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Westrop SC, Maenhout L, Melville CA, McGarty AM. Understanding capabilities, opportunities and motivations to engage in physical activity for adults with intellectual disabilities: A qualitative evidence synthesis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13258. [PMID: 39198027 DOI: 10.1111/jar.13258] [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: 02/22/2023] [Revised: 05/03/2024] [Accepted: 05/18/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND There is a paucity of theory-informed physical activity research with adults with intellectual disabilities. This study aimed to address this by synthesising existing literature and applying the COM-B model to understand capabilities, opportunities and motivations. METHODS A qualitative evidence synthesis was conducted and reported in accordance with PRISMA guidelines and the ENTREQ. Three databases were systematically searched up to and including February 2022. Qualitative research relating to the physical activity of adults with intellectual disabilities were included. Thematic synthesis was conducted with themes mapped onto the COM-B model. RESULTS Twenty-five studies were included. Influences of physical activity were identified and mapped onto the COM-B model, which also included COM-B influences of social support provided by caregivers. CONCLUSIONS There are many complex influences of physical activity for adults with intellectual disabilities. Researchers should consider the influences contributing to caregivers' capacity to support physical activity.
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Affiliation(s)
- Sophie C Westrop
- School of Health and Wellbeing, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
- School of Education, Language and Psychology, York St John University, York, UK
| | - Laura Maenhout
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Craig A Melville
- School of Health and Wellbeing, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
| | - Arlene M McGarty
- School of Health and Wellbeing, College of Medical and Veterinary Life Sciences, University of Glasgow, Glasgow, UK
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Ng AP, Kim S, Chervu N, Gao Z, Mallick S, Benharash P, Lee H. Disparities in outcomes of colorectal cancer surgery among adults with intellectual and developmental disabilities. PLoS One 2024; 19:e0308938. [PMID: 39190755 DOI: 10.1371/journal.pone.0308938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 08/02/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Disparities in colorectal cancer screening have been documented among people with intellectual and developmental disabilities (IDD). However, surgical outcomes in this population have yet to be studied. The present work aimed to evaluate the association of IDD with outcomes following colorectal cancer resection. METHODS All adults undergoing resection for colorectal cancer in the 2011-2020 National Inpatient Sample were identified. Multivariable linear and logistic regression models were developed to examine the association of IDD with risk factors as well as outcomes including mortality, complications, costs, length of stay (LOS), and non-home discharge. The study is limited by its retrospective nature and did not capture disease staging or time of diagnosis. RESULTS Among 722,736 patients undergoing colorectal cancer resection, 2,846 (0.39%) had IDD. Compared to patients without IDD, IDD patients were younger and had a higher burden of comorbidities. IDD status was associated with increased odds of non-elective admission (AOR 1.40 [95% CI 1.14-1.73]) and decreased odds of treatment at high-volume centers (AOR 0.64 [95% CI 0.51-0.81]). Furthermore, IDD patients experienced significantly greater LOS (9 vs 6 days, p<0.001) and hospitalization costs ($23,500 vs $19,800, p<0.001) relative to neurotypical patients. Upon risk adjustment, IDD was significantly associated with 2-fold increased odds of mortality (AOR 2.34 [95% CI 1.48-3.71]), 1.4-fold increase in complications (AOR 1.41 [95% CI 1.15-1.74]), and 6.8-fold increase in non-home discharge (AOR 6.83 [95% CI 5.46-8.56]). CONCLUSIONS IDD patients undergoing colorectal cancer resection experience increased likelihood of non-elective admission, adverse clinical outcomes, and resource use. Our findings highlight the need for more accessible screening and patient-centered interventions to improve quality of surgical care for this at-risk population.
