The lived experiences of registered nurses caring for people with intellectual disability in the acute care hospital context in Australia

Background People with intellectual disability (ID) experience poorer health outcomes than the general population. One of the barriers to quality healthcare is lack of knowledge and understanding of ID by nurses (Trollor et al., 2017). The near absence of ID content in pre-registration nursing curricula plays a part in the poor understanding of the varied and complex healthcare needs of this vulnerable population leading to negative attitudes and subsequent shortfalls in the provision of quality care (Howie et al., 2021). Rationale/Justification It is important to understand the experiences of acute care RNs when providing care in the absence of any meaningful ID education, given the recognised extra skills required to facilitate appropriate and quality nursing care. An extensive search of the literature determined no studies have been conducted concerning the lived experience of RNs caring for people with ID in the acute care hospital context, both internationally and in Australia, which provided a rationale for this study to be undertaken. Expected Outcomes Knowledge generated from this proposed study will provide new insights and understanding available to clinicians and health care services. Through an evidenced-based approach, such knowledge has the potential to guide nursing practice, nurse educators and curriculum designers, and policy makers at all levels of health service provision, including the Council of Deans for Nursing and Midwifery. Aims/objectives/research question The aim of this study was to explore the lived experiences of registered nurses (RNs) in caring for people with ID in the acute care hospital context in Australia. The study research objectives were: i) to understand the lived experience of RNs, as described by them, in caring for a person with ID, and ii) to describe how individuals made sense of their experience in caring for a person with ID. The research question posed was: What is the lived experience of registered nurses caring for people with intellectual disability in the acute care hospital context in Australia? Research design and methods The methodological approach chosen to best answer the research question was descriptive phenomenology informed by the works of Husserl (1859-1938) and adopting Colaizzi’s (1978) seven-step data analytical framework. Participant details The number of participants is expected to be between 10 to 15. The inclusion criteria are Registered nurses who: • were involved in the direct care of a person with ID in the past four years. • have worked in a private or public hospital, or who have worked in community settings involving admissions and discharges of people with ID in an acute care facility in any State or Territory of Australia. Participants will be asked to attend two interviews. The first interview will take one hour or more. The second interview is to confirm that data analysed from the first interview is true and correct and will take about 30 minutes. Interviews will be conducted face-to-face, on Skype, or by phone at a mutually agreed place and time. Interviews will be audio recorded and later transcribed by a professional transcriber. Process of Recruitment An advertisement will be placed in a number of nursing magazines or journals that have a national circulation inviting interested potential participants to be part of the study. The advertisement will contain information about the study, level of expected involvement, and contact details of the researcher, inviting interested registered nurses to make contact by phone or by email. Results/outcomes/future plans Participants will be sent a summary of the written report if consent is given. Dissemination of findings will be through a thesis, publications in peer reviewed journals, and at national and international conferences.

研究背景
与普通人群相比，智力障碍（intellectual disability, ID）人群的健康转归更差。优质医疗服务的障碍之一在于护士对ID缺乏认知与了解（Trollor等，2017）。护理专业注册前课程中几乎未涉及ID相关内容，这也是导致护士对这一弱势群体多样且复杂的医疗照护需求认知不足，进而产生负面照护态度、最终难以提供优质护理的原因之一（Howie等，2021）。

研究依据
鉴于为智力障碍人群提供优质护理需具备额外的专业技能，在未接受过系统ID相关教育的前提下，了解急症科室注册护士（registered nurses, RNs）的照护体验具有重要意义。经广泛文献检索发现，目前国际及澳大利亚范围内均无针对急症病房注册护士照护ID人群的真实体验相关研究，这正是本研究开展的依据。

预期成果
本拟开展研究所得的研究结果，将为临床医护人员与医疗服务机构提供全新的认知与理解视角。基于循证实践的研究成果，可用于指导各级医疗服务体系中的护理实践、护理教育者与课程设计者，以及政策制定者——其中包括护理与助产学院院长委员会（Council of Deans for Nursing and Midwifery）。

研究目标与问题
本研究旨在探索澳大利亚急症病房注册护士（RNs）照护ID人群的真实照护体验。本研究的具体目标包括：① 按照注册护士自身的表述，了解其照护ID人群的真实体验；② 阐释受访者如何解读自身照护ID人群的经历。本研究提出的研究问题为：澳大利亚急症病房中，注册护士照护智力障碍人群的真实体验为何？

研究设计与方法
为精准解答研究问题，本研究采用由胡塞尔（1859-1938）理论支撑的描述现象学方法，并采用Colaizzi（1978）提出的七步数据分析框架。

研究对象详情
预计纳入10~15名研究对象。纳入标准如下：① 近四年内曾直接照护过ID人群；② 曾在澳大利亚任意州或领地的私立/公立医院工作，或曾在涉及急症病房ID患者收治与出院的社区医疗机构工作。所有研究对象需参与两次访谈：首次访谈时长为1小时及以上，第二次访谈时长约30分钟，用于确认首次访谈所得分析数据的真实性与准确性。访谈可采用面对面、Skype或电话形式，在双方协商一致的时间与地点开展。访谈将进行音频录制，后续由专业转录员完成转录工作。

招募流程
本研究将在多家全国发行的护理类杂志与期刊刊登招募广告，邀请有意向的潜在研究对象参与。广告中将包含本研究的相关信息、预期参与程度说明，以及研究者的联系方式，有意向的注册护士可通过电话或电子邮件与研究者取得联系。

研究结果与后续计划
若研究对象同意，将向其提供研究书面报告的摘要。研究结果将通过学位论文、同行评议期刊发表，以及在全国及国际学术会议上汇报的形式进行传播。