bluuebunny/crossref_metadata_2025_split huggingface dataset:
A decision model for community nurses providing bereavement care
Authors: Brownhill Suzanne , Chang Esther , Bidewell John , Johnson Amanda 
Published: May 2014

Community (district) nurses play a significant role in assisting and supporting bereaved informal carers (family members and friends) of recently deceased clients of palliative care. Bereavement care demands a wide range of competencies including clinical decision-making. To date, little has been known about the decision-making role of community nurses in Australia. The aim of this study was to conduct in-depth examination of an existing data set generated from semi-structured interviews of 10 community nurses providing follow-up bereavement care home visits within an area health service of a metropolitan region of Sydney, Australia. A grounded theory approach to data analysis generated a model, which highlights an interaction between ‘the relationship’, ‘the circumstances’ (surrounding the bereavement), ‘the psychosocial variant’, ‘the mix of nurses’, ‘the workload’, and ‘the support’ available for the bereaved and for community nurses, and elements of ‘the visit’ (central to bereavement care). The role of community nurses in bereavement care is complex, particularly where decision-making is discretionary and contingent on multiple variables that effect the course of the family's grief. The decision model has the potential to inform community nurses in their support of informal carers, to promote reflective practice and professional accountability, ensuring continuing competence in bereavement care.
Simulation-based education in support of HCA development
Authors: McKenzie Smith Michelle , Turkhud Kelly 
Published: May 2014

In the wake of the Francis Report and its 290 recommendations, the role and training of the healthcare assistant (HCA) have once again come under the spotlight. Francis asks for HCAs to be regulated and national standards for their education and training to be agreed ( Francis, 2013 ). The HCA Crisis Avoidance and Resource Management (CARMA) course has run at the Montagu Clinical Simulation Centre (MCSC), South Yorkshire for 5 years now. This article evaluates the impact that this course, which uses simulation-based education as a teaching methodology, has had on the attitudes of HCAs and on their role in clinical practice. Simulation is an ideal educational method for addressing nontechnical skills, such as communicating with patients and members of the multidisciplinary team ( Gaba, 2004 ). Allowing participants to prepare for emergency situations, simulation-based education gives individuals and teams the opportunity to practise within a safe environment, making behaviours more or less permanent ( Beaubien and Baker, 2004 ).
Addressing cancer fear and fatalism—how you can help
Authors: Kaplan Gwen , Kilgour Gill 
Published: May 2014

Every year in the UK, around 300 000 people are diagnosed with cancer, about the same as the population of Coventry. More people are surviving the disease nowadays—in fact, survival rates have doubled in the past 40 years. Yet through our seven years of experience of talking to the public, we know many believe cancer is still a death sentence and don't want to know if they have it. We also hear echoes of this belief from some working in the health profession, who have a remit to encourage people to adopt healthier lifestyles and seek help early if they are worried about a symptom. Fear and the sense of fatalism about the disease can be major barriers to accessing help earlier and everyone—including healthcare assistants and assistant practitioners—can play a role in addressing this.
Informing patients about sudden unexpected death in epilepsy: A survey of specialist nurses
Authors: Lewis Sheila , Higgins Sue , Goodwin Mel 
Published: May 2014

