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
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 th...
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-3999-z |
| _version_ | 1818179216627204096 |
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| author | Ockert Coetzee Leslie Swartz Charlotte Capri Colleen Adnams |
| author_facet | Ockert Coetzee Leslie Swartz Charlotte Capri Colleen Adnams |
| author_sort | Ockert Coetzee |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T21:00:21Z |
| format | Article |
| id | doaj.art-164a0faa2d1c4edcab89bea16b30fd65 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-11T21:00:21Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-164a0faa2d1c4edcab89bea16b30fd652022-12-22T00:50:59ZengBMCBMC Health Services Research1472-69632019-03-0119111010.1186/s12913-019-3999-zWhere 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 disabilityOckert Coetzee0Leslie Swartz1Charlotte Capri2Colleen Adnams3Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur HospitalAlan J Flisher Centre for Public Mental Health, Department of Psychology, Stellenbosch UniversityDepartment of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur HospitalDepartment of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur HospitalAbstract 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.http://link.springer.com/article/10.1186/s12913-019-3999-zIntellectual disabilityChallenging behaviourNICE guidelinesLow-income contexts |
| spellingShingle | Ockert Coetzee Leslie Swartz Charlotte Capri Colleen Adnams 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 Intellectual disability Challenging behaviour NICE guidelines Low-income contexts |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Intellectual disability Challenging behaviour NICE guidelines Low-income contexts |
| url | http://link.springer.com/article/10.1186/s12913-019-3999-z |
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