Røstad Monica, Whittington Richard, Søndenaa Erik
Department of Mental Health, Norwegian university of Science and Technology (NTNU), Trondheim, Norway.
Brøset Center for Research and Education in Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway.
J Multidiscip Healthc. 2025 Mar 14;18:1523-1537. doi: 10.2147/JMDH.S504229. eCollection 2025.
This article explores the use of coercion to address significant food-related challenges among individuals with intellectual disabilities in Norway. The goal was to examine how food-related coercion differs from non-food coercion and to document the challenges and support methods, given the limited information available on this topic. The study aims to enhance understanding and potentially reduce the use of coercion.
The study analyzed coercive decision documents from municipalities using quantitative cross-sectional and cohort-longitudinal designs. The cross-sectional design included 120 decisions from 2020, comparing food-related (44) and non-food-related (76) coercion. The cohort-longitudinal design tracked the 44 individuals subjected to food-related coercion from 2018 to 2021, identifying characteristics of these decisions over four years.
In the cross-sectional analysis (n=120), food-related coercive measures were linked to overweight, diagnoses of stomach and intestinal issues, and general somatic health challenges. The average age was higher. The cohort-longitudinal study (n=44) highlighted a distinction between challenges related to consuming food and managing food itself. There was limited support and follow-up from general practitioners and clinical dietitians.
The study discusses the relationship between health knowledge and behavioral challenges in implementing coercion to regulate access to food and drink. It also addresses how behavior regulation can overshadow the need for measures related to preventing and managing lifestyle challenges.
There is a need for comprehensive expertise in health and lifestyle diseases within services for people with intellectual disabilities. The lack of follow-up from general practitioners and dietitians, along with the absence of systematic interventions, indicates a significant gap in support for issues related to obesity, overeating, and uncritical food intake. Legislation aims to prevent significant damage and the use of coercion but may overshadow underlying lifestyle diseases by focusing on behavioral challenges without addressing lifestyle issues.
本文探讨了在挪威,使用强制手段来应对智障人士面临的重大饮食相关挑战的情况。目标是研究饮食相关的强制手段与非饮食强制手段有何不同,并鉴于关于该主题的信息有限,记录其中的挑战和支持方法。该研究旨在增进理解,并有可能减少强制手段的使用。
该研究采用定量横断面和队列纵向设计,分析了来自市政当局的强制决策文件。横断面设计包括2020年的120项决策,比较了饮食相关(44项)和非饮食相关(76项)的强制手段。队列纵向设计追踪了2018年至2021年期间遭受饮食相关强制手段的44个人,确定了这些决策在四年中的特征。
在横断面分析(n = 120)中,饮食相关的强制措施与超重、肠胃问题诊断以及一般躯体健康挑战有关。平均年龄较高。队列纵向研究(n = 44)突出了与食物消费和食物管理相关挑战之间的区别。全科医生和临床营养师的支持和随访有限。
该研究讨论了在实施强制手段以规范食物和饮料获取方面,健康知识与行为挑战之间的关系。它还探讨了行为规范如何可能掩盖预防和管理生活方式挑战相关措施的必要性。
智障人士服务机构需要具备健康和生活方式疾病方面的综合专业知识。全科医生和营养师缺乏随访,以及缺乏系统性干预,表明在支持肥胖、暴饮暴食和不加选择的食物摄入相关问题方面存在重大差距。立法旨在防止重大损害和强制手段的使用,但可能通过关注行为挑战而不解决生活方式问题,从而掩盖潜在的生活方式疾病。