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Mafuba K, Kiernan J, Chapman HM, Kupara D, Kudita C, Chester R. Understanding the contribution of intellectual disability nurses. Paper 2 of 4 - Survey. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231213434. [PMID: 37956695 DOI: 10.1177/17446295231213434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The objective was to identify ID nursing interventions and their impact on the health and healthcare of people with IDs. Data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. We identified 878 interventions that could be undertaken by ID nurses from 7 countries. We categorised the interventions into five themes: effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. Findings demonstrate that ID nurses play important roles in improving the health and healthcare experiences of people with IDs.
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Affiliation(s)
| | - Joann Kiernan
- Edge Hill University and Alder Hey Children's Hospital, UK
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Kelleher E, Martin AM, Caples M, Wills T. Acute service and disability service providers experiences of joint working to improve health care experiences of people with an intellectual disability compared to non-joint working: A mixed-method systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231209345. [PMID: 37864518 DOI: 10.1177/17446295231209345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Persons with intellectual disabilities require frequent access to acute services. Many also access disability services within the community. Reports and enquiries have highlighted the sub-optimal healthcare provided to this group when accessing healthcare in acute services. Joint working between acute and disability services has been identified as a measure to improve healthcare for this group. A mixed method systematic review was undertaken to explore current evidence of joint working between both service providers. Twelve publications were included, and the data were analysed using thematic analysis. Confusion around responsibility and limited training in acute services prevented joint working from occurring. Information-sharing is pivotal in promoting joint-working, but measures which facilitated it were not always used. Albeit acute services demonstrated a strong commitment to deliver quality care to those with intellectual disabilities. Much of the available research captures the experiences of staff in acute services. There is a paucity of research available exploring experiences of disability service providers.
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Mafuba K, Kiernan J, Kudita C, Chapman HM, Kupara D, Chester R. Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231196588. [PMID: 37611566 DOI: 10.1177/17446295231196588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to a evaluate intellectual disability nurses' confidence in their understanding of the interventions they undertook. Quantitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work need to be undertaken by nurse leaders ascertain and address this lack of clarity.
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Affiliation(s)
| | - Joann Kiernan
- Edge Hill Universityand Alder Hey Children's Hospital, UK
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McCormick F, Marsh L, Taggart L, Brown M. Experiences of adults with intellectual disabilities accessing acute hospital services: A systematic review of the international evidence. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1222-1232. [PMID: 33316110 DOI: 10.1111/hsc.13253] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/12/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Adults with intellectual disabilities experience significant physical and mental health needs when compared to their typically developing peers. Previous research evidences that many people with intellectual disabilities have negative encounters within acute hospitals. The aim of this systematic review was to identify the specific views and experiences of adults with intellectual disabilities when accessing acute hospital services arising from the available literature. The review commenced in June 2019 and was updated in May 2020. A systematic search of five electronic databases including CINAHL Plus, MEDLINE, Web of Science, SCOPUS and PsycINFO was undertaken. Studies published from 2014, peer-reviewed, written in English and referred to adults with intellectual disabilities aged 18 plus and acute hospital settings were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Critical Appraisal Skills Programme quality assurance checklist were used to review all selected papers. Five studies from a total of 421 were deemed suitable for inclusion in the review as the voices of adults with intellectual disabilities were present. Poor communication from healthcare staff towards adults with intellectual disabilities emerged in four studies while the use of the hospital passport and the intellectual disability liaison nurse to significantly improve the hospital experience for adults with intellectual disabilities was identified in two of the studies. Following a systematic and thematic analysis of the studies, three main overarching themes emerged: communication; information sharing; and compassion and respect. Despite the national and international focus on improving healthcare for people with intellectual disabilities, this review highlights lack of communication, inadequate information sharing and issues related to compassionate care and respect. The review identifies the possibility that an increased use of hospital passports and an extension of the intellectual disability liaison nursing roles may enhance the hospital experience for people with intellectual disabilities.
