Tacy: Historical Background

Brittney Tacy, NURS 7455

Introduction

 Although research on adults with intellectual disabilities is growing, there are still many gaps in the research. One of the gaps is in the area of having a healthy lifestyle and the challenges of health promotion for people with intellectual disabilities. More specifically, providing nutrition services and nutrition intervention programs for adults with adults with intellectual disabilities, which is highly, influenced by the communication between direct care staff providing care for adults with intellectual disabilities. A brief literature review outlines how current research can be applied in the future to bridge the gaps in research for this population and that have also influenced the focus of my dissertation.

Lorentzen, Bente., Wikstrom, Britt-Maj. (2012). Healthy lifestyles for people with intellectual disabilities through a health intervention program. Open Journal of Nursing, 2, 157-164. doi.or/10.4236/ojn.2012.23024.

According to Lorentzen and Wikstrom (2012) there is a lack of research related to health care service and public health interventions for people with intellectual disabilities and also a lack of information on how nurses can support people with disabilities by reducing health disparities. Using a qualitative method research design, the researchers were able to determine that there is a knowledge base about healthy lifestyles, physical activity, and healthy food. In addition, social interaction and self-determination were key aspects of life for adults with intellectual disabilities (Lorentzen et al, 2012).

The results from this study are important for future researchers because it shows that adults with intellectual disabilities do have an understanding of healthy behaviors and future programs should aim to do more than simply educate this population on healthy behaviors. Also, with social interaction and self-determination being aspects of their lives, they should be built into the programs as well. For example, the article outlines how dancing can bring people together and help build friendships (Lorentzen et al, 2012). Moving beyond basic information and creating meaningful prevention programs should be a focus area for future research; however, this study should be replicated with adults with more severe intellectual disabilities to see if the same conclusions are drawn. This study was also limited in the sense that the sample size was 13.

Naaldenberg, Jenneken. Kuijken, Noortje., Dooren, Kate van., van Schrojenstein Lantman de valk, Henny. (2013). Topics, methods and challenges in health promotion for people with intellectual disabilities: A structured review of literature. Research in Developmental Disabilities, 34, 4534-4545. doi.org/10.1016.j.ridd.2013.09.029.

Naaldenberg et al (2013) conducted a review of literature and found studies on adults with intellectual disabilities identified substantial challenges for recruiting, implementing interventions, and the selection of outcomes, measures, and the usability of measures themselves. Based on the review of literature the researchers recommend the need for more theoretically driven studies that take into account the views and expectations of the participants and also examines the reliability and validity of outcome measures for the ID population (Naaldenberg et al, 2013). The results from the literature review are invaluable for researchers and future studies. The recruitment and implementation of prevention programs needs to be studied to help guide research in the right direction. Without the knowledge of what the best method of recruitment is or how best to implement a prevention program, we run the risk of seriously offending the target population and also ignoring their basic need to be involved in research focusing on their community.

The main limitation of this study was the number of articles reviewed (25), and whether or not the same results would be concluded if that number was greater or different inclusion criteria were used. This study should be duplicated to include more articles and also different criteria to determine if there is a consistent pattern in current literature.

Van Riper CL, Wallace LS. (2010). Position of the American dietetic association: Providing nutrition services for people with developmental disabilities and special health care needs. Journal of the American Dietetic Association, 110, 296-307. Doi:10.1016/j.jada.2009.12.003.

In a position statement from the American Dietetic Association (2010), nutrition services should be provided by registered dietitians (RD) and dietetic technicians registered (DTRs), as part of a comprehensive care plan for all people with developmental disabilities and special health care needs. Furthermore, nutrition services should be provided throughout their lifetimes in a fashion that is interdisciplinary, family oriented, community-based, and finally culturally competent (Van Riper et al, 2010). Based on this statement it is clear that there is more to creating nutrition interventions or programs for the ID population. Factors such as growth alteration, metabolic disorders, poor feeding skills, medication-nutrient interactions, and partial or total dependence on eternal or parental nutrition need to be addressed in nutrition plans targeting people with intellectual disabilities. For future research, including RDs and DTRs in the creation prevention and treatment programs is paramount.

King Jl, Pomeranz JL, Merten JW. (2013). Nutrition interventions for people with disabilities: A scoping review. Disability and Health Journal. Doi: 10.1016/j.dhjo.2013.12.003.

In a review conducted by King, Pomeranz, and Merten (2013) that looked at sixteen articles on community based nutrition intervention for adults with intellectual disabilities, there was some success in improving health outcomes. Due to the fact that many people with disabilities are less likely to utilize traditional preventative health services, such as nutrition programs it is important to identify any nutrition plan targeting this population that has had positive results (King et al, 2013). Based on this review, future researchers can begin to create studies based on the limitations identified such as small sample size, lack of follow-up studies, and the need for comparison groups. Researchers now have a better understanding of where there are gaps and what they can do to help minimize them and improve research for the adult with intellectual disability population. This source was limited in the sense that is was a scoping review instead of a systematic review, but still provided some good direction for future research with a more in depth look at the research beforehand.

McConkey, R., Morris, I., Purcell, M. (1999). Communications between staff and adults with intellectual disabilities in naturally occurring settings. Journal of Intellectual Disability Research, 43(3), 194-205.

The previous reviews discuss the importance of healthy lifestyles, the challenges of health promotion efforts, and nutrition interventions and those challenges, one main aspect to keep in mind is the interaction between staff and clients which is discussed in the study conducted by McConkey, Morris, and Purcell. According to McConkey et al, the communication efforts between staff and clients’ need drastic improvement (1999). The study indicated that when working with nonverbal clients staff relied most heavily on verbal questions and also did not adapt the questions to the level of understanding for the clients (McConkey et al, 1999). This article is important for future research because it describes a very important topic when evaluating current and future prevention or treatment programs. Was the language used appropriate and in a method similar to that used by the participants? Although this study is older, it still outlines something people often forget when working with adults with intellectual disabilities, that being communication.

Conclusion

The brief review has given me valuable knowledge when conducting research with adults with intellectual disabilities such as understanding the need for more creative programs. Programs should move beyond providing basic knowledge and include activities that will encourage behavior change. There are many challenges when conducting research for this population and there is limited information regarding how to recruit participants and to implement an intervention program. Nutrition programs should include licensed professionals based on the additional needs of this population such as medication-nutrient interactions. There are few nutrition programs that have shown some positive results in place that could be adapted to be more successful and work in different communities across the country. Finally, the communication used when working directly with the target population needs to be tailored to meet their needs both verbally and for difficulty/understanding. Again, these articles have shaped the focus of my dissertation.