共查询到20条相似文献，搜索用时 15 毫秒
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Oliver Chadwick Jennifer Beecham Nicola Piroth Sarah Bernard & Eric Taylor 《Child and Adolescent Mental Health》2002,7(2):66-72
Need for, and receipt of, respite care services were examined in a representative sample of 103 5–11-year-old children with severe intellectual disability and their families. Children for whom respite care was wanted had significantly more severe disabilities and behaviour problems than those whose parents felt they did not need it; their parents also reported significantly higher levels of stress. However, among those who wanted respite care, none of these factors appeared relevant to whether or not they had received it. The results suggest the need for greater account to be taken of the severity of the child's behaviour problems and intellectual disabilities in the allocation of respite care services, and also for measures to improve the supply of respite care placements capable of managing children with more challenging behaviour. 相似文献
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R. S. Balogh H. Ouellette‐Kuntz M. Brownell A. Colantonio 《Journal of intellectual disability research : JIDR》2013,57(3):226-239
Background Hospitalisations for ambulatory care‐sensitive (ACS) conditions are used as an indicator of access to, and the quality of, primary care. The objective was to identify factors associated with hospitalisations for ACS conditions among adults with an intellectual disability (ID) in the context of a publicly insured healthcare system. Methods This study examined adults with an ID living in a Canadian province between 1999 and 2003 identified from administrative databases. Using 5 years of data for the study population, characteristics of persons hospitalised or not hospitalised for ACS conditions were compared. Using a conceptual model, independent variables were selected and an analysis performed to identify which were associated with hospitalisations for ACS conditions. The correlated nature of the observations was accounted for statistically. Results Living in a rural area [odds ratio (OR) 1.3; 95% confidence intervals (CI) = 1.0, 1.8], living in an area with a high proportion of First Nations people (OR 2.3; 95% CI = 1.3, 4.1), and experiencing higher levels of comorbidity (OR 25.2; 95% CI = 11.9, 53.0) were all associated with a higher likelihood of being hospitalised for an ACS condition. Residing in higher income areas had a protective effect (OR 0.56; 95% CI = 0.37, 0.85). None of the health service resource variables showed statistically significant associations. Conclusions Persons with an ID experience inequity in hospitalisations for ACS conditions according to rurality, income and proportion who are First Nations in a geographic area. This suggests that addressing the socio‐economic problems of poorer areas and specifically areas densely populated by First Nations people may have an impact on the number of hospitalisations for ACS conditions. Study strengths and limitations and areas for potential future research are discussed. 相似文献
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Carli Friedman Mary C. Rizzolo Natasha A. Spassiani 《Journal of Policy and Practice in Intellectual Disabilities》2020,17(1):70-78
People with intellectual and developmental disabilities (IDD) have significantly poorer health than the general population. A key threat to health programs for people with IDD is commitment from stakeholders, especially service organizations. The aim of this study was to explore the role disability service organizations play in promoting the best possible physical and mental health of people with IDD. To do so, this study analyzed secondary Personal Outcome Measures® data from 1,341 people with IDD in the United States using binary logistic regressions. Our findings revealed that organizational supports can play a key role in promoting the health of people with IDD. By paying attention to all of these aspects of health and supports, especially discrepancies in supports, service organizations can work to counteract health disparities in those they support. 相似文献
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K. S. Brooker;R. De Greef;J. N. Trollor;C. S. Franklin;J. Weise; 《Journal of Policy and Practice in Intellectual Disabilities》2024,21(1):e12497
