bluuebunny/crossref_metadata_2025_split huggingface dataset:
Admission decisions following contact with an emergency mental health assessment and intervention service
Authors: Brooker Charlie , Ricketts Thomas , Bennett Simon , Lemme Francesca 
Published: June 2007

Aims.  To define the demographic and clinical profile of individuals referred to an emergency mental health assessment team. To identify factors associated with being admitted to inpatient psychiatric services or not admitted following an emergency assessment.Background.  Crisis resolution and home treatment services are being developed across the UK, targeted towards people with severe mental health problems, who would otherwise require hospitalization. Further information about people presenting to an emergency mental health assessment service may clarify the skills that are required to deliver effective crisis resolution and home treatment services.Method.  Over a six‐month period referrals to, and admission decisions by, an emergency mental health assessment team were recorded. Measures used were the Health of the Nation Outcome Scale and the Crisis Triage Rating Scale.Age, sex and postcode data were recorded. Postcode data were used to identify the Townsend Deprivation Index for each individual. Reasons given for the referral were categorized. A preliminary descriptive analysis was performed for all people referred. The Demographic and clinical characteristics of referrals admitted and not admitted were then compared. A multivariate logistic regression was performed in order to investigate the possible impact of demographic and clinical characteristics on admission status.Results.  A total of 375 individuals were referred. Forty‐eight (12·8%) were admitted. Higher referral rates were significantly associated with more deprived areas of the city. Referrers most frequently identified suicide risk as the reason for referral, followed by deterioration of an existing serious mental health problem. The mean Health of the Nation Outcome Scale score of all people referred was 10·5. Those admitted had a significantly greater mean Health of the Nation Outcome Scale score than those not admitted. The mean Crisis Triage Rating Scale score of all people referred was 11·0. Those admitted had a significantly lower (worse) mean Crisis Triage Rating Scale score than those not admitted. Individuals with lower Crisis Triage Rating Scale scores tended to have a higher (more deprived) Townsend index scores. Crisis Triage Rating Scale and Health of the Nation Outcome Scale scores were significantly negatively correlated.Conclusions.  Crisis resolution and home treatments need to target areas of greatest deprivation. Social interventions will be important. Presentations related to suicide risk are likely to be common. The Crisis Triage Rating Scale may be a useful brief alternative to Health of the Nation Outcome Scale.Relevance to clinical practice.  This study highlights the valuable role of mental health nurses in frontline emergency mental health care in particular mental health nurses skills in conducting a risk assessment in an emergency.
Effects of the diabetic patients’ perceived social support on their quality‐of‐life
Authors: Göz Fugen , Karaoz Sureyya , Goz Mustafa , Ekız Secıl , Cetın Ibrahım 
Published: June 2007

Aim.  The aim of this descriptive study was to determine effects of the diabetic patients’ perceived social support on theirs life qualities.Background.  Type 2 diabetes and its treatment effects patients’ quality of life. Quality‐of‐life is important for people with diabetes and their health care providers. Social support for diabetic adults has been shown to benefit disease management and adjustment.Research design.  This research was conducted with 66 type 2 diabetic patients who came for control to the diabetes policlinic between May and June 2003 at diabetes polyclinic in Kocaeli State Hospital of Marmara Region in Turkey. Informed consent was obtained from patients. Data were collected by using the quality‐of‐life scale (SF‐36), perceptional social support scale and the questionnaire prepared by the researchers.Method.  For the analysis of data, Mann–Whitney U‐test, Kruskal–Wallis test, Pearson and Spearman correlation analysis have been employed.Results.  Perceived social support and quality‐of‐life were increased together. Male patients’ and retired patients’ quality life score and perceived social support were high. Meanwhile when educational level was increased, perceived social support and quality‐of‐life were increased. The quality life scores and perceived social support scores were high in patients who living alone and used oral antidiabetic drugs.Conclusions.  If perceived social support and quality‐of‐life were increased together, it means social support increases quality‐of‐life. That is why nurses must try to plan some strategies for increase social support of patients.Relevance to clinical practice.  Assessment of social support of type 2 diabetic patients may assist in determining individualized goals and strategies. Enhanced social support in diabetes self‐management may subsequently improve metabolic control, self‐management and psychosocial adjustment to diabetes.
Supplementary nurse prescribing for patients with skin conditions: a national questionnaire survey
Authors: Carey Nicola , Courtenay Molly , Burke Joanna 
Published: June 2007

