Hemşirelerin Zihinsel Yetersizliği Olan Hastaların Klinik Bakımına Yönelik Görüşleri

Year 2025, Volume: 6 Issue: 2, 90 - 104, 01.10.2025

Hatice Yıldırım Sarı , Aslı Alaca , Saime Yıldırım , Nalan Karaoğlan , Aslı Çatıkoğlu , Beste Özgüven Öztornacı

https://doi.org/10.70479/thdd.1657652

Abstract

Amaç: Bu çalışma ile zihinsel yetersizliği olan hastaların klinik bakımına yönelik yetişkin ve çocuk hemşirelerinin görüşleri, uygulamaları ve yaşanan güçlüklerinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Araştırma tanımlayıcı tipte olup, TREND kontrol listesine uygun olarak düzenlenmiştir. Örneklem 190 hemşireden oluşmaktadır. Veriler internet ağı üzerinden çevrimiçi teknoloji yöntemi ile ulaşılan hemşilere anket uygulanarak toplanmıştır. Etik kurul izni ve araştırmaya katılan hemşirelerden gönüllü olur formu ile onay alınmıştır. Confidential Inquiry into Premature Deaths of People with Intellectual Disabilities (CIPOLD) çalışmasındaki anketten yola çıkılarak hazırlanan ankette, tanımlayıcı bilgiler ve zihinsel yetersizliği olan bireyin bakımına ilişkin bilgi soruları yer almaktadır.
Bulgular: Çalışmada yer alan hemşirelerin %85.8’i kadın olup, %60.9’u lisans mezunu, %37.9’u çocuk hastalara bakım vermektedir. Hemşirelerin %18,9’u zihinsel yetersizliği olan hastalara sürekli olarak bakım vermektedir. Hemşirelerin %42.1’i zihinsel yetersizliği olan hasta bakımı ile ilgili mezuniyet öncesi eğitim aldığını ve %17.9’u hizmet içi eğitim almadığını bildirmiştir. Hemşirelerin %86.3’ü zihinsel yetersizliği olan hastaya bakım verirken güçlük yaşamakta olup bu hemşirelerin %58.9’u hastalarla iletişim kurmakta güçlük yaşadığını belirtmektedir.
Sonuç: Bu araştırmanın sonucunda gerek yetişkin gerekse çocuk hemşirelerinin zihinsel yetersizliği olan hastalara bakım verirken başta iletişim güçlüğü olmak üzere bazı güçlüklerle karşılaştığı belirlenmiştir.

Keywords

Hasta güvenliği , hemşirelik bakımı , zihinsel yetersizlik

Ethical Statement

Araştırmanın Etik Yönü T.C. İzmir Katip Çelebi Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu Kurulu’ndan (Karar no:0575/Tarih:23.12.2021) izin alınmıştır. Veri toplama işleminde hemşirelere araştırma hakkında bilgi verilmiştir. Araştırmaya katılmaya gönüllü olan hemşireler çalışmaya dahil edilmiştir. Çevrimiçi yöntem ile veri toplamada bireylerden anket formunun önüne eklenen etik beyan ile yazılı onam alınmıştır.

Supporting Institution

Destekleyen kurum bulunmamaktadır.

Thanks

Araştırma grubu olarak katılan hemşirelere teşekkür ederiz.

Nurses' Opinions on Clinical Care of Patients with Mental Disabilities

Abstract

Aim: The aim of this study was to examine the opinions, practices and difficulties experienced by adult and paediatric nurses regarding the clinical care of patients with intellectual disability.
Material and Methods: The study is descriptive and organized in accordance with the TREND checklist. The sample consisted of 190 nurses. The data were collected by applying a questionnaire to the nurses reached by online technology method over the internet network. Ethics committee approval and consent was obtained from the nurses participating in the study with a voluntary consent form. The questionnaire, which was prepared based on the questionnaire in the Confidential Inquiry into Premature Deaths of People with Intellectual Disabilities (CIPOLD) study, includes descriptive information, information questions on the care of the individual with intellectual disability.
Results: Among the nurses in the study, 85.8% were female, 60.9% had a bachelor's degree, and 37.9% cared for paediatric patients. 18.9% of the nurses continuously care for patients with intellectual disability. It was reported that 42.1% of the nurses received pre-graduation training on the care of patients with intellectual disability, 12.1% received no training and 17.9% did not receive in-service training. 86.3% of nurses have difficulty in caring for patients with intellectual disability and 58.9% of these nurses state that they have difficulty in communicating with patients.
Conclusion: As a result of this study, it was determined that both adult and paediatric nurses faced some difficulties, especially communication difficulties, while caring for patients with intellectual disabilities.

