Attitudes towards people with physical or intellectual disabilities among nursing, social work and medical students (2017)

Source: Wiley Online Library Journal of Clinical Nursing

Authors: Kritsotakis, Galanis, Papastefanakis, Meidani, Philalithis, Kalokairinou, & Sourtzi

Abstract

Aims and objectives

To examine and compare undergraduate healthcare students’ attitudes toward people with physical or intellectual disabilities in Greece.

Background

The experience that people with disabilities have with health care is a complex interaction between their medical condition and the social and physical environment. Attitudes of the nursing and healthcare staff affect the quality of care and people’s adaptation to their disability, self-image and rehabilitation outcomes.

Design

Descriptive cross-sectional survey.

Methods

Nursing, Social Work, and Medicine students (N=1007, 79.4% female) attending three Universities (Athens, Crete) completed during 2014-2016 two standardized scales regarding physical (ATDP – B) and intellectual disability (CLAS – ID). Descriptive and multivariate logistic regression analyses were performed.

Results

Attitudes toward physically disabled people in Greece (ATDP – B scores) were poor with scores just above the mid-point. Medical studies and higher knowledge and contact with individuals with physical disabilities signified marginally more positive attitudes. Gender and age displayed no associations with attitudes. Regarding intellectual disability (CLAS–ID scores), nursing students had slightly less positive attitudes in ‘Similarity’ but more positive attitudes in ‘Sheltering’ subscales. Previous work and contact was related to more favourable and higher age to less favourable ‘Similarity’ and ‘Sheltering’ attitudes. Males had higher ‘Exclusion’ scores. Those who knew people with intellectual disabilities had less favorable ‘Empowerment’ attitudes. Knowledge was related to more positive attitudes in all four CLAS – ID subscales.

Conclusions

Greek health and social care students showed poor attitudes towards people with physical and intellectual disability.

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Include “Low-Tech” Options to Share Health Information with People with Disabilities

Source: New Hampshire Disability & Public Health Project (DPH) Data Briefs & Reports

Health and medical information is commonly shared via web sites, social media, smart phone apps, and even text messaging. However, these high tech options are not accessible to all people. Adults with disabilities in New Hampshire (NH) are significantly less likely than adults without disabilities to have access to information electronically.

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New Hampshire Adults with Disabilities Need Better Diabetes Prevention Care

Source: New Hampshire Disability & Public Health Project (DPH) Data Briefs & Reports

In New Hampshire, adults with mobility and cognitive limitations are significantly more likely to experience diabetes (26%) than adults with no disability (9%).1 The disparity in diabetes prevalence results in higher costs to Medicaid programs and poorer health outcomes and quality of life for people with disabilities.2  Promising diabetes prevention care for adults with disabilities includes accessible and inclusive health promotion.

Several factors contribute to a higher risk of diabetes, including:

• Unhealthy eating habits that result, in part, from uninformed and limited food choices;

• Lack of physical activity due to social, environmental, and behavioral barriers; and

• Lack of knowledge and support to address risk factors for diabetes.

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Pain and pain assessment in people with intellectual disability: Issues and challenges in practice

Source: 2017 – British Journal of Learning Disabilities – Wiley Online Library

Authors: Owen Doody, Maria E. Bailey

Abstract

Accessible summary

Pain is difficult to identify when people cannot communicate. If pain is not identified, it cannot be managed and causes stress. Pain assessment is essential in order to identify pain. Pain assessment requires a combination of knowledge, health assessments and observations.

Abstract

Background Individuals with intellectual disability experience the same chronic diseases and conditions as the general population, but are more likely to have physical and psychological co-morbidities, resulting in a higher risk of experiencing pain and having more frequent or severe pain.

Method This position paper aims to highlight the importance of pain assessment for people with intellectual disability. Results As people with intellectual disability live within the community and/or remain in the family home, they are accessing a wide range of healthcare services. This necessitates that nurses across all care settings are knowledgeable regarding appropriate/alternative pain assessment methods for people with intellectual disability. While many pain assessment tools are available for use with the intellectual disability population, they are often not well established or infrequently used to establish their validity.

Conclusion Although self-report is the gold standard in pain assessment, pain assessment for people with intellectual disability is often challenging as they may be unable to self-report their pain due to their levels of communication or cognitive ability. Assessment requires a combination of approaches amalgamating: pain assessment, health assessment and observation of behaviours.

