bluuebunny/crossref_metadata_2025_split huggingface dataset:
An audit of the use of the Barthel Index in palliative care
Authors: Godfrey Jackie , Poole Lisa 
Published: May 2014

The Barthel Index (Mahoney and Barthel, 1965) is an objective tool which assesses an individual’s ability to perform activities of daily living; for example, personal care, mobility, transfers, bathing and feeding. The purpose of this study was to investigate whether the Index could be used with patients with life-threatening illnesses who are admitted to the inpatient intermediate care unit, to aid clinical practice, establish patients’ current level of function, and highlight any progress or deterioration in abilities. The overall aim was to facilitate discharge planning and ensure that patients were managed in their preferred place of care. This was a clearly defined group of patients in a specific clinical area. The authors recognise that to improve consistency of findings, the study may need to be applied to a larger cohort of patients with a greater research emphasis. The article presents the results of an audit of 50 patients. The findings suggest that those patients with a low Barthel score on admission, or those with a score dropping by ten or more per week, are significant predictors of a short prognosis. It concludes that the Barthel Index would be a useful tool in the community to prevent inappropriate admission for those with a low score where the patient wishes to die at home. It could also be used as a monitoring tool to help discharge planning and fast-tracking to the preferred place of care in inpatient settings, and may also assist in community health care (CHC) planning.
The reflections you get: an exploration of body image and cachexia
Authors: Hinsley Ros , Hughes Rhidian 
Published: May 2014

Background: Cachexia has a detrimental effect on quality of life and is an indicator of poor prognosis. The meanings people attach to their lived experiences of cachexia is unknown. Aims: To explore the impact of cachexia on body image of people with advanced cancer, their emotions, relationships and social functioning. Design: Qualitative study using face to face in-depth interviews of a conversational style. Rich narrative data analysed by thematic content analysis. Participants: Twelve participants recruited from two community palliative care teams in south east England. Results: Altered body image impacts onto other aspects of embodiment: the emotions, spirituality, relationships and social functioning. Lives were restricted and isolated, which was compounded by emotional distancing by carers and health care professionals. Participants discussed their repeated attempts to re-adapt to disruptions of self caused by an altered body image. Conclusions: The key study implications focus on the need for: i) improved holistic care and support, and advice; ii) training and awareness raising of care professionals and iii) further research on the lived experiences of the condition and the development of effective measures of cachexia.
Theraputic relationships in specialist palliative care nursing practice
Authors: Canning Deebs , Rosenberg John P , Yates Patsy 
Published: May 2014

There has been limited research into the scope or standards of specialist palliative care nursing practice in an Australian context. This study sought to develop a competency framework that described the core domains of specialist palliative care nursing. This article explores one key domain of specialist palliative care nursing practice – therapeutic relationships – that was identified as underpinning other domains of practice. A mixed method was used, involving a literature review, a survey including practice exemplars and an interview of specialist palliative care nurses. Seventy-four registered nurses working in designated specialist palliative care nursing roles from each Australian state and mainland territory were involved. The nurses represented metropolitan, regional, rural and remote communities, various inpatient facilities and community practice settings. Five core domains of specialist palliative care nursing practice were identified: complex supportive care, collaborative practice, leadership, improving practice and therapeutic relationships. Therapeutic relationships were identified as the central domain of specialist palliative care nursing practice to which all other domains were inextricably linked.
A survery of commitment and compassion among nurses in residential aged care
Authors: Phillips Jane L , Davidson Particia M , Ollerton Richard , Jackson Debra , Kristjanson Linda 
Published: May 2014

Aim: To assess the views and attitudes of aged care staff providing direct care towards palliative care and to identify their learning needs. Design: Survey design using purposive sampling methods. Findings: Nurses and care assistants (n=222) employed within nine residential aged care facilities in regional Australia completed the survey. The majority had received ‘on the job training’ and were committed to providing end-of-life care. Differences in the level of confidence to deal with patient/family interactions and manage complex palliative care scenarios were evident between nurses and care assistants (p<0.05). Both nurses and care assistants perceived a need for further education in symptom management and communication, yet their content need differed significantly between groups. Conclusions: Nurses and care assistants in residential aged care facilities demonstrate commitment to the delivery of palliative care and express a need for increased palliative care competencies. The heterogeneity of roles and educational preparation within the aged care workforce indicate that tailored palliative care education initiatives are required to meet the learning needs of aged care nurses and care assistants, particularly in relation to end-of-life care. These data have implications for skill-mix and model of care development.
Hope in terminal illness: an evolutionary concept analysis
Authors: Johnson Sarah 
Published: May 2014

