1
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Ong N, Gee BL, Long JC, Zieba J, Tomsic G, Garg P, Lapointe C, Silove N, Eapen V. Patient safety and quality care for children with intellectual disability: An action research study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:885-911. [PMID: 35657332 DOI: 10.1177/17446295221104619] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Children with intellectual disability experience significant challenges in accessing and receiving high-quality healthcare leading to poorer health outcomes and negative patient experiences. Families of these children often report a need for healthcare staff to better understand, communicate, and collaborate for better care while staff acknowledge a lack of training. To address this, we utilised an action research framework with a pre- and post- survey to evaluate an integrated continuing professional development and quality improvement program combining strategies from education, behavioural psychology and quality improvement that was delivered in two departments within a tertiary children's Hospital in Metropolitan Sydney in 2019-2020. Parents reported noticeable changes in the clinical practice of staff, and staff acknowledged and attributed their shift in behaviour to raising awareness and discussions around necessary adaptations. The program demonstrates a novel method for knowledge translation to practice and systems improvements.
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Affiliation(s)
- Natalie Ong
- Child Development Unit, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Brendan Loo Gee
- Academic Unit of Child Psychiatry South West Sydney (AUCS), UNSW Sydney & Ingham Institute, Sydney, NSW, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Jerzy Zieba
- Academic Unit of Child Psychiatry South West Sydney (AUCS), UNSW Sydney & Ingham Institute, Sydney, NSW, Australia and Department of Psychology, University of Rzeszow, Poland
| | - Gail Tomsic
- Child Development Unit, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Pankaj Garg
- Specialist Disability Health Team, Department of Community Paediatrics, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Caleb Lapointe
- The KidsSim Centre, Children's Hospital at Westmead, Sydney, NSW, Australia
- The KidsSim Centre, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Natalie Silove
- Child Development Unit, Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry South West Sydney (AUCS), UNSW Sydney & Ingham Institute, Sydney, Australia
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2
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Towson G, Daley S, Banerjee S. Intellectual disabilities teaching for medical students: a scoping review. BMC MEDICAL EDUCATION 2023; 23:818. [PMID: 37915002 PMCID: PMC10621142 DOI: 10.1186/s12909-023-04766-4] [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: 05/03/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND People with intellectual disabilities are a marginalized group whose health experiences and outcomes are poor. Lack of skill and knowledge in the healthcare workforce is a contributing factor. In England, there is a new legislative requirement for mandatory intellectual disability training to be given to the existing healthcare workforce, including doctors. There is a lack of evidence about effective models of educational delivery of such training in medical schools. We undertook a scoping review to assess the range of intellectual disabilities educational interventions and their effectiveness. METHODS We included any study from 1980 onwards which reported an educational intervention on intellectual disability, or intellectual disability and autism, for medical students from any year group. Databases searched included PUBMED, ERIC, Scopus and Web of Science as well as searches of grey literature and hand searching two journals (Medical Education and Journal of Learning Disabilities). 2,020 records were extracted, with 1,992 excluded from initial screening, and a further 12 excluded from full-text review, leaving 16 studies for inclusion. Data was extracted, quality assessed, and findings collated using narrative analysis. RESULTS We found a variety of intervention types: classroom-based teaching, simulation, placement, home visits, and panel discussions. There was substantial variation in content. Most studies involved lived experience input. Across studies, interventions had different learning outcomes which made it difficult to assess effectiveness. Overall study quality was poor, with high use of non-validated measures, making further assessment of effectiveness problematic. CONCLUSIONS There is a need for more consistency in intervention design, and higher quality evaluation of teaching in this area. Our review has drawn attention to the variety in teaching on this topic area and further research should focus on updating this review as curriculum changes are implemented over time.