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Affiliation(s)
- Ayesha P Ng
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Shineui Kim
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Nikhil Chervu
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Zihan Gao
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Saad Mallick
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
- Department of Surgery, Division of Cardiac Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - Hanjoo Lee
- Department of Surgery, Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA, United States of America
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Kildahl AN. Bias in assessment of co-occurring mental disorder in individuals with intellectual disabilities: Theoretical perspectives and implications for clinical practice. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:393-414. [PMID: 36708367 PMCID: PMC11059834 DOI: 10.1177/17446295231154119] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Influence from bias is unavoidable in clinical decision-making, and mental health assessment seems particularly vulnerable. Individuals with intellectual disabilities have increased risk of developing co-occurring mental disorder. Due to the inherent difficulties associated with intellectual disabilities, assessment of mental health in this population often relies on a different set of strategies, and it is unclear how these may affect risk of bias. In this theoretical paper, we apply recent conceptualisations of bias in clinical decision-making to the specific challenges and strategies in mental health assessment in intellectual disabilities. We suggest that clinical decision-making in these assessments is particularly vulnerable to bias, including sources of bias present in mental health assessment in the general population, as well as potential sources of bias which may be specific to assessments in this population. It follows that to manage potential bias, triangulating information from multi-informant, multi-method, interdisciplinary assessment strategies is likely to be necessary.
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Affiliation(s)
- Arvid Nikolai Kildahl
- Arvid Nikolai Kildahl, Regional Section Mental Health, Intellectual Disabilities/Autism, Oslo University Hospital, Verkensveien 19, Oslo, Asker 1385, Norway.
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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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Milot É, Couvrette R, Marthouret B, Caouette M, Beauchamp J. [Points de vue d'adultes vieillissants ayant une déficience intellectuelle à l'égard de leur participation sociale]. Can J Aging 2024:1-9. [PMID: 38602185 DOI: 10.1017/s0714980824000138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
Au cours du vieillissement, les adultes ayant une déficience intellectuelle (DI) vivent de nombreux changements susceptibles d'influencer leurs possibilités d'exercer leurs activités quotidiennes et leurs rôles sociaux. Une bonne connaissance de leurs points de vue sur le sujet apparaît cruciale pour mieux adapter l'offre de services à leurs besoins. Cette recherche a pour but de mieux comprendre les points de vue des personnes ayant une DI à l'égard de leurs possibilités de participation sociale à travers l'avancée en âge. Des entrevues individuelles et un atelier participatif ont été réalisés avec des adultes âgés de 40 à 75 ans dans la ville de Québec. L'analyse de leurs propos a permis d'identifier leurs points de vue relatifs à trois thèmes, soit leurs capacités, les possibilités d'exercer leur participation sociale et les soutiens reçus. Pour conclure, des recommandations sont proposées afin que les pratiques soutiennent réellement leur participation sociale à travers l'avancée en âge.
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Affiliation(s)
- Élise Milot
- Professeure titulaire à l'École de travail social et de criminologie de l'Université Laval, chercheure régulière au Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), au Centre de recherche et d'expertise en gérontologie sociale (CREGÉS) et à l'Institut universitaire en déficience intellectuelle et trouble du spectre de l'autisme (IU-DI-TSA), Université Laval, École de travail social et de criminologie. Pavillon Charles-De Koninck, bureau 5444, 1030, av. des Sciences-Humaines, Québec G1V 0A6
| | - Romane Couvrette
- Maîtrise en Travail Social, étudiante au doctorat en travail social, Université Laval, École de travail social et de criminologie. Pavillon Charles-De Koninck, bureau 5444, 1030, av. des Sciences-Humaines, Québec G1V 0A6
| | - Bertille Marthouret
- Étudiante à la maîtrise en travail social, Université Laval, École de travail social et de criminologie. Pavillon Charles-De Koninck, bureau 5444, 1030, av. des Sciences-Humaines, Québec G1V 0A6
| | - Martin Caouette
- Professeur au département de psychoéducation et de travail social de l'Université du Québec à Trois-Rivières et chercheur régulier au CIRRIS et à l'IU-DI-TSA, Université du Québec à Trois-Rivières, Département de psychoéducation et travail social. 3351, boul. des Forges, (Local 1024 M-S) C.P. 500, Trois-Rivières (Qc), G8Z 4M3
| | - Julie Beauchamp
- Professeure au département de psychiatrie et de neurosciences, Université Laval et chercheure régulière à Vitam - Centre de recherche en santé durable et au CREGÉS, Université Laval, Faculté de médecine, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, Québec, G1V 0A6
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McMahon M, McCallion P, McCarron M. An invisible population: Late-stage cancer diagnosis for people with intellectual or developmental disability. Cancer 2024; 130:668-670. [PMID: 38014927 DOI: 10.1002/cncr.35132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Mahar et al. found that people with intellectual or developmental disabilities are more likely to be diagnosed with metastatic breast (female) and colorectal cancer in comparison to the general population. This editorial discusses the urgent need to develop effective strategies aimed at reducing this inequity for people with intellectual or developmental disabilities.
