Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care

Breaking barriers: a commentary on research gaps in cancer and depression among individuals with intellectual disabilities

The European Commission's Strategy for the Rights of Persons with Disabilities 2021-2030 aims to ensure equal opportunities and rights for all individuals, including those with intellectual disabilities. People with intellectual disabilities are often underrepresented in cancer prevention and screening policies, leading to disparities in health outcomes and early mortality. The intersection of intellectual disability, cancer, and depression represents an underexplored area in healthcare research. Individuals with intellectual disability diagnosed with both cancer and depression face compounded challenges impacting their quality of life, proper access to medical care, and treatment outcomes. To address these gaps in the systems globally, a focused effort is indispensable to understand their unique needs and better tailor care strategies for this target group. Therefore, this commentary outlines the challenges in researching individuals with intellectual disabilities who have a dual diagnosis of cancer and depression. Challenges include providing informed consent, ethical researcher-participant relationships, and maintaining confidentiality and autonomy. Strategies for improvement include creating accessible procedures, raising awareness, and involving individuals with intellectual disabilities in research ethics committees.

Australian Registered Nurse's' Awareness of Key Issues, Ambivalence and Education Related to the Health of People With Intellectual Disability and/or Autism

BACKGROUND

Health outcomes of people with Autism Spectrum Disorder and/or Intellectual Disability are poor. Yet there is a paucity of nurse education and preparation to care for people with Autism Spectrum Disorder and Intellectual Disability.

METHOD

A cross sectional survey of Australian Registered Nurses related to their educational experience, awareness of the national disability support scheme and the concept of making reasonable adjustments.

RESULTS

The majority of Australian Registered Nurses did not experience undergraduate content related to caring for people with Autism Spectrum Disorder and/or Intellectual Disability. Few participants experienced a dedicated clinical placement. Just over one half of the participants were aware of reasonable adjustments. Continuing professional education was significantly related to a greater awareness of reasonable adjustments and less ambivalence.

CONCLUSION

Education plays a key role in promoting awareness and reducing ambivalence. Education focussed on understanding the diversity in the particular types of neurodiversity is particularly efficacious.

Indonesian nurses' awareness and application of reasonable adjustments when caring for people with intellectual disability and/or autism

AIM

This study aimed to understand Indonesian nurses' familiarity with the concept of reasonable adjustments, and the frequency of its application within their practice.

BACKGROUND

People with intellectual disability and/or autism are exposed to significant barriers when accessing healthcare and have poorer health outcomes than those without developmental disabilities. Reasonable adjustments can improve accessibility and quality of healthcare for people with disabilities and involves adapting practices and environments to promote equitable healthcare.

INTRODUCTION

There is a scarcity of literature focused on the application of reasonable adjustments in the Indonesian nursing context. A greater understanding of the application of reasonable adjustments in this context can help inform nursing curricula and policy.

METHODS

A cross-sectional, descriptive survey -was undertaken and is reported in accordance with the Strengthening the Reporting of Evaluations and Non-randomised Designs. Following descriptive analysis, bivariate analyses were undertaken between key demographic, workplace, and self-reported capability variables, and familiarity and implementation of reasonable adjustments.

RESULTS

The majority of respondents were not familiar with the concept of reasonable adjustments and self-reported sometimes applying it within their practice. Higher levels of educational and clinical exposure to intellectual disability and/or autism, and self-capability variables, were significantly associated with familiarity with reasonable adjustments and their application.

CONCLUSIONS

An increase in nursing curricula focused on caring for people with intellectual disability and/or autism, including content focused on applying reasonable adjustments, is indicated.

IMPLICATIONS FOR NURSING POLICY

Given that, internationally, people with intellectual disability and/or autism have disproportionately negative health outcomes and experiences, findings highlighting gaps in understanding and application of reasonable adjustments of Indonesian nurses have substantial implications for nursing policy and curriculum.

Disability Education for Health Personnel and Impact on Health Outcomes for Persons with Autism: A Scoping Review

Autism manifests in various progressive, fluctuating, or static differences that may be disabling. This requires healthcare staff to provide individualized, culturally competent care for autistic people (AP). However, staff are underprepared since disability curricula are not universally implemented, which may exacerbate health disparities for AP. The Alliance for Disability in Health Care Education (ADHCE) delineated staff competencies to address disparities. The purpose of this review was to describe what is known about disability education initiatives and health-related outcomes for AP. The review included published literature on disability education for any health personnel providing services to AP in any setting where healthcare services are delivered. In June 2023, six databases were queried. Of 3,396 screened reports, 42 were extracted. Most articles originated in the United States and reported various instructional strategies on child-focused educational content for small interprofessional groups in various settings. The biomedical and biopsychosocial disability models were prominent. The training covered few, if any, ADHCE competencies and rarely involved collaboration with AP. Positive outcomes included improved functional health, behavior, and communication. Patient-reported outcomes and physical and psychosocial health were underreported. Future initiatives should involve scaled-up global efforts, address core competencies for care across the lifespan, and establish community partnerships to ensure meaningful outcomes.

A survey of Indonesian nurses' educational experiences and self-perceived capability to care for people with intellectual disability and/or autism spectrum disorder

AIMS

To describe Indonesian nurses' educational experience regarding care for people with intellectual disability and/or autism and to explore if these educational experiences are associated with their self-perceived confidence, comfort, knowledge and preparedness to care for these cohorts.

DESIGN

Cross-sectional descriptive survey.

METHODS

A descriptive survey tool utilized in a study of Australian registered nurses was replicated and adapted for this study. Following descriptive analysis, chi-square analyses were undertaken to explore associations between educational experiences, and self-rated measures of confidence, comfort and knowledge to work with people with intellectual disability and/or autism. Although there was no end-user involvement in the design of the study, the concepts explored have all been raised by those with lived insights of intellectual disability and/or autism as being critical to their healthcare experiences.

RESULTS

There were 544 complete responses, and 51.7% were not exposed to any educational or clinical content relevant to caring for people with intellectual disability and/or autism. Moderate to low levels of self-perceived confidence, comfort, knowledge and preparedness to address healthcare needs of these cohorts were reported. Significant associations were identified between educational and clinical experiences during undergraduate training, and higher levels of self-perceived confidence, comfort and knowledge.

CONCLUSION

Mirroring international literature, the findings of this study highlight a large proportion of Indonesian nurses had little educational experience relevant to caring for people with intellectual disability and/or autism, and have relatively low levels of self-reported capability.

IMPACT

This study highlights gaps in the educational experiences, and self-perceived confidence, comfort, knowledge and preparedness of Indonesian nurses regarding caring for people with intellectual disability and/or autism. Given that internationally, people with intellectual disability and/or autism have disproportionately negative health outcomes and experiences, these findings have substantial implications for nursing curriculum, policy and professional development.

Barriers to communication with people with developmental disabilities: A reflexive thematic analysis

People with Intellectual Disability and/or autism internationally experience some of the worst health outcomes of any population group. Registered nurses have been identified as having educational deficits in this domain, which include knowledge of adjustments to communication. This study aimed to explore perceived barriers to communication with people with Intellectual Disability and/or autism. A thematic analysis of data from an open-ended free-text survey question exploring barriers to communicating in a cross-sectional survey of 279 Australian registered nurses conducted in 2020 was undertaken. Six interrelated themes were identified. Increased educational content in undergraduate and postgraduate level nursing courses is indicated. The findings identify the benefit of educational design based on the foundation of understanding the diversity in thinking and information processing represented by the forms of neurodiversity in Intellectual Disability and Autism Spectrum Disorder.