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Studies worldwide indicate that people with intellectual disability have high risks of physical and mental morbidities, and poor quality of health care. This study was aimed at determining general practitioners' perceptions on barriers in clinical assessment and training needs with regard to the healthcare of community-dwelling people with intellectual disability.
A survey questionnaire was developed specifically for the study through focus group discussions and a literature review. The study was conducted as a cross-sectional anonymous survey of private general practitioners practicing in Singapore. The survey contained questions on their experience and training needs in assessing and treating patients with intellectual disability.
Forty-nine of the 272 questionnaires sent out were returned. The respondents were predominantly male general practitioners working in “solo” practices. For most general practitioners, the proportion of patients with intellectual disability ranged from 1% to 5%. Nearly 90% of general practitioners identified problems in communicating with such patients as an important barrier that affected the quality of assessment of their health conditions. Other barriers identified were behavioral issues and sensory impairments. Only one-third of the general practitioners were confident that they had sufficient knowledge of physical and mental health conditions related to patients with intellectual disability. Three-fourths of the general practitioners believed that further training in this area would be beneficial.
Appropriate interventions to address barriers in assessment and management of patients with intellectual disability with further training for general practitioners may improve the standard of healthcare provided to this population group.
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Obesity increases the risk of many chronic diseases and contributes to functional disabilities. We assessed the relationship among obesity and obesity related chronic disease and disability in Korean adults.
This study used data from the 2005 Korean National Health and Nutrition Examination Survey. A total of 5,462 persons (2,325 men, 3,137 women) aged 20 years and older were included in this analysis. Obesity was measured by body mass index and abdominal obesity was by waist circumference. Information on the presence of chronic diseases was based on the self-report of having been diagnosed by physicians. Functional disability was assessed using the Korean activities of daily living (K-ADL) and the Korean instrumental ADL (K-IADL) scales.
The relationship between obesity and prevalence of obesity-related chronic diseases was higher in the older aged group (>60 years for men, >70 years for women) than in the younger aged group. Waist circumference was more related to a higher prevalence of chronic diseases than body mass index in the younger aged group. Abdominal obesity increased the risk (odds ratio, 2.59; 95% confidence interval, 1.19 to 5.66) of having limitation in activities of daily living for the younger aged men after adjustments for age, smoking status, presence of chronic diseases, and body mass index. Body mass index was not associated with disability in either men or women.
The association between obesity and prevalence of chronic disease differed depending on age and sex. It is important to control abdominal obesity to prevent disability in younger aged men.
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