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Affiliation(s)
- Martin McMahon
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland
- Trinity Centre for Ageing and Intellectual Disability (TCAID), School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland
| | - Phillip McCallion
- Trinity Centre for Ageing and Intellectual Disability (TCAID), School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland
- School of Social Work (College of Public Health), Temple University, Philadelphia, Pennsylvania, USA
| | - Mary McCarron
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland
- Trinity Centre for Ageing and Intellectual Disability (TCAID), School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, Ireland
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McMahon M, Lynch L, Wormald A, Eustace-Cook J, McCarron M, McCallion P, Smith V. Prevalence and incidence of cancer amongst adults with intellectual disability - a systematic review and meta-analysis protocol. HRB Open Res 2024; 6:51. [PMID: 38332848 PMCID: PMC10850849 DOI: 10.12688/hrbopenres.13740.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Background People with intellectual disabilities have poorer health and die earlier than their peers without identified disabilities. This difference represents a significant inequality. Until recently, it was considered that cancer was less common in this population, mainly because they did not live long enough to develop age-related cancers. However, recent evidence has identified that people with intellectual disabilities may be at an increased risk of developing cancer but more likely to present for medical treatment at a later stage when cancer has spread. Nonetheless, the evidence is lacking and there is a need to understand the prevalence and incidence of cancer and subtypes of cancer in adults with intellectual disabilities. Methods A systematic review and meta-analysis will be undertaken to investigate the prevalence and incidence of cancer and subtypes of cancer in adults with an intellectual disability. The JBI Systematic reviews of prevalence and incidence and the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to develop this protocol. Electronic databases will be searched using predefined search terms to identify relevant studies using the Condition Context Population (CoCoPop) framework. Eligible studies should be observational and have published baseline data that have estimated or presented data on the prevalence or incidence of cancer in adults with intellectual disabilities. To assess the methodological quality of studies included in this review a modified version of the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data will be used. Prevalence and incidence proportions will be analysed separately with individual study data being pooled using the DerSimonian-Laird proportion method and a random effects meta-analysis will be undertaken. Discussion This review will advance the epidemiological evidence to identify where targeted cancer care interventions are needed to help reduce the inequalities that this population experiences. Systematic review registration PROSPERO registration number: CRD42023423584.
