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The role of supported employment agencies in promoting the health of people with learning disabilities: a briefing report for Department of Health and agencies
- Authors:
- VIGNA Elisa, BEYER Stephen, KERR Michael
- Publisher:
- Welsh Centre for Learning Disabilities
- Publication year:
- 2011
- Pagination:
- 22p.
- Place of publication:
- Cardiff
Health promotion is particularly important for people with learning disabilities. Particular health problems faced by people with learning disabilities include obesity, smoking and alcohol use. This research examines the role of supported employment agencies (SEAs) in promoting the health of people with learning disabilities. A web survey was set up to investigate the strategies used by the UK SEAs to prevent behaviour that risks health. Fifty agencies completed the survey: 79% from England; 13% from Wales; 4% from Scotland; and 4% from Northern Ireland. The report presents the results regarding the activities of SEAs in assessing, training and providing ongoing support in relation to health and well-being promotion initiatives. Data on the agency’s awareness of the health problems people with learning disabilities face were included in the survey results. The research identified health promotion assistance agencies either delivered directly or outsourced to health professionals. The paper identifies the potential for agencies to capitalise on their role as employment mediators to promote healthy lifestyles for employees with learning disabilities.
Self-management abilities of diabetes in people with an intellectual disability living in New Zealand
- Authors:
- HALE Leigh A., et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(4), December 2011, pp.223-230.
- Publisher:
- Wiley
Diabetes is more prevalent is people with intellectual disabilities than the general population. This qualitative study aimed to understand how to improve the self-management abilities of diabetes in people with an intellectual disability (ID) by exploring the understanding of diabetes held by 14 adults with ID and either type 1 or type 2 diabetes in New Zealand. Participants fell into three categories of understanding: those who had a good understanding; those who had limited understanding; and those with only a very basic understanding. While all of the participants were actively engaged in the self-management process, support from others was important, even for those with a good understanding of the disease. The authors concluded that while those with ID could be taught self-management, it was important to continue education and support throughout their lives. User-friendly teaching resources are recommended to achieve the education and support required.
Qualitative study of malnutrition in people with intellectual disabilities
- Authors:
- FRANSSEN Janine J. L., MAASKANT Marian A., SCHROJENSTEIN Henny M. J. van
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(4), December 2011, pp.239-246.
- Publisher:
- Wiley
People with intellectual disabilities (ID) are vulnerable to underweight status, often because of co-occurring eating disorders. However, it is unclear whether this results in malnutrition. This qualitative study investigated the awareness and knowledge of three physicians, three dieticians, and three direct care staff regarding malnutrition in people with ID from six different service providers in the Netherlands. Semi-structured interviews were held to explore participants’ experiences with problems and possible solutions. Findings revealed that the dieticians and physicians saw malnutrition prevalent in persons with ID that their clients, but they were uncertain about why this was the case. However, the direct care staff were certain that malnutrition was not present. The authors suggested screening of high-risk persons for the presence of malnutrition, and recommended education of direct care staff about healthy nutrition and weight. In ending, the authors called for the development of a screening instrument for malnutrition specifically for people with ID.
Longitudinal follow-up of weight change in the context of a community-based health promotion programme for adults with an intellectual disability
- Authors:
- THOMAS G. R., KERR M. P.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 24(4), July 2011, pp.381-387.
- Publisher:
- Wiley
Obesity has been identified as a major health concern in adults with intellectual disabilities. ‘Fit4Wales’ is an ongoing health promotion service delivered by a NHS physiotherapy team which screens, documents and monitors the weight status of individuals with an intellectual disability. The aims of this study were to evaluate the accessibility of this programme and the outcome in terms of weight alteration. The study analysed routine data collected prospectively from the attendees of the Fit4Wales programme. A total of 191 adults with intellectual disabilities were screened and monitored over a 2-year period. The findings showed that 69% of the samples were overweight, obese, or morbidly obese at the beginning of the programme. Despite attendance at intermediate follow-up clinics, 21% of the sample failed to attend at year 1 and 34% failed to attend at year 2 clinics. In terms of BMI changes at year one, 52% of the at-risk BMI category remained static, 26.7% showed a worsening weight status and 20.7% showed an improving weight status. At year 2, 52.1% of the at risk BMI category remained static, while 22% got worse and 25% showed an improvement in weight status. This evaluation demonstrates that long-term health promotion services are challenging to deliver. To be successful, further research is needed into multi-disciplinary programmes which incorporate the primary carers and are responsive to NICE guidelines.
The role of staff in health promotion in community residences for people with intellectual disabilities: variation in views among managers and caregivers
- Authors:
- BERGSTROM Helena, WIHLMAN Ulla
- Journal article citation:
- Journal of Intellectual Disabilities, 15(3), September 2011, pp.167-176.
- Publisher:
- Sage
- Place of publication:
- London
Staff in community residences for people with intellectual disabilities are expected both to promote residents’ health and to support their right to make their own choices. The aim of this article was to explore variation in views among managers and caregivers on the role of staff in health promotion. A qualitative study was conducted using semi-structured interviews with 6 managers and 6 caregivers from community residences in Stockholm County. Analysis of the transcripts revealed 5 qualitatively different main categories of roles that staff play in health promotion: the parent; the manipulator; the coach; the educator; and the libertarian. Managers mainly expressed views that placed them among the least protective/controlling categories, whilst caregivers were at the other end of the spectrum. The transcripts were also analysed to reveal the lifestyle-related risk factors for ill-health and barriers to a healthy lifestyle that staff in community residences must handle. The results highlight the ethical conflict that faces staff trying to support a healthy lifestyle as well as the autonomy of the residents.
