British Journal of Learning Disabilities最新文献_第4页

Ageing, osteoporosis and intellectual disability; risks differ, and diagnosis can be missed 老龄化、骨质疏松症和智力残疾；风险不同，诊断可能被遗漏

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-04-08 DOI: 10.1111/bld.12598

Eilish A. Burke, Rachael Carroll, Maire O'Dwyer, J Bernard Walsh, Philip McCallion, Mary McCarron

Background

People with intellectual disability often present atypically for various health conditions, making it challenging to identify concerns, particularly when communication challenges are also considered. Additionally, they may face barriers to healthcare access, resulting in many conditions going unnoticed. Health screening inequities are also evident in this population, and osteoporosis, a silent condition often only diagnosed postfracture, requires screening; however, if this does not happen, it may result in unnecessary fracture. Therefore the aim of this study is to identify predictors of osteoporosis in older adults with intellectual disability and examine potential inequity in the diagnosis of the condition.

Methods

The study used data from the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA). Bone quality was measured using quantitative ultrasound (QUS). Logistic regression was performed to identify significant predictors of poor bone quality, including chronic health conditions, dietary intake, medication use and activity levels.

Results

Out of 575 participants who completed QUS, osteoporosis prevalence was objectively measured at 41%, with a further 33.2% measured within the osteopenic range, but less than 2 in 10 had a doctor's diagnosis of osteoporosis. Reported Dual-Energy X-ray Absorptiometry screening uptake was low at 18.2%. Three major predictor variables of osteoporosis and osteopenia were found significant: difficulty walking 100 yards, taking antiepileptic drugs medicines and taking proton pump inhibitors. The model achieved an overall classification accuracy of 70.8% for osteopenia and 72.5% for identifying osteoporosis.

Conclusion

The study highlights the different risk factors in people with intellectual disability, the potential for missed diagnoses and the likelihood there is inadequate screening. There is an urgent need for robust risk assessment and reasonable adjustments to ensure equitable screening and targeted preventive strategies. Clinicians must consider specific concerns for this population to avoid missed diagnoses and reduce the adverse effects of osteoporosis/osteopenia, such as an increased risk of fragility fractures.

背景智障人士通常会因各种健康状况而表现出不典型的症状，这使得识别他们的健康问题变得非常困难，尤其是在考虑到沟通障碍的情况下。此外，他们可能在获得医疗保健服务方面面临障碍，导致许多疾病被忽视。健康筛查的不公平在这一人群中也很明显，骨质疏松症是一种无声的疾病，通常只有在骨折后才会被诊断出来，需要进行筛查；但是，如果不进行筛查，可能会导致不必要的骨折。因此，本研究旨在确定智障老年人骨质疏松症的预测因素，并检查在诊断该疾病时可能存在的不公平现象。方法本研究使用了爱尔兰老龄化纵向研究（IDS-TILDA）智障补充资料中的数据。采用定量超声波（QUS）测量骨骼质量。结果在完成定量超声波检查的 575 名参与者中，客观测量的骨质疏松症患病率为 41%，另有 33.2% 的人被测量为骨质疏松，但每 10 人中只有不到 2 人被医生诊断为骨质疏松症。据报告，双能量 X 射线吸收测定法的筛查率较低，仅为 18.2%。研究发现，骨质疏松症和骨质疏松症的三个主要预测变量具有重要意义：行走 100 码有困难、服用抗癫痫药物和服用质子泵抑制剂。该模型对骨质疏松症的总体分类准确率为 70.8%，对骨质疏松症的识别准确率为 72.5%。目前迫切需要进行强有力的风险评估和合理调整，以确保公平筛查和有针对性的预防策略。临床医生必须考虑到这一人群的特殊关切，以避免漏诊并减少骨质疏松症/骨质疏松的不良影响，如增加脆性骨折的风险。

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引用次数: 0

Storytelling, Special Needs and Disabilities: Practical Approaches for Children and Adults By Nicola Grove, Routledge. 2022. ISBN: 9780367746858 讲故事、特殊需求和残疾：儿童和成人的实用方法》，NicolaGrove 著，Routledge 出版社。2022.ISBN: 9780367746858

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-04-04 DOI: 10.1111/bld.12596

Gareth Smith, Charlotte Parkhouse

引用次数: 0

‘The whole thing is beyond stress’: Family perspectives on the experience of hospitalisation through to discharge for individuals with severe learning disabilities and complex needs 整件事压力山大"：从家庭角度看有严重学习障碍和复杂需求的人从住院到出院的经历

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-29 DOI: 10.1111/bld.12595

Megan Stock, Mark Mulholland, Vivien Cooper, Annabel Head, Sam Prowse, David Wellsted, Silvana E. Mengoni, Louisa Rhodes, Helen Ellis-Caird

Background

People with severe learning disabilities and complex needs are more likely to experience delayed discharge from hospital; however, there is little research into their experience in hospital and as they move out as part of the Transforming Care Programme.