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Affiliation(s)
- Martin McMahon
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, D02 PN40, Ireland
- Trinity Centre for Ageing with Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Dublin, Ireland
| | - Louise Lynch
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, D02 PN40, Ireland
- Trinity Centre for Ageing with Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Dublin, Ireland
| | - Andrew Wormald
- Trinity Centre for Ageing with Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Dublin, Ireland
| | - Jessica Eustace-Cook
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, D02 PN40, Ireland
| | - Mary McCarron
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, D02 PN40, Ireland
- Trinity Centre for Ageing with Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Dublin, Ireland
| | - Philip McCallion
- Trinity Centre for Ageing with Intellectual Disability (TCAID), The University of Dublin Trinity College, School of Nursing & Midwifery, Dublin, Ireland
- School of Social Work (College of Public Health), Temple University, Philadelphia, Pennsylvania, USA
| | - Valerie Smith
- School of Nursing & Midwifery, The University of Dublin Trinity College, Dublin, D02 PN40, Ireland
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Nurminen F, Rättö H, Arvio M, Teittinen A, Vesala HT, Saastamoinen L. Medicine use in people with intellectual disabilities: a Finnish nationwide register study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1291-1305. [PMID: 36372946 DOI: 10.1111/jir.12988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/09/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are a vulnerable group in our society; many of them depend on other people for assistance in their everyday lives. Compared with the general population, people with ID have poorer general health and, therefore, need more healthcare services and use more medicines. The aim of this study is to define the population of all Finnish people with ID using administrative data and to compare their medicine use and expenditure on medicines to those of the age-matched and sex-matched controls. METHODS People with ID and their age-matched and sex-matched controls (1:1) were extracted from nationwide healthcare and social allowance registers. Administrative register data on all prescription medicine purchases in 2019 were used to determine the prevalence of medicine use in both groups on a general level and by medicine categories. The differences in the prevalence of medicine use between the two groups were analysed using the logistic regression model. In addition, we studied the total expenditure on reimbursable medicine purchases covered by the National Health Insurance between people with ID and control group. RESULTS The subpopulation of people with ID consisted 37 196 individuals, of whom 82.7% purchased prescription medicines in 2019. The corresponding share of individuals purchasing prescription medicines in the control group was 70.3%. The differences in the prevalence of medicine use between the two populations were highest in the younger age groups (0-6, 7-12 and 13-17). In the study population, 28.1% (OR = 12.28; 95% CI: 11.54-13.07) of the people used antipsychotics, making it the most used medicine category in people with ID. In the control group, 3.3% of people used antipsychotics. Compared with the control group, the use of antiepileptics, drugs for constipation, mineral supplements and anxiolytics was four to seven times higher among people with ID. Furthermore, the median expenditure on medicine use among people with ID was four times higher than in the control group. CONCLUSIONS Compared with the control group, people with ID used more medicines, especially psychotropics, and their expenditure on medicine use was higher.
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Affiliation(s)
- F Nurminen
- Research Unit, The Social Insurance Institution, Helsinki, Finland
| | - H Rättö
- Research Unit, The Social Insurance Institution, Helsinki, Finland
| | - M Arvio
- Päijät-Häme Joint Municipal Authority, Neurology, Lahti, Finland
- PEDEGO, Oulu University Hospital, Oulu, Finland
- Department of General Practice, Turku University, Turku, Finland
- Turku University Central Hospital, Turku, Finland
| | - A Teittinen
- Research Unit, The Social Insurance Institution, Helsinki, Finland
| | - H T Vesala
- Finnish Association on Intellectual and Developmental Disabilities (FAIDD), Espoo, Finland
| | - L Saastamoinen
- Research Unit, The Social Insurance Institution, Helsinki, Finland
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May P, El-Mallakh RS. Historical Perspective Regarding Health Care of Adults with Neurodevelopmental Disorders. South Med J 2023; 116:964-966. [PMID: 38051172 DOI: 10.14423/smj.0000000000001629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
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Moloney M, Hennessy T, Doody O. Parents' perspectives on reasonable adjustments in acute healthcare for people with intellectual disability: A qualitative descriptive study. J Adv Nurs 2023; 79:4268-4279. [PMID: 37391905 DOI: 10.1111/jan.15772] [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: 03/03/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023]
Abstract
AIM To describe parents' perspectives on reasonable adjustments in acute healthcare for people with intellectual disability (ID). BACKGROUND People with ID are vulnerable in terms of their health needs and marginalized when accessing and utilizing acute healthcare services. Reasonable adjustments are positive measures that can help alleviate health disparities. However, despite significant research advocating their use, evidence of implementation of reasonable adjustments in acute healthcare practice is limited. DESIGN A qualitative descriptive study. METHODS Qualitative semi-structured interviews were conducted with six parents of children with ID, who had accessed and used acute healthcare services. The interviews were conducted between January and May 2022, audio-recordings were transcribed and thematically analysed. RESULTS Parents described limited or no experiences of reasonable adjustments when accessing or utilizing acute healthcare services for their children. The findings are captured in three themes; describing the reality, understanding the impact and signposting the future. The findings highlight a lack of implementation of reasonable adjustments in acute healthcare which negatively impacts the experience of all stakeholders. CONCLUSION There is a pressing need for reasonable adjustments to be implemented at a strategic level across acute healthcare services, so that people with ID and their families can access person-centred acute healthcare when needed. IMPACT The research findings will inform researchers interested in reasonable adjustments and implementation research, and those interested in advocating for the rights of people with ID. REPORTING METHOD This study adhered to the Equator research reporting checklist: Consolidated criteria for reporting qualitative research: a 32-item checklist for interviews and focus groups. PATIENT OR PUBLIC CONTRIBUTION A parent of a child with an ID was part of the research team informing the design, data collection, data analysis and write-up of this article.
