Mollie Gilchrist

A randomised controlled trial of lay-led self-management for people with multiple sclerosis.

OBJECTIVE To determine the impact of the Chronic Disease Self-Management Course (CDSMC) on people with multiple sclerosis (MS). METHODS 2-group, randomised, controlled trial with Intervention Group (IG) and Waiting-List Control Group (WLCG). Additional data were collected from a Comparison Group (CG) who chose not to attend the CDSMC. Participants completed baseline questionnaires; IG participants attended the CDSMC immediately; all participants were assessed at 4-months and 12-months. RESULTS 216 baseline questionnaires were returned; 73% were female, mean age 51.1 years, mean disease duration 12.0 years. Results showed that the CDSMC had an impact on self-management self-efficacy (ES 0.30, p=0.009 for the IG) and MSIS physical status (ES 0.12 for the IG, p=0.005). There were no other statistically significant changes. However, trends towards improvement on depression (ES 0.21 for the IG, p=0.05) and MS self-efficacy (ES 0.16 for the IG, p=0.04) were noted. All improvements were maintained at 12-months. At baseline, CG participants were older, had longer disease duration (p<0.01) and less anxiety (p=0.009) compared to RCT participants. CONCLUSION The CDSMC provides some small positive effects for people with MS. Motivation to attend may be linked to psychological distress and disease duration. PRACTICE IMPLICATIONS The CDSMC may be of value for those with mild anxiety/depression who need extra support. Attendance early in the disease course is recommended.

A journey of self‐discovery: an intervention involving massage, yoga and relaxation for children with emotional and behavioural difficulties attending primary schools

This study reports on an intervention involving massage, yoga and relaxation delivered to young children with identified emotional and behavioural difficulties, and at risk of exclusion. Children (n = 126) were invited by the head teacher to participate in the Self‐discovery Programme (involving massage, yoga, breath work and relaxation) with parental consent. A total of 107 children aged 8–11 years were given consent by their parents to participate in the study and completed all measures. Children were allocated by the head teacher into the Control (n = 54) or Intervention (n = 53) Groups. The Control Group did not take part in the Self‐discovery Programme. Both groups continued to receive any additional support provided. Results indicate that children in the Intervention Group showed improvements in self‐confidence, social confidence, communication and contribution in the class. Children in the Intervention Group were noted by teachers to use skills learned on the Self‐discovery Programme during the school day.

Information and self‐management needs of people living with bleeding disorders: a survey

Summary.  The aim of the study was to conduct a survey of information and self‐management needs among members of the UK Haemophilia Society (HS). Of 1082 members mailed, 307 took part in the survey, the mean age was 52.4 years (SD 14.8), 85% were male, 96% white and 66% were living with haemophilia A. 90% felt that there is a lack of understanding amongst the public regarding bleeding disorders, 76% felt that health professionals understood their health and information needs and 32% had experienced problems managing anxiety and or depression. Results suggest that there was a ‘stigma’ attached to having a bleeding disorder and almost half are very careful about informing others that they have a bleeding disorder. Self‐efficacy was relatively high within the sample. Many respondents wanted to be kept informed about current research and the opportunity to participate in research. Women experienced a greater need for more information than men, particularly in the area of the ‘medical management’ and ‘emotional’ topics. Men appeared to need more information and or training on ‘physical’ aspects such as physiotherapy and joint replacement. The study provides an insight into the educational and self‐management needs of those affected by bleeding disorders and highlights the importance of providing accessible information.

A Randomised Controlled Trial of Lay-Led Self-Management for Myocardial Infarction Patients Who have Completed Cardiac Rehabilitation

Background: There are increasing opportunities for MI patients to attend lay-led, community based generic self-management programmes via self-referral. Aims: To determine the effectiveness of the Expert Patient Programme (EPP) for MI patients who had completed CR using a randomised controlled, wait-list design, with a nested qualitative study. Methods: The Intervention Group attends the EPP immediately after completing the baseline assessment; The Control Group had the opportunity to attend the EPP after completion of the 4-month follow-up. 192 MI patients (72% men) completed baseline assessment; 162 responded at follow-up. Telephone interviews were conducted with 10 male and 9 female Intervention group participants. Results: Intention-to-treat analysis revealed no statistically significant differences between the groups although a pattern of small improvements among the Intervention Group was observed over time. Interviews revealed that Intervention Group participants viewed CR as being more about instruction whereas the EPP was viewed as being more about discussion, mutual support, and goal setting. A gender difference emerged whereby male participants valued information exchange whereas female participants expressed a preference for emotional support and social interaction within the EPP context. Conclusion: The EPP appears to hold few benefits for MI patients who have attended CR.

