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Events such as the COVID-19 pandemic and the war in Ukraine have increased people's awareness of mental health issues. Psychological trauma impacts patients in the acute care setting through physical and mental health presentations. Trauma is a public health issue crossing all socioeconomic groups and is related to social determinants of health. Trauma-informed care (TIC) is an evidence-based approach to providing care. TIC is within the scope of nursing practice and improves outcomes for patients. However, there is a lack of standard terms or practices within healthcare. Additionally, there is superficial acknowledgment of the need for TIC at the local or national level regarding policy. Nurses need to adopt TIC into practice and advocate for policy change to improve the health and lives of those seeking care. [ABSTRACT FROM AUTHOR]

Background: Paediatric palliative care (PPC) has evolved in response to the increased prevalence of children who have been diagnosed with life-limiting conditions. Nursing care is a fundamental aspect of PPC and understanding nurses' experiences is imperative to the provision and development of quality holistic child-centred services. Aim: To review nurses' experiences of providing palliative care for children with life-limiting conditions. Method: A systematic database search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline and Scopus was undertaken. Key words consisted of 'palliative care' or 'terminal care' or 'dying' or 'end-of-life care' and children* or paediatric* or pediatric* and 'nurs* experience*' or 'nurs* view*' or 'nurs* perspective*' or 'nurs* feeling*'. Inclusion criteria included peer-reviewed studies published between 2016–2023 in the English language. Findings: A thematic approach was adopted with the 11 papers selected for the review and each study critically analysed to identify three recurring themes. The themes included: 'a broken wreck', 'makes a life worth living' and 'challenges in doing 100%'. Findings point to mixed feelings among nurses in providing PPC and suggest that nurses experience emotional distress when caring for dying children. With appropriate supports and inspiration from their paediatric patients, nurses are determined to provide a 'good death' for the children in their care. Nevertheless, the perceived lack of knowledge and experience, communication struggles and personal dilemmas can be predisposing factors in triggering negative experiences among nurses when providing palliative care for children with life-limiting conditions. Recommendations: Education and policy development is required to meet the practice needs and support the emotional needs of nurses engaged in PPC. Further research is required to generate PPC evidence-based nursing interventions. In doing so, high quality PPC practice will be promoted, thereby ensuring high quality PPC for the children and their families. [ABSTRACT FROM AUTHOR]

Objective: To improve wound-related quality of life (QoL) in clients with hard-to-heal wounds in their lower limbs and to increase referrals to multidisciplinary teams in the management of care for these clients. Method: This was a quality improvement project with a two-group pretest–posttest interventional evaluation design. We implemented a package of interventions including the WounDS app, education related to wound care, and client engagement through a QoL self-assessment. Wound-related QoL was measured using the Cardiff Wound Impact Schedule and referrals to the multidisciplinary team were tracked through chart audits. We explored nurses' experiences with the interventions through semi-structured interviews. Results: Clients' average ratings for 'wellbeing', 'physical symptoms and daily living', and 'overall QoL' improved by 27%, 38% and 54%, respectively. The number of referrals increased by 78% post intervention. Nurses described the interventions as effective strategies that motivated them to implement a holistic approach to care. Conclusion: The project was successful in creating a culture shift to practice holistic wound care. This package of interventions (WounDS app, education and client self-assessment of QoL) led to improvements in the QoL of clients with hard-to-heal wounds. Further studies are needed to generalise the findings. Strategies for sustainability include forming a champion group and providing the education and decision supports based on nurses' educational needs assessment. [ABSTRACT FROM AUTHOR]

This case study explores the benefits of transanal irrigation as a treatment for a patient with a spinal cord injury who was experiencing chronic constipation. In this case, the patient was having episodes of autonomic dysreflexia as a result of the constipation. This condition is unique to patients with spinal cord injury and presents a stroke risk. The article outlines the contraindications and cautions that need to be considered in assessing a patient's suitability for transanal irrigation, and the elements that form part of a holistic assessment by a specialist nurse. [ABSTRACT FROM AUTHOR]

