1.46, 95% CI = 1.10 to 1.95; OR = 1.28, 95% CI = 0.99 to 1.66, respectively). Most patients with ID and their controls enrolled in DMPs received routine examinations at similar frequencies. CONCLUSION Although DMPs do not specifically address the needs of patients with both chronic illness and ID, these patients do not seem underserved in the management of chronic diseases in terms of consultation, medication, and tests.
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Affiliation(s)
- Milou van den Bemd
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Maarten Cuypers
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Bianca Wm Schalk
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Erik Wma Bischoff
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
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Park BY, Cho HA, Shin H. Disparity in access for people with disabilities to outpatient dental care services: a retrospective cohort study. BMC Oral Health 2023; 23:213. [PMID: 37060034 PMCID: PMC10102694 DOI: 10.1186/s12903-023-02948-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/06/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND People with disabilities face difficulties in oral health management and gaining access to dental care. The availability of a regular source of dental care (RSDC) is an important factor that influences the access to health services and care management. The purpose of this study was to determine the effect of the availability of RSDC on the number of annual dental visits and dental expenses per visit among people with disabilities. METHODS Data of 7,896,251 patients with dental problems in South Korea were analyzed using the 2002-2018 National Health Insurance claims data. A generalized estimating equation was applied to analyze the repeated-measurement data, and the interaction effect between RSDC and the disability severity was evaluated. RESULTS The number of annual dental visits was higher among people with (2.62) than among those without (2.23) disabilities. Despite their increased dental needs, both annual dental visits and dental expenses per visit were low among older individuals (p < 0.001). The proportion and frequency of annual dental visits was lower among women than among men with disabilities. RSDC had differential effects on the severity of disability. Compared to people without disabilities, RSDC increased the number of annual dental visits (p = 0.067) and the dental expenses per visit (p < 0.05) among those with severe disabilities, but the effect on the number of annual dental visits was not significant among those with mild disabilities (p = 0.698). CONCLUSIONS Our results suggest a need for a special dental care system for people with disabilities, to ensure an RSDC, particularly for women and for older people with disabilities.
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Affiliation(s)
- Bo-Young Park
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Han-A Cho
- Department of Dental Hygiene, Shinhan University, Uijeongbu-Si, Republic of Korea
| | - Hosung Shin
- Department of Social and Humanity in Dentistry, Wonkwang University School of Dentistry, 460 Iksan Dearo, Iksan, 54538, North Jula, Korea.
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Wigham S, Bourne J, McKenzie K, Rowlands G, Petersen K, Hackett S. Improving access to primary care and annual health checks for people who have a learning disability: a multistakeholder qualitative study. BMJ Open 2022; 12:e065945. [PMID: 36564116 PMCID: PMC9791416 DOI: 10.1136/bmjopen-2022-065945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To investigate key stakeholders' views on how to improve access to primary care in general practice settings for people with learning disabilities (or intellectual disabilities). Further to explore how inequalities and barriers in specific areas including annual health checks might be addressed. DESIGN A qualitative study design was used with data collected during focus groups, interviews and open-response surveys; data analysis was thematic and informed by stakeholder consultation. Processes to facilitate quality included triangulation of stakeholder perspectives, triangulation of data collection methods and checking interpretation of findings with participants. SETTING UK regional services including learning disability organisations, primary care general practitioner (GP) clinical practice networks and supported housing organisations. PARTICIPANTS Sixteen people participated in the study: four people with learning disabilities participated in a focus group; four relatives completed an interview or survey; eight GPs, practice nurses and supported housing managers participated in interviews. RESULTS Five overarching themes describing approaches to improve primary care access for people with learning disabilities were identified including: prioritisation, proactivity, innovation and improvement, personalisation and prevention and follow-up. Definitions of themes were described and illustrated with quotes. Ten recommendations informed by the thematic analysis, stakeholder consultation, research and primary care guidance were codeveloped with people with learning disabilities. CONCLUSIONS All stakeholders identified problems, with primary care interfaces being misaligned with the needs of people with learning disabilities. The recommendations informed by all stakeholders can be used to guide development of service provision to better meet the needs of people with learning disabilities in primary care. Future research should explore professionals' understanding of reasonable adjustments.
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Affiliation(s)
- Sarah Wigham
- Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Jane Bourne
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Gill Rowlands
- Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Elswick Family General Practice, Newcastle upon Tyne, UK
| | - Katharine Petersen
- Forum Family Practice, Cramlington, UK
- Learning Disability Network, North East and North Cumbria, UK
| | - Simon Hackett
- Population Health Sciences Institute, Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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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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Chan DNS, Law BMH, Au DWH, So WKW, Fan N. A systematic review of the barriers and facilitators influencing the cancer screening behaviour among people with intellectual disabilities. Cancer Epidemiol 2021; 76:102084. [PMID: 34920342 DOI: 10.1016/j.canep.2021.102084] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/29/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022]
Abstract
Individuals with intellectual disabilities (ID) may require assistance in accessing healthcare services, including cancer screening. A better understanding of the factors affecting cancer screening utilisation among these individuals is needed for the development of strategies to promote screening uptake in them. This review aimed to explore the facilitators of and barriers to cancer screening utilisation among people with ID. A literature search was conducted using five databases, and an additional snowball search yielded 16 studies for inclusion in the review. Overall, the methodological quality of these studies was good (43-100%). In this review, we noted barriers to screening among individuals with ID, including perceptions of fear, distress, and embarrassment; unpreparedness for screening; negative interactions with healthcare professionals; a lack of knowledge about cancer screening; mobility issues; a high severity of ID; and a lack of ability to provide consent and communicate verbally. Facilitators to screening among these individuals were also identified, including living in a supervised setting, prior use of other healthcare services, being educated about screening via social media, having carers accompany them to screening appointments, and having dual insurance coverage or a higher income. Our review highlights the current needs of individuals with ID undergoing cancer screening. Strategies should be developed to address these needs, such as the provision of training to healthcare professionals on how to conduct screening for people with ID.
