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Do demographic, and clinical characteristics influence meeting NICE quality standards for young people transitioning to adult intellectual disability services? 人口统计学和临床特征是否会影响过渡到成人智障服务的年轻人达到NICE质量标准?
IF 1.1 Q3 Medicine Pub Date : 2022-08-19 DOI: 10.1108/amhid-12-2021-0051
Paul Soper, A. Stewart, R. Nathan, Sharleen Nall-Evans, Rachel Mills, Felix Michelet, S. Jaydeokar
PurposeThis study aims to evaluate the quality of transition from child and adolescent services to adult intellectual disability services, using the relevant National Institute for Health and Care Excellence (NICE) standard (QS140). In addition, this study also identifies any differences in transition quality between those young people with intellectual disability with and without autism.Design/methodology/approachUsing routinely collected clinical data, this study identifies demographic and clinical characteristics of, and contextual complexities experienced by, young people in transition between 2017 and 2020. Compliance with the quality standard was assessed by applying dedicated search terms to the records.FindingsThe study highlighted poor recording of data with only 22% of 306 eligible cases having sufficient data recorded to determine compliance with the NICE quality standard. Available data indicated poor compliance with the standard. Child and adolescent mental health services, generally, did not record mental health co-morbidities. Compliance with three out of the five quality statements was higher for autistic young people, but this only reached statistical significance for one of those statements (i.e. having a named worker, p = 0.02).Research limitations/implicationsMissing data included basic clinical characteristics such as the level of intellectual disability and the presence of autism. This required adult services to duplicate assessment procedures that potentially delayed clinical outcomes. This study highlights that poor compliance may reflect inaccurate recording that needs addressing through training and introduction of shared protocols.Originality/valueTo the best of the authors’ knowledge, this is the first study to examine the transition process between children’s and adults’ intellectual disability health services using NICE quality standard 140.
目的本研究旨在使用相关的国家健康与护理卓越研究所(NICE)标准(QS140),评估从儿童和青少年服务向成人智力残疾服务的过渡质量。此外,这项研究还确定了患有和不患有自闭症的智障年轻人在过渡质量方面的任何差异。设计/方法/方法利用常规收集的临床数据,本研究确定了2017年至2020年间转型期年轻人的人口统计学和临床特征,以及他们所经历的背景复杂性。通过对记录使用专门的检索词来评估是否符合质量标准。发现该研究强调了数据记录不佳,在306例符合条件的病例中,只有22%的病例记录了足够的数据来确定是否符合NICE质量标准。现有数据表明不符合标准。一般来说,儿童和青少年心理健康服务机构没有记录心理健康合并症。自闭症年轻人对五分之三的质量陈述的依从性更高,但这仅对其中一种陈述(即有指定的工作人员,p=0.02)具有统计学意义。研究局限性/含义缺失的数据包括基本的临床特征,如智力残疾水平和自闭症的存在。这需要成人服务重复评估程序,这可能会延迟临床结果。这项研究强调,合规性差可能反映出记录不准确,需要通过培训和引入共享协议来解决。独创性/价值据作者所知,这是第一项使用NICE质量标准140检查儿童和成人智障健康服务之间过渡过程的研究。
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引用次数: 1
Systematic review of systematic reviews on psychological therapies for people who have intellectual disabilities: 1. Quality appraisal 智力障碍患者心理治疗的系统综述:质量评估
IF 1.1 Q3 Medicine Pub Date : 2022-08-04 DOI: 10.1108/amhid-01-2022-0003
C. Clarke, S. Kellett, N. Beail
PurposeThis paper aims to assess the quality of systematic reviews on the effectiveness of psychological therapy for adults with intellectual disabilities (ID) and mental health difficulties.Design/methodology/approachFour electronic databases were used: Cochrane, PsycINFO, PubMed and Scopus. Studies were included if they were a systematic review focused primarily on psychological therapy for adults with ID and mental health difficulties. Systematic reviews focused on anger were also considered for inclusion. These reviews were rated for quality on the Amstar-2, a quality rating tool designed to evaluate systematic reviews.FindingsTwelve relevant systematic reviews were identified, which included seven reviews focused primarily on cognitive behavioural therapy, two on psychodynamic therapy and three on third-wave therapies. The AMSTAR-2 indicated that all 12 reviews were of “critically low” quality. Thus, there are significant problems with the evidence base.Originality/valueTo the best of the authors’ knowledge, this is the first systematic review of systematic reviews of the effectiveness of psychological therapies for people who have ID. It provides an overview of the quality of the evidence base into one place.