Nearly 5 million people are now living with diabetes in the UK, with many receiving treatment and management in the community. With their unique and intimate insight into patients' lives, the community nurse is well-placed to offer support, education and advocacy to those who might be struggling to manage their condition. Francesca Ramadan explores the multiple ways in which a community nurse might facilitate a preventative, holistic and personalised approach to diabetes treatment and management. [ABSTRACT FROM AUTHOR]

In this piece, the Association of Nephrology Nurses UK provides an update on the activities of the association and the future [ABSTRACT FROM AUTHOR]

The article discusses the integration of artificial intelligence (AI) in nursing practice. Topics include how Nursing and Midwifery Council (NMC) has effectively managed AI's integration in nursing, benefits of AI, and its drawbacks including the potential erosion of the human touch in care and decision-making.

The article discusses the concept of person-centered care as the foundation of contemporary nursing practice. Topics include definition of person-centred nursing policy and health policy, incompatibility of person-centred nursing and forensic mental health care, and conditions that practitioners must exhibit for effective person-centred care.

This article will investigate the district nurse's role in managing urinary catheter blockages, looking at why people require long-term catheterisation and the causes of blockages and then reviewing treatment methods. Current practice will be critically analysed and compared to the most up to date research and literature to inform district nurses of best evidence-based practice in the hopes of improving service user outcomes and quality of life and reducing the impact this problem has upon district nursing services with regards to time and resources. [ABSTRACT FROM AUTHOR]

Sally Star, Holistic Health Practitioner and Nurse with specialisms in specialist community public health nursing, educator, and Founder Member, Holistic Nurses UK (www.linkedin.com/in/sallystaratbioelectriclife) [ABSTRACT FROM AUTHOR]

The article highlights the need for foot wound to be dealt with in holistic and timely manner to ensure the best possible outcomes for the patient and clinicians. Topics covered include healthcare professionals from other disciplines that podiatrists can involve as a multidisciplinary team (MDT) approach to wound management, factors in determining the aetiology of foot wounds, and devices available to podiatrists to offload the foot, particularly the heel.

Nurse prescribing has become a well-established aspect of advanced clinical practice working alongside key NHS principles and drivers to address the increasing complexities in patient care and the demands on the health service. Prescribing practice is governed by ethical and legal principles to ensure a holistic patient-centred approach. It has been recognised as a valuable resource that could effectively transform healthcare services to reduce hospital admissions and long hospital stays and improve the quality of life for patients with long-term conditions and multiple comorbidities. This article will provide an overview of prescribing practice. [ABSTRACT FROM AUTHOR]

Managing ulceration in the lower limb for a patient with diabetes can be complex and challenging, requiring a multiprofessional, patient-centred, holistic approach with early referral for specialist review as key. Any delay in referral and intervention can be catastrophic, as time is tissue. Peripheral arterial disease and neuropathy both contribute significantly to the delays in wound healing, and it is important to rapidly recognise the problems with an informed assessment and understand the possible reasons for delayed wound healing, so that management is appropriate, rapid referrals are made and patient outcomes are optimised. This article discusses some of the reasons why wound healing is complicated in those with diabetes as a comorbidity. [ABSTRACT FROM AUTHOR]

Background/Aims: The importance of resilience among patients with chronic diseases has been demonstrated, but rarely among patients with heart failure. This study examines resilience and its relationship with spiritual wellbeing among this patient group. Methods: This descriptive study was carried out with 130 patients with heart failure in Iran. The tools used were a 29-item resilience scale and the Paloutzian and Ellison Spiritual Wellbeing scale. Results: The average resilience score was 107±19.5. Among the demographic variables, age, education, duration of disease and the presence of other concomitant diseases were significantly correlated with the patients' total resilience scores (P<0.05). The average spiritual wellbeing score was 83.12, with results showing a significant and direct relationship between resilience and spiritual wellbeing (P=0.001, r=0.386). Conclusions: Levels of resilience have a strong relationship with spiritual wellbeing among patients with heart failure. Therefore, building resilience should be incorporated into holistic care of these patients. [ABSTRACT FROM AUTHOR]

