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Jojo N, Wilson RL. Enhancing Disability Nursing Practice in Australia: Addressing Educational Preparedness. Int J Ment Health Nurs 2024. [PMID: 38873821 DOI: 10.1111/inm.13373] [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] [Received: 10/30/2023] [Revised: 05/08/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024]
Abstract
People with intellectual disabilities (IDs) face significant health challenges, including poor outcomes, limited access to health care, and a 26-year life expectancy gap compared with the general population. This highlights the need for improved public health and social policies to enhance the quality of care in hospital and community settings. An integrated literature review was conducted to examine the state of disability nursing practice in Australia following the implementation of the National Disability Insurance Support (NDIS) scheme. The review included English-language studies published from 2010 to 2023. Systematic searches in five databases resulted in a final sample of 28 studies. The data were then thematically analysed, and the following three themes emerged: Workforce development and professional standards, hospital experience and support needs of individuals with IDs, and nursing curriculum and ID. Study findings suggest that nurses lack preparation for effective health communication with individuals with IDs and their families. Evidence is insufficient to guide nursing practice and policies in ID care. Varying understandings of practice standards exist among nurses. Nursing curriculums in Australia fail to adequately prepare students to manage the unique needs of individuals with IDs, perpetuating the high mortality rates in this population. Specialised nursing practice areas are vital for meeting the complex needs of individuals with IDs. Reintroducing a disability nursing specialty and integrating dedicated study units and clinical placements in undergraduate programmes are recommended steps to improve care outcomes and support the overall well-being of this population.
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Affiliation(s)
- Natasha Jojo
- School of Nursing and Midwifery, Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Rhonda L Wilson
- Mental Health Nursing, RMIT University, Melbourne, Victoria, Australia
- Central Coast Local Health District, NSW Health, Gosford, New South Wales, Australia
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Cashin A, Morphet J, Wilson NJ, Pracilio A. Barriers to communication with people with developmental disabilities: A reflexive thematic analysis. Nurs Health Sci 2024; 26:e13103. [PMID: 38408760 DOI: 10.1111/nhs.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
People with Intellectual Disability and/or autism internationally experience some of the worst health outcomes of any population group. Registered nurses have been identified as having educational deficits in this domain, which include knowledge of adjustments to communication. This study aimed to explore perceived barriers to communication with people with Intellectual Disability and/or autism. A thematic analysis of data from an open-ended free-text survey question exploring barriers to communicating in a cross-sectional survey of 279 Australian registered nurses conducted in 2020 was undertaken. Six interrelated themes were identified. Increased educational content in undergraduate and postgraduate level nursing courses is indicated. The findings identify the benefit of educational design based on the foundation of understanding the diversity in thinking and information processing represented by the forms of neurodiversity in Intellectual Disability and Autism Spectrum Disorder.
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Affiliation(s)
- Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia
| | - Julia Morphet
- Nursing and Midwifery, Monash University, Peninsula Campus, Frankston, Victoria, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Richmond, New South Wales, Australia
| | - Amy Pracilio
- Faculty of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
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Verstraten-Oudshoorn LM, Coppus AM, de Klein M, Bakker-van Gijssel EJ. Parents' perspectives on provided health care for adults with Down syndrome: A qualitative interview study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13173. [PMID: 37937673 DOI: 10.1111/jar.13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/17/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND A comprehensive multidisciplinary medical guideline for adults with Down syndrome is lacking in the Netherlands. In this study, we aim to explore parents' views on multidisciplinary care and identify which aspects of health care they find most important in the context of developing such a guideline. METHOD This qualitative study used semi-structured interviews. Nineteen interviews were conducted with parents of adults with Down syndrome. The main themes and subthemes were identified from the transcripts by using the framework method. RESULTS Four main themes were identified which should be addressed in the guideline according to the parents: parents' support in medical care, patient-centred care, important medical topics and the organisation of medical care. CONCLUSIONS This study provides insights into parents' opinions about medical care for adults with Down syndrome. These insights are used in the construction of a guideline to improve medical care for adults with Down syndrome.
