bluuebunny/crossref_metadata_2025_split huggingface dataset:
Driving and vision
Authors: Marsden Janet , Craig Stephen 
Published: May 2014

Driving is an important mode of travel in most of the world and, because it facilitates many activities of daily life, it is seen as fundamental to concepts of quality of life. Up to 3.5 million people in the UK alone could be driving with eyesight below the legal minimum and this has huge implications for them and for all other road users. Ophthalmic clinicians, by the nature of their speciality, care for and work with people with varying degrees of visual capability. This article discusses the standards of vision for driving and evidence around vision and driving standards, particularly in relation to some of the issues that ophthalmic professionals may need to discuss with their older patients and clients in the practice setting.
Bursting the bubblewrap: evolution and monitoring of nurse-performed Nd:YAG laser capsulotomy service
Authors: Forbes Marina 
Published: May 2014

Aim To assess a new nurse-led capsulotomy service Method Evaluation and audit of the first 500 patients treated Results More patients received individualised care in a calmer environment Conclusion Advancing nurse practice to increase service capacity benefits staff, patients and the health economy, but other areas lose nursing expertise as a result
The psychosocial needs of patients undergoing ocular-odonto-kerato-prosthesis (OOKP) surgery: a nurse perspective
Authors: Wilson-Miller Rebecca , Stanley Helen 
Published: May 2014

This article explains osteo-odonto-kerato-prosthesis (OOKP) surgery from a nursing perspective, offering a detailed view of the surgical process to aid understanding of these complex patients’ needs, enabling nurses to meet the RCN Ophthalmic Competencies (2005), where nurses are expected to anticipate the effects of clinical diagnosis on the individuals and family/supporters and adjust care to enhance wellbeing. Ocular surface disease and absolute tear deficiency can lead to corneal blindness and severe discomfort ( Geerling et al, 2002 ). It is suggested that OOKP surgery is the keratoprosthesis (artificial cornea) of choice for end-stage corneal blindness ( Liu et al, 2005 ), involving the use of a patient's own tooth root to support an optical cylinder ( Fukuda et al, 2008 ), which is then implanted onto the patient's eye. An in-depth critical review of the literature was performed to offer the reader an explanation of the history of OOKP surgery, and to explore the needs of OOKP patients from a nursing perspective. This literature review indicated that patients undergoing OOKP surgery would benefit from increased psychosocial support from ophthalmic nurses, which can be provided by increasing own knowledge and understanding of the issues relating to this procedure and utilising resources, such as the Changing Faces charity, to facilitate better rehabilitation.
Cardiopulmonary resuscitation policies in northwest England hospices: a telephone survey
Authors: Douglas Claire A , Lewis-Jones Cathy 
Published: May 2014

Design A survey into existence of resuscitation policies in hospices in Northwest England Methods All 25 hospices in the region were contacted. The clinical services manager or equivalent person was interviewed by telephone by means of a structured questionnaire. Results The telephone survey had a 96% response rate. Sixteen (67%) hospices did not have a resuscitation policy although 50% of this group were developing a policy. Only eight (33%) hospices had a formal policy at the time of interview. Twenty hospices (83%) provided staff with annual training in basic resuscitation. One hospice (4%) discussed cardiopulmonary resuscitation (CPR) with all patients admitted, whereas six (25%) discussed CPR only if the patient raised the topic. Five hospices (21%) would advise the patients that they should be cared for in an acute hospital, as no resuscitation would be provided. Only four hospices (17%) had written information on resuscitation. Discussion There was significant variation in the production and adherence to guidelines on resuscitation, with some patients being denied access to specialist palliative care units, as they would wish resuscitation. Much anxiety and confusion regarding this topic existed and staff clearly required further education and guidance in order to develop policies within their units and to provide standard treatment within all specialist palliative care units.
Exploring Aboriginal peoples’ experience of relocation for treatment during end-of-life care
Authors: McGrath Pam 
Published: May 2014

Aim To explore indigenous peoples’ experience of relocation for medical treatment during end-of-life care. Methods The data were collected from 72 qualitative interviews conducted throughout the regional, rural and remote areas of the Northern Territory, Australia, with Aboriginal patients and carers and the health professionals who cared for them. Results Relocation for indigenous peoples is a frightening experience. There are a myriad of fears including: the fear of leaving home, especially for people who had never been away from their homelands; the fear of disempowerment associated with leaving the support of family networks; fears about hospital environments and ‘high-tech’ treatments; fear of cultural alienation for familiar foods and ways of being; fear of travel; fear of loneliness; fear of language and communication barriers; financial fears; and fear of dying away from the homeland. Conclusion The findings demonstrate the strong need for building-up local palliative care services and raise significant questions about the cultural appropriateness of the Western biomedical rationale for relocation during end-of-life care.
Exploring the role of community palliative care nurse specialists as educators
Authors: Husband Jacqueline , Kennedy Catriona 
Published: May 2014