“Tell me what they do to my body”: A survey to find out what information people with learning disabilities want with their medications

Fifty-eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy-read leaflets and pictures.

Authors: Rebecca Fish, Chris Hatton, Umesh Chauhan

Source: British Journal of Learning Disabilities – 2017 – Wiley Online Library

Abstract

Accessible summary

We gave a questionnaire to self-advocates who were attending a conference. The questionnaire asked them how they felt about the information they get with their medicine. Fifty-eight people completed the questionnaire. Many of them said they did not get enough information about their medicine. Most people wanted easy-read leaflets and pictures. There are many different places to find easy-read information on the internet. We think they should be collected and checked. We also think that doctors and chemists need to spend more time with people to explain about medicines.

Abstract

Background Previous research has found that people with learning disabilities are not given prescription information that is tailored to their needs. We wanted to find out people’s information requirements.

Materials and Methods A questionnaire was co-produced by the authors and consultants with learning disabilities. It asked what information people received from their GP and pharmacist about medications. The questionnaire was circulated at a self-advocacy conference in the North of England. Fifty-eight self-advocates completed the questionnaire.

Results Information from GPs and pharmacists was mainly instructional, referring to when and how to take the medicine and dosage. Most respondents struggled to read the leaflets and remember verbal information. Many wanted the information in easy-read format, and some wanted pictures or diagrams as well. A key theme was that health professionals often talked only to carers or support workers rather than involving the patient directly, and some respondents disclosed that they were not informed about side effects or alternative medications.

Conclusions Health professionals should take time to discuss health issues and medication with the individual rather than only with carers. This could be facilitated by providing information in an accessible format.

Management and prevalence of long-term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population-based cohort study

Source: JARID

Sally-Ann Cooper, Laura Hughes-McCormack, Nicola Greenlaw, Alex McConnachie, Linda Allan, Marion Baltzer, Laura McArthur, Angela Henderson, Craig Melville, Paula McSkimming, Jill Morrison First published: 20 July 2017

Abstract

Background In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators.

Method Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses.

Results Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%–100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation.

Conclusions Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care.

What Effect Does Transition Have on Health and Well-Being in Young People with Intellectual Disabilities? A Systematic Review

 Source: JARID

Background Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, the present authors could find no synthesis of evidence on health and well-being outcomes during transition in this population. This review aimed to answer this question. MethodPRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed, and grey literature was searched. Papers were selected based on clear inclusion criteria. Data were extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results A total of 15 985 articles were extracted; of these, 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and well-being issues in this population during transition to adulthood, including obesity and sexual health issues. Conclusion This review reveals a gap in the literature on transition and health and points to the need for future work in this area.

How I bridge 2 worlds as a deaf medical student

Growing up as a deaf person has given me unique insights into patient care, which I hope to incorporate into my practice when I’m a physician.

Source: How I bridge 2 worlds as a deaf medical student

 

I was born profoundly deaf in both ears, which means I could only hear sound above 95 decibels. Without hearing aids, I could hear extremely loud sounds, such as a plane taking off or a train going by, only if I was near them. With hearing aids, I could hear sound at 40 decibels and up, so I could understand one-on-one conversations as long as there was no background noise, the person didn’t mumble and I could see his or her mouth clearly.

Before starting medical school, I got a cochlear implant, which helps me hear so much more than I could before. When I listen to music now, I can hear all the different sounds rather than one static sound, and it’s much easier to differentiate between the instruments. Understanding speech has also become much easier. I now communicate orally with hearing people and via sign language with deaf people. However, I am still deaf, and there are still times when I am unable to understand what people are saying, such as group settings where there’s a lot of ambient noise.

I chose osteopathic medicine because I heard from many patients who spoke highly of DOs, and the osteopathic philosophy resonated with me as well. I strongly believe in treating the person as a whole and that lifestyle factors can dramatically affect a person’s health. Ultimately, I hope to become an obstetrician-gynecologist. I’d like my practice to include caring for deaf patients—some deaf people have very little health literacy due to communication barriers growing up, which is something I hope to combat.

Culture and communication

Growing up as a deaf person has given me insights I hope to incorporate in my future practice as a physician. The first is the importance of maintaining eye contact during conversations. That’s not only because it helps me lip-read and understand what’s being said; eye contact shows that you are truly listening to the other person. It shows respect.

