Factors influencing the intention of students to work with individuals with intellectual disabilities

Including the issue of receiving payment for sex in intervention for substance use disorder: Professionals' intentions and interventions

BACKGROUND

Studies have shown that a high percentage of individuals with substance use disorder (SUD) are involved in receiving payment for sex (RPS). The stigma associated with RPS may lead to non-disclosure of RPS in drug treatment services thus preventing fully benefitting from SUD treatment. Research on RPS in the context of SUD interventions is scarce. The current study examined the extent to which social workers believe they should attend to the issue of RPS as part of the treatment of addictions and the extent of their self-reported work with RPS, as associated with comfort in discussing sexual issues in treatment (CDSIT), professional self-efficacy, attitudes towards people who engage in RPS, and attitudes towards social justice.

METHOD

A sample of 171 social workers who had worked with individuals with SUD in addiction treatment centers completed an online questionnaire. The main analyses were only conducted on participants who completed the full questionnaire (n = 124).

RESULTS

Most social workers believe in the importance of addressing RPS issues in treatment of individuals with SUD, but mostly did not translate their beliefs into practice. Attitudes toward social justice and toward people who engage in RPS, and the interaction between self-efficacy and CDSIT were associated with the belief in the importance of addressing RPS in treatment. The main factor that contributed to the self-reported work with RPS was CDSIT.

CONCLUSION

Policy-makers should promote specific training for professionals in the addiction field to address the issue of RPS when working with individuals with SUD, and increase levels of CDSIT.

Transformative care for people with disabilities: Empowering senior nursing students with competency based clinical education-A qualitative study of the impact

BACKGROUND

People with disabilities (PWD) constitute 26 % of the U.S. population yet no nursing schools have compulsory clinical education specific to PWD. Inadequate education and negative attitudes lead to lack of preparedness for working with PWD. To meet the needs of this highly underserved population, nursing students need training and experience in the care of PWD.

OBJECTIVE

The objective of this paper is to report three themes from the qualitative evaluation of two immersive clinical experiences with PWD for undergraduate nursing students designed to evaluate competencies for working with PWD.

DESIGN

Curriculum evaluation using qualitative methods.

METHODOLOGY

During and after the clinical experience, qualitative data (reflection papers, debriefing responses, and group interviews) were collected with a volunteer sample of senior nursing student participants of the clinical experiences with PWD. Thematic analysis was used to identify changes in students' attitudes, perceived competence, and motivation for working with PWD.

FINDINGS

Three major themes are reported in this paper: A positive shift in perspective of PWD (attitudes), impact of the experience on students' practice with PWD (comfort, confidence, awareness and motivation), and revelations from the experience (attitudes and resource awareness).

CONCLUSIONS

A comprehensive immersive clinical experience caring for PWD provides a real-world laboratory with important experiential learning activities that help students acquire and apply knowledge about the healthcare needs of PWD. Reflection activities facilitate synthesis of that knowledge. Results from this study suggest that this clinical experience can transform students' attitudes toward PWD, enhance their clinical skills, and motivate them to consider a nursing career with this highly under-served population.

Professional preference for mental illness: The role of contact, empathy, and stigma in Spanish Social Work undergraduates

The treatment of the mentally ill people is a challenge across the world, and different professionals, such as doctors, social workers, psychologists, or nurses, take care of this group. Nonetheless, mental health is not a vocational sector preferred by students and professionals of many of these careers. Research has proposed that professional preference for a patient group would be positively influenced by intergroup contact (quantity and quality) and empathy (perspective-taking), and negatively associated with intergroup anxiety and social distance. However, the evidence testing this proposal was partial and mainly referring to other patient groups such as minorities or immigrants. The major aim of this cross-sectional study was to clarify two research questions referring to mentally ill persons: Do contact and empathy protect undergraduates from intergroup anxiety and social distance and promote professional preference? Do intergroup anxiety and social distance predict professional preference and mediate the influence of contact and empathy in professional preference? A convenience sample of 409 Social Work undergraduates (81% females) from three Spanish universities completed a questionnaire between February and June 2020. Concerning direct relationships, the structural equation model showed that the quantity of contact only predicted intergroup anxiety negatively; quality of contact and empathy negatively predicted intergroup anxiety and social distance; intergroup anxiety positively predicted social distance; intergroup anxiety and social distance negatively predicted professional preference. Concerning mediated relationships, the influence of quality of contact and empathy on social distance was mediated by intergroup anxiety; social distance mediated the relationship of intergroup anxiety with professional preference; both anxiety and distance mediated the influence of quality of contact and empathy in professional preference. These results encourage interventions aimed at enhancing professional preference for mental illness by improving contact, knowledge, and empathy and reducing stigma in students and workers from diverse mental health careers.

