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This pilot study assessed text messaging as an early intervention for preventing pressure ulcers (PrUs) in individuals with spinal cord injury (SCI) post-hospital discharge. Thirty-nine wheelchair-users discharged after acquiring a SCI, underwent randomisation into an intervention group (n = 20) with text messages and a control group (n = 19). All participants received standard post-discharge care and completed a skincare questionnaire before and 6-month after discharge. Primary outcomes included feasibility and acceptability of early intervention using text messaging, alongside performance, concordance, and attitudes toward skincare. Secondary outcomes measured perception and the incidence of PrUs. Baseline demographics were comparable between the intervention and control groups. Eight of 20 participants completed 6-month follow-up questionnaires in the intervention group, six participants completed the 6-month questionnaires in the control group,. Participants expressed high satisfaction with text messages, understanding of content, and increased confidence in preventing PrUs. At 6-month post-discharge, the intervention group showed improved prevention practices, heightened awareness of PrU risks, and increased perceived importance of prevention, which were not observed in the control group. However, there were no significant differences in PrU incidence, possibly due to the small sample size and short follow-up. The study demonstrates that using text messaging as an early intervention for PrU prevention in individuals with SCI is feasible and well-received. Preliminary results suggest a positive impact on participants' attitudes and practices, indicating the potential of text messaging to reduce PrU incidence. However, further research with larger samples and extended follow-up is crucial to validate these promising initial findings. • This is the first study evaluating feasibility of text messagings for PrU prevention in spinal cord injury patients. • Participants were highly satisfied with receiving and understanding text messages, recommending them for PrU prevention. • Participants receiving messages showed improved practices, awareness, and reduced barriers of PrU prevention post-discharge. • If future larger studies show significant results, this intervention could be a valuable tool in community healthcare. [ABSTRACT FROM AUTHOR]

Pressure ulcers cause significant, detrimental effects on personal wellbeing. They represent a serious health and social care burden. Nurses and those working in support roles are primarily accountable for preventing pressure ulcers. Healthcare support workers are an expanding group of key workers in the UK. To examine healthcare support workers' knowledge and attitudes regarding pressure ulcer prevention. A cross-sectional study was conducted from December 2020 to June 2021, using Knowledge and Attitudes toward Pressure Ulcer Prevention Assessment Tool. A total of 164 participants completed the questionnaire fully. A low mean knowledge score of 0.42 ± 0.14, but a positive attitude score of 0.76 ± 0.10 per item were reported. The weakest areas of knowledge include aetiology, risk assessment and addressing pressure-reducing interventions for patients at risk. Higher mean scores per item in knowledge of pressure ulcer prevention were reported in participants working in acute hospital wards and nursing homes (0.468 ± 0.15, 0.47 ± 0.08 respectively) than those in other settings (p < 0.05). Participants working in primary care scored lowest (0.33 ± 0.12). The scores of participants with more positive attitudes towards pressure ulcer prevention significantly correlated with higher score of knowledge (p < 0.005). While positive attitudes towards pressure ulcer prevention exist among healthcare support workers, this is overshadowed by significant knowledge deficits. Findings highlight the importance of continuing structured education for support workers across both acute and community settings. A future national survey and interventional study are needed to examine support workers' pressure ulcer knowledge and to inform a national continuous education strategy. • Nurses and healthcare support workers are primarily accountable for preventing pressure ulcers. • Healthcare support workers are an expanding group of key workers in the UK. • Positive attitude towards pressure ulcer prevention exists but is overshadowed by significant knowledge deficits among healthcare support workers. • The outcome identify weak areas in knowledge of pressure ulcer prevention among healthcare support workers. • Findings highlight the importance of continuing structured education for support workers across both acute and community settings. [ABSTRACT FROM AUTHOR]

