Amor-Salamanca A, Menchon J M
Fundación Vallparadís, Department of Psychiatry, Mutua Terrassa University Hospital, Spain.
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Spain.
J Intellect Disabil Res. 2017 Apr;61(4):341-347. doi: 10.1111/jir.12355. Epub 2017 Jan 5.
Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability.
Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge. The results were compared with data obtained from a control group of people with no ID who attended an ED for any reason during the same period.
Somatic complaints were the main reason for ED attendance among persons with PID (90% of consultations). These complaints were more often related to the central nervous system than was the case among non-ID patients (16 vs. 4.7%), whereas other kinds of non-central nervous system somatic complaint were less common among persons with PID (74 vs. 91%). A diagnosis implying physical pain was given less often to people with PID than to controls (3 vs. 20%).
The results suggest that persons with PID are less able to conceptualise and communicate information about their symptoms, especially as regards pain, and that this influences the diagnosis they are given when attending an ED. Professionals working in this environment need to be aware of this possibility so as not to underestimate or overlook such symptoms and the illnesses related to them.
关于重度智力残疾（PID）患者前往综合医院急诊科（ED）就诊的信息较少。本研究旨在了解前往急诊科就诊的PID患者是否能得到与无此类残疾者相同类型的诊断。
在18个月的时间里，我们收集了PID患者前往急诊科所有非预约就诊的数据，以确定会诊原因（根据西班牙急诊护理协会使用的分类）及出院时的最终诊断。将结果与同期因任何原因前往急诊科就诊的无智力残疾对照组人群的数据进行比较。
躯体不适是PID患者前往急诊科就诊的主要原因（90%的会诊）。与非PID患者相比，这些不适更常与中枢神经系统有关（分别为16%和4.7%），而其他类型的非中枢神经系统躯体不适在PID患者中较少见（分别为74%和91%）。与对照组相比，PID患者被诊断为存在身体疼痛的情况较少（分别为3%和20%）。
结果表明，PID患者在概念化和传达有关其症状的信息方面能力较差，尤其是在疼痛方面，这影响了他们在急诊科就诊时所得到的诊断。在这种环境下工作的专业人员需要意识到这种可能性，以免低估或忽视此类症状及与之相关的疾病。
