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Managing health problems in people with intellectual disabilities
- Authors:
- van SCHROJENSTEIN LANTMAN-DE VALK Henny M.J., WALSH Patricia Noonan
- Journal article citation:
- British Medical Journal, 13.12.09, 2008, pp.1408-1412.
- Publisher:
- British Medical Association
People with intellectual disabilities have a higher prevalence of health problems that the general public, and their health needs are often unrecognised and unmet. A up-to-date clinical review for medical generalists on the health needs of people with learning disabilities is presented. The article also covers communication, treatment decisions and developing health management plans.
Type 2 diabetes: living a healthier life
- Authors:
- SPEAKUP SELF ADVOCACY, (Producer)
- Publisher:
- Speakup Self Advocacy
- Publication year:
- 2008
- Pagination:
- DVD
- Place of publication:
- Rotherham
Having diabetes means that your body produces too little or no insulin. If you have type 2 diabetes (also known as non-insulin dependent diabetes), your body produces some insulin, but less than you need. The insulin you do produce does not work properly. Whether you have had type 2 diabetes for some time, or if you are newly diagnosed, this section gives advice on how to eat healthily, manage the medication you may have to take and generally avoid the long term complications associated with having diabetes Your family and friends will also find this website useful, in particular the sections regarding hypoglycaemia (often referred to as 'hypo' or 'diabetic coma'), when your blood sugars may fall dangerously low and hyperglycaemia, when the opposite happens and your blood sugars rise too high. Having diabetes does not mean that you cannot live a normal life, but it does mean that you have to be more aware of your health now and how it will affect areas of your life such as working or travelling.
The impact of repeated health checks for adults with intellectual disabilities
- Authors:
- FELCE David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(6), November 2008, pp.585-596.
- Publisher:
- Wiley
An earlier study found that a structured health check conducted in primary care identified clinically significant previously unrecognized morbidity among adults with intellectual disabilities. This study aimed to examine whether follow-up health checks would identify equally significant newly identified morbidity and to investigate this as a function of the interval between health checks. Adults with intellectual disabilities who had had an initial health check (n = 108) participated: group 1 (n = 39) had a repeat health check an average of 28 months later, group 2 (n = 36) had a repeat health check an average of 44 months later and group 3 (n = 33) did not have a subsequent health check. Thirty participants in group 1 had a second repeat health check an average of 14 months after the first repeat. An audit of the results of the health check established whether morbidity was newly identified. Information was collected on each participant's age, gender, place of residence, skills, challenging behaviour, social abilities, psychiatric status and perceived health. Comparisons within groups over time or between groups at a point in time were made using non-parametric statistics. A similar number of newly identified health problems were found at the repeat health check compared to the initial check. The nature of needs identified was also similar. There was no association between the number of new needs identified at the repeat health check and the interval between it and the initial check. The perceived health of participants receiving health checks tended to decline. As the level of new need revealed by repeated checks at even the shortest interval since the previous check studied here (mean = 14 months) was as high as that found by the initial check, annual health checking could be a justifiable intervention for this population. Decline in perceived health may represent more accurate assessment by carers following feedback from the health checks.
The impact of checking the health of adults with intellectual disabilities on primary care consultation rates, health promotion and contact with specialists
- Authors:
- FELCE David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(6), November 2008, pp.597-602.
- Publisher:
- Wiley
Studies have found that health checking in primary care led to the identification of previously unrecognized morbidity among adults with intellectual disabilities. This study aimed to evaluate whether health checking stimulated increased consultation with the general practitioner or another member of the primary care team, increased health promotion actions undertaken outside the health check or increased contact with specialists. Data on the above three categories of activity were abstracted from the medical records of 77 adult participants with intellectual disabilities for eight 6-month periods before and seven 6 month periods after they had undergone a health check. Comparisons of access to care before and after the health check were made using non-parametric statistics. On average, participants had 5.4 and 1.8 primary care and specialist consultations per year respectively. There were no significant differences in either rate before and after the health check. The frequency of health promotion actions increased significantly after the health check from a mean of 1.2 to 2.2/year. Comparison of the primary care and specialist consultations rates of people with intellectual disabilities with those for the general population might suggest that the former have greater access to these services. However, comparison to the general practitioner consultation rates of patients with other chronic conditions would seem to indicate that contact with primary care may not be commensurate with need. Attention to health promotion is inadequate.
Meanings and experiences of menstruation: perceptions of institutionalized women with an intellectual disability
- Authors:
- CHOU Yueh-Ching, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(6), November 2008, pp.575-584.
