Intellectual Disability Nurses Research Articles

A distinctive profession? Building professional identity and knowledge for intellectual disability nursing education.

Intellectual disability nursing students can struggle to build a professional identity and make sense of their extensive curriculum and its application to practice. In this article Legitimation Code Theory (LCT) and Critical Discourse Analysis (CDA) are used to facilitate an examination of the organising principles underlying intellectual disability nursing and the relationships agents construct between intellectual disability and other nursing divisions. In particular this paper explores the relationship with general nursing, and examines the connections and boundaries that intellectual disability nursing builds with general nursing, and their implications. LCT and CDA are used to examine how access to theory for intellectual disability nursing students, as compared to their general nursing peers, is facilitated. The bases of specialisation in intellectual disability nursing is also explored. This article considers how these findings can contribute to strengthening the professional identity of the intellectual disability nurse and building the related knowledge base.

The Global Intellectual Disability Nursing Research Collaboratory: Forming an international transformational nursing network.

This paper explains how we created the Global Intellectual Disability Nurse Research Collaboratory (GIDNRC), a transformative network. The GIDNRC aims to make improvements in the understanding, research, policy, clinical care, and support provided to people with an intellectual disability. In 2022, the World Health Organization (WHO) called upon healthcare leaders internationally to take actions to promote more equal healthcare for disabled persons. This paper promotes the GIDNRC as a way for professionals to work together to make more equal healthcare throughout the world for people with intellectual disabilities. We created this paper by reviewing peer-reviewed literature and research, international policies, and nursing networking initiatives. This paper explores current policy, research, and practice issues that formed the basis of beginning the GIDNRC, including how the COVID-19 pandemic changed care. Nurses are over 50% of the world's health workforce. Therefore, they have the potential to make a large impact in making care for people with intellectual disability much more equal than currently exists throughout the world. However, barriers exist. Forming the GIDNRC, as well as using the World Wide Web, offers an opportunity to address barriers to this goal. Nurses can address the needs of people with intellectual disability in their daily nursing practice. The GIDNRC aims to strengthen these clinical skills, understand how care may vary throughout the world, and share knowledge, good practices, and new ways to approach care for people with an intellectual disability worldwide. International nursing policy should actively focus on the needs of people with intellectual disabilities and the role nurses play in addressing these health needs. The GIDNRC may provide an important way to achieve developments in this policy.

A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities.

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

Understanding the contribution of intellectual disabilities nurses. Paper 4 of 4 - Impacts of intellectual disability nursing interventions.

Internationally, there is a wide variety of roles and expectations for intellectual disabilities nurses, and the range of nursing interventions they undertake in this field has not been clearly identified. In this paper we report the impacts of intellectual nursing interventions from an online survey of intellectual disability nurses. An online survey, using voluntary response sampling was used to collect case study examples from 230 participants from seven countries. We identified 13 themes of the impacts, and 23 broad groups of case examples of intellectual disability nursing interventions with, pregnant women, children, adults, older adults, and people at the end of life. Awareness of the roles of intellectual disability nurses and their importance in addressing health inequalities and facilitating the use of mainstream services for people with intellectual disabilities will enable improved healthcare experience and healthcare outcomes for people with intellectual disabilities.

Understanding the contribution of intellectual disabilities nurses. Paper 1 of 4 -Scoping literature review

The objective of this scoping review was to summarise evidence on the contribution of intellectual disabilities nurses to improve the health and well-being of children, adults and older people with intellectual disability, now and for the future. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used. We included 54 publications. We identified 154 interventions undertaken by intellectual disability nurses. We categorised the intellectual disability nursing interventions into three themes: effectuating nursing procedures, enhancing impact of services, and enhancing quality of life. Findings point to high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly updated. This will provide opportunities to engage more effectively in evidence-based practice.

Understanding the contribution of intellectual disability nurses. Paper 2 of 4 - Survey.