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Affiliation(s)
- Freda McCormick
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Lynne Marsh
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Michael Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Howie VA, Welch AJ, Horton ES, Wirihana LA. The quandary of registered nurses untrained in adult intellectual disability nursing when caring for this diverse patient group in acute care settings: An integrated literature review. J Clin Nurs 2021; 30:1542-1555. [PMID: 33462921 DOI: 10.1111/jocn.15663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/24/2020] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To critically appraise relevant literature on the lived experiences of registered nurses caring for adults with intellectual disability in the acute care setting in Australia to determine current knowledge and gaps in the literature. BACKGROUND People with intellectual disability have the right to the highest attainable health care the same as everyone else. However, inequities still exist in the delivery of health care across the globe, including Australia that result in poorer health outcomes for this population group. Part of the problem is a lack of understanding of the complexities of ID care due to an absence of ID specific content in undergraduate curricula. DESIGN Integrative literature review. METHODS Electronic databases were searched for relevant empirical and theoretical literature. Additional articles were found by reviewing reference lists of selected articles resulting in ten articles for review. Selected articles were critically appraised using JBI critical appraisal tools. Data were analysed using comparative thematic analysis. PRISMA checklist completed the review. RESULTS Two main themes emerged from the data that informed the gap in knowledge: (a) Defining nursing practice; and (b) Confidence to practice. CONCLUSIONS There was limited qualitative research published on the topic. International studies revealed that a lack of understanding of the ID condition due to inadequate education left registered nurses feeling underprepared, unsupported and struggling to provide optimal care. No studies were located on the phenomenon within the Australian context. A study exploring the lived experiences of RNs in Australia is needed to offer a deeper understanding of the phenomenon that will help inform practice. RELEVANCE TO PRACTICE Including ID care in national undergraduate and postgraduate nursing curricula must become a nursing educational and professional priority to support nurses more fully in their practice to ensure patients with ID receive the highest attainable standard of nursing care.
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Affiliation(s)
- Virginia Anne Howie
- School of Nursing, Midwifery & Social Sciences, CQ University Australia, North Rockhampton, QLD, Australia
| | - Anthony Joseph Welch
- School of Nursing, Midwifery & Social Sciences, CQ University Australia, North Rockhampton, QLD, Australia
| | - Eleanor Sandra Horton
- School of Nursing and Midwifery, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Lisa Anne Wirihana
- School of Nursing, Midwifery & Social Sciences, CQ University Australia, North Rockhampton, QLD, Australia
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Fisher K, Robichaux C, Sauerland J, Stokes F. A nurses' ethical commitment to people with intellectual and developmental disabilities. Nurs Ethics 2020; 27:1066-1076. [PMID: 32228209 DOI: 10.1177/0969733019900310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: This article explores the issues of knowledge deficits of healthcare professionals in meeting the needs of people with IDD throughout the life span, and to identify factors that contribute to these deficits. Although statistics vary due to census results and the presence of a "hidden population," approximately 1%-3% of the global population identify as living with an intellectual or developmental disability. People with intellectual or developmental disability experience health inequities and confront multiple barriers in society, often related to the stigma of intellectual or developmental disability. Disparities in care and service are attributed to a lack of knowledge and understanding among healthcare providers about people with intellectual or developmental disability, despite their increased risk for chronic health problems. The near absence of educational programs in nursing both nationally and internationally contributes to this significant knowledge deficit. In addition, ethical considerations between paternalistic beneficence and idealized autonomy have resulted in a lack of clear direction in working with a population that is often ignored or exploited. Nurses who view people with intellectual or developmental disability as vulnerable without assessing or acknowledging their capabilities may err toward paternalism in an effort to "first do no harm." Likewise, nurses who fail to recognize the challenges and limitations faced by people with intellectual or developmental disability may not provide sufficient protections for a vulnerable person. People with intellectual or developmental disability are not binary, but rather complex individuals with a myriad of presentations. This article seeks to encourage a well-informed model of nursing care. Through an ethical lens, this article explores the nurse's ethical commitments in cases of victimization, access to care, decision making, and the provision of optimal end-of-life care for people with intellectual or developmental disability.
