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Hayward BA. A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities. Int J Ment Health Nurs 2024; 33:957-966. [PMID: 38291653 DOI: 10.1111/inm.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.
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Affiliation(s)
- Brent A Hayward
- Department of Education, East Melbourne, Victoria, Australia
- Department of Education, School of Social and Political Sciences, Faculty of Arts, University of Melbourne, Parkville, Victoria, Australia
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Spong J, Iacono T, Weise J, Trollor J, Spong L, Lenten T. Preparedness and training needs of a regional public mental health service to support people with intellectual disability. Aust J Rural Health 2024; 32:724-739. [PMID: 38715521 DOI: 10.1111/ajr.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/12/2024] [Accepted: 04/22/2024] [Indexed: 08/29/2024] Open
Abstract
OBJECTIVE To explore the preparedness and training needs of a regional public mental health workforce to support people with intellectual disability and mental ill health. SETTING AND PARTICIPANTS Staff from a regional public mental health service in Victoria, Australia. DESIGN A mixed-methods design comprised a survey, interviews and a focus group to collect data about staff attitudes, confidence, education and professional development regarding supporting people with intellectual disability and mental ill health. Descriptive and thematic analyses were used. RESULTS Data from 31 survey respondents, seven interviews and one focus group were analysed. Survey descriptive analyses showed participants believed treating people with intellectual disability was part of their role but reported areas of low confidence along with insufficient education and training in intellectual disability mental health. Thematic analyses from interviews showed that underpinning confidence, education and training were the themes (1) need for flexibility, such as having more time and (2) solutions but with challenges, such as limited opportunity to upskill and availability of experts. A need for collaborative problem-solving where staff share skills and information to work towards person-centred solutions was a key theme from the focus group analysis. CONCLUSION Professional development in intellectual disability mental health is required for the regional public mental health workforce but needs to account for the challenges experienced and reflect how teams function. Exploration of described preparedness offered a possible learning approach informed by workforce members. Collaborative learning approaches to supporting people with intellectual disability and mental ill health are suggested.
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Affiliation(s)
- Jo Spong
- Living with Disability Research Centre, La Trobe University, Bendigo, Victoria, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Teresa Iacono
- Living with Disability Research Centre, La Trobe University, Bendigo, Victoria, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Lisa Spong
- Bendigo Health Mental Health Services, Bendigo Health, Bendigo, Victoria, Australia
| | - Tim Lenten
- Bendigo Health Mental Health Services, Bendigo Health, Bendigo, Victoria, Australia
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Tumanggor RD, Pracilio A, Siregar CT, Wilson NJ, Cashin A. A survey of Indonesian nurses' educational experiences and self-perceived capability to care for people with intellectual disability and/or autism spectrum disorder. J Adv Nurs 2024; 80:1838-1851. [PMID: 37950365 DOI: 10.1111/jan.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/02/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
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.
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Affiliation(s)
| | - Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | | | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | - Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia
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Pracilio A, Wilson NJ, Tumanggor RD, Cashin A. Indonesian nurses' awareness and application of reasonable adjustments when caring for people with intellectual disability and/or autism. Int Nurs Rev 2024. [PMID: 38506342 DOI: 10.1111/inr.12959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
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.
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Affiliation(s)
- Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | | | - Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia
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Cashin A, Morphet J, Wilson NJ, Pracilio A. Barriers to communication with people with developmental disabilities: A reflexive thematic analysis. Nurs Health Sci 2024; 26:e13103. [PMID: 38408760 DOI: 10.1111/nhs.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
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.