Aim.  To examine the prescribing practices of supplementary nurse prescribers (working in both primary and secondary care) who prescribe medicines for patients with skin conditions and the factors that facilitate or inhibit this mode of prescribing.Background.  Nurses work in a variety of roles, with varying levels of expertise, are involved in the treatment management of a broad range of skin diseases. Skin conditions are those for which independent nurse prescribers prescribe most frequently. The role of the nurse, limitations of the formulary and inter‐professional relationships influence the prescribing practices of these nurses. There is no evidence currently available examining the impact and activity of supplementary nurse prescribing for patients with skin conditions.Methods.  A convenient sample of 580 nurses who prescribed for skin conditions and were qualified supplementary nurse prescriber, self‐completed a written questionnaire.Results.  Five hundred and twenty (89·7%) nurses were based in primary care and worked in general practice. Four hundred and thirty‐six (75%) held a degree level qualification or higher, 41 (7%) had specialist dermatology training and 512 (88·3%) had more than 10 years postregistration nursing experience. Supplementary prescribing was used by a minority of nurses. Nurses who had specialist dermatology training used this mode of prescribing most frequently. Doctor and pharmacists lack of understanding of supplementary prescribing, lack of peer support and clinical management plans prevented the implementation of this mode of prescribing.Conclusions.  Supplementary prescribing is used by a minority of nurses to treat skin conditions. A number of factors prevent nurses from using this mode of prescribing including lack of specialist training and lack of support in practice.Relevance to clinical practice.  Specialist dermatology training, an understanding of supplementary prescribing by the members of the healthcare team, and support in practice are required if supplementary prescribing is to be implemented effectively for the treatment of skin conditions.
Determining the political influence of nurses who work in the field of hepatitis C: a Delphi survey
Authors: McKeown Clare , Gibson Faith 
Published: June 2007

Aim.  The principle aim of this study was to determine the political influence and the professional profile of nurses who work in the field of hepatitis C.Background.  Hepatitis C has emerged as a major public health problem. Its growing impact on health services has led to the development and expansion of a range of specialist nursing roles in hepatitis C. The professional group has never been profiled in the current political and social context, although many nurses traverse patient, organizational and strategic levels of practice and service development.Design.  A multi‐centre survey design using the Delphi technique was undertaken to gain consensus. A total of 160 nurses who work in the field of hepatitis C, were invited to participate. The target population was located from 90 sites across the United Kingdom. Data collection comprised two questionnaire rounds. Final sample included 40 participants in round 1 and 34 in round 2.Findings.  The results showed strong consensus on the necessity of structural and policy changes at national and regional levels and nurses’ inclusion within that process. Of note was the need for policy group representation and engagement in the commissioning agenda. Overall, the findings demonstrate that most nurses have advanced contextual understanding of the issues. There is evidence of political activities and nursing influence at local and regional levels. This is less evident at national level, where there is only a core of active members.Conclusion.  These findings reveal nurses to be operating and thinking strategically without referencing their activities as political. Nurses should be more focused in translating strategic thinking into political activities. This should be coordinated and supported through the Hepatitis Nurse Specialist Forum to ensure nurses become increasingly visible in driving services forward at policy level.Relevance to practice.  Successive governments have failed to address the serious structural problems in resource allocation, lack of public awareness and policy direction. This is where patient, organizational and strategy levels interface in hepatitis C because policy affects patients and organizations, patient level care affects policy direction and nurses can influence all three.
Strategies in caring for women with postpartum psychosis – an interview study with psychiatric nurses
Authors: Engqvist Inger , Nilsson Agneta , Nilsson Kerstin , Sjöström Björn 
Published: June 2007

Aim and objective. The aim of this study was to explore strategies in caring for women with postpartum psychosis used by nurses.Background. The most serious type of psychiatric illness in connection with childbirth is postpartum psychosis. Nearly two in 1000 newly delivered women are stricken by postpartum psychosis. Most of these patients need psychiatric care to recover. While earlier studies point to the need for psychiatric care, knowledge of specific nursing strategies in caring for postpartum psychosis patients remains limited.Methods. Interviews with 10 experienced psychiatric nurses were carried out, transcribed verbatim and an inductive content analysis was made.Result. The main strategies for care found in this study were: (i) To create a patient–nurse relationship and (ii) To apply nursing therapeutic interventions. Presence, continuity and nurse‐patient partnership contributed to create a relationship and incorporate the rest of the care team. To satisfy the patients’ basic needs and feeling of security was the foundation of the nursing therapeutic interventions. Confirmation and giving hope were also used as nursing therapeutics as well as information to the patient and her relatives about her illness.Conclusion. The conclusion of the study is that strategies used by nurses are a combination of general and psychiatric nursing approaches but the specificity in caring knowledge for caring patients with postpartum psychosis requires further development.Relevance to clinical practice. The result of the study indicates that it is important to organize patient care for postpartum psychosis with continuity and consistency and to support the nurse to create a relationship and therapeutic intervention with the patient. The present study shows the importance of further developing specific nursing theories that can be applied when caring for patients with postpartum psychosis. It also shows the need for further pedagogical education for mental health nurses.
‘It was not chest pain really, I can't explain it!’ An exploratory study on the nature of symptoms experienced by women during their myocardial infarction
Authors: Albarran John W , Clarke Brenda A , Crawford Jenny 
Published: June 2007

