The prevalence of challenging behaviors: a total population study

Emerson, Eric; Kiernan, Chris; Alborz, Alison; Reeves, David; Mason, Heidi; Swarbrick, Rebecca; Mason, Linda; Hatton, Chris

doi:10.1016/s0891-4222(00)00061-5

Cited by 591 publications

(473 citation statements)

References 8 publications

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“…Internationally, our estimates of severe visual problems was close to the prevalence of blindness (5.0%) reported in a detailed Dutch study of visual impairment among adults with ID. 20 Similarly, our recorded prevalence of behavioural problems was similar to the prevalances reported in earlier regional studies in England 96 and Norway. 97 The lower recording of cancer, IHD and COPD in adults with ID was surprising, especially given the high prevalence of comorbid risk factors for IHD, such as diabetes, obesity, hypothyroidism, chronic kidney disease and stroke.…”

Section: Disease Prevalencesupporting

confidence: 89%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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Background People with intellectual disability (ID) have poorer health than the general population; however, there is a lack of comprehensive national data describing their health-care needs and utilisation. Annual health checks for adults with ID have been incentivised through primary care since 2009, but only half of those eligible for such a health check receive one. It is unclear what impact health checks have had on important health outcomes, such as emergency hospitalisation. Objectives To evaluate whether or not annual health checks for adults with ID have reduced emergency hospitalisation, and to describe health, health care and mortality for adults with ID. Design A retrospective matched cohort study using primary care data linked to national hospital admissions and mortality data sets. Setting A total of 451 English general practices contributing data to Clinical Practice Research Datalink (CPRD). Participants A total of 21,859 adults with ID compared with 152,846 age-, gender- and practice-matched controls without ID registered during 2009–13. Interventions None. Main outcome measures Emergency hospital admissions. Other outcomes – preventable admissions for ambulatory care sensitive conditions, and mortality. Data sources CPRD, Hospital Episodes Statistics and Office for National Statistics. Results Compared with the general population, adults with ID had higher levels of recorded comorbidity and were more likely to consult in primary care. However, they were less likely to have long doctor consultations, and had lower continuity of care. They had higher mortality rates [hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.3 to 3.9], with 37.0% of deaths classified as being amenable to health-care intervention (HR 5.9, 95% CI 5.1 to 6.8). They were more likely to have emergency hospital admissions [incidence rate ratio (IRR) 2.82, 95% CI 2.66 to 2.98], with 33.7% deemed preventable compared with 17.3% in controls (IRR 5.62, 95% CI 5.14 to 6.13). Health checks for adults with ID had no effect on overall emergency admissions compared with controls (IRR 0.96, 95% CI 0.87 to 1.07), although there was a relative reduction in emergency admissions for ambulatory care-sensitive conditions (IRR 0.82, 95% CI 0.69 to 0.99). Practices with high health check participation also showed a relative fall in preventable emergency admissions for their patients with ID, compared with practices with minimal participation (IRR 0.73, 95% CI 0.57 to 0.95). There were large variations in the health check-related content that was recorded on electronic records. Limitations Patients with milder ID not known to health services were not identified. We could not comment on the quality of health checks. Conclusions Compared with the general population, adults with ID have more chronic diseases and greater primary and secondary care utilisation. With more than one-third of deaths potentially amenable to health-care interventions, improvements in access to, and quality of, health care are required. In primary care, better continuity of care and longer appointment times are important examples that we identified. Although annual health checks can also improve access, not every eligible adult with ID receives one, and health check content varies by practice. Health checks had no impact on overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Future work No formal cost-effectiveness analysis of annual health checks was performed, but this could be attempted in relation to our estimates of a reduction in preventable emergency admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Section: Disease Prevalencesupporting

confidence: 89%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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“…The prevalence rate of challenging behaviour in people with intellectual disabilities has been reported as 10-15% (Emerson et al, 2001). Challenging behaviour can both impact on the quality of life of the person exhibiting the behaviour and present difficulties for carers .…”

