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Checklists for general practitioner diagnosis of depression in adults with intellectual disability
- Authors:
- TORR J., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 52(11), November 2008, pp.930-941.
- Publisher:
- Wiley
In Australia, diagnosis and management of depression in adults with intellectual disability (ID) often occurs within the primary care setting. Few tools are available to assist general practitioners (GPs) in the diagnostic process. The study aim was to assess properties of carer and GP checklists developed to address this problem. Participants were 49 adults with ID and their paid carers (support workers), and GPs for 27 adults. Data from carer and GP checklists were gathered, in addition to carer completed Developmental Behaviour Checklist – Adults (DBC-A). Adults with ID also received a comprehensive psychiatric assessment. Both checklists demonstrated good internal consistency (KRS-20 = 0.90). A factor analysis of the carer checklist indicated a single factor on which three section totals had loadings of greater than 0.722 (depressed mood, loss of interest, and social interaction and communication). This factor was interpreted to be depression. The GP checklist data were insufficient for factor analysis, but section totals were moderately correlated with most corresponding carer checklist section totals. Carer section totals related to depression also correlated highly with the DBC-A Depression sub-scale, demonstrating good concurrent validity. Contrasting results were obtained for the GP checklist. Most (n = 42) of the participants were diagnosed with a psychiatric disorder, precluding the testing of checklist specificity and sensitivity. The carer checklist shows promise as a means of gathering information needed by a GP in the diagnosis of depression in adults with ID. Further research into its underlying properties and clinical uses of a combined depression checklist is warranted.
A pilot of interventions to improve health care in adolescents with intellectual disability
- Authors:
- LENNOX Nicholas G., REY-CONDE Therese F., FAINT Sonya
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(5), September 2008, pp.484-489.
- Publisher:
- Wiley
People with intellectual disability often have poor health which may be improved through better health advocacy and enhanced communication with their general practitioner. To this end, this study examined the use of the Comprehensive Health Assessment Program (CHAP) and the Ask health diary previously developed for adults with intellectual disability and trialled their use in adolescents attending a Special School in Australia. A CHAP health review completed by both carers and General Practitioners was used to collect information about adolescents' health. An Ask health diary was used in school to learn health advocacy and communication skills. Thirty students, their parents and their eight teachers participated in the trial. The CHAP health review resulted in a mean of 5.2 health conditions being found, and 1.4 planned actions by the general practitioner per adolescent. The Ask health diary was highly accepted by the students and teachers. There did not appear to be any increase in communication skills of the students after using the diary in the school for one term. The CHAP health review and Ask health diary have the potential to improve the health of adolescents with intellectual disability.
General practice registrars' care of people with intellectual disabilities
- Authors:
- COOK Angus, LENNOX Nicholas
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 25(1), March 2000, pp.69-77.
- Publisher:
- Taylor and Francis
This Australian study examines the barriers experienced by general practice registrars in their provision of health care to people with intellectual disabilities. A questionnaire was sent to 289 general practice registrars employed in practices across Australia. Barriers identified included difficulties in assessment and communication factors, limitations in consultation time, inadequate training and education in the field of intellectual disability, problems maintaining continuity of care and uncertainties relating to resources available for people with intellectual disabilities. Possible solutions are explored, such as improved training of registrars and the development of a handbook about intellectual disabilities.
Who provides primary health care for people with an intellectual disability: General practitioner and general practice characteristics from the BEACH dataset
- Authors:
- WEISE Janelle, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 42(4), 2017, pp.416-421.
- Publisher:
- Taylor and Francis
Background: People with an intellectual disability (ID) have complex healthcare needs yet experience barriers to participation in primary care. Further research is required to examine if the characteristics of general practitioners (GPs) and their practices influence their delivery of care to people with ID. Methods: Data from the Bettering the Evaluation and Care of Health program was used to determine if there are significant differences in the ID-GP and Non ID-GP group. Analysis included characteristic-specific rates, chi-square, and odds ratios. Results: This study found that GPs who were Australian medical graduates, practising in rural areas, in accredited practices, and in some states of Australia were significantly more likely to be classified to the ID-GP than the Non ID-GP group. Conclusions: This research suggests that certain GP and practice characteristics may present barriers to primary care participation for people with ID and supports the need for a comprehensive national action framework. (Publisher abstract)
Cluster randomized-controlled trial of interventions to improve health for adults with intellectual disability who live in private dwellings
- Authors:
- LENNOX Nicholas, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 23(4), July 2010, pp.303-311.
- Publisher:
- Wiley
People with intellectual disability who live in the community often have poor health and healthcare, partly as a consequence of poor communication, recall difficulties and incomplete patient health information. This study sought to improve the health advocacy skills of the person with intellectual disability and their carer. A cluster randomised-controlled trial with 2 × 2 factorial design was conducted with adults with intellectual disability to investigate 2 interventions to enhance interactions among adults with intellectual disability, their care providers and general practitioners (GPs). The interventions were the Comprehensive Health Assessment Program (CHAP), a one-off health review tool, and the Ask health diary, designed for ongoing use. The effects of the interventions were measured over the 12 months after their introduction and compared with the activity in the preceding year. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. A total of 242 participants were successfully followed up. The results showed that increased health promotion, disease prevention and case-finding activity were found in the intervention groups using the CHAP. It had a positive impact on Pneumococcus vaccination, hearing testing, Hepatitis A vaccinations, vision testing, and weight measurement. There were no strong changes in the measured outcomes in the group who used the Ask health diary alone.
Meeting in the middle: improving communication in primary health care consultations with people with an intellectual disability
- Authors:
- ZIVIANI Jenny, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 29(3), September 2004, pp.211-225.
- Publisher:
- Taylor and Francis
The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate. This qualitative study in which five GPs, three people with intellectual disability, seven carers and two advocates (parent and friend) were interviewed was conducted in Brisbane, Australia. The aim was to better understand the factors that have an impact upon the success of communication in a medical consultation. Findings suggested that GPs were concerned with the aspects of communication difficulties which influenced their ability to adequately diagnose, manage and inform patients. Implications for practice management were also identified. People with intellectual disability reported frustration when they felt that they could not communicate adequately with the GP and annoyance when they were not included in the communication exchange. Carers were strong advocates for the person with intellectual disability, but indicated insufficient skill and knowledge to provide the level of assistance required in the consultation. The outcome was a model of cooperation that outlined the responsibilities of all players in the medical encounter, prior to, during and after the event.
GP and support people's concerns and priorities for meeting the health care needs of individuals with developmental disabilities: a metropolitan and non-metropolitan comparison
- Authors:
- IACONO Teresa, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 28(4), December 2003, pp.353-368.
- Publisher:
- Taylor and Francis
General practitioners (GPs) from the Australian state of Victoria and support people were surveyed about their concerns and priorities for meeting the health care needs of people with developmental disabilities. Despite the poor response rate (22% and 27%), sampling adequacy was obtained, and the tools were found to have construct validity. According to the results, GPs had concerns about the assessment and management of people with developmental disability and tended to rely on support people. They knew about many services in their communities, but were less likely to know about non-medical, and government and non-government disability services. Support people reported concerns about health care service providers' lack of knowledge, family stress during periods of hospitalisation, and, particularly for rural respondents, the need to travel to access services. There were relatively few differences in responses from metropolitan versus non-metropolitan respondents, which may be explained by the relative accessibility of Victorian rural towns when compared with other Australian states.