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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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Bertuzzi A, Martin A, Clarke N, Springate C, Ashton R, Smith W, Orlowski A, McPherson D. Clinical, humanistic and economic outcomes, including experiencing of patient safety events, associated with admitting patients to single rooms compared with shared accommodation for acute hospital admissions: a systematic review and narrative synthesis. BMJ Open 2023; 13:e068932. [PMID: 37147093 PMCID: PMC10163491 DOI: 10.1136/bmjopen-2022-068932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES Assess the impact of single rooms versus multioccupancy accommodation on inpatient healthcare outcomes and processes. DESIGN Systematic review and narrative synthesis. DATA SOURCES Medline, Embase, Google Scholar and the National Institute for Health and Care Excellence website up to 17 February 2022. ELIGIBILITY CRITERIA Eligible papers assessed the effect on inpatients staying in hospital of being assigned to a either a single room or shared accommodation, except where that assignment was for a direct clinical reason like preventing infection spread. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesised narratively, according to the methods of Campbell et al. RESULTS: Of 4861 citations initially identified, 145 were judged to be relevant to this review. Five main method types were reported. All studies had methodological issues that potentially biased the results by not adjusting for confounding factors that are likely to have contributed to the outcomes. Ninety-two papers compared clinical outcomes for patients in single rooms versus shared accommodation. No clearly consistent conclusions could be drawn about overall benefits of single rooms. Single rooms were most likely to be associated with a small overall clinical benefit for the most severely ill patients, especially neonates in intensive care. Patients who preferred single rooms tended to do so for privacy and for reduced disturbances. By contrast, some groups were more likely to prefer shared accommodation to avoid loneliness. Greater costs associated with building single rooms were small and likely to be recouped over time by other efficiencies. CONCLUSIONS The lack of difference between inpatient accommodation types in a large number of studies suggests that there would be little effect on clinical outcomes, particularly in routine care. Patients in intensive care areas are most likely to benefit from single rooms. Most patients preferred single rooms for privacy and some preferred shared accommodation for avoiding loneliness. PROSPERO REGISTRATION NUMBER CRD42022311689.
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Affiliation(s)
| | | | | | | | - Rachel Ashton
- Ashton Editorial Consulting, London, UK
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
| | - Wayne Smith
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
| | - Andi Orlowski
- The Health Economics Unit, NHS England and NHS Improvement Midlands, West Bromwich, UK
- Department of Primary Care and Public Health, Imperial College London, London, UK
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4
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Turnbull H, Dark L, Carnemolla P, Skinner I, Hemsley B. A systematic review of the health literacy of adults with lifelong communication disability: Looking beyond accessing and understanding information. PATIENT EDUCATION AND COUNSELING 2023; 106:151-162. [PMID: 36283904 DOI: 10.1016/j.pec.2022.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To determine the a) extent to which people with lifelong communication disability are included in health literacy research, b) level of health literacy of people with lifelong communication disability, c) methods applied to measure the health literacy of people with lifelong communication disability, d) barriers and facilitators mediating the health literacy of people with lifelong communication disability, and e) outcomes of health literacy interventions for people with lifelong communication disability. METHODS We searched for studies relating to health literacy, people with lifelong communication disability, and key areas of the Sørensen et al. (2012) health literacy model (i.e., accessing, understanding, appraising, applying health information, personal/environmental/systemic barriers and facilitators). RESULTS Analysis of 60 studies demonstrated that this population is not well represented. Insufficient research exists to inform statements on level of health literacy or methods used to measure health literacy of this population. Barriers and facilitators appear consistent with those applicable to the general population. Health literacy intervention outcomes were variable. CONCLUSION Significant gaps exist in the research which has primarily focused on people with intellectual disability accessing and understanding health information. PRACTICE IMPLICATIONS Findings can inform policies, practice, and future research on health literacy and people with lifelong communication disability.
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Affiliation(s)
- Harmony Turnbull
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia.
| | - Leigha Dark
- Communication & Inclusion Resource Centre (CIRC), Scope Australia, Hawthorn, Australia.
| | - Phillippa Carnemolla
- School of Built Environment, University of Technology Sydney, Ultimo, Australia.
| | - Ian Skinner
- School of Allied Health Exercise & Sports Sciences, Charles Sturt University, Port Macquarie, Australia.
| | - Bronwyn Hemsley
- Graduate School of Health, University of Technology Sydney, Ultimo, Australia; Faculty of Education and the Arts, The University of Newcastle, Newcastle, Australia.
