bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out-of-hours medical cover in community hospitals: implications for palliative care
Authors: Kerr Chris , Hawker Sheila , Payne Sheila , Lloyd-Williams Mari , Seamark David 
Published: May 2014

Background The new General Medical Services contract in England means many GPs have transferred out-of hours work to their primary care organization, with implications for continuity of palliative care in community hospitals. Aim To examine existing arrangements for out-of-hours medical cover in community hospitals, focusing on palliative care. Methods Telephone survey of community hospital managers/senior nurses across England and Wales. Results Interviews (n=62) revealed nursing staff were satisfied with existing out-of-hours care. Concern was expressed about the future of out-of-hours medical care from GPs as new services will cover larger areas, meaning unknown doctors may attend, taking longer to arrive. Conclusion Arrangements for out-of-hours medical cover in community hospitals are in transition, threatening the continuity of care for dying patients.
Racial differences in perceptions held by caregivers of long-term ventilator patients at end-of-life
Authors: Kelley Carol G , Daly Barbara J , Douglas Sara L , Standing Theresa 
Published: May 2014

Aim: The purpose of this pilot study was to describe and compare perceptions of preparation for death and satisfaction with end-of-life care in African American and Caucasian caregivers of long-term ventilator (LTV) patients. Design: A comparative descriptive design was used to pilot test items from specific domains from the After-Death Bereaved Family Member Interview. Interviews were conducted on 37 bereaved caregivers of LTV patients who participated in a large experimental study. Findings: There was a statistically significant association between African American and Caucasian caregivers in the area of being informed of the patient’s condition. African American caregivers felt more informed than Caucasian caregivers. Over half of African American and Caucasian caregivers reported feeling ‘fairly to very confident’ about what to expect when their loved one was dying. Conclusion: Health care providers should be sensitive to potential differences between African American and Caucasian family caregivers in providing end-of-life care.
Evaluation of a training programme to teach a guided self-help psychological intervention to hospice staff
Authors: Galfin JM , Watkins ER , Harlow T 
Published: May 2014

Aims: A recent trial demonstrated that a brief guided self-help intervention reduces anxiety in palliative patients. This study investigated whether training palliative nurses to deliver a guided self-help intervention would improve their routine management of psychological distress. Design: A randomized controlled cluster trial compared a team of nurses who attended training (n=5) with a team allocated to a no-training control condition (n=5) on self-reported behaviour and confidence in addressing psychological distress. Ratings of patient psychological distress at routine clinical assessments were also examined pre- and post-training to assess the impact of training on patient distress. Results: As predicted, patients cared for by the trained team demonstrated a significantly greater reduction in distress post-training than patients cared for by the untrained team. However, there was no significant difference in self-reported behaviour and confidence. Conclusion: These findings suggest that brief workshop-based training improves clinical outcomes on psychological distress and may be a means to increase the accessibility of effective psychological interventions in palliative care.
WHOQOL Pain and Discomfort Module: development and validity testing of the Italian version
Authors: Boero Maria Elena , Melegari Anna L , Vizzuso Paola , Braida Vanda , Panetta Valentina , Skevington Suzanne M , Mason Victoria 
Published: May 2014

Background: The World Health Organization Quality of Life scale Pain and Discomfort Module (WHOQOL PDM) was designed to assess quality of life (QoL) in adults with chronic pain. It comprises 16 items covering four facets of pain: relief, anger/frustration, vulnerability/fear/worry, and uncertainty. Aim: The purpose of this study was to validate the Italian version of the WHOQOL PDM. Methods: Chronic pain was assessed in 400 patients using the WHOQOL PDM and other pain scales, together with scales measuring associated symptoms, depression, anxiety, and QoL. Results: The WHOQOL PDM shows good internal consistency, concurrent validity (it was significantly associated with all the WHOQOL BREF domains), construct validity (it was significantly associated with other pain scales), and discriminant validity (there were significant differences among different groups of patients). Conclusions: The Italian version of the WHOQOL PDM is a brief, useful, and valid tool for assessing chronic pain and its impact on patients’ QoL.
Aggressive behaviour in older people: a review of the issues
Authors: Winn Helen 
Published: May 2014

The occurrence of aggressive behaviour in health care is increasing, as is the risk of injury to health-care professionals following an attack from a patient. Such behaviour, which can be physical or verbal, is severely challenging and may be caused by a variety of reasons, which include mental illness and seeking attention. This article provides a review of the relevant literature regarding the possible causes of aggressive behaviour in older people. It outlines the management strategies designed to prevent this challenging behaviour, which take into consideration that the client should be able to express his or her feelings or distress.
Durability of manual wheelchairs: A review
Authors: Fitzgerald Shirley G , Kelleher Annmarie 
Published: May 2014

