bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating an education programme in general palliative care for community nurses
Authors: Hughes Philippa M , Parker Chris , Payne Sheila , Ingleton M Christine , Noble Bill 
Published: May 2014

Aim To evaluate the effects of a palliative care education programme on the self-reported knowledge and confidence of 72 community nurses. Design A prospective longitudinal postal questionnaire survey was conducted. Findings Seventy-one (99%) completed a pre-course questionnaire, 52 (72%) a questionnaire at completion of the course, and 37 (51%) a questionnaire 1 year later. Following the programme, more nurses felt that their professional needs were being met well or very well. Confidence in practice showed an increasing trend over time. Desire for education was lower on course completion than at its start. Palliative Care Nursing Quiz scores rose from a pre-course median of 12.5 to 15 at course completion (P=0.001) which was maintained 1 year later. Conclusion The education programme was successful in raising standards of knowledge, professional development and confidence. Improvement was maintained 1 year later.
Adult bereavement in five English hospices: Participants, organisations and pre-bereavement support
Authors: Reid David , Field David , Payne Sheila , Relf Marilyn 
Published: May 2014

Method: In-depth organisational case studies of five English hospice bereavement services. Analysis: Thematic analysis of qualitative interviews and focus groups and scrutiny of documentary material provided by the hospice bereavement services. Findings: Despite the differences in philosophies and activities among the hospices a common pattern of support were apparent. All made contact with the bereaved relatives or main carers shortly after the patient’s death, all provided information about practical and emotional aspects of bereavement and a mixture of social and therapeutic support. None of the hospices used formal ‘risk assessment’, but at all sites there were processes in place to identify people who might benefit from bereavement support. Pre-bereavement support and continuity between this and bereavement support were important aspects. Conclusions: The case studies allowed analysis of individual characteristics and comparison between services. The high response rates suggest thst the questionnaires used were acceptable to bereaved people. A clear and explicit rationale for bereavement support activities is a pre-requisite for the development of a cohesive and integrated programme of support to help resolve difficult decisions about individual clients. Prebereavement support by hospice staff positively contributes to the person’s experience of bereavement. Hospices should address the issue of providing the appropriate level of bereavement support.
Children’s needs when facing the death of a parent from cancer: part two
Authors: MacPherson Catriona , Emeleus Martha 
Published: May 2014

A small exploratory study was conducted to identify the psychosocial needs of children facing the death and subsequent bereavement of a parent from cancer. The focus was on the palliative phase of care through the bereavement period with the aim of identifying the best way forward in further developing a community-based service for children in Fife. Part one selectively reviewed the literature related to children’s and families’ needs when facing and dealing with the death of a parent, and described. Part two presents the results and reports the issues which will be considered as a basis for future service development.
Development and evaluation of a Nursing Assistant Computerized Education Programme
Authors: Ersek Mary , Wood Becky B 
Published: May 2014

Aim: To describe the development and evaluation of the Nursing Assistant Computerized Education Programme (NA-CEP), a computer-based palliative care curriculum for nursing assistants. Methods: Sixty-five nursing assistants working in various clinical settings completed measures to evaluate usability, clarity, and relevance of the programme to their work. Participants’ end-of-life knowledge and confidence also was assessed before and after NA-CEP use. Results: Findings indicate that NA-CEP is easy to use, clearly presented, appropriate in reading level and content, and highly relevant to nursing assistant practice. NA-CEP also significantly increased nursing assistants’ knowledge about palliative care. Conclusions: Evaluation findings indicate that NA-CEP is a useful tool for nurses and others who are responsible for training, orientation, and continuing education of nursing assistants.
Symptom pathways from referral to death: measuring palliative care outcomes
Authors: Lewin Gill , Haslehurst Paula , Smith Joanna 
Published: May 2014

This article reports on the first stage of a process to develop a clinical performance indicator for a community-based palliative care service that may inform the development of an agreed set of indicators for the whole sector. The study explores whether symptom data that are routinely collected to plan and monitor the care being provided by a community-based palliative care service also have the potential to be used to audit care against standards, compare services, and inform funders or purchasers. The article looks at the symptom distress scores of patients over the whole episode of their care from referral to death, by constructing pathways for each symptom (pain, insomnia, appetite, nausea, bowel, breathing problems, fatigue and pain). How these data may provide a multi-purpose measure of clinical outcomes is then discussed. It is concluded that, following further research to establish the symptom assessment scale’s reliability and validity in different settings, it should be considered for universal adoption by palliative care services.
‘Making sense’: nurses' experiences of changing practice in caring for dying patients in New Zealand
Authors: Thurston Jenny , Waterworth Susan 
Published: May 2014