Methods

Six family members of people with complex needs who had moved out of hospital took part in four focus groups co-facilitated with an expert-by-experience consultant. Participants' relatives had hospital admissions that ranged from 6 weeks to 11 years. Transcripts were analysed using reflexive thematic analysis. Additional reflections are included from an expert-by-experience consultant to capture their unique perspective.

Results

Family members reported stories of abuse in hospital and parallel experiences of institutionalisation and trauma, resulting in long-lasting impacts on themselves and their relative. Family members felt let down and undervalued by professionals. They described relief when their relatives moved out of hospital, but there were on-going difficulties accessing the right support in the community and so stability felt fragile.

Conclusions

Key recommendations to support community living include respecting family members' expertise, improving partnership working and offering psychological support for family members and people with complex needs post-discharge.

有严重学习障碍和复杂需求的人更有可能出现延迟出院的情况；然而，作为护理转型计划的一部分，对他们在医院和出院时的经历却鲜有研究。参与者亲属的住院时间从 6 周到 11 年不等。我们采用反思性主题分析法对记录誊本进行了分析。家庭成员报告了他们在医院遭受虐待的故事，以及同时经历的机构收容和心理创伤，对他们自己和亲属造成了长期影响。家庭成员感到失望并被专业人员低估。他们描述了亲属搬出医院时的欣慰，但在社区获得适当支持方面一直存在困难，因此感觉稳定性很脆弱。支持社区生活的主要建议包括尊重家庭成员的专业知识、改善合作关系以及为家庭成员和出院后有复杂需求的人提供心理支持。

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引用次数: 0

Exploring the inequalities of women with learning disabilities deciding to attend and then accessing cervical and breast cancer screening, using the Social Ecological Model 利用社会生态模型，探索有学习障碍的妇女决定参加并随后接受宫颈癌和乳腺癌筛查的不平等现象

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-18 DOI: 10.1111/bld.12587

Kate Sykes, Grant J. McGeechan, Emma L. Giles

Background

Women with learning disabilities are less likely to access cervical and breast cancer screening when compared to the general population. The Social Ecological Model (SEM) was used to examine the inequalities faced by women with learning disabilities in accessing cervical and breast cancer screening in England, UK.

Methods

The findings from a qualitative systematic review and a Q methodology study were triangulated. Framework analysis, in line with the SEM, was used to develop an integrated set of findings.

Findings

Women with learning disabilities may lack knowledge of cancer symptoms, and cancer screening, as well as being scared about the process and getting the results. The attitudes of family and paid carers towards screening may influence women with learning disabilities' decisions as to whether screening is seen as favourable; support and training may ensure unbiased perspectives. Barriers were also associated with how cancer screening programmes are designed, such as postal invitations which assumes an ability to read. In addition, screening staff need to be aware of the general needs of people with learning disabilities, such as the benefits of easy-to-read documents. Lastly, multidisciplinary working is required so reasonable adjustments can be embedded into cancer screening pathways.

Conclusion

This article highlights multiple methods to reduce the inequalities faced by women with learning disabilities, which can be achieved through reasonable adjustments. Embedding reasonable adjustments can support women with learning disabilities in making an informed decision and accessing screening if they choose to. This may result in women with learning disabilities getting a timely cancer diagnosis.

与普通人群相比，有学习障碍的女性接受宫颈癌和乳腺癌筛查的可能性较低。我们采用社会生态模型 (SEM) 来研究英国英格兰有学习障碍的妇女在接受宫颈癌和乳腺癌筛查时所面临的不平等。

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引用次数: 0

Menstruation and learning disability across the life course: Using a two-part scoping exercise to co-produce research priorities 月经与一生中的学习障碍：利用由两部分组成的范围界定工作共同制定研究重点

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-18 DOI: 10.1111/bld.12592

Sarah Earle, Susan Ledger, Victoria Newton, Lorna Rouse, Elizabeth Tilley

Background

Across the life course, women and girls with learning disabilities and their carers report difficulties in accessing information and support with menstruation, yet their experiences are often overlooked in initiatives to improve menstrual health and wellbeing. Our aim was to collaborate with women with learning disabilities to co-produce future research priorities in a UK context.

