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The nursing assessment, and the contribution it makes to the identification of an individual's health needs, is often a complex and multidimensional process. This is always true when the individual concerned has a severe learning disability. The nurse should develop the assessment in partnership with individuals who may experience major communication difficulties, or have unappreciated levels of perceptual or cognitive dysfunction. They may also live with the ongoing possibility that their affective or behavioural responses may be misinterpreted as 'challenging behaviour'. This case study focuses upon one particular young man with a severe learning disability living in a community home. Drawing upon the principles of qualitative research methods, especially those of 'grounded theory', this study aims to demonstrate how these can be used to develop a uniquely person-centred assessment. A systematic process of observation, analysis and reflection produces a detailed picture of the individual and his or her particular health states. The strength of this approach is threefold. Firstly, the person is considered as an active participant and remains the central focus. Secondly, in contrast to many other forms of assessment, the person is viewed as dynamic with ever changing needs. Thirdly, the process of nursing judgement is made explicit and integrated into the assessment process. [ABSTRACT FROM AUTHOR]

Aim: To develop a cognitive behavioural treatment (CBT) approach that included novel attention training components to support symptom management in children with a primary diagnosis of Functional Movement Disorder (FMD)., Method: Eighteen children (9 male and 9 female) with a mean age of 13 years (sd = 2.46, range 10-18 years) were assessed and completed CBT with novel attention training components. Treatment outcomes were measured using the Child Global Assessment Scale (CGAS) which was administered at baseline and post-treatment., Results: Scores on the CGAS improved significantly post-treatment (p < 0.001) with all participants showing significant change in functioning on the basis of the Reliable Change Index (RCI), with clinically significant change across classification boundaries., Interpretation: This case series provides support for the use of CBT with attention training components for the management of FMD. Larger trials are necessary to identify which individual treatment components are most effective and to better understand and quantify response to treatment. Future clinical treatment studies would benefit from the inclusion of objective measures of interoception and attentional focus., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Children who are adopted have frequently experienced a range of aversive experience which impact on their ability to form secure attachments. Dyadic Developmental Psychotherapy (DDP) is an intervention designed to develop and promote secure attachments with children who have experienced developmental trauma. Eight adoptive parents participated in semi-structured interviews regarding their experiences of attending the 'Nurturing Attachment' group informed by DDP. The transcripts of their interviews were explored using Interpretative Phenomenological Analysis. The analysis revealed five inter-connected superordinate themes which were as follows: A supportive group, A shift in perspective, 'Turning trauma into secure attachment', 'Am I doing it right?' and Continuing the adoption journey. Themes are considered in relation to the theoretical underpinnings and practice of DDP. Some further implications for clinical and research practice are also discussed.

Objective: To consider the potential of self-help relaxation training to treat depression after stroke., Design: Randomized controlled trial with cross-over at three months., Setting: Community., Participants: In total, 21 people with stroke, aged 49-82 years., Intervention: Autogenic relaxation CD., Main Measure: Hospital Anxiety and Depression Scale-Depression (HADS-D) subscale., Results: No difference in depression change scores was identified between the treatment and control groups; however, on two follow-ups, significant positive differences relative to screening were found for the treatment group (at 2 months Z = -2.55, P = .011 and 12 months Z = -2.44, P = .015). A partial η 2  = .07 was identified., Conclusion: Self-help relaxation holds promise as a self-help treatment for depression after stroke. Findings from this trial, considered with others of relaxation for depression, suggest that a study including a total of 80 participants would likely be sufficient to establish efficacy of the treatment, relative to controls, in those with stroke.

Objective: To follow up participants in a randomised controlled trial of relaxation training for anxiety after stroke at 12 months., Design: Twelve month follow-up to a randomised controlled trial, in which the control group also received treatment., Setting: Community., Participants: Fifteen of twenty one original participants with post-stroke anxiety participated in a one year follow-up study., Interventions: A self-help autogenic relaxation CD listened to five times a week for one month, immediately in the intervention group and after three months in the control group., Main Measures: Hospital Anxiety and Depression Scale-Anxiety subscale and the Telephone Interview of Cognitive Status for inclusion. Hospital Anxiety and Depression Scale-Anxiety subscale for outcome. All measures were administered by phone., Results: Anxiety ratings reduced significantly between pre and post-intervention, and between pre-intervention and one year follow-up ( χ 2 (2) = 22.29, p < 0.001)., Conclusions: Reductions in anxiety in stroke survivors who received a self-help autogenic relaxation CD appear to be maintained after one year.

Objective: To consider relaxation as a potential treatment for anxiety in stroke survivors living in the community, including feasibility and acceptability., Design: Randomised two group design (intervention and control)., Participants: All participants (n = 21) were stroke survivors living in the community who reported experiencing anxiety (Hospital Anxiety and Depression Scale - Anxiety Subscale ⩾ 6)., Interventions: The intervention group were asked to listen to a self-help autogenic relaxation CD, five times a week, for at least one month. Participants completed the Hospital Anxiety and Depression Scale at screening and then monthly for three months., Results: At each assessment following screening, participants who received the relaxation training were significantly more likely to report reduced anxiety compared to those who had not received the training (Month 1 P = 0.002; Month 2 P < 0.001; Month 3 P = 0.001). After one month, seven of the intervention group (n = 10) had completed the relaxation training as directed and planned to continue using it. The intervention appeared practical to deliver and relatively inexpensive, with minimal adverse effects., Conclusions: Preliminary evidence suggests that autogenic relaxation training delivered in a self-help CD format is a feasible and acceptable intervention, and that anxiety is reduced in stroke survivors who received the intervention. Future studies should seek to recruit a larger and more heterogeneous sample of 70 participants., (© The Author(s) 2015.)

Background:   The task of fostering today is a complex one and foster carers need good quality support. This paper discusses a consultation service for foster carers., Method:   It draws upon our qualitative experiences to explore the important themes that have emerged during the provision of the consultation service., Results:   Foster carers are highly satisfied with the consultation service, which provides them with improved levels of access to psychological advice, a different understanding of the children, and continuing support if required., Discussion:   The reasons for this satisfaction, together with some of the difficulties we have experienced, are explored. Experimental research is needed to investigate the complex relationship between consultation, support, confidence and understanding for foster carers and to consider the long-term effects of consultation for the carer and the child.