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Affiliation(s)
| | - Antonia M Coppus
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mieke de Klein
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Esther J Bakker-van Gijssel
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Siza, Residential Care Facility for People with Disabilities, Arnhem, The Netherlands
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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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McMahon MJ, O'Connor AM, Dunbar P, Delany A, Behan L, Grogan C, Keyes LM. Mortality in residential care facilities for people with disability: a descriptive cross-sectional analysis of statutory notifications in Ireland. BMJ Open 2023; 13:e065745. [PMID: 37147100 PMCID: PMC10163474 DOI: 10.1136/bmjopen-2022-065745] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES To determine incidence of death in residential care facilities for people with disability in Ireland, primary cause of death, associations of facility characteristics and deaths, and to compare characteristics of deaths reported as expected and unexpected. DESIGN Descriptive cross-sectional study. SETTING All residential care facilities for people with disability operational in Ireland in 2019 and 2020 (n=1356). PARTICIPANTS n=9483 beds. MAIN OUTCOME MEASURES All expected and unexpected deaths notified to the social services regulator. Cause of death as reported by the facility. RESULTS 395 death notifications were received in 2019 (n=189) and 2020 (n=206). 45% (n=178) were for unexpected deaths. Incidence of death per 1000 beds per year was 20.83 for all, 11.44 for expected and 9.39 for unexpected deaths. Respiratory disease was the most common cause of death, accounting for 38% (n=151) of all deaths. In adjusted negative binomial regression analysis, congregated settings versus non-congregated (incidence rate ratio (95% CI): 2.59 (1.80 to 3.73)) and higher bed numbers (highest vs lowest quartile) (4.02 (2.19 to 7.40)) were positively associated with mortality. There was also a positive n-shaped association with category of nursing staff-to-resident ratio when compared with zero nurses. Emergency services were contacted for 6% of expected deaths. Of the deaths reported as unexpected, 29% were receiving palliative care and 10.8% had a terminal illness. CONCLUSION Although incidence of death was low, residents of congregated and larger settings had higher incidence of death than residents of other settings. This should be a consideration for practice and policy. Given the high contribution of respiratory diseases to deaths and the potential avoidability of these, there is a need for improved respiratory health management in this population. Nearly half of all deaths were reported as unexpected; however, overlap in the characteristics of expected and unexpected deaths highlights the need for clearer definitions.
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Affiliation(s)
- Martin J McMahon
- Health Information Quality Authority, Mahon, Cork, Ireland
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
- Trinity Centre for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | | | - Paul Dunbar
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Anna Delany
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Laura Behan
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Carol Grogan
- Health Information Quality Authority, Mahon, Cork, Ireland
| | - Laura M Keyes
- Health Information Quality Authority, Mahon, Cork, Ireland
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Doyle C. Past, Present and Future: Perspectives on an Oral History of Intellectual Disability Nursing. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:190-205. [PMID: 35143729 PMCID: PMC9941797 DOI: 10.1177/17446295211065195] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Thirty-one participants engaged in this oral history research study aimed at exploring the lived experience of intellectual disability nurses and healthcare assistants' knowledge of the trajectory of intellectual disability nursing over the last 30 years in the Republic of Ireland and England. This paper documents some of these experiences offering perspectives on intellectual disability nursing and what is important for the future. Findings from Ireland consider the nature of intellectual disability services and the registered nurse in intellectual disability. Findings from England focus on opportunities and restrictions in intellectual disability nursing, shared visions, the changing context within which work took place and also the internal and external supports that impacted their roles. It is evident that intellectual disability nurses must be responsive to the changing landscape of service provision and also the requirements for contemporary new roles to meet the changing needs of people with intellectual disabilities.
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Affiliation(s)
- Carmel Doyle
- Carmel Doyle, School of Nursing and
Midwifery, Trinity College, 24D’olier Street, Dublin 2 D02 T283, Ireland.