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Affiliation(s)
- Mairead Moloney
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, Limerick, Ireland
| | - Therese Hennessy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
- Health Implementation Science and Technology, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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McMahon MJ, O'Connor AM, Dunbar P, Delany A, Behan L, Grogan C, Keyes LM. Mortality in residential care facilities for people with disability: a descriptive cross-sectional analysis of statutory notifications in Ireland. BMJ Open 2023; 13:e065745. [PMID: 37147100 PMCID: PMC10163474 DOI: 10.1136/bmjopen-2022-065745] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES To determine incidence of death in residential care facilities for people with disability in Ireland, primary cause of death, associations of facility characteristics and deaths, and to compare characteristics of deaths reported as expected and unexpected. DESIGN Descriptive cross-sectional study. SETTING All residential care facilities for people with disability operational in Ireland in 2019 and 2020 (n=1356). PARTICIPANTS n=9483 beds. MAIN OUTCOME MEASURES All expected and unexpected deaths notified to the social services regulator. Cause of death as reported by the facility. RESULTS 395 death notifications were received in 2019 (n=189) and 2020 (n=206). 45% (n=178) were for unexpected deaths. Incidence of death per 1000 beds per year was 20.83 for all, 11.44 for expected and 9.39 for unexpected deaths. Respiratory disease was the most common cause of death, accounting for 38% (n=151) of all deaths. In adjusted negative binomial regression analysis, congregated settings versus non-congregated (incidence rate ratio (95% CI): 2.59 (1.80 to 3.73)) and higher bed numbers (highest vs lowest quartile) (4.02 (2.19 to 7.40)) were positively associated with mortality. There was also a positive n-shaped association with category of nursing staff-to-resident ratio when compared with zero nurses. Emergency services were contacted for 6% of expected deaths. Of the deaths reported as unexpected, 29% were receiving palliative care and 10.8% had a terminal illness. CONCLUSION Although incidence of death was low, residents of congregated and larger settings had higher incidence of death than residents of other settings. This should be a consideration for practice and policy. Given the high contribution of respiratory diseases to deaths and the potential avoidability of these, there is a need for improved respiratory health management in this population. Nearly half of all deaths were reported as unexpected; however, overlap in the characteristics of expected and unexpected deaths highlights the need for clearer definitions.
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Affiliation(s)
- Martin J McMahon
- Health Information Quality Authority, Mahon, Cork, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
- Trinity Centre for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | | | - Paul Dunbar
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Anna Delany
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Laura Behan
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Carol Grogan
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Laura M Keyes
- Health Information Quality Authority, Mahon, Cork, Ireland
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Djordjevic M, Glumbić N, Brojčin B, Banković S, Žunić Pavlović V. Differences in pragmatic communication skills of adults with intellectual disabilities and dual diagnoses. Front Psychiatry 2023; 14:1072736. [PMID: 36816408 PMCID: PMC9934929 DOI: 10.3389/fpsyt.2023.1072736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Pragmatics includes a set of skills related to language structure and meaning that allow the speaker to use the language appropriately and in accordance with different communication situations. The aim of this research was to determine the differences in pragmatic communication skills of adults with intellectual disabilities, dual diagnoses, and typical development, and to determine the effects of gender, age, the level of intellectual functioning and speech comprehension on their achievements on two assessment instruments. METHODS The sample included 180 adults (60 typically developing participants, 60 with intellectual disabilities, and 60 participants with dual diagnoses). We used two instruments to assess pragmatic communication skills - Communication Checklist - Adult, CC-A, and the Assessment Battery for Communication, ABaCo. In order to test the differences between the three groups of participants, we used canonical discriminant analysis. RESULTS Discriminant analysis revealed two significant canonical functions. Function one (speech comprehension and the level of intellectual disability, social engagement, and paralinguistic scale) differentiates between typically developing participants and participants with dual diagnoses the most. The second canonical function (language structure, linguistic scale, paralinguistic scale, extralinguistic scale, and context scale) differentiates between participants with intellectual disabilities and participants with dual diagnoses the most. According to the results, age did not affect pragmatic achievements. DISCUSSION Pragmatic skills are very complex, and different instruments measure different dimensions of these abilities. The results of this research lead to the conclusion that we can differentiate between the pragmatic abilities of typically developing people, people with intellectual disabilities, and those with dual diagnoses with the help of the ABaCo battery and the CC-A questionnaire.