The objective was to identify ID nursing interventions and their impact on the health and healthcare of people with IDs. Data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. We identified 878 interventions that could be undertaken by ID nurses from 7 countries. We categorised the interventions into five themes: effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. Findings demonstrate that ID nurses play important roles in improving the health and healthcare experiences of people with IDs.

Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation.

The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to a evaluate intellectual disability nurses' confidence in their understanding of the interventions they undertook. Quantitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work need to be undertaken by nurse leaders ascertain and address this lack of clarity.

Insights from Henri Nouwen for Intellectual Disability Nursing.

Henri Nouwen's writings provide opportunity for nurses, students, and educators to reflect on nursing in the context of Christian faith. This article offers insight from Nouwen's work and its relevance to intellectual disability nursing practice and education. Five themes are developed from Nouwen's insights: 1) the descending way, 2) insignificance and marginalization, 3) learning to support the person, 4) building relationship, and 5) trusting God will catch you.

Intellectual disability nurses' challenges in medication management in primary health care: A qualitative study.

This study examines how intellectual disability nurses employed in residential living services for persons with intellectual disabilities, in Norway, deal with medication management for these individuals. Using a qualitative study, a total of 18 intellectual disability nurses were interviewed as part of four focus groups. The results demonstrate six main challenges: First, Being alone with the responsibility of medication management - a challenge; Second, The need for further competence development; Third, Teaching and supervising unskilled colleagues in safe medication management; Fourth, Interpreting residents with little or only nonverbal communication; Fifth, The need to act as advocates when residents require hospitalization; Sixth, Deficient systems for medication management on several levels. The findings point to several major flaws in the system of medication management, which necessitates the need for highly qualified intellectual disability nurses. Managers must ensure that there is a secure system to mitigate errors and promote patient safety.

Fourth year intellectual disability student nurses’ journey and future work intention: a qualitative study

BackgroundThe aim of this qualitative study is to explore the views and experiences of final year BSc intellectual disability nursing students’ journey, future work plans and examine factors influencing their migration intentions following graduation.MethodsA qualitative component of a mixed methods study where a focus group interview was conducted with final year BSc intellectual disability nursing students (n = 10) from one University in Ireland in June 2019. A topic guide was utilised, and participant’s were interviewed about their programme, future work plans and migration intentions. An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and thematic development. Duffy’s conceptual model of identity transformation provided a structure to analyse the data and map themes onto the conceptual framework.ResultsThe findings were mapped onto the five stages of Duffy’s (2013) conceptual model of identity transformation: Pre-Entry; Reaffirming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to promote intellectual disability nursing and address professional esteem issues, support for education and professional development, such as providing career guidance opportunities prior to course completion, development of clinical skills within their education programme and support for the professional development of new graduates. Participant’s identified uncertainty about career opportunities and saw scope for future professional development opportunities particularly in community-based work.ConclusionThis study has identified that final year intellectual disability nursing students are uncertain about career options and opportunities for intellectual disability nurses in other country’s. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of people with intellectual disability. This study identified a clear need for direction and information regarding intellectual disability nursing roles and career opportunities.

The value and contribution of intellectual disability nurses/nurses caring for people with intellectual disability in intellectual disability settings: A scoping review.

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. 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. 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. 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.

Past, Present and Future: Perspectives on an Oral History of Intellectual Disability Nursing.

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 30years 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.

Meeting the mental health needs of a young person with an intellectual disability: a case study

Young people with intellectual disabilities are at greater risk of developing mental health issues. However, their mental health needs are often not recognised and therefore remain untreated.This article discusses a case study concerning a young man with a mild intellectual disability and co-existing obsessive-compulsive disorder, which was first identified in adolescence. It describes his experience of accessing appropriate services and interventions, and details the care and support that he received from community-based services, which enabled him to continue living with his family. The case study reveals various issues that are relevant to other young people in similar situations, as well as for service providers and professionals, including intellectual disability nurses.