Aims: To clarify the concept of hope as perceived by patients with a terminal illness, to develop hope as an evidence-based nursing concept, to contribute new knowledge and insights about hope to the relatively new field of palliative care; endeavouring to maximize the quality of life of terminally ill patients in the future. Method: Utilizing Rodgers’ (2000a) evolutionary concept analysis methodology and thematic content analysis, 17 pieces of research-based literature on hope as perceived by adult patients with any terminal illness pathology, from the disciplines of nursing and medicine have been reviewed and analyzed. An exemplary case of the concept in action is presented along with the evolution of the concept hope in terminal illness. Results: Ten essential attributes of the concept were identified: positive expectation; personal qualities; spirituality; goals; comfort; help/caring; interpersonal relationships; control; legacy; and life review. Patients’ hopes and goals are scaled down and refocused in order to live in the present and enjoy the time they have left with loved ones. Conclusion: By completing all the steps to Rodgers’ (2000a) evolutionary view of concept analysis, a working definition and clarification of the concept in its current use has been achieved. This provides a solid conceptual foundation for further study.
Circumstances surrounding death and nursing difficulties with end-of-life care for individuals with ALS in central Japan
Authors: Ushikubo Mitsuko , Okamoto Koichi 
Published: May 2014

Purpose: This study aimed to clarify the circumstances surrounding death for people with amyotrophic lateral sclerosis (ALS) in Japan and difficulties in providing home-care end-of-life nursing for these individuals. Method: A questionnaire was mailed to the directors of 709 home-care nursing agencies located in central Japan. Results: Of 232 questionnaires returned (response rate 32.8%), 49 reported treating someone with ALS. Overall, 31% of these patients died at home, whereas 63% were admitted to hospital from a few days to months preceding death. Respiratory insufficiency was identified as the cause of death in 73% of cases, 45% of the deaths were sudden, and 27% of the deaths involved CO2 narcosis. Analysis of the reported nursing difficulties resulted in five categories: lack of adaptation to the disease or disease progression by the patient and/or their family, involvement with family, how to select/deliver care, decision-making and communication, and poor collaboration with other practitioners. Conclusion: Family care and family education are important to supporting the end-of-life process for people with ALS. Use of advance directives and collaboration with other related practitioners are recommended to enhance communication linked to psychological care and informed consent.
Parents' perspectives on the deaths of their children in two Brazilian paediatric intensive care units
Authors: El Halal Gilda MC Abib , Piva Jefferson P , Lago Patrícia M , El Halal Michel GS , Cabral Felipe C , Nilson Cristine , Garcia Pedro CR 
Published: May 2014

Objectives: To evaluate the quality of care offered to terminally ill children and their families in the last days of life in two Brazilian Paediatric Intensive Care Units (PICUs) from the parents’ perspectives. Methods: This was a qualitative, exploratory study. Parents of a child who had died in one of the PICUs 6–12 months previously were invited to take part in two interviews: a private meeting with the PICU assistant physician who cared for their child, to discuss and review any outstanding issues related to the diagnosis, treatment, and prognosis, and a recorded interview with a researcher who was not involved in the child's treatment. Data from the interviews with the researcher were posteriorly grouped in categories according to recurrent terms. Results: Six categories emerged, three of which are reported here. The quality of communication was low; the medical staff frequently used technical terms, limiting understanding. Parental participation in the decision-making process was scarce; decisions were based on the medical perspective. Finally, families reported uncompassionate attitudes from the medical staff and excessive technology in the final moments surrounding the child's death, although nurses were highly involved with palliative care measures and demonstrated sympathetic and supportive postures. Conclusion: The interviews uncovered deficiencies in the care provided to parents in the PICUs, indicating a need for changes in practice.
Access and attitude of rural allied health professionals to CPD and training
Authors: Stagnitti Karen , Schoo Adrian , Reid Catherine , Dunbar James 
Published: May 2014

Continuing professional development (CPD) activities for allied health professionals are becoming mandatory as a means for professionals to maintain accreditation or skills. To access CPD activities, rural allied health professionals have the added costs of travel, accommodation and information technology access. It is assumed that health professionals in rural areas want access to training and CPD. In 2003, a survey of allied health professionals was carried out in Southwest Victoria, Australia, with the aim of identifying access and attitudes to CPD. Results showed that allied health professionals in Southwest Victoria were highly qualified, wished to access CPD more than four times a year and were prepared to spend a mean rate of $1000 (£300) per annum on CPD activities.
Exploring environmental control unit use in the age group 10-20 years
Authors: Paul SN , Frank AO , Hanspal RS , Groves R 
Published: May 2014