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5
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Mitchell RJ, Ryder T, Matar K, Lystad RP, Clay-Williams R, Braithwaite J. An overview of systematic reviews to determine the impact of socio-environmental factors on health outcomes of people with disabilities. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1254-1274. [PMID: 34850472 DOI: 10.1111/hsc.13665] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 11/18/2021] [Indexed: 06/13/2023]
Abstract
People with disabilities are often subject to intersecting layers of social and economic disadvantage and other barriers that drive health inequity. As a result, they frequently experience worse health than people without disabilities, beyond the direct effects of their health condition or impairment. The aim of this overview of systematic reviews was to summarise the evidence on the impact of socio-environmental factors (i.e. social, physical or attitudinal) on the health outcomes of disabled people. A systematic search of five databases (MEDLINE, PsycINFO, Embase, CINAHL and Scopus) for English-language articles from January 2000 to April 2021 was conducted. Abstracts were screened by two reviewers and reviews were critically appraised. Key data were extracted by topic, population, disability type, critical appraisal method, socio-environmental themes and health outcomes. There were 23 systematic reviews identified examining adult (60.9%) or child and young (8.7%) disabled people, with 30.4% not specifying an age range. Reviews examined people with neurological or physical (39.1%), intellectual (17.4%), sensory (8.7%) or a range of (34.8%) disabilities. Three key health outcomes (i.e. access to healthcare, health-promoting behaviour and care quality) and several recurring socio-environmental themes related to the health outcomes of disabled people were identified. Disabled people encounter common social, physical and attitudinal factors that hinder their health outcomes in terms of access to services and quality healthcare. Many preventive health services were identified as either inaccessible or not meeting the needs of disabled people. Greater involvement of disabled people in service design and awareness raising is essential.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tayhla Ryder
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Katia Matar
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Edwards AP, Hekel BE. Appraisal of disability attitudes and curriculum of nursing students: a literature review. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0029. [PMID: 34260832 DOI: 10.1515/ijnes-2021-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/30/2021] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
- Allison P Edwards
- Department of Undergraduate Studies, Cizik School of Nursing at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Barbara E Hekel
- Department of Undergraduate Studies, Cizik School of Nursing at The University of Texas Health Science Center at Houston, Houston, TX, USA
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Milne-Ives M, Shankar R, Goodley D, Lamb K, Laugharne R, Harding T, Meinert E. Humanising health and social care support for people with intellectual and developmental disabilities: Protocol for a scoping review (Preprint). JMIR Res Protoc 2021; 11:e31720. [PMID: 35507388 PMCID: PMC9118084 DOI: 10.2196/31720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health care is shifting toward a more person-centered model; however, people with intellectual and developmental disabilities can still experience difficulties in accessing equitable health care. Given these difficulties, it is important to consider how humanizing principles, such as empathy and respect, can be best incorporated into health and social care practices for people with intellectual and developmental disabilities to ensure that they are receiving equitable treatment and support. Objective The purpose of our scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the development and implementation of interventions based on humanizing principles that aim to improve health and social care practices for people with intellectual and developmental disabilities. Methods The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and PICOS (Population, Intervention, Comparator, Outcome, and Study) frameworks will be used to structure the review. A total of 6 databases (PubMed, MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science) will be searched for English articles published in the previous 10 years that describe or evaluate health and social care practice interventions underpinned by the humanizing principles of empathy, compassion, dignity, and respect. Two reviewers will screen and select references based on the eligibility criteria and extract the data into a predetermined form. A descriptive analysis will be conducted to summarize the results and provide an overview of interventions in the following three main care areas: health care, social care, and informal social support. Results The results will be included in the scoping review, which is expected to begin in October 2022 and be completed and submitted for publication by January 2023. Conclusions Our scoping review will summarize the state of the field of interventions that are using humanizing principles to improve health and social care for adults with intellectual and developmental disabilities. International Registered Report Identifier (IRRID) PRR1-10.2196/31720
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Affiliation(s)
- Madison Milne-Ives
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Rohit Shankar
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Dan Goodley
- School of Education, University of Sheffield, Sheffield, United Kingdom
| | - Kirsten Lamb
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Richard Laugharne
- Cornwall Partnership National Health Service Foundation Trust, Bodmin, United Kingdom
| | - Tracey Harding
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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Louch G, Albutt A, Harlow-Trigg J, Moore S, Smyth K, Ramsey L, O'Hara JK. Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review. BMJ Open 2021; 11:e047102. [PMID: 34011599 PMCID: PMC8137174 DOI: 10.1136/bmjopen-2020-047102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To produce a narrative synthesis of published academic and grey literature focusing on patient safety outcomes for people with learning disabilities in an acute hospital setting. DESIGN Scoping review with narrative synthesis. METHODS The review followed the six stages of the Arksey and O'Malley framework. We searched four research databases from January 2000 to March 2021, in addition to handsearching and backwards searching using terms relating to our eligibility criteria-patient safety and adverse events, learning disability and hospital setting. Following stakeholder input, we searched grey literature databases and specific websites of known organisations until March 2020. Potentially relevant articles and grey literature materials were screened against the eligibility criteria. Findings were extracted and collated in data charting forms. RESULTS 45 academic articles and 33 grey literature materials were included, and we organised the findings around six concepts: (1) adverse events, patient safety and quality of care; (2) maternal and infant outcomes; (3) postoperative outcomes; (4) role of family and carers; (5) understanding needs in hospital and (6) supporting initiatives, recommendations and good practice examples. The findings suggest inequalities and inequities for a range of specific patient safety outcomes including adverse events, quality of care, maternal and infant outcomes and postoperative outcomes, in addition to potential protective factors, such as the roles of family and carers and the extent to which health professionals are able to understand the needs of people with learning disabilities. CONCLUSION People with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation.
