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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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2
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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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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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4
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Drozd M, Jester R. Person-centred practice in the context of shorter hospital stays. Int J Orthop Trauma Nurs 2023; 51:101054. [PMID: 37866091 DOI: 10.1016/j.ijotn.2023.101054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Affiliation(s)
| | - Rebecca Jester
- RCSI Medical University Bahrain, Bahrain; Aston University, UK
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5
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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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Clarke P, Brannan R, Taylor S, MacArthur J. Person-centred critical care for a person with learning disability and COVID-19: case study of positive risk taking. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:776-784. [PMID: 37682761 DOI: 10.12968/bjon.2023.32.16.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
People with learning disabilities are known to experience a wide range of health inequalities and have a lower life expectancy than the general population. During the COVID-19 pandemic this extended to higher mortality rates following infection with the novel coronavirus. This case study presents an example of a positive outcome for Jade, a 21-year-old woman with learning disabilities and autism who required a long period in intensive care following COVID-19 infection. It demonstrates the impact of effective multidisciplinary collaboration involving the acute hospital learning disability liaison nurse and Jade's family, leading to a wide range of reasonable and achievable adjustments to her care.
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Affiliation(s)
- Penny Clarke
- Senior Charge Nurse, Intensive Care Unit, Western General Hospital, NHS Lothian, Edinburgh
| | - Rachel Brannan
- Learning Disability Liaison Nurse, NHS Lothian, Edinburgh
| | - Scott Taylor
- Consultant Nurse Learning Disabilities, NHS Lothian, Edinburgh
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7
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Ashok N, Hughes D, Yardley S. Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography. Palliat Med 2023; 37:1047-1062. [PMID: 37294100 PMCID: PMC10503257 DOI: 10.1177/02692163231175928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with diagnoses of intellectual disability or serious mental illness have higher mortality rates due to physical comorbidities; better understanding is needed to guide best practice in provision of palliative care for these populations. AIMS To identify multivoiced perspectives, drawn from lived experience of: what works, and what does not, in palliative care for people with intellectual disability or serious mental illness; challenges in, and opportunities to improve, palliative care. DESIGN A systematically constructed qualitative meta-ethnography. Protocol published (PROSPERO: CRD42021236616). DATA SOURCES MEDLINE, PsychINFO, CINAHL PLUS and Embase used without date limitations. Papers published in English, containing qualitative data on palliative care provision for people with a diagnosis of intellectual disability or serious mental illness were included. Global five-point strength score applied for relevance/quality appraisal. RESULTS Familiarity (of location, people and/or things) is important for good palliative care. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common. Adapting training for palliative care staff to address concerns and beliefs about mental illness is one of the methods that helps avoid diagnostic overshadowing. Proactive identification of service arrangements to meet needs of persons with personality, psychotic, delusional and bipolar affective disorders will help optimise care. CONCLUSIONS Evidence, including the voices of people with intellectual disability or serious mental illness is urgently needed to guide efforts to improve their access to and experience of palliative care. More evidence is especially needed to understand, develop and implement best practice for people with psychosis, bipolar affective disorder, mania and personality disorder.
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Affiliation(s)
| | | | - Sarah Yardley
- University College London, London, UK
- Central & North West London NHS Foundation Trust, London, UK
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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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Gilliand M, Bernier Emch A, Perrenoud B. Adults with intellectual disabilities' satisfaction regarding their hospitalization: A correlational descriptive study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231193461. [PMID: 37565271 DOI: 10.1177/17446295231193461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
When hospitalized, adults with intellectual disabilities are more anxious and have more unmet needs than the general population. Despite these problems, studies report contradictory results about their satisfaction with hospitalization. The aim of this study was to determine the level of satisfaction of adults with intellectual disabilities regarding their hospital care and the factors associated with satisfaction. An analysis of the Patient Satisfaction Scale (PSS) and Cognitive Appraisal of Health Scale (CAHS) instruments completed by adults with intellectual disabilities, or their caregivers, after hospitalization was done. The 32 participants' mean PSS score was 3.6/5, with means of 13.3/25 and 8.7/25 on the CAHS' 'harm/loss' dimension and 'challenge' dimension, respectively. None of the factors studied was associated with the total PSS score. Adults with intellectual disabilities were not fully satisfied with their hospital care, experiencing challenges and losses. These findings call for a rethink of the care provided to this population.
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Affiliation(s)
- Morgane Gilliand
- HESAV School of Health Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare-IUFRS, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | | | - Béatrice Perrenoud
- Lausanne University Hospital (CHUV), Lausanne, Switzerland; La Source School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
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Ní Riain M, Wickham S. "She just makes it easier…" The impact of having a dedicated nursing role in supporting people with intellectual disability when accessing acute hospitals, from the perspective of their support staff, the Irish context. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231190252. [PMID: 37499117 DOI: 10.1177/17446295231190252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Learning Disability Liaison Nurses have been shown to improve hospital experiences and this is an emerging role in Ireland. This research qualitatively explored the impact of a Clinical Nurse Specialist Acute Hospital Liaison from the perspective of staff in an intellectual disability community organisation. Participants identified significant challenges with supporting people attending hospitals including accessing and understanding information, anxieties and not being prepared for transitions through the hospital. The findings demonstrate the introduction of this role is a supportive, positive step with reports of improved information sharing, feeling better prepared and alleviating anxieties related to supporting someone in hospital. The findings clearly identify that this role has considerable benefits when set in a community organisation. This role has had a positive impact on service users and staff when interacting with hospitals, providing evidence of the value of this role in Ireland and also of they having a specialist qualification in the role.