The Effects of a Disaster Preparedness app on Community Knowledge and Intentional Behavior in Hurricane Risk Areas

OBJECTIVE

With the advancement of technology, disaster preparedness related to hurricane hazards can be taught through an app. This study aimed to examine the effect of using an android-based disaster preparedness app on community knowledge and intentional behavior in hurricane risk areas.

METHODS

A quasi-experimental study was conducted from October to November, 2020 and a total of 80 respondents were recruited using cluster sampling. The treatment group was given the intervention in the form of the disaster preparedness app for 2 weeks. Meanwhile, the control group received home visits and conventional education about hurricane disasters twice throughout the same period. We then used a Wilcoxon Signed Rank test to analyze the pre-test and post-test and a Mann-Whitney U test to compare between treatment and control groups.

RESULTS

After the implementation of the SiBen app, we found a statistically significant difference in knowledge between treatment and control groups (P < 0.003) and intentional behavior between treatment and control groups (P < 0.001).

CONCLUSION

The findings indicate that the disaster preparedness app was an effective educational program able to improve the knowledge and intentional behavior among community members in a hurricane risk area.

Appraisal of disability attitudes and curriculum of nursing students: a literature review

Worldwide, more than one billion people live with a disability (World Health Organization. (2011). World report on disability. Retrieved from https://www.who.int/disabilities/world_report/2011/report/en/). People with a disability (PWD) have unmet needs with the delivery of health care, secondary to nursing student's negative attitudes, knowledge, and skill deficits. This integrative literature review evaluated nursing student's education and attitudes towards PWD. Deficient education, attitudes, knowledge, and skills are addressed. Combined search terms utilized included: healthcare students; healthcare education; nursing students; clinical experience; clinical rotation; attitude of health care students; and exposure to PWD. Thirty articles were analyzed with common themes identified. Educational methods that produced improved attitudes, knowledge and skills included standardized patients with disabilities; phenomenological approaches; curriculum enhancement; empathy exercises and clinical experiences (Anderson, E. S., Ford, J., & Thorpe, L. (2011). Learning to listen: Improving students' communication with disabled people. Medical Teacher, 33(1), 44-52. doi: 10.3109/0142159X.2010.498491; Castro, S. S., Rowe, M., Andrade, L. F., & Cyrino, E. G. (2018). Developing competencies among health professions students related to the care of people with disabilities: A pilot study. Interface: Comunicacao, Saude, Educacao, 22(65), 551-563. doi: 10.1590/1807-57622016.0684; Hensel, D., Malinowski, C., & Watts, P. A. (2015). Implementing a pediatric camp clinical for pre-licensure education. Nursing Education Perspectives, 36(1), 60-61. doi: 10.5480/12-871.1; Levett-Jones, T., Lapkin, S., Govind, N., Pich, J., Hoffman, K., Jeong, S. Y., . . . Everson, N. (2017). Measuring the impact of a 'point of view' disability simulation on nursing students' empathy using the comprehensive state empathy scale. Nurse Education Today, 59, 75-81. doi: 10.1016/j.nedt.2017.09.007; Smith, P., Ooms, A., & Marks-Maran, D. (2016). Active involvement of learning disabilities service users in the development and delivery of a teaching session to pre-registration nurses: Students' perspectives. Nurse Education in Practice, 16(1), 111-118. doi: 10.1016/j.nepr.2015.09.010). Nursing schools must incorporate disability education to fully realize its impact and eliminate barriers to transform care.

