Where there is no evidence: implementing family interventions from recommendations in the NICE guideline 11 on challenging behaviour in a South African health service for adults with intellectual disability.

Journal: BMC health services research

Volume: 19

Issue: 1

Year of Publication: 2019

Affiliated Institutions:  Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, , South Africa. Alan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch University, Private Bag X, Matieland, , South Africa. Lswartz@sun.ac.za.

Abstract summary 

Low- and middle-income countries often lack the fiscal, infrastructural and human resources to conduct evidence-based research; similar constraints may also hinder the application of good clinical practice guidelines based on research findings from high-income countries. While the context of health organizations is increasingly recognized as an important consideration when such guidelines are implemented, there is a paucity of studies that have considered local contexts of resource-scarcity against recommended clinical guidelines.This paper sets out to explore the implementation of the NICE Guideline 11 on family interventions when working with persons with intellectual disability and challenging behavior by a group of psychologists employed in a government health facility in Cape Town, South Africa.In the absence of evidence-based South African research, we argue that aspects of the guidelines, in particular those that informed our ethos and conceptual thinking, could be applied by clinical psychologists in a meaningful manner notwithstanding the relative scarcity of resources.We have argued that where guidelines such as the NICE Guidelines do not apply contextually throughout, it remains important to retain the principles behind these guidelines in local contexts. Limitations of this study exist in that the data were drawn only from the clinical experience of authors. Some of the implications for future research in resource-constrained contexts such as ours are discussed. Smaller descriptive, qualitative studies are necessary to explore the contextual limitations and resource strengths that exist in low- and middle-income settings, and these studies should be more systematic than drawing only on the clinical experience of authors, as has been done in this study.

Authors & Co-authors:  Coetzee Ockert O Swartz Leslie L Capri Charlotte C Adnams Colleen C

Study Outcome 

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Statistics
Citations :  McGill P, Papachristoforou E, Cooper V. Support for family carers of children and young people with developmental disabilities and challenging behaviour. Child Care Health Dev. 2006;32:159–165. doi: 10.1111/j.1365-2214.2006.00600.x.
Authors :  4
Identifiers
Doi : 162
SSN : 1472-6963
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Challenging behaviour;Intellectual disability;Low-income contexts;NICE guidelines
Study Design
Cross Sectional Study
Study Approach
Qualitative,Systemic Review
Country of Study
South Africa
Publication Country
England