Exploring the Experiences and Attitudes of Healthcare Professionals Caring for People with Intellectual Disability

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)

Emily Cooper Tucker (Creator)

Institution

East Carolina University (ECU )

Web Site: http://www.ecu.edu/lib/

Abstract: People with intellectual disability experience profound health disparities and care inequities. A systematic review focusing on the implementation of community-based mental health interventions for adults with intellectual disability highlighted a dearth of research. However, disparities exist across every area of health, and are not exclusive to mental health services. Previous researchers identified two major contributing factors to the gap in healthcare (a) provider attitudes toward intellectual disability, and (b) inadequate provider training. Therefore, a transformative convergent parallel mixed methods design was conducted to expand and enhance what is available in the literature with two guiding parts to the study. Part one of the study was designed to understand the attitudes of healthcare professionals toward intellectual disability. Part two was designed to explore the experiences of primary care providers caring for adults with intellectual disability. The research question for part one was, what are the attitudes of healthcare professionals toward intellectual disability, with hypotheses that attitudes will be overall positive and may be different based on participant gender and age. Preliminary analysis of data collected from 81 healthcare professionals to date, confirms that healthcare professionals have relatively positive attitudes toward people with intellectual disability. More data is being collected to determine if differences in attitudes based on age and gender are significant. Part two of the mixed-methods study utilized focus groups to answer the following research question, what are the personal and professional experiences of primary care providers that influence how they care for adult patients with intellectual disability? A total of seven focus groups were conducted, across three different clinic locations throughout the United States. Each clinic site hosted a family medicine residency program. There were a total of 46 focus groups participants who consisted of faculty, residents, and clinic staff. Analysis yielded two thematic clusters (a) themes regarding experiences caring for patients with intellectual disability, and (b) themes regarding training needs and recommendations. Focus group data from cluster one, regarding the experiences caring for patients with intellectual disability, yielded six salient themes: (a) patient agency, (b) communication strategies, (c) systemic barriers to care, (d) deficit view of disability, (e) equitable healthcare and (f) communication of intellectual disability. Focus group data regarding the second cluster yielded one training salient theme with five subthemes: (a) guardianship processes and consent for treatment procedures (b) mental health assessment delivery and follow-up, (c) knowledge of community resources, (d) communication barriers, and (e) identifying and communicating a diagnosis of intellectual disability. Participants shared that the training sub thematic areas were largely absent in residency education curricular experiences. Results confirmed that improvements in training are needed that incorporate a contextual understanding of disability and empower providers to move past a deficit-based perspective of disability. This dissertation advances the knowledge of clinical care for adults with intellectual disability and training needs for primary care providers working with this patient population. It also serves to advance the field of medical family therapy by highlighting the important role agency, communion, and promoting equitable healthcare play in improving health outcomes for people with intellectual disability.

Additional Information

Publication

Dissertation

Language: English

Date: 2023

Subjects

intellectual disability;healthcare;health education;

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