School of Nursing and Midwifery

Permanent URI for this collection

https://hdl.handle.net/2086/1216

Browse

Now showing 1 - 20 of 545

Metadata only
A 51 year retrospective study of the trends of height, weight and body mass index at the time of death in those aged 16-103.
(Elsevier, 2001-06) Woodward, Helen; Rutty, Jane; Rutty, Guy
Open Access
A systems approach in the prevention of undernutrition among children under five in Tanzania: Perspectives from key stakeholders
(MDPI, 2024-05-21) Frumence, Gasto; Jin, Yannan; Kasangala, Amalberga; Bakar, Saidah; Mahiti Reuben Gladys; Ochieng, B.
Undernutrition among under-fives is one of the major public health challenges in Tanzania. However, there are limited studies assessing the contribution of cultural-related strategies in the prevention of child undernutrition in Tanzania. This study aimed at exploring participants’ experiential views regarding developing culturally sensitive strategies for the elimination of child undernutrition for under-fives in Rukwa, Iringa, Ruvuma, Songwe and Njombe regions located in the Southern Highlands in Tanzania. This study applied focus group discussions (FGDs) with forty practitioners to explore culturally-sensitive strategies for effectively preventing child undernutrition in Tanzania. The study participants were purposively selected, and thematic analysis was used to identify themes within the data. This study revealed that district- and lower-level administrative systems should prioritize nutrition interventions in their plans, allocating adequate resources to implement culturally sensitive nutrition interventions, while national-level organs need to strengthen institutional capacity and ensure the availability of funds, skilled human resources and a legal framework for the effective implementation and sustainability of nutrition interventions at the district and lower-levels. This study highlights that for the successful implementation of culturally sensitive strategies towards the elimination of child undernutrition, there is a need to use a systems approach that allows for collaborative governance whereby different sectors act together to address the persistent malnutrition epidemic.
Metadata only
Abatacept for rheumatoid arthritis.
(Elsevier, 2011) Rojahn, Ruth
Open Access
Access to specialist palliative care to manage pain in people dying at home: give them a VOICE
(BMJ, 2019-07-10) Harrison Dening, Karen
Commentary only. Implications for practice and research ► People who receive specialist palliative care or have a stated preference to die at home have a significantly higher chance of experiencing good pain relief as they die, irrespective of their disease aetiology. ► People dying with cancer receive better pain relief than those dying of non-cancer disease. ► Access to specialist palliative care services and advance care planning should be available to all; irrespective of diagnosis. ► Researchers and policymakers should consider how to ensure improvements in pain management for patients at home through advice and support from community specialist palliative care services.
Metadata only
Accessing care services after sexual violence: A systematic review exploring experiences of women in South Africa
(AOSIS, 2023-10-25) Hinsliff-Smith, K.; McGarry, Julie; Griffiths, Sarah; Randa, Moreoagae
Background: Sexual violence against women is a global phenomenon. This is a particular issue in South Africa, where it is estimated with evidence provided that up to half of all women will encounter gender-based and/or sexual violence from a partner during their lifetime. Therefore, evidence suggests that addressing the needs of women in South Africa is a priority. Objective: This qualitative review aimed to explore the experiences of women seeking care from first contact healthcare facilities in South Africa after sexual violence and during follow-up care. Method: This systematic review was conducted using the PRISMA checklist for systematic reviews and in line with a published protocol (PROSPERO, CRD42019121580) and searched six relevant databases in 2022. A total of 299 sources were screened, with 5 forming the overall synthesis. Results: Two synthesised themes of women’s experiences emerged at the time of reporting and during attendance at follow-up healthcare services. Conclusion: South Africa does have an established legal framework for prosecution and can provide support for survivors of sexual violence through established Thuthuzela Care Centres (TCCs). The review identifies that survivors’ needs are not clearly established when seeking medical attention initially nor identifying support or appropriate pathways. Contribution: The review has the potential to characterise the support available for women, the type and nature of sexual violence and interventions that may be used by healthcare professionals to support survivors especially during follow-up care.
Open Access
