Disability-related content in nursing textbooks

Although the American with Disabilities Act in 1990 mandated that people with disabilities (PWDs) have equal access to facilities and services, men and women with disabilities continue to report receiving inadequate health care. The need to address disability in health professions education, including nursing, has been identified by the U.S. Surgeon General, researchers, and the disability community. This study examined how disability issues are integrated in textbooks commonly used in nursing programs and differences in coverage by seven textbook categories (e.g., medical-surgical, pediatrics). A total of 33 textbooks used in undergraduate nursing curricula were systematically reviewed for inclusion of disability content using a review grid developed with the input of PWDs. Two researchers independently reviewed each textbook and at least three members of the team developed consensus ratings for each of 224 content items for each textbook. Sums of consensus ratings were calculated for each topic, each textbook, and all seven categories of textbooks. Ratings of each category of disability-related content were calculated and ranked from highest to lowest. Two investigators reviewed the consensus ratings for each category of book as well as written comments provided during the initial steps of the review. Analysis revealed that disability-related content was largely absent from textbooks and categories of textbooks. Although disabling conditions were discussed, issues related to lifelong or preexisting disability were often not addressed. Abuse, a major issue for PWDs, was barely addressed in detail in any of the textbooks. There were significant differences (p = .005) in inclusion of disability-related content by type of textbook; the highest ranked category was community health. Topics that would be expected in specific categories were often addressed infrequently or not at all. The results of this study suggest the need for faculty members to address disability in their nursing curricula in creative ways until textbook authors and publishers begin to address this issue. The large and growing population of 60 million individuals with disabilities mandates this action.