Search

UK health policy dictates that Advance Care Planning (ACP), including the use of living wills, promotes choice and quality regarding end of life care for those with chronic and life-threatening conditions and it has been incorporated in self-management training. This paper reports a qualitative evaluation based on in-depth interviews with 31 respondents who had completed a UK-based lay-led self-management course (The Expert Patients Programme), and 12 respondents who had completed the same course adapted for people who are HIV positive. We draw upon previous social research on 'death awareness' and the biographical context of illness experience and management in examining the impact of incorporating this subject within a self-management intervention. The analysis demonstrates that many participants were unprepared to face issues raised in the session with material represented as disrupting some aspects of illness adaptation and existing views about death and dying. Positioning educational material on death and dying alongside that on 'positive' sell-management of illness highlights the complexities and sensitivities of planning for end of life care with implications for future educational interventions of this type. Keywords: UK; Chronic illness; Biographical disruption; Self-management training; Advance care planning; Death and dying; Expert patients; HIV

Encouraging self-management has been viewed as one means of reducing health service utilisation and contributing to improved demand management. However, the processes and imputed relationship between self-management education skills and health service contact are poorly understood. This paper reports on data from an embedded qualitative study which ran alongside a randomised controlled trial in England designed to test the clinical and cost effectiveness of a self-care support policy which found no statistically significant reductions in health service utilisation. Drawing on concepts from the sociology of chronic illness, analyses suggest that the biographical and social context relevant to individuals' experience of living with a long-term condition, history of health service utilisation, and relationships with health professionals are relevant to understanding the impact of self-management education and related policies aimed at bringing about changes in service use. Our study suggests that future health policy assumptions about utilisation in the context of chronic disease management and self-care support polices may benefit by acknowledging the complex, contextual and recursive nature of health service utilisation operating in the life worlds of patients' experience of living with a long-term condition. Keywords: UK; Self-care; Self-management; Health service utilisation; Chronic illness

ABSTRACT There is little published literature regarding children and young people with stomas and their preoperative care. Research in adults reveals negative psychosocial consequences, but the perceptions of children and [...]

Summary This article outlines evidence-based approaches to paediatric catheterisation in acute care settings. The reasons for catheterisation, anatomy and physiology of the urinary system and the procedure and potential complications [...]

Informed decision-making and informed Consent are major issues for the family of a child requiring surgery. Providing and sharing information and answering the child's and parents' questions are fundamental to [...]

The meaning of osteoarthritis symptoms for older people with this disease is discussed. While senior citizens portrayed these symptoms as a normal part of aging, they also described how much they disturbed daily life.

Congenital adrenal hyperplasia (CAH) encompasses a range of autosomal recessive inherited enzyme deficiencies that impact cortisol biosynthesis pathways. Although reported as a rare and lifelong disorder, it holds chronic health risks for individuals that can influence menstruation. The purpose of this environmental scan and integrative literature review was to identify health information pertinent to CAH and menstruation in order to inform health providers, increase patient education, and promote menstrual wellbeing. Analysis identified that while information about menses is reported, information about menstrual irregularities and their management in adolescents and women with CAH is uncertain. Furthermore, there is insufficient good quality research and knowledge on CAH and menstruation to inform health providers in their practice with this population. The need for individuals with CAH to access evidence-informed information is constrained by the state of current understanding and limitations in knowledge translation. The importance of having trustworthy and safe spaces in which to ask questions and draw on ethically sound, language appropriate, and evidence-informed material is paramount in supporting women's confidence and wellbeing across their lifetime. We encourage the building of stronger relationships between researchers, health providers, support groups and individuals to improve knowledge translation and dissemination regarding CAH and menstruation. [ABSTRACT FROM AUTHOR]

Abstract An audit was undertaken in one children's hospital to evaluate practice relating to indwelling urethral catheterisation of children. The records of 47 patients admitted over an eight-month period were [...]