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Affiliation(s)
- Gemma Louch
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UK
| | - Abigail Albutt
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UK
| | | | - Sally Moore
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Kate Smyth
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UK
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Lauren Ramsey
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UK
| | - Jane K O'Hara
- NIHR Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UK
- School of Healthcare, University of Leeds, Leeds, UK
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Drozd M, Chadwick D, Jester R. A cross-case comparison of the trauma and orthopaedic hospital experiences of adults with intellectual disabilities using interpretative phenomenological analysis. Nurs Open 2021; 8:858-869. [PMID: 33570307 PMCID: PMC7877147 DOI: 10.1002/nop2.693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/25/2020] [Accepted: 10/28/2020] [Indexed: 11/12/2022] Open
Abstract
AIM To present the cross-case comparison component of a qualitative study exploring and describing the experiences of adults with an intellectual disability who have received trauma and orthopaedic hospital care for musculoskeletal conditions or injuries in the United Kingdom. DESIGN A qualitative, exploratory study was conducted using 1:1 semi-structured interviews to describe the lived experiences of trauma and orthopaedic hospital care from the perspectives of people with intellectual disabilities and a carer of a person with profound and multiple intellectual disabilities. The data were analysed using interpretative phenomenological analysis. The Standards for Reporting Qualitative Research guidelines were applied. RESULTS There were common and interconnected experiences across the five participants: communication challenges; lack of person-centred care; issues related to pain management; lack of confidence in hospital care; the valuable support and expertise of carers; and incompetence of hospital staff and isolation and loneliness.
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Affiliation(s)
- Mary Drozd
- University of WolverhamptonWolverhamptonUK
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10
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Johnson E, Heyns T, Nilsson S. Nurses' perspectives on alternative communication strategies use in critical care units. Nurs Crit Care 2021; 27:120-129. [PMID: 33624908 DOI: 10.1111/nicc.12612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Critically ill patients have the right to communicate and participate in their treatment to avoid adverse medical outcomes due to the severity of their illness, their responsiveness, and level of consciousness. This human right has often been neglected by health care professionals, as a result of limited alternative communication support provided to patients who are unable to speak due to, for example, endotracheal intubation. Despite the successful use of alternative communication strategies in critical care units (CCUs) in other countries, limited implementation in South African hospitals has been reported. AIMS AND OBJECTIVES This study aimed to determine the perspectives of South African nurses working in CCUs on the frequency of use of alternative communication strategies to support patient-centred communication with critically ill adult patients. DESIGN The study followed a quantitative non-experimental survey research design. METHODS A total of 210 nurses working in both private and public hospitals completed a survey on their perspectives on the use of alternative communication strategies in CCUs. RESULTS Nurse participants reported experience working with critically ill and communication-vulnerable patients. Nurse-patient communication mainly involved the use of pen and paper, facial expressions and gestures to obtain information relating to patients' needs and their health history. Limited use of speech-generating communication devices was reported. CONCLUSION Nurse training on the use and implementation of alternative communication strategies, such as communication boards or electronic speech-generating devices, should be investigated to improve nurses' communication with communication-vulnerable patients in South Africa. RELEVANCE TO CLINICAL PRACTICE The results are applicable in clinical practice due to patients' need for alternative communication. The nurses mainly used low-tech solutions, which are cheap and easy to access. However, there exists an opportunity to increase the use of available digital solutions.
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Affiliation(s)
- Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Tanya Heyns
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Stefan Nilsson
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Niazov Z, Hen M, Ferrari JR. Online and Academic Procrastination in Students With Learning Disabilities: The Impact of Academic Stress and Self-Efficacy. Psychol Rep 2021; 125:890-912. [PMID: 33573501 DOI: 10.1177/0033294120988113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The steady growth in the number of college students with learning disabilities (LD) increases the need to investigate their unique characteristics and behaviors in academia. The present study examined the differences in academic and online procrastination, academic stress, and academic self-efficacy between college students with and without LD. In addition, the relationship between these variables was examined. It was assumed that the difficulties experienced by college students with LD would lead them to increased levels of academic stress, and academic and online procrastination. The results showed significant differences in the levels of all variables except online procrastination between students with (n = 77) and without (n = 98) LD. Further analysis indicated that academic stress and academic self-efficacy mediated the link between LD and academic and online procrastination. These findings support the notion that during higher education, students with LD experience more difficulties than students without LD, which at times will lead them to increased levels of procrastination. However, further studies are needed to understand the nature of online procrastination in students with LD in higher education.
