Embedding routine health checks for adults with intellectual disabilities in primary care: practice nurse perceptions

Macdonald, Sara; Morrison, Jill; Melville, Craig; Baltzer, M.; MacArthur, L.; Cooper, Sally‐Ann

doi:10.1111/jir.12475

Cited by 5 publications

(29 citation statements)

References 25 publications

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“…These comprehensive health assessments, conducted as preventive and diagnostic measures, in primary‐care clinics have been shown to be beneficial for health of people with DDs. The health checks for one patient with DDs typically took 48 min to carry out (Macdonald et al, 2018). The time required to administer the health check was centred around the operational impact on how this intervention impinged on nurses' everyday workload and practice particularly if dealing with larger numbers of patients (Macdonald et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…The health checks for one patient with DDs typically took 48 min to carry out (Macdonald et al, 2018). The time required to administer the health check was centred around the operational impact on how this intervention impinged on nurses' everyday workload and practice particularly if dealing with larger numbers of patients (Macdonald et al, 2018). Ndengeyingoma and Ruel (2016) identified that nurses had insufficient time to intervene adequately in situations concerning people with DDs in the emergency room and hospital ward, particularly when care was urgent.…”

Section: Resultsmentioning

confidence: 99%

“…Insufficient staffing magnified the problems associated with managing people with DDs. Nurses reported that because of insufficient staffing providing people with DDs the necessary accommodations were challenging (Macdonald et al, 2018). The nurse—patient ratio did not allow nurses to allocate more time to patients with DDs, thereby respecting their varied needs (Ndengeyingoma & Ruel, 2016).…”

Section: Resultsmentioning

confidence: 99%

“…Focussed resources can support and enhance consistency of nursing care and contribute to a safer environment for both nurses and their patients with DDs (Scarpinato et al, 2010). A study examining the benefits of nurse conducted routine health checks in the primary care of people with DDs (the intervention), versus standard health care, found the intervention was most successful with patients whose problems or issues were recognized by nurses, and that further training of nurses would maximize potential benefits for the patients (Macdonald et al, 2018). A written critical incident technique in the United Kingdom helped nurses to pick up cues from their clients with DDs about their religious beliefs and practices and to formulate care plans using a client‐centred approach.…”

Section: Resultsmentioning

confidence: 99%

“…These comprehensive health assessments, conducted as preventive and diagnostic measures, in primary-care clinics have been shown to be beneficial for health of people with DDs. The health checks for one patient with DDs typically took 48 min to carry out (Macdonald et al, 2018).…”

Section: Time Constraints and Insufficient Staffingmentioning

confidence: 99%

See 4 more Smart Citations

Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care

et al. 2022

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Aims To identify barriers and facilitators to nursing care of individuals with developmental disabilities (DDs). Background Individuals with DDs experience health disparities. Nurses, although well positioned to provide optimal care to this population, face challenges. Design Narrative review of extant published peer‐reviewed literature. Data Sources Electronic databases, ProQuest and EBSCO, were searched for studies published in English between 2000 and 2019. Review Methods Three reviewers reviewed abstracts and completed data extraction. Knowledge synthesis was completed by evaluating the 17 selected studies. Results Emerging themes were: (1) barriers and challenges to nursing interventions; (2) facilitators to nursing care; and (3) recommendations for nursing education, policy and practice. Conclusion Nursing has the potential to be a key partner in supporting the health of people with DDs. Impact There is a need for specific education and training, so nurses are better equipped to provide care for people with DDs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Time Constraints and Insufficient Staffingmentioning

confidence: 99%

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Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care

et al. 2022

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Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services