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Affiliation(s)
- Georgia Towson
- Brighton and Sussex Medical School, Centre for Dementia Studies, University of Sussex, Trafford Building, Room 101, Falmer, BN1 9RY, UK
| | - Stephanie Daley
- Brighton and Sussex Medical School, Centre for Dementia Studies, University of Sussex, Trafford Building, Room 101, Falmer, BN1 9RY, UK.
| | - Sube Banerjee
- Faculty of Medicine and Health Sciences, University of Nottinham, Nottingham, UK
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3
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Campbell EG, Rao SR, Ressalam J, Bolcic-Jankovic D, Lawrence R, Moore JM, Iezzoni LI. Caring for Adults With Significant Levels of Intellectual Disability in Outpatient Settings: Results of a National Survey of Physicians. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:36-48. [PMID: 36548375 DOI: 10.1352/1944-7558-128.1.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/15/2022] [Indexed: 06/17/2023]
Abstract
Between 1% and 2% of the U.S. population has an intellectual disability (ID) and often experience disparities in health care. Communication patterns and sedation use for routine medical procedures are important aspects of care for this population. We explored physicians' communication patterns and sedation use in caring for patients with significant levels of ID through a mailed survey of 1,400 physicians among seven specialties in outpatient settings (response rate = 61.0%). Among physicians who saw at least one patient with significant levels of ID in an average month, 74.8% reported usually/always communicating primarily with someone other than the patient. Among specialists, 85.5% (95% CI: 80.5%-90.5%) reported doing so, compared to 69.9% (95% CI: 64.4%-75.4%) for primary care physicians (p < 0.001). Also, 11.4% reported sedating at least one patient with significant levels of ID for a routine procedure. Three quarters of physicians reported communicating primarily with persons other than the patient usually or always-an approach that, in some instances, may not align with best medical practice. The percentage of physicians who report sedating at least one individual is associated with significant ID and the physician's volume of patients with significant ID.
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Affiliation(s)
| | - Sowmya R Rao
- Sowmya R. Rao, Massachusetts General Hospital Biostatistics Center and Boston University School of Public Health
| | - Julie Ressalam
- Julie Ressalam, University of Colorado School of Medicine
| | | | - Rosa Lawrence
- Rosa Lawrence, University of Colorado School of Medicine
| | - Jaime M Moore
- Jaime M. Moore, University of Colorado School of Medicine
| | - Lisa I Iezzoni
- Lisa I. Iezzoni, Massachusetts General Hospital and Harvard Medical School
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4
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Navas P, Verdugo MÁ, Martínez S, Amor AM, Crespo M, Deliu MM. Impact of COVID-19 on the burden of care of families of people with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:577-586. [PMID: 34888996 DOI: 10.1111/jar.12969] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/06/2021] [Accepted: 11/26/2021] [Indexed: 01/02/2023]
Abstract
AIM This study analysed the impact that COVID-19 and the response measures implemented by the Spanish Government have had on families of individuals with intellectual and developmental disabilities. METHOD Data on 323 family members (M = 52.3 years old; SD = 10.5) were collected through an online survey, which was focused on analysing difficulties experienced and service provision during lockdown. RESULTS Many families (66.3%) have seen their level of stress increased during lockdown because of, among other reasons, a greater burden of care. Difficulties were associated with the closure and changes in disability-related services. Families of people with extensive support needs have generally experienced greater difficulties. CONCLUSION Support services should have been considered essential services during lockdown. The failure to receive support has resulted in excessive burden on families, who had to assume a multitude of roles to support their family member with intellectual and developmental disability.
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Affiliation(s)
- Patricia Navas
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Miguel Ángel Verdugo
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Sergio Martínez
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Antonio M Amor
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Manuela Crespo
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Madalin M Deliu
- Institute on Community Integration (INICO), University of Salamanca, Salamanca, Spain
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5
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Lazcano-Ponce E, Angeles-Llerenas A, Rodríguez-Valentín R, Salvador-Carulla L, Domínguez-Esponda R, Astudillo-García CI, Madrigal-de León E, Katz G. Communication patterns in the doctor-patient relationship: evaluating determinants associated with low paternalism in Mexico. BMC Med Ethics 2020; 21:125. [PMID: 33302932 PMCID: PMC7731770 DOI: 10.1186/s12910-020-00566-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Paternalism/overprotection limits communication between healthcare professionals and patients and does not promote shared therapeutic decision-making. In the global north, communication patterns have been regulated to promote autonomy, whereas in the global south, they reflect the physician's personal choices. The goal of this study was to contribute to knowledge on the communication patterns used in clinical practice in Mexico and to identify the determinants that favour a doctor-patient relationship characterized by low paternalism/autonomy. METHODS A self-report study on communication patterns in a sample of 761 mental healthcare professionals in Central and Western Mexico was conducted. Multiple ordinal logistic regression models were used to analyse paternalism and associated factors. RESULTS A high prevalence (68.7% [95% CI 60.0-70.5]) of paternalism was observed among mental health professionals in Mexico. The main determinants of low paternalism/autonomy were medical specialty (OR 1.67 [95% CI 1.16-2.40]) and gender, with female physicians being more likely to explicitly share diagnoses and therapeutic strategies with patients and their families (OR 1.57 [95% CI 1.11-2.22]). A pattern of highly explicit communication was strongly associated with low paternalism/autonomy (OR 12.13 [95% CI 7.71-19.05]). Finally, a modifying effect of age strata on the association between communication pattern or specialty and low paternalism/autonomy was observed. CONCLUSIONS Among mental health professionals in Mexico, high paternalism prevailed. Gender, specialty, and a pattern of open communication were closely associated with low paternalism/autonomy. Strengthening health professionals' competencies and promoting explicit communication could contribute to the transition towards more autonomist communication in clinical practice in Mexico. The ethical implications will need to be resolved in the near future.