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Affiliation(s)
- Muireann Ní Riain
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Sheelagh Wickham
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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11
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Rinaldi R, Batselé E. "Is it my job?" An exploratory qualitative analysis of medical specialists' adaptation strategies when addressing the health needs of people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:388-403. [PMID: 35503871 DOI: 10.1177/17446295221095706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Access to equal healthcare is a priority for people with intellectual disabilities. Most studies have focused on primary care providers; however, the administration of inclusive healthcare also relies on medical specialists, who should be considered a specific group because their practice varies significantly in this regard. Semi-directive interviews were conducted with 12 medical specialists to explore their representations regarding the care of people with intellectual disabilities. An inductive thematic analysis was applied to the data. The results highlighted a significant heterogeneity between practitioners' representations of people with intellectual disabilities in healthcare, current practices, and their perceptions and expectations in the process of ensuring quality care. This study highlights the importance of considering medical specialists' awareness raising and training to handle consultations with people with intellectual disabilities. From a broader perspective, a clear political framework to guide healthcare practices at the national level should be developed.
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Affiliation(s)
- Romina Rinaldi
- Université de Mons, Service d'Orthopédagogie Clinique, Mons, Belgium
| | - Elise Batselé
- Université de Mons, Service d'Orthopédagogie Clinique, Mons, Belgium
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12
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Ee J, Lim JM, Stenfert Kroese B, Rose J. Family carers' experiences of providing care for their adult relative with intellectual disabilities and mental health problems in Singapore. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104241. [PMID: 35504125 DOI: 10.1016/j.ridd.2022.104241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 03/22/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Families in Singapore are primarily involved in the care of their relatives with intellectual disabilities and the study aimed to explore their experiences taking care of their relatives with intellectual disabilities and mental health problems. METHOD Nine unpaid family carers were interviewed. The interviews were analysed using Interpretative Phenomenological Analysis. RESULTS Analysis revealed four themes 1) Making sense of behaviours; 2) Staff are the experts; 3) Public reaction and 4) Worries and hopes for the future. CONCLUSIONS Family carers found it difficult to identify and manage the mental health symptoms of their relatives and sought help from specialist mental health professionals. They were satisfied with the specialist services and found psychotropic medication helpful to reduce the symptoms. Family carers expressed worries about their relative not being accepted by the public and did not make future care plans. More resources are needed to increase accessibility of specialist mental health services for people with intellectual disabilities. It is recommended for service providers to collaborate with family carers and provide them with resources and skills to empower them to care for their relatives with intellectual disabilities.
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Affiliation(s)
| | | | | | - John Rose
- University of Birmingham, United Kingdom
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13
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Appelgren M, Persson K, Bahtsevani C, Borglin G. Swedish registered nurses' perceptions of caring for patients with intellectual and developmental disability: A qualitative descriptive study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1064-1076. [PMID: 34009687 DOI: 10.1111/hsc.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/11/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
Patients with intellectual and developmental disability (IDD) are often misinterpreted and misunderstood. Studies show that, in general, healthcare professionals have limited knowledge about IDD, and registered nurses (RNs) often report feeling unprepared to support this group of patients. Therefore, more knowledge about how to adequately address care for this patient group is warranted. This qualitative study employs an interpretative descriptive design to explore and describe Swedish RNs' perceptions of caring for patients with IDD, here in a home-care setting. Twenty RNs were interviewed between September 2018 and May 2019, and the resulting data were analysed through an inductive qualitative content analysis. The study adheres to consolidated criteria for reporting qualitative research (COREQ). Our analysis found that nurses' perceptions of caring for patients with an IDD could be understood from three overarching categories: nursing held hostage in the context of care, care dependent on intuition and proven experience and contending for the patients' right to adequate care. Our findings show that the home-care context and organisation were not adjusted to the needs of the patients. This resulted in RNs feeling unable to provide care in accordance with their professional values. They also explained that they had not mastered the available augmentative and alternative communication tools, instead using support staff as interpreters for their patients. Finally, on a daily basis, the RNs caring for this group of patients took an active stance and fought for the patients' right to receive the right care at the right time by the right person. This was particularly the case with issues involving psychiatric care.