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Affiliation(s)
- Dorothy N S Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Bernard M H Law
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Doreen W H Au
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ning Fan
- Yan Chai Hospital, Hospital Authority, Hong Kong SAR, China.
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12
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Fortney S, Tassé MJ. Urbanicity, Health, and Access to Services for People With Intellectual Disability and Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 126:492-504. [PMID: 34700348 DOI: 10.1352/1944-7558-126.6.492] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/13/2021] [Indexed: 06/13/2023]
Abstract
Previous research suggests that residence in non-metropolitan areas is associated with lower access to preventive care and poorer health. However, this research has been largely restricted to the general population, despite data demonstrating disparities in health status and access to healthcare services for people with intellectual and developmental disabilities (IDD). The current study examined several hypotheses involving the effects of rurality on access to preventive healthcare and services and health status: (1) individuals in non-metropolitan areas will have lower preventive healthcare utilization, (2) individuals in non-metropolitan areas will have poorer health outcomes, and (3) individuals in non-metropolitan areas will have poorer access to services. The current study uses data from the National Core Indicators (NCI) Adult Consumer Survey 2015-2016: Final Report which included Rural-Urban Commuting Area (RUCA) Codes for the first time. Results of logistic regression suggest that, despite connection to disability services, the health status and access to preventive healthcare services of people with IDD generally follow patterns similar to those observed in the general population. Namely, people with IDD in non-metropolitan areas have decreased access to healthcare services, preventive healthcare utilization, and health status. Despite some exceptions, it appears effects of rurality are not completely mitigated by current state and federal efforts.
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Affiliation(s)
- Stoni Fortney
- Stoni Fortney and Marc J. Tassé, The Ohio State University
| | - Marc J Tassé
- Stoni Fortney and Marc J. Tassé, The Ohio State University
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13
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Olsen MI, Halvorsen MB, Søndenaa E, Strand BH, Langballe EM, Årnes A, Michalsen H, Larsen FK, Gamst W, Bautz-Holter E, Anke A. Factors associated with non-completion of and scores on physical capability tests in health surveys: The North Health in Intellectual Disability Study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:231-242. [PMID: 34643025 DOI: 10.1111/jar.12942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/25/2021] [Accepted: 09/15/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study investigated the completion rates, scores and factors associated with non-completion and low scores on physical capability tests in a health survey administered to adults with intellectual disabilities. METHOD Assessment comprised body mass index (BMI), the Short Physical Performance Battery (SPPB), the timed up-and-go (TUG) test, the one-legged stance (OLS) test; and gross motor, communication and behavioural functioning tests. RESULTS The completion rates among 93 participants (aged 17-78) were 46% for the SPPB, 42% for the TUG, and 31% for the OLS. More severe intellectual disability (OR = 3.12, p < .001) and lower BMI (OR = 0.859, p = .001) were related to test non-completion. The SPPB scores were below the reference values from the general population. Lower scores were associated with older age, motor disabilities and intellectual disability severity. CONCLUSIONS Including physical capability tests in health surveys among adults with intellectual disabilities is important to monitor functional status and guide prevention strategies.
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Affiliation(s)
- Monica Isabel Olsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Faculty of Health Sciences, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marianne Berg Halvorsen
- Department of Paediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Erik Søndenaa
- Faculty of Medicine, Institute of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Brøset, St. Olavs University Hospital, Trondheim, Norway
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen Melbye Langballe
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Anders Årnes
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
| | - Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Faculty of Health Sciences, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Frode Kibsgaard Larsen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway
| | - Wenche Gamst
- Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway
| | - Erik Bautz-Holter
- Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), University of Oslo, Oslo, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Faculty of Health Sciences, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), University of Oslo, Oslo, Norway
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14
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Jin J, Agiovlasitis S, Yun J. Predictors of perceived health in adults with an intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 101:103642. [PMID: 32330846 DOI: 10.1016/j.ridd.2020.103642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/28/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The effects of Intellectual disability (ID) levels, body mass index (BMI) categories, and other factors on perceived health status of adults with ID are not well-known. AIMS We aimed to examine: (a) the relationship between perceived health and level of intellectual function; (b) the influence of different BMI categories on a perceived health; and (c) the effect of the modifiable behavioral factors on perceived health. METHODS AND PROCEDURES We examined the aims using data from the 2013-2014 Adult Consumer Survey of the National Core Indicator. We extracted demographic (e.g. age, BMI) and modifiable behavior-related variables (e.g. physical activity participation, having a job) and used logistic regression models to analyze the relationships. OUTCOMES AND RESULTS Logistic regressions showed that more severe ID level is associated with worse perceived health, but when other variables related to personal and behavioral characteristics were accounted for, this relationship was no longer significant. Obese adults with ID had worse perceived health than those with normal weight; this effect remained significant even after considering other variables. Those in the overweight category did not differ in perceived health status from those of normal weight. The effects of all modifiable behaviors on perceived health were significant. CONCLUSIONS AND IMPLICATIONS Health promotion programs for adults with ID may benefit by consideration of modifiable behaviors.
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Affiliation(s)
- Jooyeon Jin
- University of Seoul, 163 Seoulsiripdaero, Seoul 02504, Republic of Korea.
| | - Stamatis Agiovlasitis
- Mississippi State University, PO Box 6186, Mississippi State, MS 39762, United States.
| | - Joonkoo Yun
- East Carolina University, M60 Minges, Mail Stop 559, Greenville, NC 27858, United States.
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