Engelli ve Özel Gereksinimli Hasta Grubunda Bakım
Özet
Cerrahi girişim sürecinde engelli ve özel gereksinimli bireylere bakım özen ve dikkat gerektirmektedir. Bakım bireyselleştirilmiş, bütüncül ve multidisipliner bir yaklaşımla sağlanmaktadır. Hemşireler, bu süreçte hastaların fiziksel, psikolojik ve sosyal durumlarını değerlendirerek etkili iletişim, güvenlik önlemleri ve çevre düzenlemeleri ile destekleyici bir bakım ortamı yaratmaktadır. Aile ve bakım vericilerin katılımı, hasta eğitimi ve sağlık profesyonelleri arasında iş birliği, perioperatif süreç boyunca hastaların iyileşmesini ve refahını arttırmaktadır. Bu süreçte engellilik türüne göre bireye verilen bakımda özen gösterilmesi gereken konular farklılık gösterebilmektedir. Görme engelli bireylerin yeni ortama uyum sağlama süreçleri, beslenme durumlarının değerlendirilmesi ve ameliyat öncesi bilgilendirilmiş onamlarının Braille alfabesiyle hazırlanması gerekmektedir. İşitme engelli bireylerle yardımcı cihazlar, işaret dili ve yazılı materyaller kullanılarak etkili iletişim sağlanmaktadır. Dil ve konuşma engelli bireylerle iletişimde alternatif yöntemler ve sözsüz ağrı değerlendirme araçları kullanılmaktadır. Ortopedik engelli bireylerin mobilizasyonu ve çevresel düzenlemelerle düşmelerin önlenmesi büyük önem taşımaktadır. Ruhsal ve duygusal engelli bireylerde, psikososyal destek, anlaşılır biçimde iletişim kurmak ve bakıma katılımlarını sağlamak faydalı olmaktadır. Gelişimsel engelli bireylerde, duyusal ihtiyaçlar göz önünde bulundurularak ve ailelerle işbirliği yapılarak bakım süreci yönetilmektedir. Zihinsel engelli bireylerin ameliyat sonrası komplikasyon risklerinin yüksek olduğu belirtilmekte ve multidisipliner ekiplerle kaliteli bakım sağlanması gerektiği vurgulanmaktadır. Öğrenme güçlüğü olan bireylerde ise bireyselleştirilmiş bakım planları ve özel değerlendirme araçları kullanımı önerilmektedir. Cerrahi hemşireleri perioperatif süreç boyunca bakımın sürekliliğini sağlayarak ve hasta haklarını koruyarak engelli ve özel gereksinimli bireylerin refahını artırmada ve iyileşmesini sağlamada kritik bir rol oynamaktadır.
In the surgical intervention process, the care of individuals with disabilities and special needs requires attention and diligence. Care is provided in an individualized, holistic, and multidisciplinary approach. Nurses create a supportive care environment by evaluating the physical, psychological, and social conditions of patients, and by implementing effective communication, safety measures, and environmental adjustments. The involvement of family and caregivers, patient education, and collaboration among health professionals enhance the recovery and well-being of patients throughout the perioperative period. The specific aspects of care that need attention can vary depending on the type of disability. For visually impaired individuals, it is necessary to facilitate their adaptation to the new environment, assess their nutritional status, and prepare their informed consent in Braille. Effective communication with hearing-impaired individuals is ensured through the use of assistive devices, sign language, and written materials. Alternative methods and nonverbal pain assessment tools are used for communication with individuals who have speech and language impairments. Preventing falls by mobilizing and making environmental adjustments is crucial for individuals with orthopedic disabilities. Psychosocial support, clear communication, and encouraging participation in care are beneficial for individuals with mental and emotional disabilities. For individuals with developmental disabilities, the care process is managed by considering sensory needs and collaborating with families. It is noted that individuals with intellectual disabilities have a higher risk of postoperative complications, and multidisciplinary teams should provide quality care. For individuals with learning disabilities, it is recommended to use individualized care plans and special assessment tools. Surgical nurses play a critical role in enhancing the well-being and recovery of individuals with disabilities and special needs by ensuring continuity of care and protecting patient rights throughout the perioperative process.
