Angela Williams

Emotion work in paramedic practice: the implications for nurse educators.

Contemporary paramedic practice involves the emergency assessment, management, treatment and transport of the public with minor and major; potentially life threatening conditions (Caroline, 2008). Paramedics are exposed to a myriad of human emotions related to suffering, pain, devastating trauma and death. Managing their own and others emotions appears to be a crucial component of their work, however there is a paucity of evidence relating to this aspect of the role. The movement of preregistration paramedic education into higher education has impacted on nurse educators in some settings, who are undertaking key administrative, managerial, teaching and personal tutoring roles. This is a valuable opportunity for nurse educators to contribute to the education of student paramedics in the crucial area of emotion work as part of interprofessional health care education. This paper examines emotional labour in health care, historical influences on paramedic education, the limited empirical research and the impact of gender, which provide insights into this profession crucial for nurse educators. The implications of emotion work for the educational curriculum and the support of student paramedics are discussed and strategies such as counselling, reflection and personal tutoring are suggested. Mentorship selection and preparation are highlighted and the need for a cultural change in attitude towards emotion work.

Psychometric development of the Upper Limb Lymphedema Quality of Life Questionnaire demonstrated the patient-reported outcome measure to be a robust measure for breast cancer–related lymphedema

OBJECTIVES To develop and undertake initial validation of a patient-reported outcome measure to assess health-related quality of life in patients with breast cancer-related upper limb lymphedema (ULL). STUDY DESIGN AND SETTING We developed and validated the Upper Limb Lymphedema Quality of Life (ULLQoL) scale in two stages: devising the items and pretesting with patients and clinicians; longitudinal validation to test its psychometric properties-underlying dimensions, internal consistency, test-retest reliability, construct validity, and responsiveness. Patients with ULL were recruited from two outpatient clinics. RESULTS We derived the ULLQoL scale from a pool of 98 items generated by patients. After further consultation, we produced the draft ULLQoL scale. For validation, 103 patients with ULL completed the draft scale and two generic health measures: SF-36 and ED-5D-3L. Psychometric analysis identified two components, physical and emotional well-being, with good internal consistency and test-retest reliability. Significant correlations with SF-36, EQ-5D-3L, and percentage excess limb volume confirmed construct validity. The ULLQoL scale showed good responsiveness to change reported by lymphedema patients and moderate to large effect sizes. CONCLUSION The 14-item ULLQoL scale is a robust ULL-specific measure that is feasible and valid to use in both the clinical and research settings.