Learning Disability Nursing (Doc)
Added on 2021-04-16
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Running head: NURSINGLearning Disability NursingName of student:Name of university:Author note:
1NURSINGIntroductionLearning disability nurses are entailed to carry out professional practice with the aim ofproviding specialist healthcare and support to individuals with learning disability and theirfamilies, and guide them in a manner that is supportive of a better quality of life. Practicedevelopment in learning disability can be achieved through engagement in continual researchand translation into practice after critical appraisal of the research available. Against the growingtrends of obesity prevalence across the globe, the need of management of obesity amongindividuals with the learning disability has been acknowledged. Individuals are likely to face co-morbid conditions as a result of obesity such as hypertension and type 2 diabetes which leads toincreased burden on individuals as well as caregivers. The present essay aims to address theresearch question of how management of obesity can be done among individuals with learningdisability. The paper discusses the evidence gathered around the topic and analyses theirfeasibility, appropriateness, meaningfulness and effectiveness. Based on the appraisal, the bestpractice for the issue is identified. Next, analysis of the factors is done that would inhibit orpromote the implementation of the best practice. The following section uses a changemanagement model for showing how the change can be implemented. Moving on, theinvolvement of service users and stakeholders in implementation of the change is highlighted.The conclusion summarizes the key points from the paper. For answering the research question, it was appropriate to search for relevant researcharticles in electronic databases. Medline, Science Direct and CINHAL were some of thedatabases referred to. Peer-reviewed articles reflecting on the chosen topic were selected withpublication year not beyond 2013. Five articles were selected for the paper that gave maximalinformation of the concerned practice area.
2NURSINGDiscussion of evidencesSpanos, Melville and Hankey (2013) carried out research for evaluating the clinicaleffectiveness of weight management interventions in individuals with learning disabilities andobesity. The evaluation was done with the help of recommendations presented in updated clinicalguidelines on first line management of obesity. A systematic literature review was carried outwith papers published between the years 1982 and 2011 found in reputed databases. Theevaluation was done, and 22 papers were included. The classifications of interventions weredone as per the components of behaviour change alone, behaviour change plus physical activity,dietary advice or physical activity alone, dietary plus physical activity advice and multi-component. Eight studies focused on multi-component interventions, while no study includedexercise programs. Three studies were successful in highlighting significant weight loss ofindividuals at six months after implementation of the intervention. The studies did not supportany particular interventions on the basis of effectiveness. The study indicated that there is a needfor examination of the usefulness of multi-component weight management interventions in thisregard. The main focus on the study was therefore in multi-component interventions, whosefeasibility is hindered by the fact that a combination of physical activity and diet with abehaviour change strategy for influencing lifestyle might be difficult to design. The interventionis nevertheless appropriate since the key factors related to obesity that is diet, physical activityand health behaviour are addressed through it. It is meaningful since individuals can relate to theintervention and gain a positive experience out of it. However, the effectiveness of theintervention is limited, as pointed out by the review. Beeken et al. (2013) assessed a manualised weight management program (Shape Up-LD)addressing obese and overweight individuals with mild to moderate learning disabilities. The
3NURSINGstudy was a pilot randomized controlled trial. The background to the study was that a rich pool ofliterature highlight that individuals with learning disabilities come across drastic consequences ofobesity. The study focused on recruiting 60 obese and overweight individuals with mild-moderate learning disabilities as well as their caregivers. Shape Up-LD was proposed to be theintervention provided in addition to usual care. The manualised intervention involved 12 weeklysessions including messages on healthy eating messages, information on physical activity andapplicability of behaviour change methods for helping people consider proper management oftheir weights. Feasibility outcomes included recruitment rates, compliance rates, completionrates, loss to follow-up, a collection of information for cost-effectiveness analysis and anestimation of the treatment effect on weight. Weight loss can be achieved through Shape Up-LDthat leads to better quality of life. This marks the effectiveness of the intervention. Theintervention is practical as educational sessions can be easily carried out in support of skilledhealthcare workers. The intervention is meaningful since patients are likely to have a positiveopinion about the intervention. Since the knowledge gap between the individuals would beaddressed through the intervention, the beliefs and thoughts related to it would be appreciated. Willems et al. (2016) carried out a systematic review of utilization of behavior changetechniques integrated into lifestyle change interventions for individuals with learning disabilities.The review considered examining how behavioural change techniques can increase physicalactivity and enhance nutrition. It is noteworthy to be mentioned in this regard that obesity can bemanaged through dietary changes and increased physical activity. 45 studies were included in thesystematic review, and for assessment of the quality of interventions, the researchers considereduse of Physiotherapy Evidence Database. The results indicated that behavior change techniqueswere directed at providing information about behavior changes. The studies included were of low
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