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Affiliation(s)
- Marie Appelgren
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- City of Malmö, Borough Administration Operation Support Management, Malmö, Sweden
| | - Karin Persson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Christel Bahtsevani
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Gunilla Borglin
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
- Department of Nursing Education, Lovisenberg Diaconal University College, Oslo, Norway
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Doody O, Hennessy T, Moloney M, Lyons R, Bright AM. The value and contribution of intellectual disability nurses/nurses caring for people with intellectual disability in intellectual disability settings: A scoping review. J Clin Nurs 2022; 32:1993-2040. [PMID: 35301775 DOI: 10.1111/jocn.16289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/22/2021] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND People with intellectual disability experience poorer health and healthcare access issues. As a leading role in healthcare provision for people with intellectual disability nurses are key to supporting person-centred care and health outcomes. However, little is known about specialist intellectual disability nursing and their contribution to care provision for people with intellectual disability. METHODS A systematic scoping review. Searches of seven academic databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Complete, PsycINFO, Embase, Scopus and Web of Science were conducted to identify relevant literature. Literature addressing intellectual disability nursing or nursing care for people with intellectual disability in intellectual disability centres/units/care homes were reviewed and reported as per PRISMA-ScR checklist and PRISMA flow diagram. RESULTS The published literature (n = 68) is extensive and describes the value and contribution of intellectual disability nursing across all domains of professional practice and supports a biopsychosocial-educational approach to addressing the physical, mental and social needs of clients with intellectual disability across the care continuum of health management, health promotion and health education. CONCLUSIONS Despite the importance of the review question and the large volume of publication evidence detailing wide-ranging professional nursing roles and responsibilities, there remains limited literature on the assessment and intervention strategies employed by intellectual disability nurses that highlight their specialist knowledge and skill. Future research should focus on making the role of the nurse more visible and presenting their unique contributions to client care, service delivery, policy and ultimately to the art and science of nursing.
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Affiliation(s)
- Owen Doody
- Department of Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Therese Hennessy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mairead Moloney
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Rosemary Lyons
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Ann-Marie Bright
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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15
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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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Lunde H, Blaalid L, Areskoug Josefsson K, Gerbild H. Social educator students' readiness to address sexual health in their future profession. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:1059-1070. [PMID: 34800072 DOI: 10.1111/jar.12962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Norwegian social educator students' attitudes towards addressing sexual health are unknown, even if their future clients often have needs related to sexual issues. PURPOSE To investigate social educator students' readiness to address sexual health in their future profession. METHODS In 2019, 213 social educator students (response rate 34%) responded to the Students' Attitudes towards addressing Sexual Health Extended online questionnaire. RESULTS Most of the social educator students felt comfortable and ready to address sexual health in their future profession, but thought they had insufficient competence and education concerning sexual health. There were gender and age differences when discussing sexual health among persons with intellectual disabilities. CONCLUSION Despite most Norwegian social educator students feeling ready to address sexual health, they needed additional competences and education. Further research is needed concerning the effectiveness of educational interventions targeting competence in sexual health, to ensure sufficient support for clients in this field.
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Affiliation(s)
- Hilde Lunde
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Laila Blaalid
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kristina Areskoug Josefsson
- Department for Behavioural Sciences, Oslo Metropolitan University, Oslo, Norway.,School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.,Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Helle Gerbild
- Health Science Research Centre, UCL University College, Odense, Denmark.,Centre for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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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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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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20
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Drozd M, Chadwick D, Jester R. The voices of people with an intellectual disability and a carer about orthopaedic and trauma hospital care in the UK: An interpretative phenomenological study. Int J Orthop Trauma Nurs 2021; 42:100831. [PMID: 33563567 DOI: 10.1016/j.ijotn.2020.100831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/04/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION People with intellectual disabilities have a greater prevalence of musculoskeletal conditions and injuries than the general population. Orthopaedic and trauma hospital care has not been investigated with this group who seldom have their voices heard or their experiences valued and interpreted. AIM To understand the orthopaedic and trauma hospital experiences from the perspective of people with intellectual disabilities. METHODS A qualitative approach, focusing on peoples' lived experiences was utilised. A purposive sample of five participants was recruited and one-to-one, semi-structured interviews were undertaken. Analysis of the interviews employed an interpretative phenomenological analytical framework. FINDINGS There were communication challenges, a lack of person-centred care, issues with pain management, a lack of confidence in hospital care, valuable support and expertise of carers, incompetence of hospital staff and isolation and loneliness. DISCUSSION AND CONCLUSIONS There were significant short comings as people with intellectual disabilities and a carer perceived they were unsupported and received poor care. Recommendations for practice: Person-centred care is needed along with specific education and training, including close liaison with the experts by experience - people with intellectual disabilities, their carers as well as the specialists in intellectual disability.
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Affiliation(s)
- Mary Drozd
- University of Wolverhampton, Institute of Health, Sister Dora Building Room WP129, Walsall Campus, Gorway Road, Walsall, WS1 3BD, UK.
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21
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Honeyman C. Planning surgery for young people with learning disabilities. Nurs Child Young People 2021; 33:26-31. [PMID: 32954703 DOI: 10.7748/ncyp.2020.e1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 11/09/2022]
Abstract
Surgery for spinal deformity is complex and preparation involves a wide multidisciplinary team. For young people with learning disabilities, especially those who have behaviour that challenges, there are further considerations to ensure that their hospital stay is a positive experience and all their additional needs are met. Staff and carers need to be well informed and there must be effective communication. Evaluation of one patient's journey through pre-assessment, surgery and rehabilitation has identified the need for more input from learning disability liaison nurses in acute children's services.
