Zihinsel Engellilerde Sağlık Okuryazarlığı: Karma Yöntem Bir Literatür Taraması

Engel, karmaşık ve çok boyutlu bir gerçektir. Dünya genelinde iki yüz milyon zihinsel engelli bireyolduğu tahmin edilmektedir. Türkiye’de ise 2.530.376 engelli birey olduğu saptanmıştır. Bireyler, engeldurumuna bağlı olarak riskli sağlık davranışlarını daha sık sergilemektedir. Engelli bireyler, sağlıklarınıkoruma ve geliştirme için sağlık hizmetlerine daha yoğun ihtiyaç duymalarına rağmen, hizmete erişimleridaha düşük düzeydedir. Hastalıklara bağlı olarak genel yaşam kaliteleri düşük ve ortalama yaşam süreleri dedaha kısadır. Sağlık okuryazarlığının geliştirilmesi engelli bireylerin sağlıklarını koruma ve geliştirme içinbaşvurulabilecek temel stratejilerden birisidir. Bu araştırmanın genel amacı hafif düzeyde zihinsel engellibireylerde sağlık okuryazarlığı konusunda 1990-2020 yılları arasında gerçekleştirilmiş olan çalışmalarınincelenmesidir. Araştırma, karma yöntem literatür taramasına dayalı olarak belirlenen ölçütlere uyan toplam19 çalışma kapsamında sürdürülmüştür. Çalışmalar incelendiğinde; dört çalışma deneysel desende, ikiçalışma betimsel desende, diğerleri (n=12) ise teorik tartışma veya derleme türünde hazırlandığı saptanmıştır.Çalışmalarda zihinsel engelli bireylerin öz yönetim algısı, sağlığı geliştirme, sağlık hizmet sunumu vehizmete erişim, ilaç kullanımı ve ağız sağlığı konuları incelenmiştir. Zihinsel engelli bireylerde sağlıkokuryazarlığı konusunda hazırlanan bu araştırmaya dahil edilen çalışmaların tamamında, hizmete erişim ve sağlıkla ilgili bilgilerin anlaşılabilirliği vurgusu yer almaktadır. Hedef grupların karar verme sürecindegüçlendirilmesine yönelik çalışma sayısı ise oldukça sınırlıdır. Çalışma sonuçlarından yola çıkarak zihinselengelli bireylerin sağlık okuryazarlıklarının geliştirilmesi için birtakım öneriler getirilmiştir.

A Mixed Method Literature Review on Health Literacy of Intellectually Disabled Individuals

Disability is a complex and multidimensional fact. It is estimated that there are 200 millionintellectually disabled persons around the world. In Turkey, it was founded that 2.530.376 individiual’sdisability. They exhibit risky health behaviours more frequently depending on the condition of theirdisability. Although they are more intensely in need for healthcare services to maintain and improve theirhealth, they have a lower levels of access to the services. They have lower quality of life and a shorter lifetime due to disorders. Development of health literacy is one of the basic strategies to be utilized so thatdisabled persons can maintain and improve their health. This research aimed to review the studies conductedon health literacy among mildly intellectually disabled persons between 1990 and 2020. The research wascarried out on 19 studies meeting the criteria that were set based on the mixed-methods literature review.When the studies are examined; the four studies were prepared in an experimental design, two studies wereprepared in a descriptive design, and the others (n = 12) were found to be prepared as theoretical discussionor review. In the studies, the perception of self-management, health promotion, health service delivery andaccess to services, drug use and oral health of individuals with intellectual disabilities were investigated.Emphasis is placed on access to services and the comprehensibility of health-related information in all of thestudies included in this study on health literacy in individuals with intellectual disabilities. The number ofstudies to strengthen the target groups in the decision-making process is quite limited. Based on the results ofthe studies, some suggestions have been made to improve the health literacy of intellectual disabledindividuals.

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Akalın, E. (2009). Türk toplumunda sağlık okuryazarlığının belirlenmesi. http://www.actus.com.tr/files/t_sinopsis.pdf.
Akbulut, Y. (2015). Sağlık okuryazarlığının sağlık harcamaları ve sağlık hizmetleri kullanımı açısından değerlendirilmesi. İçinde Yıldırım, F. ve Keser, A. (Edt.), Sağlık okuryazarlığı (syf: 113-125). Ankara Üniversitesi Yayınları.