Childbearing women from ethnic minority groups in the United Kingdom (UK) have significantly poorer perinatal outcomes overall. Childbearing women from ethnic minority groups report having poorer experiences and outcomes in perinatal care, and health professionals report having difficulty in providing effective care to them. Yet barriers in relation to providing such care remain underreported. The aim of this study was to elicit midwives' insights in relation to the common barriers in providing effective perinatal care to women from ethnic minority groups with 'high risk' pregnancies and how to overcome these barriers. A qualitative study was undertaken in a single obstetric led unit in London, UK. A thematic analysis was undertaken to identify themes from the data. A total of 20 midwives participated. They self-identified as White British (n = 7), Black African (n = 7), Black Caribbean (n = 3) and Asian (n = 3). Most (n = 12) had more than 10 years' experience practising as a registered midwife (range 2 – 35 years). Four themes were identified: 1) Communication, 2) Continuity of carer, 3) Policy and 4) Social determinants. Racism and unconscious bias underpin many of the findings presented. Co-created community hubs may improve access to more effective care for childbearing women from ethnic minority groups. A focus on robust anti-racism interventions, continuity of carer, staff wellbeing and education along with the provision of orientation and bespoke translation services are also suggested for the reduction of poorer outcomes and experiences. Along with policies designed to promote equality and irradicate racism, there is a need for co-created community hubs and continuity of carer in perinatal services. Further research is also required to develop and evaluate culturally safe, and evidence-based interventions designed to address the current disparities apparent. [ABSTRACT FROM AUTHOR]

To develop and examine the reliability, and validity of a questionnaire measuring concordance for performing pressure-relief for pressure ulcer (PrU) prevention in people with Spinal Cord Injury (SCI). Phase I included item development, content and face validity testing. In phase II, the questionnaire was evaluated for preliminary acceptability, reliability and validity among 48 wheelchair users with SCI. Thirty-seven items were initially explored. Item and factor analysis resulted in a final 26-item questionnaire with four factors reflecting concordance, perceived benefits, perceived negative consequences, and personal practical barriers to performing pressure-relief activities. The internal consistency reliability for four domains were very good (Cronbach's α = 0.75-.89). Pearson correlation coefficient on a test-retest of the same subjects yielded significant correlations in concordance (r2 = 0.91, p =.005), perceived benefit (r2 = 0.71, p <.04), perceived negative consequences (r2 = 0.98, p <.0001), personal barriers (r2 = 0.93, p=.002). Participants with higher levels of concordance reported a greater amount of pressure-relieving performed. Individuals viewing PrU as a threatening illness were associated with higher scores of concordance and tended to report a greater amount of pressure-relieving performance which provides evidence of criterion related validity. The new questionnaire demonstrated good preliminary reliability and validity in people with SCI. Further evaluation is necessary to confirm these findings using larger samples with follow-up data for predictive validity. Such a questionnaire could be used by clinicians to identify high risk of patients and to design individualised education programme for PrU prevention. • A shorter questionnaire was developed to measure concordance of pressure-relieving activities. • The new questionnaire demonstrated good preliminary reliability and validity based on small sample. • The new questionnaire may help identify high risk patients. • The findings gained from the questionnaire may help design tailored education programme for PrU prevention. [ABSTRACT FROM AUTHOR]

