A cross‐practice context exploration of nursing preparedness and comfort to care for people with intellectual disability and autism

Abstract

Aims and Objectives To compare the self‐perceived preparedness, knowledge, comfort and confidence of Australian Registered Nurses when caring for people with ID and/or ASD across contexts of practice: primary care and community, intensive care, acute hospital, emergency department, paediatrics and ID/ASD. Background There is limited research comparing nursing preparedness and competency when caring for people with intellectual disability (ID) and/or autism (ASD) across nursing contexts of practice. A greater understanding of the differed educational preparedness, confidence and comfort across contexts of practice can aid the development of tailored educational programmes to improve nursing capacity to care for this cohort. Design Cross‐sectional descriptive study. Methods A descriptive survey tool of registered nurses (n = 69.3). Comparative inferential analysis was undertaken between the independent categorical variable of six nursing contexts of practice across several dependent variables including age, years since registration, educational content and exposure, knowledge, comfort and confidence. This cross‐sectional study was undertaken according to the STROBE Statement checklist of items. Results Occupying an ID/ASD nursing role was significantly associated with higher reported levels of educational preparedness, professional development and postgraduate education relevant to caring for people with ID and/or ASD. Levels of self‐reported knowledge of care issues, confidence and comfort when undertaking healthcare tasks was significantly associated with the context of practice, with nurses working in ID/ASD settings reporting the highest levels across all variables. Conclusion The findings of the study highlight an association between greater educational exposure to content relevant to working with people with ID/ASD and subsequently working in that field. Relevance to clinical practice This study has highlighted that professional development programmes aiming to improve nursing capacity to care for people with ID and/or ASD, should be informed by and address differing gaps in confidence, comfort and educational preparedness across nursing contexts of practice.

Barriers to communication with people with developmental disabilities: A reflexive thematic analysis

“…A study into the efficacy of an online Continuous Practice Development program focused on nursing care of people with Intellectual Disability and/or autism in mainstream health settings, which involved synchronous and asynchronous learning opportunities, demonstrated statistically significant difference in self-reported comfort, confidence, and preparedness to provide care to people with Intellectual Disability and/or autism as compared with baseline (Cashin et al, 2023). Further study is needed, but it is likely that increasing appropriate undergraduate and post graduate content in nursing program will achieve similar outcomes.…”

“…This reality extends to nurses having low levels of awareness and knowledge related to Intellectual Disability and/or autism (Appelgren et al, 2018), as well as feeling unprepared to care for people with Intellectual Disability and/or autism (Howie et al, 2021). For instance, a national survey of 693 Australian Registered Nurses, the largest survey of nurses related to care of people with Intellectual Disability and/or autism identified internationally, reported that nurses have low levels of relevant educational experience and self‐perceived confidence and competence when caring for people with Intellectual Disability and/or autism in mainstream health settings (Cashin, Pracilio, Buckley, Kersten, et al, 2022; Cashin, Pracilio, Buckley, Morphet, et al, 2022). Additionally, a self‐perceived knowledge deficit in nurses in the concept of making reasonable adjustments to practice was identified (Wilson et al, 2022).…”

Intellectual disability healthcare in Australia: Progress, challenges, and future directions

“…The intellectual disability health sector in Australia has strong roots in primary care, where a lot of early research and pivotal work around the utility of health assessments was undertaken (e.g., Lennox et al, 2010). More recent research has focused on understanding knowledge and skill gaps in our health workforce (e.g., Cashin et al, 2022) and describing how people with intellectual disability use our health system to inform service planning (e.g., Srasuebkul et al, 2021). Groundwork, including Medicare reimbursement and collation of evidence of effectiveness, has been laid to support routine application of comprehensive annual health assessments by GPs.…”

“Someone Like Anyone Else”: A Qualitative Exploration of New Zealand Health Professional Students’ Understanding of Disability

“…A supported interprofessional discussion with disabled people enabled a critical reflection on the merits and limitations of the social and biomedical models of disability and health [55]. For already practicing HPs, these personal and professional strategies might also prove valuable, especially for HPs who have not specialized in working with a specific disabled population (for example, intellectual disability) and who demonstrate more negative attitudes and emotions towards these people, compared to HPs who benefit from greater exposure whilst working [22,23,27,28].…”

“…Similar to practicing HPs, these behaviors arose from a lack of confidence with approaching disabled people and a feeling of being 'overwhelmed' due to a lack of training with positive disability-specific experiential learning opportunities [15]. Previous surveys of registered nurses have shown preparedness via upskilling and postgraduate learning opportunities is associated with more comfort and knowledge to care for people with intellectual disability and autism [27,28].…”