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Chiang YJ, Lee LH, Chen SL, Yang CI. Healthcare workers' experiences of caring for patients diagnosed with intellectual disability co-occurrent with psychiatric disorders. J Psychiatr Ment Health Nurs 2022; 29:842-851. [PMID: 34854163 DOI: 10.1111/jpm.12811] [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] [Received: 05/13/2021] [Revised: 10/19/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Intellectual disability (ID) involves problems with general mental abilities and affects intellectual functioning and adaptive functioning. People diagnosed with ID present higher levels of functional disability, which means they usually have difficulty or the inability to independently perform basic activities of daily living. Little to no attention has been paid to the issues of the mental health of people diagnosed with ID. Specifically, healthcare workers' experiences of caring for patients with IDPD have been neglected. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The findings increase our understanding and partially address the knowledge gap regarding the situations and circumstances faced by healthcare workers in caring for patients diagnosed with intellectual disability co-occurrent with psychiatric disorders (IDPD). In cases of insufficient staffing, healthcare workers may be forced to ignore the individualized needs of patients so as to facilitate management. Healthcare workers may also feel frustrated by not being able to anticipate or deal with patients' unexpected problem behaviours or accidents. They adapt by adjusting their expectations of their patients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Healthcare administrators need to understand the difficulties faced by staff in caring for patients diagnosed with IDPD, arrange appropriate in-service education to increase the healthcare workers' knowledge and skills in caring for patients diagnosed with IDPD, and create warm and supportive environments for them. The government department responsible for the management of ID patient care institutions should be able to regularly monitor the overall staffing and quality of care in these institutions. ABSTRACT: Introduction When intellectual disability co-occurs diagnosed with psychiatric disorders (IDPD), the impact of the burden of illness on the affected individuals, their caregivers, their family and friends, and the services that provide for them is particularly high. The issues of the mental health of people diagnosed with ID have received little, if any, attention. One specific area of neglect is healthcare workers' experiences of caring for patients diagnosed with IDPD. Aim The aim of this study was to understand healthcare workers' experiences of caring for patients diagnosed with IDPD. Methods A qualitative descriptive research approach and semi-structured interviews were used in this study. We interviewed 15 participants who had experience in caring for patients diagnosed with a dual diagnosis of IDPD. Findings Four themes were found, as follows: (1) Negative impacts of insufficient staffing on the quality of care, (2) Constantly worrying about harmful incidents, (3) Discovering effective ways to provide individual patient care and (4) Adjusting expectations and attitudes towards patients. Participants' experiences revealed that they perceived the importance and effectiveness of providing individualized care for IDPD patients. However, when staffing is insufficient, they may be forced to ignore the individualized needs of patients so as to facilitate management. They may also feel frustrated by not being able to anticipate or deal with patients' unexpected problem behaviours or accidents. In addition, they adapt by adjusting their expectations of the patients. Discussion The findings from this research help to fill the knowledge gap in our understanding of healthcare workers' experiences of and their perspectives on caring for patients diagnosed with IDPD. Implications for Practice Healthcare administrators need to understand the difficulties faced by staff in caring for patients diagnosed with IDPD, arrange appropriate in-service education to increase the healthcare workers' knowledge and skills in caring for patients diagnosed with IDPD, and create warm and supportive environments for them. The government department overseeing the management of institutions providing ID patient care should be empowered to conduct regular monitoring of the overall staffing and quality of care in such institutions.
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Affiliation(s)
- Ya-Ju Chiang
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Li-Hung Lee
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
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Işık MT, Çokan Dönmez Ç, Can Özdemir R. Relationship between nurses' professional values, empathy, and patience: A descriptive cross-sectional study. Perspect Psychiatr Care 2022; 58:2433-2441. [PMID: 35365849 DOI: 10.1111/ppc.13078] [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] [Received: 05/05/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
AIM The aim of this study was to determine the relationships between the nurses' professional values and their empathy and patience levels, and the factors affecting them. METHODS This descriptive cross-sectional study was conducted with 215 nurses working at a university hospital between February and April 2021. Data were collected using the "Nurse Information Form," "Nurses' Professional Values Scale," "Patience Scale," and "The Toronto Empathy Questionnaire." FINDINGS Results of our study revealed that nurses had high scores for the perception of professional values, empathy levels, and patience levels. CONCLUSIONS Nurses had high scores for perceptions of professional values, empathy levels, and patience levels. Nurses' demographic characteristics influenced the scores.
