bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing students' concerns about end of life in California, Norway, and Sweden
Authors: Smith-Stoner Marilyn , Hall-Lord Marie Louise , Hedelin Birgitta , Petzäll Kerstin 
Published: May 2014

Aim: To investigate concerns about dying for newly admitted nursing students from California, Norway, and Sweden. Method: A total of 389 undergraduate nursing students who had just started their nursing programme participated. Data was collected with a questionnaire that included two instruments—the Concerns about Dying instrument and the Sense of Coherence instrument—and background questions. The data was analysed using statistical and content analysis. Results: There were statistically significant differences between the three groups of students in terms of their age, their experience in health care, whether they had previously attended a dying patient, the age at which they first encountered the death of a loved one, and their concerns about dying. Two main categories emerged from the analysis of the open questions: ‘attending to dying and grieving persons' and ‘thinking about one's own death’. Conclusion: The study provides important insights into the concerns that newly admitted students bring to the nursing programme.
Adjusting to the caregiving role: the importance of coping and support
Authors: Epiphaniou Eleni , Hamilton David , Bridger Susanne , Robinson Vicky , Rob George , Beynon Teresa , Higginson Irene , Harding Richard 
Published: May 2014

Background: Although informal end-of-life care is associated with significant physical and psychological morbidity for caregivers, few interventions have been developed to meet these needs. This study aimed to identify existing coping and support mechanisms among informal cancer caregivers in order to inform intervention development. Method: One-to-one semi-structured qualitative interviews were undertaken with 20 informal cancer caregivers of home palliative care patients. Results: Caregivers’ existing coping strategies included distraction, mental stimulation, emotional release, looking for the positive aspects of caregiving, and disengaging from stressful thoughts. The majority of the participants described the importance of support and understanding from family and friends. Conclusions: The data suggests that feasible and acceptable interventions will be those that are targeted to caregivers to assist them in optimising existing coping strategies and support from family and friends.
Use of electronic data collection to assess pain in thalassaemia: a feasibility study
Authors: Trachtenberg Felicia L , Martin Marie , Green Sage , Oliveros Olivia , Carson Susan , Gerstenberger Eric , Allen Racquel , Eile Jennifer , Haines Dru 
Published: May 2014

AimTo assess the feasibility of collecting electronic pain data from thalassaemia patients, based on its acceptability and convenience to the participants and study team.MethodsParticipants in the Thalassemia Clinical Research Network Assessment of Pain Survey Study completed the Brief Pain Inventory (BPI) quarterly by paper or phone interview. Participants in a substudy completed the BPI Short Form daily over three non-consecutive transfusion cycles through an automated telephone system.ResultsThe consent rate for the main study was 93%, with 93% retention. The substudy had 75% retention, with more than 75% of scheduled calls completed. Regular monitoring of enrolment, missed calls, data quality, and the performance of the subcontractor for the automated system was crucial to fulfillment of the study goals.ConclusionsUse of electronic data collection for patient-reported outcomes was convenient for both patients and study personnel but required human interactions beyond the automated system to maximise data quantity and quality.
Nurses' perspectives on the discharge of cancer patients with palliative care needs from a gastroenterology ward
Authors: Aamodt Ina Marie Thon , Lie Irene , Hellesø Ragnhild 
Published: May 2014

Background: People with cancer usually like to spend as much time as possible at home rather than in the hospital. Nurses have a pivotal role when patients are discharged to a unit in hospital or from hospital to the community health-care system. Aim: To explore how frontline surgical nurses assess patients with gastrointestinal cancer receiving palliative care and the implications of their assessment and competency for the patients' discharge destinations. Methods: A descriptive exploratory approach was used involving focus group interviews with a purposive sample of ten nurses from an inpatient gastroenterology surgical ward at a university hospital in Norway. Transcriptions of the interviews were analysed using Kvale and Brinkman's thematic approach. Results: Two overall themes emerged that had implications for the nurses' recommendations for optimal patient follow-up care after discharge: ‘the complexity of and fluctuations in the patients' health status' and ‘considering the competency of the nurses at the discharge destinations’. Conclusions: This study illustrates surgical nurses' perspectives on the discharge destinations of cancer patients receiving palliative care. The findings have implications for initiatives aimed at providing more home-based palliative care.
Clinical nurse specialists’ perspectives on advance care planning conversations: a qualitative study
Authors: Boot Michelle , Wilson Catherine 
Published: May 2014