Objective: To evaluate a simple acupressure protocol in LIV3 and LI4 acupoints in women with primary dysmenorrhea.Methods: This paper reports a randomized, single blinded clinical trial. 90 young women with dysmenorrhea were recruited to three groups to receive 20min acupressure every day in either LIV3 or LI4, or placebo points. Acupressure was timed five days before menstruation for three successive menstrual cycles. On menstruation, each participant completed the Wong Baker faces pain scale, and the quality of life short form -12 (QOL SF-12).Results: Intensity and duration of pain between the three groups in the second and third cycles during the intervention (p<0.05) differed significantly. Significant differences were seen in all domains of QOL except for mental health (p=0.4), general health (p=0.7) and mental subscale component (p=0.12) in the second cycle, and mental health (p=0.9), and mental subscale component (p=0.14) in the third cycle.Conclusion: Performing the simple acupressure protocol is an effective method to decrease the intensity and duration of dysmenorrhea, and improve the QOL. Registration ID in IRCT: IRCT2016052428038N1. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of simple acupressure protocol in LIV3, LI4 and placebo points on the quality of life (QOL) in women with premenstrual syndrome (PMS).Method: This paper reports a randomized, single blinded clinical trial. 97 participants (students in of Hormozgan University of Medical Sciences, Iran) with PMS were allocated to three groups to receive 20min acupressure on different acupoints for 14days before menstruation for three consecutive menstrual cycles (training and then two cycles self applied acupressure). The acupoints were LIV3 and LI4; one group received acupressure at a placebo point. Each participant completed the PSST scale (to determine PMS severity), HADS scale (for depression and anxiety), and quality of life SF12.Results: The number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group (p<0.04). Moreover, depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the placebo group (p<0.05).Analyzing the score of SF12 fields in the second and third cycles showed a significant difference in all dimensions between the intervention and placebo groups. There was no significant difference between LIV3 and LI4 acupressure groups in decrease of PMS symptoms, anxiety and depression and improving SF12scores (p<0.05).Conclusion: Performing the simple acupressure protocol at LIV3 and LI4 is an effective method to decrease the severity of PMS symptoms, anxiety and depression, and to improve the QOL. Pressure at LIV3 and LI4 appears to be equally effective. [ABSTRACT FROM AUTHOR]

Summary Background Published research has demonstrated that the multiple mini-interview (MMI) is a reliable assessment instrument in medical and nursing student selection. There is a dearth of evidence specifically relating to the advancement and subsequent evaluation of MMIs in the context of student midwife selection. Objectives To develop, pilot and examine the reliability of MMIs in pre-registration student midwife selection in a UK setting. Design and setting DeVellis' framework for questionnaire development underpinned the generation of MMI scenarios. BSc (Hons) Midwifery Studies students at a Higher Education Institution in the UK volunteered to participate in ‘mock’ MMI circuits during the first week of their programme. Results An eight station model was piloted. Communication skills were rated at each station as a generic attribute. Station specific attributes assessed included: compassion and empathy; respect for difference and diversity; honesty and integrity; intellectual curiosity and reflective nature; advocacy; respect for privacy and dignity; team working and initiative; the role of the midwife and motivation to become a midwife. Participants' responses to scenario questions were rated on a 7 point scale. Cronbach's alpha scores measuring internal consistency ranged from 0.91 to 0.97 Conclusion The systematic development of the MMI model and scenarios resulted in ‘excellent’ reliability across all stations. These findings endorse the MMI technique as a reliable alternative to the personal interview in informing final decisions in pre-registration student midwife selection. [ABSTRACT FROM AUTHOR]

Summary: Background: The expansion of the higher educational sector in the United Kingdom over the last two decades to meet political aspirations of the successive governments and popular demand for participation in the sector (the Widening Participation Agenda) has overlapped with the introduction of e-learning. Objectives: This paper describes teachers' views of using e-learning for non-traditional students in higher education across three disciplines [nursing, chemistry and management] at a time of massification and increased diversity in higher education. Design: A three phase, mixed methods study; this paper reports findings from phase two of the study. Settings: One university in England. Participants: Higher education teachers teaching on the nursing, chemistry and management programmes. Methods: Focus groups with these teachers. Findings: Findings from these data show that teachers across the programmes have limited knowledge of whether students are non-traditional or what category of non-traditional status they might be in. Such knowledge as they have does not seem to influence the tailoring of teaching and learning for non-traditional students. Teachers in chemistry and nursing want more support from the university to improve their use of e-learning, as did teachers in management but to a lesser extent. Conclusions: Our conclusions confirm other studies in the field outside nursing which suggest that non-traditional students' learning needs have not been considered meaningfully in the development of e-learning strategies in universities. We suggest that this may be because teachers have been required to develop e-learning at the same time as they cope with the massification of, and widening participation in, higher education. The findings are of particular importance to nurse educators given the high number of non-traditional students on nursing programmes. [Copyright &y& Elsevier]