目的本文旨在评估对智力残疾(ID)和心理健康困难成年人心理治疗有效性的系统评价的质量。设计/方法/方法使用四个电子数据库:Cochrane、PsycINFO、PubMed和Scopus。如果研究是一项系统综述,主要关注有ID和心理健康困难的成年人的心理治疗,则将其包括在内。还考虑纳入以愤怒为重点的系统评价。这些评论在Amstar-2上进行了质量评级,这是一种旨在评估系统评论的质量评级工具。发现确定了12篇相关的系统综述,其中7篇综述主要关注认知行为疗法,2篇综述关注心理动力疗法,3篇综述关注第三波疗法。AMSTAR-2指出,所有12项审查的质量都“极低”。因此,证据基础存在重大问题。独创性/价值据作者所知,这是对ID患者心理治疗有效性的系统评价的首次系统评价。它将证据库的质量概述到了一个地方。
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引用次数: 2
Psychiatric symptoms influence the performance on the Screener Intelligence and Learning Disabilities in general mental health care in The Netherlands 精神症状影响荷兰普通精神卫生保健筛查者智力和学习障碍的表现
IF 1.1 Q3 Medicine Pub Date : 2022-06-16 DOI: 10.1108/amhid-12-2021-0052
J. Nieuwenhuis, E. Noorthoorn, P. Lepping, N. Mulder, H. Nijman
PurposeA recently published study showed a 41% prevalence of mild intellectual disability (MID) and borderline intellectual functioning (BIF) in a large sample of Dutch psychiatric patients. This study aims to examine if the outcomes of the Screener for Intelligence and Learning Disabilities (SCIL) were affected by the severity of psychiatric symptoms during admission.Design/methodology/approachThe authors administered the SCIL and the Kennedy Axis V (domain psychological impairment) at two moments when patients were sufficiently stabilised and just before discharge.FindingsA total of 86% of the respondents had the same outcome regardless of the time of administration. The Kennedy score correlated modestly with changes in the SCIL scores, suggesting that the severity of psychiatric symptoms just modestly affected the performance.Practical implicationsRecognising MID/BIF in mental health care is essential but challenging for clinicians. The authors concluded that screening with the SCIL allows clinicians to identify patients with MID/BIF at an early stage of their admission, which helps to individualise treatment and reduce the risk of aggression, coercive measures and prolonged admissions. However, the authors prefer to assess all patients on cognitive impairment as early as possible after referral at a more stable moment in time.Originality/valueTo the best of the authors’ knowledge, there is no research concerning screening instruments on MID/BIF used at admission wards in Mental Health Care.