Objective: The aim of the study was to identify the challenges experienced by clinical nurse specialists (CNSs) when facilitating advance care planning (ACP) conversations with terminally ill patients. This paper focuses on the factors that influence CNSs when they are deciding whether to open an ACP discussion. Methods: Semi-structured interviews were used to collect data from eight purposively selected palliative care CNSs working in two different community teams. The interviews were recorded, transcribed, and analysed to identify themes. Findings: ACP required the CNSs to ‘walk a tightrope’, balancing potential harm with purported benefit. The nurses identified that their decision to introduce an ACP discussion was influenced by three key factors: an assessment of the patient's readiness to discuss the topic, their physical condition, and the nurse's relationship with the patient and family. Conclusion: ACP involves risk-taking on the part of those initiating it, owing to the potential for unforeseen or negative consequences. Further research is required to identify the factors that facilitate nurses involving patients in ACP.
Improving dementia care in nursing homes: experiences with a palliative care symptom-assessment tool (MIDOS)
Authors: Krumm Norbert , Larkin Philip , Connolly Michael , Rode Peter , Elsner Frank 
Published: May 2014

Background In the past decade, the palliative care approach has been used in the care of frail older people living with debilitating chronic conditions, including dementia. Aim To describe health professionals' experiences of assessing the symptoms of people with dementia using a cancer-patient-oriented symptom-assessment tool from a palliative care context. Method This was a qualitative study that used semi-structured interviews (n=13) with clinical staff in three nursing homes prior to and following the implementation of the Minimal Documentation system for Palliative care (MIDOS) tool for assessing symptoms over a period of 6 weeks. Results Baseline interviews showed specific concerns about symptom assessment, such as uncertainty about underlying symptoms in residents who appeared to be in distress. After the implementation of the MIDOS tool, participants reported that daily use of the tool was perceived as helpful in evaluating symptoms other than pain and improved internal communication between staff regarding clinical decision making. Conclusion The MIDOS tool was perceived as a helpful and valuable complement to existing tools. Participants expressed some concerns regarding the subjective nature of perceiving symptoms and clinical decision making. The use of tools such as the MIDOS tool has the potential to enhance the quality of palliative care in dementia care.
Impact of a legislative framework on quality of end-of-life care and dying in an acute hospital in Spain
Authors: Sánchez Juana María Sepúlveda , Sánchez José Carlos Canca , Trueba Enrique Pérez , Dominguez Antonio Rueda , Asencio José Miguel Morales , Gil Isabel María Morales 
Published: May 2014

Background In Andalusia, Spain, a legislative framework was put in place in 2010 to guarantee dignity in dying and quality of care in the last phase of life. Aim The aim of this study was to determine whether health professionals have incorporated the requirements of this legislation into their clinical practice and whether there have been improvements in decision-making procedures affecting the quality of dying in hospitals. Methods A cross-sectional analysis was carried out in an acute hospital in Andalusia, Spain. Clinical records of patients who died in the Costa del Sol Hospital were evaluated before and after the new legislative framework was introduced. Participants were all the patients aged over 18 years (n=398) who died in 2009 (n=216) or 2011 (n=182) of oncological disease or non-oncological chronic disease. Bivariate analyses evaluated differences between the two periods and associations among the patients’ characteristics and the context of care. Results Provision of information on measures to facilitate comfort and the relief of physical suffering increased from 15.7% to 22.0%, although this was not significant. There was a significant increase in the number of patients who received joint counselling in this regard from doctors and nurses, from 0% in 2009 to 7.1% in 2011. Conclusions The minimal changes found 1 year after the implementation of the framework confirm that culture change is a lengthy, difficult task that cannot be achieved through laws alone.
Psychoneuroimmunology: a theoretical basis for occupational therapy in oncology?
Authors: Mailoo Venthan J , Williams Catherine J 
Published: May 2014

Psychoneuroimmunology is the scientific study of the physiological two-way link between the mind and the immune system. It is difficult to find published results of clinical controlled trials of the therapeutic effects of occupational therapy modalities in cancer care. The roots of occupational therapy have been neglected and perhaps forgotten in England's NHS, resulting in the loss of professional identity. The original occupational therapy ethos is, however, supported by psychoneuroimmunology research findings.This article looks at the oncology-specific psychoneuroimmunology literature and its implications for cancer treatment. It highlights the point that further research based on psychoneuroimmunology could contribute to an evidence base for occupational therapy in oncology.
Predicting outcome for older people in a hospital setting: which scales are appropriate?
Authors: Slade Anita , Fear Jon , Tennant Alan 
Published: May 2014