A safety huddle is a meeting held among district nurses, allied health professionals, specialist nurses, administrative staff, community matrons and healthcare assistants, also known as the wider multidisciplinary team. This article aims to identify and discuss the importance of safety huddles within a community nursing team. The author, a Specialist Community Practitioner District Nurse (SCPDN), explores why safety huddles were introduced and the implications of staff and patient safety if a safety huddle is not performed. The article also discusses the role of the SCPDN, how patient harm is sustained when communication failures occur within a team, new technologies implemented into practice and the implementation of safety huddles electronically. [ABSTRACT FROM AUTHOR]

Person-first thinking makes it a virtue to 'see the person, not the disability', overlooking, or making an effort to overlook, a person's impairment in order to see 'the person within'. This might seem a caring and compassionate approach in everyday nursing practice, but on closer examination it can be seen as unhelpful and even discriminatory. This article considers why this should be the case and introduces the affirmation model as a basis for a different way of thinking about the issue. [ABSTRACT FROM AUTHOR]

Pressure ulcer/injury remains a significant health problem in the community, requiring comprehensive care. Nurses are involved in the management and prevention of pressure injury. However, to date, studies focusing on applying nursing theory to pressure ulcer care have been limited. In the present study, the three dimensions of Lydia Hall's 1964 theory—core, care and cure—are extensively discussed and linked with the practice of pressure injury management. It is hoped that this review will help community nurses understand the application of this nursing theory to the prevention and management of pressure injury. [ABSTRACT FROM AUTHOR]

Malignant wounds are a complication of cancer, and usually occur in those individuals with advanced disease. When healing ceases to be the goal, treatment is centred around symptom control and improving quality of life. Caring for individuals with malignant wounds presents challenges for patients, their families and nurses alike. This article discusses the holistic management of malignant wounds, with an emphasis on the control of both physical and psychosocial symptoms of wound management, as well as the impact that this may have on all those involved. Common physical symptoms of malignant wounds include malodour, bleeding, pain, exudate and pruritis. Psychosocial symptoms may result in social isolation and depression. All these symptoms have a huge impact, not only on patients and their families, but also on healthcare professionals both during and after care. Managing these symptoms requires a multidisciplinary approach to facilitate the best possible outcomes for patients and their caregivers. [ABSTRACT FROM AUTHOR]

The article aims to help community nurses be aware of the patient's journey before and after an operation for them to continue to support patients at home. Topics mentioned include the use of a validated quality-of-life assessment tool to help in identifying areas to be addressed, a stoma practice pack for preparing the patient and their family to accept and deal with stoma care, assessment of preoperative nutritional status.

The role of the district nurse is imperative in the care of patients in a district nursing team's caseload. Through the role of care manager, district nurses are accountable for the overall coordination of the care patients receive. Their responsibilities include caring for acutely ill patients, those with long-term conditions and people who require end-of-life care, in addition to health promotion and patient education. They provide personcentred, preventive and coordinated care, which reduces unnecessary hospital admissions and enables patients who have a range of complex needs to remain at or return to home. In this article, a case study is used to provide an overview of the role and accountability of the district nurse in the care of patients who have complex needs. [ABSTRACT FROM AUTHOR]

An introduction to articles published within the issue is presented, including one on repositioning regimens that tissue viability nurse (TVN) should consider to prevent pressure ulcer (PU) in patients, another on the essential role that nutrition plays in wound healing, and one on the use of moisturizers in the prevention of skin tears.