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Affiliation(s)
- Meryem Türkan Işık
- Department of Fundamental Nursing, Faculty of Nursing, Mersin University, Mersin, Turkey
| | - Çiler Çokan Dönmez
- Department of Medical Genetics, Cukurova University Medical Hospital, Adana, Turkey
| | - Rana Can Özdemir
- Department of Medical History and Ethics, Faculty of Medical, Akeniz Üniversty, Antalya, Turkey
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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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Doody O, Bailey ME, Hennessy T. Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research. BMJ Open 2021; 11:e051858. [PMID: 34615681 PMCID: PMC8496393 DOI: 10.1136/bmjopen-2021-051858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To capture the extent and nature of intellectual disability nursing publications in Ireland. DESIGN Scoping review using Arksey and O'Malley approach. DATA SOURCES Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020. ELIGIBILITY CRITERIA Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education. DATA EXTRACTION AND SYNTHESIS Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken. RESULTS The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring. CONCLUSIONS This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.
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Affiliation(s)
- Owen Doody
- Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Maria E Bailey
- Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Therese Hennessy
- Nursing and Midwifery, University of Limerick, Limerick, Ireland
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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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Ahlström G, Hansson JÅ, Kristensson J, Runesson I, Persson M, Bökberg C. Collaboration and guidelines for the coordination of health care for frail older persons with intellectual disability: A national survey of nurses working in municipal care. Nurs Open 2020; 8:1369-1379. [PMID: 33373108 PMCID: PMC8046122 DOI: 10.1002/nop2.753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/15/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care. DESIGN National survey study with cross-sectional design. METHODS Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied. RESULTS The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.
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Affiliation(s)
- Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jan-Åke Hansson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jimmie Kristensson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Ingrid Runesson
- Department of Social Work, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Magnus Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Christina Bökberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Doody O, Murphy L, Moloney M. Clinical placements in intellectual disability nurse education: A scoping review. NURSE EDUCATION TODAY 2020; 94:104593. [PMID: 32942244 DOI: 10.1016/j.nedt.2020.104593] [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] [Received: 03/17/2020] [Revised: 07/12/2020] [Accepted: 08/08/2020] [Indexed: 06/11/2023]
Abstract
Intellectual disability undergraduate nurse education is provided in partnership between third level institutes and healthcare providers. The changing healthcare landscape has resulted in a reduction of the number of clinical placement's available to students, as persons with intellectual disabilities previously supported in institutional settings are now supported to live more independently and included within their community. This review aims to identify the range and efficacy of clinical placement's currently utilised within intellectual disability undergraduate nurse education. A scoping review framework was utilised to present a broad understanding and knowledge synthesis of the available literature. A systematic search strategy detected relevant papers across eight electronic databases. A total of 451 non-duplicate papers were identified. The review methods yielded ten papers for inclusion. Of these papers, nine were from the United Kingdom (UK) and one from Australia. Findings indicate that there is limited published literature on this topic and a notable absence of literature from Ireland, which is one of only two countries that have direct entry intellectual disability undergraduate nurse education. This review highlights the need to explore alternative placement options not traditionally considered/available to undergraduate nursing students and that further research is needed in this area.
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Affiliation(s)
- Owen Doody
- Department of Nursing and Midwifery. University of Limerick, Ireland.
| | - Louise Murphy
- School of Nursing and Midwifery, National University of Ireland, Galway.
| | - Mairead Moloney
- Department of Nursing and Midwifery. University of Limerick, Ireland.