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Affiliation(s)
- Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia
| | - Julia Morphet
- Nursing and Midwifery, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Richmond, New South Wales, Australia
| | - Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
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Ong N, Lucien A, Long J, Weise J, Burgess A, Walton M. What do parents think about the quality and safety of care provided by hospitals to children and young people with an intellectual disability? A qualitative study using thematic analysis. Health Expect 2024; 27:e13925. [PMID: 38014873 PMCID: PMC10768875 DOI: 10.1111/hex.13925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVES Children with intellectual disability experience patient safety issues resulting in poor care experiences and health outcomes. This study sought to identify patient safety issues that pertain to children aged 0-16 years with intellectual disability admitted to two tertiary state-wide children's hospitals and a children's palliative care centre; to describe and understand these factors to modify the Australian Patient Safety Education Framework to meet the particular needs for children and young people with intellectual disability. DESIGN, SETTING AND PARTICIPANTS Parents of children with intellectual disability from two paediatric hospitals and a palliative care unit participated in semi-structured interviews to elicit their experiences of their child's care in the context of patient safety. Thirteen interviews were conducted with parents from various backgrounds with children with intellectual, developmental and medical diagnoses. RESULTS Eight themes about safety in hospital care for children and young people with intellectual disability emerged from thematic analyses: Safety is not only being safe but feeling safe; Negative dismissive attitudes compromise safety, quality and care experience; Parental roles as safety advocates involve being heard, included and empowered; Need for purposeful and planned communication and care coordination to build trust and improve care; Systems, processes and environments require adjustments to prevent patient safety events; Inequity in care due to lack of resources and skills, Need for training in disability-specific safety and quality issues and Core staff attributes: Kindness, Patience, Flexibility and Responsiveness. Parents highlighted the dilemma of being dismissed when raising concerns with staff and being required to provide care with little support. Parents also reported a lack of comprehensive care coordination services. They noted limitations within the healthcare system in accommodating reasonable adjustments for a family and child-centred context. CONCLUSIONS The development of an adapted Patient Safety Education Framework for children with intellectual disability should consider ways for staff to transform attitudes and reduce bias which leads to adaptations for safer and better care. In addition, issues that apply to quality and safety for these children can be generalised to all children in the hospital. PATIENT AND PUBLIC CONTRIBUTION Parent advocates in the project advisory team were shown the questions to determine their appropriateness for the interviews.
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Affiliation(s)
- Natalie Ong
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Child Development Unit, Children's Hospital at Westmead, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Abbie Lucien
- UNSW Medicine, University of New South Wales, Kensington, New South Wales, Australia
| | - Janet Long
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Medicine, University of New South Wales, Randwick, New South Wales, Australia
| | - Annette Burgess
- Medical Education, Education Office, Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
| | - Merrilyn Walton
- School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
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Cashin A, Pracilio A, Buckley T, Trollor JN, Wilson NJ. Filling the Gaps: Evaluation of an Online Continuing Professional Development Program for Australian Registered Nurses to Build Capacity to Care for People With Developmental Disability. J Contin Educ Nurs 2023; 54:554-560. [PMID: 37855824 DOI: 10.3928/00220124-20231013-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND People with autism spectrum disorder and/or intellectual disability have some of the worst health outcomes of any population group. Internationally, it has been identified that RNs are not adequately prepared to provide care to these groups through mainstream health care services. METHOD A cross-sectional online evaluation survey of participants who completed learning to build the capacity of RNs to care for people with autism spectrum disorder and/or intellectual disability was conducted. RESULTS The learning site was found to be easily accessible and engaging, and it facilitated knowledge construction. A statistically significant increase in self-reported comfort, confidence, and preparedness compared with the sample of RNs in a national survey conducted before the site launch was identified. CONCLUSION This online continuing professional development program facilitated RNs' perceived comfort, confidence, and preparedness to care for people with autism spectrum disorder and/or intellectual disability. Findings suggest the merit of high-quality online continuing professional development programs to fill this educational gap. [J Contin Educ Nurs. 2023;54(12):554-560.].
