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Background Early recognition of stroke symptoms and immediate response is necessary to ensure timely access to treatment of stroke. However, many individuals fail identify symptoms of stroke or delay in seeking medical attention. The Irish Heart Foundation launched the “Act Fast” campaign which included three waves of broadcasting on national television and radio, throughout 2010 and 2011. Stroke awareness campaigns may have the potential to influence behaviour and response to stroke. Methods A non-experimental, descriptive, quantitative, cross-sectional study was conducted. The Stroke Action Test (STAT)1 was used to investigate how participants would respond to specific symptoms of stroke. A convenience sample (n=89) of older adults attending an outpatient clinic in a university teaching hospital completed the questionnaire. The mean age of respondents was 79.6 years (SD =9.3). Results Just 4.5% (n=4) of respondents identified what all 4 letters of FAST represent. Overall, 48% (n=43) of respondents recognised all 6 symptoms of stroke and 100% (n=89) recognised at least 2 symptoms of stroke as per STAT. The stroke symptom most frequently recognised was sudden numbness of the face, arm or leg at 99% (n=88). The stroke symptom least frequently recognised was sudden trouble seeing in one or both eyes at 56% (n=50). Despite this 81% (n=64) of respondents would not respond appropriately to 50% of symptoms of stroke described in the STAT. 52% (n=46) of respondents identified irregular heart beat as a risk factor for stroke. Finally, 29% (n=26) of respondents had heard of thrombolysis while just 2% (n=2) had heard of thrombectomy. Conclusion Awareness of stroke symptoms does not necessarily influence response to stroke in older adults. Future stroke awareness campaigns should consider FAST2 which speaks to treatment (thrombolysis or thrombectomy) as well as time.

Background and Aims: Individuals with inflammatory bowel disease experience debilitating symptoms on a daily basis, but little is known about symptom burden in IBD. The objectives were to (i) identify the most prevalent symptoms and the average number of symptoms experienced; (ii) assess symptom frequency, severity and distress; and (iii) determine the most burdensome symptoms experienced by individuals with inflammatory bowel disease. Methods: A cross-sectional descriptive design was used to collect data in a single regional treatment centre in Ireland. A consecutive and unique sample of 247 individuals diagnosed with Crohn’s disease and ulcerative colitis completed a modified disease-specific version of the Memorial Symptom Assessment Scale. Results: Participants reported experiencing a median of 10 symptoms during the last week, but as many as 16 symptoms were experienced by those with active disease. Of the symptoms experienced, lack of energy was identified as the most burdensome symptom. Bowel symptoms of urgency and diarrhoea and irritable bowel syndrome-type symptoms such as feeling bloated and flatulence were also problematic. Worry was ranked the most burdensome psychological symptom experienced. Symptom burden scores varied according to disease type and disease status, with significant differences found between those with active and inactive disease. Conclusions: Individuals with inflammatory bowel disease experience a considerable number of symptoms and are burdened by both physical and psychological symptoms, particularly during active disease. Healthcare professionals’ focus of assessment needs to be broadened to encompass multiple symptoms. Greater attention needs to be given to fatigue and psychological symptoms.

Background self-neglect (SN) is a global health and social problem affecting societies, which is largely hidden, under-reported and underresearched. Community nurses (CNs) and social workers (SWs) need to be knowledgeable about SN. Objective to determine CNs and SWs sources and level of SN knowledge. Methods quantitative, descriptive and cross-sectional. Subjects CNs and SWs working in the community with older people at risk of SN. Settings participants were recruited from four Health Service Executive (HSE) areas in Ireland. Instrument a questionnaire was developed to elicit levels and sources of SN knowledge. A postal survey was used. Results of the 566 questionnaires posted, 339 responded (Nurses (N) N = 305; SWs N = 34), a 60% response. SWs had statistically higher knowledge scores (P = 0.002), and difference in average scores between CNs and SWs was statistically significant (P = 0.037). There was a statistically significant difference between practice and personal experience (P = 0.44), and use of literature/books (P = 0.037) between CNs and SWs, with SWs using both sources more. Higher knowledge scores were significantly associated with number of SN cases, higher education and gender. Conclusion there is a need for interdisciplinary training on SN.

Background: delirium is a common neuropsychiatric disorder. The natural course is of an acute, fluctuating and often transient condition; however, accumulating evidence suggests that delirium can be associated with incomplete recovery. Despite a growing body of research, a lack of clarity exists regarding definition and outcomes. Objective: to clarify the definition of recovery of delirium used in the literature. Methods: a Medline search was performed using relevant keywords. Studies were included if they were in English, provided any definition of recovery and were longitudinal. Excluded articles were duplicated studies, case studies, review articles or articles related to alcohol, children, subsyndromal delirium only or those investigating core symptoms such as function. Results: fifty-six studies met the inclusion criteria. Only two studies used clinical criteria alone for the diagnosis of delirium; most studies used at least one validated scale-either categorical or continuous severity scales. A variety of 16 different terms were used to define the 'recovery of delirium'. The definitions of each term also varied. Studies using severity scales used either cut-off points or percentage reduction between assessments, while others using dichotomous scales (yes/no) defined recovery as one or more days of negative delirium. Conclusion: an agreed terminology to define recovery in delirium is required. A distinction should also be made between symptomatic and overall recovery, as well as between long- and short-term outcomes. It is proposed that cognitive recovery should be central to defining recovery in delirium.

Background Cardiovascular disease accounts for 39% of all deaths in Ireland each year. Many of these deaths are due to acute myocardial infarction (AMI). The diagnosis of AMI has major implications for individuals in terms of health and social gain, health related quality of life and living and adapting to a chronic illness. The diagnosis requires lifestyle changes such as changes to diet, smoking habit, physical activity, and stress management. Aims The aim of this descriptive qualitative study was to explore patients' perspectives of making lifestyle changes following AMI. Methods Using a descriptive qualitative approach, ten participants were interviewed 6 weeks following discharge about their experiences. Data were collected using in depth interviews and analysed using thematic analysis. Research findings Four themes emerged: lifestyle warning signs, taking responsibility for lifestyle changes, professional support and looking forward to the future. The findings offer insight into the everyday realities, which patients experience regarding lifestyle changes particularly in relation to smoking cessation and stress management. The difficulties encountered by participants 6 weeks following discharge reflect the implementation of too many life style changes at once as well as the lack of professional help in the community to support participants in their endeavours to make lifestyle changes. In addition, overprotection by family members was a source of frustration and aggravation for participants. Conclusion The study highlights the need for the development of primary care services and cardiac rehabilitation programmes to support patients as well as providing information to families to reduce anxiety and fear.