Aim: To explore nurses' experiences of a top-down change that involved the introduction of the Liverpool Care Pathway for the Dying Patient (LCP). Methods: Using a qualitative design, two focus groups were conducted with a total of ten nurses and five semi-structured individual interviews were conducted with senior nurse managers. Findings: The nurses viewed their experience with the LCP positively, highlighting an improvement in their knowledge base regarding care of the dying. ‘Making sense’ was a key theme that reflected how the nurses attempted to manage the impact of the change on their own practice and on the nursing team. Conclusion: Organisations need to invest skilled manpower, time, and resources into supporting nurses in their transitions. The benefits of such investment are an increased likelihood of implementing evidence-based care and sustained practice and organisational change. For patients and their families and friends this investment will result in tangible improvements in the delivery of treatment and care at a time in their lives when they are most vulnerable.
Gait aid use by ambulatory older people in a residential setting: a descriptive exploration
Authors: Watson SC , Chipchase LS , Mackintosh SF 
Published: May 2014

The aim of this study was to describe the use of gait aids by ambulatory older people in a residential care setting. A cross-sectional exploration generating both qualitative and quantitative data was undertaken in a South Australian low-care population (n = 31). Demographic data were collected via case note review. Type of aid, mode of use and reasons for gait aid use were investigated via a structured face-to-face interview. Results identified four discrete groups of gait aid users in this population: those who used no aid (n = 5), those who used a stick only (n = 7), those who used a frame only (n = 13) and those who used both a stick and a frame (n = 6). In total, 31% of gait aids were self-prescribed and 33% of frames were used inappropriately. A vast range of psychosocial and behavioural factors was described by subjects to influence gait aid type and use. These findings suggest that self-prescription by older people may indicate alternative underlying needs that may be better met by therapeutic interventions other than gait aid prescription.
Preparing patients to self-manage faecal continence following spinal cord injury
Authors: Pryor Julie , Jannings Wendy 
Published: May 2014

Spinal cord injury is catastrophic and there is much to learn for the injured person. During inpatient rehabilitation in Australia, it is the responsibility of the nurse to teach the patient to care for him or herself. One of the components of this self-care is the management of the patient's newly acquired neurogenic bowel. However, readiness and motivation to learn about this may be missing or weak, and non-adjustment to the injury may initially impair the patient's learning. Astute assessment is therefore needed to determine the person's learning ability. As a result, the bowel management programme can be adjusted accordingly to either meet the needs of a self-directed learner or a dependent learner. Whichever the case, well designed education materials will facilitate patient learning and the transfer of education from inpatient to community settings. This article highlights the complexity of preparing patients with spinal cord injury for the self-management of faecal continence.
Physiotherapy for people with Parkinson's disease in the UK: an exploration of practice
Authors: Ashburn Ann , Jones Diana , Plant Rowena , Lövgreen Brenda , Kinnear Elizabeth , Handford Felicity , Loader Sue 
Published: May 2014

The aim of this study of physiotherapy in Parkinson's disease was to identify current baseline activity and opinion on best practice to inform a model for future evaluations. The two-phase study comprised a Delphi survey of specialist physiotherapists (n=49) followed by case studies of best practice sites (n=9), involving interviews with professionals (n=29) and patients (n=30) and a documentary analysis of patients' notes. There was strong consensus that physiotherapy was optimized within a multidisciplinary context, that treatment (which was eclectic in nature) aimed to maximize functional ability and that outcome should be assessed at this level. Patients and carers were able to identify physical, psychological and social benefits of physiotherapy. This study was a first step in a coordinated drive to link research to practice. The subsequent development and review of Guidelines for Physiotherapy Practice in Parkinson's Disease will inform the current National Institute for Clinical Excellence Parkinson's disease guidelines exercise.
Driving after stroke: A study of recollection of advice and compliance with guidelines
Authors: Johnston J , Chaudhuri M Datta , Stocks SJ , Dey P 
Published: May 2014

Following a stroke, patients may have deficits that affect their ability to drive. The Royal College of Physicians recommend that health professionals provide advice to promote adherence to Driver and Vehicle Licensing Agency (DVLA) guidelines. The authors surveyed 46 participants who had had a stroke at least 1year ago to determine whether they received and complied with current advice. When compared to those who did not receive advice, those who did were significantly more likely to obtain medical permission before driving, but there were no significant differences in the frequency with which they complied with other recommendations. Many who notified the DVLA benefited from an assessment. Driving status and advice should be recorded in medical records and hospital staff should emphasize the positive benefits that may follow assessments and compliance with current guidance.
Horsemastership part 1: Therapeutic components and link to occupational therapy
Authors: Lee Young Rhona 
Published: May 2014