Referanslar
WHO. Disability and Health 2023. Available from: https://www.who.int/news-room/fact sheets/detail/disability-and-health (Accessed: 12th May 2024)
Türkiye İnsan Hakları ve Eşitlik Kurumu. 3 Aralık Dünya Engelliler Günü Basın Açıklaması (12/05/2024 tarihinde https://www.tihek.gov.tr/3-aralik-dunya-engelliler-gunu-basin-aciklamasin adresinden ulaşılmıştır).
T.C. Aile ve Sosyal Hizmetler Bakanlığı. Engeli ve Yaşlı İstatistik Bülteni. Ocak 2022.
WHO. Disability, Health inedquity. Available from: https://www.who.int/health-topics/disability#tab=tab_2 (Accessed 12th May 2024)
World Health Organization. Disability Sixty-Sixth World Health Assembly 2013. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_12-en.pdf (Accessed 12th May 2024)
Aile ve Sosyal Hizmetler Bakanlığı. Engelli Hakları Ulusal Eylem Planı 2023-2025, 2030 Engelsiz Vizyon
WHO. Global report on health equity for persons with disabilities. Geneva: World Healt Organization 2022. Available from: https://www.who.int/publications/i/item/9789240063600 (Accessed: 12th May 2024)
WHO. 40 actions to achieve health equity for persons with disabilities 2022. Available from: https://www.who.int/health-topics/disability (Accessed 12th May 2024)
CDC. Disability and Health Owerviev 2024. Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html#:~:text=According%20to%20the%20World%20Health,%2C%20walking%2C%20or%20problem%20solving (Accessed 12th May 2024)
Bourne MJ, Smeltzer SC, Kelly MM. Healthcare inequities among adults with developmental disability: An integrative review with implications for nursing education. Nurse Educ Pract; 2021 Nov; 57:103225. doi: 10.1016/j.nepr.2021.103225.
Lindwall L, von Post I. Continuity created by nurses in the perioperative dialogue-a literature review. Scand J Caring Sci; 2009 Jun;23(2):395-401. doi: 10.1111/j.1471-6712.2008.00609.x.
Neil J.A. Preoperative Care .İn: Harding, M.M., Kwong, J., Roberts, D., Hagler, D., Reinisch, C. (eds.) Lewis's Medical-Surgical Nursing Assessment and Management of Clinical Problems. Eleventh Ed. New York; 2020. p.299-312.
Karasin M. Special needs populations: perioperative care of the patient with creutzfeldt‐jakob disease. AORN Journal. 2014; 100(4): 390-410.
Hemmelgarn B. The perioperative surgical home, enhanced recovery after surgery and how integration of these models may improve care for medically complex patients. Canadian Journal of Surgery. 2021; 64(4): 381-390.
Balakas K, Gallaher CS, Tilley C. Optimizing perioperative care for children and adolescents with challenging behaviors. MCN American Journal of Maternal/Child Nursing. 2015;40(3):153-159. doi: 10.1097/NMC.0000000000000124
Camicia M, Heimgartner NM. Concept of Rehabilitation for Chronic and Disabling Health Problems. İn: Ignatavicius DD, Workman ML, Rebar C. (eds). Medical-Surgical Nursing-Concepts for Interprofessional Collaborative Care. 10th edition, Canada: Elsevier Health Sciences; 2021.p 115-117
Bruhn JG. Patient assessment in the preoperative setting. Journal of Perianesthesia Nursing. 2014; 29(6), 420-432. doi:10.1016/j.jopan.2014.07.011
Hemsley B, Balandin S. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: Informing new translational research. Augmentative and Alternative Communication. 2014; 30(4): 329-343.
Smeltzer SC, Avery C, Haynor P. Interactions of people with disabilities and nursing staff during hospitalization. The American Journal of Nursing. 2012;112(4):30-7. doi: 10.1097/01.NAJ.0000413454.07369.e3. PMID: 22421319.