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Ong N, Lucien A, Long JC, Weise J, Walton M, Burgess A. What do healthcare staff think about the quality and safety of care provided to children and young people with an intellectual disability? A qualitative study using the framework method of analysis. BMJ Open 2023; 13:e071494. [PMID: 37491102 PMCID: PMC10373726 DOI: 10.1136/bmjopen-2022-071494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To elicit patient safety issues pertaining to children and young people with intellectual disability in hospital from healthcare staff perspectives. This follows a previous paper of parent interviews of patient safety experiences of their child in hospital. DESIGN Qualitative study. SETTING We conducted semi-structured interviews and focus groups of staff of tertiary children's hospitals based on the domains of the Patient Safety Education Framework and using the framework methodology for data analysis. PARTICIPANTS There were 29 female and 7 male staff aged between 27 and 70 years from a range of departments and specialties including ancillary staff. INTERVENTION Questions based on the patient safety framework were developed from consultation with parents, researchers and clinicians exploring staff views and experiences of safety and quality care of these children in hospital. During April 2021 to May 2022, 22 interviews and 3 focus groups were conducted of staff who have had experience caring for children and young people with intellectual disability in the last 12 months in the hospital. RESULTS Key themes elicited include Definition of Safety, Need to consider additional vulnerabilities of children and young people with intellectual disability in hospital, Communication is key to safe care, Parent and family perspectives on safe care, Management challenges compromising safety and Service system gaps in preventing, identifying and managing risk. CONCLUSIONS Staff need to consider additional vulnerabilities, mitigate negative attitudes and biases towards better engagement and relationships with parents, children and young people of this population. Improvement of current systems that prevent the identification, prevention and management of risk and safety issues for this population need to be undertaken. Future developments include combining data from parent interviews, academic and grey literature in developing safety competencies in this population for training and education of staff across the health system.
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Affiliation(s)
- Natalie Ong
- Children's Hospital Westmead Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Child Development Unit, The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Abbie Lucien
- Faculty of Medicine, School of Psychiatry, UNSW, Sydney, New South Wales, Australia
| | - Janet C Long
- Australian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Merrilyn Walton
- Office of Teaching and Learning in Medicine, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Annette Burgess
- Medical Education, Education Office, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
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Brown M, MacArthur J, Truesdale M, Higgins A. The transition from child to adult health services for young adults with intellectual disabilities: An evaluation of a pilot of an online learning resource for Registered Nurses. Nurse Educ Pract 2022; 64:103424. [PMID: 35947941 DOI: 10.1016/j.nepr.2022.103424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 10/16/2022]
Abstract
AIM This study formed the third phase of a national study on the experience of transition from child to adult health services for young adults with intellectual disabilities. The aim of this phase was to evaluate the accessibility and acceptability of an on-line learning resource for Registered Nurses. BACKGROUND The population of young adults with intellectual disabilities and complex needs is increasing. Consequently, more will move from child to adult healthcare, with evidence highlighting that for some their experiences of the transition process is poor. The main study provided contemporary evidence to raise the awareness of Registered Nurses of the needs of young adults with intellectual disabilities and their role in enabling an effective transition from child to adult services. METHODS The online learning resource was developed and piloted with Registered Nurses involved in the transition from child to adult health services for young adults with intellectual disabilities and complex needs. Data collection involved an online survey and semi-structured interviews. RESULTS Twelve Registered Nurses from 2 Scottish NHS Boards completed the questionnaire and 3 participated in a follow-up interview. The findings suggest that the mode of on-line delivery and most of the content of the learning resource were both acceptable and accessible to Registered Nurses across a range of areas of nursing practice. The learning resource was further adapted in response to the participant data. CONCLUSION This on-line learning resources offers the potential for Registered Nurses, and potentially other healthcare professionals to undertake evidence-based, structured further education regarding the effective transitions for young adults with intellectual disabilities and their families. TWEETABLE ABSTRACT Registered Nurses have key contributions to enable the transition from child to adult healthcare for young adults with intellectual disabilities.
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Affiliation(s)
- Michael Brown
- School of Nursing & Midwifery, Queen's University, Belfast, Northern Ireland, UK.