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Affiliation(s)
- Mirjana Djordjevic
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Nenad Glumbić
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Branislav Brojčin
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Slobodan Banković
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Vesna Žunić Pavlović
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
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McMahon M, Hatton C, Hardy C, Preston NJ. The relationship between subjective socioeconomic status and health in adults with and without intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1390-1402. [PMID: 36054256 PMCID: PMC9804692 DOI: 10.1111/jar.13028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 07/04/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND This study investigated if subjective socioeconomic status (SSS) is related to self-rated health (SRH) and objective indicators of health in people with and without intellectual disability. METHODS Participants were 217 adults with, and 2350 adults without intellectual disability in Jersey. In the intellectual disability sample, 85 (39.2%) participants consented independently, while 132 (60.8%) participants consented through proxy procedures. The MacArthur Scale of Subjective Social Status was used to measure SSS. The Euro-Qol EQ-5D-5L and a five-point scale ranging from poor to excellent health were used to measure SRH. RESULTS Higher SSS and younger age were predictors of better SRH for the proxy-report intellectual disability group. Being employed was associated with higher EQ-5D-5L index values for all intellectual disability groups. CONCLUSION As SSS was only related to SRH in the proxy intellectual disability group, further research with a larger intellectual disability sample is needed to explore its utility further.
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Affiliation(s)
- Martin McMahon
- Division of Health ResearchLancaster UniversityLancasterUK
- Health and Community Services Government of JerseyJerseyUK
| | - Chris Hatton
- Division of Health ResearchLancaster UniversityLancasterUK
- Faculty of Health, Psychology & Social CareManchester Metropolitan UniversityManchesterUK
| | - Claire Hardy
- Division of Health ResearchLancaster UniversityLancasterUK
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Amir N, Smith L, Valentine AM, Mitra M, Parish SL, Moore Simas TA. Clinician perspectives on the need for training on caring for pregnant women with intellectual and developmental disabilities. Disabil Health J 2021; 15:101262. [PMID: 35031269 PMCID: PMC8983509 DOI: 10.1016/j.dhjo.2021.101262] [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: 07/28/2021] [Revised: 11/27/2021] [Accepted: 12/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Women with intellectual and developmental disabilities (IDDs) experience disparities in obstetric care access and quality, in addition to communication gaps with healthcare providers. Many obstetric providers are untrained and uneducated about critical aspects of providing care to persons with IDDs. OBJECTIVE The study was conducted to describe obstetric clinicians' training experiences related to providing obstetric care to women with IDDs, to assess the perceived need for formalized training, and to identify recommendations for training content. METHODS This study involved qualitative individual interviews (n = 9) and one focus group (n = 8) with obstetric clinicians who self-reported experience caring for women with IDDs during pregnancy. Descriptive coding and content analysis techniques were used to develop an iterative codebook related to education and training; codes were applied to the data. Coded data were analyzed for larger themes and relationships. RESULTS Analysis revealed three main themes: 1. Need for obstetric training and education: No participant reported receiving any training in caring for pregnant women with IDDs. Participants expressed a need for formal education. 2. Recommendations for formal training: Participants noted the need for training during residency and beyond, and all healthcare staff members should be included in training. 3. Training outcomes should increase knowledge, enhance attitudes, and develop practical skills related to care for pregnant women with IDDs. CONCLUSION Results indicate a need for systematic training efforts regarding obstetric care for women with IDDs. Improved training and education may decrease health inequities and improve the quality of care, and thus pregnancy outcomes, for women with IDDs. LEVEL OF EVIDENCE VI.