Caregiver attitudes to gynaecological health of women with intellectual disability
- Authors:
- LIN Lan-Ping, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 36(3), September 2011, pp.149-155.
- Publisher:
- Taylor and Francis
Previous research has indicated with women with intellectual disability (ID) have reduced access to reproductive health care. As caregivers often take charge of healthcare issues for people with ID, this study aimed to describe caregiver attitudes and to examine determinants of acceptable gynaecological health for women with ID. A mailed-out, self-administered, structured questionnaire was completed by 1152 caregivers responsible for the care of women with ID. Attitudinal perceptions of reproductive health were divided into 4 domains: menstruation, menopause, sex education, and preventive healthcare. Each of these domains had 5 issues which were scored according to the level of agreement with each issue. Most of the caregivers expressed agreement concerning the implementation of gynaecological healthcare checks, such as Pap smear or mammography tests. The study also revealed that more attention needs to be paid to the following factors: enforcing workplace training for reproductive health; strengthening public reproductive health services; and improving the reproductive health knowledge of caregivers.
The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe
- Authors:
- MARTINEZ-LEAL R., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(9), September 2011, pp.858-872.
- Publisher:
- Wiley
Despite progress in deinstitutionalisation, relatively little is known about the health of people with intellectual disability (PWID) who live in large institutions or those living in small residential services, family homes or independently in the community. Nor are there any international comparisons at the European level of the health status and health risks of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses without formal support. A total of 1269 persons with ID and/or their proxy respondents were interviewed in 14 EU countries using the P15 multinational assessment battery to collect data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, formal support and stage of deinstitutionalisation. Obesity and sedentary lifestyle were prevalent along with illnesses such as epilepsy, mental disorders, allergies or constipation. There were more cases of myocardial infarction, chronic bronchitis, osteoporosis and gastric or duodenal ulcers among participants in countries at the early stage of deinstitutionalisation. There were important deficits in variables related health promotion such as screening and vaccination in family homes and independent living arrangements. The authors point to the important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation.
Cancer prevention and health promotion for people with intellectual disabilities: an exploratory study of staff knowledge
- Authors:
- HANNA L. M., TAGGART L., COUSINS W.
- Journal article citation:
- Journal of Intellectual Disability Research, 55(3), March 2011, pp.281-291.
- Publisher:
- Wiley
People with intellectual disabilities are living longer but are also at increased risk of health problems compared to the general population. Recognising the early signs and symptoms of cancer in a population with cognitive impairment and communication difficulties poses difficulties for family and professionals alike. Engagement in health promotion and cancer prevention is also a challenge. This postal survey explored how carers address these challenges. Forty staff, across fifteen residential facilities in Northern Ireland, completed a questionnaire about the risk and protective factors of stomach, breast, cervical and testicular cancer. They then completed questions about 90 adults with ID, recording body mass index, lifestyle choices (i.e. smoking, diet), Helicobacter pylori testing, family history of cancer and staff's health promotion and cancer prevention activities with them. The women had significantly higher BMIs than the men and only two people had been tested for the H. pylori infection. The majority of the staff had not received training in cancer prevention and most were unaware of the family histories of the people in their care. There was considerable variation in how staff approached health promotion and screening for specific cancers. The authors conclude that health promotion and cancer prevention activities for people with ID could be improved. The importance of staff training in order to raise knowledge and awareness is highlighted.
Neighbourhood deprivation, health inequalities and service access by adults with intellectual disabilities: a cross-sectional study
- Authors:
- COOPER S.-A., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(3), March 2011, pp.313-323.
- Publisher:
- Wiley
The relationship between intellect, education, deprivation and health is said to be complex but adults with intellectual disabilities (IDs) experience more health inequalities and are more likely to live in deprived areas. This study set out to determine whether the extent of deprivation in the area where a person lives affects their access to services and thus contributes to health inequalities. Interviews were conducted with 1023 adults with IDs within a defined location in Greater Glasgow and their medical records were reviewed. The extent of area deprivation was defined by postcode. Area deprivation did not influence access to social supports, daytime primary health-care services or hospital admissions, but people in more deprived areas made less use of secondary outpatient health care and more use of accident and emergency care. Women in more deprived areas were more likely to have had a cervical smear but there was little association with other health promotion uptake. Area deprivation was not associated with access to paid employment, daytime occupation, or respite care. The results were largely unchanged after adjusting for type of accommodation and level of ability. It is concluded that deprivation may not contribute to health inequality in those with IDs in the same way as in the general population.
An audit of a smoking cessation programme for people with an intellectual disability resident in a forensic unit
- Authors:
- CHESTER Verity, GREEN Fatima N., ALEXANDER Regi T.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 5(1), January 2011, pp.33-41.
- Publisher:
- Emerald
This article first briefly reviews the literature on smoking and smoking cessation programmes for people with intellectual disability. A smoking cessation programme in place in a forensic in-patient service for people with intellectual disabilities in the East of England is then described together with the findings of an audit to establish the prevalence and significant associations of smoking in this group and the effect of the intervention. The intervention focused on health education and nicotine replacement therapies. The audit included 79 patients, 48 of whom were smokers on admission. Fifteen subjects gave up smoking while resident in the service. Those who did not give up significantly reduced the number of cigarettes they smoked per day. Female smokers appeared less likely to give up than men. Length of stay and treatment with antipsychotic medication were not significantly linked to smoking behaviour. There was a significant relationship between the level of security in which a patient was resident and smoking. Patients treated on medium secure wards were significantly more likely to be smokers than those in lower levels of security. The authors conclude that this simple smoking cessation programme appeared to be effective in cutting down smoking rates and tobacco consumption in this population. They comment that the findings need to be viewed with caution as the audit was limited by the lack of a control group and conducted in a single service.