Paper
Friday, July 23, 2004
10:00 AM - 10:30 AM
Friday, July 23, 2004
3:00 PM - 3:30 PM
Development of an Observational Tool to Identify GERD in At-Risk Older Adults With Mental (Intellectual) Disabilities
Wendie Medina, RN, MS, ND, Mennonite College of Nursing, Mennonite College of Nursing, Illinois State University, Normal, IL, USA
| Learning Objective #1: n/a |
| Learning Objective #2: n/a |
Significance:Nurses in the field of mental retardation and developmental disabilities supervise staff caregivers implementing nursing care/supports to adults with intellectual disabilities, in congregate settings like community day training centers. Implications:Delegation necessitates staff be knowledgeable and trained in observing, recognizing and reporting potential signs/symptoms of mental or physical distress. Problem:As adults with intellectual disabilities age, physiologically their risk for gastroesophageal reflux disease (GERD) increases. Challenging communicative modes-predominantly behavioral/non-language based- and staff caregivers’ minimal or lack of training in non-verbal communications of distress, GERD signs/symptoms, and GERD treatment places this population at high risk of unidentified/untreated GERD. Purpose:This research establishes baseline data on behavioral communication of potential GERD distress signs/symptoms, like participation in daily activities and sleep disturbances. Objective:Development of a tool for staff caregivers to identify factors and behavioral/non-language responses that may be the only way adults with intellectual disabilities communicate their physical distress from GERD follows. Methods:A convenience sample of 15 subjects (Axis II diagnoses: severe/profound mental retardation) at day training sites in Illinois was used for phenomenological observations of behavioral/non-language responses over six weeks. The site's behavior tracking record, familiar to staff, was employed to document observations, participation in daily activities, sleep disturbances. Review of subject records to identify additional GERD risk factors was completed. Data analysis included descriptive statistics, frequencies, tables and spreadsheets. Results:Literature-based GERD risk factors (observed or identified in subject records) were correlated with behavioral/non-language responses potentially indicative of pain/suffering from GERD, and disturbances in daily activity participation and sleep. Application to Practice:Development of a staff caregiver intervention blending communication concepts, nursing process, and Watson’s theory of caring is the next step. Conclusion:User-friendly procedures, GERD assessment instrumentation, and staff training program for caregivers’ caring recognition, identification and treatment of GERD in adults with intellectual (mental) disabilities are the evidence-based applications of this research.
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Sigma Theta Tau International
July 22-24, 2004