Heart failure is a condition that is increasing in prevalence in the UK, with high patient mortality rates and frequent hospital admissions. Nurse-led heart failure services help to improve patient outcomes through aiding pharmacological, interventional and holistic care. Heart failure management teams that work to support patients can vary greatly from service to service. This article discusses the evidence and guidelines supporting an integrated multidisciplinary approach to chronic heart failure nursing care. [ABSTRACT FROM AUTHOR]

Patient expectations need to be managed prior to all aesthetic procedures in order to improve outcomes and reduce the risk of liability. Some of the challenges aesthetic nurses face today in managing patients' expectations include pressures from mass media, and the boom of selfies, airbrushing and celebrity culture. Ensuring patients have a clear and realistic understanding of what a treatment can achieve at the outset improves the likelihood of an optimal outcome and increases patient satisfaction. [ABSTRACT FROM AUTHOR]

Several treatment options are now available to men with metastatic castration-resistant prostate cancer (mCRPC). While survival rates for mCRPC continue to improve, patients are faced with increasingly complex treatment pathways and decisions. The clinical nurse specialist (CNS) plays a crucial role in navigating patients with mCRPC through their treatment pathway and fulfils a number of key responsibilities, including providing holistic care and support to patients and their families, educating and communicating with them in a timely and effective manner, and liaising with other healthcare professionals to seamlessly coordinate patient treatment. However, increasing patient caseloads and administrative duties are leaving CNSs with little time to fulfil their supportive role. Additional resources are needed in order to both promote and preserve this supportive role, thus ensuring that mCRPC patients receive the best possible care. [ABSTRACT FROM AUTHOR]

A cancer diagnosis and the patient’s response to the news pertains to all types of cancer, however, in this article, the focus is on urological cancer. Intrinsic to the management of this patient group is the urology multidisciplinary team, in which the role of the cancer nurse specialist (CNS) is pivotal. For most people, a cancer diagnosis is arguably their worst fear. It is therefore prudent that a holistic approach is used when determining care and ensuring that appropriate support is forthcoming. This necessitates an assessment of the physical, psychological/emotional, psycho-social, spiritual and cultural components of the individual’s healthcare needs, and accordingly, devising a plan of care to secure the best outcomes. This article concentrates on the psychological/emotional component. It outlines a case study of a patient’s response to the consultant’s question in the joint consultation clinic, examines the CNS’s interpretation and understanding of the events, and her perspective on whether factors such as fear, anxiety and distress influence the individual’s response to the diagnosis, their comprehension of information and the messages relayed, and consequently, their ability to manage the ensuing issues. It also looks at the support available to cancer patients following the receipt of a cancer diagnosis and its efficacy in addressing their concerns. Integral to this is effective communication, specifically the timely provision of information by health professionals. [ABSTRACT FROM AUTHOR]

Wrinkles remain a primary concern for aesthetic patients, as wrinkles are often one of the first visible signs of ageing. Aesthetic practitioners need to have a thorough understanding of the different interventions available for this indication, as well as the role of intrinsic and extrinsic factors of ageing and the impact they will have on treatment outcomes. This paper provides an overview of some popular treatment modalities for the reduction of facial wrinkles. The paper is mainly focused on the use of botulinum toxin and dermal fillers; however, several treatment modalities, such as radiofrequency and ultrasound, are also examined. Other considerations, such as body image and holistic patient assessment, are also explored. [ABSTRACT FROM AUTHOR]

Many individuals approaching the end of life with advanced dementia will live in a care or residential home. A wide spectrum of care is required and physical and safety needs may be prioritised above all other requirements. The Namaste Care Programme is designed to provide a holistic approach to meeting the needs of those with advanced dementia. This paper will outline the process of introducing this programme into a care home and its impact upon those who were involved. With a small sample of residents (n=9) the programme ran for 4 weeks. Feedback was gathered at baseline and during the programme from family and staff. This service innovation offered useful insights and indicated that it has the potential to improve the experiences of those with dementia, their family members and staff. The learning gained will be valuable when developing this initiative at scale and for future robust evaluation. [ABSTRACT FROM AUTHOR]