COVID-19: intellectual disability nurses and the role of networking during a pandemic

Why you should read this article:• To enhance your understanding of the networking role of the registered nurse in intellectual disability• To familiarise yourself with the requirements of the networking role during the COVID-19 pandemic• To learn more about how to access services for clients with a learning disability during COVID-19The role of the registered nurse in intellectual disability (RNID) includes networking, which is an important aspect of supporting people with an intellectual disability with their health and social care needs. Networking involves RNIDs communicating with various people in intellectual disability services, mainstream health services and local communities. The advent of coronavirus disease 2019 (COVID-19) resulted in RNIDs having to use their networking competences to support clients and their families, particularly in accessing the services they needed to maintain their health during the pandemic.This article examines this networking role and discusses the developments required for RNIDs to support people with an intellectual disability effectively during a pandemic. The article also calls for further research and clarification of the networking aspect of the RNID role. This will provide knowledge that can underpin intellectual disability nursing education and practice.

Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research

ObjectivesTo capture the extent and nature of intellectual disability nursing publications in Ireland.DesignScoping review using Arksey and O’Malley approach.Data sourcesSix databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were...

Supervising students in a complex nursing practice- a focus group study in Norway

BackgroundThe supervisory role of registered nurses and intellectual disability nurses will be even more essential in the future, to support the education of competent newly graduated candidates. To our knowledge few studies have explored nursing student supervisors’ perspectives on supervision across primary- and hospital healthcare services and also across nurse educational programs. The aim of the current study was to investigate supervisors’ perspectives on supervising from different clinical settings, and across registered nurses’ and intellectual disability nurses’ clinical practice.MethodsThe study had an exploratory and descriptive design. The study was conducted within one university college catchment area in Southeastern-Norway. Eight focous group interviews were conducted in primary healthcare (n = 4) and hospital (n = 4) wards. A total of 31 registered nurses and three intellectual disability nurses participated. Hsieh and Shannon’s conventional content analysis was used to analyze the data.ResultsParticipants across primary- and hospital healthcare agreed that clinical practice was complex, and required that students gained competence in both technical and non-technical skills. Moreover, needed skills were described both as general and arena specific, and as both basic and advanced. Participants perceived that technical and non-technical skills together, ideally should lead to students being able to «see the person» behind the patient.ConclusionsSupervisors emphasized the challenges of supervising students in a complex nursing practice. Students should gain both procedural competence and an ability to provide person-centred care, and this challenged the supervisors’ own competence. Our findings indicate a need to support supervisors, to enable them to meet these challenges.

Standards for practice in intellectual and developmental disability nursing: A Delphi study

BackgroundThe practice standards of specialist areas of nursing need to be distinctive and reflect contemporary practice. In the absence of intellectual and developmental disability content in curriculum design at both undergraduate and postgraduate levels, nurses practising in this specialty area need a clear set of standards that guide their practice. AimTo redevelop a contemporary set of practice standards by combining findings from a three-year research project with the Delphi technique to determine consensus. MethodsThe Delphi technique was applied to a draft set of eight standards that were developed based on research generated by the project. Data were generated through two Delphi rounds conducted via Qualtrics© online surveys. Data analysis consisted of descriptive statistics for percentage agreement, and content analysis for qualitative data. FindingsResponse rate was 72% for round one and 77% for round two. Consensus was reached for each of the eight standards in round one. Consensus was reached for the schema, following round two. DiscussionThe revised set of specialty standards offers points of distinction that sets them apart from other practice standards by reflecting the values, knowledge and skills required to work in intellectual and developmental disability nursing. ConclusionA combination of research evidence and the Delphi technique was useful in determining a new framework for practice standards that reflected current practice. Differentiating specialty practice standards offers identity and guidance for nurses practicing in specialised areas of nursing. The revised standards are a useful resource in policy development and education design.

