PubMed Health⌕ Search

Biomedical subjects

N Lennox

Publications and source records attributed to N Lennox.

9 recordsLinked to original sources

Queensland psychiatrists' attitudes and perceptions of adults with intellectual disability.

BACKGROUND: Quality mental health care for adults with an intellectual disability (ID) depends upon the availability of appropriately trained and experienced psychiatrists. There have been few surveys of psychiatrists working with this population. METHOD: This Australian study obtained psychiatrists' attitudes to and perceptions of the mental health needs of adults with an ID. Training needs were also sought. The survey instrument used was a purposely designed, 28-item self-administered questionnaire featuring multiple-choice and open-ended questions. RESULTS: The majority of psychiatrists expressed concerns about treatment of this group, describing unmet needs. A total of 75% considered that antipsychotics were overused to control aggression, and 34% of psychiatrists were reluctant to treat adults with an ID. In total, 85% agreed that mental health in ID should be offered as a training option for psychiatric registrars, and that specialized mental health services would provide a high standard of care for this population. CONCLUSION: Broad concerns are raised regarding pathways to mental health care for adults with an ID in Australia. An Australia-wide training strategy needs to be developed. Partnerships between mental health, disability and community services that serve the mental health needs of this population, should actively seek to engage psychiatrists.

Adult↗

Comprehensive health assessments during de-institutionalization: an observational study.

BACKGROUND: People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase. METHODS: This research aimed to investigate the effectiveness of a specially designed health review, the comprehensive health assessment program (CHAP) health review, in a group of adults as they transitioned out of the care of the last institution for people with ID in Tasmania. There were 25 residents reviewed by their GPs. RESULTS: The CHAP reviews picked up a number of health conditions and stimulated health promotion activities. Some of the findings were: a high number of abnormal Body Mass Indexes (19/23), immunizations given (13/23), vision impairment reported (2/23), mental health issues recorded (4/23) and skin abnormalities described (17/23). There were 22 referrals made to other health professionals (Australian Hearing Service 4, dentists 3, optometrists 3, psychiatrists 2, neurologists 2, ophthalmologist 1, urologist 1, ultrasound 1, mammogram 1, family planning 1, physiotherapist 1, continence nurse 1 and respiratory physician 1). These were in addition to various requests for pathology. CONCLUSIONS: The CHAP health review was effective in identifying a number of health issues in the population of people with ID as they transitioned out of institutional care into the general community.

Adult↗

Beating the barriers: recruitment of people with intellectual disability to participate in research.

BACKGROUND: The health status of people with intellectual disability (ID) is poor, yet very little research has been done on their health needs. There are several barriers to performing this research. The aim of our research was to examine the significant barriers encountered in recruiting adults with ID to participate in research. METHODS: Our project was a randomized controlled trial aiming to improve health advocacy of people with ID. We approached many organizations to recruit participants and kept records of our results. Recruitment was very low for the first 4 months. Then we adopted two new recruitment strategies--in-service telephone recruitment and meetings with prospective participants. We then monitored the subsequent recruitment rates. We also questioned participants about the difficulties they encountered when considering recruitment. RESULTS: Initial recruitment of participants yielded less than one-third of the expected number. Additional strategies implemented were partially successful. Significant barriers to recruitment included several sectoral issues and the challenges arising from the research process. CONCLUSIONS: While this population is a difficult one to reach for research, attempts to do so should not be abandoned, because the potential health benefits for this underserved group far outweigh the recruitment barriers experienced.

Adult↗

New insights into the genetic basis of intellectual disabilities.

BACKGROUND: Within general practice patients with intellectual disabilities are common. OBJECTIVE: This article sheds some new light on the underlying genetic mechanisms of intellectual disabilities. It outlines the genetic basis of known inherited and sporadic causes that have recently been understood through new molecular advances. DISCUSSION: General practice has an important role to play in pursuing a precise biomedical diagnosis by improving information provided to the patient and family regarding recurrence risks and prognoses as well as management issues specific to the underlying condition. New molecular techniques are providing us with specific diagnostic tools as well as improving our understanding of the complex mechanisms that contribute to what is known as human intelligence.

Child↗

The fragile X syndrome.

Fragile X syndrome (FXS) is the most common cause known of inherited developmental disability. New and widely available techniques in DNA analysis allow both affected individuals and carriers to be tested from a simple blood sample. It is now recognised that a wide range of clinical severity occurs in both sexes. Specific treatment and interventional strategies are now available and of great benefit to individuals, families and carers. Genetic counselling allows families to make informed decisions. General practitioners can play a central role in detection and management of this syndrome.

Fragile X Syndrome↗

Prader-Willi syndrome.

People with Prader-Willi syndrome (PWS) and their families provide a unique challenge to the general practitioner. This article provides an outline of the key information and management issues for general practitioners who care for people with PWS and their families.

Family Practice↗

The psychiatric care of people with intellectual disabilities: the perceptions of consultant psychiatrists in Victoria.

OBJECTIVE: This study was undertaken to establish the perceptions of psychiatrists regarding the care of people of intellectual disabilities. METHOD: A 28-item self-administered questionnaire was developed, piloted and sent on two occasions to 467 psychiatrists who receive the newsletter of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists. The questionnaire incorporated a Likert scale to document the opinions of the respondents. RESULTS: A response rate of 51.1% was achieved. The respondents indicated that, in their opinion, people with intellectual disabilities receive a poor standard of care in the inpatient and community setting. To improve this situation, the following strategies were recommended: the development of improved liaison between services; improved training for all personnel who provide services to people with intellectual disabilities; the development of greater resources; and support for professionals working in the area. The study also indicates that there is a core group of very interested psychiatrists who are currently practising and that people with intellectual disabilities are accessing private psychiatric services. In addition, the results suggest that diagnostic overshadowing is not a major barrier to psychiatric assessment, and that disorders which were presumed to be commonly overlooked by doctors (such as depression) are in fact frequently being diagnosed. CONCLUSIONS: Despite some positive findings, the majority of psychiatrists who responded held major concerns about the situation of people with intellectual disabilities. To improve the care provided to these people, it is recommended that these concerns are addressed by the psychiatric profession and responsible government departments in conjunction with university departments of psychiatry.

Australia↗

The psychiatric care of people with intellectual disabilities: the perceptions of trainee psychiatrists and psychiatric medical officers.

OBJECTIVE: The main aim of this study was to document the perceptions of trainee psychiatrists and psychiatric medical officers regarding the psychiatric care of people with intellectual disabilities. METHOD: A 28-item self-administered questionnaire was developed by the investigators and pretested on eight psychiatrists and psychiatric trainees. A revised version of the questionnaire was then sent to 128 psychiatric trainees and 27 medical officers working in the public psychiatric services in Victoria. 116 questionnaires were returned, and the responses analysed. RESULTS: The results indicate a high degree of interest in the psychiatry of intellectual disability, however this was tempered by a feeling that the respondents and their senior colleagues are inadequately trained. The respondents expressed major concerns regarding the care of people with dual disabilities in the hospital and community setting, and significant support for the development of specialised units and subspecialisation within psychiatry. The major concerns which were identified would in part explain why 30% of the respondents felt that they would prefer not to treat people with an intellectual disability and a psychiatric disorder. CONCLUSION: We can only support the assertion made by the Burdekin Report [12] that "there is an urgent need for academic research, increased clinical expertise and substantial increased resources in the much neglected area of dual disability.

Attitude of Health Personnel↗