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This paper reports on findings from an integrative literature review of evaluation studies undertaken into sexual health promotion preparation programmes aimed at professionals with a sexual health promotion remit. Using a pre-defined search strategy, inclusion criteria and PRISMA guidelines, databases were systematically searched. Studies were screened and those included were quality assessed. Twenty-seven relevant studies were identified. Thematic analysis showed programmes were diverse in terms of how they had been developed, the content included, approaches to evaluation and outcomes identified. Evaluations showed participation in a training programme encouraged participants to feel more comfortable and confident to discuss sexual health within their role and more likely to introduce sexual health into client discussions. The types of programmes and evaluation approaches were diverse making direct comparison between them challenging. There should be agreed core outcome impact measures for sexual health education programmes in the areas of knowledge, comfort, skills and changes to practice, to allow for more direct comparison in future evaluation studies.

Objectives: The aim of this study was to evaluate a Health Service Executive (HSE) Foundation Programme in Sexual Health Promotion (FPSHP) with a specific emphasis on capacity building. Design: A mixed-method design using both quantitative and qualitative methods was used to collect the data. Setting: The FPSHP was delivered to staff working in health, education and community settings and was designed and facilitated by sexual health promotion staff who are part of the Irish HSE. Methods: A survey, designed by the researchers, as well as individual telephone interviews with past participants was used to evaluate the programme. Out of a possible 200 participants, 97 completed the questionnaire (response rate 49%), and a total of 22 telephone interviews were completed. Results: There was generally a high level of satisfaction with the FPSHP. Participants reported high levels of individual and intra-organisational capacity-building activities, but apart from networking, interorganisational capacity-building activities were reported less frequently and tended to be ad hoc in nature. Satisfaction with the programme was high and so was the perception of its sustained impact. Motivation, satisfaction with the programme and attending of further training were strong predictors of reported sustained impact. Conclusion: Capacity building in sexual health promotion was affected positively by participation in the programme. Nonetheless, a greater emphasis on capacity building at an inter-organisational level needs to be considered. It is recommended that participants need to be motivated, guided and supported in the use of strategies to achieve this.

Background: This article reports on an evaluation of four family support programmes in Ireland for families of people with a physical or an intellectual disability or autism. The focus of the evaluation, which took place within a year of the programmes' completion, was on establishing whether the programmes had an impact on families' capacity to effectively support their family member. Method: A mixed-method design was used, which included a survey (n = 38) and interviews (n = 19) with participating family members. Ethical approval for the study was given by the relevant university ethics committee. Results: Findings suggest that participation in the programmes enhanced knowledge, attitudes, and competencies of families and also impacted their ability to advocate for their family member and to connect with the community. Discussion and conclusions: Whilst outcomes were overwhelmingly positive, further follow-up would be required to ascertain if sustained capacity building took place.

Objectives: People with intellectual disability, particularly people with Down syndrome, are at an increased risk for early-onset dementia, in comparison to people without an intellectual disability. The aim of this review was to scope the current landscape of post-diagnostic dementia supports for people with intellectual disability. Method: A systematic search of five electronic databases (CINAHL, Medline, PsycArticles, PsycInfo and Web of Science) was conducted for this scoping review. Results were screened independently by two reviewers, with a third reviewer for arbitration where necessary. Results: Forty-two studies met the inclusion criteria, and relevant information was extracted. The articles included focussed on the experiences of people with intellectual disability and dementia, as well as the role of carers, family members and staff. Key themes included ageing in place, environmental supports for people with intellectual disability and dementia, dementia-specific interventions and therapies, as well as the feasibility of these interventions. Besides the studies that focussed on these themes, other studies focussed on staff training and family supports. Conclusion: This review highlights the importance of implementing timely and appropriate post-diagnostic supports for people living with intellectual disability and dementia. More controlled trials are required on post-diagnostic dementia supports for people with intellectual disability. [ABSTRACT FROM AUTHOR]