Section: Challenging Behaviourmentioning

confidence: 99%

The relationship between challenging behaviour, burnout and cognitive variables in staff working with people who have intellectual disabilities

Mills

Rose

2011

J intellect Disabil Res

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OverviewThis thesis is submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (Clin. Psy. D.) at the University of Birmingham. It is comprised of two volumes and includes a research study and reports of clinical work while on placement during clinical training.Volume I includes a literature review paper and an empirical paper. The literature review examines the literature on stress in staff who work with people with intellectual disabilities and challenging behaviour in order to address the question of whether there is an association between challenging behaviour and stress. The empirical paper follows on from the literature review in that it examines whether the relationship between challenging behaviour and staff burnout is for the instructions for authors). Finally, Volume I also contains a public domain briefing paper detailing the findings of the literature review and research study.Volume II includes five Clinical Practice Reports describing work completed on adult, child, learning disability and forensic placements. The reports describe a case study of a 59 year old woman with a mild learning disability presenting with generalized anxiety formulated from both cognitive and psychodynamic perspectives, a single-case experimental design study of a 10 year old boy with an autistic spectrum disorder and challenging behaviour where a behavioural intervention was implemented, a case study of a 13 year old boy with Obsessive Compulsive Disorder from a cognitive-behavioural perspective, a small scale service related research project exploring the barriers to implementing early warning signs work in a Community Mental Health Team setting, and an abstract providing a summary of an oral presentation of a 25 year old man with schizoaffective disorder in a medium secure forensic setting implementing a cognitive intervention. In order to ensure anonymity names and identifying information have been altered or omitted. AcknowledgementsFirstly I would like to thank all the participants who kindly took the time to complete the questionnaires for this study. I would also like to thank all the home managers and services I have liaised with who have been extremely helpful in the organisation of the study.

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“…A number of patient groups, such as those with mental health problems (Moss et al, 2000) and intellectual disability (Emerson et al, 2001), may display aggression and it is frequently the reason for referral or admission to specialist services (McKenzie et al, 2000a;Broadhurst and Mansell, 2007). In order to safely manage aggressive situations health staff must have an understanding of the individual, environmental and staff factors that might escalate or deescalate the situation (Maier, 1996;Black et al, 1997) and of best practice in this area (Kaplan and Wheeler, 1983;Ball et al, 2004;Brosnan and Healey, 2011).…”

Section: Introductionmentioning

confidence: 99%

A comparison of the effectiveness of a game informed online learning activity and face to face teaching in increasing knowledge about managing aggression in health settings

McKenzie¹

2012

Adv in Health Sci Educ

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Citation: McKenzie, Karen (2013) A comparison of the effectiveness of a game informed online learning activity and face to face teaching in increasing knowledge about managing aggression in health settings. Advances in Health Sciences Education, 18 (5 Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University's research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners. Single copies of full items can be reproduced, displayed or performed, and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well as a hyperlink and/or URL to the original metadata page. The content must not be changed in any way. Full items must not be sold commercially in any format or medium without formal permission of the copyright holder. The full policy is available online: http://nrl.northumbria.ac.uk/policies.html This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.) AbstractThe present study compared the impact of face to face teaching with a short online game informed learning activity on health participants' knowledge about, and confidence in, managing aggressive situations. Both forms of teaching resulted in a significant increase in participants' knowledge and confidence. Face to face training led to significantly greater increases in knowledge but was equivalent in terms of confidence. Both forms of teaching were rated positively, but face to face teaching received significantly higher ratings than the online activity. The study suggests that short online game informed learning activities may offer an effective alternative for health professional training where face to face training is not possible. Further research is needed on the longer term impact of both types of training on practice.

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The prevalence of challenging behaviors: a total population study

Cited by 591 publications

References 8 publications

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

The relationship between challenging behaviour, burnout and cognitive variables in staff working with people who have intellectual disabilities

A comparison of the effectiveness of a game informed online learning activity and face to face teaching in increasing knowledge about managing aggression in health settings

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