Pauline Banks

Understanding and Assessing the Impact of End-Stage Renal Disease on Quality of Life: A Systematic Review of the Content Validity of Self-Administered Instruments Used to Assess Health-Related Quality of Life in End-Stage Renal Disease

Advances in healthcare, combined with an increasing number of adults with end-stage renal disease (ESRD), mean that there is a growing number of people now surviving on renal replacement therapy. The issue of health-related quality of life (HR-QOL) is becoming increasingly important in this area. For this reason, the content validity of various instruments used to measure HR-QOL in an ESRD population were explored.Systematic searches of MEDLINE (1950–2009) were conducted using terms related to ESRD combined with terms associated with measuring HR-QOL. A total of 378 abstracts were identified, detailing the repeated use of six generic measures and four disease-specific measures. The generic HR-QOL measures discussed include the Medical Outcomes 36-Item Short Form Survey (SF-36), the EuroQOL 5 Dimension (EQ-5D), and the WHO QOL assessment (WHOQOL-BREF). The most frequently used disease-specific measure discussed is the Kidney Disease QOL instrument (KDQOL) and its derivative versions (KDQOL-SF, KDQOL-36).The appropriateness of using the SF-36 in this population is challenged and recommendations include using the WHOQOL-BREF in cases when a generic instrument is required and the KDQOL-SF when a more disease-specific measurement is called for.

Flying Start NHS™: easing the transition from student to registered health professional

AIMS AND OBJECTIVES To evaluate the impact and effectiveness of Flying Start NHS™ on the confidence, competence and career development of newly qualified practitioners. BACKGROUND The first year of practice as a registered nurse, midwife, or allied health professional is recognised as challenging. This paper presents the findings of a two-year evaluation of Flying Start NHS™, a web-based programme developed by NHS Education Scotland to support newly qualified health professionals during the transition from student to qualified practitioner. DESIGN Descriptive design with one to one and focus group interviews, plus a survey. METHODS The evaluation employed a multi-method approach including telephone interviews with Flying Start NHS™ leads/coordinators (n=21) and mentors (n=22) and focus groups with newly qualified practitioners (n=95). An online survey was completed by 547 newly qualified practitioners. RESULTS A majority of newly qualified practitioners reported that Flying Start NHS™ had been useful in terms of clinical skills development and confidence. Those who were able to take protected time were more likely to complete the learning units and report that the support they received was good. Both newly qualified practitioners and mentors reported a lack of time. Newly qualified practitioners who took up posts in the community expressed greater satisfaction with the support received. CONCLUSIONS NHS Boards should ensure that there is an ethos of support at all levels, as well as an understanding of the purpose of Flying Start NHS™ and what newly qualified practitioners require to do to complete it. The expectation that newly qualified practitioners will enrol on Flying Start NHS™ should be accompanied by an expectation that they will complete the programme in their first year, coupled with support to enable them to do so. RELEVANCE TO CLINICAL PRACTICE Undertaking Flying Start NHS™ in the first year of employment increases clinical skills development and confidence. Mentors require training and time to enable them to provide support.

Enriching the care of patients with dementia in acute settings? The Dementia Champions Programme in Scotland.

Admission to hospital has been found to have a negative impact on people with dementia. The Scottish Dementia Champions programme was developed to prepare health and social service Dementia Champions working in acute settings as Change Agents. The programme was initially delivered to a cohort of 100 health professionals via blended learning, and comprised five study days, a half day spent in a local community setting, and e-learning. In order to complete the programme and graduate, participants were required to complete and submit reports relating to three work-based activities. The evaluation of the project adopted a two-pronged approach: Impact on programme participants was assessed by scores derived from the Approaches to Dementia Questionnaire (ADQ) (Lintern, 1996) completed at Study Days 1 and 5, and analysis of qualitative data derived from the three written assignments. Participants were asked to evaluate course materials and input for each of the five study days, as well as satisfaction with delivery. Analysis of data derived from the ADQ and 100 reflective reports of the community experience indicate that participants’ perceptions of people with dementia shifted significantly during the Programme. Participants identified a range of issues which should be addressed with a view to improving the experiences of people with dementia in acute settings, and put in place actions to bring about change. The format of the programme provided a cost effective means to prepare NHS and Social Service Dementia Champions as Change Agents for practice within a relatively short period of time, and would be transferrable to other staff groups as well as different organisational structures in other countries.

Secondary School Transition for Children with Special Educational Needs: A Literature Review.

