6 results
Search Results
2. Understanding the quality‐of‐life experiences of older or frail adults following a new dens fracture: Nonsurgical management in a hard collar versus early removal of collar.
- Author
-
Closs, Mia, Brennan, Paul, Niven, Angela, Shenkin, Susan, Eborall, Helen, and Lawton, Julia
- Subjects
CERVICAL vertebrae injuries ,PATIENT autonomy ,PAIN measurement ,HEALTH services accessibility ,CERVICAL collars ,HEALTH attitudes ,QUALITATIVE research ,RESEARCH funding ,LIFE expectancy ,INTERVIEWING ,SOCIOECONOMIC factors ,VERTEBRAL fractures ,DECISION making in clinical medicine ,TREATMENT effectiveness ,JUDGMENT sampling ,DESCRIPTIVE statistics ,CAREGIVERS ,LONGITUDINAL method ,QUALITY of life ,CONCEPTUAL structures ,PAIN management ,COMPARATIVE studies ,DATA analysis software ,INTERPERSONAL relations ,PATIENTS' attitudes ,PHYSICAL activity ,PATIENT participation ,OLD age - Abstract
Introduction: In the United Kingdom, fractures of the cervical dens process in older and/or frail patients are usually managed nonsurgically in a hard collar. However, hard collars can lead to complications and this management approach is now being questioned, with growing interest in maximising patients' short‐term quality‐of‐life. It is vital that patients' perspectives are considered; yet, there is a dearth of literature examining the aspect. To help inform wider decision‐making about use of collar/no collar management of dens fractures in older/frail people, we explored older/frail people's experience of the two management approaches and how they affected their perceived quality‐of‐life. Methods: We interviewed older and/or frail adults with a recent dens fracture (aged ≥65 years or with a clinical frailty score of ≥5) or their caregiver. Participants were recruited from both arms of a clinical trial comparing management using a hard collar for 12 weeks (SM) with early removal of the collar (ERC) and were interviewed following randomisation and again, 12–16 weeks later. Data were analysed using a framework approach. Results: Both participant groups (SM/ERC) reported substantial, negative quality‐of‐life (QoL) experiences, with the fall itself and lack of access to care services and information being frequent major contributory factors. Many negative experiences cut across both participant groups, including pain, fatigue, diminished autonomy and reduced involvement in personally meaningful activities. However, we identified some subtle, yet discernible, ways in which using SM/ERC reinforced or alleviated (negative) QoL impacts, with the perceived benefits/burdens to using SM/ERC varying between different individuals. Conclusion: Study findings can be used to support informed decision‐making about SM/ERC management of dens fractures in older/frail patients. Patient or Public Contribution: Public and patient involvement contributors were involved in the study design, development of interview topic guides and interpretation of study findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
3. 'Maybe they should regulate themquite strictly until they know the true dangers': a focus group study exploring UK adolescents' views on e-cigarette regulation.
- Author
-
Weishaar, Heide, Trevisan, Filippo, and Hilton, Shona
- Subjects
TEENAGERS ,TOBACCO use ,TEENAGER attitudes ,GOVERNMENT regulation ,ELECTRONIC cigarettes ,MARKETING ,GOVERNMENT policy ,SMOKING laws ,CONSUMER attitudes ,DOCUMENTATION ,FOCUS groups ,SAFETY ,SALES personnel ,QUALITATIVE research ,RULES ,JUDGMENT sampling ,THEMATIC analysis ,DATA analysis software ,DESCRIPTIVE statistics ,FIELD notes (Science) - Abstract
Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
4. Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study.
- Author
-
Birt, Linda, Lane, Kathleen, Corner, Jason, Sanderson, Kristy, and Bunn, Diane
- Subjects
WELL-being ,NURSES' attitudes ,COVID-19 ,ETHICS ,SOCIAL support ,WORK ,LEADERSHIP ,INTERVIEWING ,PEER relations ,QUALITATIVE research ,NURSING care facilities ,RESPONSIBILITY ,EXPERIENTIAL learning ,PSYCHOSOCIAL factors ,GERIATRIC nursing ,RESEARCH funding ,JUDGMENT sampling ,THEMATIC analysis ,DATA analysis software ,PSYCHOLOGICAL adaptation ,NURSING home employees ,PSYCHOLOGICAL resilience ,PSYCHOLOGICAL distress - Abstract
Introduction: The COVID‐19 pandemic had an unprecedented effect on those living and working in care‐homes for older people, as residents were particularly vulnerable to contracting the SARS‐CoV‐2 virus, associated with high morbidity and mortality. Often undervalued, care‐home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID‐19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. Objective: To explore RNs' experiences of working in older people's care‐homes during the COVID‐19 pandemic. Design: Qualitative interview study. Setting: Care‐homes for older people in England and Scotland, UK. Methods: Recruitment via direct contact with care‐homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of care‐home, and location. Data collected through one‐to‐one online interviews using topic guide developed collaboratively with care‐home nurses, focusing on how COVID‐19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. Results: Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March–June 2021; majority aged 46–55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID‐19. RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt that relatives and regulatory bodies were not always appreciative. RNs developed enhanced clinical skills, increasing their professional standing, but reported having to compromise care, leading to moral distress. Broadly, participants reported a sense of solidarity across care‐home staff and working together to cope with the crisis. Conclusion: Care‐home nurses felt unprepared for managing the COVID‐19 pandemic, many experienced moral distress. Supporting care‐home nurses to recover from the pandemic is essential to maintain a healthy, stable workforce and needs to be specific to care‐home RNs, recognizing their unique pandemic experiences. Support for RNs will likely benefit other care‐home workers either directly through wider roll‐out, or indirectly through improved wellbeing of nurse leaders. Clinical relevance: The COVID‐19 pandemic, an international public health emergency, created many challenges for Registered Nurses (RNs) working in long‐term care facilities for older people, as residents were particularly vulnerable to the impact of the SARS‐CoV‐2 virus. Care‐home RNs faced challenges distinct from their hospital‐based nursing peers and non‐nursing social care colleagues due to their isolation, leadership roles, professional legal obligations, and ethical responsibilities, leading to psychological distress on the one hand, but also a newly found confidence in their existing and newly developed skills, and increased recognition by the wider health community of their specialisms. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