The National Institute for Health and Clinical Excellence (NICE) recommends that people with epilepsy and their families and carers should be ‘given and have access to’ information about sudden unexpected death in epilepsy (SUDEP). The aim of this survey was to examine what, when and how information about SUDEP is disseminated to patients by clinical nurse specialists in epilepsy (CNSEs). Method : A total of 250 postal questionnaires were sent to members of the Epilepsy Nurses Association (ESNA) in July 2006. Responses were received from 146 nurses (58%). CNSEs accounted for 103 (71%) of the respondents. The remaining responses were excluded as not being CNSEs. Results : CNSEs discussed SUDEP with most patients (50%). They tended to raise SUDEP when discussing specific risks (48%) and general risk (71%). Forty-five CNSEs would discuss the issue at diagnosis and 17 when therapy was started. Risk factors mentioned included non-compliance (84%), safety risks (78%), nocturnal seizures (68%), alcohol/drugs use (67%) and history of status epilepticus (65%). The main behavioural responses noted were, improved adherence (62%), avoidance of risk (59%) and anxiety(49%). Only 57% of CNSEs were aware that guidelines regarding SUDEP exist. Conclusions : As SUDEP appears to be related to seizures, management should include optimal drug treatment and seizure control. This may present a challenge as patients generally want to lead as normal a life as possible.
Evaluating a fast-track service for diagnosing MND/ALS against traditional pathways
Authors: Callagher Pauline , Mitchell Douglas , Bennett Wendy , Addison-Jones Robert 
Published: May 2014

The fast-track diagnostic service for people suspected of having MND/ALS was introduced at the Royal Preston Hospital in January 2005. This service aims to shorten waiting times, decrease requirements for inpatient admission and enable the final diagnosis to be presented in a clinic-based environment in a planned, controlled manner. In this article, the diagnostic process for people suspected of having MND in Lancashire and South Cumbria is described. Comparisons are made between the fast-track diagnostic services and traditional diagnostic pathways (i.e. outpatient clinic, hospital transfer, private referral), outlining the timelines from referral to diagnosis. Secondly, patients' perceptions of their experience of the diagnostic services will be described.
Assessing multiple sclerosis patients’ and carers’ views of respite care
Authors: Mullan Fiona , Acheson Karen , Coates Vivien 
Published: May 2014

Background: People with multiple sclerosis (MS) often require full-time care, which may be provided by informal carers. Respite becomes a vital part of carers’ lives allowing temporary relief. Little attention in the literature is given to the people who experience respite care. Aim: The aim of this study was to assess the views of respite care by MS patients and their carers. Method: A cross sectional survey was conducted in Northern Ireland, one questionnaire for patients and another for carers. The lists of two long stay respite units provided the sample for the study, from these 96 patients and 96 carers were approached. A total of 70 patients (73%) and 28 carers (29%) responded. Results: Seventy-one percent of patients used respite care to give their carers a break; 64% of carers used respite to relieve stress. More than half, 64% of patients, enjoyed respite; 6% were angry about requiring respite; 57% of carers felt guilty about using respite. Overall, 81% of patients were satisfied with respite. Almost all carers (96%) stated that respite allowed them to continue caring. Conclusions: Both patients and carers felt respite was a positive and necessary form of care. The study did highlight that activities or outings for patients in respite would be welcomed.
Stories as evidence: Why do midwives still use directed pushing?
Authors: Perez-Botella Mercedes , Downe Soo 
Published: May 2014

This article uses story-telling techniques to describe and then reflectively analyse the practice of directed pushing in the second stage of labour. The practice is endemic despite evidence from formal research that it does not benefit women and babies, and, indeed, that it may be harmful. The lessons from the narrative account are discussed alongside the formal evidence base. The article is based on a student midwife's story of observing a midwife who used directed pushing to ‘manage’ the expulsive phase of labour in one case. Three specific aspects are discussed, namely the paradox of research-based evidence, trust policies, and professional skills and beliefs; technocratic monitoring and mechanical theories of childbirth; and issues of power and resistance. The intention is to highlight the potentially dramatic impact that story telling could have in the shaping of maternity services when constructively used as a tool to inform practice. This is the first of a two-part series of articles that explore the issues around normality and the expulsive phase of labour. The second article will address the phenomenon of so-called ‘premature’, or ‘early’ pushing.
Why don't midwives ask about domestic abuse?
Authors: Buck Lisa , Collins Sally 
Published: May 2014