Kagan S. Interactions between healthcare professionals and patients with speech disabilities: The experiences of patients and professionals. International Journal of Language & Communication Disorders. 2011; 46(5): 563-577. doi:10.1111/j.1460-6984.2011.00094.x
Devran Ecer H. Engelli ve Türkçe bilmeyen hastaların Cerrahi Süreçte Bakımı. Yavuz Van Giersbergen M (ed.), Cerrahi Hemşireliği içinde. 1.baskı. Ankara: Nobel Tıp Kitabevi ; 2023. P 250-258
Morris M, Ziviani J. Physical and social environmental factors affecting participation of children with disabilities. Occupational Therapy International. 2008;15(2), 86-102. doi:10.1002/oti.247
Rugkåsa J, Tveit OG, Berteig J, et al. Collaborative care for mental health: a qualitative study of the experiences of patients and health professionals. BMC Health Services Research. 2020;20: 1-10.
King TA, Duffy J. Peri-operative care of elective adult surgical patients with a learning disability. Anaesthesia. 2022; 77(6): 674-683. doi: 10.1111/anae.15691.
Doody O, Hennessy T, Bright AM. The role and key activities of Clinical Nurse Specialists and Advanced Nurse Practitioners in supporting healthcare provision for people with intellectual disability: An integrative review. Internatinal Journal of Nursing Studies. 2022;129:104207. doi: 10.1016/j.ijnurstu.2022.104207.
Winterberg AV, Jones E, Ding L, el al. Adaptive Care for Perioperative Patients With Developmental Disabilities: An Exploration of Interventions and Family Experience. Journal Pediatric Health Care. 2022;36(6): 529-539. doi: 10.1016/j.pedhc.2022.05.019.
Malinzak EB. Perioperative care of adults with Down syndrome: a narrative review. Canadian Journal of Anesthesia. 2021;68(10): 1549-1561. doi: 10.1007/s12630-021-02052-9.
Kurre PA, Orthopaedic Care Coordination for the Intellectually and Developmentally Disabled Adult in the Residential Care Setting A Perfect Storm. Orthopaedic Nursing. 2014;33(5): 251 – 254. doi: 10.1097/NOR.00000000000000080.
Lin JA, Liao CC, Chang CC, el al. Postoperative adverse outcomes in intellectually disabled surgical patients: a nationwide population-based study. PLoS One. 2011;6(10): e26977. doi: 10.1371/journal.pone.0026977.
Gürbüz S, Çiçek A.Engelli de Yaşanır Engeller De Aşılır: Görme Engelliler. Sosyal ve Beşerî Bilimler Dergisi. 2023; 7(2): 504-515
Morse AR, Seiple W, Talwar N, el al. Association of Vision Loss With Hospital Use and Costs Among Older Adults. JAMA Ophthalmol. 2019;137(6): 634–640 doi:10.1001/jamaophthalmol.2019.0446
Jones N, Bartlett H. The impact of visual impairment on nutritional status: A systematic review. British Journal of Visual Impairment. 2018;36(1)
Bhalla S, Venishetty N, Sohn G, et al. Perioperative complications of legally blind patients undergoing total knee arthroplasty: A national inpatient sample database study. Journal of Orthopaedics. 2023;43: 69-74. doi: 10.1016/j.jor.2023.07.026
Venishetty N, Sohn G, Nguyen I, Trivedi M, Mounasamy V, Sambandam S. Perioperative complications of legally blind patients undergoing total hip arthroplasty- A national in-patient sample database study. Journal of Orthopaedics . 2023;40: 47-51. doi:10.1016/j.jor.2023.04.019.
NCBI. Hospital Care for patients with Vision Impairment, Sight Loss Council, Good practice guidance for hospitals when supporting blind or partially sighted people. Available from: https://www.sightlosscouncils.org.uk/wp-content/uploads/2020/10/SLC_hospital_best_practice_v2.pdf (Accessed 12th May 2024)
Vision Center of Excellence Walter Reed National Military Medical Center. Caring For Patıents Who Are Blind or Visually Impaired. Available from: http://vce.health.mil/ Revised Date: 03 November 2014 (Accessed 12th May 2024)
Özata M, Karip S. Engelli bireylerin sağlık hizmetleri kullanımında yaşadıkları sorunlar: Konya örneği. Hacettepe Sağlık İdaresi Dergisi. 2017; 20(4): 397-407
Al-Yahyai Rn Bsn ANS, Arulappan Rn Rm Bsc N Msc N PhD N DNSc J, Matua GA, Al-Ghafri Rn Bsn SM, Al-Sarakhi Rn Bsn SH, Al-Rahbi Rn Bsn KKS, Jayapal SK. Communicating to Non-Speaking Critically Ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy. SAGE Open Nursing. 2021:31;7:23779608211015234. doi: 10.1177/23779608211015234
Eti Aslan F. Ağrının Değerlendirilmesi ve Ölçümü. Eti Aslan F. (Ed.) Ağrı Doğası ve Kontrolü içinde. İstanbul: Avrupa Tıp Kitapçılık; 2006. p. 69-99
Molla K, Aslan M. Fiziksel engelli olan hastaların hemşirelik bakım davranışı algısı ve etkileyen faktörlerin belirlenmesi. Sağlık ve Yaşam Bilimleri Dergisi. 2023; 5(3), 153-161.