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Affiliation(s)
- Eduardo Lazcano-Ponce
- Population Health Research Centre, National Institute of Public Health, Cuernavaca, Morelos, Mexico.,Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Angelica Angeles-Llerenas
- Population Health Research Centre, National Institute of Public Health, Cuernavaca, Morelos, Mexico. .,Research Ethics Committee, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Rocío Rodríguez-Valentín
- Population Health Research Centre, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | | | | | - Eduardo Madrigal-de León
- Hospital Director at the National Institute of Psychiatry Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Gregorio Katz
- Department of Mental Health, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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6
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Casanova Dias M, Perera B, Riese F, De Picker L, Pinto da Costa M, Petricean A, Kanellopoulos A, Krysta K, Baessler F. Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions. Eur Psychiatry 2020; 63:e99. [PMID: 33183377 PMCID: PMC7737176 DOI: 10.1192/j.eurpsy.2020.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.
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Affiliation(s)
- Marisa Casanova Dias
- National Centre for Mental Health, School of Medicine, Cardiff University, Cardiff, United Kingdom.,Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Bhathika Perera
- Haringey Learning Disability Partnership, Barnet, Enfield and Haringey Mental Health Trust, London, United Kingdom
| | - Florian Riese
- Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium.,University Psychiatric Hospital Campus Duffel, Antwerp, Belgium
| | - Mariana Pinto da Costa
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, United Kingdom.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,Hospital de Magalhães Lemos, Porto, Portugal
| | - Alina Petricean
- National Centre for Mental Health, BSMHFT, Birmingham, United Kingdom
| | - Athanasios Kanellopoulos
- Center for Adolescent Medicine, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Krzysztof Krysta
- Department of Rehabilitation Psychiatry, Medical University of Silesia, Katowice, Poland
| | - Franziska Baessler
- Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
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7
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Olsson S, Gustafsson C. Employees' experiences of education and knowledge in intellectual disability practice. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12338] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sylvia Olsson
- Department of School of Health Care and Social WelfareMälardalen University Eskilstuna Sweden
| | - Christine Gustafsson
- Department of School of Health Care and Social WelfareMälardalen University Eskilstuna Sweden
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8
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Zhou M, Du W, Salvador-Carulla L, Glasgow N. Adverse drug event-related hospitalisation in persons with neurodevelopmental disorders: a state-wide retrospective cohort study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:429-440. [PMID: 30609156 DOI: 10.1111/jir.12586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 11/06/2018] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known about the sociodemographic and clinical characteristics of adverse drug events (ADEs) in patients with neurodevelopmental disorders (NDD). OBJECTIVE The objective of this study was to describe and compare the demographic details of people with and without NDD hospitalised due to ADEs. METHODS The all-inclusive New South Wales Admitted Patient Data Collection from 2001 to 2014 was employed to identify ADE-related hospitalisations in patients with NDD using the International Classification of Diseases 10th revision Australian modification codes. We derived case sets specific to different clinical groups and patient characteristics and compared proportional differences between patients with and without intellectual disability using chi squared tests. RESULTS A total of 2173 patients with NDD were admitted for acute care of ADEs, accounting for 0.7% of all ADE-related hospitalisations. Hospitalised ADEs among patients with NDD increased by twofold over the 14-year study period. Psychotropic medications and opioid analgesic medications were leading causes of ADE-related hospitalisations in patients with NDD. Compared with their counterparts, patients with NDD were younger, experienced more socio-economic disadvantage and less private insurance coverage, suffered with less severe but different co-morbid clinical conditions and incurred more challenges in the acute hospital care setting. CONCLUSION Although the pattern of ADE-related hospitalisations in patients with NDD differed from that in patients without NDD, there is a lack of targeted healthcare programmes to meet their special needs. This study suggests the need for countermeasures in primary healthcare settings to reduce the burden of ADEs in this vulnerable group.