Allen, J. Dodd, K. J., Taylor, N. F., McBurney, H. & Larkin, H. (2004). Strength training can be enjoyable and beneficial for adults with cerebral palsy. Disability and Rehabilitation, 26(19),1121-1127. http://dx.doi.org/10.1080/09638280410001712378
Arksey, H. & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32.
Bergstrom, H., Elinder, L. S. & Wihlman, U. (2014). Barriers and facilitators in health education for adults with intellectual disabilities--a qualitative study. Health Education Research, 29(2), 259–271. http://dx.doi.org/10.1093/her/cyt111
Bergström, H., Hagströmer, M., Hagberg, J. & Elinder, L. S. (2013). A multi-component universal intervention to improve diet and physical activity among adults with intellectual disabilities in community residences: A cluster randomised controlled trial. Research in Developmental Disabilities, 34(11), 3847–3857. http://dx.doi.org/10.1016/j.ridd.2013.07.019
Boardman, L., Bernal, J. & Hollins, S. (2014). Communicating with people with intellectual disabilities: a guide for general psychiatrists. Advances in Psychiatric Treatment, 20(1), 27– 36. http://dx.doi.org/10.1192/apt.bp.110.008664
Burton, P. & Phipps, S. (2009). Economic costs of caring for children with disabilities in Canada. Canada Public Policy, 35(3), 269-290.
Cardol, M., Rijken, M. & Van S. L. T H. (2011). People with mild to moderate intellectual disability talking about their diabetes and how they manage. Journal of Intellectual Disability Research. 56(4). 351-360. http://dx.doi.org/10.1111/j.1365-2788.2011.01472.x
Chesney, E., Goodwin, G. & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry, 13, 153-160.
Chinn, D. (2014). Critical health literacy health promotion and people with intellectual disabilities. Asia-Pacific Journal of Health, Sport & Physical Education, 5(3), 249– 265. http://dx.doi.org/10.1080/18377122.2014.940811
Chinn, D. (2019). Talking to producers of easy read health information for people with intellectual disability: Production practices, textual features, and imagined audiences. Journal of Intellectual & Developmental Disability, 44(4), 410-420. http://dx.doi.org/10.3109/13668250.2019.1577640
Chinn, D. & Homeyard, C. (2016). Easy read and accessible information for people with intellectual disabilities: Is it worth it? A meta-narrative literature review. Health Expectations, 20(6), 1189–1200. http://dx.doi.org/10.1111/hex.12520
Desai, M., Messer, L. B. & Calache, H. (2001). A study of the dental treatment needs of children with disabilities in Melbourne, Australia. Australian Dental Journal, 46, 41-50. http://dx.doi.org/10.1111/j.1834-7819.2001.tb00273.x
Diaz, K. M. (2019). Leisure time physical activity and all cause mortality among adults with intellectual disability: the National Health Interview Survey. Journal of Intellectual Disability Research. 64(2), 180-184. http://dx.doi.org/10.1111/jir.12695
Durstine, J. L., Painter, P., Franklin, B. A., Morgan, D., Pitetti, K. H. & Robert, S. O. (2000). Physical activity for the chronically ill and disabled. Sports Medicine 30(3), 207-219. http://dx.doi.org/10.2165/00007256-200030030-00005
Emerson, E. & Hatton, C. (2014). Health inaqualities and people with intellectual disabilities. Cambridge Press.