In the UK the clinical nurse specialist role (CNS) has evolved in an uncoordinated manner resulting in a broad job remit, with clinical, managerial, research and educational elements. CNSs working in specialist palliative care are expected to contribute to the delivery of education but many have received no formal training to support them in this aspect of their role. There has been limited research exploring the role the community palliative care CNS in providing education, making this study timely. Aim: The aim of this study was to explore the role of the community palliative care CNS as educator. Method: Hermeneutic phenomenology, using semi-structured interviews with a convenience sample of eight community palliative care CNSs was the approach used. Formal ethical approval was obtained and all participants provided written informed consent. Colaizzi’s framework for analysis provided a structured and transparent approach to data analysis. A summary of the findings were verified by the participants to enhance the credibility of interpretation presented here. Results: Data analysis identified three main themes; conflict of expectations, credibility as a teacher and making the education role work. This study highlighted a team approach may address the conflict of expectations between the role specifications and practice reality. Conclusion: The CNS has a role in education. However for some CNSs, providing informal education rather than formal education may be appropriate. If the community palliative care CNS provides formal education, they require the knowledge and skills to deliver it effectively. The role of the CNS in palliative care education in the community should respond to personal, professional and local needs.
Parental perspectives of initial end-of-life care communication
Authors: Hendricks-Ferguson Verna L 
Published: May 2014

Significance: An important research priority is to explore parents’ perspectives of the introduction of end-of-life care (EOL) options for a dying child by their health care provider. Aims: To examine parents’ perspectives of: (1) the timing and method used by health care providers to introduce EOL options for their child and (2) what their preference would have been regarding the selected time and method to introduce EOL options. Design: Retrospective, descriptive study. Analysis: Qualitative method, content analysis. Results: The retrospective study design gave parents the ability to reflect on what was helpful or harmful when health care providers introduce or discuss palliative and end-of-life care options for the dying child. Important suggestions were shared regarding when this information should be discussed with the parents of a child with a life-threatening illness.
‘Catching’ the concept of spiritual care: implementation of an education programme
Authors: Hickey Deb , Doyle Carolyn , Quinn Sharon , O’Driscoll Peter , Patience Dawn , Chittick Karen , Cliverd Angie 
Published: May 2014

This article will outline the achievements of a project group as they translate the recommendations set out in the UK National Institute for Health and Clinical Excellence (NICE) guidance on spiritual care provision in clinical practice (NICE, 2004). It was evident that there was an opportunity to offer a comprehensive, competency-based course that developed recognition of the spiritual care needs of patients with cancer and their carers. A two-day experiential programme was devised that included role play, the evidence base, theory and fun, resulting in the acquisition of tacit and explicit knowledge. The course was based around the following tenets: Spiritual issues are broader than religious ones and include a quest for meaning in the illness, resolution of old conflicts and integration of past life experiences (Barraclough, 1994) We cannot know others except by knowing ourselves (Carrither, 1992). It is hoped that by providing holistic training that stimulates the growth of an individual’s spirituality and allows them to identify their spiritual needs, we can increase understanding, awareness, confidence and knowledge in ways that can have a real application within the workplace, enabling spiritual care provision to become realistically integral to care.
Experiences of nurses practising home-based palliative care in a rural South African setting
Authors: Campbell Laura Mary 
Published: May 2014

Background: Home-based care is necessary in rural South Africa owing to the impact of the HIV/AIDS epidemic, inaccessible health-care institutions, and overcrowding in hospitals. Palliative care has been introduced as part of home-based care and there is a call for research to inform practice, training, and support of caregivers. This exploratory paper reports on four nurses’ experiences of providing home-based palliative care (HBPC) in rural KwaZulu-Natal. Methodology: The study employed the qualitative method of photo-elicitation, which was used as a launching point for individual one-to-one interviews with the participants. Findings: HBPC increases access to care and provides a means of humanizing care and supporting patients in familiar community structures. It also enables nurses to practise independently and facilitates practise of traditional customs and use of traditional medicines. Challenges include patients’ understanding of palliative care and nurses being placed at risk. Conclusion: The study uncovered several benefits to HBPC for patients and nurses, but also highlighted various challenges in its implementation. Further research is needed before any recommendations for practice, training, and support can be made.
Home visiting nurses' attitudes toward caring for dying patients, and related workplace factors
Authors: Sakai Mahiro , Naruse Takashi , Nagata Satoko 
Published: May 2014