5. Responding to the health needs of trafficked people: A qualitative study of professionals in England and Scotland.
- Author
-
Williamson, Victoria, Borschmann, Rohan, Zimmerman, Cathy, Howard, Louise M., Stanley, Nicky, and Oram, Sian
- Subjects
ATTITUDE (Psychology) ,HEALTH services accessibility ,HEALTH status indicators ,HUMAN rights ,INTERVIEWING ,RESEARCH methodology ,MEDICAL care ,MEDICAL care use ,MEDICAL personnel ,MEDICAL referrals ,NATIONAL health services ,MENTAL health services ,NEEDS assessment ,POLICE psychology ,PROFESSIONS ,PUBLIC officers ,RESEARCH funding ,STATISTICAL sampling ,SOCIAL justice ,PSYCHOLOGY of crime victims ,QUALITATIVE research ,HEALTH facility translating services ,GOVERNMENT policy ,JUDGMENT sampling ,PSYCHOSOCIAL factors ,SOCIAL support ,THEMATIC analysis ,HUMAN trafficking ,DESCRIPTIVE statistics - Abstract
Trafficked people require timely and ongoing access to healthcare services. Yet, many encounter difficulties accessing and utilising healthcare services, both while in situations of exploitation and after their escape. This research investigated barriers that hinder healthcare providers from identifying, providing care and making necessary referrals for trafficked people in the United Kingdom (UK). Semi‐structured, face‐to‐face interviews were conducted with healthcare (n = 23) and non‐health (n = 27) professionals with relevant policy or practical experience related to human trafficking in the UK. Topic guides covered identifying, referring and providing care to trafficked people. Transcripts were analysed using thematic analysis. Four interconnected themes emerged: trafficked persons' entitlements to healthcare, availability of healthcare resources, providers' knowledge about trafficking, and the particular needs of trafficked individuals. Providers explained that policies limiting entitlements to healthcare created significant obstacles to care, as did the inadequate resourcing of interpreter services, trafficking support services, and specialist mental health services. Few healthcare professionals reported having received training on responses to trafficked people and most were unaware of support options and referral routes. Healthcare professionals will be better equipped to serve trafficked individuals if they are provided training to identify and respond to human trafficking, guidance on referral and support options and entitlements to care. Simultaneously, improving trafficked people's healthcare access and use will also require government interventions to ensure they are not unjustifiably denied healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
6. Breast pumps as an incentive for breastfeeding: a mixed methods study of acceptability.
- Author
-
Crossland, Nicola, Thomson, Gill, Morgan, Heather, MacLennan, Graeme, Campbell, Marion, Dykes, Fiona, and Hoddinott, Pat
- Subjects
BREASTFEEDING & psychology ,ADAPTABILITY (Personality) ,BREASTFEEDING promotion ,BREAST pumps ,CONFIDENCE intervals ,FOCUS groups ,INTERVIEWING ,LACTATION ,RESEARCH methodology ,CASE studies ,MEDICAL personnel ,RESEARCH funding ,STATISTICAL sampling ,SCALE analysis (Psychology) ,SMOKING cessation ,SURVEYS ,QUALITATIVE research ,SAMPLE size (Statistics) ,JUDGMENT sampling ,MULTIPLE regression analysis ,THEMATIC analysis ,DATA analysis software ,MEDICAL coding ,ODDS ratio ,ECONOMICS - Abstract
Increasing breastfeeding rates would improve maternal and child health, but multiple barriers to breastfeeding persist. Breast pump provision has been used as an incentive for breastfeeding, although effectiveness is unclear. Women's use of breast pumps is increasing and a high proportion of mothers express breastmilk. No research has yet reported women's and health professionals' perspectives on breast pumps as an incentive for breastfeeding. In the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study, mixed methods research explored women's and professionals' views of breast pumps as an incentive for breastfeeding. A survey of health professionals across Scotland and North West England measured agreement with ‘a breast pump costing around £40 provided for free on the NHS’ as an incentive strategy. Qualitative interviews and focus groups were conducted in two UK regions with a total of 68 participants (pregnant women, new mothers, and their significant others and health professionals) and thematic analysis undertaken. The survey of 497 health professionals found net agreement of 67.8% (337/497) with the breast pump incentive strategy, with no predictors of agreement shown by a multiple ordered logistic regression model. Qualitative research found interrelated themes of the ‘appeal and value of breast pumps’, ‘sharing the load’, ‘perceived benefits’, ‘perceived risks’ and issues related to ‘timing’. Qualitative participants expressed mixed views on the acceptability of breast pumps as an incentive for breastfeeding. Understanding the mechanisms of action for pump type, timing and additional support required for effectiveness is required to underpin trials of breast pump provision as an incentive for improving breastfeeding outcomes. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.