Centers for Disease Control and Prevention. 2021. Increase in developmental disabilities among children in the United States. Aveliable from: https://www.cdc.gov/ncbddd/developmentaldisabilities/features/increase-in-developmental-disabilities.html (Accessed 12th May 2024)
Öztürk Ö, Andsoy II. Özel Gereksinimi Olan Bir Hasta Grubu: Down Sendromlu Çocuklar ve Perioperatif Hemşirelik Yaklaşımları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2015;2: 79–84.
T.C. Cumhurbaşkanlığı Mevzuat Bilgi Sistemi. Özel Eğitim Hizmetleri Yönetmeliği 2018. (20/05/2024 tarihinde https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=24736&MevzuatTur=7&MevzuatTertip=5 adresinden ulaşılmıştır)
AAİDD. Defining Criteria for Intellectual Disability. Available from: https://www.aaidd.org/intellectual-disability/definition (Accessed 12th May 2024)
Patel DR, Cabral MD, Ho A, et al. A clinical primer on intellectual disability. Translational Pediatrics. 2020;9: 23-35. doi: 10.21037/tp.2020.02.02.
Blair J. Care of the person with a learning disability in the perioperative environment. Journal of Perioperative Practice. 2018 ;28(10):256-257. doi: 10.1177/1750458918797594.
Referanslar
WHO. Disability and Health 2023. Available from: https://www.who.int/news-room/fact sheets/detail/disability-and-health (Accessed: 12th May 2024)
Türkiye İnsan Hakları ve Eşitlik Kurumu. 3 Aralık Dünya Engelliler Günü Basın Açıklaması (12/05/2024 tarihinde https://www.tihek.gov.tr/3-aralik-dunya-engelliler-gunu-basin-aciklamasin adresinden ulaşılmıştır).
T.C. Aile ve Sosyal Hizmetler Bakanlığı. Engeli ve Yaşlı İstatistik Bülteni. Ocak 2022.
WHO. Disability, Health inedquity. Available from: https://www.who.int/health-topics/disability#tab=tab_2 (Accessed 12th May 2024)
World Health Organization. Disability Sixty-Sixth World Health Assembly 2013. Available from: https://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_12-en.pdf (Accessed 12th May 2024)
Aile ve Sosyal Hizmetler Bakanlığı. Engelli Hakları Ulusal Eylem Planı 2023-2025, 2030 Engelsiz Vizyon
WHO. Global report on health equity for persons with disabilities. Geneva: World Healt Organization 2022. Available from: https://www.who.int/publications/i/item/9789240063600 (Accessed: 12th May 2024)
WHO. 40 actions to achieve health equity for persons with disabilities 2022. Available from: https://www.who.int/health-topics/disability (Accessed 12th May 2024)
CDC. Disability and Health Owerviev 2024. Available from: https://www.cdc.gov/ncbddd/disabilityandhealth/disability.html#:~:text=According%20to%20the%20World%20Health,%2C%20walking%2C%20or%20problem%20solving (Accessed 12th May 2024)
Bourne MJ, Smeltzer SC, Kelly MM. Healthcare inequities among adults with developmental disability: An integrative review with implications for nursing education. Nurse Educ Pract; 2021 Nov; 57:103225. doi: 10.1016/j.nepr.2021.103225.
Lindwall L, von Post I. Continuity created by nurses in the perioperative dialogue-a literature review. Scand J Caring Sci; 2009 Jun;23(2):395-401. doi: 10.1111/j.1471-6712.2008.00609.x.