People with intellectual disability experience some of the greatest health disparities in Australia. Individuals are expected to access mainstream health services that are ill equipped to meet their needs. The Australian government has made recent commitments to improve the healthcare of people with intellectual disability. This article describes the Australian health system and how it responds to the needs of people with intellectual disability. It draws on examples of advances in policy, inclusion, and service development, achieved through concrete and persistent systemic advocacy, to discuss emerging evidence on the delivery of healthcare to people with intellectual disability in Australia. The article also highlights immediate priorities including increasing the uptake of health assessments, building the capacity of our health workforce, and responding to the needs of people with intellectual disability in COVID-19 outbreaks or other natural disasters. Intellectual disability healthcare is at a dynamic point in Australia with commitment and funding from government to lead to change. It is critical that momentum in health services development is maintained to enable improved health outcomes for people with intellectual disability. 相似文献
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Susan Wood Satheesh Gangadharan Freya Tyrer Rohit Gumber John Devapriam Avinash Hiremath Sabyasachi Bhaumik 《Journal of Policy and Practice in Intellectual Disabilities》2014,11(1):1-7
Healthcare pathways are a relatively new approach to delivering care in intellectual disability services. The authors endeavored to ascertain and explore successes and challenges in the implementation of care pathways in a National Health Service adult intellectual disability service in Leicestershire, UK. Data were obtained from a variety of sources including observations of multidisciplinary team meetings, issue logs, and feedback from health professionals. Constant comparative analysis identified 10 themes: communication between health professionals; clarity and dissemination of relevant documentation; multidisciplinary working; role of health professionals; role of administrative staff; locality differences; information technology systems; care pathway procedures; attitudes toward care pathways; and impact on clients. It was found that a new implementation of care pathways approach to service delivery in the healthcare setting can be challenging for health professionals. Some of the challenges were generic to service change and could be addressed through careful and organized preplanning of the implementation process. Others, such as organizational culture and attitudes within the organization, were contextual and may be unique to each service and warrant significant advance consideration when attempting implementation. 相似文献
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Jacqueline H. Byrne Nicholas G. Lennox Robert S. Ware 《Journal of intellectual & developmental disability》2016,41(1):66-74
Background People with intellectual disability have substantially more unidentified health needs than the general population. We systematically reviewed the effectiveness of primary healthcare interventions intended to increase health actions for people with intellectual disability.Methods Electronic databases were searched on 16 September 2014. Randomised and non-randomised studies with a concurrent control group were identified. Study quality was assessed and, where possible, meta-analysis was undertaken.Results Five studies (3 randomised controlled trials, 1 matched cohort study, and 1 cohort study) with a total of 1,570 participants were included. General practitioner-led health checks were the most effective intervention and resulted in significantly more clinical activities, such as vision testing (risk ratio [RR]?=?3.3, 95% CI [2.3, 4.7]) and hepatitis B vaccinations (RR?=?2.4, 95% CI [1.7, 3.4]).Conclusions Health checks were the only intervention to significantly increase short-term health promotion and disease prevention activity. The long-term effect of any intervention remains unknown. 相似文献
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James K. H. Jung Marina Heifetz Anna Durbin 《Journal of intellectual & developmental disability》2019,44(3):346-356
Background: HIV among individuals with intellectual and developmental disabilities (IDD) is rarely studied. This scoping review examined the HIV prevalence, health service use, prevention and risk behaviours among individuals with IDD.
Method: Journal articles, book chapters and theses written in English and published from 1991 to 2017 in four academic databases (PubMed, PsycINFO, CINAHL and Web of Science) were eligible for inclusion.
Results: From 1636 unique records, 32 documents were included in this review. They contained limited information on HIV prevalence and health service use by individuals with IDD and HIV. Most studies identified a poor understanding of HIV and high-risk behaviours, such as inconsistent condom use, among individuals with IDD. While HIV education programs were effective for this population, no studies identified educational interventions for their service providers.