Background: Advanced colorectal cancer (CRC) is frequently a lethal disease. Mutations in the BRAF gene is a key driver in CRC pathogenesis and confers a poor prognosis. To date, Irish data on this molecular subtype of CRC is lacking. Aims: Our aim was to compare the natural history of Irish patients with BRAF (BRAFMUT) metastatic CRC with a control group of metastatic CRC patients without BRAF mutation (BRAFWT wild- type). Method: A retrospective observational analysis of advanced CRC patients with known BRAFMUT was conducted by chart review. BRAFMUT patients were identified from the Cork University Hospital (CUH) histopathology database. Controls with known BRAFWT were randomly selected from the database. Demographic characteristics and clinicopathological data were recorded. Survival was assessed with Kaplan–Meier curve/Cox proportional hazard models. Results: Twenty patients with BRAFMUT and 36 with BRAFWT were studied. BRAFMUT were more likely female (75% vs 33%, p = 0.007) and right-sided (65% vs 31.4%, p = 0.033). Median overall survival was lower in BRAFMUT group (17.3 months (95% CI 0–40.8)) compared to patients with BRAFWT (median survival not reached, log rank p = 0.001). On multivariate analysis, BRAFMUT was independently associated with an increased risk of mortality (HR 12.76 (95% CI 3.15–51.7), p < 0.001). Conclusion: BRAFMUT advanced colorectal cancer was associated with significantly reduced overall survival in this Irish CRC population. Knowledge of mutation status should now be considered standard of care and should dictate management. Surgeons should be aware of this genetic signature as the natural history of the disease may mitigate against an aggressive surgical strategy. A prospective study should be conducted to further corroborate these findings. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify, appraise and summarise the available evidence relating to community nurses' attitudes, knowledge and educational needs in relation to urinary continence. Background: Community nurses play a pivotal role in identifying and supporting individuals who experience urinary continence issues. Gaps in nurses' continence‐related education and knowledge may contribute to sub‐optimal assessment and management across the continuum of care. Design: A systematic review. Methods: MEDLINE, CINAHL Complete and EMBASE were searched from inception to November 2020; keywords used included community nurses, urinary continence, incontinence, knowledge, attitude and education needs. Given the degree of heterogeneity between included studies, a meta‐analysis was not feasible. Included studies were critically evaluated; key study characteristics and findings pertinent to the review purpose were summarised. The review adhered to the PRISMA 2020 checklist. Results: Four studies reported in six papers were included. Community nurses lacked knowledge in certain areas of urinary continence and incontinence. Nurses reported they were adequately prepared but without sufficient knowledge to effectively care for those with urinary incontinence. Community nurses' attitudes to urinary incontinence were generally positive, but they demonstrated misconceptions that urinary incontinence was inevitable and less distressing for older people. Conclusions: There is limited research exploring community nurses' knowledge, attitudes and education needs in relation to urinary continence and incontinence care. Community nurses may have knowledge gaps and less favourable attitudes to some aspects of urinary continence care. [ABSTRACT FROM AUTHOR]

Aim: The aim was to analyse the psychometric properties of a patient‐reported‐experience measure, the Patient Enablement and Satisfaction Survey (PESS), when used to evaluate the care provided by Advanced Nurse Practitioners (ANPs) in terms of factor structure and internal consistency. The PESS is a 20‐item, patient‐completed data collection tool that was originally developed to measure patient experience and enablement following consultation with nurses in general practice. Design: Cross‐sectional survey; validity and reliability analysis. Methods: The sample in this study consisted of 178 patients who consulted with 26 ANPs working in four different specialities. Data were collected between June and December 2019. An exploratory factor analysis of the PESS was conducted to determine convergent validity which was supported by parallel analysis and the traditional Kaiser criterion. The internal consistency of individual PESS items was determined via Cronbach's alpha, McDonald's omega, the Average Variance Extracted tests and item‐subscale/total score correlations. Results: A three‐factor structure (PESS‐ANP) was found through exploratory factor analysis and this was supported by parallel analysis, the traditional Kaiser criterion and the percentage of variance explained criterion. A high degree of internal consistency was reported across all factors. One question was omitted from the analysis ('Overall Satisfaction') following the identification of problematic cross‐loadings. The three factor solution was identified as: patient satisfaction, quality of care provision and patient enablement. Conclusion: The findings of this study propose a three‐factor model that is sufficiently reliable for analysing the experience and enablement of patients following consultation with an ANP. Impact: Increasingly, patient‐reported experience measures are being used to evaluate patients' experience of receiving care from a healthcare professional. The PESS was identified to be reliable in evaluating the experience of patients who receive care from an ANP while a three‐factor structure was proposed that can capture specific attributes of this care. [ABSTRACT FROM AUTHOR]