Aim To identify workplace factors related to home visiting nurses' (HVNs) positive attitudes toward caring for dying patients. Methods In this cross-sectional study, 343 HVNs working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. Results 304 questionnaires (88.6%) were returned, and the data of 206 HVNs (60.1%) in 54 different agencies was analysed. Multiple regression analysis showed that attendance at terminal care seminars, agency support of schedule organisation enabling attendance at terminal care seminars, and positive feedback from patients and families were significantly positively associated with HVNs' attitudes toward terminal care. Conclusion These results may give useful interventional methods for nursing managers to enhance HVNs' terminal care practices.
Experiences and perceptions of nurses caring for dying patients and families in the acute medical admission setting
Authors: Mak Yim Wah , Lim Chiang Vico Chung , Chui Wai To 
Published: May 2014

Aim: This study aimed to explore the experiences and perceptions of nurses caring for dying patients and their families in the acute medical admission setting. Methods: A qualitative interpretive descriptive methodology was used to explore the experiences and perceptions of 15 nurses recruited via purposive sampling from three acute medical wards of a hospital in Hong Kong. Results: The nurses perceived insufficiency and experienced great mental and physiological strain regarding their caring roles in this setting. Four themes were derived from the findings: lack of preparedness for patients’ deaths, reflecting on their own nursing roles for dying patients, reflecting on the meaning of death and their personal experiences of the death of their own family members, and coping with caring for dying patients. Conclusions: There are similarities between these experiences and those of nurses in similar settings in different cultures. There is a need for further research into and educational preparation of nurses in bereavement care and means of coping with somatic, cognitive, behavioural, and emotional responses in an environment where the emphasis is on curing people who are dying rather than caring for them.
Nurses’ perceptions of proactive palliative care: a Dutch focus group study
Authors: Verschuur Els ML , Groot Marieke M , Sande Rob van der 
Published: May 2014

Background Early identification of pain and other problems is an important aspect of palliative care. Although nurses have an important role in palliative care, little is known about nurses’ perceptions of proactive palliative care. Objectives This study aimed to explore nurses’ perceptions and experiences of proactive identification of problems and requirements among patients with palliative care needs. Methods This was a qualitative study in which 16 nurses working in palliative care took part in two focus groups. Results All of the nurses underlined the importance of their early involvement in palliative care. Anticipation of possible future problems, advice and information about end-of-life care and palliative care facilities, and assessment of patients’ wishes regarding care and preferred place of death were mentioned as important aspects of the early identification of problems and needs. Four themes were identified: the start of proactive palliative care; communication, support, and guidance; advocating for patients; and cooperation with health professionals. Conclusions Nurses’ involvement in proactive palliative care is important in supporting patients’ palliative care management. Ongoing education, focused on multidisciplinary communication and cooperation, professional development, and empowerment of nurses, remains of utmost importance.
Buteyko: A useful tool in the management of asthma?
Authors: Thomas Sandy 
Published: May 2014

Medical management of asthma focuses on drugs which, although effective, are costly and produce side-effects. Recent evidence suggests a role for breathing interventions that reduce total ventilation, such as the Buteyko method, which has strong similarities to techniques already used by therapists to manage hyperventilation. Both approaches should be made readily available to patients with asthma. Asthma nurses and therapists should consider these techniques to enable patients to ‘step down’ drug treatments in accordance with medical guidelines. This may involve a re-thinking of their role, from one where the main emphasis is on supporting the established medical model towards one that also offers a non-pharmacological alternative. This article explains the aims of Buteyko and discusses the increasing evidence base for methods that reduce ventilation and may benefit many patients with asthma, not just those with established chronic hyperventilation.
Does the introduction of a simple wedge to school seating reduce adolescent back pain?
Authors: Candy Elizabeth , Watts Richard , Shepstone Lee 
Published: May 2014

Back pain in adolescence is an increasingly common problem. The objective of this study was to assess the effects of a change in seating position for students suffering from back pain. Volunteer students between the ages of 16 and 18 years were recruited from two schools. Students completed pain diaries on a twice daily basis. After the first week, the intervention school students were given a high density foam wedge to use on normal school chairs. In total, 48 students took part in the study: 26 in the control and 22 in the intervention school. Use of the wedge was associated with a significant reduction in both intensity and frequency of back pain recorded in the intervention school (P <0.001). The results of this study demonstrate that a change in seating position appears to reduce back pain in school students. A randomized cluster study is planned to investigate this further.
Work activities of occupational therapists in Australian mental health services
Authors: Lloyd Chris , King Robert 
Published: May 2014