The aim of this article is to explain the differences between the three main categories of manual wheelchairs and describe the durability characteristics of each type. Findings are presented from several research studies that have compared wheelchair durability across these wheelchair classifications. Results indicate that the most durable type of manual wheelchair (ultralightweight) weigh less than 13.6 kg and are completely adjustable. These wheelchairs are made out of lightweight materials such as titanium and have been shown to last longer, with fewer catastrophic repairs than their heavier counterparts. Recommendations are also provided regarding how to obtain an ultralightweight wheelchair.
A guide to evaluating different wheelchair seat cushions
Authors: Rithalia Shyam 
Published: May 2014

Over the years, there has been a considerable increase in the number and variety of wheelchair seat cushions. People required to select a cushion are faced with a confusing and often misleading array of commercial literature. The cost of these products range from less than £100 to several hundred pounds, so the importance of a logical approach to their selection cannot be overstated. Inappropriate selection not only wastes capital resources, but it can also be very harmful to the patient. Although the effectiveness of a wheelchair cushion is best evaluated through clinical trials, these are expensive to conduct and in the case of new products, such evidence is not readily available. In order to overcome this drawback, researchers have developed experimental methods of evaluation based upon existing knowledge of pressure ulcer aetiology. This article describes the most common methods, along with a new technique known as pressure relief index.
Development of a foundation degree in health and social care
Authors: Cochrane A , Chambers A , Duffy A , Harrison L , Stewart H , Selfe J , Ingman E 
Published: May 2014

Health care in the UK is at present experiencing a shortfall of qualified health-care professionals. One initiative that has been proposed is to provide foundation degrees, which meet the needs of employers in a range of health and welfare settings and prepares students to support clients in maximizing their independence within a programme of care. This article describes the development of the foundation degree in health and social care at the University of Central Lancashire, UK. A two-stage consultative exercise with practitioners was undertaken in the form of focus groups. These were multidisciplinary and grouped according to practice area. This form of consultation has enabled clinicians to feel valued for their skills and opinions and has ensured a curriculum that is relevant and current to the needs of practice.
Influence of unilateral neglect on independence in activities of daily living after stroke
Authors: Pomeroy Caroline HC 
Published: May 2014

This article summarizes a systematic literature review conducted to establish whether the phenomenon of unilateral neglect (UN) has a substantial impact upon an individual's independence in activities of daily living after stroke. The literature was scrutinized to ensure compatibility with pre-established inclusion criteria and to generate themes for discussion. Consistency of critique methodology was structured through the use of set questions. Findings of the review were more complex than anticipated, not least because of the influence of additional perceptual and cognitive deficits existing alongside UN. Activities conducted outside personal space were found to be less impaired by UN than those within it, despite agreement not being reached over whether neglect can exist in different areas of space. It has also been suggested that load and familiarity have a strong influence upon ability, which leads existing rehabilitation techniques to be brought into question. Inconsistencies are great throughout defining, detecting and treating UN. Decreasing these would go a long way towards improving effective and integrated stroke services, as required by the National Service Framework for Older People. Recommendations have been made for areas in need of research and implications for future practice are discussed.
Moving and handling patients safely: A product guide
Authors: Finucane Caroline 
Published: May 2014

Buying suitable equipment for moving and handling people is essential, as manual lifting can place a severe strain on those assisting and put them at risk of developing a work-related musculoskeletal injury. This article offers information on the different types of mobility aids and hoists available and provides contact details for the manufacturers and suppliers of such equipment. It aims to provide a useful guide for therapists and carers involved in handling people, and for those who are able to independently transfer with the use of the right mechanical aid.
Choosing a manual wheelchair: The options
Authors: Fernandes Tanya 
Published: May 2014

There are a variety of manual wheelchairs available on the market designed to help individuals with mobility difficulties to carry out daily living tasks as independently as possible. Participation in such activities is crucial in enabling users to integrate into society and prevent isolation as a result of a disability. A holistic approach to assessment should take into account all aspects of individual need and will result in the selection of the most appropriate piece of equipment, which in turn may result in an improvement in the quality of life for any individual with an impairment of function. This article will look at the considerations that need to be taken into account when prescribing manual wheelchairs as well as highlighting some of the options available on the market.
The test-retest reliability of a battery of new occupational performance assessments
Authors: Ikiugu Moses N , Anderson Angela , Manas Diane 
Published: May 2014