Keywords

Mental disabilities , nursing care , patient safety

References

• 1. Tuffrey-Wijne I, Goulding L, Gordon V, Abraham E, Giatras N, Edwards C, Gillard S, Hollins S. The challenges in monitoring and preventing patient safety incidents for people with intellectual disabilities in NHS acute hospitals: Evidence from a mixed-methods study. BMC Health Services Research. 2014; 14(1): 432. https://doi.org/10.1186/1472-6963-14-432
• 2. World Health Organization, WHO Global report on health equity for persons with disabilities. 2 December 2022. https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/global-report-on-health-equity-for-persons-with-disabilities
• 3. Yu A, Flott K, Chainani N, Fontana G, Darzi A. Patient safety 2030. London: NIHR Imperial Patient Safety Translational Research Centre. 2016; 45.
• 4. Heslop P, Blair PS, Fleming P, Hoghton M, Marriott A, Russ L. The Confidential Inquiry into premature deaths of people with intellectual disabilities in the UK: A population-based study. Lancet (London, England). 2014; 383(9920): 889-895. https://doi.org/10.1016/S0140-6736(13)62026-7
• 5. Trollor, J., Srasuebkul, P., Xu, H., & Howlett, S. (2017). Cause of death and potentially avoidable deaths in Australian adults with intellectual disability using retrospective linked data. BMJ Open, 7(2), e013489. https://doi.org/10.1136/bmjopen-2016-013489
• 6. Lacono T, Bigby C, Unsworth C, Douglas J, Fitzpatrick P. A systematic review of hospital experiences of people with intellectual disability. BMC Health Services Research. 2014; 14: 505. https://doi.org/10.1186/s12913-014-0505-5
• 7. Mimmo L, Harrison R, Hinchcliff R. Patient safety vulnerabilities for children with intellectual disability in hospital: A systematic review and narrative synthesis. BMJ Paediatrics Open. 2018; 2(1): e000201. https://doi.org/10.1136/bmjpo-2017-000201
• 8. Heslop P, Blair PS, Fleming P, Hoghton M, Marriott A, Russ L. The Confidential Inquiry into premature deaths of people with intellectual disabilities in the UK: a population-based study. Lancet. 2014 Mar 8;383(9920):889-95. doi: 10.1016/S0140-6736(13)62026-7. Epub 2013 Dec 11. PMID: 24332307.
• 9. Tuffrey-Wijne I, Giatras N, Goulding L, Abraham E, Fenwick L, Edwards C, Hollins S. Identifying the factors affecting the implementation of strategies to promote a safer environment for patients with learning disabilities in NHS hospitals: A mixed-methods study. NIHR Journals Library. 2013. http://www.ncbi.nlm.nih.gov/books/NBK259489/
• 10. Gibbs SM, Brown MJ, Muir WJ. The experiences of adults with intellectual disabilities and their carers in general hospitals: A focus group study. Journal of Intellectual Disability Research: JIDR. 2008; 52(12): 1061-1077. https://doi.org/10.1111/j.1365-2788.2008.01057.x
• 11. Sağlık Bakanlığı (SB). (2023). Sağlık İstatistikleri Yıllığı. 20.09.2025 tarihinde https://www.saglik.gov.tr/TR-107086/saglik-istatistikleri-yilligi-2023-yayinlanmistir.html adresinden erişildi.
• 12. Drozd M, Clinch C. The experiences of orthopaedic and trauma nurses who have cared for adults with a learning disability. International Journal of Orthopaedic and Trauma Nursing. 2016; 22: 13-23. https://doi.org/10.1016/j.ijotn.2015.08.003
• 13. Bradbury-Jones C, Rattray J, Jones M, Macgillivray S. Promoting the health, safety and welfare of adults with learning disabilities in acute care settings: A structured literature review. Journal of Clinical Nursing. 2013; 22(11-12): 1497-1509. https://doi.org/10.1111/jocn.12109