Conclusion: There is a need for educational programs and policies on HIV for both service providers and individuals with IDD. 相似文献
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J. D. Lin C. F. Yen C. W. Li & J. L. Wu 《Journal of intellectual disability research : JIDR》2005,49(1):86-94
Objectives The aims of the present study were to examine health characteristics and healthcare utilization in relation to people with intellectual disability (ID) having psychiatric disorders in Taiwan. Methods A cross-sectional study was employed; study subjects were recruited from the National Disability Registration Database. Taiwan, stratified by administrative geographical area for the study. Statistical analysis of 1026 carers for people with ID was made to examine the health status and healthcare utilization of individuals with ID having psychiatric disorders. Results Approximately 12.1% of people with ID had psychiatric disorders. These individuals were more likely to be poorer in health condition and consuming more medical services (in the outpatient, inpatient and emergency care areas), than those individuals without psychiatric disorders. These individuals with psychiatric disorders were also taking medicines regularly at a far greater percentage than did those without psychiatric disorders. Conclusions Given the high prevalence of psychiatric disorders among individuals with ID, the healthcare system should take further steps to develop an appropriate health status monitoring system and community-based and easily accessible mental health services for them. 相似文献
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Background Individuals with Down syndrome increasingly survive into adulthood, yet little is known about their healthcare patterns as adults. Our study sought to characterise patterns of health care among adults with Down syndrome based on whether they had fully transitioned to adult‐oriented providers by their inception in this cohort. Methods In this retrospective observational cohort study, healthcare utilisation and annualised patient charges were evaluated in patients with Down syndrome aged 18–45 years who received care in a single academic health centre from 2000 to 2008. Comparisons were made based on patients' provider mix (only adult‐focused or ‘mixed’ child‐ and adult‐focused providers). Results The cohort included 205 patients with median index age = 28 years; 52% of these adult patients had incompletely transitioned to adult providers and received components of their care from child‐focused providers. A higher proportion of these ‘mixed’ patients were seen exclusively by subspecialty providers (mixed = 81%, adult = 46%, P < 0.001), suggesting a need for higher intensity specialised services. Patients in the mixed provider group incurred higher annualised charges in analyses adjusted for age, mortality, total annualised encounters, and number of subspecialty disciplines accessed. These differences were most pronounced when stratified by whether patients were hospitalised during the study period (e.g. difference in adjusted means between mixed versus adult provider groups: $571 without hospitalisation, $19 061 with hospitalisation). Conclusions In this unique longitudinal cohort of over 200 adults aged 18–45 years with Down syndrome, over half demonstrated incomplete transition to adult care. Persistent use of child‐focused care, often with a subspecialty emphasis, has implications for healthcare charges. Future studies must identify reasons for distinct care patterns, examine their relationship with clinical outcomes, and evaluate which provider types deliver the highest quality care for adults with Down syndrome and a wide variety of comorbidities. 相似文献
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J. Weise A. Pollack H. Britt J. N. Trollor 《Journal of intellectual disability research : JIDR》2016,60(11):1119-1127
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Janelle Weise Allan J. Pollack Helena Britt 《Journal of intellectual & developmental disability》2017,42(4):416-421
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. 相似文献
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M. M. Meijer S. Carpenter F. A. Scholte 《Journal of Policy and Practice in Intellectual Disabilities》2004,1(1):10-15
Abstract An invitational conference organized by the Netherlands Society of Physicians for Persons with Intellectual Disabilities (NVAVG) and the European Association of Intellectual Disability Medicine (MAMH), in collaboration with the Erasmus Medical Center's Department of Specialist Training for Physicians for People with Intellectual Disabilities, had as its aim the development and issuance of an European manifesto on adequate health care for people with intellectual disabilities (ID). This paper provides an overview of the basis for the conference and the manifesto and lays out recommendations for the implementation of the manifesto's main points. The group's product, the European Manifesto on Basic Standards of Health Care for People with Intellectual Disabilities, summarizes the core elements of adequate health care for individuals with ID, and offers guidance on how Europe's nations may address deficiencies in health provision for people with ID. The manifesto's main points include a call for greater available and accessible health care, increasing the competencies in ID of health professionals, educators, and researchers, a greater reliance on a multidisciplinary approach to health care, more specialist services, and a proactive emphasis on personal health management. 相似文献
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