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Affiliation(s)
| | - Meirav Hen
- Tel-Hai Academic College, Qiryat Shemona, Israel
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12
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Charles ML. Communication experiences of family caregivers of hospitalized adults with intellectual and developmental disabilities-A qualitative study. Nurs Open 2020; 7:1725-1734. [PMID: 33072356 PMCID: PMC7544848 DOI: 10.1002/nop2.557] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 11/11/2022] Open
Abstract
Aim To explore communication experiences between family caregivers of adults with intellectual and developmental disabilities (I/DD) and healthcare personnel during hospitalization. Design A qualitative descriptive study approach with interviews of family caregivers was used. Method Face-to-face, semi-structured interviews were conducted from June-September 2015 with ten family caregivers of adults with I/DD. Participants were recruited through an advocacy organization in the north-eastern United States. Data were analysed by content analysis. The Standards for Reporting Qualitative Research was the chosen checklist. Results The four overarching themes: "Need for Advocacy"; "Need for Better Communication"; "Sense of Abandonment"; and "Lack of Confidence" along with 12 subthemes were identified. Overall, participants reported miscommunications leading to instances of mistrust in hospital staff's competence to deliver quality patient care.
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Affiliation(s)
- Marie Lourdes Charles
- College of Health ProfessionsLienhard School of NursingPace UniversityNew YorkNew YorkUSA
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13
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Drozd M, Chadwick D, Jester R. An integrative review of the hospital experiences of people with an intellectual disability: Lack of orthopaedic and trauma perspectives. Int J Orthop Trauma Nurs 2020; 39:100795. [DOI: 10.1016/j.ijotn.2020.100795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 01/13/2023]
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Edge D, Ewing L. The predictive validity of the MoCA‐LD for assessing mental capacity in adults with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1280-1287. [DOI: 10.1111/jar.12621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 03/07/2019] [Accepted: 05/02/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Edge
- Jeesal Akman Care Corporation Ltd Dereham UK
- School of Psychology University of East Anglia Norwich UK
| | - Louise Ewing
- School of Psychology University of East Anglia Norwich UK
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Appelgren M, Bahtsevani C, Persson K, Borglin G. Nurses' experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach. BMC Nurs 2018; 17:51. [PMID: 30524202 PMCID: PMC6276187 DOI: 10.1186/s12912-018-0316-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/08/2018] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Marie Appelgren
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
- City of Malmö, Borough Administration Operation Support Management, SE-205 80 Malmö, Sweden
| | - Christel Bahtsevani
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
| | - Karin Persson
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
| | - Gunilla Borglin
- 1Department of Care Science, Faculty of Health and Society, Malmö University, SE-205 06 Malmö, Sweden
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16
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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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17
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Moro TT, Savage TA, Gehlert S. Agency, social and healthcare supports for adults with intellectual disability at the end of life in out-of-home, non-institutional community residences in Western nations: A literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 30:1045-1056. [PMID: 28585240 DOI: 10.1111/jar.12374] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The nature and quality of end-of-life care received by adults with intellectual disabilities in out-of-home, non-institutional community agency residences in Western nations is not well understood. METHOD A range of databases and search engines were used to locate conceptual, clinical and research articles from relevant peer-reviewed journals. RESULTS The present authors present a literature review of the agency, social and healthcare supports that impact end-of-life care for adults with intellectual disabilities. More information is needed about where people with intellectual disabilities are living at the very end of life and where they die. CONCLUSIONS The support needs for adults with intellectual disabilities will change over time, particularly at the end of life. There are some areas, such as removing barriers to providing services, staff training, partnerships between agencies and palliative care providers, and advocacy, where further research may help to improve the end-of-life care for adults with intellectual disabilities.
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Affiliation(s)
- Teresa T Moro
- College of Nursing, Rush University Medical Center, Chicago, IL, USA
| | - Teresa A Savage
- Department of Women, Children, and Family Health Science, College of Nursing, Chicago, IL, USA
| | - Sarah Gehlert
- E. Desmond Lee Professor of Racial and Ethnic Diversity, George Warren Brown School of Social Work, St. Louis, MO, USA
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18
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Brown M, Taggart L, Karatzias T, Truesdale M, Walley R, Northway R, Macrae S, Carey M, Davies M. Improving diabetes care for people with intellectual disabilities: a qualitative study exploring the perceptions and experiences of professionals in diabetes and intellectual disability services. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:435-449. [PMID: 28247543 DOI: 10.1111/jir.12369] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 02/04/2017] [Accepted: 02/08/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners. METHODS A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area. In total, 29 qualitative interviews were conducted: 10 with diabetes practitioners from primary and secondary care, 14 from ID services and 5 from community care services regarding diabetes service provision for this population. Thematic content analysis was undertaken to identify the themes and subthemes. RESULTS Three main themes were identified: (1) enabling access to services to meet diabetes-related care needs of people with ID; (2) communication and service improvements between staff, patients and across services; and (3) providing person-centred diabetes care and developing adapted resources to increase patient self-care. CONCLUSIONS The findings of this study have important international implications in how diabetes practitioners plan and deliver services for people with ID and other vulnerable groups with limited cognitive ability and communication skills and difficulties in self-management. The findings highlight that access to diabetes education and adapted resources is needed, and if 'reasonable adjustments' are made to service provision and practice, people with ID can benefit from improved healthcare. Developing joint clinics to share knowledge and resources between diabetes and ID practitioners may improve service delivery and continuity of care, and thereby diminish the costs of not providing quality care.