Summary: This paper illustrates the role of psychodynamic small group work in integrating theory and practice for nursing students. Psychodynamic work with individual patients and small staff groups is established in some areas of medical and nursing practice although not widely used in general nursing. Clinical material which was brought to two group supervision sessions by student nurses on clinical placement is presented in this paper and discussed using a psychodynamic perspective. A critical review of psychodynamic small group work and a position paper is presented in this paper to argue that using a psychodynamic approach in nurse education may address the theory–practice gap for student nurses by allowing them to reflect on the emotional issues arising in clinical placements. The paper illustrates how supervision can assist students to integrate theory and practice. It is suggested that reflecting on feelings in small group work with student nurses with a tutor or supervisor who works psychodynamically may help students integrate their theoretical and practical learning. Understanding the theory–practice gap from a psychodynamic perspective may help nurse tutors in their personal tutor work to integrate theoretical and practical learning for students and thereby support students in providing good quality care for their patients. [Copyright &y& Elsevier]

Summary: Approaches to the longstanding challenges of ‘integrating’ subject-based and work-based knowledge have typically focused on questions of how learning can be ‘transferred’ from one setting to another, relating the assumed ‘abstract’ nature of theory to the assumed ‘real’ nature of practice. This is often seen as a single movement as encapsulated in the term ‘from theory to practice’. The authors have developed a fresh approach that concentrates on different forms of knowledge and the ways in which these are contextualised and ‘re-contextualised’ in movements between different sites of learning in colleges and workplaces. While the research has been carried out in a range of professional fields outside nursing, the arguments put forward by the authors are relevant to continuing debates within nursing around the theory–practice gap. The aim has been to explore how the subject-based and work-based aspects of a curriculum or learning programme can articulate with one another more effectively. The potential of the ‘re-contextualisation’ approach for nurse education is outlined, with a view to further research. The original research was sponsored by the London Chamber of Commerce and Industry Commercial Education Trust and the Economic and Social Research Council Teaching and Learning Research Programme. [Copyright &y& Elsevier]

• A large number of people in the UK (> 24,000) report using British Sign Language (BSL) as their first language. Their access to health information is very poor and health professionals do not understand their health needs. • Pregnancy, birth and postnatal outcomes for deaf women can be affected by a lack of understanding and recognition of their maternity needs. • Our literature review shows that deaf women may avoid seeking care, may have a lack of access to health information and healthcare providers may have a lack of deaf awareness. • Current care provisions do not always meet the needs of the deaf BSL using women. Health professionals need awareness of deafness as a culture and how to best meet the needs of the community to improve health outcomes for women and their babies. An estimated 24,000 people in the UK report using British Sign Language (BSL) as their first language. Misconceptions about deaf culture and language mean that deaf people have less access to health information and their health literacy is lower. Deaf people's health needs go under the radar in primary care with ensuing poorer health outcomes. Deaf women's experiences of maternity care are poorly understood. Using Whittemore and Knafl's method for an integrative review, the following databases were searched: EMBASE, MedLine, CINAHL and Maternity and Infant Care. After reviewing 430 journal article titles and abstracts against the inclusion/exclusion criteria, 11 articles were included for final review. Selected studies were conducted internationally and were available in English. 10 were qualitative studies, 1 used survey design. They were reviewed using the Caldwell Framework. These show that deaf women avoid seeking care, have a lack of access to health information and healthcare providers, including midwives, have a lack of deaf awareness. For deaf women, during pregnancy, birth and postnatal periods, this can mean having longer hospital stays and more complex postnatal care needs in both the hospital and community setting. Current care provisions do not always meet the needs of the deaf BSL using women who use maternity services. Midwives should be aware of deafness as a culture and how to best meet the needs of the community to improve health outcomes for women and their babies. [ABSTRACT FROM AUTHOR]

