Paula Ormandy

Defining information need in health – assimilating complex theories derived from information science

Background  Key policy drivers worldwide include optimizing patients’ roles in managing their care; focusing services around patients’ needs and preferences; and providing information to support patients’ contributions and choices. The term information need penetrates many policy documents. Information need is espoused as the foundation from which to develop patient-centred or patient-led services. Yet there is no clear definition as to what the term means or how patients’ information needs inform and shape information provision and patient care. Theoretical synthesis  The assimilation of complex theories originating from information science has much to offer considerations of patient information need within the context of health care. Health-related research often focuses on the content of information patients prefer, not why they need information. This paper extends and applies knowledge of information behaviour to considerations of information need in health, exposing a working definition for patient information need that reiterates the importance of considering the patient’s goals and understanding the patient’s context/situation. A patient information need is defined as ‘recognition that their knowledge is inadequate to satisfy a goal, within the context/situation that they find themselves at a specific point in the time’. This typifies the key concepts of national/international health policy, the centrality and importance of the patient. Conclusions  The proposed definition of patient information need provides a conceptual framework to guide health-care practitioners on what to consider and why when meeting the information needs of patients in practice. This creates a solid foundation from which to inform future research.Background  Key policy drivers worldwide include optimizing patients’ roles in managing their care; focusing services around patients’ needs and preferences; and providing information to support patients’ contributions and choices. The term information need penetrates many policy documents. Information need is espoused as the foundation from which to develop patient‐centred or patient‐led services. Yet there is no clear definition as to what the term means or how patients’ information needs inform and shape information provision and patient care.

Evaluation of the organisation and delivery of patient-centred acute nursing care

Abstract The key driver for this study arose from two serious untoward incidents that occurred in a large district general hospital in the United Kingdom. Following investigation of both these events the Director of Nursing in post at that time believed that poor organisation and delivery of care may have been a contributory factor. This paper reports the findings on one phase of a multi-phase study and focuses upon the perceptions and experiences of the hospital staff around the organisation and delivery of patient-centred acute nursing care. Although we saw little evidence of multi-disciplinary approaches to care, it was evident that the issue which had the biggest impact upon both the organisation and delivery of care was staffing levels.

Comparison of nephrology nursing interventions across five European countries.

Comparing nursing interventions between different countries is helpful towards developing a common nursing culture within Europe. The aim of the study was to compare the frequency of 14 specific nursing interventions indicators across five European countries (Belgium, Scotland, Czech Republic, Greece and the North of England). Data were collected as an integral part of the European Practice Database Project across two cycles (2005 and 2006) involving 172 renal centres. Using Pearsons chi-square and descriptive statistics the frequency of 11 out of the 14 nurse intervention indicators was found to vary significantly across the five countries. Indeed specific nurse interventions such as delegation, telephone consultations and laboratory data interpretation potentially identify where nurse activity is changing in response to pressures such as advancing nurse roles, staff shortages and increased patient demand.

EUROPEAN PRACTICE IN HAEMODIALYSLYSLYSIS: RERESULTS OF THE EPD

SUMMARY The European Practice Database (EPD) project, developed by the EDTNA/ERCA Research Board, collects data on renal practice at centre level in different European countries. Results presented in this paper focus on the European Practice in Haemodialysis centres from 8 European countries or regions following data collection from 2002 to 2004. These results will enable international comparison in practice and will stimulate further research and the development of new practice recommendations.

Study protocol : responding to the needs of patients with IgA nephropathy, a social media approach

Abstract Background IgA nephropathy is the most common cause of glomerulonephritis in the Western world and predominantly affects young adults. Demographically these patients are the biggest users of social media. With increasing numbers of patients turning to social media to seek information and support in dealing with their disease, analysis of social media streams is an attractive modern strategy for understanding and responding to unmet patient need. Methods To identify unmet patient need in this population, a framework analysis will be undertaken of prospectively acquired social media posts from patients with IgA nephropathy, acquired from a range of different social media platforms. In collaboration with patients and members of the clinical multidisciplinary team, resources will be created to bridge gaps in patient knowledge and education identified through social media analysis and returned to patients via social media channels and bespoke websites. Analysis of the impact of these resources will be undertaken with further social media analysis, surveys and focus groups. Conclusions Patients with chronic diseases are increasingly using social networking channels to connect with others with similar diseases and to search for information to help them understand their condition. This project is a 21st century digital solution to understanding patient need and developing resources in partnership with patients, and has wide applicability as a future model for understanding patient needs in a variety of conditions.

Extending conceptual understanding: How interprofessional education influences affective domain development

ABSTRACT Interprofessional learning (IPL) can influence affective domain development of students through teaching activities that facilitate learning with, from, and about other professions. Current quantitative evidence offers limited explanation of how this learning is achieved within IPL programmes. This article tests a conceptual framework drawn from theories on IPL and affective domain development (attitudes, values, and behaviours) to explain what works for whom, when, and in what circumstances. The objectives of the study were twofold: to evaluate the impact of the IPL programme on the student’s attitudes and values, and to identify behaviour changes in clinical practice towards interprofessional working. Using an action research approach, based in practice, an IPL programme was delivered over 6 weeks. Students from five professions, nursing, radiography, physiotherapy, social work, and podiatry (n = 63), participated over the two action research cycles and in semi-structured focus groups (n = 37). The recorded personal experiences of the IPL activities on the students were examined in relation to the type of activity; impact on the affective domain of learning (attitude, value, or behaviour) and self-reported outcome on application to their practice. Modification in affective domain development was measured to identification or internalisation stage for 30 of the students. Self-reported outcomes on application to practice included direct impact on patient care, personal resilience building, improved communication, and ability to challenge practice. This article presents a conceptual framework not evident in current research, in regard to what IPL works for whom, in what circumstances, and when. IPL activities that address a personal reward or incentive and are delivered over four weeks, imitating ‘circles of care,’ that explore self-assessment, team building, and reflection can lead to sustained change in values, attitudes, and behaviours.

Organ donation among ethnic minorities: how UK primary care can help promote it

There continues to be a significant paucity of Asian organ donors despite numerous public education campaigns in the UK.1 The prevalence of type 2 diabetes, a major cause of renal failure, is up to six times greater among South Asians, especially within the Indian, Pakistani, and Bangladeshi communities as compared with the white population.2,3 However, the lower organ donation rates among this group result in a disproportionate number of Asian patients waiting longer for transplants.4 Promoting organ donation in this group represents one of the major challenges facing the transplant community and, despite a number of initiatives introduced in the UK, there has been little success. The role of GPs in influencing the South Asian community in the UK to improve organ donation is potentially significant. Here we reflect on our work (a PhD thesis by Agimol Pradeep — not published as yet), which sought to explore the impact of education interventions in increasing the number of organ donors …

British Renal Society to develop first UK Renal Nurse Association

Vice Presidents of the British Renal Society are leading on the formation of a UK Renal Nurse Association. At present, a formal renal nurse association does not exist, meaning there is no single voice representing either registered or non-registered nurses working in the field of kidney care. Karen Jenkins and Paula Ormandy discuss the results of a recent nurse survey and focus group.