UNIVIDD, Intellectual Disability and Developmental Disorders Research Unit, Fundación Villablanca, Grup Pere Mata, Reus, Spain Department of Psychiatry, University of Cádiz, Spain.
J Intellect Disabil Res. 2011 Sep;55(9):858-72. doi: 10.1111/j.1365-2788.2011.01439.x. Epub 2011 Jul 5.
Despite progress in the process of deinstitutionalisation, very little is known about the health conditions of people with intellectual disability (PWID) who live in large institutions and PWID living in small residential services, family homes or independent living within the community. Furthermore, there are no international comparison studies at European level of the health status and health risk factors of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses with no formal support.
A total of 1269 persons with ID and/or their proxy respondents were recruited and face-to-face interviewed in 14 EU countries with the P15, a multinational assessment battery for collecting data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, availability of formal support and stage of deinstitutionalisation.
Obesity and sedentary lifestyle along with a number of illnesses such as epilepsy, mental disorders, allergies or constipation were highly prevalent among PWID. A significantly higher presence of myocardial infarctions, chronic bronchitis, osteoporosis and gastric or duodenal ulcers was found among participants in countries considered to be at the early stage of deinstitutionalisation. Regardless of deinstitutionalisation stage, important deficits in variables related to such medical health promotion measures as vaccinations, cancer screenings and medical checks were found in family homes and independent living arrangements. Age, number of people living in the same home or number of places in residential services, presence of affective symptoms and obesity require further attention as they seem to be related to an increase in the number of illnesses suffered by PWID.
Particular illnesses were found to be highly prevalent in PWID. There were important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation. PWID are in need of tailored primary health programs that guarantee their access to quality health and health promotion and the preventative health actions of vaccination programs, systematic health checks, specific screenings and nutritional controls. Extensive national health surveys and epidemiological studies of PWID in the EC member states are urgently needed in order to reduce increased morbidity rates among this population.
尽管在去机构化进程中取得了进展，但对于居住在大型机构中的智障人士（PWID）和居住在小型住宿服务、家庭住宅或社区内独立生活中的 PWID 的健康状况知之甚少。此外，在欧洲层面上，没有国际比较研究比较居住在有正式支持和护理的人员配备齐全的住宿服务中的 PWID 与居住在无人值守的家庭住宅或无正式支持的独立住宅中的 PWID 的健康状况和健康风险因素。
在 14 个欧盟国家，共有 1269 名智障人士及其代理受访者参加了 P15 多国家评估工具的面对面访谈，该工具用于收集与 PWID 相关的健康指标数据。参与者根据其居住安排、正式支持的可用性和去机构化阶段进行分组。
肥胖和久坐不动的生活方式，以及癫痫、精神障碍、过敏或便秘等多种疾病，在 PWID 中普遍存在。在被认为处于去机构化早期阶段的国家的参与者中，发现心肌梗死、慢性支气管炎、骨质疏松症和胃溃疡或十二指肠溃疡的比例明显更高。无论去机构化阶段如何，在家庭住宅和独立居住安排中，与疫苗接种、癌症筛查和医疗检查等医疗保健促进措施相关的变量都存在重要缺陷。年龄、同一家庭居住的人数或住宿服务的地点数量、情感症状的存在和肥胖需要进一步关注，因为它们似乎与 PWID 患病数量的增加有关。
特定疾病在 PWID 中普遍存在。根据可用正式支持的水平和去机构化的阶段，不同的居住安排存在重要差异。PWID 需要量身定制的初级保健计划，以保证他们获得高质量的健康和健康促进，并采取预防措施，如疫苗接种计划、系统的健康检查、特定筛查和营养控制。迫切需要在欧盟成员国中对 PWID 进行广泛的国家健康调查和流行病学研究，以降低该人群的发病率。