Secondly, because of growing up in the deaf culture, I’m very aware that all cultures are different. Physicians may not encounter deaf patients frequently, but they will definitely care for patients who have special needs when receiving medical care, such as a disability or an interpreter if English isn’t their primary language. As a patient, I’ve learned that I need to speak up about my needs, because sometimes people just are not aware. As a physician, I’ll know to ask patients what they need.

Victoria MacPherson, OMS II (center), attends the Philadelphia College of Osteopathic Medicine, as do Victoria Gordon, OMS II, (left) and Helen Lesser, OMS II (right). (Photo provided by Victoria MacPherson)

Tips for physicians

Physicians should keep in mind that American Sign Language is its own language, so written English doesn’t automatically translate to ASL. A deaf person who uses exclusively ASL and is not fluent in English might have trouble understanding written text, which is why some patients prefer to use an interpreter.

At the end of the visit, I appreciate being asked to repeat back my treatment plan so my physician can be sure I fully understand what was said. Receiving a written copy of my doctor’s recommendations is also very helpful—that’s probably true for any patient, not only those who are deaf.

If you’re unsure how to communicate with a patient who is deaf, or anyone with a disability, just ask! I suggest language such as, “I believe in offering top-notch accessible care. Do you need any special accommodations?” Then let the patients explain to you what they need, because they are the experts on themselves.

Developing a medical picture book for reducing venipuncture distress in preschool-aged children

Source: International Journal of Nursing Practice

Ying Tsao, Hui-Chen Kuo, Hsui-Chuan Lee and Shuenn-Jiun Yiin
Version of Record online: 20 JUL 2017 | DOI: 10.1111/ijn.12569

Abstract

Aim

Distress associated with needle-related procedures is a major concern in preschool-aged children nursing. This study developed a medical picture book for supporting preschool-aged children facing a venipuncture and determined the effectiveness of such a book intervention in decreasing behavioural distress.

Methods

The picture book was designed in 3 stages: developing stories on medical situations, penning the text, and drafting the book. We conducted a quasiexperimental study to examine the effectiveness of the book. The behavioural distress of the control and picture book groups were assessed before, during, and after the intervention by using the Observational Scale of Behavioral Distress-Revised (OSBD-R).

Results

We created a 12-page picture book, Sick Rui-Rui Bear, in which cartoon characters were depicted undergoing venipunctures, as a guide for vein injection and for facilitating positive venipuncture outcomes in preschool-aged children. Over time, the OSBD-R scores of the picture book group were significantly lower than those of the control group (P < .001).

Conclusion

We recommend the picture book be routinely read and used during venipunctures to decrease procedural distress in preschool-aged children.

SUMMARY STATEMENT
What is already known about this topic?

  • Venipunctures may cause varying levels of distress in preschool-aged children. Pain is experienced during venipunctures, which often terrifies children and prolongs the intravenous procedures and the associated displeasure.
  • Although some picture books have been used to describe the medical procedures to children, to our knowledge, the process of venipunctures has not been explained for preschool-aged children.

What this paper adds: (research findings/key new information)

  • We created a picture book titled Sick Rui-Rui Bear, in which cartoon characters were depicted as receiving venipunctures. This 12-page book is a guide to vein injection and is aimed at facilitating excellent venipuncture outcomes for preschool-aged children.
  • We adopted analytical statistics to compare the behavioural distress scores of the control and venipuncture picture book groups. Results showed that the picture book group had significantly lower scores of OSBD-R over time than that of the control group.

The implications of this paper: (how findings influence or can be used to change policy/practice/research/education)

  • When administering a venipuncture, nurses should be concerned about the distress in preschool-aged children. Interaction among nurses, parents, and preschool-aged children can be stimulated by providing them with a venipuncture picture book, thereby enabling preschool-aged children to face such a medical treatment experience.
  • Nurses can use a venipuncture picture book to reduce distress in preschool-aged children during vein injection.

 

 

Crisis Trends – Crisis Text Line

Crisis Trends aims to empower journalists, researchers, school administrators, parents and all citizens to understand the crises Americans face so we can work together to prevent future crises from happening.

Source: Crisis Trends – Crisis Text Line

Explore trends across texter conversations across all states in the U.S. http://crisistrends.org/

Crisis Text Line: Text 741-741 from anywhere in the USA, anytime, about any type of crisis.