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Affiliation(s)
- Cheryl Honeyman
- The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, England
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22
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Bur J, Missen K, Cooper S. The impact of intellectual disability nurse specialists in the United Kingdom and Eire Ireland: An integrative review. Nurs Open 2020; 8:2018-2024. [PMID: 34388861 PMCID: PMC8363355 DOI: 10.1002/nop2.690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/04/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
AIM To identify and evaluate the impact of Intellectual Disability Nurse Specialists person-centred care for people with intellectual disability. DESIGN An Integrative review of the literature was performed between January 2007-December 2017. METHODS Searching the PubMed Library of Medicine, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline Ovid, PsychINFO, Health Source: Nursing/Academic edition. A total of eight articles were selected for the final study example, including four mixed methods studies and four qualitative studies. RESULTS Three Intellectual Disability Nurse Specialist models were evaluated, and three main themes emerged: person-centred care, organizational and practice development. CONCLUSION The Intellectual Disability Nurse Specialist expert knowledge and skills contribute to the development of effective systems and processes. The results highlighted the complex nature of the Intellectual Disability Nurse Specialist role and the importance of ongoing development, promotion and evaluation and their contribution to care in the healthcare setting.
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Affiliation(s)
- Jennifer Bur
- School of Nursing and Health Professionals, Federation University, Churchill, Vic, Australia
| | - Karen Missen
- School of Nursing and Health Professions, Federation University, Churchill, Vic, Australia
| | - Simon Cooper
- School of Nursing and Health Professions, Federation University, Churchill, Vic, Australia
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23
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Alexander R, Ravi A, Barclay H, Sawhney I, Chester V, Malcolm V, Brolly K, Mukherji K, Zia A, Tharian R, Howell A, Lane T, Cooper V, Langdon PE. Guidance for the Treatment and Management of COVID-19 Among People with Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020; 17:256-269. [PMID: 32837529 PMCID: PMC7307021 DOI: 10.1111/jppi.12352] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 01/19/2023]
Abstract
The current COVID‐19 pandemic is a pressing world crisis and people with intellectual disabilities (IDs) are vulnerable due to disparity in healthcare provision and physical and mental health multimorbidity. While most people will develop mild symptoms upon contracting severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2), some will develop serious complications. The aim of this study is to present guidelines for the care and treatment of people with IDs during the COVID‐19 pandemic for both community teams providing care to people with IDs and inpatient psychiatric settings. The guidelines cover specific issues associated with hospital passports, individual COVID‐19 care plans, the important role of families and carers, capacity to make decisions, issues associated with social distancing, ceiling of care/treatment escalation plans, mental health and challenging behavior, and caring for someone suspected of contracting or who has contracted SARS‐CoV‐2 within community or inpatient psychiatric settings. We have proposed that the included conditions recommended by Public Health England to categorize someone as high risk of severe illness due to COVID‐19 should also include mental health and challenging behavior. There are specific issues associated with providing care to people with IDs and appropriate action must be taken by care providers to ensure that disparity of healthcare is addressed during the COVID‐19 pandemic. We recognize that our guidance is focused upon healthcare delivery in England and invite others to augment our guidance for use in other jurisdictions.
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Affiliation(s)
- Regi Alexander
- Little Plumstead Hospital, Hertfordshire Partnership University NHS Foundation Trust Norwich UK.,University of Hertfordshire Hatfield United Kingdom
| | - Ambiga Ravi
- Bowlers Green, Hertfordshire Partnership University NHS Foundation Trust Hatfield UK
| | - Helene Barclay
- Little Plumstead Hospital, Hertfordshire Partnership University NHS Foundation Trust Norwich UK
| | - Indermeet Sawhney
- Lexden Hospital, Hertfordshire Partnership University NHS Foundation Trust Colchester UK
| | - Verity Chester
- Little Plumstead Hospital, Hertfordshire Partnership University NHS Foundation Trust Norwich UK
| | - Vicki Malcolm
- Little Plumstead Hospital, Hertfordshire Partnership University NHS Foundation Trust Norwich UK
| | - Kate Brolly
- Little Plumstead Hospital, Hertfordshire Partnership University NHS Foundation Trust Norwich UK
| | - Kamalika Mukherji
- Hertfordshire Partnership University NHS Foundation Trust Hatfield UK
| | - Asif Zia
- Hertfordshire Partnership University NHS Foundation Trust Hatfield UK
| | - Reena Tharian
- Hellesdon Hospital, Norfolk and Suffolk NHS Foundation Trust Norwich UK
| | - Andreana Howell
- ReseArch in DevelopmentAl NeuropsychiaTry (RADiANT) Norwich UK
| | - Tadhgh Lane
- ReseArch in DevelopmentAl NeuropsychiaTry (RADiANT) Norwich UK
| | | | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR) University of Warwick Coventry UK.,Worcestershire Health and Care NHS Trust Worcester UK.,Coventry and Warwickshire Partnership NHS Trust, Coventry UK
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24
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Spassiani NA, Abou Chacra MS, Selick A, Durbin J, Lunsky Y. Emergency department nurses’ knowledge, skills, and comfort related to caring for patients with intellectual disabilities. Int Emerg Nurs 2020; 50:100851. [DOI: 10.1016/j.ienj.2020.100851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 01/21/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022]
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25