This paper reports on the findings of a pre-post and follow-up evaluation of a sexual health promotion programme in Ireland. Substantial progress in skills, knowledge, confidence and comfort were reported by participants which were to a large extent maintained over time. Evidence emerged of the successful translation of learning into practice in a number of areas, including engaging proactively with service users about sexual health and developing educational programmes and materials. The paper highlights contextual factors that support and inhibit sustainable changes to practice that need to be addressed in order to maximise the impact of capacity building education. [ABSTRACT FROM AUTHOR]

Objectives: Acute hospitals, in particular the emergency department, can be disorienting for people living with dementia. As part of a larger project to improve care for people living with dementia, dementia-inclusive modifications were made to two emergency department bays in a large acute care hospital in Ireland. Modifications to spatial configuration included noise reduction, altered lighting and the addition of an orientation aid and fixed seating for relatives. Method: A mixed methods approach was employed with both service user and service provider perspectives explored (survey of service providers (n = 16) and interviews with family carers (n = 10) at one time point and interviews with service providers (n = 8 and n = 5) and key stakeholders (n = 3) as well as audit data (at two time points) to evaluate the impact of the modifications made to the emergency department. Results: Orientation and navigation within the modified bays were improved though technical issues with the orientation aid were highlighted. Further user information on the functionality of the adjustable lighting would be required to maximise its benefits. This lighting and use of calming colours, together with the addition of noise-reduction bay screens, served to reduce sensory stimulation. The provision of adequate space and seating for family carers was extremely beneficial. The removal of unnecessary equipment and use of new structures to store relevant clinical equipment were other positive changes implemented. A number of challenges in the design development of the modified bays were highlighted, as well as ongoing broader environmental challenges within the emergency department environment. Conclusion: The findings suggest that the modified bays contributed positively to the experience of people living with dementia and their families in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Weight loss (WL) has long been recognized as an important factor associated with reduced quality of life (QoL) and reduced survival in patients with cancer. The body mass index (BMI)‐adjusted weight loss grading system (WLGS) has been shown to be associated with reduced survival. However, its impact on QoL has not been established. The aim of this study was to assess the relationship between this WLGS and QoL in patients with advanced cancer. Methods: A biobank analysis was undertaken of adult patients with advanced cancer. Data collected included patient demographics, Eastern Cooperative Oncology Group performance status, and anthropometric parameters (BMI and %WL). Patients were categorized according to the BMI‐adjusted WLGS into one of five distinct WL grades (grades 0–4). QoL was collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐C30. The Kruskal–Wallis test and multivariate logistic regression analyses were used to assess the relationship between the WLGS and QoL scores. Overall survival was assessed using Kaplan–Meier curve and Cox proportional hazard models. Results: A total of 1027 patients were assessed (51% male, median age: 66 years). Gastrointestinal cancer was most prevalent (40%), and 87% of patients had metastatic disease. Half (58%) of patients had a WL grade of 0–1, while 12%, 20%, and 10% had WL grades of 2, 3, and 4, respectively. Increasing WL grades were significantly associated with poorer QoL functioning and symptoms scales (all P < 0.05). Physical, role, and emotional functioning decreased by a median of >20 points between WL grade 0 and WL grade 4, while appetite loss, pain, dyspnoea, and fatigue increased by a median score >20 points, indicative of a large clinical significant difference. Increasing WL grades were associated with deteriorating QoL summary score. WL grades 2, 3, and 4 were independently associated with a QoL summary score below the median (<77.7) [odds ratio (OR) 1.69, P = 0.034; OR 2.06, P = 0.001; OR 4.29, P < 0.001, respectively]. WL grades 3 and 4 were independently associated with reduced overall survival [hazard ratio 1.54 (95% confidence interval: 1.22–1.93), P < 0.001 and hazard ratio 1.87 (95% confidence interval: 1.42–2.45), P < 0.001, respectively]. Conclusions: Our findings support that the WLGS is useful in identifying patients at risk of poor QoL that deteriorates with increasing WL grades. WL grade 4 is independently associated with a particularly worse prognosis and increased symptom burden. Identification and early referral to palliative care services may benefit these patients. [ABSTRACT FROM AUTHOR]