Methods

We undertook a two-part scoping exercise to explore what is known about this topic from a life course perspective, beginning pre-menarche and extending to post-menopause support. This combined a rapid scoping review of the literature since 1980 with a stakeholder consultation where people with learning disabilities, family carers, advocacy groups and staff working across education, health and social care were invited to share their experiences of menstruation support.

Findings

UK and international literature provided insight across five narrative themes. Seventy stakeholders took part in our consultation, enabling the identification of five key themes. Findings across both highlight examples of supportive practice and valued resources alongside enduring health inequalities and barriers to menstruation support faced by women and girls with learning disabilities across the life course.

Conclusion

Our scoping exercise identified multiple gaps in research and practice, ongoing reproductive health inequalities and a need for improved access to peer support, resources and training that take a life course approach. The scoping exercise indicates the need for further empirical research on menstruation and learning disability, with a particular focus on collating people's lived experiences.

在整个生命过程中，有学习障碍的妇女和女孩及其照顾者都表示很难获得有关月经的信息和支持，但在改善月经健康和福祉的活动中，她们的经历往往被忽视。我们的目标是与有学习障碍的妇女合作，共同制定英国未来的研究重点。

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引用次数: 0

The role of lived experience eye care champions in improving awareness and access to eye care services for people with learning disabilities and/or autism 生活经验眼科护理倡导者在提高学习障碍者和/或自闭症患者对眼科护理服务的认识和获取方面的作用

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-12 DOI: 10.1111/bld.12594

Marek Karas, Donna O'Brien, Lance Campbell, Rebecca Lunness, Joanne Kennedy, Grace McGill, Stephen Kill, Lisa Donaldson

<div> <section> <h3> Background</h3> <p>Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer-to-peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs.</p> </section> <section> <h3> Methods</h3> <p>The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project.</p> </section> <section> <h3> Findings</h3> <p>The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions.</p> </section> <section> <h3> Conclusions</h3> <p>From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours

背景有记录显示，学习障碍者和/或自闭症患者在获得眼科护理方面存在不平等，其原因包括：初级眼科护理服务的使用率低、眼部问题的识别率低、现有服务缺乏指引和合理调整、对护理成本的担忧，以及地区和国家层面的眼科护理政策历来对这些问题重视不够。2019 年，慈善机构 SeeAbility 雇用了四名有学习障碍和/或自闭症生活经验的眼科护理倡导者（ECCs），在伦敦和英格兰西北部的当地社区开展工作。他们提供点对点支持，帮助人们了解良好眼健康的必要性，并在地方、地区和国家层面与政策制定者以及学习障碍、自闭症和眼科护理专业人士接触，以影响个别从业者的临床实践（在现有服务/路径模式内），并在更大范围内影响 "轻松护眼 "路径的委托。本研究探讨了这些易护理中心的经验。研究采用个案研究的方法来描述这些易护理中心在 2019 年 3 月至 2023 年 3 月期间的经验。通过对四位幼儿保育员进行结构化访谈和工作量分析，对这一新颖的健康促进项目有了多方面的了解。研究结果幼儿保育员认为这一角色很有用，并表示随着时间的推移，他们对自己的实践和影响越来越有信心，但他们需要持续的支持。据报告，他们很好地理解了宣传信息。在早期阶段建立良好的联系网络（包括学习障碍人士和医疗保健专业人员）是关键所在。与专业人员的关系是支持性的、积极的，在这些互动中，他们对自己的生活经历做出了积极的情感回应。这项工作为今后的发展提出了一些重要建议，其中包括计划建立网络、支持演讲和沟通技巧以及确定关键信息和知识。随着时间的推移，幼儿保育员的自信心不断增强，但他们的生活经历对受众产生的情感影响也需要支持。有必要评估与该计划互动的人是如何看待该计划的，以及该计划是如何改变行为从而取得更好的健康成果的。

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引用次数: 0

Evaluation of a co-designed Health Check-in for adults with intellectual and developmental disabilities and family caregivers to support pandemic recovery 评估为智力和发育障碍成人及家庭照顾者共同设计的健康检查，以支持大流行病的恢复

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-08 DOI: 10.1111/bld.12593

Yona Lunsky, Tiziana Volpe, Laura St. John, Anupam Thakur, Johanna Lake, the H-CARDD COVID Program Team

Background

The COVID-19 pandemic has brought about disruptions in healthcare for adults with intellectual and developmental disabilities. There is a need to explore ways to promote proactive healthcare and better prepare individuals for healthcare encounters.

Methods

A co-designed tool, the COVID Check-in Tool, was introduced as part of a virtual health education programme to encourage proactive healthcare. Implementation of this Health Check-in was evaluated with 36 adults with intellectual and developmental disabilities and 96 family caregivers who completed the programme using surveys, structured interviews and focus groups.