Aims and objectives.  This study sought to explore the presenting nature of cardiac symptoms as experienced by women diagnosed with a myocardial infarction. The objectives were to use the participants’ own words to gain a detailed understanding of how they perceived their evolving symptoms.Background.  Women with coronary heart disease tend to delay seeking help despite experiencing symptoms. The classic hallmarks used to diagnose a myocardial infarction have been based on research primarily involving white middle‐aged men with a focus on specific descriptions of chest pain. Whether these hallmarks apply to women in the same way as they apply to men is an area of increasing contention.Design.  Using a purposive sample, a qualitative design was used to investigate the nature of cardiac symptoms experienced by women prior to and at the time of their myocardial infarction.Method.  Twelve women participated in semi‐structured in‐depth tape‐recorded interviews conducted while they were in hospital.Results.  Three interlinking themes emerged, which reflect a changing dynamic status in health, mediated by the perceived threat of individual symptoms. These included gradual awareness, not having pain in the chest and reactions to symptoms.Conclusions.  It would appear that symptom presentation and distribution amongst women may not follow the pattern traditionally associated with current understanding of a ‘typical’ myocardial infarction. These differences together with perceptions about their cardiac symptoms may influence their health‐seeking behaviours.Relevance to clinical practice.  Women with a myocardial infarction may present with non‐specific chest symptoms, which are difficult to interpret or recognize by patients and health professionals alike. Skill in recording history and in performing a comprehensive assessment of initial and current symptoms will enable nurses to identify women with a differential diagnosis of chest pain readily. Additionally, to increase awareness of coronary heart disease, nurses must use any opportunity to educate women of all age groups.
An RCT of adherence therapy for people with schizophrenia in Chiang Mai, Thailand
Authors: Maneesakorn Suparpit , Robson Deborah , Gournay Kevin , Gray Richard 
Published: June 2007

Aim.  The aim of this paper was to evaluate the effectiveness of adherence therapy‐a brief intervention based on compliance therapy and motivational interviewing techniques‐in a sample of people with schizophrenia in Thailand.Background.  Poor adherence is problematic, but knowledge about how to improve medication adherence is limited. Studies focusing on the effects of interventions used to improve adherence have produced inconsistent outcomes and have been mainly conducted in western countries.Methods.  An exploratory single blind randomized controlled trial was conducted in Chiang Mai, Thailand. Thirty‐two patients with schizophrenia were randomly allocated to receive eight weekly sessions of adherence therapy or continue with their treatment as usual. Patients were assessed at baseline and after nine weeks. The primary outcome was overall psychotic symptoms. Secondary outcomes were general functioning, attitude towards and satisfaction with antipsychotic medication and medication side effects.Results.  The findings of this study indicated that patients who received adherence therapy significantly improved in overall psychotic symptoms, attitude towards and satisfaction with medication compared with treatment as usual but no significant difference was found in general functioning or side effects compared with treatment as usual.Relevance to clinical practice.  Adherence therapy has a positive impact on patients’ psychiatric symptoms, attitude towards and satisfaction with medication. Nurses can effectively deliver adherence therapy following intensive training.
A study of the efficiency and convenience of an advanced portable Wound Measurement System (VISITRAKTM)
Authors: Sugama Junko , Matsui Yuko , Sanada Hiromi , Konya Chizuko , Okuwa Mayumi , Kitagawa Atsuko 
Published: June 2007