The prompt assessment of patients as fit for photopheresis is imperative to ensure delivery of a safe and efficient service. Before January 2015 the photopheresis unit was reliant on patients contacting the department directly to cancel their appointment if they were unwell or were suffering from any pre-defined exclusion criteria. Methods to reduce the number of cancellations and patients arriving unwell were therefore examined. The authors combined aspects of patient pre-assessment with telephone triage to develop a system that could provide better care and improve the use of resources within the department. The pre-assessment telephone triage system successfully reduced cancellations and increased patient awareness of conditions that would prevent delivery of photopheresis treatment. Subsequently the quality improvement initiative established that the pre-assessment telephone triage system saved the photopheresis unit over £33 000 over a 12-month period. [ABSTRACT FROM AUTHOR]

Clare Mechen, runner up at the BJN Awards 2019, describes the work of the Leg Club for which her team was shortlisted [ABSTRACT FROM AUTHOR]

The article discusses how nurses can engage in holistic assessments of constipated patients, and it mentions the causes of constipation, examinations of patients' fecal samples, and symptoms such as rectal discomfort and fever. The relationship between constipation and a patient's dietary fiber and fluid intake levels is assessed, along with a digital rectal examination by a suitably trained nurse. Self-management and other treatments for constipation are mentioned.

The health service is having to plan for an increasingly older population putting extra demand on services, with a greater emphasis on providing care at home. A health board in Wales brought in an Early Response Service, which assessed whether patients attending accident and emergency needed to be admitted to hospital or could receive care at home. This qualitative study looked at the experiences of both patients and staff members in both settings. A multiple case study was undertaken using semi-structured interviews. The theoretical framework was derived from Kolcaba's comfort theory and the bio-psycho-social model. Staff were identifying the most suitable patients for care at home and all hospital admissions were necessary, as the patients required greater medical/ surgical intervention than those cared for at home. [ABSTRACT FROM AUTHOR]

This article provides an overview of how health psychology can be used by nurses to help patients experiencing common mental health problems and psychological distress. Mental health problems are common and are associated with poor outcomes, especially for patients with comorbid physical health conditions. Mental health problems are associated with unhealthy behaviours such as smoking, physical inactivity, overeating and excessive alcohol use, which will result in poorer outcomes for patients. Consideration of a patient’s psychological health is therefore important for all nurses providing holistic care. Awareness of the symptoms of psychological distress, good communication skills and simple screening instruments can be used by nurses to assess patients’ mental health. The cognitive and behavioural risk factors associated with depression and anxiety are also explored, as an understanding of these can help nurses to provide appropriate care. [ABSTRACT FROM AUTHOR]

The provision of quality end-of-life care is essential when a neonate is dying. End-of-life care delivered in a neonatal intensive care unit (NICU) must consider the needs of both the newborn and their family. The purpose of this paper is to demonstrate how comfort theory and its associated taxonomic structure can be used as a conceptual framework for nurses and midwives providing end-of-life care to neonates and their families. Comfort theory and its taxonomic structure are presented and issues related to end-of-life care in the NICU are highlighted. A case study is used to illustrate the application of comfort theory and issues related to implementation are discussed. The delivery of end-of-life care in the NICU can be improved through the application of comfort. [ABSTRACT FROM AUTHOR]

International interest in quality of life (QoL) has been affected by patients' prolonged survival, the increasingly aging population, the increase in chronic conditions and the increasing costs of health care. This has also led to the development of QoL instruments that meet the psychometric criteria necessary for reliable and valid outcome measures in research, health policy decision-making and, increasingly, in clinical practice. Despite the proliferation of QoL instruments available to inform best practice, clinicians seldom routinely apply them. One of the barriers to using QoL instruments is the unfamiliarity nurses have with existing instruments. In order to increase community health nurses' familiarity with existing QoL assessments, the aim of this paper is to describe five instruments and modules that have been developed by the World Health Organization's Quality of Life Assessment Group for the assessment of QoL among healthy and ill adults and to describe how their applicability could enhance evidence-based practice in community nursing. [ABSTRACT FROM AUTHOR]