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Desroches M. Nurses' attitudes, beliefs, and emotions toward caring for adults with intellectual disabilities: An integrative review. Nurs Forum 2020; 55:211-222. [PMID: 31800106 DOI: 10.1111/nuf.12418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Negative health-care provider attitudes are a contributing factor to the myriad health disparities faced by people with intellectual disabilities (ID). Nursing comprises the nation's largest health-care profession, yet no integrative review on this topic is found. PURPOSE To organize findings of studies exploring nurses' attitudes, beliefs, and emotions about caring for adults with ID, to identify areas for future research, and to discuss recommendations for nursing practice. METHODS Whittemore and Knafl's integrative review method guided this study. RESULTS Twenty studies were conducted across eight countries, dichotomized according to mainstream or ID nursing specialty, and were mostly setting-specific. Common themes included: "knowing the person," "paternalism/infantilization," "communication challenges," "organizational support," "time," and "ID-specific knowledge and experience." Mainstream nurses' emotions were primarily negative, whereas ID nurses experienced conflicting positive and negative emotions. Antecedents and effects of nurse attitudes and emotions on the quality of care of adults with ID were identified. CONCLUSIONS/IMPLICATIONS Despite recent increased research on this topic across multiple countries, further research is needed. The findings of this study will aid the development of strategies to address negative nurse attitudes toward caring for adults with ID and act as a foundation for future research beyond the descriptive stage.
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Affiliation(s)
- Melissa Desroches
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts
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Desroches ML, Sethares KA, Curtin C, Chung J. Nurses' attitudes and emotions toward caring for adults with intellectual disabilities: Results of a cross-sectional, correlational-predictive research study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1501-1513. [PMID: 31318122 DOI: 10.1111/jar.12645] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/15/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Negative healthcare provider attitudes may contribute to healthcare disparities in adults with intellectual disabilities. This study identified predictors of nurses' attitudes and emotions toward caring for adults with intellectual disabilities in the United States. METHOD A convenience sample of 248 nurses was used to collect nurses' attitudes and emotions toward caring for adults with intellectual disabilities (Adapted Caring for Adults with Disabilities Questionnaire) and quality of life beliefs (Prognostic Beliefs Scale). RESULTS Overall, nurses held less positive attitudes toward caring for an adult with intellectual disability versus a physical disability. Intellectual disability nurses held more positive attitudes and emotions and less negative emotions than non-intellectual disability nurses. Quality of life beliefs predicted nurse attitude, positive emotions and negative emotions. The number of adults with intellectual disabilities cared for during the nurse's career predicted negative emotions. CONCLUSIONS Future interventions should focus on improving nurses' understanding of the quality of life of adults with intellectual disabilities.
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Affiliation(s)
| | | | - Carol Curtin
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Joohyun Chung
- University of Massachusetts Dartmouth, North Dartmouth, MA, USA
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Jester R, Santy-Tomlinson J, Drozd M. The use of patient reported outcome measures (PROMs) in clinical assessment. Int J Orthop Trauma Nurs 2018. [DOI: 10.1016/j.ijotn.2018.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Northway R, Rees S, Davies M, Williams S. Hospital passports, patient safety and person-centred care: A review of documents currently used for people with intellectual disabilities in the UK. J Clin Nurs 2017; 26:5160-5168. [PMID: 28881074 DOI: 10.1111/jocn.14065] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review hospital passports currently in use for people with intellectual disabilities in the UK and to make recommendations for practice. BACKGROUND Hospital passports have been introduced internationally to address communication barriers that may limit access to appropriate health care for people with intellectual disabilities. They are viewed as promoting patient safety and person-centred care but their format may vary, they are not always used appropriately, and hence, their effectiveness may be limited. DESIGN Qualitative content analysis. METHODS Sixty hospital passports in use in the UK were reviewed against a coding frame by two members of the research team. Areas of interest included key patient and primary care information, support network details, consent and capacity, support required in relation to activities of daily living, length of the document and completion details. Results were entered into Excel. RESULTS Considerable variation was found between documents in terms of terminology, length and format. Most included information regarding communication and support needs although some omitted important information such as allergies, risk assessment and need for reasonable adjustments. CONCLUSIONS Considerable variation exists between current hospital passports, which may limit their effectiveness: key information required may not be included and/or it may not be easy to locate. Greater standardisation of documents is required, but this process should include input from all key stakeholders. RELEVANCE TO CLINICAL PRACTICE Internationally nurses provide care for people with intellectual disabilities and others with communication difficulties. Hospital passports are one way of enhancing safety and person-centred care, need to be accessed and used as a basis for care planning. However, variation in format may limit this effectiveness and nurses should work with others to develop a more standardised approach, which better meets the needs of all stakeholders.