Successful transition from primary to secondary school is important for psychosocial well-being. Children with special educational needs (SEN) may face additional complexities at transition, although the impact of this process on childrens psychosocial adjustment has been underexplored. The article aims to review systematically the literature exploring the impact of transition on the concerns and psychosocial adjustment of children with SEN in comparison to typically developing children. Published studies were identified through a systematic search of six electronic databases. Articles fulfilling inclusion criteria were reviewed and a quality criteria system was developed to rank studies. Children with specific learning difficulties perceive lower levels of social support and more peer victimisation after transition than typically developing children, but methodological limitations and the modest number of studies restricted the conclusions that could be drawn.

The psychometric properties of the hospital anxiety and depressions scale adapted for use with people with intellectual disabilities

BACKGROUND There is increasing recognition of depression in people with intellectual disabilities (ID). There is a need to develop well-standardised self-report measures for both clinical and research purposes. This paper presents some psychometric properties of the Hospital Anxiety and Depression Scale (HADS) adapted for use with people with ID. The anhedonic emphasis in the depression scale of the HADS may be particularly useful for people with ID who present with high rates of physical co-morbidity. METHOD A total of 197 people with ID completed an adapted HADS; 32 participants also completed the Zung Depression Scale and 42 also completed the Glasgow Depression Scale. RESULTS The obtained factor structure is similar to the original form of the scale used with people without ID. However, the underlying question wording of the HADS, where most depression items are phrased positively and most anxiety items are phrased negatively, makes clear interpretation of the factor structure difficult. The HADS has an adequate internal reliability and correlates well with other self-report measures of depression. CONCLUSIONS The HADS may need further adaptation; however, the measurement of anhedonia is a useful addition to the self-report measures of depression available for people with ID.

Family Health Nursing: A Response to the Global Health Challenges

The European Family Health Nursing Project is a revitalized World Health Organization initiative led by the University of the West of Scotland. Partner countries include Armenia, Austria, Germany, Italy, Poland, Portugal, Romania, Slovenia, and Spain. European Union Lifelong Learning funding was received in 2011 to facilitate a consistency of approach in the development of a definition of family health nursing, required core competencies and capabilities, and consequent education and training requirements. Global health challenges have informed the development of the project: increasingly aging populations, the increasing incidence in noncommunicable diseases that are currently the main cause of death, and the significant progress made in the way health systems have developed to meet the demands in relation to access and equality of health services. Governments and policy makers should develop a health workforce based on the principles of teamwork and interdisciplinarity while recognizing the core contribution of the “specialist generalist” role in the primary care setting.

Dementia in the workplace: a review

Purpose – Recent changes affecting state pension age, and earlier diagnosis, will result in more people with dementia in employment. The purpose of this paper is to establish the nature of support that would enable/enables people with dementia or mild cognitive impairment to continue employment post diagnosis. Design/methodology/approach – An integrative review was carried out supported by information derived from a thematic analysis of data from interviews with seven relatives supporting a younger person with dementia and one person with dementia. Findings – Six papers were identified for inclusion in the review. Findings from the published papers and interviews indicated that work is a significant issue for people with dementia highlighting problems with job retention, work performance and the impact of diagnosis. Research limitations/implications – The review highlighted a dearth of high-quality research in the area. Although employment was not the main focus of the interviews, the extracts highlight s...

The quality of on-line communication in a national learning programme for newly qualified nurses, midwives and allied health professionals

Asynchronous communication has become the dominant mode of on-line instruction and has been incorporated into Flying Start NHS, an on-line programme for newly qualified NMAHPs in the transition phase from student to registered practitioner. On-line programmes have a number of objectives including the delivery of educational materials and the development of on-line communities. This study sought to provide a direct and objective understanding of the quality of the on-line community within Flying Start NHS and give an indication of areas of strength and weakness. The study used mixed methods including a Gricean analysis of on-line communication focusing on quantity, quality, relevance, and manner, and a thematic analysis of communication content. There was little evidence that students engaged in the type of interactive communication essential for creating on-line learning communities. The majority of postings related to progression through Flying Start. The small number of communications which did begin to engage with the learning materials were limited with little evidence of the development of critical debate. Analysis of the qualitative data indicates that the period of transition continues to be stressful with Flying Start NHS being undertaken concurrently with local CPD being seen as duplication of effort.

The Impact of Dietary Restrictions on Quality of Life in Kidney Disease

Kidney disease represents a chronic, distressing, and debilitating diagnosis with relatively few treatment options and those options that are available are associated with a number of complications that impact deleteriously on the individual patient’s quality of life. Nutritional and fluid aspects of patient management are critical to the quality of life of the patient and the trajectory of prognosis. This chapter explores the relationship of dietary parameters to quality of life in the patient with kidney disease.