| | | | - Maria Truesdale
- Institute of Health and Well-being, University of Glasgow, Glasgow, Scotland, UK
| | - Anna Higgins
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK
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Toward mainstream nursing roles specialising in the care of people with intellectual and developmental disability. Collegian 2022. [DOI: 10.1016/j.colegn.2022.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Wilson NJ, Pracilio A, Kersten M, Morphet J, Buckely T, Trollor JN, Griffin K, Bryce J, Cashin A. Registered nurses' awareness and implementation of reasonable adjustments for people with intellectual disability and/or autism. J Adv Nurs 2022; 78:2426-2435. [PMID: 35128714 DOI: 10.1111/jan.15171] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/17/2022] [Accepted: 01/20/2022] [Indexed: 11/27/2022]
Abstract
AIM To describe Australian registered nurses' awareness, and implementation of reasonable adjustments within their practice when caring for people with intellectual disability and/or autism. Additionally, the association between key demographic, workforce, and respondent variables and familiarity of the term and regularity of use was explored. DESIGN Cross-sectional survey. METHODS Survey data were collected between August and October 2020 using an online survey tool. Data were analysed using descriptive and inferential statistics. RESULTS Familiarity of the concept of reasonable adjustments was relatively low, compared to respondents who report applying adjustments when caring for people with intellectual disability and/or autism. Higher levels of confidence, comfort, and knowledge when caring for this cohort were associated with greater awareness and application of reasonable adjustments. CONCLUSION A higher volume, and diversity in type of, nursing education related to care for people with intellectual disability and/or autism is indicated.
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Affiliation(s)
- Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, New South Wales, Australia
| | - Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Michelle Kersten
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Julia Morphet
- School of Nursing & Midwifery, Monash University, Frankston, Victoria, Australia
| | - Thomas Buckely
- Acute/Critical Care Nursing, Susan Walki Building, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, UNSW Medicine & Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Ken Griffin
- Australian Primary Health Care Nurses Association, Melbourne, Victoria, Australia
| | - Julianne Bryce
- Australian Nursing and Midwifery Federation, Melbourne, Victoria, Australia
| | - Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia
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Cashin A, Pracilio A, Buckley T, Morphet J, Kersten M, Trollor JN, Griffin K, Bryce J, Wilson NJ. A cross-practice context exploration of nursing preparedness and comfort to care for people with intellectual disability and autism. J Clin Nurs 2021; 31:2971-2980. [PMID: 34787352 DOI: 10.1111/jocn.16131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/24/2021] [Accepted: 11/04/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To compare the self-perceived preparedness, knowledge, comfort and confidence of Australian Registered Nurses when caring for people with ID and/or ASD across contexts of practice: primary care and community, intensive care, acute hospital, emergency department, paediatrics and ID/ASD. BACKGROUND There is limited research comparing nursing preparedness and competency when caring for people with intellectual disability (ID) and/or autism (ASD) across nursing contexts of practice. A greater understanding of the differed educational preparedness, confidence and comfort across contexts of practice can aid the development of tailored educational programmes to improve nursing capacity to care for this cohort. DESIGN Cross-sectional descriptive study. METHODS A descriptive survey tool of registered nurses (n = 69.3). Comparative inferential analysis was undertaken between the independent categorical variable of six nursing contexts of practice across several dependent variables including age, years since registration, educational content and exposure, knowledge, comfort and confidence. This cross-sectional study was undertaken according to the STROBE Statement checklist of items. RESULTS Occupying an ID/ASD nursing role was significantly associated with higher reported levels of educational preparedness, professional development and postgraduate education relevant to caring for people with ID and/or ASD. Levels of self-reported knowledge of care issues, confidence and comfort when undertaking healthcare tasks was significantly associated with the context of practice, with nurses working in ID/ASD settings reporting the highest levels across all variables. CONCLUSION The findings of the study highlight an association between greater educational exposure to content relevant to working with people with ID/ASD and subsequently working in that field. RELEVANCE TO CLINICAL PRACTICE This study has highlighted that professional development programmes aiming to improve nursing capacity to care for people with ID and/or ASD, should be informed by and address differing gaps in confidence, comfort and educational preparedness across nursing contexts of practice.