Application of the Theory of Planned Behavior to Predict Nutrition Students' Intention to Work with Older Adults

As Registered Dietitian Nutritionists play an important role in providing nutrition care plans for successful aging, it is important to identify factors influencing nutrition students' intention to work with older adults. A cross-sectional study was conducted to identify significant predictors of nutrition students' intention to work with older adults by utilizing the Theory of Planned Behavior (TPB). A total of 183 students, majoring in Nutrition at a large Southern University, completed a questionnaire examining validated TPB constructs. Structural Equation Modeling with maximum likelihood was used to analyze the data. The structural model provided a good fit to the data (x² = 44.95, df = 38, p < 0.01; RMSEA = 0.03, CFI = 0.99; TLI = 0.99. Attitude (γ = 0.49, p < 0.001) and subjective norm (γ = 0.39, p < 0.001) emerged as significant predictors of nutrition students' intention to work with older adults. Findings highlight the importance of providing dietetics curricula that provide opportunities for students to develop positive attitudes toward working with older adults. Dietetic educators should present themselves as positive role models in working with older adults, as the educators influence students' intention to work with this population.

Nurses' experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach

BACKGROUND

Research suggests that registered nurses (RNs) do not feel adequately prepared to support patients with intellectual disability disorder (IDD). This is unsurprising, as few European health sciences curricula include undergraduate and graduate training courses in IDD. As RNs are often in the front line of care, eliciting in-depth knowledge about how they experience nursing this group of patients is vital. Our aim in this study was to develop a conceptual understanding about RNs' experiences of nursing patients with IDD.

METHOD

We undertook a systematic review and meta-ethnography to synthesise qualitative research studies found in PubMed, CINAHL, PsycINFO, ERIC databases and by manual searching to identify additional studies. We condensed translatable second-order constructs, and developed an idiomatic translation. Finally, we formulated line of argument (LOA) syntheses to capture the core of the idiomatic translations.

RESULTS

We included eighteen published studies from eight countries involving 190 RNs. The RNs' experience of nursing patients with IDD were reflected in 14 LOAs. Six of these reflected a tentatively more distinctive and at times unique conceptualisation of RNs' experience of nursing this group of patients. The remaining eight LOAs represented a conceptualisation of nursing per se, a conceptualisation of nursing that was interpreted as a universal experience regardless of context and patient group.

CONCLUSION

Lack of awareness and knowledge are likely breeding grounds for the 'otherness' that still surrounds this group of patients. In encounters between patients and RNs, focusing on the person behind the disability label could be one way to secure relevant nursing care for patients with IDD. Undertaking appropriate under- and postgraduate education alongside the implementation of nursing models focusing on patient-centred care would help RNs in reducing the health and care inequalities this group of patients still face.

TRIAL REGISTRATION

PROSPERO 2017: CRD42017077703.

Perceptions towards disability among social work students in Israel: Development and validation of a new scale

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale-Perceptions Toward Disability Scale (PTDS)-to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = -.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy-to-administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people.

Stigma and Developmental Disabilities in Nursing Practice and Education

Individuals with developmental disabilities (DD) experience stigma, discrimination, and barriers, including access to appropriate health care, that restrict their ability to be equal participants in society. In this study, underlying contexts, assumptions, and ways of acting are investigated that perpetuate inequalities and pejorative treatment toward those with disabilities. Several nurse researchers and educators suggest specific content for, or approaches to, education about DD. Critical pedagogy that employs cultural competency and a disability studies' framework to guide curriculum and course development will allow assumptions underlying common health care practices that oppress and "other" people with disabilities to be exposed and changed.

Using the Theory of Planned Behaviour to examine enrolled nursing students' intention to care for patients with alcohol dependence: A survey study

BACKGROUND

Nurses are often the first point of contact for patients hospitalized due to alcohol-related causes. Alcohol dependence is highly stigmatized and as a result healthcare professionals often have low behavioural intentions, meaning low willingness to care for these patients. This can have a direct influence on quality of care.

OBJECTIVES

The purpose of this study was to explore enrolled nursing students' intention to care for patients with alcohol dependence and the antecedents, preliminary factors, that predict this within the Theory of Planned Behaviour; specifically attitudes, subjective norms, self-efficacy and controllability.

DESIGN

The study was a cross-sectional survey using the Theory of Planned Behaviour.

SETTING

Two Technical and Further Education South Australia campuses across metropolitan Adelaide.