The purpose of this retrospective study was to analyse the demography and use of Environmental control units (ECU's) within a regional setting in the age group 10–20 years. It was envisaged that this information might raise awareness and use of ECUs by health care professionals. The North Thames Regional ECU database was interrogated to identify users provided with an ECU between the ages of 10–20 years and also examined for sex, type of school attended, diagnosis, and source of referral. Of those involved in the study 54 users (39 male) with a mean age at first assessment of 14 years (range 10—20 years) had been provided with ECUs as of September 2003. Eighty nine per cent of school age users attended mainstream schools. Muscular dystrophy and cerebral palsy accounted for 42% and 29% of diagnoses respectively. Seventy nine per cent of referrals came from community occupational therapists (OTs). No referrals resulting in the provision of an ECU were received directly from a neurologist or rehabilitation physician. One referral was received from a paediatrician. In North Thames, community OTs are the commonest referrers for ECUs and muscular dystrophy is the most common medical diagnosis in paediatric and adolescent users of ECUs respectively. The potential for ECUs to enable young people to remain independent and to ease the strain on their families may not be understood among other healthcare professionals.
Patient satisfaction with accelerated discharge following unilateral knee replacement
Authors: Barker Karen L , Reilly Kathleen A , Minns Lowe Catherine , Beard David J 
Published: May 2014

The aim of this study was to identify and describe patients' satisfaction after accelerated and usual discharge from hospital following elective orthopaedic surgery. It identified patients' perceived discharge preferences and describes factors that they believed to be important. The research was conducted with 41 patients who had participated in a randomized controlled trial comparing accelerated discharge after Oxford unicompartmental knee replacement with standard care. A qualitative study design using a combination of a validated questionnaire and supplementary open questions was used. The data from this open question underwent content analysis. Both accelerated and usual care patients appeared to be highly satisfied following their knee replacement. This study indicates that patients seem satisfied with early discharge and that the majority who had experienced accelerated discharge would prefer accelerated discharge again in the future, if they required similar surgery. The benefits of being at home, altruism, experience and knowledge were reasons provided for this view.
An audit of patient records into the nature of pulsed shortwave therapy use
Authors: Mansour Al-Mandeel Maryam , Watson Tim 
Published: May 2014

This evaluative audit aimed to investigate the nature of pulsed shortwave therapy (PSWT) use in outpatients clinics in England through the analysis of patient records. Eight randomly selected hospitals were chosen to reflect variations in practice across the country. Information concerning the total number of patients seen in these departments, the proportion of patients treated with PSWT, the mode of treatment (duration of exposure, PSWT parameters, treatment frequency and outcome) and the conditions treated were collected and analysed. A total of 1750 sets of physiotherapy patient notes were evaluated of which, 192 patients were treated with PSWT, averaging 11% of all treatments. The treatment records were found to be of generally poor quality. None of the files examined fulfilled the Chartered Society of Physiotherapy standards of documentation. Eighty eight percent of the files did not have reproducible treatment plans in terms of dose parameters. The issues raised by this evaluative audit are considered in the context of therapy treatment notes and in relation to PSWT.
The physical self-concept in patients with depressive and anxiety disorders
Authors: Knapen Jan , Vermeersch Joeri , Van Coppenolle Herman , Cuykx Veerie , Pieters Guido , Peuskens Joseph 
Published: May 2014

Patients suffering from depressive and/or anxiety disorders are characterized by a low physical selfconcept. The objective of the present study was to investigate which variables were related to the physical self-concept in these patients. One hundred and ninety-one patients (67 males and 124 females) hospitalized in a university psychiatric hospital in Belgium took part in the study. The severity of depression and anxiety, level of physical activity, physical self-concept, perceived benefits and barriers towards physical exercise, and motivation towards psychomotor therapy were assessed by means of questionnaires and a visual analogue scale. A stepwise multiple linear regression analysis was used to ascertain the explaining variables of the physical self-concept. The explaining variables, in order of importance, were: severity of depression, barriers towards physical exercise, motivation towards psychomotor therapy, level of physical activity, age and gender. Patients with a low physical self-concept are characterized by a high severity of depression, a low level of physical activity and a low motivation towards psychomotor therapy. They also experience many barriers towards physical exercise.
A UK survey of therapists' perspectives on post-amputation hopping
Authors: Stokes D , Curzio J , Bacon E , Barker L , Berry A , Morten M 
Published: May 2014