Routine screening for domestic abuse in pregnancy is recommended and midwives are in an ideal position for this role. However due to an apparent reluctance to enquire about domestic abuse it often remains a hidden problem with detrimental consequences for women and their unborn children. The aim of this systematic review was to identify the most commonly reported factors that prevent healthcare professionals from routinely screening women for domestic abuse. Six electronic databases were searched for all articles published in the English language up to January 2006. Data, including all the reported reasons for not screening for domestic abuse, were extracted from all the studies which met the inclusion criteria. A simple ‘vote-counting’ analysis was performed with graphical representation and calculation of weighted means. Thirteen papers met the inclusion criteria. The perceived barriers to screening appeared similar across a range of specialities and clinical settings. The most commonly cited factors were: lack of time, lack of training, and inadequate resources. Domestic abuse remains a serious public health issue and is frequently exacerbated by pregnancy. Our results suggest that raising awareness of the issue should help midwives understand the need to prioritise screening and find the time required to do so. Encouragingly it also suggests that improving basic education and increasing access to simple resources, such as leaflets giving details of where to get support, may provide practitioners with the confidence required to ask women about domestic abuse.
Effectivness of cooling gel pads and ice packs on perineal pain
Authors: Navvabi Shahin , Abedian Zahra , Steen-Greaves Mary 
Published: May 2014

This article reports the findings of a randomized controlled trial undertaken at the Hazrat Ommolbanin University Maternity Hospital in Mashhad, Iran, which investigated the effectiveness of localized cooling treatments to alleviate perineal trauma. From October 2005 to February 2006, 121 primiparous women who were at term and had an episiotomy were randomly recruited to one of three treatment groups (Group 1 – no localized cooling; Group 2 – Ice pack; Group 3 – cooling gel pad). The intensity of pain, wound healing and women's satisfaction levels were the main outcomes measured. The intensity of pain was measured by a Numeric Rating Scale (NRS) (1–10) and wound healing was evaluated by the REEDA scale within 4 hours of episiotomy repair; at days 1, 2, 5 and 10. The use of oral analgesia was measured at day 10. Women's satisfaction levels with oral analgesia and localized cooling treatments were also assessed at day 10 by a NRS. There was evidence that localized cooling treatments are effective in alleviating perineal pain, which was in favour of the cooling gel pad group. A statistical significant difference was reported at 4 hours (P=0.003); day 2 (P=0.004); and at day 10 (P=0.044). At days 1 and 5 there was evidence of a reduction in the intensity of pain but this did not reach a statistical significant difference. A reduction in the use of oral analgesia was reported in favour of the cooling gel pad group (P<0.001). Women's satisfaction levels with oral analgesia were similar within the three treatment groups but a higher level of satisfaction when assessing localized treatment was reported by the cooling gel pad group (P‹0.001). Wound healing rates were also reported to be better in the cooling gel pad group when compared to the other two groups (P<0.001). Women's views and treatments to alleviate perineal pain without any adverse affects on wound healing are important aspects of midwifery care. This trial has demonstrated evidence that localized cooling of the perineum reduces the intensity of pain. Women were more satisfied when applying cooling gel pads and this treatment appeared to assist in wound healing.
Failure to void in labour: postnatal urinary and anal incontinence
Authors: Birch Linda , Doyle Patrick M , Ellis Roger , Hogard Elaine 
Published: May 2014

The objectives was to identify the impact of intrapartum voiding on postnatal urinary and anal incontinence. A longitudinal, prospective, repeated measures, cohort study design was used. The study was set in one of the biggest and busiest acute NHS university teaching hospitals in the North West of England, which provides maternity care to over 4000 women each year. Primiparous women with no pre-existing disease (n=516) participated and were recruited after a normal 20-week gestation obstetric ultrasound scan. Data was collected using validated questionnaires during the last trimester of pregnancy and postnatally at six weeks, six months and finally at one year. Obstetric and demographic data was extracted from case notes. This included age, body mass index, gestation, duration of labour, analgesia, birth weight, mode of delivery and perineal trauma. Statistical analysis was undertaken using Statistics Package for Social Sciences (SPSS version 13.0). The main outcome measures were urinary incontinence symptoms and anal incontinence symptoms. Prolonged periods of time in labour without emptying the bladder was associated with increased rates of postnatal urinary incontinence (OR 2.36) and may also contribute to anal incontinence. Postnatal urinary incontinence may be reduced if intrapartum bladder care policies reflect frequent emptying. This preliminary data supports large-scale exploration of the association between postnatal anal incontinence and bladder emptying in labour.
Kurdish women's experiences and perceptions of their first pregnancy
Authors: Shaho Ronak 
Published: May 2014