Coventry university students’ experience of mental health problems

Growing numbers of university students are reporting mental health problems and using counselling services. The purpose of this study was to examine Coventry University students’ experience of mental health problems. The Department of Health (DoH) Mental Health Survey questionnaire (2003) was used to examine the experience of mental health problems and help seeking behaviour. Within the last 12 months nearly three quarters of students had experienced anxious or depressed moods, or, personal, mental, nervous or emotional problems, with a third of students failing to seek help. Ethnic minority students were more likely to report problems and less likely to seek help when compared to white students. Male students were less likely to seek help compared to female students. There are few existing studies that have focused on the mental health of students at universities established after 1992 from existing polytechnics. Coventry University exceeds the Government benchmark targets for recruiting students from non-traditional backgrounds. Our results show that it is these groups of students who are more likely to experience mental health problems.

An evaluation of a basic life support CD-ROM

The faculty has developed a basic life support (BLS) CD-ROM as part of a staff development project across the UK’s south west region’s universities. The introduction of the BLS CD-ROM to the faculty represents a paradigm shift, from the former method of delivering an acetate-based BLS lecture to groups of students across the professional disciplines. It is the intention that all students and staff requiring BLS instruction, should access the CD-ROM to gain and test essential theoretical knowledge, and have an opportunity to observe best practice through video demonstrations. The production of the BLS CD-ROM meets many of the current National Health Service and Higher Education agendas, with the potential for learning to take place in clinical environments and for developing key transferable skills. The tool can also be used to achieve the requirements for multi-professional education. This presentation introduces the evaluative testing by questionnaire of the beta version of the CD-ROM, using a convenient sample of 26 Diploma nursing students, adult branch. The results identify changes needed before implementation of the CD-ROM as a learning tool across all pre- and post-qualified professional groups. The students particularly valued the opportunity to learn at their own pace, and the use of critical thinking scenarios, which enhanced their learning. A small number of technical and presentational errors were identified for correction. Students also made suggestions for other improvements and further developments of multimedia learning materials. While this enthusiastic appraisal is acknowledged, the current paucity of research demands that the faculty continues to evaluate the use of the CD-ROM when fully implemented. This research will be used to inform further developments of multi-media learning materials.

A Journey of Self-Discovery: An Intervention Involving Massage, Yoga and Relaxation for Children with Emotional and Behavioural Difficulties Attending Primary Schools.

This study reports on an intervention involving massage, yoga and relaxation delivered to young children with emotional and behavioural difficulties. Children (n = 126) were invited to participate in the Self‐discovery Programme (SDP) with parental consent. A total of 107 children aged 8–11 years completed the SDP and all measures. Children were allocated to a Control (n = 54) or Intervention (n = 53) group. The results indicate that children in the Intervention group showed improvements in self‐confidence, social confidence, communication and contributions in class. Children in the Intervention group were noted by teachers to use skills learned on the SDP during the school day.

Computer-based instruction for improving student nurses’ general numeracy: is it effective? Two randomised trials

In response to concern over the numeracy skills deficit displayed by student nurses, an online computer programme, “Authentic World®”, which aims to simulate a real-life clinical environment and improve the medication dosage calculation skills of users, was developed (Founded in 2004 Authentic World Ltd is a spin out company of Glarmorgan and Cardiff Universities, Cardiff, Wales UK.). Two randomised controlled trials were conducted, each at a UK University, in order to investigate the impact of Authentic World® on student nurses’ general numeracy abilities. All first year nursing students who gave consent were randomised equally into an intervention or control group. The intervention group were given access to Authentic World®. The primary outcome measure was the students’ scores on a general numeracy test. The Intention to Treat (ITT) analysis in both trials revealed a small negative effect of Authentic World® on general numeracy, which was statistically significant in one trial. However, compliance with the intervention was very low in both trials, with only 24 and 12% of students allocated to the intervention groups spending more than 15 minutes using the programme. Providing nursing students with access to Authentic World® is not an effective use of resources since use of the programme appears to be very low.

Psychosocial well-being of parents of children with ataxia who attended the Training and Support Programme: A 12-month follow-up

The aim of this study was to investigate the impact of a Training and Support Programme (TSP) for parents of children with ataxia, 12 months after commencing the programme. The TSP provides instruction in basic massage to parents of children with disability and life limiting conditions. Questionnaires were mailed at 12-month follow-up to 27 parents who had completed a questionnaire at 4-month follow-up. Of the 14 parents who responded, the median age was 46 years (range 37-57 years), 11 were female and 6 were still massaging their children at 12-month follow-up. Eight children were male, median age 14 years (range 8.3-22.0 years). Results revealed trends towards improvements in parental satisfaction with life and improvements in childrens sleeping and bowel movements for those who were still massaging their children at 12-month follow-up. Results suggest that it may be useful to offer parents support and encouragement in the year after attending the TSP, if they wish to continue to massage their children.