Evidence and Practice
Why you should read this article: • To familiarise yourself with the principles of mindfulness • To be aware of the potential benefits of mindfulness for people with learning disabilities • To understand how mindfulness sessions can be adapted to meet the needs of people with learning disabilities • Learning disability nurses can support service users to access appropriate mindfulness-based interventions and monitor outcomes The use of mindfulness in people with learning disabilities and co-morbid physical and/or mental health conditions is becoming increasingly common. Various studies have demonstrated its usefulness in managing conditions such as anxiety and depression, as well as reducing aggression and behaviour that challenges in this population. This article explores the evidence base to support the benefits of mindfulness for people with learning disabilities and details the role of learning disability nurses in supporting service users to use mindfulness effectively. It also provides examples of mindfulness exercises and suggests how such interventions can be adapted to meet the individuals’ needs.
A literature review exploring challenges for paid carers providing palliative care
Why you should read this article: • To understand how a person with learning disabilities may express their mental health issues • To gain insight into the thoughts and feelings of people with learning disabilities and coexisting mental health issues • To recognise the level of care and support required by people with learning disabilities and mental health issues Background Minimal research has been undertaken into the views of service users with learning disabilities and mental health issues on the care and support they receive. Aim To actively involve adult service users with a learning disability in improving the understanding of service providers, practitioners and carers of the service users’ experiences of mental healthcare. Method A psychosocial research approach was employed to support the involvement of seven service users with learning disabilities who live in community settings. Semi-structured interviews were conducted with all seven participants to produce data relating to their views on the mental health care they had received. Data were also obtained from consultations with carers and from patient records kept by service providers. Findings Participants often associated their mental health issues with stressful life events, were reviewed regularly and treated by psychiatrists for mental health issues. They were often able to express their thoughts and feelings about their mental health issues, while some of the participants were also aware of being involved in decisions about their care. The data also showed an increased awareness among service providers, practitioners and carers of the mental health and emotional issues experienced by individuals with learning disabilities, particularly following implementation of the policy of community care and resettlement of service users from long-stay hospitals. Conclusion The participants’ data showed the diverse negative experiences and events experienced by people with learning disabilities related to the recognition of their need for mental health care. Some of the findings reflect those of other studies. Future recommendations include further research into the perspectives of people with coexistent learning disabilities and mental health issues.
The application of Kitwood’s theory
Why you should read this article: • To enhance your understanding of the functional needs of people with complex physical impairments • To increase your awareness of challenges and the benefits of environmental control systems • To appreciate the role of occupational therapists in the assessment of people’s occupational functioning Environmental control systems (ECSs) are a form of assistive technology that can enable people with complex physical impairments to operate a range of appliances and devices by remote control, therefore enabling them to maintain a higher level of independence. The functional independence and improved communication abilities afforded by ECSs can, in turn, increase people’s confidence, self-esteem and feelings of self-worth.
Why you should read this article: • To understand the importance of writing for publication • To familiarise yourself with the role of peer review • To be aware of the differences between continuing professional development articles and research articles There is an expectation that nurses should use evidence to inform practice but having access to this evidence requires other nurses to write about and publish their work to generate a new evidence base. There is also an expectation that nurses should publish to improve knowledge, although for some the thought of writing can seem challenging. This article presents a reflection on the author’s experience of writing, from her first attempt at publishing through to becoming a published author, and then publishing continuing professional development articles. It provides insight into the work involved in becoming a published author.
Why you should read this article • Mental health concerns in people with intellectual disabilities can be difficult to identify due to various factors, including the person’s physical health, behaviour and cognition, and formal and informal carers’ skill deficits and attitudes • Knowledgeable and skilled health professionals must be present in the daily lives of people with an intellectual disability to identify and explore emerging mental health issues, make referrals, implement interventions and monitor outcomes • Registered intellectual disability nurses play a vital role in ensuring that the mental health of people with an intellectual disability is addressed and maximised Mental health concerns are prevalent in regard to those with intellectual disability. There are many reasons for this, some of which may relate to the causation of the person’s intellectual impairment. Other extraneous factors, such as the number of significant life events, may also result in compromised mental health. For many people, however, mental health problems may go untreated, which may relate to difficulties in diagnosis or in ascribing the signs and symptoms to other causes. With increasing numbers of people with an intellectual disability making use of regular community health services, and the reported unfavourable nature of such services, mental health problems may not be addressed. Registered intellectual disability nurses have a crucial role to play in ensuring that the mental health concerns of people with an intellectual disability are identified and addressed in an expeditious manner to achieve maximum well-being. This article explores such mental health concerns and, drawing on a brief case study, describes the role of nurses.
Asthma is a long-term condition that requires patient education, support and close monitoring. It is important that individuals are empowered and educated about their asthma and supported to self-manage as appropriate. Self-management is a goal that is recommended as an established and effective approach. However, it can be challenging for many individuals, including those with learning disabilities. Learning disability nurses can support individuals diagnosed with asthma to self-manage the condition and should have the knowledge, skills and competence to do so.
Care should be person-centred, holistic and underpinned by current evidence-based practice
The knowledge and skills required to manage patients with a PEG tube safely and effectively
Many adults with intellectual disabilities require nutritional support as feeding problems are prevalent in this population. While many types of nutritional support are available, enteral feeding tubes, such as nasogastric (NG) tubes, are considered safe and effective. NG tube feeding is a common clinical procedure carried out to maintain patients’ nutritional needs when they have swallowing difficulties or cannot tolerate oral feeding. Insertion of an NG tube provides adequate nutrition and improves positive health outcomes and quality of life, but being fed through an NG tube may alter patients’ perceptions of feeding and mealtimes. Healthcare professionals, including intellectual disability nurses, should not underestimate the social aspect of mealtimes or the physical and psychological effects of NG tube feeding in patients with intellectual disabilities. Demonstrating competence and compassion with regard to insertion and care of an NG tube and applying best practice to ensure patient safety and well-being are critical to supporting patients with intellectual disabilities.
Healthcare professionals who support people who require an inhaler or nebuliser need to know how to use the devices, monitor and assess patients’ inhaler techniques effectively. Often, people have inadequate inhaler techniques, which can lead to poor management of their respiratory condition, increased signs and symptoms, reduced quality of life and increased use of primary/secondary care services and treatment costs. This article explains how to use inhalers and nebulisers appropriately and considers some of the challenges for children and adults with a learning disability. It also describes some devices and assessment tools, and explores assessment/review methods to help ensure people use their inhalers/nebulisers successfully.