Background: Whilst there has been a focus on the importance of social support for managing long‐term conditions, there has been little specific focus on the characteristics of social networks that shape self‐management. Policy emphasis is placed on individual responsibility for self‐care, and this influences commissioning of health‐care services. Assumptions are often made by policymakers about accessibility and preference for support and the influence of the social context on chronic illness management. Objective: To examine the social networks of individuals with long‐term conditions and identify how the characteristics of their composition influences support needs. Design, setting and participants: Thirty participants completed initial face‐to‐face in‐depth interviews, telephone follow‐ups and final face‐to‐face interviews in the north‐west of England. A longitudinal qualitative design was used to elicit the subtle changes in relationships over a year. Findings: The findings suggest that the relationships which constitute a social network influence perceived support needs and attitudes to self‐management. The amalgamation of relationships was characterized into three network typologies (family focused, friend focused or health‐care professional focused) according to which types of relationships were dominant. In the absence of support, accounts highlighted a small number of substitutes who could provide support at times of critical need. Discussion: This study challenges the notion of ‘self’‐management as an individual construct as many of the practices of illness management involved the support and/or negotiation of roles with others. By examining the nuances of relationships, this study has highlighted the tacit boundaries of practical and emotional support provision. [ABSTRACT FROM AUTHOR]

The Health Foundation is an independent charity working towards improving the quality of care for people in the UK. It provides information that focuses on health care, research and evaluation, [...]

Altun I, Karakoc A (2012) Management of hypothermia: impact of lecture-based interactive workshops on training of pediatric nurses. Pediatric Emergency Care. 28, 5, 455-459. Berg-Nielsen TS, Wichstrom L (2012) The [...]

Social restrictions of spina bifida contribute to parenting stress Vermaes IPR et al (2008) Parents' personality and parenting stress in families of children with spina bifida. Child: Care, Health and [...]

Whether it is knowing about contraceptive choices or explaining about sexually transmitted infections, this site offers advice to make it easier to discuss sexual health. It also offers information to [...]

Considering the difficulties some young people face when talking to adults there are few available alternative services for them to contact. However, Youth2Youth's helpline is staffed by young people who [...]

Recent research has shown that violence in teenage relationships is highly prevalent and that teenagers have surprisingly tolerant attitudes to violence in relationships. Evidence also shows that coercive and controlling [...]

Shoshan L et al (2008) Use of anal plugs in the treatment of fecal incontinence in patients with meningomyelocele (MMC). Journal of Pediatric Nursing. 23, 5, 395-399. Aim To evaluate [...]

Michaud Let al (2009) Outcome of functional constipation in childhood: A 10-year follow-up study. Clinical Pediatrics. 48, 1, 26-31. Aim To assess the longer-term outcome of functional constipation in childhood [...]

Chrzan Ret al (2008) Colonic washout enemas for persistent constipation in children with recurrent urinary tract infections based on dysfunctional voiding. Urology. 71, 4, 607-610. Aim To explore the use [...]

Al-Farsi S, Oliva M, Davidson R et al (2009) Periurethral cleaning prior to urinary catheterization in children: sterile water versus 10% povidone-iodine. Clinical Pediatrics. 48, 6, 656-660. Aim This comparative [...]

Collection of a urine sample from an infant who may have a urinary tract infection (UTI) is problematic (Etoubleau et al 2009). In such circumstances, the National Institute for Health [...]

Ingram J, Salmon D (2007) No Worries: Young people's experiences of nurse-led drop-in sexual health services in South West England. Journal of Research in Nursing. 12, 305-316. Aim To evaluate [...]

Turnbull T et al (2008) A review of parental involvement in sex education: The role for effective communication in British families. Health Education Journal. 67, 182-195. Aim To review the [...]

Thurman AR et al (2008) Preventing recurrent sexually transmitted diseases in minority adolescents (RCT). Obstetrics and Gynecology. 111, 6, 1417-1425. Aim This randomised-controlled trial (RCT) compared the efficacy of a [...]

Joronen K, Astedt-Kurki P (2005) Familial contribution to adolescent subjective well-being. International Journal of Nursing Practice. 11, 3,125-133. Research aim To obtain further understanding of factors within the family that [...]

The internet is increasingly being used as a source of health advice and information by individuals with long term conditions (LTCs). Specifically, online forums allow people to interact with others with similar conditions. However, it is not clear how online health information is assessed by those with LTCs. This study aims to address this gap by exploring how individuals with contested and uncontested LTCs utilise internet forums. Semi-structured interviews were conducted with 20 participants with ME/CFS and 21 participants with type 1 and 2 diabetes and analysed using thematic analysis. Participants were recruited via online and offline routes, namely forums, email lists, newsletters, and face-to-face support groups. The findings indicate that the use of online forums was a complex and nuanced process and was influenced by a number of individual and illness-specific factors. Participants trusted those with similar experiences and perspectives as themselves, while also valuing conventional biomedical information and advice. By accessing support online, forum users were able to draw on a personalised form of support based on the lived experiences of their peers. However, the role of digital literacy in developing and maintaining online relationships must be acknowledged. [ABSTRACT FROM AUTHOR]