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Affiliation(s)
- M Zhou
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
- Pharmacy department, People's Hospital of Xinjiang, Urumqi, China
| | - W Du
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia
| | - L Salvador-Carulla
- Centre of Mental Health Research, Research School of Population Health, Australian National University, Canberra, Australia
| | - N Glasgow
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Canberra, Australia
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9
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Işık M, Zorba E. The effects of hemsball on the motor proficiency of students with intellectual disabilities. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2018; 66:104-112. [PMID: 34141372 PMCID: PMC8132925 DOI: 10.1080/20473869.2018.1488534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 06/08/2018] [Indexed: 06/12/2023]
Abstract
Objective: The effects of hemsball game skills development program on the motor proficiency level of children in the 12-16 age group with mild and moderate intellectual disabilities (ID) have been examined in this study. Method: A total of 50 (25 experimental group +25 control group) students, 23 of which had mild intellectual disabilities (ID) and 27 with moderate ID studying in special education classes in the schools in Afyonkarahisar province in Turkey participated in the study. While no training was given to the control group, the students in the experimental group were subjected to 60 min of applications involving a basic hemsball training program per day for 3 days per week throughout 12 weeks. Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) sub-tests (balance, bilateral coordination, upper-limb coordination) were applied twice, once before starting the program (pre-test) and once after the program was completed (post-test). The obtained data were tested with paired-samples t-test and independent-samples t-test. Result and Conclusion: As a result of the study, it was noted that the application of the hemsball game skill development program had incurred significant differences between the experimental and control group according to the post-test as well as the pre-test and post-test for the experimental group which were positive. However, it was determined that the application was more effective in students with moderate level ID than students with mild ID.
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Affiliation(s)
- Meltem Işık
- School of Physical Education and Sport, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Erdal Zorba
- Sport Sciences Faculty, Gazi University, Ankara, Turkey
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10
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Folch-Mas A, Cortés-Ruiz MJ, Salvador-Carulla L, Kazah-Soneyra N, Irazábal-Giménez M, Muñoz-Lorente S, Tamarit-Cuadrado J, Martínez-Leal R. [New considerations on the health of the persons with intellectual developmental disorders]. SALUD PUBLICA DE MEXICO 2018; 59:454-461. [PMID: 29211267 DOI: 10.21149/8201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/12/2017] [Indexed: 11/06/2022] Open
Abstract
Recent literature indicates that people with Disorders of Intellectual Development (DID) experience health disparities in the pathologies that they present, and a worst access to health care. However, current evidence-based knowledge is still sparse outside the Anglo-Saxon countries. The POMONA-I and POMONA-II European projects aimed to collect information on the health status of people with DID in Europe. The POMONA-ESP project in Spain is meant to collect health information in a wide and representative sample of persons with DID. Also, there are studies that claim for the need of specialized services for people with DID at the public health system. There are also studies about the current state of the education and training about DID for students within the health sector. In this paper we review the latest evidences about the health of the persons with DID and we present the main research activities and care initiatives about this issue.