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Affiliation(s)
- M Brown
- Department of Nursing and Midwifery, School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Department of Clinical Psychology, Specialist Learning Disability Services, NHS Lothian, Edinburgh, UK
| | - L Taggart
- Department of Nursing, Institute of Nursing and Health Research, University of Ulster, Coleraine, UK
| | - T Karatzias
- Department of Nursing and Midwifery, School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Department of Clinical Psychology, Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - M Truesdale
- Department of Nursing and Midwifery, School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - R Walley
- Department of Nursing and Midwifery, School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - R Northway
- Department of Nursing and Midwifery, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - S Macrae
- Department of Nursing and Midwifery, School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - M Carey
- Leicester Diabetes Centre, Department of Health Sciences, University Hospitals of Leicester, Leicester
| | - M Davies
- Leicester Diabetes Centre, Department of Health Sciences, University Hospitals of Leicester, Leicester
- Diabetes Research Centre, Department of Health Sciences, University of Leicester, Leicester, UK
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19
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Lewis P, Gaffney RJ, Wilson NJ. A narrative review of acute care nurses’ experiences nursing patients with intellectual disability: underprepared, communication barriers and ambiguity about the role of caregivers. J Clin Nurs 2017; 26:1473-1484. [DOI: 10.1111/jocn.13512] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Lewis
- School of Nursing and Midwifery; Western Sydney University; Richmond NSW Australia
| | - Ryan J Gaffney
- School of Nursing and Midwifery; Western Sydney University; Richmond NSW Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery; Ingham Institute for Applied Medical Research; Western Sydney University; Richmond NSW Australia
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20
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Ailey SH, Brown PJ, Ridge CM. Improving hospital care of patients with intellectual and developmental disabilities. Disabil Health J 2017; 10:169-172. [PMID: 28087196 DOI: 10.1016/j.dhjo.2016.12.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 12/28/2016] [Indexed: 11/30/2022]
Abstract
People with intellectual disabilities and developmental disabilities (IDD) face poorer care and outcomes when hospitalized than patients without IDD. A panel discussion Hospital care for individuals with IDD: The Issues and Challenges was held at the Annual Conference of the American Academy of Developmental Medicine and Dentistry, held in Chicago July 8-10, 2016. Among the panelists were representatives from Rush University Medical Center in Chicago, IL and Saint Barnabas Medical Center in Livingston, NJ who discussed efforts to improve hospital care of patients with IDD at their institutions. Systemic changes are needed to improve care, however, programs that target improving care for patients with IDD are possible within current systems and with current staff who are empowered to make changes that improve the quality of care.
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Affiliation(s)
- Sarah H Ailey
- Rush University Medical Center College of Nursing, United States.
| | - Paula J Brown
- Rush University Medical Center Office for Equal Opportunity, United States
| | - Caitlin M Ridge
- Saint Barnabas Medical Center, RWJBarnabas Health, United States
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21
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Heutmekers M, Naaldenberg J, Frankena TK, Smits M, Leusink GL, Assendelft WJJ, van Schrojenstein Lantman-de Valk HMJ. After-hours primary care for people with intellectual disabilities in The Netherlands-Current arrangements and challenges. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:1-7. [PMID: 27484922 DOI: 10.1016/j.ridd.2016.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 06/29/2016] [Accepted: 07/12/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little is known about the organisation of after-hours primary care for people with intellectual disabilities (ID), and mainstream care is not self-evidently accessible or fit for this group. A first step towards improvement is a greater understanding of current after-hours primary ID care. AIMS This study explores the organisation of and experiences with after-hours primary care provided for people with ID in The Netherlands. METHODS AND PROCEDURES A telephone survey amongst 68 care provider services including questions on organisational characteristics, problem areas, facilitators, and inhibitors. OUTCOMES AND RESULTS A multitude of different after-hours primary care arrangements were found. Primary care physicians (PCPs) were involved in almost all care provider services, often in alliance with PCP cooperatives. Specialised ID physicians had differing roles as gatekeeper, primary caregiver, or consultant. Most problems during the after-hours arose regarding daily care professionals' competences. Facilitators and inhibitors of after-hours primary care were themed around complexity of, and need for, specialised care, multidisciplinary team of professionals, communication and information, and prerequisites at organisational level. CONCLUSIONS AND IMPLICATIONS Evidence on specific after-hours health needs of people with ID is needed to strengthen collaboration between specialist ID care services and mainstream healthcare services to adequately provide care.
