Do health consultations for people with learning disabilities meet expectations? A narrative literature review

Abstract

Accessible Summary People with learning disabilities have unmet health needs. Annual health checks were brought in to improve health care, but do they work? The research shows checks lead to more tests for illness and illness being identified. A lot of people still do not see their doctor, and not all doctors do health checks. Future research needs to understand how people with disabilities feel about seeing their doctor or nurse, and how doctors and nurses feel towards them. Abstract AimTo explore the benefits and disadvantages of annual health checks for people with learning disabilities, including: What are the rationales and outcome measures for health checks? How well do health checks meet the needs of people with learning disabilities? What areas does research in this topic need to focus on in the future? BackgroundHealth consultations are an interpersonal activity that influence health outcomes and attitudes towards self and health professionals for people with learning disabilities. Annual health checks have been introduced to improve health inequalities for people with learning disabilities. MethodA narrative literature review of health care for people with learning disabilities was undertaken to evaluate health care for this population, and specifically the outcomes from annual health checks. FindingsWhile annual health checks have made some improvements in terms of health outcomes, attendance for appointments is still low, provision is variable and experiences of health checks for people with learning disabilities are under‐researched. ConclusionsService user‐led research into their health experiences is needed. Research into the attitudes and experiences of health professionals in relation to people with learning disabilities is needed. Healthcare inequalities are only being partially addressed—improvement is needed in terms of service user experience and engagement.

Editorial: The case for more action and more research into healthcare provision and health inequalities for people with intellectual disabilities

“…Annual health checks can be effective in identifying unmet health needs and ensuring referral for further assessment and treatment (Chapman et al, 2018), but inequalities of access, health assessment, Despite numerous articles, policies and guidance, barriers continue to result in poorer health outcomes than expected for people with intellectual disabilities. There are various mechanisms by which these inequities occur: the under-identification of people with intellectual disabilities is a key factor, but while this is sometimes due to poor co-ordination between services, it may also be due to felt stigma, where the person and their family fear increased external control or poorer services as a consequence of the label.…”

“…Annual health checks can be effective in identifying unmet health needs and ensuring referral for further assessment and treatment (Chapman et al, 2018), but inequalities of access, health assessment, interventions and outcomes persist. Chris Hatton and his team explored the ‘Health and healthcare of people with learning disabilities in the United Kingdom through the COVID‐19 pandemic’, finding that the negative impact of COVID‐19 on health and healthcare for people with autism/intellectual disabilities was significant and long‐lasting, with reduced access to health and social care, including annual health checks, likely to have longer‐term effects on identification and early management of illness.…”

Challenges of colorectal cancer screening in patients with learning disabilities: the way forward

“…People with LD have different degrees of dependency defined by their communication needs and, therefore, require different skills on the part of the carers to perceive their feelings [15][16][17][18][19]. The carers need to know how to perceive different facial and behavioural expressions of the patient with LD to make an appropriate inference and act accordingly [15,20,21].…”

Implicancias éticas en la atención hospitalaria a personas con discapacidad intelectual: una revisión narrativa

“…Los factores de riesgo asociados a insatisfacción en PDI han sido descritos en publicaciones como la de Burke et al (23) , donde la pertenencia a grupos minoritarios como la población de color, además, la comunicación no verbal, la baja condición socioeconómica y cultural, así como aquellos que conviven con cuidadores jóvenes son más propensos a recibir una atención que no brinda satisfacción; sobresale el nivel socioeconómico, ya que el acceso a servicios de apoyo como personal de enfermería especializado se limita por los altos costos, por lo que quedan supeditados a la atención en servicios gubernamentales no siempre idóneos. La implementación de un personal de "enlace", tal vez una enfermera entrenada en la atención de PDI, podría ser un recurso útil en los hospitales para facilitar la comunicación, aunque son necesarios más estudios que demuestren fehacientemente esta afirmación (24,25) .…”