Mastebroek M, Naaldenberg J, Lagro-Janssen A L, van Schrojenstein Lantman de Valk H
Radboud University Medical Center, Department of Primary and Community Care - Intellectual Disabilities and Health, Internal Post and Route 152, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Radboud University Medical Center, Department of Primary and Community Care - Intellectual Disabilities and Health, The Netherlands.
Res Dev Disabil. 2014 Sep;35(9):1978-87. doi: 10.1016/j.ridd.2014.04.029. Epub 2014 May 24.
Many barriers to the provision of general practice (GP) care for people with intellectual disabilities (ID) relate to problems in exchanging health information. Deficits in the exchange of health information may have an adverse impact on healthcare access and health outcomes in individuals with ID. The aim of this paper is to report how health information exchange (HIE) in GP care for people with ID is being described in the ID healthcare literature. Thematic analysis of 19 included articles resulted in six major themes: (1) communication skills; (2) organisational factors; (3) record keeping and sharing; (4) health literacy and self-advocacy; (5) carers and health professionals' knowledge; and (6) third parties. The results indicate that HIE takes place in a chain of events happening before, during, and after a medical consultation, depending on specific contextual care factors. The included papers lack a broad focus on the entire HIE process, and causes and effects of gaps in health information are described only marginally or on a very general level. However, a study of the HIE process in its entirety is imperative in order to identify weak links and gaps in information pathways. The themes presented here provide a starting point for an in-depth study on the HIE process in GP care for individuals with ID that may facilitate future research on health interventions in this setting.
为智障人士提供全科医疗服务存在许多障碍，这些障碍与健康信息交换方面的问题有关。健康信息交换不足可能会对智障人士的医疗服务可及性和健康结果产生不利影响。本文旨在报告智障人士医疗保健文献中如何描述全科医疗服务中针对智障人士的健康信息交换（HIE）情况。对19篇纳入文章进行主题分析后得出了六个主要主题：（1）沟通技巧；（2）组织因素；（3）记录保存与共享；（4）健康素养与自我倡导；（5）照顾者和健康专业人员的知识；（6）第三方。结果表明，健康信息交换发生在医疗咨询之前、期间和之后的一系列事件中，这取决于具体的情境护理因素。纳入的论文缺乏对整个健康信息交换过程的广泛关注，健康信息差距的原因和影响仅在很小程度上或非常笼统地进行了描述。然而，为了识别信息路径中的薄弱环节和差距，对整个健康信息交换过程进行研究势在必行。这里呈现的主题为深入研究全科医疗服务中针对智障人士的健康信息交换过程提供了一个起点，这可能会促进该领域未来关于健康干预措施的研究。