Since mythology, the horse has been referred to as a healer and a helper of humans. Yet, it is only within the past 50 years that the horse has truly been recognized as having therapeutic value. Horsemastership, a generic term defined as ‘the care, maintenance and use of the horse in all pleasure and commercial activities’, has potential to be used as a therapeutic medium. Indeed, horsemastership is successfully used as a therapeutic medium for young adults (16–25 year olds) with additional needs at the Fortune Centre of Riding Therapy, a residential specialist college based in the New Forest. Despite this, however, the existing literature to support this specialist area is minimal.The first part of this article takes a comprehensive view of horsemastership by discussing all the distinct aspects that can be used as a treatment medium for people with additional needs. The skills and knowledge of the occupational therapist are also applied to highlight the potential involvement and role that the occupational therapy profession has to offer in this field.
Assessment for and provision of positioning equipment for children with motor impairments
Authors: Hong Chia Swee 
Published: May 2014

Posture is a dynamic process that underpins movement and function. Appropriate positioning for children with a motor impairment, such as cerebral palsy, is essential. Careful assessment is needed to ensure the provision of the most appropriate piece of equipment to enable correct positioning. This article considers some of the factors that may cause postural control problems and their functional implications. It explores the basic process involved in assessing a child for appropriate equipment and provides an overview of the latest equipment on the market to enable supine, side lying, prone, sitting and standing positions.
A comparison of Finnish and British rehabilitation curricula
Authors: Lukkarinen Hannele , Lahtinen Mari 
Published: May 2014

The purpose of this research was to assess a Finnish and a British curriculum of rehabilitation by means of benchmarking. The following aspects were assessed: the basic purpose of education; the qualifications provided by the educational programme; the objectives of education; the curricular model; the study modules and their contents; the coursework practices; and the evaluation and development of the curriculum. According to a comparative assessment, the Finnish and British curricula had the same underlying starting point: in both countries, rehabilitation is regarded a societally topical and multidisciplinary issue that is addressed in the educational programme. The studies are based on different systems of credit units and scores, but after a standardization of scoring, the programmes are mutually comparable and roughly correspond to each other There is, however, a significant difference in the two curricula: the structure of the study modules. Finnish study modules are practical-based and focus on the experiences of different individuals, groups of patients and health professionals. The education focuses on rehabilitation issues and aims to enhance students' awareness of and competence in certain target areas of practice. The British study modules are more research-based; the focus is on the scientific approach and the ways to produce knowledge. The British curriculum risks ignoring practical issues surrounding individual patients and therapists, but its focus on research-based practice means that practice is logically and consistently structured. The Finnish curriculum focuses on issues surrounding therapists and patients but risks becoming fragmented, as rehabilitation can be studied from many different scientific perspectives.
Teaching evidence-based practice: A survey of UK's higher education provision
Authors: Dewey A , Dean T , Ward D , Harris J 
Published: May 2014

Evidence-based practice (EBP) ensures that clinical health management decisions are based on valid, reliable and relevant evidence determined by sound research and evaluation. It is a key element of both the clinical governance and clinical effectiveness agendas. Clearly, there is a need to provide adequate educational and professional attributes to meet this increasing demand. The aim of this research was to identify and map all UK postgraduate courses that focus on EBP within health- and social-care services. Electronic searching of internet databases and all UK postgraduate electronic prospectuses using the broad term ‘evidence based’ was undertaken. Course details and prospectuses were obtained and reviewed, where available. In total, 12 postgraduate courses were identified. These could be broadly categorized into two distinct groups: five courses focused on health-care sciences designed for multidisciplinary health professionals and seven targeted clinical specialities. UK universities therefore provide relatively few courses in EBP. Two models of EBP education appear to be developing, which either specifically target EBP as a separate component of the curriculum or integrate into existing subjects. Further evaluation is needed to determine the relative merits of each.
A 1-year study of gait characteristics in diabetes: The impact of rosiglitazone
Authors: Petrofsky Jerrold , Lee Scott , Cuneo Maria , Dial Russell , Sanchez Marty , Kwan Sam 
Published: May 2014