Findings

Forty-four percent of participants engaged in the Health Check-in process, resulting in many reported benefits for those who participated. However, there were also barriers to initiating the Check-in, along with challenges using the COVID Check-in Tool, according to both the adults with disabilities who were interviewed and the family caregivers.

Conclusions

The study underscores the importance of considering ways to integrate tools into routine healthcare practices, to facilitate improved healthcare delivery for people with intellectual and developmental disabilities during pandemic recovery efforts. As well, involving people with lived experience in the development and implementation of healthcare resources is critical.

COVID-19 大流行给智力和发育障碍成人的医疗保健带来了混乱。有必要探讨如何促进积极主动的医疗保健，并让个人为医疗保健做好更充分的准备。

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引用次数: 0

Co-producing ethics guidelines together with people with learning disabilities 与有学习障碍的人共同制定道德准则

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-08 DOI: 10.1111/bld.12590

Mary Bottomley, Jodie Bradley, Lisa Clark, Bryan Collis, Bojana Daw Srdanovic, Victoria Farnsworth, Annie Ferguson, Dan Goodley, Andrew Fox, Nikita K. Hayden, Charlotte Lawthom, Rebecca Lawthom, Claudia Magwood, Robert McLean, Ian Middleton, Alison Owen, Matty Prothero, Simon Rice, Simon Richards, Katherine Runswick-Cole, Kelly Scargill, Rohit Shankar, Toni Ann Wood

Background

We are a research team of clinical, academic and advocacy-based researchers with and without learning disabilities, working on the Humanising Healthcare (for people with learning disabilities) project. The project is dedicated to finding and sharing healthcare practices that enhance the lives of people with learning disabilities. As part of our ethics applications to access National Health Service study sites for fieldwork, we worked together to write guiding principles for co-producing research ethics with researchers with learning disabilities. In this paper, we introduce these Participatory Ethics Good Practice Guidelines and reflect on our collaboration.

Methods

We reflect on developing the Participatory Ethics Good Practice Guidelines. These guidelines were developed during online co-production meetings with our full research team, including advocacy-based organisation researchers, clinical researchers and university researchers. We considered consent, understanding research, and understanding research methods during the development of these Guidelines.

Findings

We present ten guidelines for co-producing research with people with learning disabilities.

Conclusions

Our findings may be helpful to researchers with learning disabilities, university and clinical researchers, funders, and those who work in research governance (e.g., ethics committees and university research departments).

背景我们是一个由临床、学术和宣传研究人员组成的研究团队，成员中既有学习障碍者，也有非学习障碍者，我们致力于 "人性化医疗保健（针对学习障碍者）"项目。该项目致力于发现和分享能够改善学习障碍人士生活的医疗保健实践。作为我们申请进入国家卫生服务研究机构进行实地调查的伦理申请的一部分，我们共同编写了与有学习障碍的研究人员共同制定研究伦理的指导原则。在本文中，我们将介绍这些 "参与式伦理学良好实践指南"，并对我们的合作进行反思。这些指南是在与我们整个研究团队（包括倡导型组织研究人员、临床研究人员和大学研究人员）举行的在线共同制作会议上制定的。结论我们的研究结果可能会对有学习障碍的研究人员、大学和临床研究人员、资助者以及从事研究管理的人员（如伦理委员会和大学研究部门）有所帮助。

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引用次数: 0

Homeless youth with intellectual disabilities: Precarious lives and health inequalities 无家可归的智障青年：不稳定的生活和健康不平等

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-06 DOI: 10.1111/bld.12588

Ann Fudge Schormans, Stephanie Baker Collins, Heather Allan, D. O'Neil Allen, Nathan Gray

Background

Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well-being.

Methods

We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well-being. The project involved seven co-researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co-researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities.

Findings

Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness.

Conclusion

Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.

背景无家可归的智障青少年在多个服务部门中都是隐形的。我们使用定量和定性的方法来测量流行程度，并向主要信息提供者和无家可归的智障青少年了解导致和维持无家可归的因素，以及这些因素对他们的社会、身体和心理健康和幸福的影响。该项目有七位智障和有无家可归青少年经历的共同研究者参与研究设计、数据收集、分析和传播。我们创作了论坛剧场场景，创造性地表现了该项目的研究成果。在本文中，我们将与大家分享其中的一个场景，以及三位智障共同研究者为改善对无家可归的智障青少年的支持而提出的建议。研究结果缺乏对无家可归的智障青少年的认识和了解，再加上相关部门各自为政的工作方式，导致青少年处于非常不利的地位，并在健康方面遭受不公平待遇。结论服务提供者、政策制定者和相关部门的代表需要认识到并承认无家可归的智障青年，并承担起学习和合作的责任，以制定综合的、有针对性的方法来有效地支持他们。