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Affiliation(s)
- Nili Amir
- University of Connecticut Medical School, Department of Obstetrics and Gynecology, 200 Academic Way, Farmington, CT 06032, USA; University of Masachusetts Chan Medical School, 55 Lake Ave North Worcester, MA 01605, USA.
| | - Lauren Smith
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, USA
| | - Anne M Valentine
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, USA
| | - Monika Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, USA
| | - Susan L Parish
- Virginia Commonwealth University, College of Health Professions, 900 E. Leigh Street, Box 980233 Richmond, VA 23298, USA
| | - Tiffany A Moore Simas
- University of Massachusetts Chan Medical School/UMass Memorial Health Care Department of Obstetrics and Gynecology, Pediatrics, Psychiatry, and Population and Quantitative Health Sciences Memorial Campus, 119 Belmont Street, Jaquith Building Floor 2, Worcester, MA 01605, USA
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15
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Rosencrans M, Tassé MJ, Kim M, Krahn GL, Bonardi A, Rabidoux P, Bourne ML, Havercamp SM. Invisible populations: Who is missing from research in intellectual disability? RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 119:104117. [PMID: 34736107 DOI: 10.1016/j.ridd.2021.104117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
It is estimated that approximately 41% of adults with intellectual and developmental disability (IDD) are served through the developmental disabilities (DD) system in the US. The remaining 59% include individuals who meet diagnostic criteria but are not actively receiving paid services or may not be known to the DD system. Scholars have referred to this group as the "hidden majority." Very little is known about the health and well-being of these adults. It remains to be seen if the hidden majority is comparably susceptible to mental health difficulties, given how little is known about this population by DD systems. The purpose of this manuscript is to highlight where one may identify individuals belonging to this hidden population and how researchers might effectively recruit from this group so as to ensure more representative samples of all people with IDD.
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Affiliation(s)
| | - Marc J Tassé
- The Ohio State University Nisonger Center, United States
| | - Minje Kim
- The Ohio State University Nisonger Center, United States
| | | | | | - Paula Rabidoux
- The Ohio State University Nisonger Center, United States
| | - Mary Lou Bourne
- National Association of State Directors of Developmental Disabilities Services, United States
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Leyssens L, Van Hecke R, Moons K, Luypaert S, Danneels M, Patru J, Willems M, Maes L. Postural balance problems in people with intellectual disabilities: Do not forget the sensory input systems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:280-294. [PMID: 34693604 DOI: 10.1111/jar.12948] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This pilot study aimed to explore the impact of visual, auditory and vestibular dysfunctions on the postural balance performance in adults with intellectual disabilities. Additionally, a comparison was made between the subjects with intellectual disabilities and a control group concerning static and dynamic balance tasks. METHOD Thirty adults with intellectual disabilities and 25 control subjects received a postural balance assessment. Additionally, the experimental group was subjected to a visual, auditory and vestibular screening. RESULTS The experimental group performed significantly worse and/or showed more sway compared to the control group for all balance tasks (p < .01) except the timed up and go test. Within the experimental group, a significant positive correlation (rs (24) = 0.513, p = .007) was observed between the number of failed sensory screening items and the number of failed balance tasks. CONCLUSIONS These findings suggest significant involvement of peripheral sensorial deficits in the balance problems that people with intellectual disabilities often experience.