Aims: There is a lack of evidence to guide therapists on early mobility with patients post-amputation. Guidelines were published in the UK in 2006 to assist therapists with decision making in this area. In light of these guidelines, the author sought to explore UK therapists’ views, experiences and sources of knowledge on hopping with and without aids post amputation, and identify further areas for research. Methods: A survey methodology was adopted. Data were analysed using descriptive statistics and respondents’ written remarks were explored to support the analysis. Findings: Survey responses were returned by 88 therapists; 27 occupational therapists and 61 physiotherapists. Hopping without aids was not recommended by any therapist. 61% of respondents would recommend hopping with aids in some circumstances; 63% felt that some patients have to hop to get around the home; 52% felt that hopping was inadvisable and 40% thought it would delay rehabilitation. 90% of therapists have had amputees report they are hopping. Senior staff and colleagues were the most cited source of knowledge on post-amputation mobility. Conclusions: In the absence of evidence, therapists rely on other colleagues and personal observations to inform their practice in this area. Findings suggest that therapists are following the guidelines which advise that wheelchair mobility is the ideal, but specified reasons may lead therapists to teach amputees to ambulate with aids. Further research is required on the use of hopping post-ambulation.
Discovering powered mobility skills with children: ‘Responsive partners’ in learning
Authors: Durkin Josephine 
Published: May 2014

Aims This qualitative grounded theory research study was designed and carried out as a PhD thesis to explore the question ‘How does a child learn to use powered mobility to explore their environment?’. Methods The research took place in four interconnected stages. Initially 11 typically developing children were observed and video-taped learning to use a powered wheelchair. Comparison and coding of the video data to develop the emerging themes led to three further data sets: consulting with seven experienced power mobility users in focus groups; observing 11 children with disabilities using powered wheelchairs; and focus groups with 22 peer professionals. Findings The findings identified three stages of developmental learning and the themes of ‘partnerships and models’, ‘listening to disabled children’ and ‘engaging with children through play’. Analysis of these themes led to the emergence of the core category ‘responsive partner’. Conclusions A constructivist methodology of exploration enabled child-centred research to take place. Components of learning were identified and stages of progression for powered mobility discovered. Findings revealed that services should focus on the clinician being a responsive partner who does not command but is able to elicit new learning, and future research should explore this framework further.
Comparing stabilization training with balance training in recreationally active individuals
Authors: Aggarwal Anoop , Zutshi Kalpana , Munjal Jitender , Kumar Suraj , Sharma Vijai 
Published: May 2014

Aims The present study was undertaken to compare the efficacy of lumbar core stability training with that of balance training, at improving the balance performance in the recreationally active individuals. Most of the studies to date have been conducted on sporting professionals, whose activity demands are higher than the norm. The present study focuses on the recreationally active population, for which the activity demands are comparatively lesser. Methods Thirty recreationally active subjects (15 males and 15 females) were selected for this study. Subjects were randomly divided into three groups: core stability training group (CSTG), balance training group (BTG), and the control group. All subjects were assessed at baseline, and after six weeks, for balance performance, including static, dynamic and functional balance tests. Data were analyzed by paired t-test, ANOVA, Wilcoxon signed-rank test and Kruksal Wallis test. Findings Both training groups (BTG and CSTG) showed significant (P < 0.05) improvement in balance performance compared to the control group, however the improvement in the mean value for the CSTG was greater than that of the BTG. Conclusions Balance training as well as core stabilization training leads to improvement in static and dynamic balance. However none of these training leads to improvement in the functional balance performance.
The role of an Australian homeless health outreach team. Part 1: background
Authors: Lloyd Chris , Bassett Hazel 
Published: May 2014

Background The aim of this article is to describe the development, principles and practices of the Homeless Health Outreach Team in Queensland, Australia. The following article, in the next issue, builds upon this with a case study. Contents Relevant documentation and literature was reviewed. The Homeless Health Outreach Team has developed a model of practice based on local and international experience. Conclusions Specialized mental health services for the homeless have been able to successfully engage and manage clients by working in collaboration with local mental health services, housing, and non-government organisations.
Burnout and engagement among physiotherapists
Authors: Martinussen Monica , Borgen Per-Christian , Richardsen Astrid Marie 
Published: May 2014

Monica Martinussen, Per-Christian Borgen, Astrid Marie Richardsen Aims: This article describes a study examining predictors of burnout and engagement, including job demands, job resources and Type A behaviour, in a sample of Norwegian physiotherapists (N = 244). Methods: This study measured demographic and work characteristics, job demands, job resources, burnout, work engagement and type A behaviour for all members of the sample. Findings: Both job demands and resources predicted burnout and engagement, and after controlling for these factors, Type A behaviour patterns accounted for additional variance in both burnout and engagement. Finally, Type A behaviour (Achievement Strivings and Impatience-Irritability) moderated several of the predictor-burnout relationships. Conclusions: These findings support the need for studying personality traits in addition to work related factors when predicting both positive and negative work related emotions such as burnout and engagement.