• 14. Sowney M, Barr O. The challenges for nurses communicating with and gaining valid consent from adults with intellectual disabilities within the accident and emergency care service. Journal of Clinical Nursing. 2007; 16(9): 1678-1686. https://doi.org/10.1111/j.1365-2702.2006.01642.x
• 15. Hemsley B, Balandin S, Worrall L. The “Big 5” and beyond: Nurses, paid carers, and adults with developmental disability discuss communication needs in hospital. Applied Nursing Research: ANR. 2011; 24(4): e51-58. https://doi.org/10.1016/j.apnr.2010.09.001
• 16. Merrifield J. Meeting the needs of people with a learning disability in the emergency department. International Emergency Nursing. 2011; 19(3): 146-151. https://doi.org/10.1016/j.ienj.2010.07.004
• 17. Webber R, Bowers B, Bigby C. Hospital experiences of older people with intellectual disability: Responses of group home staff and family members. Journal of Intellectual & Developmental Disability. 2010; 35(3): 155-164. https://doi.org/10.3109/13668250.2010.491071
• 18. Aston M, Breau L, MacLeod E. Diagnoses, labels and stereotypes: Supporting children with intellectual disabilities in the hospital. Journal of Intellectual Disabilities. 2014; 18(4): 291-304. https://doi.org/10.1177/1744629514552151
• 19. Lewis S, Stenfert-Kroese B. An Investigation of Nursing Staff Attitudes and Emotional Reactions Towards Patients with Intellectual Disability in a General Hospital Setting. Journal of Applied Research in Intellectual Disabilities. 2010; 23(4): 355-365. https://doi.org/10.1111/j.1468-3148.2009.00542.x
• 20. Brown FJ, Guvenir J. The experiences of children with learning disablilities, their carers and staff during a hospital admission. British Journal of Learning Disabilities. 2009;37(2):110-115. https://doi.org/10.1111/j.1468-3156.2008.00522.x 21. Croot EJ. The care needs of Pakistani families caring for disabled children: How relevant is cultural competence? Physiotherapy. 2012; 98(4): 351-356. https://doi.org/10.1016/j.physio.2011.05.001
• 22. https://www.who.int/news-room/fact-sheets/detail/patient-safety
• 23. Ong N, Boulton K, Milne J, Tomsic G, Guastella A, Silove N, ve diğ. Identifying Patient Safety Competencies for Healthcare Staff Treating Children and Young People With Intellectual Disability in Hospitals: A Delphi Study. Journal of Applied Research in Intellectual Disabilities, 2025; 38:e13329. https://doi.org/10.1111/jar.13329
• 24. Howick J, Bennett-Weston A, Solomon J, Nockels K, Bostock J, Keshtkar L. How does communication affect patient safety? Protocol for a systematic review and logic model. BMJ Open. 2024 May 27;14(5):e085312. PMID: 38802275; PMCID: PMC11131125. doi: 10.1136/bmjopen-2024-085312.
• 25. Morad M, Morad T, Lis T. Safety Of The Patient Wıth Disability. Harefuah. 2022; 161(4):255-259.
• 26. Pratt K, Baird G, Gringras P. Ensuring successful admission to hospital for young people with learning difficulties, autism and challenging behaviour: A continuous quality improvement and change management programme. Child: Care, Health and Development. 2012; 38(6): 789-797. https://doi.org/10.1111/j.1365-2214.2011.01335.x
• 27. Yıldırım Sarı, H. (2024) Engelli Çocuk ve Etik. İçinde: Hemşirelik ve Etik. Ed: Turan N, Aydın A. İstanbul University Press, 2024, İstanbul, ss: 371-385)