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Barriers and facilitators to primary healthcare for people with intellectual disabilities and/or autism : an integrative review
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Doherty, A. J., Atherton, H., Boland, P., Hastings, R. P., Hives, L., Hood, K., James-Jenkinson, L., Leavey, R., Randell, E., Reed, J., Taggart, L., Wilson, N. and Chauhan, U. (2020) Barriers and facilitators to primary healthcare for people with intellectual disabilities and/or autism : an integrative review. BJGP Open, 4 (3). bjgpopen20X101030. doi:10.3399/bjgpopen20X101030
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WRAP-Barriers-facilitators-primary-health-care-people-intellectual-autism-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (939Kb) | Preview |
Official URL: https://doi.org/10.3399/bjgpopen20X101030
Abstract
Background Globally, people with intellectual disabilities and/or autism experience health inequalities. Death occurs at a younger age and the prevalence of long-term morbidities is higher than in the general population. Despite this, their primary healthcare access rates are lower than the general population, their health needs are often unmet, and their views and experiences are frequently overlooked in research, policy, and practice.
Aim To investigate the barriers and facilitators reported by individuals with intellectual disabilities, autism, or both, and/or their carers, to accessing and utilising primary health care for their physical and mental health needs.
Design & setting An integrative review was undertaken, which used systematic review methodology.
Method Electronic databases MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane were searched for relevant studies (all languages) using a search strategy. Two researchers independently screened the results and assessed the quality of the studies.
Results Sixty-three international studies were identified. Six main themes relating to barriers and facilitators emerged from an analysis of these studies. The main themes were: training; knowledge and awareness; communication; fear and embarrassment; involvement in healthcare decision-making; and time. All the themes were underpinned by the need for greater care, dignity, respect, collaborative relationships, and reasonable adjustments. Opposing barriers and facilitators were identified within each of the main themes.
Conclusion Adolescents and adults with intellectual disabilities and/or autism experience several barriers to accessing and utilising primary health care. The findings highlight the reasonable adjustments and facilitators that can be implemented to ensure that these individuals are not excluded from primary health care.
| Item Type: | Journal Article | |||||||||
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| Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Autistic people -- Medical care, Intellectual disability -- Treatment , Primary health care, Autism, Developmentally disabled | |||||||||
| Journal or Publication Title: | BJGP Open | |||||||||
| Publisher: | Royal College of General Practitioners | |||||||||
| ISSN: | 2398-3795 | |||||||||
| Official Date: | August 2020 | |||||||||
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| Volume: | 4 | |||||||||
| Number: | 3 | |||||||||
| Article Number: | bjgpopen20X101030 | |||||||||
| DOI: | 10.3399/bjgpopen20X101030 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access | |||||||||
| Copyright Holders: | Copyright © 2020, The Authors | |||||||||
| RIOXX Funder/Project Grant: |
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