The information needs of women newly diagnosed with breast cancer

Nurses can play a key role in patient education, including providing patients with useful and approrate information Rather than focusing on the process of education or information giving by nurses, this study places emphasis on the content of that information by taking the patients'perspective and asking the patients themselves what particular types of information are perceived as important at a specific point in time The aim of the study was to explore what particular types of information were important to women newly diagnosed with breast cancer, to enable nurses and other health care professionals to utilize their time as effectively as possible and provide a high-quality service to individuals in their care Women with breast cancer (a mean of 2 5 weeks from diagnosis) were interviewed and asked to compare items of information The items of information were presented m pairs and the women stated a preference for one item in that pan- Thirty-six pairs were presented in total The analysis involved the use of a Thurstone scaling model, which allowed rank ordermgs, or profiles of information needs, to be developed, reflecting the perceived importance of each item Information about the likelihood of cure, the spread of the disease and treatment options were perceived as the most important items of information at the tune of diagnosis Other information needs, in order of descending priority, included information about the risk to family, side-effects     

Timebanking and the co-production of preventive social care with adults; what can we learn from the challenges of implementing person-to-person timebanks in England?

This paper explores the potential contribution of timebanking, an innovative volunteering scheme, to the co-production of preventive social care with adults in England. Interest in volunteering in social care has increased as one proposed solution to the international crisis of a rising demand for services in juxtaposition with decreased resources. Volunteering has been particularly promoted in preventive services that prevent or delay care needs arising. Despite sustained interest in volunteering and co-production in social care, little is known about how theory translates into practice. Reporting implementation data from a Realistic Evaluation of six case studies in England, this paper explores one volunteering scheme, timebanking. The research explores how timebanks were working, what contribution they can make to adult social care, and whether they are an example of co-production. Data collected included interviews, focus groups or open question responses on surveys from 84 timebank members, and semi-structured interviews with 13 timebank staff. Each timebank was visited at least twice, and all timebank activity was analysed for a period of 12 months. Data were triangulated to improve reliability. The research found that in practice, timebanks were not working as described in theory, there were small numbers of person-to-person exchanges and some timebanks had abandoned this exchange model. Timebanks faced significant implementation challenges including managing risk and safeguarding and the associated bureaucracy, a paternalistic professional culture and the complexity of the timebank mechanism which required adequate resources. Lessons for timebanks are identified, as well as transferable lessons about co-production and volunteering in social care if such schemes are to be successful in the future.     

Psychosocial rehabilitation after disfiguring injury or disease: investigating the training needs of specialist nurses

AIM OF THIS STUDY: To investigate the training needs of specialist nurses working with patients who have disfiguring conditions. BACKGROUND: As the psychosocial impact of disfiguring illness and disease becomes more widely recognized and understood, there are increasing issues about who can provide this kind of input. Whilst nurses have been identified as the health professionals who are often the most appropriate to fulfil this role, there is less evidence that they feel confident in their skills to provide it. The volume of requests from health professionals, particularly nurses, to a lay-led organization specializing in facial disfigurement suggested both an acknowledgement of the importance of providing psychosocial support to this population, together with a perceived lack of skill in this area. DESIGN/METHOD, STUDY 1: This study used a cross-section design. Two groups of nurses working either in burns or in head and neck cancer were surveyed by questionnaire. RESULTS, STUDY 1: Both the burns group and head and neck group rated their skills in the social rehabilitation of their patient group as significantly lower than their skills in physical rehabilitation. DESIGN/METHOD, STUDY 2: Using a multiple baseline design, a pilot intervention consisting of a specifically focused resource pack and 1-day training course was delivered to eight head and neck cancer nurses. RESULTS, STUDY 2: Postintervention, only the targeted skills (those concerned with social rehabilitation) were rated as significantly improved. Research continues to establish the extent to which these skills are implemented by nurses in the clinical setting and passed on to patients. CONCLUSIONS: These findings suggest that although nurses do not feel as skilled in delivering psychosocial support to patients as they do in delivering more traditional aspects of physical nursing care, they can very easily take on this role when given simple training and access to appropriate resources. This training can be provided by a lay-led organization.     

The impact of the appearance of the anaesthetist on the patient''s perception of the pre-operative visit

The clinician's appearance is often considered a symbol which identifies and defines specific characteristics of the individual. Opinion of both lay and medical personnel on appropriate clothing inclines towards formal dress. Our aim was to assess the effect of the anaesthetist's appearance during a ward visit on the patient's evaluation of either the visit or the anesthetist himself. In our sample of 66 patients we found no evidence that the style of dress (formal: suit and tie, informal: jeans and open-necked shirt) affected that evaluation. However, when 138 patients were asked to rate the desirability of items of clothing for a male hospital doctor they expressed a preference for traditional clothing; a suit was rated as desirable and jeans as one of the four most undesirable items. We conclude that despite the conservatism of expressed opinions, the clothing worn by the anaesthetist is irrelevant to the patient's satisfaction with the visit.     

The report of the clinical standards advisory group: standards of care for people with schizophrenia in the UK and implications for mental health nursing

The report of the clinical standards advisory group: standards of care for people with schizophrenia in the UK and implications for mental health nursing
The Clinical Standards Advisory Group Schizophrenia Committee has spent two years (1993–1995) developing a standards protocol to assist all Purchasers and Providers with the task of producing optimum services for people with schizophrenia and other serious and enduring mental illnesses. This work has been underpinned by research that included visits to a representative sample of services throughout the UK. The report of this initiative, which was published in the summer of 1995, has many implications for mental health nursing. These include the continuing necessity to focus on serious mental illness; more effort to develop multidisciplinary working and the use of the Care Programme Approach; an increased focus on relevant training in case management and psychosocial interventions; the need to recognize physical health problems; the importance of medication management; and, as the Review of Mental Health Nursing emphasized, the issue of leadership should be targeted as a priority for action.     

Nurse teacher stress in Northern Ireland

Occupational stress among a 60% sample of all nurse tutors in Northern Ireland was investigated by means of the General Health Questionnaire (GHQ), Maslach Burnout Inventory and a stress questionnaire Seventy per cent of tutors judged themselves to be worse or much worse than usual on 45% of GHQ items Significant levels of moderate and high burnout were discovered on the sub-scales of emotional exhaustion and depersonalization, with an almost unanimous (95%) report of high burnout arising out of feelings of lack of personal accomplishment Male nurse tutors reported more frequent and more intense signs of burnout than their female counterparts at a statistically significant level of difference in emotional exhaustion ( P = 0 028 and P = 0 003 respectively) and in depersonalization ( P < 0 003 and P = 0 007 respectively) The work stressor most commonly identified by tutors (72%) was that of experiencing too little time to perform their duties to their satisfaction The most common request for help to alleviate workplace stress (61%) was for more support and appreciation from their seniors     

Staff anxieties about death in residential settings for elderly people

This study examined the relationship between death anxiety, the anxiety surrounding dealing practically with dying, and the level of experience of care assistants in residential settings for the elderly. It also examined the perception of the officer in charge of the establishment of the care assistants' level of anxiety. Age was the best predictor of both death anxiety and practical anxiety, the two being correlated. There was also a difference in perception of staff anxiety as a consequence of ethnic-group membership. The implications of this for training and practice are discussed.