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.

Readers Theatre as an arts-based approach to education: A scoping review on experiences of adult learners and educators.

BACKGROUND: Arts-based educational methodologies have been implemented in nursing and other health disciplines to promote person-centered approaches to care. Readers Theatre has been applied as a tool to promote compassionate and holistic approaches to care. Readers Theatre is a form of drama that requires participants to read aloud a scripted narrative to the audience. OBJECTIVES: To examine the extant literature on experiences of adult learners and educators in utilizing Readers Theatre, and its potential suitability for nurse education. The review question was: "What are the learning experiences of adult students and the teaching experiences of educators in the uptake of Readers Theatre?" DESIGN AND DATA SOURCES: Scoping review guidelines proposed by Arksey and O'Malley were adopted. Academic databases searches were carried out in ProQuest, JSTOR, Scholars Portal, EBSCO, Web of Science, PubMed, Expanded Academic ASAP, and Scopus. REVIEW METHODS: The search and keyword strategy was developed by two reviewers and approved by the lead author, and a librarian. All titles and abstracts were individually examined by the two reviewers with discrepancies discussed and resolved by both parties. Data were extracted for thematic analysis. RESULTS: A total of 31 studies were selected for the final sample. Four themes were identified within the scoping review relevant to Readers Theatre teaching-learning experiences: 1) principles and characteristics; 2) awareness, understanding, caring and empathy; 3) cross-disciplinary collaboration, interdisciplinary education, and knowledge dissemination; and 4) promoting students' skills. CONCLUSIONS: Readers Theatre has the potential to be utilized within a nursing curriculum, and particularly in theory and substantive class-based courses, through active group learning, in the application phase of knowledge acquisition.

2020 Syndemic: Convergence of COVID-19, Gender-Based Violence, and Racism Pandemics.

OBJECTIVE: To conduct a rapid knowledge synthesis of literature on the social determinants of mental health of racialized women exposed to gender-based violence (GBV) during the COVID-19 pandemic. METHODS: We adapted the Cochrane Rapid Reviews method and were guided by an equity lens in conducting rapid reviews on public health issues. Four electronic databases (Cochrane CENTRAL, Medline, ProQuest, and EBSCO), electronic news media, Google Scholar, and policy documents were searched for literature between January 2019 and October 2020 with no limitations for location. Fifty-five articles qualified for the review. RESULTS: Health emergencies heighten gender inequalities in relation to income, employment, job security, and working conditions. Household stress and pandemic-related restrictions (social distancing, closure of services) increase women's vulnerability to violence. Systemic racism and discrimination intensify health disparities. CONCLUSION: Racialized women are experiencing a 2020 Syndemic: a convergence of COVID-19, GBV, and racism pandemics, placing their wellbeing at a disproportionate risk. GBV is a public health issue and gender-responsive COVID-19 programming is essential. Anti-racist and equity-promoting policies to GBV service provision and disaggregated data collection are required.

Strategies to Promote the Inclusion of Young Adults With Developmental Disabilities in Community-Based Health Studies.

We discuss strategies to promote the inclusion of people with developmental disabilities (DDs) in qualitative community-based research studies. Strategies were applied in three projects conducted between 2012 and 2017 that addressed issues of socioeconomic challenges, discrimination, and exclusion of children and young adults with developmental disabilities (YADD). Strategies included partnership with community organizations; inclusion of YADD, family caregivers (FCs), and service providers in advisory committees (ACs); and strategies to accommodate YADD. As part of our contribution, we discuss issues of invisibility and exclusion of individuals with DDs who have "low" functioning capacities. There is a need to review studies sampling inclusion criteria as they may constitute a barrier for participation. Preference for sampling "high" functioning individuals may reinforce exclusion in research, and replicate broader patterns of socioeconomic exclusion of individuals with disabilities. Our discussion of inclusive research is informed by critical disability studies and the underlying principle "nothing about us without us."

Access Barriers to Services by Immigrant Mothers of Children with Autism in Canada.

Equal access for autism services remains suboptimal for diverse groups. In Canada, little is known about the barriers immigrant mothers face accessing services and support for their children with developmental disabilities. In this qualitative study, 21 immigrant mothers of children with Autism, from a diverse ethno cultural background, were interviewed in Toronto, Canada. We apply House's (1981) four domains of social support to analyze findings. Structural support challenges, such as delays in diagnosis, fragmented and dispersed services were common, followed by instrumental challenges due to loss of social ties and stigma. Lack of expected support from partners, and negative perceptions of services, were identified as emotional and perceptive challenges. Focused attention is required to address inequalities within the context of current access pathways for autism.

Mothering children with developmental disabilities: A critical perspective on health promotion.

We present findings of a qualitative study exploring what constitutes relevant health promotion initiatives for immigrant mothers of children with developmental disabilities. We apply a social ecological approach, with a focus on gender-specific and transformative health promotion, to examine factors impacting mothers' health and wellbeing. Twenty-eight semi-structured and open-ended interviews were conducted with immigrant mothers in the greater Toronto area, Canada. Mothers identified facilitators, challenges, and strategies for their health promotion, providing relevant insights for meaningful intervention. Our findings show that immigrant mothers' health is influenced by intersecting social determinants of health, including migration status, gender, and disability.

Stressors and Barriers to Services for Immigrant Fathers Raising Children with Developmental Disabilities.

This narrative review examines research on the experiences of immigrant fathers raising children with developmental disabilities, and considers the findings within the Canadian context. Applying Green, Johnson & Adams' (Journal of Chiropractic Medicine, 5(3), 101-117, 2006) methodology, a step-by-step process was followed to conduct the review. Four databases (PsychINFO, PubMed, CINAHL and Sociological Abstracts) were used for the search. A total of 39 articles were found to be relevant after applying the inclusion/exclusion criteria. Also 20 articles from published reference lists and peer-reviewed journal articles, located through Google Scholar, complimented the initial search. Along with House's (1981) four dimensions of social support, an intersectional approach underpinned the analysis of findings. Four themes were identified which included: economic challenges, social influences, cultural influences, and the changing gender roles of fathers. Stressors and barriers to accessing health services in the post-migration setting were examined. Based on the review's findings, the paper recommends 1) addressing income inequality, 2) improving access to health care, social and developmental services, 3) improving cultural-sensitivity of health care, social and developmental services, and 4) increasing participation of fathers. Overall, a more systemic understanding of immigrant fathers' experiences is called for, taking into account their multiple social locations.