Aims: The purpose of this pilot study was to investigate the test-retest reliability of a set of newly developed occupational performance assessment instruments based on the philosophy of pragmatism and the complexity theory. These instruments were: the Assessment and Intervention Instrument for Instrumentalism in Occupational Therapy (AIIIOT), the Daily Occupational Inventory (DOI), and the Occupational Performance Calculation Guide (OPCG). Method: An experimental study with a non-experimental test-retest design was adopted to quantify observations, and to determine the ability of the instruments to produce stable scores on repeated testing. Findings: The AIIIOT was found to have low test-retest reliability, probably owing to a very small sample. The occupational performance scores as calculated on the OPCG had reliability coefficients that approached statistical significance. Adequacy, Satisfaction, and Belief scores on the AIIIOT were found to be good predictors of the frequency of engagement in occupations perceived to be important for achievement of personal mission in life. Conclusions: These assessments have promise as clinical instruments for measuring occupational performance in occupational therapy. Further research with more robust samples is indicated to validate the instruments conclusively.
Focus group methodology Part 1: Considerations for design
Authors: Plummer-D'Amato Prudence 
Published: May 2014

There is a strong tradition of quantitative research in the health sciences, but qualitative research designs are now being used more frequently to investigate certain areas of rehabilitation, such as patients' views of health care services, and how clinicians make decisions during evaluations and treatment. Many qualitative approaches are available for conducting these types of inquiries, such as interviews, participant observation, and focus groups. Focus groups are unique because they combine interviewing, participant observation, and group interaction. Focus groups are therefore particularly useful when the researcher wants to investigate people's thoughts because the interaction between participants can elicit data and ideas that might not be uncovered in one-on-one questioning. To optimize the data obtained from focus groups, careful attention must be paid to the composition and number of groups, as well as the selection and training of the moderator, and the development of the question route. This article will review these components of focus group research design, as well as highlight other important considerations for planning and conducting focus groups. Issues specific to analysis and trustworthiness of focus group data will be addressed in Part 2.
Acute phase functional electrical stimulation for the upper limb after cervical spinal cord injury
Authors: Wallace Leslie , McQueen Jean 
Published: May 2014

Aims Anecdotal evidence suggests that early treatment with functional electrical stimulation (FES) to specific upper limb muscles and muscle groups may improve functional outcome and long-term independence in the high-level tetraplegic patient. This improvement may lead to increased independence in daily life. The authors aimed to investigate these assertions using a case study design, and encourage further work on this treatment strategy. Methods The implementation of FES at an early stage post-injury in one cervical spinal cord-injured patient is described. FES was applied with the aim of improving functional use of upper limbs. Muscle strength was assessed, using manual muscle testing with the Oxford scale, at commencement and cessation of FES treatment. Independence in activities of daily living was also recorded. Findings This case study suggests that use of FES applied during the acute phase following injury can have a positive effect on both physical and psychological outcomes. Conclusions Further work is recommended to strengthen the evidence for this intervention.
Systematic reviews in clinical practice: Evaluating evidence for management of acute whiplash-associated disorder
Authors: Wright Chris , Rushton Alison , Gamlin Jill , Farrell Derek 
Published: May 2014

Introduction The methodology of systematic review (SR) has developed considerably in recent years. The SR is rated as providing the highest level of evidence as it applies rigour in combining fi ndings from original evidence. However, concern has been expressed regarding the quality of some SRs. Critical evaluation of SRs is essential to ensure that they provide best evidence to inform management decisions in practice. Content A background to SRs illustrates their development and importance to informing decisions for best practice, especially for the busy clinical practitioner. The characteristics of a SR are evaluated using an illustrated example of the development of a SR method to evaluate conservative physical management of patients with acute whiplash-associated disorder grade II. Discussion and Conclusions Understanding the key components of a SR enables effective critique of a published review. This in turn facilitates effi cient use of the SR fi ndings within clinical decision making in practice.
Self-management techniques for bipolar disorder in a sample of New Zealand Chinese
Authors: Wang Grace , Tse Samson , Michalak Erin E. 
Published: May 2014

