Doctor-patient communication with people with intellectual disability - a qualitative study

Abstract

BackgroundPeople with intellectual disability (ID) expressed dissatisfaction with doctor-patient communication and mentioned certain preferences for this communication (our research). Since many people with ID in the Netherlands have recently moved from residential care facilities to supported accommodations in the community, medical care for them was transferred from ID physicians (IDPs) to general practitioners (GPs) in the vicinity of the new accommodation. We addressed the following research question: 'What are the similarities and differences between the communication preferences of people with ID and the professional criteria for doctor-patient communication by GPs?'MethodsA focus group meeting and interviews were used to identify the preferences of 12 persons with ID for good communication with their GP; these were compared with communication criteria used to assess trainee GPs, as described in the MAAS-Global manual.ResultsEight preferences for doctor-patient communication were formulated by the people with ID. Six of them matched the criteria used for GPs. Improvements are required as regards the time available for consultation, demonstrating physical examinations before applying them and triadic communication.ConclusionsPeople with ID hold strong views on communication with their doctors during consultations. GPs, people with ID and their support workers can further fine-tune their communication skills.

Intellectual disability and mental health problems: a qualitative study of general practitioners’ views

“…[1][2][3][4][5][6][7] Two recent attempts provide a focus to this challenge: a consensus manifesto by the European Association of Intellectual Disability Medicine 8 and an independent inquiry on a request from the British Secretary of State for Health. 9 These reports share the goal of improving healthcare services for people with ID, but the extent to which their recommendations have been implemented remains dubious.…”

Health Care Decision Making and Adults with Intellectual Disability: A Descriptive Survey

“…Existing literature, however, indicates communication barriers for individuals with intellectual disability are present in the context of health care encounters. For example, in a study (Wullink et al 2009) of individuals with intellectual disability, respondents expressed concerns regarding triadic communication during appointments with their physician (among other concerns regarding communication with their physician). These respondents shared that in many instances, a support staff member attended physician appointments with them.…”

“…These respondents shared that in many instances, a support staff member attended physician appointments with them. In these instances, they felt that their physician would address their health care with the support staff member instead of themselves (Wullink et al 2009).…”

“…For the purpose of this research study, intellectual disability is considered synonymous with individuals diagnosed with mental retardation. The literature suggests that this patient population faces barriers in communication in the pursuit of health care services (Chew, Iacono, and Tracy 2009;Harper and Wadsworth 1992;Horrell, MacLean, and Conley 2006;Wullink, Veldhuijzen, van Schrojenstein Lantman-deValk, Metsemakers, and Dinant 2009). Individuals with intellectual disability also face mischaracterization of their abilities (Keywood and Flynn 2003;Longmore 1995).…”

Promoting Self-Determination for Better Health and Wellbeing for Adolescents who have an Intellectual Disability

“…Research on barriers to health care for people with an intellectual disability has provided evidence that the communication difficulties they experience make medical assessment and management problematic (Lennox, Diggens, & Ugoni, 1997;Millar, Chorlton, & Lennox, 2004;Wullink, Veldhuijzen, van Schrojenstein Lantman-de Valk, Metsemakers, & Dinant, 2009;Ziviani, Lennox, Allison, Lyons, & Del Mar, 2004). Improved health advocacy may be one way to diminish this barrier and ultimately improve the health of people with an intellectual disability.…”