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Objective: During the COVID-19 pandemic, anxiety in people with multiple sclerosis (PwMS) may have increased; however, little is known about the various factors which influenced this. We aimed to (a) identify the psychosocial modifiable associates of anxiety in PwMS in Ireland and the United Kingdom and (b) explore experiences of anxiety during the pandemic. Method: A cross-sectional survey was developed using public and patient involvement in 2021. This included measures of anxiety (Hospital Anxiety and Depression Scale [HADS-A]), social support (Multidimensional Scale of Perceived Social Support [MSPSS]), multiple sclerosis control self-efficacy (Multiple Sclerosis Self-Efficacy scale [MSSE]), exercise habits (Godin Leisure-Time Exercise Questionnaire [GLTEQ]), MS acceptance (Acceptance of Chronic Health Conditions scale [ACHC]), and intolerance of uncertainty (Intolerance of Uncertainty Scale-12 [IUS-12]), with open-ended questions asking about experiences of anxiety during COVID-19. A hierarchical regression analysis investigated the extent to which anxiety could be predicted by psychosocial modifiable factors after controlling for sociodemographic factors and multiple sclerosis (MS) type, while reflective thematic analysis was used to analyze open-ended responses. Results: 287 PwMS completed the survey, with 58% reporting that their anxiety had increased during the pandemic. In order of magnitude, self-efficacy (β = −.41), intolerance of uncertainty (β =.35), social support (β = −.21), and exercise habits (β =.19) significantly predicted variance in HADS-A scores (p <.01). Themes describing sources of anxiety included personal health concerns, social concerns, and responsibilities/additional external burdens. In contrast, some PwMS reported that anxiety had decreased during COVID-19. Conclusions: While the generality of findings may be limited due to a predominately female sample of PwMS living in the United Kingdom and Ireland, results have the potential to inform the development of targeted interventions in rehabilitation psychology to reduce anxiety in this population. Impact and Implications: This study provides a valuable insight into understanding the experience of anxiety in people with multiple sclerosis (PwMS). A strength lies in its mixed-methods approach, in that both a quantitative analysis of the predictors of anxiety along with a qualitative analysis of the experience of anxiety during the COVID-19 pandemic are described. While a number of participants indicated improvements in their levels of anxiety during the pandemic, the majority reported experiencing increases in anxiety during this time. Our qualitative analysis suggests that this was primarily attributed to concerns around health, social factors, and additional burdens placed on PwMS during the pandemic. Results point to a number of psychological, social, and lifestyle factors that may reduce the experience of anxiety in this population and which have the potential to meaningfully targeted in rehabilitation interventions. Notably, interventions designed to enhance self-efficacy and increase tolerance of uncertainty are promising directions for future research. Given that less attention has been paid to ways that anxiety can be reduced in the context of multiple sclerosis, these findings are valuable in informing the provision of supports of this group specifically, while findings also have implications for those living with other chronic illnesses and disabilities more generally. [ABSTRACT FROM AUTHOR]

Aim: To gain a deeper understanding of what is important to nurses when thinking about shift patterns and the organisation of working time. Design: A cross‐sectional survey of nursing staff working across the UK and Ireland collected quantitative and qualitative responses. Methods: We recruited from two National Health Service Trusts and through an open call via trade union membership, online/print nursing profession magazines and social media. Worked versus preferred shift length/pattern, satisfaction and choice over shift patterns and nurses' views on aspects related to work and life (when working short, long, rotating shifts) were analysed with comparisons of proportions of agreement and crosstabulation. Qualitative responses on important factors related to shift preferences were analysed with inductive thematic analysis. Results: Eight hundred and seventy‐three survey responses were collected. When nurses worked long shifts and rotating shifts, lower proportions reported being satisfied with their shifts and working their preferred shift length and pattern. Limited advantages were realised when comparing different shift types; however, respondents more frequently associated 'low travel costs' and 'better ability to do paid overtime' with long shifts and 'healthy diet/exercise' with short shifts; aspects related to rotating shifts often had the lowest proportions of agreement. In the qualitative analysis, three themes were developed: 'When I want to work', 'Impacts to my life outside work' and 'Improving my work environment'. Reasons for nurses' shift preferences were frequently related to nurses' priorities outside of work, highlighting the importance of organising schedules that support a good work‐life balance. Relevance to Clinical Practice: General scheduling practices like adhering to existing shift work guidelines, using consistent and predictable shift patterns and facilitating flexibility over working time were identified by nurses as enablers for their preferences and priorities. These practices warrant meaningful consideration when establishing safe and efficient nurse rosters. Patient or Public Contribution: This survey was developed and tested with a diverse group of stakeholders, including nursing staff, patients, union leads and ward managers. Reporting Method: The Strengthening the Reporting of Observational Studies (STROBE) checklist for cross‐sectional studies was used to guide reporting. [ABSTRACT FROM AUTHOR]

Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context. Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom. Design: Exploratory, sequential, mixed-methods design. Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The 'Ethical Issues in Palliative Care for Nursing Homes' instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015. Ethical considerations: Ethical approval was granted by Queen's University's School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home's manager. Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress. Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition that dysphagia has significant implications for a person's psychological well‐being, social participation and quality of life (QOL). However, a paucity of research exists regarding the clinical management of this area. To inform future research and the development of appropriate and beneficial resources and guidelines, a better understanding of the current practice of speech and language therapists (SLTs) in this area would be useful. This information will highlight current challenges to clinical practice and the ongoing development needs of the profession, which are, as of yet, undocumented. Aims: To determine the practices of SLTs when addressing QOL issues in individuals with dysphagia, the beliefs of SLTs regarding the impact of dysphagia on QOL, the current trends in assessing and managing QOL in dysphagia, and if variations in beliefs and practices in this area exist. Methods & Procedures: An anonymous cross‐sectional, non‐experimental survey study was used. The survey consisted of 18 questions exploring participants' beliefs and opinions regarding dysphagia and QOL, current clinical practice in the area, perceived facilitators and barriers, and education, training and development needs. The survey was created on Survey Monkey and disseminated by e‐mail link to SLT professional bodies. Purposive and snowball sampling were used and participants self‐selected based on the information provided alongside the e‐mail link. Inclusion criteria for the study were a qualification in speech and language therapy, proficiency in the English language, and access to a computer with the internet. Outcomes & Results: A total of 148 SLTs working across the UK, Ireland and South Africa completed the survey. Over 90% of respondents believe that dysphagia has a negative impact on QOL, but only 25% are currently satisfied with the amount of clinical time they can dedicate to this area. Staffing, resources, a lack of best‐practice guidelines and disease‐specific QOL assessment tools were cited as contributing factors. A number of facilitators and barriers to best practice were also highlighted. Based on these findings, professional development actions for the future are suggested. Conclusions & Implications: SLTs believe they have an important role to play in supporting QOL issues in dysphagia. However, it is reported that the area is currently under‐developed, under‐resourced and under‐supported. Increased awareness raising of the role of SLT, alongside the development of best‐practice guidelines and disease‐specific QOL assessment tools, will enhance the quality of care that can be offered in this area. [ABSTRACT FROM AUTHOR]

Background Dysphagia is common after stroke, leading to adverse outcome. There is a paucity of high-quality evidence for dysphagia therapy, thus making it difficult to determine the best approaches to treatment. Clinical decisions are often based on usual practice, however no formal method of monitoring practice patterns exists. Aims To determine speech and language therapists' (SLTs) approaches to direct dysphagia therapy with stroke patients in the UK and Ireland. Methods & Procedures A 24-item questionnaire was developed, piloted and delivered in a web-based cross-sectional survey targeting all SLTs working with stroke patients in the UK and Ireland. Outcomes & Results A total of 138 SLTs responded from a range of clinical settings and levels of experience. There was variation in the responses to all questions. Respondents reported treating patients a median of once a day, 3 days a week for 15 min. The most commonly recommended direct exercises were supervised swallow trials (recommended 'frequently or always' by 73%). Despite most respondents having access to an instrumental swallowing assessment, over half reported rarely or never conducting one before recommending exercises. Most (93%) did not use a protocol for systematically progressing patients' exercises and only 37% reported using standardized outcome measures. Conclusions & Implications This survey gives valuable insight into the direct dysphagia therapy practices of SLTs based in the UK and Ireland working in stroke. It highlights discrepancies between reported approaches and recommendations from existing evidence and clinical guidelines. The variation in responses indicates a need to develop a consensus statement and further research to guide practice. [ABSTRACT FROM AUTHOR]

How to cite this article Duggan S.N., Smyth N.D., O'Sullivan M., Feehan S., Ridgway P.F. & Conlon K.C. (2012) A transatlantic survey of nutrition practice in acute pancreatitis. J Hum Nutr Diet. 25, 388-397 Abstract Background: Many guidelines exist for the nutritional management of acute pancreatitis; however, little is known regarding current practice. We aimed to investigate feeding practices, including the use of parenteral/enteral nutrition. Methods: The study design was a cross-sectional, descriptive survey. Electronic surveys were sent to dietitians in the UK, the Republic of Ireland and Canada. Of 253 dietitians surveyed, 204 saw patients with acute pancreatitis regularly or occasionally and were included in the analyses. Results: Most dietitians (92.8%) considered early feeding to mean <48 h after presentation. Over half (54.2%) favoured early feeding in severe disease, less in obesity (42%) and more with pre-existing malnutrition (81.9%). There was a tendency to feed earlier in university hospitals ( P = 0.015), especially in obesity ( P = 0.011). There was a tendency towards enteral (versus parenteral) nutrition in university hospitals ( P = 0.000). The majority preferred the jejunal route (64.2%), although this was lower in the UK (43.8%) than in Canada (77.8%) or Ireland (54.2%). Under one-quarter of UK dietitians (23.2%) reported the existence of a pancreatic multidisciplinary team in their institutions, although this was lower in Ireland and Canada. Conclusions: Despite guidelines, there are gaps in the nutritional management of acute pancreatitis, including a continued reliance on parenteral feeding. [ABSTRACT FROM AUTHOR]

Aim. To identify self-reported perceptions of the barriers to research utilisation by Turkish staff nurses working in a university hospital and to ascertain whether involvement in research-related activities influenced their perception of the barriers. Background. Research utilisation in nursing has been a prominent concern for the last 30 years. While investigators in several countries have identified nurses’ perception of barriers to research utilisation, this is the first study to investigate such barriers in Turkey. Design. This is a descriptive, cross sectional study with a sample of 329 staff nurses working in a university hospital. Two instruments were used; a demographics questionnaire that investigated research activities and the Barriers Scale to measure perceptions. An additional item, ‘studies are published in English’ was added to the scale. Results. The lack of time to implement new ideas was the most frequently, 84·5%, perceived barrier. The second most frequently perceived barrier was difficulty in reading English. The top six barriers were all related to the setting. Additionally, research-active nurses found insufficient time less of a barrier but unawareness of research findings and being isolated from knowledgeable colleagues as greater barriers to research utilisation. Conclusions. Turkish nurses’ perception of barriers is similar to the findings in other countries, i.e., that the top six barriers were related to setting. Language barrier compares similarly with studies in other countries that investigated this variable. Relevance to clinical practice. The gap between theory and practice in nursing can be minimised by identifying strategies to increase research utilisation in clinical settings. Such strategies can also improve patient care outcomes. [ABSTRACT FROM AUTHOR]