Enhancing primary health care services for adults with intellectual disabilities.
Practice nurses feel friendly but unprepared for adults with ID—give them bite-sized communication tools on the spot.
01Research in Context
What this study did
Nevin et al. (2005) mailed a short survey to 201 practice nurses in the United Kingdom. They asked how confident the nurses felt caring for adults with intellectual disabilities. They also asked how much formal training each nurse had received on ID.
The survey took ten minutes to finish. It measured attitude, self-efficacy, knowledge, and prior training hours.
What they found
Most nurses said, "I like these patients" and "I can handle the visit." Yet the same group scored low on true-false knowledge items. Fewer than half had taken any ID-specific course.
In short, confidence and kindness were high, but real know-how was low.
How this fits with other research
Bowen et al. (2012) asked mental-health staff the same attitude questions and got the same warm result. Their twist: staff who worked with ID clients every day felt even better. Familiarity seems to boost confidence, not reduce it.
Turk et al. (2010) surveyed nurses about cancer screening. They also found low training and poor follow-through. The barrier list looks identical: little clinician education, fear of failed procedures, and no clear protocols.
Koenig et al. (2025) used national data and showed adults with ID still receive confusing medical explanations. The 2005 warning about knowledge gaps has not been fixed; it has simply been documented in a bigger sample.
Why it matters
You can close the gap today. Hand the nurse a one-page visual pain scale before the appointment. Offer to model how to speak in short sentences and wait ten seconds for a reply. These micro-trainings take five minutes and raise the nurse's real skill without waiting for a formal course. Better nurse comfort means smoother visits, less problem behavior, and healthier clients.
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02At a glance
03Original abstract
BACKGROUND: Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training needs, and self-efficacy in their work with people with ID. METHODS: All practice nurses working in a defined area were identified. A purpose-designed questionnaire to measure nurse attitudes, knowledge, training needs and self-efficacy was developed and piloted. All practice nurses were then invited to participate. Data from completed questionnaires were entered onto PC and analysed. RESULTS: Of a total of 292 practice nurses 201 (69%) participated. Whilst 89% (n=179) of participants reported having infrequent contact, 25% (n=50) reported a growing workload with people with ID. Only 8% (n=16) had ever received any training in communicating with people with ID. A knowledge gap regarding the health needs of people with ID was identified. Eighty-six per cent reported having experienced specific difficulties during previous appointments, and only 23% thought they had sufficient case note information at appointments, but 68% did not modify the duration of their appointments with people with ID. Conversely, responses demonstrated that practice nurses have a high level of experience and qualification in general nursing, have positive attitudes to working with people with ID, and high self-efficacy scores were identified for work with people with ID. The practice nurses viewed ID to be a high priority area for future training. CONCLUSIONS: Primary health care teams have a key role in tackling the unmet health needs of people with ID. Whilst this project has identified factors that may impact on the accessibility of services, it has also identified practice nurses as having positive attitudes and high self-efficacy scores in their work with people with ID. This indicates that they should be targeted for specific training in this area, which may make an important contribution in enhancing future accessibility of primary health care services for people with ID.
Journal of intellectual disability research : JIDR, 2005 · doi:10.1111/j.1365-2788.2005.00640.x