PARTICIPANTS

n=86 enrolled nursing students completed the survey (62% response rate).

METHODS

Enrolled nursing students' intention, attitudes, subjective norms, self-efficacy and controllability were measured using a Theory of Planned Behaviour Questionnaire. The Short Alcohol and Alcohol Problems Perception Questionnaire investigated attitudes in more detail and a short knowledge scale assessed alcohol-related knowledge.

RESULTS

Subjective norms and attitudes had a significant, positive effect on intention to care within the final model, accounting for 22.6% of the variance, F2,83=12.12, p<0.001. Subjective norms were the strongest predictor. External factors such as age, previous alcohol training and alcohol-related knowledge held direct paths to antecedents of intention.

CONCLUSIONS

Subjective norms were the strongest predictor of intention to care for patients with alcohol dependence, followed by attitudes. The study provides an understanding of enrolled nursing students' intention to care for alcohol dependent patients. These findings can assist in developing tailored alcohol training for students, to increase attitudes and foster behavioural change, in order to improve the quality of care for these patients.

Addressing Health Disparities at the Intersection of Disability, Race, and Ethnicity: the Need for Culturally and Linguistically Appropriate Training for Healthcare Professionals

Within the USA, nearly one in five, or 56.7 million people, live with a disability. Disabilities are ubiquitous; yet, health care professionals (both clinical and public health) lack training and competence to care for the general health needs and cultural considerations presented by people with disabilities. This problem is compounded when people with disabilities are from racial and ethnic minority backgrounds. In order to prevent and eliminate the health disparities faced by people with disabilities, especially those from diverse racial and ethnic backgrounds, health care professionals must have opportunities to learn about and discuss appropriate methods for dealing with the concerns of these populations. Morehouse School of Medicine created and implemented a course for MPH students that begins to address this issue.

Training on intellectual disability in health sciences: the European perspective

BACKGROUND

Intellectual disability (ID) has consequences at all stages of life, requires high service provision and leads to high health and societal costs. However, ID is largely disregarded as a health issue by national and international organisations, as are training in ID and in the health aspects of ID at every level of the education system.

SPECIFIC AIM

This paper aims to (1) update the current information about availability of training and education in ID and related health issues in Europe with a particular focus in mental health; and (2) to identify opportunities arising from the initial process of educational harmonization in Europe to include ID contents in health sciences curricula and professional training.

METHOD

We carried out a systematic search of scientific databases and websites, as well as policy and research reports from the European Commission, European Council and WHO. Furthermore, we contacted key international organisations related to health education and/or ID in Europe, as well as other regional institutions.

RESULTS

ID modules and contents are minimal in the revised health sciences curricula and publications on ID training in Europe are equally scarce. European countries report few undergraduate and graduate training modules in ID, even in key specialties such as paediatrics. Within the health sector, ID programmes focus mainly on psychiatry and psychology.

CONCLUSION

The poor availability of ID training in health sciences is a matter of concern. However, the current European policy on training provides an opportunity to promote ID in the curricula of programmes at all levels. This strategy should address all professionals working in ID and it should increase the focus on ID relative to other developmental disorders at all stages of life.

The use of nouns and verbs by children with Down syndrome in two different situations

PURPOSE

To verify the use of nouns and verbs by children with Down syndrome and to compare this use between conditions of interaction with the mother and the Speech-language pathologist (SLP).

METHODS

Participants were 21 children aged between 5 and 11 years, divided into three groups, according to chronological and mental age as established by the results of the Primary Tests of Nonverbal Intelligence. The speech sample was obtained through free interaction situations that were videotaped during session of 30 minutes and transcribed in specific protocols. The first 100 utterances from the first five minutes were used. The interval between each situation ranged from 7 to 15 days. T-test and analysis of variance were used for statistical analysis and the significance level adopted was of 5%.

RESULTS

More verbs than nouns were used in both conditions; however, a higher number of nouns were observed during the interaction with the SLP. The between-group comparison in the interaction with the SLP shows significant differences for verbs and nouns, but during the interaction with the mother, there was tendency for difference only for the verbs.

CONCLUSION

The data indicate the growing development on using of nouns and verbs according to the increase of age. There was a higher use of verbs when compared with nouns mainly in the condition of interaction with the SLP.