Meeting in the middle: improving communication in primary health care consultations with people with an intellectual disability

Ziviani, Jenny; Lennox, Nicholas; Allison, Heather; Lyons, Michael; Del Mar, Chris

doi:10.1080/13668250412331285163

Cited by 132Patient-Provider Communication in HealthcareDown syndrome and intellectual disability researchInterpreting and Communication in Healthcare

Meeting in the middle: improving communication in primary health care consultations with people with an intellectual disability

Ziviani, Jenny, Lennox, Nicholas, Allison, Heather, Lyons, Michael, Del Mar, Chris·2004·Journal of Intellectual & Developmental Disability

DOI 10.1080/13668250412331285163

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Abstract

The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate. This qualitative study in which five GPs, three people with intellectual disability, seven carers and two advocates (parent and friend) were interviewed was conducted in Brisbane, Australia. The aim was to better understand the factors that have an impact upon the success of communication in a medical consultation. Findings suggested that GPs were concerned with the aspects of communication difficulties which influenced their ability to adequately diagnose, manage and inform patients. Implications for practice management were also identified. People with intellectual disability reported frustration when they felt that they could not communicate adequately with the GP and annoyance when they were not included in the communication exchange. Carers were strong advocates for the person with intellectual disability, but indicated insufficient skill and knowledge to provide the level of assistance required in the consultation. The outcome was a model of cooperation that outlined the responsibilities of all players in the medical encounter, prior to, during and after the event.

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Healthcare practitioners may rely on communicating with a carer, family member, or support worker rather than with the service user directly.
“Healthcare practitioners may rely on communicating with a carer, family member, or support worker rather than with the service user directly.23,25,36,45,47”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [36]
A warm, friendly, and caring attitude from healthcare providers enables service users to access healthcare facilities and discuss sensitive health concerns.
“A warm, friendly, and caring attitude from healthcare providers enables service users to access healthcare facilities and discuss sensitive health concerns.22,34–37”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [36]
Facilitators, in terms of reasonable adjustments in the clinical environment, may include easy-read information, coloured pictures, models, photos, videos, symbols, and demonstration dolls.
“Facilitators, in terms of reasonable adjustments in the clinical environment, may include easy-read information, coloured pictures, models, photos, videos, symbols, and demonstration dolls.13,36,48,65”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [36]
Additional time is often required for effective communication with people who have intellectual disabilities and/or autism.
“Additional time is often required for effective communication with people who have intellectual disabilities and/or autism.31,36,47,48”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [36]
Healthcare professionals themselves share the notion that seeing the same professional would provide the opportunity to gain a better understanding of the medical history and communication style of the service user.
“This notion is also shared by healthcare professionals themselves, with suggestions that this would provide the opportunity to gain a better understanding of the medical history and communication style of the service user.36”
From Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review (2020) · cites this paper as [36]

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Authors: Ziviani, J., Lennox, N., Allison, H., Lyons, M., & Del Mar, C.
Affiliations: The University of Queensland (AU)
University of Newcastle Australia (AU)
Centre for General Practice, University of Queensland, Australia
ORCID: Ziviani, Jenny
Lennox, Nicholas
Allison, Heather
Venue: Journal of Intellectual & Developmental Disability
Publisher: Informa UK Limited
Published: 2004-09
Volume: 29
Issue: 3
Pages: 211-225
ISSN: 0045-0634 (ISSN-L)
1366-8250
1469-9532
DOI: 10.1080/13668250412331285163
OpenAlex: W1990912406
Cited by: 132
References: 0
Citations by year: 2026: 5 · 2025: 7 · 2024: 7 · 2023: 8 · 2022: 14 · 2021: 3 · 2020: 6 · 2019: 9 · 2018: 4 · 2017: 10 · 2016: 12 · 2015: 5 · 2014: 10 · 2013: 7 · 2012: 9
FWCI: 5.75
Type: journal article
Language: en
Open access: closed
Locations: Journal of Intellectual & Developmental Disability (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Health Sciences › Health Professions › General Health Professions › Interpreting and Communication in Healthcare
Keywords: intellectual disability, primary care, physician-patient communication, general practitioners, caregivers, patient advocates, medical consultation, communication difficulties, diagnosis and management, patient inclusion, practice management, cooperation models

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Meeting in the middle: improving communication in primary health care consultations with people with an intellectual disability

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