Aims The aim of the study presented in this article was to consider how New Zealand Chinese with bipolar disorder manage their condition, regain and maintain wellness through the use of self-management techniques. Methods Nine New Zealand Chinese with bipolar disorder type I or II who had reasonable performance in role functioning were interviewed. Data analysis was guided by the inductive approach. Findings In contrast to Western psychosocial interventions, which emphasize the individual's independence, self-advocacy and self-identity, New Zealand Chinese are more likely to value themselves through relationships with others. Most participants emphasized the importance of harmony with self and others, and adopted passive and nature-oriented attitudes encouraged by Taoism to deal with life stress. Strategies of ‘taking it easy’ and ‘looking at problems in others’ shoes' were frequently used when dealing with interpersonal conflicts. Conclusions The concepts of health and life as part of traditional Chinese culture were found to be the fundamental elements influencing the participants' coping patterns. There is a strong need for facilitating the connection between health professionals and clients. This study indicates that to do this, health professionals must be aware of the importance of cultural sensitivity when delivering health care in a multicultural environment.
Communication and quality of life in individuals receiving home mechanical ventilation
Authors: Laakso Katja , Markström Agneta , Hartelius Lena 
Published: May 2014

Aims While in clinical reality many ventilator-supported individuals have been observed to experience difficulties with their communication, research in this area is still scarce. The article aims to address this gap by looking at communicative activity and participation and health-related quality of life (HRQL) in individuals receiving home mechanical ventilation (HMV). The study focuses on how patients themselves experience their communicative participation and HRQL, and whether there might be a relationship between demographic factors, HRQL, and communicative activity and participation. Methods Nineteen individuals receiving HMV via tracheostomy (n=17) or non-invasive means (n=2) participated in the study. Three different questionnaires were used: the generic Sickness Impact Profile, the disease-specific Severe Respiratory Insufficiency questionnaire, and the Living with Dysarthria questionnaire measuring communicative participation. Communicative activity was assessed in terms of speech intelligibility. Findings The study found that speech intelligibility is decreased in individuals receiving HMV and that these individuals experience high levels of dysfunction in their communication. Still, communicative participation was not severely impaired. The study did not demonstrate any significant correlation between quality of life measures and communicative participation or intelligibility. Conclusions Communication was one of the areas of HRQL with which the participants experienced difficulties. Nevertheless, the results of the study show that communicative participation and intelligibility levels do not contribute independently to the reduced HRQL.
Interviewing in qualitative research: The one-to-one interview
Authors: Ryan Frances , Coughlan Michael , Cronin Patricia 
Published: May 2014

Background The one-to-one interview is a commonly used data collection method in health and social research. Increasing attention has been given in the literature to the process of conducting an interview, particularly with respect to the role of the interviewer and the relationship between the interviewer and interviewee. The individual interview is a valuable method of gaining insight into people's perceptions, understandings and experiences of a given phenomenon and can contribute to in-depth data collection. However, the interview is more than a conversational interaction between two people and requires considerable knowledge and skill on behalf of the interviewer. Content Interviews vary in type and structure depending on their philosophical orientation. This article examines the process of conducting the interview from a generic point of view, while making reference to different approaches. Considerations are also raised regarding interviewing in challenging situations. Conclusions Several important stages need to be followed when conducting an interview. The nature of the questions, questioning techniques, listening and the interviewer-interviewee interactions are crucial to obtaining a successful outcome. Similarly, ethical considerations and the protection of participants are fundamental aspects of interviewing. Although interview data may be used as evidence about people's perceptions and understanding, it is pertinent to remember that responses may be shaped by variables such as if and how the interviewer has influenced the interviewee, and the level of trust and rapport between the two people. Hence, it is essential that interviewers are cognisant of the various techniques underpinning the interview process to maximize results.
The synthesis: An innovative approach to student research
Authors: Molineux Matthew 
Published: May 2014

Background Although there is an expectation for health practitioners to be able to use research to inform their practice, opportunities for students to actually plan, conduct and report a research project are diminishing. Students are less able to gain first-hand experience of research as a result of demands to include more in curricula, and increasingly rigorous and time-consuming ethical review procedures. It is important, therefore, for health educators to explore different research methods and approaches. Content This article proposes the synthesis, an entirely literature-based approach, as a method to enable students to plan and conduct a research project. It is more than a literature review in that it requires students to synthesize material from two previously unrelated fields. As a result it is possible to shine a new light on issues facing health-care professionals and their patients/clients, by bringing new ways of thinking to issues. Conclusions Although the synthesis is a nascent concept in student health professional education, it has the potential to offer students first-hand experience of the research process, and so contribute to their development as research aware professionals.