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Affiliation(s)
- Marloes Heutmekers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Tessa K Frankena
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Marleen Smits
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department IQ healthcare, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Geraline L Leusink
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Willem J J Assendelft
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Primary and Community Care, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Axmon A, Karlsson B, Ahlström G. Health care utilisation among older persons with intellectual disability and dementia: a registry study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:1165-1177. [PMID: 27730719 DOI: 10.1111/jir.12338] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/18/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Both persons with intellectual disability (ID) and persons with dementia have high disease burdens, and consequently also high health care needs. As life expectancy increases for persons with ID, the group of persons with the dual diagnosis of ID and dementia will become larger. METHOD Through national registries, we identified 7936 persons who had received support directed to persons with ID during 2012, and an age- and gender-matched sample from the general population. A national registry was also used to collect information on health care utilisation (excluding primary care) for the period 2002-2012. Health care utilisation was measured as presence and number of planned and unplanned in-patient and out-patient visits, as well as length of stay. RESULTS In comparison with persons with ID but without dementia, persons with ID and dementia were more likely to have at least one planned out-patient visit (odds ratio [OR] 8.07), unplanned out-patient visit (OR 2.41), planned in-patient visit (OR 2.76) or unplanned in-patient visit (OR 4.19). However, among those with at least one of each respective outcome, the average number of visits did not differ between those with and without dementia. Persons with ID and dementia were less likely to have at least one planned out-patient visit than persons with dementia in the general population sample (OR 0.40), but more likely to have at least one unplanned in-patient visit (OR 1.90). No statistically significant differences were found for having at least one unplanned out-patient or planned in-patient visit. Nevertheless, among those with at least one unplanned out-patient visit, the number of visits was higher in the general population sample. CONCLUSIONS Persons with ID and dementia are less likely to receive planned health care than persons with dementia in the general population. They have, however, higher levels of unplanned health care utilisation. This may be an indication that the current support system is not sufficient to meet the challenges of increased longevity among persons with ID.
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Affiliation(s)
- A Axmon
- Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - B Karlsson
- Healthcare and medical services, County Council, Uppsala, Sweden
| | - G Ahlström
- Department of Health Sciences, Lund University, Lund, Sweden
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23
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Sandberg M, Ahlström G, Axmon A, Kristensson J. Somatic healthcare utilisation patterns among older people with intellectual disability: an 11-year register study. BMC Health Serv Res 2016; 16:642. [PMID: 27829424 PMCID: PMC5103402 DOI: 10.1186/s12913-016-1880-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 10/30/2016] [Indexed: 12/02/2022] Open
Abstract
Background People with intellectual disabilities (ID) are known to have more diseases and are believed to start aging earlier than the general population. The population of older people with ID is growing, but knowledge about their use of healthcare is limited. This study aimed to explore somatic healthcare utilisation patterns among people with ID living in Sweden, in comparison with the general population from 2002 to 2012. Methods Participants were a group of people with ID (n = 7936) aged 55 years and older in 2012, and an equal-sized, birth year and sex matched, general population sample (n = 7936). Participants were divided into age groups of 5-year intervals. Data regarding in- and outpatient care were collected from the Swedish National Patient Register. Results In the younger age groups, the ID group had higher healthcare utilisation compared with the general population sample, with higher risks for planned and unplanned somatic in- and outpatient care, particularly for unplanned inpatient registrations. Decreasing patterns were seen with age; with lower risks in the ID group for the oldest age groups. This was most evident in planned somatic in- and outpatient care. In those with at least one registration, the ID group had a longer unplanned length of stay in the younger age groups, but fewer planned visits to physicians in somatic outpatient care compared with the control group. Conclusions Compared with the general population, people with ID show higher healthcare utilisation in younger age groups. Healthcare utilisation decreases with age, and in old age, fewer people with ID use healthcare compared with the general population. The barriers to accessing planned healthcare for older people with ID need more investigation. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1880-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Magnus Sandberg
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Anna Axmon
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.,Department of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Jimmie Kristensson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.,Department of Health, Blekinge Institute of Technology, SE-371 45, Karlskrona, Sweden
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24
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Hemsley B, Georgiou A, Hill S, Rollo M, Steel J, Balandin S. An integrative review of patient safety in studies on the care and safety of patients with communication disabilities in hospital. PATIENT EDUCATION AND COUNSELING 2016; 99:501-511. [PMID: 26566195 DOI: 10.1016/j.pec.2015.10.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/29/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To review the research literature on the experiences of patients with communication disabilities in hospital according to the Generic Model of patient safety. METHODS In 2014 and 2015, we searched four scientific databases for studies with an aim or result relevant to safety of hospital patients with communication disabilities. The review included 27 studies. RESULTS A range of adverse event types were outlined in qualitative research. Little detail was provided about contributing or protective factors for safety incidents in hospital for these patients or the impact of the incidents on the patient or organisations involved. CONCLUSION Further research addressing the safety of patients with communication disabilities is needed. Sufficient detail is required to identify the nature, timing, and detection of incidents; factors that contribute to or prevent adverse events; and detail the impact of the adverse events. PRACTICE IMPLICATIONS In order to provide safe and effective care to people with communication disabilities in hospital, a priority for health and disability services must be the design and evaluation of ecologically appropriate and evidence-based interventions to improve patient care, communication, and reduce the risk of costly and harmful patient safety incidents.
