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Millions people in the world live with some type of disability, and nearly 20% of adults in the U.S. are living with physical or mental disability.The oxford dictionary disability describes a disability as a physical or mental condition that limits a person's movements, senses, or activities. It can divided into physical or cognitive disability and then divided even further. A study conducted by Dinsmore allowed patients to reveal their concerns about their hospital care. As a result of this survey, a focused piece of research was commissioned to assess the levels of service being delivered to hospital patients with learning disabilities.Hahn conducted a study with advanced practice nurses and the interventions they use for older adults for preventive intervention model for adults aging with developmental disabilities. Healthcare organizations are expected to meet the needs of this diverse population and sensitive to patients with health­based challenges and disabilities (Hahn 2014) .
In the study conducted by Dinsmore and Higgins, the group for the study was recruited from a charity organization for people with disabilities. They wanted to help the conductors of the study with the project. The participants interviewed had to have a disability and had to have some type of experience being in a hospital setting.Thirteen interviews with this group were conducted and members of these people’s families were also interviewed and they provided a different vantage point for the disabled family member’s hospital stay. The finalised interview structure consisted of a discussion of nine topics a full report of the investigation, including a thorough discussion. A full report

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of the investigation, including the discussions were made, compared and their concerns and many of their feelings were shared.

Many of the family members interviewed believed that their knowledge of the

disability of a person of their loved one who was a patient in the hospital was vital to the effective planning and implementation to of his or her hospital care. Almost all of the participants thought that this knowledge was rarely used by hospital staff, and that their efforts to share this knowledge was rarely made use of effectively, and often ignored or dismissed. Family members provided numerous examples of cases where the knowledge they held did or could have made an impact to a their loved one's care while in the hospital. Interviewees described the use of a patient passport.
Dinsmore and Higgins (20110 explain the use of a passport:: A patient passport is a document a person with a learning disability can take with them when attending hospital. It contains important information about their healthcare needs, as well as informal yet valuable information about the person, such as their hobbies and culinary preferences. Only two of those interviewed possessed a patient passport, and one of those disclosed that they no longer took it with them to hospital because it was never used by the staff participants who did not possess a patient passport expressed an interest in their use and to varying degrees stated that they believed ownership of one would have a positive effect on their future hospital experiences. It is recommended that hospital staff should

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make ‘reasonable adjustments’ to the provision and delivery of services for vulnerable groups, in accordance with the disability equality legislation.
Participants gave mixed accounts of whether they had found hospital staff willing to make such adjustments. At the end of each interview, recommendations were given by participants at the conclusion of each interview. Most, in one way or another, wanted to see greater empathy and understanding on the part of hospital staff when dealing with patients with learning disabilities. The majority of participants were convinced that the staff they had encountered had either did not receive specialist training for caring for people with a learning disability or had much experience. The members of the study who had positive experiences often credited “kind, gentle, empathic attitudes shown by hospital staff as being the most important factors,” (Dinsmore and Higgins 2011).
In the study conducted by Hahn, the type of disability he refers to is a severe and chronic disability that is attributable to a mental or physical impairment that begins before an individual reaches adulthood. These disabilities include “ intellectual disability,cerebral palsy, epilepsy, autism, and disabling conditions closely related to intellectual disability or requiring similar treatment,” (Hahn, 2014).
The method for this study was a descriptive data analysis of identified data of the
NIC interventions noted by nurse practitioners during the first and second follow up visits of the in­home preventive model (Hahn, 2014) The data came from the two NP followup visits with a sample that included 80 adults with mild to moderate intellectual disability, ages 29 to 68 years. The preventive in­home intervention models included a sample from the population of adults with developmental disabilities. The nursing

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interventions that took place in the preventive intervention model were designed to reduce health risks and promote health for adults aging with developmental disabilities.
It was discovered that health education was the most frequently reported NIC intervention for most nurses in this study.This allows for providers reinforces the knowledge that individuals with developmental disabilities often rely on support to assist them in understanding preventive health measures and health behaviors directed toward good health.“The NIC interventions of this study mirrored the eight NIC interventions reported as significant by nurses practicing with individuals with disabilities. The NIC Core Developmental Disabilities Interventions Checklist is a study tool that is based on the 30 NIC interventionsidentified as core to the developmental disabilities nursing specialty. Although some were infrequent,except for Medication management and
Self­care assistance The variety of interventions were not as likely to be used by the practitioners including anger control assistance, Emotional support (similar to Coping enhancement), Safety enhancement (similar to Environmental management: safety),
Seizure management, and two NIC interventions on Communication enhancement.
Hahn believed that education about health promotion for people with disabilities is not well covered in nursing programs. He stated that, “ lack of knowledge of the health issues and tailored screening guidelines for individuals with developmental disabilities may contribute to health disparities,” (Hahn 2014).
People with developmental disabilities have faced disparities in health care including access to routine preventive care, underrecognized or undertreated health

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conditions,and unprepared healthcare providers. In Dinsmore and Higgins study, they focused on the thoughts and opinions of a small group of people with disabilities. May of the individuals in their study felt that they were not treated with the utmost dignity and respect they thought they deserved. Even family members believed they, having years of knowledge of dealing with the patient's disability, had not been valued and had been ignored when it came to the care of their loved on. In Hahns study, he analyzed nurse practitioners interventions for individuals with disability and how it compared to NIC’s interventions based on the patient's condition. Although this was compared to a group with no disabilities results could vary based on each individual practitioner and may not have anything to do with whether or not the person has a disability. Both studies suggest a disparity among people with disabilities and people who do not in a hospital setting and in others. It is important for health care workers to be aware of the many different types of disabilities and yet treating them as individuals and providing individualized, culturally sensitive care for clients with disabilities and making sure to promote their abilities, skills, and strengths to maintain their current health status and resolve their healthcare needs.

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References
Dinsmore, A., & Higgins, L. (2011). Study of patients' experiences of treatment by hospital staff.
CINHAL,14(5).
Retrieved from: http://web.b.ebscohost.com.ezproxy.deltacollege.edu/ ehost/ pdfviewer/pdfviewer?sid=5f0cd85d­cd53­48e8­8ee0­da9b736724fd%40sessio nmgr111&vid=29&hid=110 Hahn, A., Hammel, J., Sazerro, J., & Sakrajek, A. (2013). Using nursing intervention classification in an advance practice registered nurse­led preventive model for adults aging with developmental disabilities.
CINHAL
, 46 (5), 304­13. doi: 10.1111/jnu.12085