Aims and objectives.  A reduction of pressure ulcer wound area is one of the most important indicators of wound healing. A wound measurement system (VISITRAKTM), which calculates the area based on simple tracings of wounds, has been developed as a practical tool for assessing wound area at the bedside. However, its accuracy has remained to be clarified in a clinical setting. This study aimed to clarify the clinical accuracy of the VISITRAK system.Design.  A descriptive correlational study.Methods.  Intra‐ and inter‐rater reliability of wound measuring techniques were calculated using an intraclass correlation coefficient (ICC) from 10 pressure ulcers. Concurrent validity was assessed, using 30 pressure ulcers, by comparing VISITRAK and digital planimetry. Assessment times for VISITRAK and digital planimetry were also compared for clinical practicality.Results.  The VISITRAK reliability results showed high (0·99) ICC values. For validity, a correlation coefficient between VISITRAK and digital planimetry was 0·99. The median time to take a measurement with VISITRAK was significantly shorter than that required for digital planimetry.Conclusions.  Based on our results, VISITRAK was found to have high intra‐ and inter‐rater reliability and high validity.Relevance to clinical practice.  The short measurement time with the VISITRAK system, and the ability to use it at the bedside, make it a useful, convenient device for clinical use.
Consensus and diversity: an action research study designed to analyse the roles of a group of mental health consultant nurses
Authors: Jinks Annette M , Chalder Gill 
Published: June 2007

Aim.  The purpose of this action research study was to enable a group of mental health consultant nurses in the UK to map the scope and dimensions of their roles. This initial benchmarking exercise is a precursor to the development of plans for role improvement and evaluation.Background.  There is a growing body of literature that addresses advanced nursing practice roles. There is, however, no international agreement on what constitutes an advanced practice role. A few countries have addressed the statutory requirements governing such roles. Consultant nurses’ roles in the UK are relatively new innovations that aim to enhance care. However, only a few investigations have evaluated the dimensions and impact of these roles.Methods.  The study was framed by use of action research as a form of self‐reflective enquiry. Initial data were generated through use of four focus group discussions, which were held with a group of consultant nurses employed predominately at a mental health National Health Service Trust. Five structured confirmatory questionnaires developed from the focus group data were also administered.Findings.  Analysis of the focus group data gave five themes, 71 categories and 271 items that were used to inform development of the questionnaires. Responses to the questionnaire showed that 61% (n = 166) of the items had non‐consensus responses. It was found there was most consensus relating to leadership theme with 63% (n = 19) items having consensus responses. Least agreement was found in the education theme where there was <15% (n = 5) agreement to individual items.Conclusions.  The study demonstrated complexity and variety in how the consultant nurses’ roles in the UK are being developed.Relevance to clinical practice.  The potential for consultant nurse roles to enhance patient care is tremendous. This study provides initial indicators, which the practitioners involved, can use to plot future developments and changes to their roles.
Skin testing technique and precision in stinging insect allergy
Authors: Corallino Massimo , Nico Andrea , Kourtis Georgios , Caiaffa Maria Filomena , Macchia Luigi 
Published: June 2007

Aim.  We report on quantitative analysis of skin tests in patients undergoing Hymenoptera venom immunotherapy. The need for accuracy, coupled with a sound manual technique, in performing this procedure is emphasized. Involuntary errors may occur and pose serious problems with interpretation of results. A revealing example is reported and the strategy devised to analyse the flaws and overcome the resulting problems is presented and discussed.Background.  Skin testing plays a key role in the diagnosis of most allergic disease and in the assessment of allergen immunotherapy. Particularly, insect sting allergy requires implementation of complex and demanding skin testing protocols and a competent nursing practice.Methods.  Sixteen patients were tested before starting the immunotherapy and after three years of treatment. Cutaneous response (expected to decline, following immunotherapy) was assessed as: (i) allergen‐elicited wheal areas; (ii) ratios between allergen‐elicited wheal areas and homologous histamine (positive controls) wheal areas.Results.  By using allergen‐elicited areas, the paradoxical result was obtained that skin reactivity had increased instead of decreasing, upon immunotherapy. Histamine response analysis suggested that this paradox might rather be the result of a technical flaw. Analysis of written notes of routine clinical meetings revealed that an important manual flaw had been detected (and corrected) some years earlier, affecting the results of the baseline testing (viz. the allergen was injected deeper in the skin, yielding a weaker response). Skin reactivity evaluation in terms of allergen–histamine ratio confirmed this interpretation, as, when the baseline ratios were compared with the three years immunotherapy ratios, a distinct decline in skin reactivity was detected, as expected.Conclusions.  Skin testing in insect sting allergy is a conceptually and manually complex procedure, which should be subjected to systematic quality control assessment, like a laboratory procedure. The personnel involved in the performance of this procedure should receive appropriate and extensive training.Relevance to clinical practice.  Diagnosis of allergic diseases and monitoring of immunotherapy largely rely on impeccable skin testing technique.