Nursing supervisors' perspectives on student preparedness before clinical placements- a focus group study.

The study was conducted in a county in Southeastern-Norway, with 317.000 inhabitants, and within one hospital and one university college catchment area. Focus group interviews were conducted in the periode August to December 2018. Data were analyzed using Hsieh and Shannon's conventional content analysis. 34 nursing supervisors participated, three intellectual disability nurses and 31 registered nurses, working in four different primary healthcare wards and four different hospital wards. Participants' age ranged from 23 to 58 years, one male only. Through the analysis we derived the category 'Shared responsibility for preparation' with subcategories a) Individual initiative, and b) University college facilitation. Findings indicate that there is a gap between nursing supervisors' expectations and reality regarding students' preparedness for clinical placements. Moreover, nursing supervisors did not seem to focus on their own role in student preparedness.

“You Had To Just Kind Of Rub Her Cheek”: Memories and Emotions of Mental Deficiency Nurses in Alberta, Canada, 1945 - 1975

Mental deficiency nursing evolved as a distinct, yet little known field of nursing education and practice in several countries during the twentieth century. In Canada it became a separate area of nursing in only one of its provinces, Alberta, and it was tied to one large institution, called the Provincial Training School for the care of developmentally disabled children and, eventually, also adults. This paper contributes to the history of mental deficiency nursing, currently called intellectual disability nursing, an existing specialty actively practiced in the UK and Ireland for example. Alberta’s program was established in 1933 and continued until 1973. I examine this history through the lens of three mental deficiency nurses’ experiences of their education and work at the institution shared in an oral history interview. These nurses worked in the institution in the period after the Second World War. Their stories provide a unique perspective on a field of nursing work and education that grew increasingly controversial during the latter half of the 20th century when public debate arose over the institutionalization of people with developmental disability. Moreover, the institution’s entanglement within an active eugenics policy and practice maintained in the province of Alberta until 1972 added to the controversy. Their stories provide insight in the perceptions and emotions of mental deficiency nurses, experienced and remembered some sixty years later in an interview. I examine how the nurses took up this work and how their professional identity was depicted and changed, especially as public debate arose from the 1970s onward. The stories provide a unique micro-historical lens to explore larger social and cultural tensions over eugenics, disability, care and dependency, and over mental deficiency nurses’ work. Résumé Les soins infirmiers en déficience mentale ont évolué en tant que branche distincte, mais méconnue, de la formation et la pratique infirmière dans plusieurs pays au cours du 20e siècle. Au Canada, ils sont devenus une discipline séparée des soins infirmiers dans une seule province, en Alberta, et ils ont été liés à une grande institution nommée la Provincial Training School pour les soins aux enfants ayant des déficiences intellectuelles et, éventuellement, aux adultes. Cet article contribue à l’histoire des soins infirmiers en déficience mentale, à notre époque appelés soins infirmiers en déficience intellectuelle, une spécialité existante et activement pratiquée, par exemple, au Royaume-Uni et en Irlande. Le programme en Alberta a été établi en 1933 et s’est poursuivi jusqu’en 1973.

Nurses' perspectives on technical skill requirements in primary and tertiary healthcare services.

AimTo explore nurses' perspectives on technical skill requirements in primary and tertiary healthcare services and their perspectives on where students should learn these skills.DesignThe study was conducted in Norway and had a cross‐sectional, multicentre, descriptive design.MethodsWe used a questionnaire to explore registered nurses and intellectual disability nurses' perspectives on technical skill requirements and learning (N = 437).ResultsAll the skills included in the university college curricula were reported to be required, and most skills should from the respondents' perspective be learned in the university college. There were significant differences between registered nurses and intellectual disability nurses about their perspectives on skill learning, but no significant differences between respondents in the interface between hospital and municipality wards.ConclusionsResults from this study indicate that nurses need extensive technical skills in both primary and tertiary health care. Findings also indicate a need to modify the university college curricula.