There is limited information in current literature on the experiences of pregnant Kurdish women in Iran. The purpose of this study was to describe how these women experienced and perceived their first pregnancy and the meanings they attached to those experiences. A qualitative study was carried out. Data were obtained from 15 women whose interviews were tape-recorded and transcribed. The women's experiences were varied and diverse. Most had difficulty coping with the physical and emotional symptoms of pregnancy. Physical effects, psychological effects, interaction with their husbands, babies, and relatives were the essential domains related to the experience of pregnancy. Pregnancy is a difficult time for most women and midwives are in a position to make the experience more comfortable and satisfying for these women. Midwives should focus on preparing women for the often dramatic changes in pregnancy at their antenatal visits.
Developing an interactive electronic maternity record
Authors: Homer Caroline SE , Catling-Paull Christine J , Sinclair Dee , Faizah Nor , Balasubramanian Venki , Foureur Maralyn J , Hoang Doan B , Lawrence Elaine 
Published: May 2014

Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women's participation in their maternity care; gives them an increased sense of control and improves communication among care providers. They have been successfully used in the UK and New Zealand for almost 20 years. Despite evidence that supports the use of hand-held records, widespread introduction has not occurred in Australia. The need for an electronic version of pregnancy hand-held records has become apparent, especially after the introduction of the Electronic Medical Record in Australia. A personal digital assistant (PDA) was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet. This article will describe the testing of the antenatal electronic maternity record.
Using service-users' views to design a maternal obesity intervention
Authors: Khazaezadeh Nina , Pheasant Hannah , Bewley Susan , Mohiddin Abdu , Oteng-Ntim Eugene 
Published: May 2014

Obesity is increasingly a matter of concern in the general population, but maternal obesity has received limited emphasis compared to adult and childhood obesity. In addition there is a lack of evidence regarding service users' views. A qualitative study was conducted to identify and understand the health-care needs of service users in Lambeth in south-east London. Semi-structured interviews were conducted with six obese pregnant women and three obese women trying to conceive. The lack of awareness of obesity as well as the lack of existing services was acknowledged. The need to develop and implement evidence-based care pathways which focus on improving the identification and management of obesity and include a community-based multi-component, and culturally sensitive intervention was recommended. This feasibility study has highlighted key issues raised by women given the limited evidence of effectiveness around interventions for this target group.
Kangaroo care in pre-term or low birth weight babies in a postnatal ward
Authors: Gregson Sarah , Blacker Jonathan 
Published: May 2014

Objective: To compare the efficacy of Kangaroo care (skin-to-skin contact with mother) with standard care (next to the mother in a cot) for premature, low birth weight and babies of diabetic mothers in a transitional care ward setting. Method: This was a cohort study undertaken in a transitional care/postnatal ward of a UK district general hospital. The study involved 214 babies (107 in the study group, 107 in the control group) with a gestation 34-36+6 weeks, small for gestational age and babies of diabetic mothers. Babies in the study group had Kangaroo care following birth up to 6 weeks of age. Control group had standard care (in the cot next to the mother). The main outcome measure was the length of hospital stay. The secondary outcome measures were breastfeeding at discharge from hospital and at 6 weeks, admission to neonatal intensive care unit (NICU) and parent satisfaction. Results: There was a significant reduction in mean length of stay (4.33 vs. 5.01 days, P = 0.017, 95% CI 3.93-4.73 and 4.58-5.44) in the study group compared to the control. There was also an increase in exclusive breastfeeding rates on discharge from hospital in the study group (72% vs. 55% P = 0.01, OR 2.09, 95% CI 1.18-3.69). There were no differences in feeding outcomes at 6 weeks, or in admission to NICU. Conclusions: Kangaroo care is a simple intervention that reduces length of hospital stay and improves breastfeeding rates on discharge from hospital for babies cared for in a transitional care/postnatal ward setting. Parents rate Kangaroo care highly, especially in the first 2 weeks following birth.
The role of fathers in breastfeeding: Decision-making and support
Authors: Datta Jessica , Graham Berni , Wellings Kaye 
Published: May 2014