Discharge from hospital to a nursing home represents a major event in the life of an older person and should follow the most comprehensive functional and medical assessment. This article aimed to identify factors that influence placement and specifically test which widely used standardized instruments of health status may be useful in an assessment. A cohort study was undertaken of 549 patients admitted to three acute ‘medicine for the elderly’ wards in an NHS Trust in Northern England. Outcome measures were a variety of health status measures in current use. Results showed that baseline assessment using generic self-completed measures of health status failed to predict future placement. However, four measures used routinely within a clinical setting – the Northwick Park Dependency Scale, the Abbreviated Mental Test Score, the Modified Barthel Index and the Caregiver Strain Index – did discriminate across outcomes.
Mental health recovery and occupational therapy in Australia and New Zealand
Authors: Lloyd Chris , Tse Samson , Bassett Hazel 
Published: May 2014

Every individual with mental illness has the right to be safe and cared for. Most people will receive the love and care from their families and friends, but they will also expect mental-health professionals, occupational therapists and the community to work together to provide the necessary services to support their recovery from mental illness. This article highlights the development of the recovery approach for people with mental illness in Australia and New Zealand. The implications of recovery concepts for occupational therapy, in the areas of individualized approach, participation of service users and carers, person-centred assessment and intervention, intersectoral links and mental-health promotion, are discussed. There are a number of key areas requiring further research and debate, notably the most effective means of implementing and evaluating recovery-focused interventions.
A review of the use of Lycra pressure orthoses for children with cerebral palsy
Authors: Attard Jes , Rithalia Shyam 
Published: May 2014

Dynamic Lycra pressure orthoses (or garments) have been used in recent years as a treatment modality for children with motor impairment, namely cerebral palsy. Improving function is the ultimate goal of prescribing such garments, but there are other important beneficial effects, such as improving proximal stability to help posture and function. This article attempts to explain, in view of current knowledge, how and why dynamic Lycra pressure garments are used and their benefits to children who wear them, providing an outline of current theories behind their function. Two case reports are detailed and some areas for further research are identified.
An extended role for support workers: the views of occupational therapists
Authors: Mackey Hazel 
Published: May 2014

The health and social care environment in Britain is undergoing rapid change and reorganization, which requires occupational therapy practitioners to consider the service they provide, the skill mix needed to support service provision and the boundaries, roles and relationships between professionally qualified staff and support workers. A study, using a qualitative design, was conducted to discover what occupational therapy practitioners perceive to be the major factors that need to be addressed before an extended role for support workers can be implemented. Five focus group interviews were conducted with occupational therapy practitioners, both qualified and unqualified, from a large NHS community trust in the West Midlands. Five key factors emerged: the need to increase role clarity; to lessen role threat; to review organizational effectiveness; to ensure clear delegation; and to design and implement responsive training programmes.
Purchasing electric profiling beds: Benefits and challenges
Authors: Rush Anita 
Published: May 2014

Pressure ulcer prevention and treatment has relied on the provision of special beds and mattresses in the past. When patients spend most of their time in bed, it is essential to ensure that they are as comfortable as possible, can change position, are at a reduced risk of sustaining pressure damage and ultimately, are able to get in and out of bed with ease. The correct choice of bed is paramount as it will provide a safe working environment for carers and a better quality of care for the patient. The aim of this article is to raise the awareness of organizations to the benefits of electric profiling beds and highlight the pitfalls of implementing a electric profiling bed replacement programme. The article concludes that purchasing an electric profiling bed is not as straightforward as it may appear: for organizations implementing a bed replacement programme, it requires systems in place that enable best value for money, are cost-effective and have cost improvements.
Perceptions of interprofessional roles within the spinal cord injury rehabilitation team
Authors: Pellatt Glynis Collis 
Published: May 2014

A spinal cord injury requires input from a range of health-care professionals. Interprofessional teamwork has been seen as the cornerstone of rehabilitation. However, teamwork may be affected by misperceptions of role and function between professional groups. This article presents some findings from a larger ethnographic research study. Its aim is to identify the perceptions of professionals of the roles and relationships within the rehabilitation team. Semistructured interviews were carried out with 27 health-care professionals in a spinal cord injuries unit. The findings suggest a ‘knowing paradox’ in that nurses, occupational therapists and doctors felt that their colleagues misunderstood their role, yet all the professionals felt that they understood their colleagues’ contribution to rehabilitation. Misunderstandings may cause conflict that could impact on the patient's rehabilitation experience. Therefore, professionals need to develop supportive structures that enable greater communication and understanding of each other's roles and competencies.
Recently qualified physiotherapists' perceptions of work-related musculoskeletal disorders
Authors: Graham Lynsey , Gray Heather 
Published: May 2014