This paper examines the effect of parish nursing as a faith community initiative to support the work of district and community nurses and improve health outcomes. It discusses the reasons why faith communities might embark upon health initiatives, and describes the practice of parish nursing and its history and development in the UK. With reference to both quantitative and qualitative outcomes, the relevance of the practice in the UK health scene is assessed. The paper suggests that connecting with the third sector through parish nursing could enhance the work of community and district nurses; this would present additional sources of holistic care and health promotion and can be offered in an optional but complementary manner to the care provided through the NHS. [ABSTRACT FROM AUTHOR]

Pressure ulcers (PUs) are caused by tissue damage when the blood supply to an area of skin is diminished as a result of pressure. Although most pressure ulcers are preventable, all patients are at risk. Nurses have a central role in prevention and management of pressure areas. They should be able to assess patients' risk of developing PUs using evidence-based practice, recognised risk assessment tools and by completing a holistic assessment. Nurses must be able to identify the risk factors associated with developing PUs and implement appropriate measures to deliver harm-free care. Repositioning techniques, monitoring and ongoing care strategies are essential for pressure ulcer prevention in practice. [ABSTRACT FROM AUTHOR]

Chronic oedema is a condition that can become more complex to manage if allowed to progress. With the risk of chronic oedema increasing with age, complex presentations may become more commonplace as projections indicate an ageing population. A full holistic assessment is vital, taking into account venous, lymphatic and arterial elements of a vascular assessment, in order to determine the underlying disease process. Competency-based techniques for the application for below-knee and thigh-length application of inelastic cohesive compression exist and support clinicians in the successful management of chronic oedema. In cases of severe or complex chronic oedema, the specialist clinician can adopt strategies to adapt standard application to achieve volume reduction, shape, and tissue improvement. [ABSTRACT FROM AUTHOR]

Objective: Chronic venous leg ulcers (CVLUs) are common and recurrent, however, care for patients predominantly has a focus which overlooks the impact of the condition on quality of life. The aim of this study was to develop a simple, evidence-based consultation template, with patients and practitioners, Method: A nominal group was undertaken to develop a new consultation template for patients with CVLUs based on the findings of earlier qualitative study phases. Results: A user-friendly two-sided A4 template was designed to focus nurse-patient consultations on the quality of life challenges posed by CVLUs. Conclusion: CVLUs impact negatively on the quality of life of the patient but this receives inadequate attention during current consultations. This new template will help to ensure that key concerns are effectively raised, explored and addressed during each consultation [ABSTRACT FROM AUTHOR]

As the population in the UK ages increasing numbers of people will present with skin problems (Associate Parliamentary Group on Skin, 2000; Office for National Statistics (ONS), 2013). Ageing skin is more prone to a range of conditions including infections, infestations, eczema and psoriasis (Davies, 2008). One of the presenting features of many of these conditions is itching, also known as pruritus. It can be difficult for busy professionals to diagnose skin conditions in day-to-day practice (All Party Parliamentary Group on Skin, 1998; Associate Parliamentary Group on Skin, 2000). This article uses a case study approach that aims to enable nurses practicing at advanced level to identify and treat the causes of pruritus. [ABSTRACT FROM AUTHOR]

Wound care is expensive and can cause immeasurable stress and inconvenience to patients and their significant others. It is therefore in the best interest of the patient, their significant others and the NHS as a whole that wounds are expertly assessed, managed and healed in the quickest timeframe possible. Nurses play a pivotal role in the process of accurate holistic wound assessment, evaluation and treatment. This article aims to help further develop and enhance both professional and clinical wound care assessment and evaluation skills. Pertinent wound care literature is critically reviewed and the crucial nature and important components of comprehensive wound assessment for facilitating the highest possible quality wound care to patients are presented alongside recommendations regarding how the enhanced knowledge and skills could be applied into everyday wound care practice. [ABSTRACT FROM AUTHOR]

The article focuses on the reflections on a urooncology clinical nurse specialist training post. Topics discussed include consultants review all the metastatic prostate cancer patients from the five hospitals within Barts Health NHS Trust; and Professor Powles receives all the bladder and renal cancer patients from North East London and runs the tertiary referral service for these tumour sites.