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Man J, Kangas M. Best Practice Principles When Working With Individuals With Intellectual Disability and Comorbid Mental Health Concerns. QUALITATIVE HEALTH RESEARCH 2020; 30:560-571. [PMID: 31328633 DOI: 10.1177/1049732319858326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Working with individuals with dual disabilities can be a complex process in the presence of limited evidence base to guide clinical practice. The aims of this qualitative study were to investigate perceptions of best practices of Australian psychologists who work with this specialist population. Thirty-eight Australian psychologists working in the intellectual disability field participated in eight semistructured focus groups. Perceptions of evidence-based practice for individuals with intellectual disabilities and in relation to mental health assessment were explored. Psychologists demonstrated resourcefulness in adapting to limits in available evidence-based practice and in modifying mainstream practice to suit the needs of individuals with dual disabilities. Findings suggest the necessity of practice-based evidence in contributing to the evidence base, and person-centered approaches in relation to best practice for people with intellectual disabilities. Implications for strengthening psychologists' clinical competency and bridging the research and practice gap are discussed.
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Affiliation(s)
- Joyce Man
- Centre for Emotiona Health, Macquarie University, Sydney, New South Wales, Australia
- University of Cambridge, Cambridge, United Kingdom
| | - Maria Kangas
- Centre for Emotiona Health, Macquarie University, Sydney, New South Wales, Australia
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26
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Sparby LE, Olsvold N, Obstfelder A. Mediating the interface between voluntariness and coercion: A qualitative study of learning disability nurses' work in medical examinations of people with intellectual disability. J Clin Nurs 2020; 29:1539-1551. [PMID: 32043689 DOI: 10.1111/jocn.15211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 12/13/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance. BACKGROUND Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability. DESIGN We used an ethnographic comparative case design (n = 6). METHODS The study was carried out in Norway. The analysis is based on data from semi-structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used. RESULTS Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supporting the individual in three phases: preparing for the examination, facilitating the examination and, when facing resistance, intervening to ensure safe and compassionate completion of the examination. CONCLUSIONS Supporting the person was a precarious process where professionals had to balance considerations of voluntariness and coercion, progress and breakdown, safety and risk of injury, and dignity and violation. Through their support, learning disability nurses helped to constitute the "resistant" individual as "a cooperative patient," whose body could be examined within the knowledge and methods of medicine, but who could also be safeguarded as a human being through the strain of undergoing examination. RELEVANCE TO CLINICAL PRACTICE The article sheds light on how restraints are used in the medical examination and treatment of people with intellectual disabilities and demonstrates the significance of professional support workers' contributions, both in facilitating safe and efficient medical care and in ensuring the least restrictive and most compassionate care possible.
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Affiliation(s)
- Linn Ebeltoft Sparby
- Centre for Care Research, North, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of ReHabilitation, Finnmark Hospital Trust, Kirkenes Hospital, Kirkenes, Norway
| | - Nina Olsvold
- Faculty of Health, VID Specialized University, Oslo, Norway
| | - Aud Obstfelder
- Department of Health Sciences in Gjøvik, NTNU, Gjøvik, Norway
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27
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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: 21] [Impact Index Per Article: 4.2] [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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28
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Oulton K, Wray J, Hassiotis A, Kenten C, Russell J, Tuffrey-Wijne I, Whiting M, Gibson F. Learning disability nurse provision in children's hospitals: hospital staff perceptions of whether it makes a difference. BMC Pediatr 2019; 19:192. [PMID: 31182066 PMCID: PMC6558867 DOI: 10.1186/s12887-019-1547-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 05/20/2019] [Indexed: 12/16/2022] Open
Abstract
Background In response to multiple United Kingdom investigations and inquiries into the care of adults with learning disabilities, Mencap produced the Getting it Right Charter which campaigned for the appointment of a Learning Disability Liaison Nurse in every hospital. More recent best practice guidelines from the Care Quality Commission included the need for all children’s units to have access to a senior learning disability nurse who can support staff and help them manage difficult situations. However, little evidence exists of the extent of learning disability nurse provision in children’s hospitals or the nature and impact of this role. Here we report selected findings from a national mixed methods study of hospital care for children and young people with and without learning disabilities in England. The extent of learning disability nurse provision in children’s hospitals is described and perceptions of staff working in hospitals with and without such provision is compared. Methods Semi-structured interviews were conducted with senior staff across 15 children’s hospitals and an anonymous survey was sent to clinical and non-clinical staff with patient (children and young people) contact within these hospitals. The survey focused on six different elements of care for those with and without learning disability, with additional questions concerning identifying and tracking those with learning disabilities and two open-ended questions. Results Forty-eight senior staff took part in interviews, which included a subset of nine nurses and one allied health professional employed in a dedicted learning disability nurse role, or similar. Surveys were completed by 1681, of whom 752 worked in a hospital with dedicated learning disability nurse provision. We found evidence of limited and varied learning disability nurse provision which was valued by hospital staff and shown to positively impact their perceptions of being capable to care for children and young people with learning disabilities, but not shown to increase staff perceptions of capacity or confidence, or how children and young people are valued within the hospital, their safety or access to appointments. Conclusion Further consideration must be given to how learning disability nurse roles within children’s hospitals are best operationalised in practice to have the greatest impact on staff and families, as well as how we monitor and evaluate them to ensure they are being utilised effectively and efficiently. Trial registration The study has been registered on the NIHR CRN portfolio 20,461 (Phase 1), 31,336 (Phases 2–4).