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Lewis P, Wilson NJ, Jaques H, O'Reilly K, Wiese M. A qualitative study of nurses' perspectives of caring for children with intellectual disability and their families in a paediatric acute care setting. J Child Health Care 2019; 23:639-651. [PMID: 31359791 DOI: 10.1177/1367493519867234] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Children with intellectual disability (ID) experience chronic and pervasive limitations across intellectual and adaptive functioning. They are also at risk of developing co-morbidities. They are likely to be hospitalised more frequently and for longer periods of time than other children. The purpose of this study was to understand the experiences of nurses when caring for children and teenagers with ID in an acute paediatric hospital setting. The aim of the research was to inform future directions for the delivery of equitable and effective care for this vulnerable population. This study used a qualitative thematic analysis of individual interviews conducted with eight registered and enrolled nurses who provided care to children and adolescents with ID in an Australian paediatric acute hospital setting. Themes which emerged from this analysis were (1) Recognising similarities and managing differences; (2) Nurse-parent relationships; and (3) Caring for children with ID requires additional time. This study highlights that navigating care delivery and relationships when working with young people with ID and their caregivers in an acute care setting is complex. Nursing children with ID in hospital requires sophisticated skills. To ensure quality healthcare for patients with ID, a range of strategies are proposed.
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Affiliation(s)
- Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Hayden Jaques
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Kate O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Michele Wiese
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
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17
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Doody O, Murphy F, Lyons R, Gallen A, Ryan J, Downey J, Sezgin D. Development of nursing quality care process metrics and indicators for intellectual disability services: a literature review and modified Delphi consensus study. BMC Health Serv Res 2019; 19:909. [PMID: 31783758 PMCID: PMC6883715 DOI: 10.1186/s12913-019-4749-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 11/15/2019] [Indexed: 12/22/2022] Open
Abstract
Background Nursing process quality care metrics and indicators are quantifiable measures of the nursing care delivered to clients. They can be used to identify and support nurses’ contribution to high quality, safe, client care and are lacking in specialist intellectual disability nursing. In a national Nursing Quality Care-Metrics project for Irish intellectual disability services, a set of nursing quality care process metrics and associated indicators were established for intellectual disability services. Methods A two-stage design approach was undertaken; a broad scoping review of the literature and a modified Delphi consensus process. The Delphi included a four round e-Delphi survey and a consensus meeting. Four hundred one intellectual disability nurses working in Ireland were recruited for the surveys and 20 stakeholders attended the consensus meeting. Results From the review, 20 existing and 16 potential intellectual disability nursing metrics were identified for nurses to prioritise in the e-surveys. After the four survey rounds, 12 intellectual disability nursing metrics and 84 associated indicators were identified. Following the consensus meeting, these were reduced to 12 metrics and 79 indicators. Conclusions This first set of intellectual disability nursing process metrics and associated indicators has been identified for implementation in practice. These metrics while developed in Ireland have international relevance and their application and appropriateness in practice needs to be evaluated.
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Affiliation(s)
- Owen Doody
- Health Research Institute and Senior Lecturer, Faculty of Education and Health Sciences, Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick, Ireland.