Neil J.A. Preoperative Care .İn: Harding, M.M., Kwong, J., Roberts, D., Hagler, D., Reinisch, C. (eds.) Lewis's Medical-Surgical Nursing Assessment and Management of Clinical Problems. Eleventh Ed. New York; 2020. p.299-312.
Karasin M. Special needs populations: perioperative care of the patient with creutzfeldt‐jakob disease. AORN Journal. 2014; 100(4): 390-410.
Hemmelgarn B. The perioperative surgical home, enhanced recovery after surgery and how integration of these models may improve care for medically complex patients. Canadian Journal of Surgery. 2021; 64(4): 381-390.
Balakas K, Gallaher CS, Tilley C. Optimizing perioperative care for children and adolescents with challenging behaviors. MCN American Journal of Maternal/Child Nursing. 2015;40(3):153-159. doi: 10.1097/NMC.0000000000000124
Camicia M, Heimgartner NM. Concept of Rehabilitation for Chronic and Disabling Health Problems. İn: Ignatavicius DD, Workman ML, Rebar C. (eds). Medical-Surgical Nursing-Concepts for Interprofessional Collaborative Care. 10th edition, Canada: Elsevier Health Sciences; 2021.p 115-117
Bruhn JG. Patient assessment in the preoperative setting. Journal of Perianesthesia Nursing. 2014; 29(6), 420-432. doi:10.1016/j.jopan.2014.07.011
Hemsley B, Balandin S. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: Informing new translational research. Augmentative and Alternative Communication. 2014; 30(4): 329-343.
Smeltzer SC, Avery C, Haynor P. Interactions of people with disabilities and nursing staff during hospitalization. The American Journal of Nursing. 2012;112(4):30-7. doi: 10.1097/01.NAJ.0000413454.07369.e3. PMID: 22421319.
Kagan S. Interactions between healthcare professionals and patients with speech disabilities: The experiences of patients and professionals. International Journal of Language & Communication Disorders. 2011; 46(5): 563-577. doi:10.1111/j.1460-6984.2011.00094.x
Devran Ecer H. Engelli ve Türkçe bilmeyen hastaların Cerrahi Süreçte Bakımı. Yavuz Van Giersbergen M (ed.), Cerrahi Hemşireliği içinde. 1.baskı. Ankara: Nobel Tıp Kitabevi ; 2023. P 250-258
Morris M, Ziviani J. Physical and social environmental factors affecting participation of children with disabilities. Occupational Therapy International. 2008;15(2), 86-102. doi:10.1002/oti.247
Rugkåsa J, Tveit OG, Berteig J, et al. Collaborative care for mental health: a qualitative study of the experiences of patients and health professionals. BMC Health Services Research. 2020;20: 1-10.
King TA, Duffy J. Peri-operative care of elective adult surgical patients with a learning disability. Anaesthesia. 2022; 77(6): 674-683. doi: 10.1111/anae.15691.
Doody O, Hennessy T, Bright AM. The role and key activities of Clinical Nurse Specialists and Advanced Nurse Practitioners in supporting healthcare provision for people with intellectual disability: An integrative review. Internatinal Journal of Nursing Studies. 2022;129:104207. doi: 10.1016/j.ijnurstu.2022.104207.
Winterberg AV, Jones E, Ding L, el al. Adaptive Care for Perioperative Patients With Developmental Disabilities: An Exploration of Interventions and Family Experience. Journal Pediatric Health Care. 2022;36(6): 529-539. doi: 10.1016/j.pedhc.2022.05.019.
Malinzak EB. Perioperative care of adults with Down syndrome: a narrative review. Canadian Journal of Anesthesia. 2021;68(10): 1549-1561. doi: 10.1007/s12630-021-02052-9.
Kurre PA, Orthopaedic Care Coordination for the Intellectually and Developmentally Disabled Adult in the Residential Care Setting A Perfect Storm. Orthopaedic Nursing. 2014;33(5): 251 – 254. doi: 10.1097/NOR.00000000000000080.
Lin JA, Liao CC, Chang CC, el al. Postoperative adverse outcomes in intellectually disabled surgical patients: a nationwide population-based study. PLoS One. 2011;6(10): e26977. doi: 10.1371/journal.pone.0026977.