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Affiliation(s)
- Bronwyn Hemsley
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia.
| | - Andrew Georgiou
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Sophie Hill
- Department of Public Health, La Trobe University, Australia
| | - Megan Rollo
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia
| | - Joanne Steel
- Faculty of Education and Art, The University of Newcastle, Newcastle, Australia
| | - Susan Balandin
- Faculty of Health, Deakin University, Melbourne, Australia
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25
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Brown M, Chouliara Z, MacArthur J, McKechanie A, Mack S, Hayes M, Fletcher J. The perspectives of stakeholders of intellectual disability liaison nurses: a model of compassionate, person-centred care. J Clin Nurs 2016; 25:972-82. [PMID: 26868057 DOI: 10.1111/jocn.13142] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To investigate the experiences of patients with intellectual disabilities, family and paid carers regarding the role of liaison nurses and the delivery of compassionate, person-centred care. From this to propose a model of person-centred care embedded in these experiences. BACKGROUND People with intellectual disabilities have a high number of comorbidities, requiring multidisciplinary care, and are at high risk of morbidity and preventable mortality. Provision of compassionate, person-centred care is essential to prevent complications and avoid death. DESIGN A qualitative design was adopted with Interpretative Phenomenological Analysis for data analysis. METHODS Semistructured interviews and focus groups were conducted. Data were analysed with a focus on compassionate, person-centred care elements and components. Themes were modelled to develop a clinically meaningful model for practice. RESULTS Themes identified vulnerability, presence and the human interface; information balance; critical points and broken trust; roles and responsibilities; managing multiple transitions; 'flagging up' and communication. CONCLUSIONS The findings provide the first 'anatomy' of compassionate, person-centred care and provide a model for operationalising this approach in practice. The applicability of the model will have to be evaluated further with this and other vulnerable groups. RELEVANCE TO CLINICAL PRACTICE This is the first study to provide a definition of compassionate, person-centred care and proposes a model to support its application into clinical practice for this and other vulnerable groups.
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Affiliation(s)
- Michael Brown
- Edinburgh Napier University, NHS Lothian, Edinburgh, UK.,Learning Disability Service, NHS Lothian, Edinburgh, UK
| | - Zoë Chouliara
- Edinburgh Napier University, NHS Lothian, Edinburgh, UK
| | | | - Andrew McKechanie
- Learning Disability Service, NHS Lothian, Edinburgh, UK.,University of Edinburgh, Edinburgh, UK
| | - Siobhan Mack
- Learning Disability Service, NHS Lothian, Edinburgh, UK.,Queen Margaret University, Musselburgh, East Lothian, UK
| | - Matt Hayes
- University of Edinburgh, Edinburgh, UK.,NHS Lothian, Edinburgh, UK
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Dithole K, Sibanda S, Moleki MM, Thupayagale-Tshweneagae G. Exploring Communication Challenges Between Nurses and Mechanically Ventilated Patients in the Intensive Care Unit: A Structured Review. Worldviews Evid Based Nurs 2016; 13:197-206. [DOI: 10.1111/wvn.12146] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Kefalotse Dithole
- Clinical Nurse Specialist, Department of Health Studies; University of South Africa; Pretoria South Africa
| | - Sambulelwe Sibanda
- Research Fellow, Department of Health Studies; University of South Africa; Pretoria South Africa
| | - Mary M. Moleki
- Professor of Nursing Studies, Department of Health Studies; University of South Africa; Pretoria South Africa
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27
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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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28
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Ilkhani M, Glasper A, Jarrett N. Nursing curricula relating to care for disabled children: literature review. Int Nurs Rev 2015; 63:78-83. [DOI: 10.1111/inr.12203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mahnaz Ilkhani
- School of Nursing & Midwifery; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Alan Glasper
- Faculty of Health Sciences; University of Southampton
| | - Nikki Jarrett
- Faculty of Health Sciences; University of Southampton
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29
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Robertson J, Hatton C, Baines S, Emerson E. Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:455-523. [DOI: 10.1111/jar.12149] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Janet Robertson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Chris Hatton
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Susannah Baines
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Eric Emerson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
- Centre for Disability Research and Policy; University of Sydney; Sydney NSW Australia
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Hemsley B, Balandin S. A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research. Augment Altern Commun 2014; 30:329-43. [PMID: 25229213 PMCID: PMC4266100 DOI: 10.3109/07434618.2014.955614] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 06/06/2014] [Indexed: 11/13/2022] Open
Abstract
Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication.