Accessing specialist support to stop smoking in pregnancy: A qualitative study exploring engagement with UK-based Stop Smoking Services
(Wiley, 2021) Griffiths, Sarah Ellen; Naughton, Felix; Brown, Katherine E.
Objectives. Specialist stop smoking services can be effective for supporting women with smoking cessation during pregnancy, but uptake of these services is low. A novel theoretical approach was used for this research, aiming to identify barriers to and facilitators of engaging with specialist smoking cessation support using the Theoretical Domains Framework (TDF). Methods. Semi-structured interviews and a focus group (n=28) were carried out with pregnant women who smoke/recently quit smoking, midwives and Stop Smoking in Pregnancy advisors from two local authority commissioned services in the UK. Inductive thematic analysis was used to code interview transcripts and deductive thematic analysis used to match emerging themes to TDF domains. Results. Themes corresponded to seven domains of the TDF: Knowledge: Knowledge of available services for pregnant smokers; Environmental context and resources: Uptake of referral to cessation services by pregnant smokers; Social Influences: Smoking norms and role of others on addressing smoking in pregnancy; Beliefs about Capabilities: Confidence in delivering and accepting pregnancy smoking cessation support; Beliefs about Consequences: Beliefs about risks of smoking in pregnancy and role of cessation services; Intentions: Intentions to quit smoking during pregnancy; Emotions: Fear of judgement from healthcare professionals for smoking in pregnancy. Conclusions. These novel findings help to specify factors associated with pregnant women’s engagement, which are useful for underpinning service specification and design by public health commissioners and service providers. Addressing these factors could help to increase uptake of cessation services and reduce rates of smoking in pregnancy.
Open Access
Accountability issues in an English emergency department: A nursing perspective
(Elsevier, 2020-05-27) Rubio-Navarro, Alfonso; Garcia-Capilla, Diego Jose; Torralba-Madrid, Maria Jose; Rutty, Jane
Introduction: Nurses confront doubts about their accountability and how it affects their clinical practice daily in the complex environment of an emergency department. Therefore, nurses’ experiences can provide vital information about the decisions and dilemmas in clinical practice that affect both healthcare professionals and patients alike. Aim: The aim of this study was to explore the perceptions of nursing staff in an English emergency department in relation to their ethical, legal and professional accountability. Methods: Ethnographic content analysis was used to analyse 34 semi-structured interviews from registered nurses working in an emergency department. Results: There were five categories found during the coding process: nursing care, staff interactions, legal and professional accountability, decision-making process and ethics and values. Conclusion: Several issues related to nursing accountability were found, including the effects of nursing shortages and the reasoning behind multidiscipinary team conflicts. Different approaches of individual and institutional accountability, the evolution of Benner’s nursing model and nursing value progression was also identified as key issues. All these phenomena affect nursing accountability in different ways, so their comprehension is paramount to understand and influence them to benefit both patients and nurses.
Metadata only
Addressing a deficit: wound care and mental health nursing
(MA Healthcare, 2007) Tremayne, P.; Moriarty, A.; Day, J.
Open Access
Addressing health inequalities, assumptions and barriers in meeting the hygiene needs of the transgender population
(Nursing Standard, 2023) Layton, Helen; Tremayne, Penny; Norton, Wendy
This article originates from the preparation of study resources for first year undergraduate nurses prior to them participating in an introductory simulation session related to patient hygiene (NMC, 2018a Annex B, 3.4,4.1,4.3 and 4.5). The lecturing team had prepared theoretical material and on reflection was acknowledged that it was overtly cisnormative. Content, both theory and simulation need to ensure that all protected characteristics of the Equality Act (2010) are addressed. This deficit influenced a need to expand knowledge and to influence and enhance care that student nurses would deliver to trans individuals who are in a healthcare setting and require assistance, support and care with their hygiene needs. Stonewall (2018) highlights that nursing schools should review curricula standards and training to ensure that it reflects LGBT-inclusive care including specific information on providing trans-inclusive care. This article considers some of the wider issues relating to this educational development and identify inequalities, assumptions and barriers in addressing the hygiene needs of trans patients. Ill-informed assumptions can lead to thoughtless care that can leave the patient feeling marginalised and discriminated against. The Nursing and Midwifery Council (2018b) stipulate the need to provide culturally competent care. There are many ways that a nurse can offer an even better care experience in promoting hygiene in a healthcare setting for these individuals.
