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Meeting in the middle: improving communication in primary health care consultations with people with an intellectual disability
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.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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“A joined-up approach, in which the sharing of inter-agency information is key, may help alleviate service users’ healthcare fears.26,36”
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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Items 101–128 of 128
Sparby, L. E., Olsvold, N., & Obstfelder, A. U. (2020) · Journal of Clinical Nursing · doi:10.1111/jocn.15211 · Cited by 10
“For people with intellectual disability, the process can be even more challenging as many may struggle to communicate, understand what is being said and cooperate as the doctor expects (Wullink, 2009; Ziviani et al., 2004).”
BackgroundFlores, A. L., Holt, S. L., Lynch, M., et al. (2022) · Journal of Communications In Healthcare · doi:10.1080/17538068.2022.2132011 · Cited by 4
“[9] found that people with IDD wanted general practitioners to demonstrate warmth and interest in them”
BackgroundLeveraging Healthcare Technology to Improve Patient-Doctor Communication
Thai, P., Flores-Cruz, G., & Roque, N. A. (2023) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/21695067231192641 · Cited by 3
“…primary care physicians primarily result from patients perceiving disrespect, time constraints, as well as the dominating and complex nature of biomedical culture in healthcare environments (Wei et al., 2020; Johansson et al., 1996; Nguyen et al., 2008; Vickers et al., 2006; Ziviani et al., 2004).”
BackgroundSnap shot: Achieving better care through a one-page personal health profile
Aston, M. L., Sweet, K., McAfee, E., et al. (2019) · Journal of Intellectual Disabilities · doi:10.1177/1744629519873503 · Cited by 3
McClimens, A., Bosworth, D., Brewster, J., et al. (2012) · Nurse Education Today · doi:10.1016/j.nedt.2012.04.021 · Cited by 3
“The foundation module would therefore focus on effective communication between professionals, families and individuals as the means by which to ensure better care, treatment and diagnosis (Gaag, 1998; Ziviani et al., 2004).”
BackgroundAnderson, L., & Larson, S. A. (2016) · Springer eBooks · doi:10.1007/978-3-319-18096-0_163 · Cited by 3
Jordanian healthcare workers’ attitudes toward stuttering and people who stutter
Al-Shdifat, K. G., Fuda, S. M., & Alwidyan, M. (2025) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2025.106125 · Cited by 3
Health From the Perspective of Adolescents With Intellectual Disabilities—Report From Poland
Gumienny, B., & Lew‐Koralewicz, A. (2025) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.70119 · Cited by 1
“People with disabilities experience unfair treatment, discrimination, lack of reasonable treatment from health services, as well as communication barriers and problems accessing services (Ali et al. 2013; Cytowska and Zierkiewicz 2020; Krahn and Fox 2014; Ziviani et al. 2004).”
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Forster, S. (2016) · Springer eBooks · doi:10.1007/978-3-319-18096-0_54 · Cited by 2
Practising family medicine for adults with intellectual disabilities
Baumbusch, J., Phinney, A., & Baumbusch, S. (2014) · Canadian Family Physician · Cited by 2
Odongo, D. A., Forkuor, J. B., Ofori‐Dua, K., et al. (2021) · Journal of Intellectual Disabilities · doi:10.1177/17446295211016171 · Cited by 2
Belew, J. L. (2010) · University of Minnesota Digital Conservancy (University of Minnesota) · Cited by 2
Oshita, J. Y., Studts, C. R., Haywood, C., Wong, A., Duffecy, J. L., & Morris, M. A. (2026) · Journal of Speech Language and Hearing Research · doi:10.1044/2026_jslhr-26-00080 · Cited by 1
Lowe, D. B., Taylor, M. J., & Hill, S. (2015) · The Journal of Rheumatology · doi:10.3899/jrheum.140989 · Cited by 1
“…professionals caring for patients with severe CV may lack familiarity with using different modes of communication, even where patients have alternative modes of communication 47 , and may be reluctant to examine and diagnose issues above and beyond the communication characteristic itself 48,49 .”
BackgroundDigit‐in‐Noise Test as a Hearing Screening Test for Individuals With Intellectual Disability
Shmerler, N., Fostick, L., & Saban‐Bezalel, R. (2024) · Journal of Intellectual Disability Research · doi:10.1111/jir.13205 · Cited by 1
Bemötande av patienter med utvecklingsstörning i vården
Norryd, M., & Tengnäs, U. (2007) · Hogskolan Ihalmstad (Halmstad University)
Parental and carer responses to Angelman syndrome and Prader-Willi syndrome.
Thomson, A. (2011) · Australasian Journal of Paramedicine
Dunne, M. C. (2016) · UA Campus Repository (The University of Arizona)
Primary healthcare interventions for people with intellectual disability
Byrne, J. H. (2016) · The University of Queensland · doi:10.14264/uql.2016.662
The social context of osteosarcopenia: Risk factors and social impact
Brennan-Olsen, S. L., Anderson, K. L. M., Beauchamp, A., O’Connor, J., & Duckham, R. L. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-820088-9.00016-0
Evans, W. (2005) · Health Communication · doi:10.1207/s15327027hc1703_7
Medical authority in Indonesian clinical : An app-based telemedicine program
Adhalia, C. K., Fakih, M., & Putri, R. W. (2023) · Malahayati International Journal of Nursing and Health Science · doi:10.33024/minh.v6i3.11639
“However, if you look at what is currently happening in the community, doctors who practice online based on applications can still provide consultation, education and even therapy (Ziviani et al., 2004).”
BackgroundOshita, J. Y., Reed, N. S., CALLAS, P. W., Morales, E. E. G., & MacLean, C. D. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2024.12.013
HIPAA Protection in a Clinical Setting
Moffat, A., Baloi, D., Geamanu, A., et al. (2025) · Michigan medical education and health bulletin. · doi:10.69735/001c.145742
HIPAA Protection in a Clinical Setting
Baloi, D., Moffat, A., Geamanu, A., et al. (2025) · Michigan medical education and health bulletin. · doi:10.69735/001c.147351
Lucas-Griffin, S. S., Wasserman, D., & Wendler, D. S. (2026) · The Journal of Law Medicine & Ethics · doi:10.1017/jme.2025.10199
“17 These suggestions emphasize involving individuals the PWID knows and trusts.”
Santra, R., Pulukuri, S. V., & Sharma, N. (2026) · Journal of General Internal Medicine · doi:10.1007/s11606-026-10807-7
Smith, S. E. (2026) · e-space (Manchester Metropolitan University) · doi:10.83056/mmu.32434797
Metadata
- 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
- 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
- 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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