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Affiliation(s)
- Laura Leyssens
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Ruth Van Hecke
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Karlien Moons
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Sofie Luypaert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Maya Danneels
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Julie Patru
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Melina Willems
- Department of Audiology, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium.,Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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McMahon M, Hatton C, Bowring DL, Hardy C, Preston NJ. The prevalence of potential drug-drug interactions in adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:930-940. [PMID: 33988262 DOI: 10.1111/jir.12844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/13/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is a high use of medications in adults with intellectual disability (ID). One implication of taking multiple medications is the potential for drug-drug interactions (DDIs). However, despite this being well highlighted in the mainstream literature, little is known about the incidence or associations of DDIs in the ID population. METHODS This study describes the prevalence, patterns and associations of potential DDIs in a total administrative sample of adults with ID known to services in Jersey. Demographic, health-related and medication data were collected from 217 adults known to ID services. Data were collected using a face-to-face survey. The Anatomical Therapeutic Chemical classification system was used to categorise medications, and Stockley's Drug Interaction Checker was used to classify potential DDIs. Drug-drug pairings were considered to be of clinical significance if they were to be 'avoided, adjusted, monitored or required further information'. RESULTS Potential DDIs of clinical significance were common. Exposure to potential DDIs of clinical significance was associated with being female, taking more than five medications (polypharmacy), living in residential care and having more health conditions. A simple regression was used to understand the effect of number of prescribed medications on potential DDIs of clinical significance. Every prescribed drug led to a 0.87 (95% confidence interval: 0.72-1.00) increase in having a potential DDI of clinical significance. CONCLUSION Adults with ID who live in residential care, who are female, exposed to polypharmacy and have more health conditions may be more likely to have potential DDIs of clinical significance. Urgent consideration needs to be given to the potential of DDIs in this population given their exposure to high levels of medication.
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Affiliation(s)
- M McMahon
- Division of Health Research, Lancaster University, Lancaster, UK
- Health and Community Services, Government of Jersey, Saint Helier, Jersey
| | - C Hatton
- Division of Health Research, Lancaster University, Lancaster, UK
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | - D L Bowring
- Health and Community Services, Government of Jersey, Saint Helier, Jersey
- CEDAR, University of Warwick, Coventry, UK
| | - C Hardy
- Division of Health Research, Lancaster University, Lancaster, UK
| | - N J Preston
- Division of Health Research, Lancaster University, Lancaster, UK
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Schott W, Tao S, Shea L. COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:975-987. [PMID: 34420427 PMCID: PMC8859009 DOI: 10.1177/13623613211039662] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
LAY ABSTRACT Autistic adults, adults with intellectual disability, and adults with other mental health conditions may have higher risk of contracting COVID-19 or experiencing more severe illness from COVID-19 if infected. We used data from Medicaid to look at whether autistic adults and other adults with intellectual disability and other mental health conditions were more likely to have risk factors for COVID-19, such as living in a residential facility, receiving services regularly in the home from outside caregivers, having had a long hospitalization, having had avoidable hospitalizations, and having high-risk health conditions. We found that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization, and having a high-risk health condition, compared to neurotypical adults without mental health conditions. Adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers, and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition. High risk of COVID-19 among autistic adults and adults with intellectual disability and mental health conditions should be recognized by clinicians, and these groups should be prioritized for vaccine outreach.
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Olsen MI, Halvorsen MB, Søndenaa E, Langballe EM, Bautz-Holter E, Stensland E, Tessem S, Anke A. How do multimorbidity and lifestyle factors impact the perceived health of adults with intellectual disabilities? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:772-783. [PMID: 33977582 DOI: 10.1111/jir.12845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID. METHOD The North Health in Intellectual Disability study is a community based cross-sectional survey. The POMONA-15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied. RESULTS The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P < 0.05], level of ID (OR 0.65, P < 0.05), numbers of physical health conditions (OR 1.6, P < 0.001) and lower motor function (OR 1.5 P < 0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30 min of physical activity daily (OR 2.0, P = 0.07). CONCLUSION Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health.
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Affiliation(s)
- M I 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
| | - M B Halvorsen
- Department of Pediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - E Søndenaa
- Faculty of Medicine and Health Sciences (MH), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Brøset, St. Olavs University Hospital, Trondheim, Norway
| | - E M Langballe
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - E Bautz-Holter
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - E Stensland
- Department of Community, Medicine, UiT - The Artic University of Norway, Tromsø, Norway
| | - S Tessem
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - A 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
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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