Clinical Fellow in Oral and Maxillofacial Surgery, Barts Health, The Royal London Hospital, London, UK.
Lead Nurse for Learning Disability, Barts Health, Barts Health NHS Trust, London, UK.
Br Dent J. 2024 Jun;236(11):876-880. doi: 10.1038/s41415-024-7449-x. Epub 2024 Jun 14.
In the healthcare domain, diagnostic overshadowing is a concerning issue involving the erroneous attribution of physical symptoms to a patient's mental health, behavioural intricacies, or pre-existing disabilities. Individuals facing learning and communication challenges are particularly susceptible to this phenomenon, struggling to articulate or comprehend their experienced symptoms. Likewise, patients with autism spectrum disorder can have an escalated risk due to possible challenges in interpreting bodily cues. This article delves into the specialised care required for individuals with learning disabilities and/or autism, highlighting the pervasive risk of diagnostic overshadowing and the potential manifestation of pain as self-injurious behaviour in these patient groups. By underscoring the need to mitigate diagnostic overshadowing within dental practice, we advocate for reasonable adjustments in care delivery and comprehensive education of the dental team. Proficient tools for pain assessment and effective communication are emphasised to collectively improve the healthcare experience for these vulnerable patient cohorts.
在医疗保健领域，诊断遮蔽是一个令人担忧的问题，涉及将身体症状错误地归因于患者的心理健康、行为复杂性或先前存在的残疾。面临学习和沟通挑战的个人特别容易受到这种现象的影响，他们难以表达或理解自己经历的症状。同样，患有自闭症谱系障碍的患者由于可能难以解释身体暗示，因此风险会增加。本文探讨了为学习障碍和/或自闭症患者提供的专业护理，强调了诊断遮蔽的普遍风险以及这些患者群体中疼痛表现为自伤行为的可能性。通过强调在牙科实践中减轻诊断遮蔽的必要性，我们主张在护理提供方面做出合理调整，并对牙科团队进行全面教育。强调了熟练的疼痛评估工具和有效的沟通，以共同改善这些弱势群体患者的医疗保健体验。
