A mixed method approach to investigating therapeutic commitment towards adults with learning disabilities: the perceptions of final year adult, mental health and learning disability student nurses

Abstract

All nurses should have the ability and disposition to engage in therapeutic relations with people who have learning disabilities. Therapeutic commitment is described as a therapeutic attitude that is influenced by nurses’ perceptions of role competency and role support. It is essential to the provision of nursing care leading to improved patient outcomes.

The study aimed to explore final year adult (AD), mental health (MH) and learning disability (LD) student nurses’ perceptions of therapeutic commitment towards people with learning disabilities and the factors they perceived influenced it. A mixed method, convergent approach for complementarity and expansion purposes was used. A survey collected quantitative and qualitative data from 398 final year student nurses across four Higher Education Institutes in Scotland.

Integrated findings suggested when caring for people with learning disabilities that student nurses are therapeutically committed, with LD student nurses’ perceptions being greater than their counterparts. LD student nurses also perceived greater role competency and reported they could access experienced support more readily. Having education, a personal experience, the opportunity to provide care whilst on clinical placement and previous work experience with people with learning disabilities influenced the therapeutic commitment and role competency all students perceived. Other influencing factors included receiving thanks, being challenged by the task and the attitudes and qualities held by the nurse. Some AD and MH student nurses believed that people with learning disabilities characteristics negatively influenced their therapeutic commitment. This study has implications for nursing practice and education as it builds on the theory of therapeutic commitment, providing new knowledge of the factors that influence it, either positively or negatively when caring for people with learning disabilities. This knowledge will support nurses to engage in positive therapeutic relationships with people with learning disabilities to enhance the delivery of nursing care.