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Affiliation(s)
- Ruth Northway
- School of Care Sciences, University of South Wales, Pontypridd, UK
| | - Stacey Rees
- School of Care Sciences, University of South Wales, Pontypridd, UK
| | - Michelle Davies
- Llanfrechfa Grange, Aneurin Bevan University Health Board, Llanfrechfa, Cwmbran, UK
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Lewis P, Gaffney RJ, Wilson NJ. A narrative review of acute care nurses’ experiences nursing patients with intellectual disability: underprepared, communication barriers and ambiguity about the role of caregivers. J Clin Nurs 2017; 26:1473-1484. [DOI: 10.1111/jocn.13512] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Lewis
- School of Nursing and Midwifery; Western Sydney University; Richmond NSW Australia
| | - Ryan J Gaffney
- School of Nursing and Midwifery; Western Sydney University; Richmond NSW Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery; Ingham Institute for Applied Medical Research; Western Sydney University; Richmond NSW Australia
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Biz C, Buffon L, Marin R, Petrova N. Orthopaedic nursing challenges in poly-traumatised patient management: A critical analysis of an Orthopaedic and Trauma Unit. Int J Orthop Trauma Nurs 2016; 23:60-71. [PMID: 27561247 DOI: 10.1016/j.ijotn.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 02/15/2016] [Accepted: 04/15/2016] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND BACKGROUND Trauma is the most frequent cause of death in people under 40 years old. It is an important problem not only because of the high mortality but also because of the consequential disability that can lead to serious economic consequences. STUDY AIMS This descriptive, comparative study investigates the definitive management of poly-traumatised patients in an Italian Orthopaedic Ward in order to highlight its strengths and weaknesses in comparison with the most recent literature. This has led to the development of a pre-established algorithm for evaluation, preventive care and management of the poly-trauma patient and a flow-chart for improved patient care. RESEARCH METHODS A five-step observational and exploratory approach was employed in this study which critically analysed the nursing management of 60 multiple trauma patients admitted to our Orthopaedic Unit from April 2013 to October 2014. RESULTS The findings highlight the need for adherence to plans of care, which can be approached by a shared management of poly-trauma patients that involves the medical team, the patient and his family/caregiver. DISCUSSION The protocols and guidelines in use in our Orthopaedic and Trauma Unit are in line with European standards, although there is still margin for improvement. The study has led to the development of an algorithm that allows health professionals to have reference values for the care of polytrauma patients. CONCLUSIONS AND RECOMMENDATIONS This study demonstrates the use of theoretical and practical tools for the evaluation and management of poly-traumatised patients during their hospital stay. We recommend the use of both proposed tools: the general algorithm and the flow-chart for the management of the poly-trauma patient, as they allow identification of barriers and facilitators related to the implementation of international guidelines, currently well-defined for Emergency Departments but not yet for Orthopaedic Units.
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Affiliation(s)
- Carlo Biz
- Orthopaedic and Traumatology Clinic, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy; Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy.
| | - Lisa Buffon
- Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy; Edith Cavell Campus, Bretton Gate, Peterborough, Cambridgeshire PE3 9GZ, United Kingdom
| | - Roberto Marin
- Orthopaedic and Traumatology Clinic, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy
| | - Natalia Petrova
- Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy
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