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Affiliation(s)
- Anabel Folch-Mas
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain
| | - María José Cortés-Ruiz
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | | | - Natalia Kazah-Soneyra
- Parc Sanitari Sant Joan de Dèu. Barcelona, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | - Marcia Irazábal-Giménez
- Parc Sanitari Sant Joan de Dèu. Barcelona, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
| | | | | | - Rafael Martínez-Leal
- Unidad de Investigación en Discapacidad Intelectual y Trastornos del Desarrollo, Fundació Villablanca, URU, IISPV. Reus, Spain.,Centre of Biomedical Research Network on Mental Health, CIBERSAM. Spain
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11
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Folch A, Salvador‐Carulla L, Vicens P, Cortés MJ, Irazábal M, Muñoz S, Rovira L, Orejuela C, González JA, Martínez‐Leal R. Health indicators in intellectual developmental disorders: The key findings of the
POMONA
‐
ESP
project. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:23-34. [DOI: 10.1111/jar.12498] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 05/24/2018] [Accepted: 05/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Annabel Folch
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) ‐ Fundació Villablanca IISPV Universitat Rovira i Virgili Reus Spain
- Department of Psychology Universitat Rovira i Virgili Tarragona Spain
| | - Luis Salvador‐Carulla
- Centre for Mental Health Research Research School of Population Health ANU College of Health and Medicine Australian National University Canberra ACT Australia
| | - Paloma Vicens
- Department of Psychology Universitat Rovira i Virgili Tarragona Spain
- Research Center in Behavioral Assessment (CRAMC) Universitat Rovira i Virgili Tarragona Spain
- Laboratory of Toxicology and Environmental Health Universitat Rovira i Virgili Tarragona Spain
| | - Maria José Cortés
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) ‐ Fundació Villablanca IISPV Universitat Rovira i Virgili Reus Spain
- Centre of Biomedical Research Network on Mental Health (CIBERSAM) Madrid Spain
| | - Marcia Irazábal
- Parc Sanitari Sant Joan de Déu Sant Boi de Llobregat Spain
- Faculty of Education Universitat de Barcelona Barcelona Spain
| | | | - Lluís Rovira
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) ‐ Fundació Villablanca IISPV Universitat Rovira i Virgili Reus Spain
| | - Carmen Orejuela
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) ‐ Fundació Villablanca IISPV Universitat Rovira i Virgili Reus Spain
| | - Juan A. González
- Asociación en Favor de las Personas con Discapacidad Intelectual de Córdoba‐ APROSUB Córdoba Spain
| | - Rafael Martínez‐Leal
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD) ‐ Fundació Villablanca IISPV Universitat Rovira i Virgili Reus Spain
- Department of Psychology Universitat Rovira i Virgili Tarragona Spain
- Centre of Biomedical Research Network on Mental Health (CIBERSAM) Madrid Spain
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12
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Nicholas DB, Calhoun A, McLaughlin AM, Shankar J, Kreitzer L, Uzande M. Care Experiences of Adults With a Dual Diagnosis and Their Family Caregivers. Glob Qual Nurs Res 2017; 4:2333393617721646. [PMID: 28804747 PMCID: PMC5533258 DOI: 10.1177/2333393617721646] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/12/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022] Open
Abstract
Individuals diagnosed with developmental disability and mental illness (a “dual diagnosis”) contend with multiple challenges and system-related barriers. Using an interpretive description approach, separate qualitative interviews were conducted with adults with a dual diagnosis (n = 7) and their caregiving parents (n = 8) to examine care-related experiences. Results indicate that individuals with a dual diagnosis and their families experience misunderstanding and stigma. Families provide informal complex care amid insufficient and uncoordinated services but are often excluded from formal care planning. A lack of available funding and services further impedes care. While negative care experiences are reported as prevalent, participants also describe instances of beneficial care. Overall, findings indicate a lack of sufficiently targeted resources, leaving families to absorb system-related care gaps. Recommendations include person- and family-centered care, navigation support, and capacity building. Prevention and emergency and crisis care services, along with housing, vocation, and other supports, are needed. Practice and research development regarding life span needs are recommended.
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13
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Bernal-Celestino RJ, León-Hurtado D, Martínez-Leal R. Acceso y morbilidad hospitalaria en personas con trastornos del desarrollo intelectual. ACTA ACUST UNITED AC 2017; 59:408-415. [DOI: 10.21149/8202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 05/12/2017] [Indexed: 11/06/2022]
Abstract
Objetivo. Las personas con trastornos del desarrollo intelectual (TDI) suelen presentar peor estado de salud que la población general. El objetivo de este estudio es evaluar el acceso y la morbimortalidad hospitalaria en los pacientes con TDI y compararla con la población general. Material y métodos. Se realizó un estudio transversal retrospectivo y se compararon los datos de los ingresos y altas hospitalarias entre pacientes con TDI y sin dichos transtornos, en Ciudad Real, España. Resultados. De un total de 51 325 altas, 441 (0.9%) correspondían a personas con TDI. Estas personas presentaban significativamente menos ingresos programados que la población general y menos intervenciones quirúrgicas y, a su vez, más ingresos debidos a enfermedades mentales y del sistema respiratorio. Conclusiones. Las personas con TDI tienen patrones de morbilidad diferentes a los del resto de la población. Además este estudio revela posibles dificultades en el acceso a la atención sanitaria en estas personas.
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