| | - Fiona Murphy
- Faculty of Education and Health Sciences, Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick, Ireland
| | - Rosemary Lyons
- Lecturer, Faculty of Education and Health Sciences, Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick, Ireland
| | - Anne Gallen
- Director of Nursing and Midwifery Planning Development Unit, National Lead for Nursing and Midwifery Quality Care Metrics Project, Health Services Executive Ireland North West, Bishop Street, Ballyshannon, Donegal, Ireland
| | - Judy Ryan
- Director of Nursing and Midwifery Planning Development Unit, Intellectual Disability Services Work-stream Chairperson, Health Services Executive Ireland South East, Kilkenny, Ireland
| | - Johanna Downey
- Quality Care Metrics Project Officer, National Lead for Intellectual Disability Services Workstream, Health Services Executive, Ireland South, Cork, Ireland
| | - Duygu Sezgin
- Postdoctoral Researcher, College of Medicine, Nursing & Health Sciences, Clinical Sciences Institute, National University of Ireland Galway, Costello Road, Galway, Ireland
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Desroches ML, Sethares KA, Curtin C, Chung J. Nurses' attitudes and emotions toward caring for adults with intellectual disabilities: Results of a cross-sectional, correlational-predictive research study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1501-1513. [PMID: 31318122 DOI: 10.1111/jar.12645] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/15/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Negative healthcare provider attitudes may contribute to healthcare disparities in adults with intellectual disabilities. This study identified predictors of nurses' attitudes and emotions toward caring for adults with intellectual disabilities in the United States. METHOD A convenience sample of 248 nurses was used to collect nurses' attitudes and emotions toward caring for adults with intellectual disabilities (Adapted Caring for Adults with Disabilities Questionnaire) and quality of life beliefs (Prognostic Beliefs Scale). RESULTS Overall, nurses held less positive attitudes toward caring for an adult with intellectual disability versus a physical disability. Intellectual disability nurses held more positive attitudes and emotions and less negative emotions than non-intellectual disability nurses. Quality of life beliefs predicted nurse attitude, positive emotions and negative emotions. The number of adults with intellectual disabilities cared for during the nurse's career predicted negative emotions. CONCLUSIONS Future interventions should focus on improving nurses' understanding of the quality of life of adults with intellectual disabilities.
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Affiliation(s)
| | | | - Carol Curtin
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Joohyun Chung
- University of Massachusetts Dartmouth, North Dartmouth, MA, USA
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Wilson NJ, Wiese M, Lewis P, Jaques H, O'Reilly K. Nurses working in intellectual disability‐specific settings talk about the uniqueness of their role: A qualitative study. J Adv Nurs 2019; 75:812-822. [DOI: 10.1111/jan.13898] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/28/2018] [Accepted: 10/09/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Nathan J. Wilson
- 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
| | - Peter Lewis
- School of Nursing and Midwifery Western Sydney University Penrith NSW Australia
| | - Hayden Jaques
- 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
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O'Reilly K, Lewis P, Wiese M, Goddard L, Trip H, Conder J, Charnock D, Lin Z, Jaques H, Wilson NJ. An exploration of the practice, policy and legislative issues of the specialist area of nursing people with intellectual disability: A scoping review. Nurs Inq 2018; 25:e12258. [PMID: 30066979 DOI: 10.1111/nin.12258] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/14/2018] [Accepted: 06/17/2018] [Indexed: 11/26/2022]
Abstract
The specialist field of intellectual disability nursing has been subjected to a number of changes since the move towards deinstitutionalisation from the 1970s. Government policies sought to change the nature of the disability workforce from what was labelled as a medicalised approach, towards a more socially oriented model of support. Decades on however, many nurses who specialise in the care of people with intellectual disability are still employed. In Australia, the advent of the National Disability Insurance Scheme offers an apt moment to reflect upon these decades of specialised nursing care as the context of this nursing care will continue to evolve. A review of the published literature was conducted to explore what has shaped the field in the past and how this might inform the future of this speciality area under new policy and service contexts. People with intellectual disability have specific health and support needs that require a specialised workforce. Specialist nurses continue to be needed for people with intellectual disability.
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Affiliation(s)
- Kate O'Reilly
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, NSW, Australia
| | - Peter Lewis
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, NSW, Australia
| | - Michele Wiese
- School of Social Science and Psychology, Western Sydney University, Penrith South DC, NSW, Australia
| | - Linda Goddard
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Albury, NSW, Australia
| | - Henrietta Trip
- Centre for Postgraduate Nursing Studies, the University of Otago, Christchurch, New Zealand
| | - Jenny Conder
- Centre for Postgraduate Nursing Studies, the University of Otago, Christchurch, New Zealand
| | - David Charnock
- Faculty of Medicine and Health Sciences, the University of Nottingham, Nottingham, UK
| | - Zhen Lin
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, NSW, Australia
| | - Hayden Jaques
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, NSW, Australia
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Penrith South DC, NSW, Australia
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