The prevalence of work-related musculoskeletal disorders (WRMSDs) among physiotherapists may be as high as 91%, with recently qualified clinicians at greatest risk. Therefore, using a focus group design, this study explored how physiotherapists, within their first 5 years of practice, perceive WRMSDs. Participants perceived physiotherapy as a high-risk profession; however, they felt that their training would prevent them developing ‘serious’ injuries. Injury preventative strategies were often neglected owing to high caseloads, time constraints, a desire to appear able to cope and moral obligations towards patients. The physiotherapists tended to respond to WRMSDs by self-treating, becoming more aware of their personal risk and taking future precautions as a result. This study highlights that there is a significant need to increase physiotherapists' awareness of their risk of WRMSDs, as well as shifting the culture within the health services to one that facilitates the use of preventative strategies.
Reliability of the Australian Therapy Outcome Measures for quantifying disability and health
Authors: Morris M , Taylor N , Dodd K , Perry A , Skeat J , Unsworth C , Duncombe D , Duckett S 
Published: May 2014

The Australian Therapy Outcome Measures (AusTOMs) quantify client outcomes for physiotherapy, speech pathology and occupational therapy across four domains: impairment (of body structure and function); limitation in functional activity; restriction of participation in societal roles; and distress/wellbeing (level of concern). Data reporting the preliminary reliability of the AusTOMs tools are presented. Participants were 150 clinicians from hospital and rehabilitation centres in Melbourne, Australia. Written case vignettes were used to obtain percentage agreement scores between raters for each of the four domains of the AusTOMs. Test–retest reliability was also determined. Satisfactory preliminary inter-rater scores were obtained, with most scales in each profession showing high levels of agreement, although some scales had at least one domain with less than 80% agreement. Across all three professions, test–retest reliability was satisfactory. Overall, specific domains showed less agreement than others, and the implications of these findings and indications for further research are discussed.
Use of video self-modelling and implementation intentions following facial nerve paralysis
Authors: Coulson Susan E , Adams Roger D , O'Dwyer Nichols J , Croxson Glen R 
Published: May 2014

This research aimed to address smile deficits after long-term facial nerve paralysis (FNP) by implementing two treatments not previously used for FNP: video self-modelling and implementation intentions. Two FNP subjects were studied, who were both experiencing difficulty producing symmetrical smiles, particularly in social situations. Smile types measured were a symmetrical (adapted) smile and an asymmetric (everyday) smile. Treatment involved each subject observing only his or her best adapted smiles on videotape, three times a day for 2 weeks. Time from onset to smile completion was recorded and to assess quality, 20 observers rated randomly ordered smiles. For adapted smiles, there was both a significant post-treatment decrease in time from initiation to completion and a rated improvement on the dimensions of overall smile quality, movement control and symmetry. Therefore, with increased speed, the more symmetrical adapted smile could be used spontaneously during designated social interactions. These case studies suggest that smile symmetry and control can still be improved some years after FNP, and that video self-modelling and implementation intentions warrant further research.
Influences on long-term exercise adherence in older patients with cardiac disease
Authors: Little Anne , Lewis Kiara 
Published: May 2014

Using a qualitative approach, this study explored attitudes, social support and barriers influencing long-term exercise adherence among five older patients with cardiac disease. Results found that patients understood and valued the benefits of health-related exercise, thereby demonstrating positive exercise attitudes. Some patients, however, were unsure of the recommended guidelines for producing exercise benefits. Introducing into exercise rehabilitation programmes strategies to assess knowledge of exercise guidelines may prove useful in confirming patients' understanding of these guidelines. Future research into the effectiveness of such strategies is recommended. Support from family, friends, and health professionals was found to be important in long-term exercise adherence. Some patients, however, were unhappy with the nature of support provided. While doctors encouraged patients to exercise, not all prescribed exercise because they knew little about the referral schemes available. This suggests the need to evaluate service provision to ensure that doctors are informed and active in prescribing exercise. Barriers, such as poor health and lower body limitations, did not prevent exercise per se, however, they did prevent patients exercising at levels recommended to protect against disease progression.
An interprofessional role-emerging placement in HIV rehabilitation
Authors: Solomon Patricia , Jung Bonny 
Published: May 2014

People with human immunodeficiency virus (HIV) are living for longer with a variety of impairments and disabilities that are amenable to rehabilitation interventions. This article presents an interprofessional model of clinical education in which an occupational therapy student and a physiotherapy student worked together to develop an emerging role for their professions in the management of HIV in a community health centre. Students developed a consultation model that focused on self-management of HIV-related disability. Students were able to provide mutual support to each other as they designed a joint assessment process and educational materials for people living with HIV. This model of clinical education successfully integrated three innovative educational elements: a role-emerging placement, interprofessional education and HIV care. Careful planning and selection of students for this type of placement is essential for its success.