Gréaux,

Moro,

Kamenov

et al. 2023

Int J Equity Health

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Background Persons with disabilities experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population. Many of the poor health outcomes experienced by persons with disabilities cannot be explained by the underlying health condition or impairment, but are health inequities driven by unfair societal and health system factors. A synthesis of the global evidence is needed to identify the factors that hinder equitable access to healthcare services for persons with disabilities, and the interventions to remove these barriers and promote disability inclusion. Methods We conducted a scoping review following the methodological framework proposed by Arksey and O’Malley, Int J Soc Res Methodol 8:19–32. We searched two scholarly databases, namely MEDLINE (Ovid) and Web of Science, the websites of Organizations of Persons with Disabilities and governments, and reviewed evidence shared during WHO-led consultations on the topic of health equity for persons with disabilities. We included articles published after 2011 with no restriction to geographical location, the type of underlying impairments or healthcare services. A charting form was developed and used to extract the relevant information for each included article. Results Of 11,884 articles identified in the search, we included 182 articles in this review. The majority of sources originated from high-income countries. Barriers were identified worldwide across different levels of the health system (such as healthcare costs, untrained healthcare workforces, issues of inclusive and coordinated services delivery), and through wider contributing factors of health inequities that expand beyond the health system (such as societal stigma or health literacy). However, the interventions to promote equitable access to healthcare services for persons with disabilities were not readily mapped onto those needs, their sources of funding and projected sustainability were often unclear, and few offered targeted approaches to address issues faced by marginalized groups of persons with disabilities with intersectional identities. Conclusion Persons with disabilities continue to face considerable barriers when accessing healthcare services, which negatively affects their chances of achieving their highest attainable standard of health. It is encouraging to note the increasing evidence on interventions targeting equitable access to healthcare services, but they remain too few and sparce to meet the populations’ needs. Profound systemic changes and action-oriented strategies are warranted to promote health equity for persons with disabilities, and advance global health priorities.

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Identifying barriers and facilitators to primary care practitioners implementing health assessments for people with intellectual disability: a Theoretical Domains Framework-informed scoping review

Caltabiano,

Bailie,

Laycock

et al. 2024

Implement Sci Commun

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Introduction People with intellectual disability experience poorer health outcomes compared with the general population, partly due to the difficulties of accessing preventive care in primary care settings. There is good evidence that structured annual health assessments can enhance quality of care for people with intellectual disability, and their use has become recommended policy in several high-income countries. However, uptake remains low. The Theoretical Domains Framework (TDF) offers a conceptual structure for understanding barriers to implementation and has been usefully applied to inform implementation of health assessments for other high-need groups, but not for people with intellectual disability. We conducted a scoping review of the literature, using the TDF, to identify barriers and facilitators influencing primary care practitioners’ implementation of annual health assessments for people with intellectual disability as part of routine primary care practice. Methods This study was conducted according to the JBI methodological approach for scoping reviews. Searches were conducted in Medline (OVID-SP), Embase (OVID-SP), PsycINFO (OVID-SP), CINHAL (EBSCO), Scopus (Elsevier) and Web of Science (Clarivate) for relevant peer-reviewed publications up to May 2023. Screening, full-text review and data extraction were completed by two independent reviewers. Data were extracted and mapped to the TDF to identify relevant barriers and facilitators. Results The search yielded 1057 publications, with 21 meeting the inclusion criteria. Mapping data to the TDF, the most frequently identified domains were (a) environmental context and resources, (b) skills, (c) knowledge and (d) emotion. Predominant factors impacting on implementation included practitioners’ lack of awareness about health assessments and their identified benefits; inadequate training and experience by practitioners in the delivery of health assessments for people with intellectual disability; insufficient time to provide health assessments; and practitioner burnout. Conclusion Using a theory-informed behavioural framework, our review aids understanding of the barriers and facilitators to improving the implementation of health assessments as part of routine care for people with intellectual disability. However, there is a clear need for further qualitative research to examine the perceptions of primary care practitioners regarding implementation barriers and facilitators to health assessments in general, including views from practitioners who are not currently undertaking health assessments.

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Embedding routine health checks for adults with intellectual disabilities in primary care: practice nurse perceptions

Abstract: While the trial found the intervention to be dominant over standard health care, the adjustments nurses made may not have maximised potential benefits to patients. Increasing training could further improve the benefits that health checks provide for people with IDs.

Cited by 5 publications

References 25 publications

Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care

Nursing care for persons with developmental disabilities: Review of literature on barriers and facilitators faced by nurses to provide care

Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services

Identifying barriers and facilitators to primary care practitioners implementing health assessments for people with intellectual disability: a Theoretical Domains Framework-informed scoping review

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