title: Enhancing primary health care services for adults with intellectual disabilities.
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.
authors.affiliation: Section of Psychological Medicine, University of Glasgow, Glasgow, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Melville
authors.forename: J
authors.initials: J
authors.lastname: Finlayson
authors.forename: S-A
authors.initials: SA
authors.lastname: Cooper
authors.forename: L
authors.initials: L
authors.lastname: Allan
authors.forename: N
authors.initials: N
authors.lastname: Robinson
authors.forename: E
authors.initials: E
authors.lastname: Burns
authors.forename: G
authors.initials: G
authors.lastname: Martin
authors.forename: J
authors.initials: J
authors.lastname: Morrison
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006801:Humans; D008607:Intellectual Disability; D020380:Needs Assessment; D009723:Nurse-Patient Relations; D009743:Nursing, Practical / Q000193:education* / Q000592:standards; D010348:Patient Care Team / Q000592:standards*; D019989:Persons with Intellectual Disabilities; D011321:Primary Nursing / Q000592:standards* / Q000706:statistics & numerical data; D012606:Scotland; D011795:Surveys and Questionnaires; D016526:Workload