Bakker-van Gijssel E J, Lucassen P L B J, Olde Hartman T C, van Son L, Assendelft W J J, van Schrojenstein Lantman-de Valk H M J
Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Siza, Residential Care Facility For People With Disabilities, PO Box 532, 6800 AM Arnhem, The Netherlands.
Radboud University Nijmegen Medical Center, Department of Primary and Community Care, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Res Dev Disabil. 2017 May;64:12-24. doi: 10.1016/j.ridd.2017.03.002. Epub 2017 Mar 16.
People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems.
The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality.
We conducted an electronic literature search of papers published between January 2000 and May 2016. After a two-phase selection process (kappa: 0.81 and 0.77) we collected data from the 29 included peer-reviewed articles on the following four domains; development, clinimetric properties (i.e. validity, reliability, feasibility, acceptability), content (i.e. ID-related health problems, prevention and health promotion topics) and effectiveness of the instruments.
RESULTS/CONCLUSIONS: We distinguished 20 different health assessment instruments. Limited information was found on the development of the instruments as well as on their clinimetric properties. The content of the instruments was rather diverse. The included papers agreed that health assessment instruments are effective. However, only three instruments evaluated effectiveness in a randomised controlled trial. Patients with ID, carers and general practitioners (GPs) generally appreciated the health assessment instruments.
Two instruments, "Stay well and healthy -Health risk appraisal (SWH-HRA)"and the "Comprehensive Health Assessment Programme (CHAP)", appeared to have the highest quality. These instruments can be used to construct a health assessment instrument for people with ID that meets scientific standards.
智障人士存在健康差异，接受推荐的年龄和性别特异性筛查及健康促进措施的可能性较低。新诊断常常被漏诊。借助健康评估工具进行评估是解决这些问题的一种方法。
本综述的目的是找出在初级保健中用于智障人士的可用健康评估工具并评估其质量。
我们对2000年1月至2016年5月发表的论文进行了电子文献检索。经过两阶段筛选过程（卡帕值分别为0.81和0.77），我们从29篇纳入的同行评审文章中收集了关于以下四个领域的数据：工具的开发、临床测量特性（即有效性、可靠性、可行性、可接受性）、内容（即与智障相关的健康问题、预防和健康促进主题）以及工具的有效性。
结果/结论：我们区分出20种不同的健康评估工具。关于这些工具的开发及其临床测量特性的信息有限。工具的内容相当多样。纳入的论文一致认为健康评估工具是有效的。然而，只有三种工具在随机对照试验中评估了有效性。智障患者、护理人员和全科医生通常对健康评估工具表示认可。
“保持健康 - 健康风险评估（SWH - HRA）”和“综合健康评估计划（CHAP）”这两种工具似乎质量最高。这些工具可用于构建符合科学标准的智障人士健康评估工具。