- Publisher:
- Wiley
No studies have ever been conducted concerning menstrual experiences among women with an intellectual disability in Taiwan. An in-depth interview was conducted at three public institutions and perceptions and experiences regarding menstruation were elicited from 55 women aged 21–65 years. The participants knew about menstrual blood and could recognize the experiences of period pain and its link to femininity. The women's management of menstruation played a big part in their institutionalized life, where they had relatively limited choice and autonomy. Positive feelings towards the menstrual cycle were experienced by some participants; however, many had negative attitudes towards sexual activities or parenting, even though they knew the association between menstruation and pregnancy. Although these women's experiences of perimenstrual symptoms are quite similar to those of women without intellectual disability, their menstrual management, interpretations and attitudes to menses are influenced by their institutional life and by the society at large.
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.
Healthcare for all: report of the Independent Inquiry into Access to Healthcare for People with Learning Disabilities
- Author:
- MICHAEL Jonathan
- Publisher:
- Independent Inquiry into Access to Healthcare for People with Learning Disabilities
- Publication year:
- 2008
- Pagination:
- 71p.
- Place of publication:
- London
The Independent Inquiry into access to healthcare for people with learning disabilities published’ revealed that although there was evidence of good practice, there are also appalling examples of discrimination, abuse and neglect The Inquiry was launched in response to Mencap’s report entitled report ‘Death by indifference’. The Mencap report looked at the stories of six people with a learning disability who were not looked after properly whilst in the care of the NHS and regrettably died as result. The Independent Inquiry, led by Sir Jonathan Michael ‘sought to identify the action needed to ensure adults and children with learning disabilities receive appropriate treatment in acute and primary healthcare in England’. The outcome of the report found that there was evidence of good practice, but also ‘appalling examples of discrimination, abuse and neglect across the range of health services’.
Characterisation of user-defined health status in older adults with intellectual disabilities
- Authors:
- STARR J. M., MARSDEN L.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(6), June 2008, pp.483-489.
- Publisher:
- Wiley
Older adults with Intellectual Disabilities (ID) have an excess disease burden that standard health assessments are designed to detect. Older adults with ID have a broader concept of health with dimensions of well being in addition to absence of disease in line with the World Health Organization's health definition. This study sought to characterise user-defined health status in a sample of older adults with ID. A user-led health assessment was administered to 57 adults with ID aged 40 years and over. Cluster analysis on user-defined health themes of participation, nutrition and hygiene/self-care identified clear separation of participants into a healthier and a less healthy group. Disease burden and medication use were greater in the less healthy group. The healthier group were taller, stronger and had better vision than the less healthy group. Constipation, urinary incontinence and faecal incontinence were commoner in the less healthy group. There were few significant differences between health groups on the majority of standard physical-examination items. There is considerable overlap between user-defined health and that assessed by standard instruments. In addition, user-defined health encompasses aspects of physical fitness not captured by traditional disease-based health models.
Methodological issues in inclusive intellectual disability research: a health promotion needs assessment of people attending Irish disability services
- Authors:
- BOLAND M., DALY L., STAINES A.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(3), May 2008, pp.199-209.
- Publisher:
- Wiley
This paper describes a combination of inclusive methods to evaluate health and health promotion needs of service users with intellectual disability. Sixty centres provide disability services to over 900 clients with intellectual disability in the East Coast Area Health Board region of Ireland (population approximately 325 000). The research included interviewer-directed surveys of 247 clients with intellectual disability (or advocates) and 180 clients with physical/sensory disability; focus groups for clients, service providers and carers; and a postal survey for centre managers. Modification of existing surveys was required for people with intellectual disability. Fifty-six of 60 (93.3%) centres participated. The response rate at the client level was 98.8% (3/250 refusals). Health behaviours, likes and dislikes were well described by clients and advocates. Clients identified the need for more creative therapy, physical activity, relaxation therapy and social activities. Service providers and carers emphasized more the need for speech and language therapy, counselling, occupational therapy and physiotherapy. Concludes that inclusive research methods can produce useful outcome measures of the health promotion needs of those with disability. Triangulation is valuable, where clients, carers and service providers are all involved in the research process.
The importance of good quality services for people with complex health needs
- Author:
- CAMPBELL Martin
- Journal article citation:
- British Journal of Learning Disabilities, 36(1), March 2008, pp.32-37.
- Publisher:
- Wiley
This article describes the use of a set of evidence-based quality indicators to assess performance by 15 NHS Boards across Scotland in a national review, with a particular focus on the quality of services for people with complex health needs. Evidence based best practice and evaluative data from previous inspections were used to develop Quality Indicators in four domains. Areas reviewed were: involvement of children and adults with learning disabilities and carers in service planning; meeting complex health needs; inpatient/hospital services and planning services/partnership working. A connection between the group of quality indicators used to assess performance in ‘meeting complex health needs’ and overall measures of quality was observed. The importance of good quality services for people with complex health needs is discussed in light of these results.