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Affiliation(s)
- Bronwyn Hemsley
- School of Humanities and Social Science, Faculty of Education and Arts, The University of Newcastle, New South Wales, Australia
| | - Susan Balandin
- School of Health and Social Development, Faculty of Health, Deakin University, Victoria, Australia
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Iacono T, Bigby C, Unsworth C, Douglas J, Fitzpatrick P. A systematic review of hospital experiences of people with intellectual disability. BMC Health Serv Res 2014. [PMID: 25344333 DOI: 10.1186/s12913‐014‐0505‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2022] Open
Abstract
BACKGROUND People with intellectual disability are at risk of poor hospital experiences and outcomes. The aims were to conduct a content and quality review of research into the acute hospital experiences of both people with intellectual disabilities and their carers, and to identify research gaps. METHOD A systematic search was conducted of primary research between 2009 and 2013 that addressed the experiences of the target group in general acute care hospitals. Quality appraisal tools yielded scores for quantitative and qualitative studies, and overarching themes across studies were sought. RESULTS Sixteen studies met inclusion criteria. Quality scores were 6/8 for a survey, and 2/11-9/11 (mean =5.25) for qualitative studies/components. Content analysis revealed seven over-arching themes covering individuals' fear of hospital encounters, carer responsibilities, and problems with delivery of care in hospitals including staff knowledge, skills and attitudes. CONCLUSIONS Our review of eligible papers revealed that despite 20 years of research and government initiatives, people with intellectual disability continue to have poor hospital experiences. The need for research to identify and investigate care at specific points of encounter across a hospital journey (such as admission, diagnostic testing, placement on a ward, and discharge) as well as to include people with a diversity of disabilities is discussed in terms of potential to influence policy and practice across health and disability sectors.
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Affiliation(s)
- Teresa Iacono
- La Trobe Rural Health School, La Trobe University, Bendigo, Bendigo 3552, Victoria, Australia.
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Iacono T, Bigby C, Unsworth C, Douglas J, Fitzpatrick P. A systematic review of hospital experiences of people with intellectual disability. BMC Health Serv Res 2014; 14:505. [PMID: 25344333 PMCID: PMC4210514 DOI: 10.1186/s12913-014-0505-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 10/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with intellectual disability are at risk of poor hospital experiences and outcomes. The aims were to conduct a content and quality review of research into the acute hospital experiences of both people with intellectual disabilities and their carers, and to identify research gaps. METHOD A systematic search was conducted of primary research between 2009 and 2013 that addressed the experiences of the target group in general acute care hospitals. Quality appraisal tools yielded scores for quantitative and qualitative studies, and overarching themes across studies were sought. RESULTS Sixteen studies met inclusion criteria. Quality scores were 6/8 for a survey, and 2/11-9/11 (mean =5.25) for qualitative studies/components. Content analysis revealed seven over-arching themes covering individuals' fear of hospital encounters, carer responsibilities, and problems with delivery of care in hospitals including staff knowledge, skills and attitudes. CONCLUSIONS Our review of eligible papers revealed that despite 20 years of research and government initiatives, people with intellectual disability continue to have poor hospital experiences. The need for research to identify and investigate care at specific points of encounter across a hospital journey (such as admission, diagnostic testing, placement on a ward, and discharge) as well as to include people with a diversity of disabilities is discussed in terms of potential to influence policy and practice across health and disability sectors.
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Affiliation(s)
- Teresa Iacono
- />La Trobe Rural Health School, La Trobe University, Bendigo, PO Box 199, Bendigo, Victoria 3552 Australia
| | - Christine Bigby
- />Department of Social Work and Social Policy, La Trobe University, Melbourne, Australia
| | - Carolyn Unsworth
- />Department of Occupational Therapy, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- />Department of Human Communication Sciences, La Trobe University, Melbourne, Australia
| | - Petya Fitzpatrick
- />Department of Social Work and Social Policy, La Trobe University, Melbourne, Australia
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Brown M, Karatzias T, O'Leary L. The health role of local area coordinators in Scotland: a mixed methods study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2013; 17:387-402. [PMID: 24166152 DOI: 10.1177/1744629513509795] [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: 06/02/2023]
Abstract
The study set out to explore whether local area coordinators (LACs) and their managers view the health role of LACs as an essential component of their work and identify the health-related activities undertaken by LACs in Scotland. A mixed methods cross-sectional phenomenological study involving local authority service managers (n = 25) and LACs (n = 40) was adopted. Quantitative data from LACs were obtained using online and postal questionnaires. Qualitative data from local authority service managers and LACs were collected using one-to-one interviews and focus groups. Thematic analysis was undertaken of the qualitative data. The results indicate that there is a need to develop further the wider public health role of LACs to incorporate health-related activities focused on broader community-based outcomes such as empowerment and community integration. By adopting a public health role, LACs will be able to contribute to the reduction of health inequalities in people with learning disabilities.
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Affiliation(s)
- Michael Brown
- Edinburgh Napier University, UK, and NHS Lothian, UK
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