The aim of this study was to obtain a profile of occupational therapists' work activities in contemporary Australian mental health services so as to better understand the specific contribution of this profession. The study also aimed to determine whether or not actual work activity was congruent with the preferred roles of occupational therapists. A cross-sectional survey of 196 occupational therapists working in mental health was conducted. For the purposes of the study, a new instrument was developed that evaluated both actual and preferred work roles in four broad categories: administrative, general clinical skills, specialist clinical skills and community development. Respondents were engaged in a greater proportion of generic than discipline-specific work activities. They reported a preference for higher levels of activity in each of the work categories. These findings suggest that, contrary to some previous reports, not only are occupational therapists in Australia engaged in a broad spectrum of non-specialist mental health work activities, but these activities are mostly congruent with their expectations and wishes.
The use of acupuncture in the management of rheumatoid arthritis: a case study
Authors: Cai Lang , Bowen Catherine Jane 
Published: May 2014

Rheumatoid arthritis is a systemic inflammatory disease of unexplained cause, with no known cure. Medications used for disease control are far from innocuous and being aware of toxicities becomes an integral part of life for the person with this disorder. Acupuncture, as a part of traditional Chinese medicine, offers a different view to health and illness from that of Western medicine and has been used in the treatment and prevention of disease for thousands of years. In this case study, a patient with an 8-year history of rheumatoid arthritis achieved a satisfactory result after being treated with acupuncture. This indicates that acupuncture could be useful in the management of this disease. However, more studies are needed to evaluate the active role of acupuncture in this field.
Building good practice: lessons from a multimethod study of speech and language therapy
Authors: Roulstone Sue , Glogowska Margaret , Peters Tim J , Enderby Pam 
Published: May 2014

This article examines data from a multimethod study of speech and language therapy for pre-school children. The study compares the impact of intervention offered immediately following assessment with a control condition of monitoring over a 12-month period. A randomized controlled trial, a survey and in-depth interviews with parents are used. Data from the component studies were reviewed in order to draw out implications for good practice. These cluster into four areas: caseload selection, eclecticism, targeting and acceptability of therapy. Therapists were found to individualize therapy for their heterogenous caseloads. Parents generally valued therapy but wanted more specific activities. The article concludes that the heterogeneity of therapists’ caseloads creates challenges for evidence-based practice. In order to increase therapists’ understanding of factors that are critical to success, therapy should be systematically varied within a well-documented hypothesis testing approach.
Factors influencing the effectiveness of manual handling education
Authors: Gray Heather , White Jade 
Published: May 2014

Annually, over one half of reported occupational injuries are associated with the manual handling of loads. Employers are legally required to provide training and education in safer handling practices, to prevent the occurrence of such injuries. However, the effectiveness of this education is not conclusive. In total, 45 back care advisers, employed in nine out of the 15 Scottish health board regions, participated in seven focus groups to explore their perceptions of the effectiveness of manual handling education. A model was developed that summarized the five key factors they perceived to be major influences, which were: training; culture and the organization; the back care advisers; resources; and evidence-based practice. This model could be used to examine potential inefficiencies in current manual handling education provision.
Evaluation of the role of the rehabilitation assistant
Authors: Knight Katherine , Larner Stuart , Waters Karen 
Published: May 2014

The aim of this study was to evaluate the role of the rehabilitation assistant: a junior multidisciplinary grade combining key elements from nursing, occupational therapy, physiotherapy and speech and language therapy. The authors analysed daily activities, sophistication of clinical thinking and functioning of the role using timesheets, the think-aloud technique and semi-structured interviews. Rehabilitation assistants were found to facilitate rehabilitation and extend therapists' roles. Mobility, washing and dressing and activities of daily living were found to constitute most of a rehabilitation assistant's average day, with nursing skills and speech and language therapy appearing only in specific teams. All of the rehabilitation assistants displayed the ability to be able to think about the reasons behind the tasks they carried out, as opposed to merely following instruction from senior staff. The organization of the role of the rehabilitation assistant differed according to the team focus, structure and process within which the team operated. However, the specific role and boundaries of rehabilitation assistants' responsibilities need to be clearly defined for the role to function optimally.