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England.
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Angela Hassiotis
- UCL Division of Psychiatry, London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF, England
| | - Charlotte Kenten
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Jessica Russell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England
| | - Irene Tuffrey-Wijne
- Faculty of Health, Social Care & Education, Cranmer Terrace, Kingston University & St George's, University of London, 6th floor Hunter Wing, London, SW17 0RE, UK
| | - Mark Whiting
- Health Research Building, University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire, AL10 9AB, England
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID), Great Ormond Street Hospital for Children NHS Foundation Trust, Level 4, Barclay House, 37 Queen Square, London, WC1N 3BH, England.,School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, GU2 7XH, England
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Read S, Heslop P, Turner S, Mason-Angelow V, Tilbury N, Miles C, Hatton C. Disabled people's experiences of accessing reasonable adjustments in hospitals: a qualitative study. BMC Health Serv Res 2018; 18:931. [PMID: 30509323 PMCID: PMC6278140 DOI: 10.1186/s12913-018-3757-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 11/22/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The UK Equality Act 2010 requires providers of health services to make changes or 'reasonable adjustments' to their practices in order to protect disabled people from discrimination or disadvantage when accessing care. Existing evidence suggests that despite this legislation, health services are not always providing reasonably adjusted care for disabled people. This paper presents the perspectives of disabled people themselves in relation to their experiences of accessing reasonable adjustments in hospitals in England. METHODS Twenty-one semi-structured interviews were held with disabled people who had a recent experience of hospital care in England. Participants were asked about the extent to which the hospital provided reasonably adjusted care, and if necessary, how they thought the provision of reasonable adjustments could be improved. Each interview was anonymised and transcribed, and the data analysed using thematic analysis. RESULTS Participants reported mixed experiences about whether and how reasonable adjustments were provided: some shared positive examples of good practice; others spoke about difficult encounters and limited provision. Recommendations made include a need for culture change in how reasonable adjustments are perceived and enacted; improvements in identifying the needs of disabled people; improvements to the hospital environment and the provision of information; and the need to involve disabled people themselves in the process of change. CONCLUSIONS Gaps remain in how reasonable adjustments are provided for disabled people accessing hospital care. It is important for hospital staff to listen to the perspectives of disabled people about the provision of reasonable adjustments, and make improvements as necessary. Hospital staff could also do more to share good practice in relation to the provision of reasonable adjustments to effectively inspire and embed positive change.
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Affiliation(s)
- Stuart Read
- Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Pauline Heslop
- Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Sue Turner
- National Development Team for Inclusion, First Floor, 30-32 Westgate Buildings, Bath, BA1 1EF UK
| | - Victoria Mason-Angelow
- Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Nadine Tilbury
- Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Caroline Miles
- Norah Fry Centre for Disability Studies, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ UK
| | - Chris Hatton
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, LA1 4YG UK
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30
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Jaques H, Lewis P, O'Reilly K, Wiese M, Wilson NJ. Understanding the contemporary role of the intellectual disability nurse: A review of the literature. J Clin Nurs 2018; 27:3858-3871. [PMID: 29893440 DOI: 10.1111/jocn.14555] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the specialist role/s that nurses perform and the specialist skills that nurses use when caring for people with intellectual disability. METHODS Adhering to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," various subject headings were used to systematically search six electronic databases for articles published in English between 2000 and 2017. A total of 27 articles were reviewed. RESULTS The literature demonstrates that similarities exist between the physical care delivered to people with intellectual disability and that delivered to people without intellectual disability. However, skills in the areas of communication, advocacy and person-centred care differ between these two groups. DISCUSSION Our findings suggest that the skill set of the specialist intellectual disability nurse is not uniquely technical but it is uniquely relational that incorporate increased patience and resilience when developing relationships with the people they care for. CONCLUSION This review has provided insights into the main differences in the skills required when working with people with intellectual disability compared to working with those without. However, minimal literature was identified that adequately describes what is unique about the performance of the role of specialised intellectual disability nurses-especially in Australia. RELEVANCE TO CLINICAL PRACTICE Understanding the skills required of nurses caring for people with intellectual disability provides the opportunity for more nurses to develop these specialised relational skills and for this branch of nursing to attract professional recognition that is currently limited.
