Clinical
Our clinical nursing articles aim to inform and educate nurse practitioners and students. This is achieved through the publication of peer-reviewed, evidence-based, relevant and topical articles.
Supporting people with intellectual disabilities to discuss death and bereavement
This article describes a public engagement project on bereavement
Investigating accessible information formats with people who have learning disabilities
Why you should read this article: • To understand the issues that some people with learning disabilities may experience when using easy-read materials • To be aware of the benefits of using various formats – including audio, video, computer programs and storytelling apps – to provide information to people with learning disabilities • To enhance your practice in the provision of accessible health information to people with learning disabilities Background Providing people who have learning disabilities with accessible information can encourage them to engage with their health and with healthcare services, thereby contributing to reduce the health inequalities they encounter. Aim To examine, with people with learning disabilities, different formats of accessible health information and explore with them which formats they found useful. Method Six focus group sessions were undertaken in which ten people with learning disabilities expressed their views on different formats of accessible health information, including easy-read materials, videos, computer programs and websites. The sessions were audio recorded and transcribed verbatim, and the data were analysed using grounded theory. An easy-read report was submitted to the group to validate the findings. Findings Participants felt valued when provided with information that acknowledged their learning disability and catered for their needs. When developing accessible information, it is important to consider the use of language, images, audio and video. Easy-read materials do not meet the needs of people with suboptimal reading skills, but technology can be used to address this issue. Conclusion The findings of this research project reflect previous research, existing guidance on accessible information and the researchers’ experience, emphasising that it is important to use clear, jargon-free language. Further research into the use of narrative in health information provision would be useful.
Using cognitive behavioural therapy in individuals with intellectual disability
Why you should read this article • To familiarise yourself with the principles underpinning cognitive behavioural therapy (CBT) • To identify the role of CBT in treating psychological disorders experienced by people with intellectual disabilities • To understand the challenges of delivering CBT for people with intellectual disabilities Cognitive behavioural therapy (CBT) has become established as a method for treating psychological disorders experienced by the general population, with considerable evidence available to support its efficacy. However, little research has been conducted into its effectiveness in treating psychological disorders experienced by people with intellectual disabilities. This article explores the various factors involved in the use of CBT for people with intellectual disabilities and how healthcare professionals and the multidisciplinary team have an important role in the CBT process. The input of learning disability nurses is also explored, particularly their vital role in supporting CBT and providing information that is concurrent with an individual’s level of understanding. Challenges in the provision of CBT for this population are also examined, for example the prevalence of diagnostic overshadowing, which can make it difficult to distinguish between cognitive impairment and mental health issues in people with intellectual disabilities.
Supporting people with learning disabilities to move out of long-stay hospitals
Transforming care: negotiating the complex discharge process
Helicobacter pylori: nurses’ perceptions of diagnosis and treatment in adults
Why you should read this article • To understand how people with a learning disability may be at an increased risk of Helicobacter pylori infection • To increase your knowledge of actions you can take to reduce the risk of spread of H. pylori infection • To learn about how to improve staff knowledge of H. pylori infection, including signs and symptoms Background Helicobacter pylori is a bacterium that lives in the stomach’s gastric mucosa layer. H. pylori is a carcinogen that increases the risk of stomach and duodenum ulcers, gastro-oesophageal reflux disease and stomach cancer. Prevalence rates of H. pylori are higher in people with a learning disability than in the general population; however, despite the increased risk of H. pylori in people with a learning disability there is a lack of literature that applies specifically to this population and their families or carers. Aim To explore issues related to the diagnosis and treatment of H. pylori in people with a learning disability by examining the attitudes, beliefs, experiences and behaviours of staff working with people with a learning disability who are undergoing assessment and/or treatment for H. pylori. Another aim of this study was to understand the barriers to using preventive strategies, completing assessments and treating H. pylori in people with a learning disability. Method Focus groups were conducted with 16 staff members from two learning disability services. Before the focus groups, staff members were sent an information sheet with facts about H. pylori in people with a learning disability. Transcribed focus group discussions were analysed to identify themes. Results Staff reported issues with identifying accurate prevalence figures for H. pylori in people with a learning disability in their services due to the limited number of people who had undergone assessment. Identifying the signs and symptoms of H. pylori was also challenging for staff due to communication difficulties with people with a learning disability, or because the individual had minor symptoms or was asymptomatic. Other staff said that symptoms could be attributed to the side effects of medicines. Staff believed that people with a learning disability should be treated for H. pylori, given the associated risks of the bacterium, but that the lack of guidance on re-testing after treatment meant it was challenging to incorporate re-testing into care planning. Conclusion Little consideration has been given to the presence of H. pylori in people with a learning disability over the past decade, despite the fact it is an important health concern that can be identified and treated. Staff, carers and people with a learning disability should discuss with their GP having a blood, stool or breath test to check for H. pylori. Adding assessment for H. pylori to annual health checks will ensure screening becomes routine and may reduce complications or signs and symptoms, such as reflux and bloating.
Alternative admission process for patients with an ASD and/or an intellectual disability
People’s experiences can be improved by ensuring a smooth transition to inpatient care
Functional assessments to involve service users in a positive behaviour support plan
Evaluating a functional assessment for people with an LD and behaviour that challenges
Supporting people with learning disabilities to have blood tests
This article describes a group intervention that took place primarily in a healthcare setting
Role of a learning disability nursing network in developing students’ skills
Why you should read this article • To enhance your awareness of how online networking can enhance your practice • To gain knowledge of the benefits of using social media for nursing students and nurses • To understand how being a member of a professional network group can provide learning disability nursing students with opportunities to develop and practise leadership skills Changes in health and social care, the complex health needs of the learning disability population and diversification of learning disability nursing roles have led to an increased need for professional networking. This can assist nurses and nursing students in communicating effectively with each other, developing professional connections and sharing optimal practice and expertise worldwide. This article describes the experience of a group of learning disability nursing students who collaborated with the Scottish Learning Disability Nursing Network steering group to promote online networking among their peers and nurses. It also outlines the role of the learning disability nursing students in this collaboration and how it has enhanced their leadership skills, as well as describing the benefits of professional online networking.
Development of training programme to manage behaviour
Some children and young people with a learning disability also present with behaviour that challenges, which can require significant care input from their parents or carers. Without specialist skilled support to meet the needs of these children and young people, behaviour that challenges can continue through adolescence and into adulthood. This article explores the development of a family training programme in one NHS trust, which aimed to provide the parents and carers of children and young people with a learning disability with safe strategies to manage behaviour that challenges. The training programme assisted parents and carers to develop confidence in managing behaviour that challenges and improved the quality of life of children and young people with a learning disability.
Exploring the value of reflexivity in learning disability research
Reflexivity can be used by researchers to manage their thoughts, feelings and preconceptions
Resource Buddy: an online resource to support mindfulness-based interventions
Exploring the evidence base for mindfulness-based interventions for people with LDs