Fifty subjects diagnosed with type 2 diabetes and 30 subjects with no history of diabetes (controls) were examined to assess their gait characteristics during the initiation of gait, gait in a linear path and during turns. Gait characteristics were measured by pressure sensors in the shoes, accelerometers on the knees and the electromyogram from the medial gastrocnemius and tibialis anterior muscles. Thirty subjects with diabetes (D1) and 20 control subjects (C) were followed for a period of 1year to see if gait changed over that period, especially in the diabetic population. Twenty additional subjects with diabetes (D2) were placed on the insulin sensitizer rosiglitazone (RSG) – a drug known to also improve vascular endothelial function – and were also followed for 1year. The results showed that D1 had more unsteadiness in their gait; they walked more slowly and with more circumduction (lateral movement during the swing phase) than did C. D1 also showed greater muscle use and co-contraction of agonist and antagonist pairs of muscle during gait when compared to controls. While the controls showed no difference in gait over the year, D1 showed deterioration in gait and D2 showed improved gait over the 1year. Thus, diabetes seems to continually deteriorate gait unless a drug like RSG is given. When RSG was administered for 1year, the velocity of gait, circumduction and muscle use was increased to near that of the age-matched controls.
The community rehabilitation unit in Leeds: A resource for people with long-term conditions
Authors: O'Connor Rory J , Best Meriel , Chamberlain M Anne 
Published: May 2014

Community rehabilitation is a well established and valuable part of the service response to the needs of people with long-term conditions. The authors explored the value of a Leeds-based community rehabilitation programme, before more formal evaluation, through two case reports of people living with long-term neurological conditions. Interventions were delivered not only in patients' homes and an outpatient rehabilitation department, but also in a facility where patients can stay overnight and access 24-hour nursing support and daily therapy input. This facility is not present in many parts of the country. Two women with a range of impairments received complex multidisciplinary interventions, incorporating repeated systematic analyses of problems by various combinations of professionals, with treatment delivered over several consecutive days across several rehabilitation disciplines. The particular benefit of the short period of focused inpatient treatment, where sustained interventions are given simultaneously by staff with complementary skills to enhance an individual’s function and maximize the gains provided by other parts of the service, is highlighted. These cases illustrate how a range of interventions, including short inpatient admissions, can be provided in a community setting to enhance participation.
The music therapy assessment tool for low awareness states
Authors: Daveson BA , Magee WL , Crewe L , Beaumont G , Kenealy P 
Published: May 2014

Many existing assessment tools for patients in low awareness states involve language functioning capabilities. Information regarding the construction and validity of a new assessment tool that relies on music, called the Music Therapy Assessment Tool for Low Awareness States (i.e. MATLAS), is presented in this paper. A total of nine assessments, involving eight patients, were examined. Results from the investigation of scores from three tools: the MATLAS, the Sensory Modality Assessment and Rehabilitation Technique (SMART), and the Wessex Head Injury Matrix Main Scale (WHIM)), as administered by multidisciplinary staff, were analysed, and the MATLAS was found to have good validity with these measures. While limitations involved in this work prevent conclusions about the validity of the MATLAS being drawn, they support the need for further research, and indicate that MATLAS may be a valid tool to assist with multidisciplinary assessment of such patients.
Emotional intelligence training in adjustment to physical disability and illness
Authors: McKenna Jacqui 
Published: May 2014

Reactions to chronic illness and disability include experience of negative emotions, and these are linked to poor psychosocial adaptation and disability-related stress. The individual's cognitive appraisal of the disability infl uences both emotional response to and management of self, therefore managing these emotions will be central to the rehabilitation process. Emotional intelligence describes the ability to understand, perceive, use, and manage the emotions of self and others. This article explores the concept and suggests how the occupational therapist can enable the emotional adjustment of an individual coping with physical disability or illness through emotional intelligence training. It is suggested that the training and facilitation of emotional intelligence abilities can be developed in an effective therapeutic relationship and by engagement in specifi c therapeutic activities in an occupational therapy programme. Research into application of emotional intelligence training in occupational therapy is suggested to explore these ideas further.
Testing of the short self-efficacy and outcome expectations
Authors: Resnick Barbara , Shaughnessy Marianne , Whitall Jill , Michael Kathleen , Nahm Eun Shim , Orwig Denise , Kopunek Sue , Macko Richard 
Published: May 2014

The purpose of this study was to test the reliability and validity of the short outcome expectations for exercise (SOEE) and short self-efficacy expectations for exercise (SSEE) scales in a sample of adults recruited into two exercise intervention studies for patients post stroke. A total of 157 individuals, 90 males (56%) and 67 females (43%) with an average age of 63.7 (SD=12.3) years participated in the study. There was evidence of internal consistency for both scales based on alpha coefficients and Rasch Model testing estimates of person and item separability, evidence of test re-test reliability with no change in scores over a 6-week period, and some support of reliability based on R2 estimates. There was evidence of validity of the measures based on confirmatory factor analysis using structural equation modeling and Rasch measurement model testing, and convergent validity testing. There was some evidence of convergent validity based on a statistically significant relationship between selfefficacy and outcome expectations, and both of these measures with physical health status. The study provided some preliminary evidence for the reliability and validity of the SSEE and SOEE when used with adult stroke patients, and suggested revisions for subsequent use of these measures are provided.