Understanding the contribution of intellectual disability nurses: Scoping research - Volume 1 of 3: Scoping literature review report

Abstract

Introduction This scoping review of literature is the first part of a 3-phase project. The RCN Foundation commissioned the University of West London and their collaborators to undertake scoping research on understanding the contribution of nurses to improving the health and well-being of children, adults and older people with intellectual disabilities, now and for the future. The overall aim of the research is to identify nursing-led and / or nursing centred interventions that are in place to address the challenging and changing needs of people with intellectual disabilities. The research sought to identify interventions, that can be implemented by nurses working in multi-disciplinary teams. The research identifies areas of good care delivery, any innovative practices, and possible gaps in the provision of care for individuals with intellectual disabilities.

Objective The overall objective of this review is to summarise evidence on the contribution of intellectual disability nurses to improve the health and well-being of children, adults and older people with intellectual disabilities, now and for the future. Methods We searched the Joanna Briggs Institute (JBI) Reports, Medline, Embase, PsycINFO, CINAHL, Academic Search Elite, ProQuest Dissertations and Theses (Global) also known as Index to Theses, ETHOS, UK Government publications, and professional organisations’ publications. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used to select the literature for review and to present the literature review report (Tricco et al., 2018; Peters et al., 2017). A mixed methods approach to the review and synthesis was used due to the heterogeneous nature of the evidence. JBI tools were used to rate studies for quality. Thematic synthesis was used to generate analytical themes. Results We retrieved 121 publications. Of these we excluded 35 after initial appraisal. We appraised 86 publications and excluded 33 after appraisal and we included 53 publications in this review. We identified a wide range of interventions (154) performed by intellectual disability nurses in a variety of settings across the lifespan. We categorised the intellectual disability nursing interventions into three themes; effectuating nursing procedures, enhancing impact of services, and enhancing quality of life. The majority of publications reported cross-sectional studies (77%), 6% of publications were literature reviews, and 17% were opinion papers. Only two of the primary studies investigated the effectiveness of intellectual disability nurse interventions. The majority of the publications focused on interventions related to adults (31). Not all publications focussed on a particular age group. One publication referred to maternity, five focussed on interventions relevant to children, ten identified interventions relevant to all age groups, five focussed on older adults, five focussed on end of life interventions and one publication was not clear. Conclusions We identified 154 interventions performed by intellectual disability nurses in a variety of settings. We categorised the interventions into three themes; Effectuating nursing procedures (52 interventions), Enhancing impact of services (73 interventions), and Enhancing quality of life (41 interventions). Publications identifying the interventions performed by intellectual disability nurses in relation to maternity, children, older adults and end of life care were limited. Publications did not demonstrate the impact and effectiveness of interventions. This advocates for high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly reviewed.