Feldman, M. A., Owen, F., Andrews, A. E., Tahir, M., Barber, R. & Griffiths, D. (2015). Randomized control trial of the 3rs health knowledge training program for persons with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 29(3), 278–288. http://dx.doi.org/10.1111/jar.12186
Flood, B. & Henman, M. C. (2015). Case study: hidden complexity of medicines use: information provided by a person with intellectual disability and diabetes to a pharmacist. British Journal of Learning Disabilities, 43(3), 234–242. http://dx.doi.org/10.1111/bld.12121
Fragala-Pinkham, M. A., Haley, S. M. & Goodgold, S. (2006). Evaluation of a community-based group fitness program for children with disabilities. Pediatric Physical Therapy, 18(2), 159- 167. http://dx.doi.org/10.1097/01.pep.0000223093.28098.12
Geukes, C., Bruland, D. & Latteck, A. D. (2018). Health literacy in people with intellectual disabilities: A mixed - method literature review. Kontakt. http://dx.doi.org/10.1016/j.kontakt.2018.10.008
Geukes, C., Bröder, J. & Latteck, A. D. (2019). Health literacy and people with intellectual disabilities: what we know, what we do not know, and what we need: a theoretical discourse. International Journal of Environmental Research and Public Health 16(3), 463. http://dx.doi.org/10.3390/ijerph16030463
Gray, J. (2018). Increasing participation of people with learning disabilities in bowel screening. British Journal of Nursing, 27(5), 250–253. http://dx.doi.org/10.12968/bjon.2018.27.5.250
Haveman, M., Perry, J., Salvador-Carulla, L., Walsh, P. N., Kerr, M., Van Schrojenstein Lantmande Valk, H., … Weber, G. (2011). Ageing and health status in adults with intellectual disabilities: Results of the European POMONA II study. Journal of Intellectual & Developmental Disability, 36(1), 49–60. http://dx.doi.org/10.3109/13668250.2010.549464
Heal, L. W. & Sigelman, C. K. (1995). Response biases in interviews of individuals with limited mental ability. Journal of Intellectual Disability Research, 39(4), 331– 340. http://dx.doi.org/10.1111/j.1365-2788.1995.tb00525.x
Heyvaert, M., Maes, B. & Onghena, P. (2013). Mixed methods research synthesis: Definition, framework, and potential. Quality & Quantity, 47, 659–676. http://dx.doi.org/10.1007/s11135-011-9538-6
Ho, P., Bulsara, M., Patman, S., Downs, J., Bulsara, C. & Hill, A. M. (2019). Incidence and associated risk factors for falls in adults with intellectual disability. Journal of Intellectual Disability Research, 63(12),1441-1452. http://dx.doi.org/10.1111/jir.12686
Kuijken, N. M. J., Naaldenberg, J., Anrooij, K. V., Sanden, M. W. G. N. der, van Schrojenstein, H. M. J., Valk, L. & Leusink, G. L. (2020). Integrating health promotion in the everyday life of people with intellectual disability—the extent to which current initiatives take context into account. Intellectual and Developmental Disabilities, 58(2), 170– 179. http://dx.doi.org/10.1352/1934-9556-58.2.170
Latteck, A. D. & Bruland, D. (2020). Inclusion of People with Intellectual Disabilities in Health Literacy: Lessons Learned from Three Participative Projects for Future Initiatives. International Journal of Environmental Research and Public Health, 17, 2455. http://dx.doi.org/10.3390/ijerph17072455
Mackert, M., Champlin, S., Su, Z. & Guadagno, M. (2015). The many health literacies: advancing research or fragmentation? Health Communication, 30(12), 1161– 1165. http://dx.doi.org/10.1080/10410236.2015.1037422
MacRae, S., Brown, M., Karatzias, T., Taggart, L., …..Davis, M., (2015). Diabetes in people with intellectual disabilities: A systematic review of the literature. Research in Developmental Disabilities, 47, 352-374. http://dx.doi.org/10.1016/j.ridd.2015.10.003
Marks, B., Sisirak, J. & Hsieh, K. (2008). Health services, health promotion, and health literacy: Report from the state of the science in aging with developmental disabilities conference. Disability and Health Journal, (3), 136–142. http://dx.doi.org/10.1016/j.dhjo.2008.04.003
Marks, B. & Sisirak, J. (2017). Nurse practitioners promoting physical activity: people with ıntellectual and developmental disabilities. The Journal for Nurse Practitioners, 13(1), 1– 5. http://dx.doi.org/10.1016/j.nurpra.2016.10.023