Open Access
Adherence to the Eatwell Guide and Population and Planetary Health: A Rank Prize Forum Repor
(Wiley, 2024-01-31) Shannon, Oliver; Townsend, Rebecca; Malcomson, Fiona; Matu, Jamie; Griffiths, Alex; Jennings, Amie; Ward, Nicola; Papier, Keren; Best, Nicola; French, Chloe; Scheelbeek, Pauline; Kim, Curie; Ochieng, B.; Jay, Fareeha; Shepherd, Kaydee; Corfe, Bernard; Fairley, Andrea; McEvoyd, Claire; Minihane, Ann-Marie; Sim, Yi Jia; Stevenson, Emma; Gregory, Sarah
This report summarises a Forum conducted in June 2023 to explore the current state of the knowledge around the Eatwell Guide, which is the UK Government’s healthy eating tool, in relation to population and planetary health. The 1.5-day Forum highlighted the limited, albeit promising evidence linking higher adherence to the Eatwell Guide with favourable health outcomes, including reduced overall mortality risk, lower abdominal obesity in post-menopausal women, and improved cardiometabolic health markers. Similarly, evidence was presented to suggest that higher adherence to the Eatwell Guide is associated with reduced greenhouse gas emissions. Presentations were given around cultural adaptations of the Eatwell Guide, including African Heritage and South Asian versions, which are designed to increase acceptability and uptake of the Eatwell Guide in these communities in the UK. Presentations highlighted ongoing work relevant to the applications of the Eatwell Guide in randomised controlled trials and public health settings, including the development of a screening tool to quantify Eatwell Guide adherence. The Forum ended with a World Café-style event, in which strengths and limitations of the Eatwell Guide were discussed, and directions for future research were identified. This Forum report serves as a primer on the current state of the knowledge on the Eatwell Guide and population and planetary health and will be of interest to researchers, healthcare professionals, and public health officials.
Metadata only
Adjusting to the assistant practitioner role.
(M.A. Healthcare, 2010) Harrison, P.
Open Access
Administering anticipatory medications in end-of-life care: A qualitative study of nursing practice in the community and in nursing homes
(Sage, 2014-07-28) Wilson, Eleanor; Morbey, Hazel; Brown, Jayne; Payne, Sheila; Seale, Clive; Seymour, Jane
Background: In the United Kingdom, an approach to improving end-of-life care has been the introduction of ‘just in case’ or ‘anticipatory’ medications. Nurses are often responsible for deciding when to use anticipatory medications, but little is known about their experiences. Aim: To examine nurses’ decisions, aims and concerns when using anticipatory medications. Design: An ethnographic study in two UK regions, using observations and interviews with nurses working in community and nursing home teams (n = 8). Findings: Observations (n = 83) and interviews (n = 61) with community nurses. Nurses identified four ‘conditions’ that needed to be established before they implemented anticipatory medications: (1) irreversibility; (2) inability to take oral medication; (3) where the patient was able, they should consent and (4) decision had to be independent of demands or requests from patient’s relatives. By using anticipation medications, nurses sought to enable patients to be ‘comfortable and settled’ by provision of gradual relief of symptoms at the lowest dose possible. They aimed to respond quickly to needs, seeking to avoid hospital admission or medical call-out, while adhering to local prescribing policies. Worries included distinguishing between pain and agitation, balancing risks of under- and over-medication and the possibility of hastening death. Conclusion: Nurses take a leading role in the administration of anticipatory medications. Nurses apply consideration and caution to the administration of anticipatory medications but some experience emotional burden. Education, training and experience played a role in the nurses’ confidence and should continue to be central to efforts to improving the quality of palliative care in the community and nursing homes.
Embargo
Administering questionnaires to older people: Rigid adherence to protocol may deny and disacknowledge emotional expression
(Elsevier, 2014-10-06) de Vries, Kay; Leppa, C.; Sandford, R.; Vydelingum, V.