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Affiliation(s)
- Hayden Jaques
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Kate O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Michele Wiese
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
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31
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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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Storms H, Marquet K, Claes N. General practitioners' and primary care nurses' care for people with disabilities: quality of communication and awareness of supportive services. J Multidiscip Healthc 2017; 10:367-376. [PMID: 29033579 PMCID: PMC5614790 DOI: 10.2147/jmdh.s140962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND General practitioners (GPs) and primary-care nurses (PCNs) often feel inexperienced or inadequately educated to address unmet needs of people with disabilities (PDs). In this research, GPs' and PCNs' communication with PDs and health care professionals, as well as their awareness of supportive measures relevant to PDs (sensory disabilities excluded), was examined. MATERIALS AND METHODS An electronic questionnaire was sent out to 545 GPs and 1,547 PCNs employed in Limburg (Belgium). GPs and PCNs self-reported about both communication with parties involved in care for PDs (scale very good, good, bad, very bad) and their level of awareness of supportive measures relevant for PDs (scale unaware, inadequately aware, adequately aware). RESULTS Of the questionnaire recipients, 6.6% (36 of 545) of GPs and 37.6% (588 of 1,547) of PCNs participated: 68.8% of 32 GPs and 45.8% of 443 PCNs categorized themselves as communicating well with PDs, and attributed miscommunication to limited intellectual capacities of PDs. GPs and PCNs reported communicating well with other health care professionals. Inadequate awareness was reported for tools to communicate (88.3% of GPs, 89% of PCNs) and benefits for PDs (44.1% of GPs, 66.9% of PCNs). CONCLUSION GPs' and PCNs' lacking awareness of communication aids is problematic. Involvement in a multidisciplinary, expert network might bypass inadequate awareness of practical and social support measures.
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Affiliation(s)
- Hannelore Storms
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Kristel Marquet
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Quality and Safety Department, Jessa Hospital, Hasselt, Belgium
| | - Neree Claes
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- vzw Wit-Gele Kruis Limburg, Genk, Belgium
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Trollor JN, Eagleson C, Turner B, Salomon C, Cashin A, Iacono T, Goddard L, Lennox N. Intellectual disability health content within nursing curriculum: An audit of what our future nurses are taught. NURSE EDUCATION TODAY 2016; 45:72-79. [PMID: 27429409 DOI: 10.1016/j.nedt.2016.06.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/01/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Individuals with intellectual disability experience chronic and complex health issues, but face considerable barriers to healthcare. One such barrier is inadequate education of healthcare professionals. OBJECTIVE To establish the quantity and nature of intellectual disability content offered within Australian nursing degree curricula. DESIGN A two-phase national audit of nursing curriculum content was conducted using an interview and online survey. SETTING Australian nursing schools offering pre-registration courses. PARTICIPANTS Pre-registration course coordinators from 31 universities completed the Phase 1 interview on course structure. Unit coordinators and teaching staff from 15 universities in which intellectual disability content was identified completed the Phase 2 online survey. METHODS Quantity of compulsory and elective intellectual disability content offered (units and teaching time) and the nature of the content (broad categories, specific topics, and inclusive teaching) were audited using an online survey. RESULTS Over half (52%) of the schools offered no intellectual disability content. For units of study that contained some auditable intellectual disability content, the area was taught on average for 3.6h per unit of study. Units were evenly distributed across the three years of study. Just three participating schools offered 50% of all units audited. Clinical assessment skills, and ethics and legal issues were most frequently taught, while human rights issues and preventative health were poorly represented. Only one nursing school involved a person with intellectual disability in content development or delivery. CONCLUSION Despite significant unmet health needs of people with intellectual disability, there is considerable variability in the teaching of key intellectual disability content, with many gaps evident. Equipping nursing students with skills in this area is vital to building workforce capacity.
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Affiliation(s)
- Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Claire Eagleson
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Beth Turner
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Carmela Salomon
- Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, UNSW Australia, 34 Botany Street, Randwick, NSW 2052, Australia.
| | - Andrew Cashin
- School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia.
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, VIC 3552, Australia.
| | - Linda Goddard
- Department of Mental Health and Learning Disabilities, London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute/The University of Queensland, Mater Hospitals, Raymond Terrace, South Brisbane, QLD 4101, Australia.