目的最近发表的一项研究表明,在荷兰精神病患者的大样本中,41%的人患有轻度智力残疾(MID)和边缘性智力功能(BIF)。本研究旨在探讨智力和学习障碍筛查(SCIL)的结果是否受到入院时精神症状严重程度的影响。设计/方法学/方法作者在患者足够稳定和出院前的两个时刻进行SCIL和肯尼迪轴V(领域心理障碍)。结果发现,无论执政时间如何,共有86%的受访者的结果相同。肯尼迪分数与SCIL分数的变化适度相关,这表明精神症状的严重程度只是适度地影响了表现。在精神卫生保健中认识MID/BIF是必要的,但对临床医生来说是具有挑战性的。作者得出结论,使用SCIL进行筛查可以让临床医生在患者入院的早期阶段识别出MID/BIF患者,这有助于个体化治疗,减少攻击、强制措施和延长入院时间的风险。然而,作者更倾向于在转诊后尽早在更稳定的时间点评估所有患者的认知功能障碍。原创性/价值据作者所知,目前还没有关于MID/BIF在精神卫生保健住院病房使用的筛查工具的研究。
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引用次数: 1
Improving Access to Psychological Therapies (IAPT): the impact of service changes due to COVID-19 on people with learning disabilities 改善心理治疗的可及性:COVID-19导致的服务变化对学习障碍者的影响
IF 1.1 Q3 Medicine Pub Date : 2022-06-09 DOI: 10.1108/amhid-01-2022-0002
Caroline Rodhouse, D. Dagnan, R. Thwaites, C. Hatton
PurposePrimary care psychological interventions for people with common mental health problems in England are primarily delivered through Improving Access to Psychological Therapies (IAPT) services. People with learning disabilities within IAPT have poorer key clinical outcomes than people who do not identify as having a learning disability. During the global COVID-19 pandemic remote consultations have accounted for nearly 90% of all contacts in IAPT services; this paper aims to report the effects of these on outcomes for people with learning disabilities.Design/methodology/approachPublicly available national data from the COVID-affected period are compared to the most recent available comparison periods that are not during the COVID pandemic. Data are presented graphically.FindingsPeople with learning disabilities differ little from those with no disabilities on several key process and outcome variables, although their clinical recovery is very much lower than those without disabilities. People with learning disabilities appear to have been affected by the changes in service delivery in a similar way to those without learning disabilities.Originality/valueDespite the shift to predominantly remote therapy delivery, outcomes for people with learning disabilities have not been differentially affected compared to those who have no recorded disability. The potential to learn what has worked and not worked in the delivery of remote interventions for people with learning disabilities is highlighted.
目的在英格兰,针对有常见心理健康问题的人的初级保健心理干预主要通过改善心理治疗(IAPT)服务提供。IAPT中的学习障碍患者的关键临床结果比未被认定为学习障碍的患者差。在全球新冠肺炎大流行期间,远程咨询占IAPT服务所有接触者的近90%;本文旨在报告这些对学习障碍者的结果的影响。将受新冠肺炎影响时期的公开可用国家数据与非新冠肺炎疫情期间的最新可用比较期进行比较。数据以图形表示。发现有学习障碍的人与没有残疾的人在几个关键的过程和结果变量上几乎没有差异,尽管他们的临床康复率远低于没有残疾的患者。学习障碍者似乎受到了服务提供变化的影响,其方式与无学习障碍者相似。独创性/价值尽管主要转向远程治疗,但与没有残疾记录的人相比,学习障碍者的结果没有受到不同的影响。强调了学习在为学习障碍者提供远程干预方面哪些有效,哪些无效的潜力。
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引用次数: 1
Impact of COVID-19 on people with Down syndrome in Japan based on regional differences frequency of emergency declarations 基于区域差异的2019冠状病毒病对日本唐氏综合征患者的影响
IF 1.1 Q3 Medicine Pub Date : 2022-05-24 DOI: 10.1108/amhid-02-2022-0009
M. Kojima
PurposeThe purpose of this study was to clarify the impact of adults with Down syndrome (DS) on COVID-19 and the status of efforts for new normal in Japan through a Web survey.Design/methodology/approachParents’ associations’ representatives sent requests to members aged 18 years or older inviting them to participate in an Internet survey. A total of 141 people cooperated, and 126 people were included in the analysis.FindingsAs a result of examining the number of times the state of emergency was declared and its impact on COVID-19, the degree of anxiety felt when hearing information about new coronavirus infections on television or the internet was significantly higher in subjects for whom the state of emergency was declared four times than in subjects for whom the state of emergency was declared two and three times in the region. This was significantly higher than that of the subjects in the areas where the state of emergency had been declared four times and significantly lower than that of the subjects in the areas where the state of emergency had been declared one time for “smiling”. The results suggest that the effects on physical and mental health, although limited, are influenced by the number of times the state of emergency was declared. From the analysis of the free text, it was inferred that some, but not all, of the subjects with DS, had their physical and mental state affected by COVID-19 to the extent that they required medical care.Originality/valueThis study clarified the psychosomatic effects of COVID-19 in people with DS in adulthood, which has not yet been fully clarified in the world. To the best of the authors’ knowledge, this is the first study in Japan to clarify the physical and mental effects of COVID-19 on people with DS and the status of new normal initiatives.