This article discusses the impact of living with a chronic wound including the individual's wellbeing and the need for clinicians to consider the complex and often challenging factors that can help or hinder the patient experience. Patient engagement in the care planning process is an important consideration in promoting concordance (Gray et al, 2011). When choosing a dressing regimen, clinical decision-making should be based on holistic assessment and include the patient's perspective, expectations and attitudes (Dowsett, 2008). Living with a chronic wound can have a significant impact on both the physical and psychological health of an individual and patients may suffer from multiple effects including reduced mobility, pain, poor nutrition and depression. Management plans that have been informed by patient feedback and are sensitive to their concerns can only serve to promote concordance and partnership and achieve a positive experience even when healing is not the endpoint. [ABSTRACT FROM AUTHOR]

Inflammatory bowel diseases such as ulcerative colitis and Crohn's disease are life-long, complex conditions. They are characterised by periods of exacerbation and remission and surgical intervention may be required in severe cases. Drugs employed in the management of IBD are used to induce remission and maintain remission. IBD has a physical, psychological and sociological impact on individuals and IBD quality standards have been developed to provide a framework for addressing the services and care that should be available for them. Complementary and alternative medicine (CAM) therapies play an important role in the holistic approach to management of IBD as they are being increasingly used alongside conventional medical treatments. Community nurses have an important role to play in the management and care of individuals with IBD and in supporting them in making informed and appropriate choices that support their wellbeing and quality of life. [ABSTRACT FROM AUTHOR]

Wound assessment has developed into a specialized and complex area j of nursing practice. Care plans and interventions are based on the initial I assessment, which must therefore be accurate and clearly documented to support correct ongoing wound care and patient management. It is vital that the underlying and contributing patient factors to both wound development and healing, delayed healing or non-healing are considered throughout the process. Evaluation of interventions must be regular and consistent. This article will discuss the importance of holistic and collaborative assessment for the patient with a wound, exploring factors affecting healing and considerations to be made on initial and continous levels. [ABSTRACT FROM AUTHOR]

The recent introduction of patient-reported outcome measures (PROMs) assessment into rheumatology practice has changed the way patients suffering from inflammatory arthritis are assessed. This article describes a cross-sectional study of 102 rheumatoid arthritis (RA) patients that was undertaken to evaluate the construct of helplessness in patients with RA, its correlation with other disease activity parameters, and its sensitivity to change following biologic therapy. The study also set out to explore the possibility of including a self-helplessness measurement, using the modified Rheumatology Attitude Index (mRAI), as part of the holistic patient assessment in standard clinical practice. Assessment of self-helplessness was shown to be significantly correlated with both psychological as well as functional status measures. The mRAI index is a highly useful and predictive tool for clinical use that is responsive to change in the patients' clinical condition. As part of the PROMs questionnaire, this scale can be applied in a manner similar to other indicators of disease activity status, and is as easy to administer and interpret in standard clinical practice. [ABSTRACT FROM AUTHOR]

The aim of this article is to promote understanding of the benefits, assessment process and suitability of catheter valves, as a form of urinary drainage for patients. A literature review on the benefits of catheter valves provides the opportunity for an in-depth discussion that compares and contrasts different urinary drainage systems. On the evidence of the literature review, all patients require a holistic assessment which considers a number of factors, and provides the nurse with the essential objective data to ascertain the suitability of the catheter valve. These data can be transferred into an easy step-by-step algorithm to help guide the nurse in making the decision, with the patient, on the most appropriate urinary catheter drainage system. [ABSTRACT FROM AUTHOR]