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探讨心智能力对智障女性乳房筛查的影响。

Exploring the impact of mental capacity on breast screening for women with intellectual disabilities.

机构信息

The Tizard Centre, University of Kent, Kent, UK.

出版信息

Health Soc Care Community. 2019 Jul;27(4):880-888. doi: 10.1111/hsc.12704. Epub 2018 Dec 19.

Abstract

This study explores the impact of mental capacity in relation to breast screening for women with intellectual disabilities in the UK. Participation in breast screening is considerably lower for women with intellectual disabilities compared to the general population. Barriers to screening include poor mobility and behavioural difficulties. There is currently no research which primarily explores the relationship between mental capacity and breast screening for this group of individuals. This paper presents the results of a cross-sectional survey of 131 women with intellectual disabilities supported by eight Social Care Providers within England and Wales. The data were collected between January 2017 and July 2017. The current research explores the decision-making process surrounding breast screening, considering the impact of associated risk factors during this process. Participants completed a specifically created survey addressing the aforementioned issues. The results indicated that women who lacked capacity, were less likely to engage in breast screening. It was also demonstrated that the process outlined in the Mental Capacity Act (MCA; 2005) was not always followed; women were not routinely assessed if there were doubts regarding their decision-making ability around breast screening and best interest meetings (BIM) were not always held if the person lacked capacity. In order to be able to generalise the current findings, further research is needed to gain a broader understanding of how professionals make decisions around breast screening for women with intellectual disabilities in case the individuals are unable to decide this independently.

摘要

本研究探讨了英国智障妇女乳房筛查中与心智能力相关的影响。与普通人群相比,智障妇女参与乳房筛查的比例明显较低。筛查的障碍包括行动不便和行为困难。目前尚无研究主要探讨这一人群的心智能力与乳房筛查之间的关系。本文介绍了对英格兰和威尔士 8 家社会服务提供者支持的 131 名智障妇女进行的横断面调查的结果。数据收集于 2017 年 1 月至 7 月之间。目前的研究探讨了乳房筛查决策过程,考虑了在此过程中相关风险因素的影响。参与者完成了一项专门针对上述问题的调查。结果表明,缺乏能力的妇女不太可能参与乳房筛查。此外还表明,《精神能力法案》(MCA;2005 年)规定的程序并非总是遵循;如果对妇女的决策能力存在疑虑,并未对其进行常规评估,并且如果个人没有能力,也并非总是举行最佳利益会议(BIM)。为了能够推广当前的研究结果,需要进一步研究,以更广泛地了解专业人员如何在智障妇女无法独立做出决定的情况下,围绕乳房筛查做出决策。

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