目的通过网络调查,了解日本成人唐氏综合征(DS)对COVID-19的影响及新常态的努力现状。设计/方法/方法家长协会代表向年满18岁的会员发出邀请,邀请他们参加网上调查。共有141人合作,其中126人被纳入分析。在检查了宣布紧急状态的次数及其对COVID-19的影响后,在该地区,宣布紧急状态四次的受试者在电视或互联网上听到有关新型冠状病毒感染的信息时感到的焦虑程度明显高于宣布紧急状态两次和三次的受试者。这一比例明显高于四次宣布紧急状态地区的调查对象,而明显低于因"微笑"而宣布一次紧急状态地区的调查对象。结果表明,紧急状态对身心健康的影响虽然有限,但受到宣布紧急状态次数的影响。根据对自由文本的分析,推断出一些(但不是全部)DS患者的身心状态受到COVID-19的影响,需要医疗护理。独创性/价值本研究阐明了COVID-19对成年DS患者的心身影响,这在国际上尚未完全阐明。据作者所知,这是日本第一项阐明COVID-19对DS患者身心影响以及新常态举措现状的研究。
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引用次数: 0
The space between the rock and the hard place: personality disorder diagnosis in people with intellectual disabilities 岩石和坚硬的地方之间的空间:智障人士的人格障碍诊断
IF 1.1 Q3 Medicine Pub Date : 2022-05-04 DOI: 10.1108/amhid-11-2021-0045
C. Downs, Kelly Rayner-Smith
PurposeThe assessment for and diagnosis of personality disorder (PD) continue to be contentious, with many prominent practitioner psychologists arguing against this specific label and providing a credible alternative framework to psychiatric diagnosis more generally. This paper aims to summarise the literature and support practitioners identifying PD in people with intellectual disabilities (ID).Design/methodology/approachRelevant National Institute for Health and Care Excellence (NICE) guidance and literature were reviewed to provide a service position on the assessment and diagnosis of PD in people with ID.FindingsFor people with intellectual disabilities, the PD label can be even less robustly applied and may be even more pejorative and obstructive. That said, there are people for whom a PD diagnosis has clear clinical utility and opens access to suitable specialist services.Practical implicationsEvidence suggests that a diagnosis of PD can be both facilitative and obstructive, and the assessment and diagnosis process should, therefore, be undertaken with caution.Originality/valueThis paper presents an account of NICE guidance and evidence on the assessment and diagnosis of PD in people with intellectual disabilities.
目的人格障碍(PD)的评估和诊断一直存在争议,许多著名的执业心理学家反对这个特定的标签,并为更普遍的精神病学诊断提供一个可信的替代框架。本文旨在总结文献和支持从业者识别与智障人士(ID) PD。设计/方法/方法回顾了国家健康与护理卓越研究所(NICE)的相关指南和文献,为ID患者PD的评估和诊断提供了服务地位。研究结果对于智障人士来说,PD的标签可能更不可靠,甚至可能更具贬义和阻碍性。也就是说,对有些人来说,PD诊断具有明确的临床效用,并可以获得合适的专业服务。实际意义证据表明,PD的诊断可能是促进性的,也可能是阻碍性的,因此,评估和诊断过程应谨慎进行。原创性/价值本文介绍了NICE在评估和诊断智障患者PD方面的指导和证据。
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引用次数: 0
Compassion‐focused therapy group for men with intellectual disabilities who had maladaptive conceptualisations of masculinity 以同情为中心的治疗小组,针对有不适应男性气概概念的智障男性
IF 1.1 Q3 Medicine Pub Date : 2022-05-03 DOI: 10.1108/amhid-06-2021-0027
R. Searle, Ianiv Borseti, K. Price
PurposeThe purpose of this paper is to determine the effectiveness of an adapted compassion-focused therapy (CFT) group treatment programme for individuals with an intellectual disability (ID), specifically aimed to help address maladaptive conceptualisations of masculinity.Design/methodology/approachOutcome measurements were competed at pre- and post-group and the effectiveness of the intervention were assessed using a Wilcoxon signed ranks test.FindingsFindings demonstrated that the treatment group showed significant differences in their “gender role conflict” subscales