Mastebroek, M., Naaldenberg, J., Lagro-Janssen, A. L. & van Schrojenstein Lantman de Valk, H. (2014). Health information exchange in general practice care for people with intellectual disabilities—A qualitative review of the literature. Research in Developmental Disabilities, 35(9), 1978–1987. http://dx.doi.org/10.1016/j.ridd.2014.04.029
Millî Eğitim Bakanlığı [Ministry of National Education] (2013). Hafif düzeyde zihinsel yetersizliği olan çocuklar ilkokulları ve ortaokulları haftalık ders çizelgesi [Children with mild intellectual disabilities weekly course schedule for primary and secondary schools]. http://www.orgm.meb.gov.tr/meb_iys_dosyalar/2018_12/24163834_hafif_dYzey_ilkokullar Y_ve_ortaokullarY.pdf
Mitra, S., Palmer, M., Kim, H., Month, D. & Groce, N. (2017). Extra costs of living with a disability: A review and agenda for research. Disability and Health Journal. 10(4), 475-484. http://dx.doi.org/10.1016/j.dhjo.2017.04.007
Ningrum, V., Wang, W. C., Liao, H. E., Bakar, A. & Shih, Y. H. (2020). A special needs dentistry study of institutionalized individuals with intellectual disability in West Sumatra Indonesia. Scientific Reports 10. Article number: 153. http://dx.doi.org/10.1038/s41598-019-56865-2
Nutbeam, D. (2000). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259-267. http://dx.doi.org/10.1093/heapro/15.3.259
Reppermund, S., Srasuebkul, P., Dean, K. & Trollor, J. N. (2019). Factors associated with death in people with intellectual disability. Journal of Applied Research in Intellectual Disabilities. 33(3), 420-429. http://dx.doi.org/10.1111/jar.12684
Rimmer, J. H., Heller, T., Wang, E. & Valerio, I. (2004). Improvements in physical fitness in adults with Down syndrome. American Journal of Mental Retardation, 109(2), 165-174. http://dx.doi.org/10.1352/0895-8017
Rimmer, J. H. & Rowland, J. L. (2018). Health promotion for people with disabilities: implications for empowering the person and promoting disability-friendly environments. Journal of Lifestyle Medicine, 2, 409-420. http://dx.doi.org/10.1177/1559827608317397
Scott, H. M. & Havercamp, S. M. (2016). Systematic review of health promotion programs focused on behavioral changes for people with intellectual disability. Intellectual and Developmental Disabilities, 54(1), 63–76. http://dx.doi.org/10.1352/1934-9556-54.1.63
Segerlantz, M., Axmon, A. & Ahlström, G. (2020). End of life care among older cancer patients with intellectual disability in comparison with the general population: a national register study. Journal of Intellectual Disability Research, 64(5), 317- 330. http://dx.doi.org/10.1111/jir.12721
Shiyko, M. P., Ram, N. & Grimm, K. J. (2012). An overview of growth mixture modeling a simple nonlinear application in OpenMx. In Hoyle, R. H. (Eds.) Handbook of structural equation modeling, (pg.532–546), Guilford Press.
Talim ve Terbiye Kurulu Başkanlığı, (2018). İlköğretim kurumları (ilkokul-ortaokul) haftalık ders çizelgesi (2018-2019) eğitim öğretim yılında uygulanacak [Primary education institutions (primary school-secondary school) weekly course schedule (2018-2019) will be applied in the academic year]. http://ttkb.meb.gov.tr/www/haftalik-ders-cizelgeleri/kategori/7
Thomson, A., Bridges, S., Corrins, B., Pham, J., White, C. & Buchanan, A. (2020). The impact of physical activity and sport programs on community participation for people with intellectual disability: a systematic review. Journal of Intellectual & Developmental Disability, 1– 11. http://dx.doi.org/10.3109/13668250.2020.1717070
UNICEF, (2019). Disability and development report: Realizing the Sustainable Development Goals by, for and with persons with disabilities. United Nations.
WHO, (2011). World report on disability. World Health Organization Regional Office for Europe.
WHO, (2013). Health literacy: The solid facts. World Health Organization Regional Office for Europe.
WHO, (2016). The Shanghai declaration. euro.who.int

ISSN: 2667-5617
Yayın Aralığı: Yılda 6 Sayı
Başlangıç: 2006
Yayıncı: ASOS Eğitim Bilişim Danışmanlık Otomasyon Yayıncılık Reklam Sanayi ve Ticaret LTD ŞTİ