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Bunn F, Burn AM, Goodman C, Robinson L, Rait G, Norton S, Bennett H, Poole M, Schoeman J, Brayne C. Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem). HEALTH SERVICES AND DELIVERY RESEARCH 2016. [DOI: 10.3310/hsdr04080] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundAmong people living with dementia (PLWD) there is a high prevalence of comorbid medical conditions but little is known about the effects of comorbidity on processes and quality of care and patient needs or how services are adapting to address the particular needs of this population.ObjectivesTo explore the impact of dementia on access to non-dementia services and identify ways of improving the integration of services for this population.DesignWe undertook a scoping review, cross-sectional analysis of a population cohort database, interviews with PLWD and comorbidity and their family carers and focus groups or interviews with health-care professionals (HCPs). We focused specifically on three conditions: diabetes, stroke and vision impairment (VI). The analysis was informed by theories of continuity of care and access to care.ParticipantsThe study included 28 community-dwelling PLWD with one of our target comorbidities, 33 family carers and 56 HCPs specialising in diabetes, stroke, VI or primary care.ResultsThe scoping review (n = 76 studies or reports) found a lack of continuity in health-care systems for PLWD and comorbidity, with little integration or communication between different teams and specialities. PLWD had poorer access to services than those without dementia. Analysis of a population cohort database found that 17% of PLWD had diabetes, 18% had had a stroke and 17% had some form of VI. There has been an increase in the use of unpaid care for PLWD and comorbidity over the last decade. Our qualitative data supported the findings of the scoping review: communication was often poor, with an absence of a standardised approach to sharing information about a person’s dementia and how it might affect the management of other conditions. Although HCPs acknowledged the vital role that family carers play in managing health-care conditions of PLWD and facilitating continuity and access to care, this recognition did not translate into their routine involvement in appointments or decision-making about their family member. Although we found examples of good practice, these tended to be about the behaviour of individual practitioners rather than system-based approaches; current systems may unintentionally block access to care for PLWD. Pathways and guidelines for our three target conditions do not address the possibility of a dementia diagnosis or provide decision-making support for practitioners trying to weigh up the risks and benefits of treatment for PLWD.ConclusionsSignificant numbers of PLWD have comorbid conditions such as stroke, diabetes and VI. The presence of dementia complicates the delivery of health and social care and magnifies the difficulties that people with long-term conditions experience. Key elements of good care for PLWD and comorbidity include having the PLWD and family carer at the centre, flexibility around processes and good communication which ensures that all services are aware when someone has a diagnosis of dementia. The impact of a diagnosis of dementia on pre-existing conditions should be incorporated into guidelines and care planning. Future work needs to focus on the development and evaluation of interventions to improve continuity of care and access to services for PLWD with comorbidity.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Frances Bunn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Anne-Marie Burn
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Louise Robinson
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Greta Rait
- PRIMENT Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London Medical School, London, UK
| | - Sam Norton
- Department of Psychology, Institute of Psychiatry, King’s College London, London, UK
| | - Holly Bennett
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Marie Poole
- Institute for Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Carol Brayne
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Drozd M, Clinch C. The experiences of orthopaedic and trauma nurses who have cared for adults with a learning disability. Int J Orthop Trauma Nurs 2015; 22:13-23. [PMID: 26573892 DOI: 10.1016/j.ijotn.2015.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 08/28/2015] [Accepted: 08/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is no published empirical research about the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability. However, adults with a learning disability sustain more injuries, falls and accidents than the general population. Because of their increased health needs, there has been a corresponding increase in their numbers attending general/acute hospitals. The 6 Cs is a contemporary framework and has been used to gauge how orthopaedic and trauma nurses rate the Care, Communication, Competence, Commitment, Courage and Compassion for patients with a learning disability in orthopaedic and trauma hospital settings compared to patients without a learning disability. AIM The aim of the study was to explore the experiences of orthopaedic and trauma nurses who have cared for people with a learning disability. DESIGN The study is based on a descriptive survey design and used a questionnaire to elicit data from participants. METHODS A convenience sample of Registered Nurses completed a questionnaire. The study was explained to delegates attending a concurrent session on the topic of acute hospital care for people with a learning disability at a conference and the questionnaire was left on a table for participants to take if they wished. Questionnaires were returned anonymously. FINDINGS Of the participants who had completed the questionnaire 100% (n = 13) had cared for a patient with a learning disability. Using the 6 Cs as a framework suggested that care, communication and competence of nurses were worse for people with a learning disability than for people without a learning disability. Three main themes emerged regarding areas of good practices: (1) promoting a positive partnership with patients and carers; (2) modifying care and interventions; (3) supporting the healthcare team. CONCLUSION There was evidence of good practices within orthopaedic and trauma settings such as the active involvement of family or a paid carer who is known to thepatient and the modification of care and interventions along with specialist advice and support from the Acute Liaison Learning Disability Nurse. There were areas of concern such as the lack of use of Hospital Passports and the inconsistent implementation of reasonable and achievable adjustments. It is unknown if the care for patients with a learning disability is adequate. However, the themes that have emerged accord with the key domains in 'A competency framework for orthopaedic and trauma practitioners' (Royal College of Nursing 2012a, 2012b) and therefore could be considered for inclusion in future orthopaedic and trauma competencies to enable sharing of best practices.
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Affiliation(s)
- Mary Drozd
- University of Wolverhampton, Institute of Health Professions, Gorway Road, Walsall, WS1 3BD, UK.
| | - Christine Clinch
- University of Wolverhampton, Institute of Health Professions, Gorway Road, Walsall, WS1 3BD, UK
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