including the Success, Power, Control and “Restrictive Affectionate Behavior Between Men” subscales; however, no significant differences were found on the Restrictive Emotionality or Conflicts Between Work and Leisure subscales. Furthermore, no significant differences were found on participants psychological well-being, psychological distress, anxiety, self-compassion or quality of life measures.Research limitations/implicationsLimitations include that a lack of qualitative information regarding outcomes, a lack of control group and a small number of participants may have impacted the outcome of the research.Practical implicationsThe Men’s Masculinity group had a positive impact on the participant’s sense of success, power and control, so it could be considered that this group enabled participants to feel more powerful and in control of their difficulties which is associated with the “drive” system of CFT.Originality/valueOverall, this study adds to the small but growing literature that supports using CFT groups as a stand-alone psychological intervention when working with people with an ID.
目的:本文的目的是确定一个以同情为中心的适应性治疗(CFT)小组治疗方案对智力残疾(ID)患者的有效性,特别是旨在帮助解决对男性气质的不适应概念。设计/方法/方法在组前和组后进行结果测量,并使用Wilcoxon签名秩检验评估干预的有效性。结果:治疗组在成功、权力、控制和男性间限制性亲爱行为的“性别角色冲突”维度上存在显著差异;然而,在限制性情绪或工作与休闲冲突的子量表上,没有发现显著差异。此外,在参与者的心理健康、心理困扰、焦虑、自我同情和生活质量测量方面没有发现显著差异。研究局限性/启示局限性包括缺乏关于结果的定性信息,缺乏对照组和少量参与者可能会影响研究结果。实际意义男性阳刚之气组对参与者的成功感、权力感和控制感产生了积极的影响,因此可以认为该组使参与者感到更强大,更能控制自己的困难,这与CFT的“驱动”系统有关。原创性/价值总的来说,这项研究增加了支持在与有身份认同的人一起工作时使用CFT小组作为独立心理干预的少量但不断增长的文献。
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引用次数: 0
Co-production of post-diagnostic psychosocial intervention with carers of people with intellectual disability and dementia 与智力残疾和痴呆症患者的护理人员共同进行诊断后心理社会干预
IF 1.1 Q3 Medicine Pub Date : 2022-04-21 DOI: 10.1108/amhid-01-2022-0006
Daniel Acton, C. Duncan, S. Jaydeokar
PurposeThis paper aims to underline the importance of using a collaborative approach when designing and adapting a post diagnostic psychosocial intervention of cognitive stimulation therapy (CST) for people with intellectual disability and dementia.Design/methodology/approachAs part of a service improvement, a manual of CST was adapted, for delivery in clinical practice. A qualitative co-production method allowed participants with a lived experience to provide regular feedback relating to the development of the adapted CST manual and intervention programme. This feedback was used to make continual development changes to the CST manual.FindingsThe study demonstrated co-production with those who provide care is valuable in adapting psychosocial therapies for people with an intellectual disability and dementia. Additional findings identified the need for carer education in ageing, dementia care and the physical health needs for older people with intellectual disability.Originality/valueTo the best of the authors’ knowledge, this is the first study that has used a co-production approach with families and carers in adapting a group therapy programme for people with an intellectual disability. This paper underlines the need for post diagnostic clinical interventions for people with dementia and those who provide care.