Background In recent years closer attention has been paid to the role of fathers in both the decision about whether to breastfeed and in supporting a breastfeeding mother. This qualitative study explores couples' decision-making regarding infant feeding, parents' views on the father's role in relation to breastfeeding, and examines some dilemmas fathers face when supporting a breastfeeding partner. Methods Eighteen men and women using maternity services at the Royal Sussex County Hospital were interviewed by telephone. Results Fathers acknowledged that the decision to breastfeed should be made by the mother and a father's role was to endorse his partner's decision and provide practical and emotional support. Those who faced breastfeeding difficulties described the processes involved in deciding whether to continue. Conclusions This small study draws upon the views of men and women living in the south-east of England in a city with high rates of breastfeeding initiation. Findings may not be generalizable to the wider population. However, in this setting new parents need information about breastfeeding and support to make informed decisions about duration and further input from health professionals when facing difficulties.
Maternal—fetal attachment and engagement with antenatal advice
Authors: Ross Emily 
Published: May 2014

Background: Following research demonstrating the effect of the intrauterine environment on childhood health and health in later life, women are encouraged to adopt healthy behaviours during pregnancy in order to promote the health of the fetus. Aim: This research aimed to explore the influences on women's engagement with healthy practices during pregnancy, particularly the effect of maternal—fetal attachment. Methods: This qualitative study used nine semi-structured interviews and one focus group. These were conducted with women who were pregnant or who had recently given birth. Participants were questioned about their attitudes towards and engagement with the health advice they received during pregnancy. Results: The bond felt with their baby was an important influence on women's decisions to adopt healthy behaviours during pregnancy. This bond was created in many ways. Previous studies have found an increase in women's adherence to healthy behaviours as levels of maternal–fetal attachment increase. However, this research found that as women became more bonded to the fetus they became more reassured of its wellbeing, and were less anxious about strictly adhering to healthy diets or abstaining from alcohol. conclusions: If health advice emphasises the wellbeing of the fetus in efforts to improve maternal health behaviour during pregnancy, women may not see its relevance if their embodied experience and diagnostic tests indicate that the fetus is healthy. The health advice offered to women should be sensitive to their personal experiences of pregnancy.
Birth practices of Nigerian women in the UK
Authors: Dike Priscilla 
Published: May 2014

This literature review was carried out in the UK to explore the cultural practices of Nigerian women during pregnancy and childbirth both within and outside their indigenous community, in order to highlight aspects of birth practices that may serve to enhance their health and wellbeing or to constrain these.Literature was sourced from journals of related disciplines. To encapsulate current knowledge and broaden the scope of the literature review, only articles published within the last 2 decades were selected for this review.Themes drawn from the literature review sum up core beliefs and practices of Nigerian women in childbirth and uncover existing knowledge on the topic in relation to: beliefs and traditions through the birth continuum, the influence of culture on birth practices and beliefs within and outside their indigenous community, challenges of culture to maternal adaptation and/or transition to motherhood in terms of migration and acculturation, the value of motherhood and children in Nigerian culture, social support or the lack of it, religion and spirituality and the interplay of these in their birth experiences. These themes bear relevance to Nigerian women’s experience of pregnancy, birth and maternity care experience both in their home country and in the UK.