A nurses' ethical commitment to people with intellectual and developmental disabilities

Health inequities among persons with disabilities: a global scoping review

Background and objective

Approximately 16% of the global population, or 1.3 billion individuals, live with disabilities, facing increased health risks. Despite international and national policies affirming the rights of persons with disabilities, healthcare disparities persist, with studies revealing higher rates of unmet medical needs, avoidable deaths, and dissatisfaction with healthcare services among this population. This scoping review aims to provide a comprehensive overview of health inequities experienced by individuals with disabilities globally.

Methods

A rapid scoping review methodology was employed to systematically search and analyze quantitative evidence on health inequities. Electronic searches were conducted in CINAHL, MEDLINE, and PsycINFO databases, supplemented by manual searches of reference lists. The selection criteria for articles in this study were as follows: (a) publication between 2011 and 2022, (b) written in English, (c) published in a peer-reviewed scholarly journal, and (d) a quantitative comparison of health inequities between persons with and without disabilities.

Results

A total of 363 scholarly works were initially identified, with 51 meeting the inclusion criteria after rigorous screening. In the course of our review, our team identified three overarching themes of health inequity, encompassing (a) access to healthcare and resources, (b) morbidity, mortality, & risk factors, and (c) social determinants of health. These studies collectively reveal disparities in healthcare access, utilization, and outcomes among persons with disabilities, highlighting the urgent need for targeted interventions to address systemic barriers and promote equitable healthcare provision.

Conclusion

This review underscores the challenges faced by individuals with disabilities in accessing quality healthcare and imperative for concerted efforts to advance health equity.

From legislation to actual health service: evaluation of health provisions in the disability law of Ghana by adolescents with mobility and visual impairments and their families

BACKGROUND

Despite Ghana's Persons with Disability Act, 2006 (Act 715) making provisions for access to healthcare services for adolescents with disabilities and their families, a corpus of literature has reported that persons with disabilities continue to face challenges in accessing healthcare services. However, the voices of adolescents with disabilities and their families are very scarce in such discourse. This study explored the experiences of adolescents with disabilities and their families in accessing healthcare services as per the provisions described in Ghana's Act 715.

METHODS

This study involved 45 participants, including 25 adolescents with disabilities and 20 family members from a municipality in Ghana. Employing a qualitative descriptive design, semi-structured interviews were conducted which was then analyzed thematically and interpreted using Critical Disability Theory.

RESULTS

The study identified two major categories of barriers to healthcare access: environmental (socio-economic difficulties, poor built environment, unavailability of rehabilitation services) and systemic (cultural beliefs, poor support at healthcare facilities and inadequate healthcare legislative provisions for families of children with disabilities). Despite legal provisions for free healthcare, participants faced significant financial barriers, with specialist services often not covered by the National Health Insurance Scheme.

CONCLUSIONS

The study calls for policy adjustments to fully cover specialist care under Ghana's National Health Insurance Scheme, establishment of local-level health assessment and resource centers, educational campaigns to change cultural perceptions, and training of healthcare workers to promote quality access to healthcare.

Clarification of ethical principle of the beneficence in nursing care: an integrative review

BACKGROUND

Ethics-based nursing practice can transform health care practices. As the biggest human capital in the health care system, nurses are obliged to follow ethical principles in this field. One of these ethical principles; is beneficence, which is considered the core of nursing care. This study aimed to investigate clarification of the principle of beneficence in nursing care and its related challenges.

METHODS

This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, and Scopus were searched using the keywords; "beneficence", "ethic", "nursing" and "care" in English and Persian in the time range of 2010 to 10 February, 2023. After applying inclusion criteria and assessing the articles using Bowling's Quality Assessment Tool, finally, 16 papers were included from 984.

RESULTS

After reviewing and evaluating the qualified articles, the findings were classified into four main categories: (1) nature, (2) applicability, (3) Relevant and influential factors, and (4) challenges related to the ethical principle of beneficence in nursing care.

CONCLUSION

Based on the results of this review it seems that paying attention to clarification the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle and finally, it leads to increasing the well-being and health of patients, reducing their mortality rate, increasing satisfaction and maintaining the respect and human dignity of patients.

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

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.

Are They the Same for All People? Nurses' Knowledge about the Basic Human Needs of People with Disabilities

Nursing care involves a continuous interaction between nurses and people with disabilities. This has created a need for assessment tools that measure nurses' knowledge about the basic human needs of people with disabilities. The aim of this cross-sectional study was to develop a Knowledge of Basic Human Needs Scale and investigate nurses' levels of knowledge about the basic human needs of people with disabilities and their association with nurses' education. Data were analyzed using principal component analysis to test the construct validity and to identify factors using principal varimax rotation. The reliability estimate was based on Cronbach's alpha coefficient. Linear regression models were used to assess the association between knowledge about basic human needs and predictors. Factor analysis extracted eight factors, explaining 66.3% of the total variance. The sampling adequacy, criterion validity, and internal consistency were satisfactory. The nurses' levels of education was associated with their knowledge about the basic human needs of people with disabilities. The questionnaire constitutes a valuable contribution to improving nurses' knowledge and practice, as well as the quality of healthcare, and it provides a contribution to improving the quality of life for people with disabilities.

Navigating End-of-Life Needs for a Person With Intellectual Disabilities and Their Caregivers

People with intellectual disabilities (IDs) are living longer, with many experiencing significant barriers to accessing palliative care and hospice services. Families, caregivers, and direct support professionals comprise essential portions of the community of support often surrounding a person with IDs. For a variety of reasons, including clinician bias and communication difficulties, many people with IDs are excluded from critical conversations regarding their health and life. This article uses a blended case study to explore the complexities and unique considerations in ensuring ethical and practical end-of-life care for people with IDs. Decision-making must center on the person with ID and include them in ways they can understand, thus facilitating their right to autonomy. A collaborative approach to care with shared expertise between caregivers and hospice and palliative care services is key to providing effective, patient-centered care at the end of life. There are tremendous areas of opportunity to improve end-of-life care for this population by partnering with people with IDs, their families, and caregivers.

A Comparative Case Study of Hospice and Hospital End-of-Life Care for Aging Adults With Developmental Disabilities

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end.