34 | Nursing in Practice | Autumn 2023

RESEARCH UPDATE

A recent study focused on support for parents of children with intellectual disability , while another found general practice needs to build expertise in the care of people affected by female genital mutilation and cutting

General practice experiences for parents of children with intellectual disability : a systematic review 1 Parents of children with intellectual disability are at a higher risk of mental and physical health difficulties and wellbeing challenges over time in comparison with other parents . 2 , 3

There has been a tenfold increase in anxiety and depression reported among this carer group since the start of the Covid-19 pandemic 4 , and evidence suggests parents of children with intellectual disability are more likely to seek medical treatment from general practice than parents of typically developing children . 5

Thomas and colleagues ( 2023 ) 1 undertook a systematic review of studies reporting the experiences of general practice described by parents who care for children with intellectual disability . Nine studies met the inclusion criteria , which included a focus on the parent carers ’ unmet needs from interactions with general practice .

The findings highlighted the concerns of parents navigating general practice on behalf of their child , and focused on their positive and negative experiences of the setting . Key findings included the parents ’ wish for better accessibility , longer consultations and greater flexibility to accommodate children with intellectual disability .

The positive experiences of general practice reported by the parents focused on supportive and understanding relationships with clinicians , and continuity of care . Negative experiences centred around clinicians ’ lack of knowledge of the wider health difficulties of patients living with intellectual disability , and concerns about general practice ’ s lack of engagement with integrated services .

The main limitation of the research was that the studies selected focused directly on the parents ’ experience with general practice and excluded potentially relevant experiences of wider healthcare .

The study concluded that tailored appointments for children with intellectual disabilities and their parents could support continuity of care , encourage better communication and improve satisfaction with care .

Reference 1 Thomas N et al . General practice experiences for parents of children with intellectual disability : a systematic review . BJGP Open 27 June 2023 ; BJGPO . 2023.0010 . DOI : 10.3399 / BJGPO . 2023.0010

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Lucille Kelsall-Knight is a lecturer in children ’ s nursing at University of Birmingham School of Nursing

Knowledge , attitudes , and practice of female genital mutilation and cutting : an observational cross-sectional study in English primary care 1 Female genital mutilation and cutting ( FGM / C ) are procedures that involve the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons . 2 There are migrant communities living in the UK whose country of origin practices FGM / C , meaning that clinicians in the UK are exposed to women and girls who have experienced FGM / C . 3

The prevalence rate of FGM / C in England and Wales is 4.8 per 1,000 population 4 , and the Department of Health and Social Care estimates that the annual cost of care for affected women and girls is £ 100m . Investment in good FGM / C services will bring long-term savings to the NHS . 5

Robinson and colleagues ( 2023 ) 1 set out to explore the knowledge , attitudes and practice of GPs and practice nurses in relation to FGM / C . They undertook a crosssectional online survey with 19 clinical commissioning groups in the West Midlands . A total of 137 GPs and practice nurses participated in the survey , which took place between September and December 2019 .

Among the respondents , a fifth ( 20 %) said they had seen patients in primary care within the previous 12 months who had undergone FGM / C . Almost all respondents ( 91 %) had received some training regarding FGM / C , although a third ( 34 %) felt the training had been inadequate .

The respondents stated that they had greater confidence in their ability to use FGM / C protocols if they believed a child was at risk , and also when identifying communities most at risk from FGM / C . However , they had lower confidence in identifying the types of FGM / C during examination and in their knowledge of support available for people who had experienced FGM / C .

The study ’ s main limitation is that it covers a small number of healthcare professionals in the West Midlands and so may not be representative of the wider UK . Overall , it highlights the importance of clinicians receiving adequate training and support to provide appropriate care to people presenting in primary care .

Reference 1 Robinson M et al . Knowledge , attitudes , and practice of female genital mutilation and cutting : an observational cross-sectional study in English primary care ( FGM / C Study ). BJGP Open 2023 ; BJGPO . 2023.0005 . DOI : 10.3399 / BJGPO . 2023.0005

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