目的本文旨在强调在为智力残疾和痴呆症患者设计和调整认知刺激疗法(CST)的诊断后心理社会干预时,使用合作方法的重要性。设计/方法/方法作为服务改进的一部分,对CST手册进行了调整,以在临床实践中提供。一种定性的联合制作方法使有生活经验的参与者能够定期提供与制定经过调整的科技委手册和干预方案有关的反馈。该反馈用于对CST手册进行持续的开发更改。研究结果表明,与那些提供护理的人合作,在为智力残疾和痴呆症患者调整心理社会治疗方面是有价值的。其他研究结果确定了在老龄化、痴呆症护理和智障老年人身体健康需求方面对护理人员教育的需求。独创性/价值据作者所知,这是第一项使用与家庭和护理人员合作的方法为智力残疾患者调整集体治疗计划的研究。这篇论文强调了对痴呆症患者和提供护理的人进行诊断后临床干预的必要性。
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引用次数: 4
Disability therapy and Valerie Sinason 残疾治疗和Valerie Sinason
IF 1.1 Q3 Medicine Pub Date : 2022-04-18 DOI: 10.1108/amhid-02-2022-0008
David O’Driscoll
PurposeThis paper aims to discuss the work of Dr Valerie Sinason and her contribution to working with people with an intellectual disability with psychotherapy.Design/methodology/approachDr Valerie Sinason is a psychoanalyst, and the author is trained in psychoanalytic psychotherapy.FindingsThe author believes there is important value in reading Valerie Sinason's contribution to the literature of psychotherapy with people with intellectual disabilities.Originality/valueIt is a review of Sinason’s contribution, and the author believes she's very original and important thinker.
本文旨在讨论Valerie Sinason博士的工作,以及她在用心理疗法治疗智障人士方面的贡献。设计/方法/方法Valerie Sinason博士是一名精神分析学家,作者接受过精神分析心理治疗方面的培训。作者认为,阅读Valerie Sinason对智障人士心理治疗文献的贡献具有重要价值。原创性/价值这是对Sinason贡献的回顾,作者认为她是一个非常有原创性和重要的思想家。
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引用次数: 0
Psychologists’ views on the accessibility and effectiveness of psychological therapies for people with intellectual disabilities and autism 心理学家对智力障碍和自闭症患者心理治疗的可及性和有效性的看法
IF 1.1 Q3 Medicine Pub Date : 2022-03-24 DOI: 10.1108/amhid-11-2021-0041
Poppy Siddell
PurposeThe purpose of this study was to explore the views of psychologists working in community teams for people who have intellectual disabilities (ID) on the provision of psychological therapies to those with ID and autism spectrum disorder (ASD).Design/methodology/approachSemi-structured interviews were carried out with seven clinical psychologists working across a large geographical area. Interviews concerned the accessibility and effectiveness of psychological therapies. These were transcribed and analysed thematically.FindingsParticipants expressed concern about lack of access to mainstream services, the lack of visibility of their service and the suitability of the physical space to deliver therapy. They were positive about the effectiveness of therapy but emphasised the importance of adaptations and managing expectations.Research limitations/implicationsThere is a lack of research in this area, and further research is needed with service users to develop a fuller understanding of their needs.Practical implicationsConsideration needs to be given on how to optimally deliver psychological therapies for this group. This will need services to become more flexible and focussed on the needs of this group of service users.Originality/valueThis paper provides insights into the views of psychologists on providing psychological therapy to people who have autism and ID.
目的本研究旨在探讨智力残疾(ID)社区团队中的心理学家对为ID和自闭症谱系障碍(ASD)患者提供心理治疗的看法。访谈涉及心理治疗的可及性和有效性。这些内容被转录并按主题进行分析。发现参与者对无法获得主流服务、他们的服务缺乏可见性以及提供治疗的物理空间是否合适表示担忧。他们对治疗的有效性持积极态度,但强调了适应和管理期望的重要性。研究局限性/含义这一领域缺乏研究,需要对服务用户进行进一步研究,以更全面地了解他们的需求。实际意义需要考虑如何为这一群体提供最佳的心理治疗。这需要服务变得更加灵活,并专注于这群服务用户的需求。独创性/价值本文深入了解了心理学家对为自闭症和ID患者提供心理治疗的看法。
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引用次数: 0
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Advances in Mental Health and Intellectual Disabilities
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