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
Date
2019
Journal Title
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Abstract
Background: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Description
CITATION: Coetzee, O., et al. 2019. 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. BMC Health Services Research, 19:162, doi:10.1186/s12913-019-3999-z.
The original publication is available at https://bmchealthservres.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at https://bmchealthservres.biomedcentral.com
Publication of this article was funded by the Stellenbosch University Open Access Fund.
Keywords
Intellectual disability, Health care, NICE guideline, Intellectual disability facilities
Citation
Coetzee, O., et al. 2019. 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. BMC Health Services Research, 19:162, doi:10.1186/s12913-019-3999-z