This paper draws on data from a larger study conducted in care home facilities in: Seattle, USA; West Sussex and Surrey in the UK; and in the lower North Island in New Zealand. Two extracts from interactions between the researchers and an older person during the administration of The Philadelphia Geriatric Morale Scale in a care home facility in New Zealand were analysed following Houtkoop-Steenstra and using a Conversation Analysis (CA) approach. In the first extract the audio-recorded transcript was examined for events of institutional talk and rephrasing of questionnaire questions. We also examined the transcript for missed cues and the impact of closed questions when administrating questionnaires to older people living in care home facilities. We then present an extract where the researcher uses a conversational approach during the administration of the same questionnaire. We conclude that rigid adherence to interview protocols when administering questionnaires to older people who cannot complete these themselves disables the interviewer from interacting and engaging in a meaningful conversation or responding to cues that indicate distress or expressions of grief. The effect of this approach may deny and disacknowledge older persons' emotional experiences and for the older person the interview may not be a therapeutic encounter. Based on our analysis and experiences of conducting this research we support recommendations that a collaborative approach, allowing an interactional exchange between interviewer and respondent, be used when administering questionnaires to older people in care home facilities.
Open Access
Admiral Nursing case management in Enhanced Healthcare in Care Homes
(OBM Geriatrics, 2021-04-21) Harrison Dening, Karen; Aldridge, Zena
The United Kingdom’s (UK) older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia, and comorbidity many of whom may require 24-hour care. Currently it is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it whilst residing in the care home. The provision of high-quality care for this population is a challenge with a lack of consistency in the provision of primary care and specialist services and a known gap in knowledge and skills. The NHS Long Term Plan aims to move care closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes (EHCH). However, such services need to be equipped with the correct skill mix to meet the needs of the care home population. Admiral Nurses are specialists in dementia care and are well placed to support the delivery of EHCH and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system. This paper discusses current gaps in service provision and how both the EHCH framework, and the inclusion of Admiral Nurses, might redress these and improve outcomes.
Open Access
Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals
(Sage, 2020-09-02) Aldridge, Zena; Oliver, Emily; Gardener, Hannah; Harrison Dening, Karen
Introduction: The rising prevalence of dementia has led to increased numbers of people with dementia being admitted to acute hospitals. This demand is set to continue due to an increasingly older population who are likely to have higher levels of dependency, dementia, and comorbidity. If admitted to the hospital, people with dementia are at higher risk of poor outcomes during and following a hospital admission. Yet, there remains a significant lack of specialist support within acute hospitals to support people with dementia, their families and hospital staff. Methods: Admiral Nurses are specialists that work with families affected by dementia and provide consultancy and support to health and social care colleagues to improve the delivery of evidenced based dementia care. Historically, Admiral Nurses have predominantly been based in community settings. In response to the increasing fragmentation of services across the dementia trajectory, the Admiral Nurse model is evolving and adapting to meet the complex needs of families impacted upon by dementia inclusive of acute hospital care. Results: The Admiral Nurse acute hospital model provides specialist interventions which improve staff confidence and competence and enables positive change by improving skills and knowledge in the provision of person-centred dementia care. The role has the capacity to address some of the barriers to delivering person centred dementia care in the acute hospital and contribute to improvements across the hospital both as a result of direct interventions or influencing the practice of others. Conclusion: Improving services for people with dementia and their families requires a whole system approach to enable care coordination and service integration, this must include acute hospital care. The increasing numbers of people with dementia in hospitals, and the detrimental effects of admission, make providing equitable, consistent, safe, quality care and support to people with dementia and their families a national priority requiring immediate investment. The inclusion of Admiral Nursing within acute hospital services supports service and quality improvement which positively impacts upon the experience and outcomes for families affected by dementia.
Open Access
Advance Care Planning for older people: The influence of ethnicity, religiosity, spirituality and health literacy
