Communication barriers that affect medication adherence in patients with learning disabilities

2021 ◽  
Vol 3 (11) ◽  
pp. 447-452
Author(s):  
Jamara Hignett

Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictural explanations. Communication passports are a tool used by learning disabled patients, these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice, there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.

2021 ◽  
Vol 32 (12) ◽  
pp. 485-490
Author(s):  
Jamara Hignett

Communication formulates a large part of a consultation and as a practitioner, it is vital to communicate effectively with a patient. Jamara Hignett provides an overview of the communication barriers that affect medication adherence in patients with learning disabilities Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictorial explanations. Communication passports are a tool used by people with learning disabilities; these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice; there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.


1998 ◽  
Vol 22 (5) ◽  
pp. 306-308 ◽  
Author(s):  
Olakunle Ashaye ◽  
George Mathew ◽  
Elizabeth Rigby

This study, assessed 63 older, long-stay, learning disabled patients, the Health of the Nation Outcome Scales (HoNOS) highlighted the expected problems in areas of cognition, physical illnesses or disabilities, relationships and activities of daily living. No significant changes were observed in the problems assessed using the HoNOS over a six-month period in this group of patients with relatively stable health problems and needs. HoNOS proved to be useful in identifying some expected problems. However, further studies are needed to assess its sensitivity to changes secondary to improvement or worsening of problems along with wider use to see if its brevity allows it to give sufficient detail on the problems of persons with learning disabilities.


2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.


2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.


1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.


2021 ◽  
pp. 154041532110204
Author(s):  
Linda S. Eanes ◽  
Carolina Huerta ◽  
Lilia Azeneth Fuentes ◽  
Beatriz Bautista

Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence–based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.


2021 ◽  
pp. 089801012110627
Author(s):  
Elizabeth Kinchen

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.


2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.


1983 ◽  
Vol 50 (3) ◽  
pp. 230-240 ◽  
Author(s):  
Rena B. Lewis

This review of research addresses the teaching of reading, one of the most common concerns in the education of students with learning disabilities. First, past conceptualizations of the condition of learning disabilities are considered, then rejected in favor of the notion that learning disabled individuals are characterized by a failure to deploy cognitive resources effectively. Next, recent research on teacher effectiveness and the technology of direct instruction is examined in relation to current understandings of the nature and treatment of learning disabilities. Finally, empirically based instructional strategies for the teaching of reading to the learning disabled are suggested.


2018 ◽  
Vol 25 (4) ◽  
pp. 266-271 ◽  
Author(s):  
R. Lee Tyson ◽  
Susan Brammer ◽  
Diana McIntosh

BACKGROUND: This article summarizes the experiences that a Midwest college of nursing had when telepsychiatry was introduced for psychiatric-mental health post-master’s nurse practitioner students to use in a clinical internship. AIMS: Implications for nurse practitioner educators will be identified, and recommendations for future research will be explored. METHOD: Described are the following: (1) policies and procedures the institution considered, (2) challenges that were encountered by faculty and students, and (3) strategies and limitations of these strategies defining best practice, what didactic content should be taught, and how clinical placements needed to be structured. RESULTS: Implications for nurse practitioner educators, practice, and research are identified. CONCLUSIONS: It is clear that telepsychiatry has an important role in the clinical education of psychiatric-mental health nurse practitioners. It is working well as a clinical internship option. The college of nursing is continuing to examine and address issues and is looking forward to enhancing the telepsychiatry experiences for students in the future.


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