Gürbüz S, Çiçek A.Engelli de Yaşanır Engeller De Aşılır: Görme Engelliler. Sosyal ve Beşerî Bilimler Dergisi. 2023; 7(2): 504-515
Morse AR, Seiple W, Talwar N, el al. Association of Vision Loss With Hospital Use and Costs Among Older Adults. JAMA Ophthalmol. 2019;137(6): 634–640 doi:10.1001/jamaophthalmol.2019.0446
Jones N, Bartlett H. The impact of visual impairment on nutritional status: A systematic review. British Journal of Visual Impairment. 2018;36(1)
Bhalla S, Venishetty N, Sohn G, et al. Perioperative complications of legally blind patients undergoing total knee arthroplasty: A national inpatient sample database study. Journal of Orthopaedics. 2023;43: 69-74. doi: 10.1016/j.jor.2023.07.026
Venishetty N, Sohn G, Nguyen I, Trivedi M, Mounasamy V, Sambandam S. Perioperative complications of legally blind patients undergoing total hip arthroplasty- A national in-patient sample database study. Journal of Orthopaedics . 2023;40: 47-51. doi:10.1016/j.jor.2023.04.019.
NCBI. Hospital Care for patients with Vision Impairment, Sight Loss Council, Good practice guidance for hospitals when supporting blind or partially sighted people. Available from: https://www.sightlosscouncils.org.uk/wp-content/uploads/2020/10/SLC_hospital_best_practice_v2.pdf (Accessed 12th May 2024)
Vision Center of Excellence Walter Reed National Military Medical Center. Caring For Patıents Who Are Blind or Visually Impaired. Available from: http://vce.health.mil/ Revised Date: 03 November 2014 (Accessed 12th May 2024)
Özata M, Karip S. Engelli bireylerin sağlık hizmetleri kullanımında yaşadıkları sorunlar: Konya örneği. Hacettepe Sağlık İdaresi Dergisi. 2017; 20(4): 397-407
Al-Yahyai Rn Bsn ANS, Arulappan Rn Rm Bsc N Msc N PhD N DNSc J, Matua GA, Al-Ghafri Rn Bsn SM, Al-Sarakhi Rn Bsn SH, Al-Rahbi Rn Bsn KKS, Jayapal SK. Communicating to Non-Speaking Critically Ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy. SAGE Open Nursing. 2021:31;7:23779608211015234. doi: 10.1177/23779608211015234
Eti Aslan F. Ağrının Değerlendirilmesi ve Ölçümü. Eti Aslan F. (Ed.) Ağrı Doğası ve Kontrolü içinde. İstanbul: Avrupa Tıp Kitapçılık; 2006. p. 69-99
Molla K, Aslan M. Fiziksel engelli olan hastaların hemşirelik bakım davranışı algısı ve etkileyen faktörlerin belirlenmesi. Sağlık ve Yaşam Bilimleri Dergisi. 2023; 5(3), 153-161.
Centers for Disease Control and Prevention. 2021. Increase in developmental disabilities among children in the United States. Aveliable from: https://www.cdc.gov/ncbddd/developmentaldisabilities/features/increase-in-developmental-disabilities.html (Accessed 12th May 2024)
Öztürk Ö, Andsoy II. Özel Gereksinimi Olan Bir Hasta Grubu: Down Sendromlu Çocuklar ve Perioperatif Hemşirelik Yaklaşımları. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2015;2: 79–84.
T.C. Cumhurbaşkanlığı Mevzuat Bilgi Sistemi. Özel Eğitim Hizmetleri Yönetmeliği 2018. (20/05/2024 tarihinde https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=24736&MevzuatTur=7&MevzuatTertip=5 adresinden ulaşılmıştır)
AAİDD. Defining Criteria for Intellectual Disability. Available from: https://www.aaidd.org/intellectual-disability/definition (Accessed 12th May 2024)
Patel DR, Cabral MD, Ho A, et al. A clinical primer on intellectual disability. Translational Pediatrics. 2020;9: 23-35. doi: 10.21037/tp.2020.02.02.
Blair J. Care of the person with a learning disability in the perioperative environment. Journal of Perioperative Practice. 2018 ;28(10):256-257. doi: 10.1177/1750458918797594.