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Affiliation(s)
- Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, NSW, Australia
| | - Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - Thomas Buckley
- Australian College of Critical Care Nursing/Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Julia Morphet
- Nursing & Midwifery, Monash University, Frankston, Vic., Australia.,College of Emergency Nursing Australasia (CENA), Beaumaris, Vic., Australia
| | - Michelle Kersten
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, NSW, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, Australia
| | - Ken Griffin
- Australian Primary Health Care Nurses Association, Melbourne, Vic., Australia
| | - Julianne Bryce
- Australian Nursing and Midwifery Federation, Melbourne, Vic., Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
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Cashin A. Understanding how to care for and support people with intellectual disability and/or autism is every nurse's business. Aust Crit Care 2021; 34:401-402. [PMID: 34412890 DOI: 10.1016/j.aucc.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Andrew Cashin
- Autism and Intellectual Disability, Faculty of Health, Southern Cross University, Lismore NSW 2480, Australia.
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Does volunteering change attitudes towards people with disabilities? A qualitative study of the experience of orthodox Jewish nursing students. Nurse Educ Pract 2021; 55:103141. [PMID: 34256260 DOI: 10.1016/j.nepr.2021.103141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND People with disabilities identify negative staff attitudes and behaviors as barriers to accessing health services. Studies show that nursing education activities specific to people with disabilities improves nursing care. This study explores the experience of orthodox Jewish nursing students volunteering with people with disabilities, how their attitudes towards this population changed. DESIGN A qualitative design was used. This research is part of an extensive ongoing study of orthodox and ultra-orthodox (Haredi) students volunteering with people with disabilities. METHODS Data from 13 semi-structured interviews, conducted between July and September 2017, with 14 male students (two students chose to be interviewed together) and four people with disabilities were analyzed using thematic analysis. RESULTS Volunteering enhanced students' awareness of the needs of people with disabilities, changed their attitude towards this population and enhanced their confidence as nurses. The individuals with disabilities valued the help they received as well as the opportunity to change the students' prior notions and stigmas regarding disability. CONCLUSIONS Projects such as ours could improve the attitude of nursing staff towards individuals with disabilities and improve nursing care. We recommend involving people with disabilities in designing such projects.
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Moloney M, Hennessy T, Doody O. Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence. BMJ Open 2021; 11:e039647. [PMID: 33619184 PMCID: PMC7903074 DOI: 10.1136/bmjopen-2020-039647] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 01/14/2021] [Accepted: 01/23/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES People with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services. DESIGN Scoping review. SETTING Acute care settings. METHODS Five databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes. RESULTS Of the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice. CONCLUSIONS The scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.
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Affiliation(s)
- Mairead Moloney
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Therese Hennessy
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
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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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Cashin A, Smith J, McQueen R, Stein T. Evaluation of a social gaming programme for young adults with Autism Spectrum Disorder. Collegian 2020. [DOI: 10.1016/j.colegn.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brown M, Macarthur J, Higgins A, Chouliara Z. Transitions from child to adult health care for young people with intellectual disabilities: A systematic review. J Adv Nurs 2019; 75:2418-2434. [PMID: 30816570 DOI: 10.1111/jan.13985] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/18/2018] [Accepted: 01/08/2019] [Indexed: 12/31/2022]
Abstract
AIMS To examine the experiences of health transitions for young people with intellectual disabilities and their carers and identify the implications for nursing practice. DESIGN A systematic review and critical appraisal of qualitative, quantitative, and mixed methods studies. DATA SOURCES A search of the relevant literature published 2007-2017 was carried out in AMED, ASSIA, CINAHL, MEDLINE, PsycINFO, PubMed, and Science Direct Sociological Abstracts databases. REVIEW METHODS A total of 12 of 637 papers identified in the search met the inclusion criteria for this review. A narrative review of the papers was undertaken by synthesizing the key findings and grouping them into concepts and emergent themes. RESULTS Four main themes were identified: (a) becoming an adult; (b) fragmented transition process and care; (c) parents as advocates in emotional turmoil; and (d) making transitions happen. CONCLUSION The range of issues that have an impact on the transition from child to adult health services for young people with intellectual disabilities and their carers raise important implications for policy development, nursing practice, and education.
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Affiliation(s)
- Michael Brown
- School of Nursing & Midwifery, Queen's University, Belfast, UK
| | | | - Anna Higgins
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Zoë Chouliara
- Division in Mental Health & Counselling, Abertay University, Dundee, UK
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