(Sage, 2019-05-03) de Vries, Kay; Banister, E.; Harrison Dening, K.; Ochieng, B.
Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of Advance Care Planning by this group across a number of countries where Advance Care Planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions. Health literacy issues have been identified as one of the main reasons for a communication gaps between physicians and their patients in discussing end-of-life care, where poor health literacy, particularly specific difficulty with written and oral communication often limits their understanding of clinical terms such as diagnoses and prognoses. This then contributes to health inequalities given it impacts on their ability to use their moral agency to make appropriate decisions about end-of-life care and complete their Advance Care Plans. Currently, strategies to promote Advance Care Planning seem to overlook engagement with religious communities. Consequently, policy makers, nurses, medical professions, social workers and even educators continue to shape Advance Care Planning programmes within the context of a medical model. The ethical principle of justice is a useful approach to responding to inequities; and to promote older peoples’ ability to enact moral agency in making such decisions.
Open Access
Advance care planning for people with dementia: Ordinary everyday conversations
(Sage, 2018-03-23) de Vries, Kay; Drury-Ruddlesden, Jenny
Advance care planning for people with dementia has become a focus of dementia care policies in developed countries. In New Zealand, the framework for dementia care relies on the person with dementia having a level of competence to enable them to participate in the planning process. For people with dementia, it may be too late to initiate these discussions in terms of decision making capacity. Consequently, decisions about end-of-life care for people with dementia are typically made by a family member who acts as a surrogate decision maker on behalf of the person with dementia. An exploratory qualitative study of 23 people who had been carers or provided support for a family member with dementia who had died within five years of the interview was undertaken. The overarching theme, ‘ordinary everyday conversations’, describes how informal conversations and discussions within the family relating to preferences at the end of life had been embedded in interactions within the families over years. Sub-themes revealed three important components enabling adherence to the prior wishes of the person with dementia through these conversations: knowing the person and belief in ‘doing the right thing’; the importance of Wills and Enduring Power of Attorney; and negotiating unexpected encounters. There is potential for families to be well prepared for the time when they may need to make decisions for the person with dementia based on ordinary everyday conversation that take place within families and throughout life. This study also suggests that more innovative approaches to making a Will may provide an important vehicle for expressing advanced care wishes.
Metadata only
Advance care planning: The role of the nurse.
(MA Healthcare Limited, 2010-09) Samanta, Ash; Samanta, Jo
Open Access
The Advanced Clinical Practitioner (ACP) in UK healthcare: Dichotomies in a new ‘multi-professional’ profession
(Elseiver, 2022-12-17) Mann, Claire; Timmons, Stephen; Evans, Catrin; Peace, Ruth; Overton, Charlotte; Hinsliff-Smith, K.
Advanced Clinical Practitioners (ACPs) work in a wide range of settings across the English National Health Service. ACPs come from a wide range of health professional backgrounds. This paper explores the ACP as a multi-professional role, and the implications of these understandings for the sociology of professions. This paper analyses what happens when a new occupational role is created that encompasses several established professions. This qualitative study gathered views and experiences across a range of stakeholders. Fifty-eight semi-structured interviews were undertaken with participants employing ACPs (n = 14) actively working in an ACP role (n = 10), training as an ACP (n = 13) or engaged in the delivery of the ACP education programme in England (n = 21). Findings were analysed into three overarching themes: (i) professional identity, (ii) differing definitions of ACP and (iii) advanced practice, professional regulation and recognition. ACPs hold a unique and emerging professional identity based on their previous professional health background and are themselves clear that they are not doctors. The role is not yet formally regulated, though many ACPs aspire to this. This research is an early look at a new type of professional which challenges existing understandings of what a profession is.
Metadata only
Advanced practitioners within the operating theatre.
(AfPP, 2004) Tanner, Judith

Browse

Browsing School of Nursing and Midwifery by Type "Article"

Results Per Page

Sort Options