Education literature worldwide is replete with studies evaluating the effectiveness of Multiple Mini Interviews (MMIs) in admissions to medicine but <1% of published studies have been conducted in selection to nursing and midwifery programmes. To examine the predictive validity of MMIs using end of programme clinical and academic performance indicators of pre-registration adult, child, and mental health nursing and midwifery students. A cross-sectional cohort study at one university in the United Kingdom. A non-probability consecutive sampling strategy whereby all applicants to the September 2015 pre-registration adult, child, mental health nursing and midwifery programmes were invited to participate. Of the 354 students who commenced year one, 225 (64%) completed their three-year programme and agreed to take part (adult 120, child 32, mental health nursing 30 and midwifery 43). All applicants were interviewed using MMIs with six and seven station, four-minute models deployed in nursing and midwifery student selection respectively. Associations between MMI scores and the cross-discipline programme performance indicators available for each student at this university at the end of year three: clinical practice (assessed by mentors) and academic attainment (dissertation mark) were explored using multiple linear regression adjusting for applicant age, academic entry level, discipline and number of MMI stations. In the adjusted models, students with higher admissions MMI score (at six and seven stations) performed better in clinical practice (p < 0.001) but not in academic attainment (p = 0.122) at the end of their three-year programme. These findings provide the first report of the predictive validity of MMIs for performance in clinical practice using six and seven station models in nursing and midwifery programmes. Further evidence is required from both clinical and academic perspectives from larger, multi-site evaluations. [ABSTRACT FROM AUTHOR]

Summary Background Little is known about how newly qualified nurses delegate to health care assistants when delivering bedside care. Aim To explore newly qualified nurses' experiences of delegating to, and supervising, health care assistants. Design Ethnographic case studies. Settings In-patient wards in three English National Health Service (NHS) acute hospitals. Participants 33 newly qualified nurses were observed, 10 health care assistants and 12 ward managers. Methods Participant observation and in-depth interviews. Findings We suggest that newly qualified nurses learn to delegate to, and supervise, health care assistants through re-working (`recontextualising') knowledge; and that this process occurs within a transitional (`liminal') space. Conclusions Conceptualising learning in this way allows an understanding of the shift from student to newly qualified nurse and the associated interaction of people, space and experience. Using ethnographic case studies allows the experiences of those undergoing these transitions to be vocalised by the key people involved. [ABSTRACT FROM AUTHOR]

Summary Background The role of the acute hospital nurse has moved away from the direct delivery of patient care and more towards the management of the delivery of bedside care by healthcare assistants. How newly qualified nurses delegate to and supervise healthcare assistants is important as failures can lead to care being missed, duplicated and/or incorrectly performed. Objectives The data described here form part of a wider study which explored how newly qualified nurses recontextualise knowledge into practice, and develop and apply effective delegation and supervision skills. This article analyses team working between newly qualified nurses and healthcare assistants, and nurses' balancing of administrative tasks with bedside care. Methods and Analysis Ethnographic case studies were undertaken in three hospital sites in England, using a mixed methods approach involving: participant observations; interviews with 33 newly qualified nurses, 10 healthcare assistants and 12 ward managers. Data were analysed using thematic analysis, aided by the qualitative software NVivo. Findings Multiple demands upon the newly qualified nurses' time, particularly the pressures to maintain records, can influence how effectively they delegate to, and supervise, healthcare assistants. While some nurses and healthcare assistants work successfully together, others work ‘in parallel’ rather than as an efficient team. Conclusions While some ward cultures and individual working styles promote effective team working, others lead to less efficient collaboration between newly qualified nurses and healthcare assistants. In particular the need for qualified nurses to maintain records can create a gap between them, and between nurses and patients. Newly qualified nurses require more assistance in managing their own time and developing successful working relationships with healthcare assistants. [ABSTRACT FROM AUTHOR]