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引用次数: 0

Mapping stakeholders to maximise the impact of research on health inequalities for people with learning disabilities: The development of a framework for the Making Positive Moves study 摸清利益相关者的情况，最大限度地扩大对学习障碍者健康不平等问题研究的影响：制定 "积极行动 "研究框架

IF 1.2 4区医学 Q3 EDUCATION, SPECIAL

British Journal of Learning Disabilities

Pub Date : 2024-03-04 DOI: 10.1111/bld.12591

Francesca Beeken, Dafni Katsampa, Moureen Duxbury, Helen-Ellis Caird, Annabel Head, Sam Prowse, David Wellsted, Pashtana Zormati, Silvana E. Mengoni, Louisa Rhodes

<div> <section> <h3> Background</h3> <p>People with learning disabilities experience health and social inequalities, and research that could improve health services may not be implemented in real-life settings. Building stakeholder networks that can share and implement research findings may address this. This paper presents a framework for building a stakeholder network that maximises the likelihood of research recommendations being implemented in practice. This was developed as part of the ‘Making Positive Moves’ (MPM) study, which explores the experiences of people with learning disabilities following discharge from a residential stay within a hospital inpatient setting.</p> </section> <section> <h3> Methods</h3> <p>We reviewed the literature on existing theoretical frameworks to support the development of a model for dissemination of the MPM findings. Stakeholder categories were identified through consultation with the MPM researchers, experts by experience and the steering group and a hub and spoke model to represent all stakeholder categories was created. These categories include person moving; family of the person moving; specialist schools; social care; care providers; regulators; third sector organisations; policy organisations; academic community; and NHS professionals. After establishing the categories, we consulted with people with learning disabilities and other stakeholders and conducted online searches to create a stakeholder database. Through information gathering and direct contact with stakeholders, we assessed levels of interest, power and engagement to determine which stakeholders to prioritise in our dissemination activities. The Stakeholder Wheel was created to present the data captured within the database and engagement profiles in an illustrative way.</p> </section> <section> <h3> Findings</h3> <p>We use two stakeholder sub-categories, user-led organisations and care providers, to demonstrate the methodological approach. The examples illustrate how a scoring system helped us to identify high-priority stakeholders who we then contacted to collaborate within developing our dissemination strategy to maximise the impact of the MPM research findings.</p> </section> <section> <h3> Conclusions</h3> <p>We developed a framework to map stakeholders for the MPM study and enable targeted dissemination to increase the impact of the research. This approach has the potential to reduce health inequalities among people with learning disabilities by increasing the awareness of and ability to implement evidence-based recommendations in real-lif

背景有学习障碍的人经历着健康和社会不平等，可以改善医疗服务的研究可能无法在现实生活中实施。建立能够分享和实施研究成果的利益相关者网络可以解决这一问题。本文介绍了建立利益相关者网络的框架，以最大限度地提高研究建议在实践中得到实施的可能性。该框架是 "积极行动"（MPM）研究的一部分，该研究探讨了学习障碍人士从医院住院环境中的住宿出院后的经历。通过咨询 MPM 研究人员、经验专家和指导小组，我们确定了利益相关者的类别，并创建了一个中心辐射模型来代表所有利益相关者类别。这些类别包括搬家者、搬家者的家人、专科学校、社会医疗机构、医疗服务提供者、监管机构、第三部门组织、政策组织、学术界以及国家医疗服务体系的专业人员。确定类别后，我们咨询了有学习障碍的人和其他利益相关者，并进行了在线搜索，以创建一个利益相关者数据库。通过收集信息和与利益相关者直接接触，我们评估了利益相关者的兴趣、权力和参与程度，以确定在传播活动中优先考虑哪些利益相关者。我们创建了 "利益相关者轮盘"，以说明性的方式展示数据库中的数据和参与情况。研究结果我们使用两个利益相关者子类别（用户主导的组织和护理提供者）来展示方法论。这些例子说明了评分系统如何帮助我们识别出高优先级的利益相关者，然后我们联系这些利益相关者，共同制定传播策略，以最大限度地扩大 MPM 研究成果的影响。这种方法可以提高人们在现实生活中实施循证建议的意识和能力，从而有可能减少学习障碍人群中的健康不平等现象。利益相关者绘图框架可应用于与学习障碍有关的研究项目，以缩小研究与实践之间的差距，减少健康不平等现象。

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