Rhian Noble-Jones

Development of the lymphoedema genito-urinary cancer questionnaire.

The aim of this study was to develop a patient self-report tool to detect symptoms of genital and lower limb lymphoedema in male survivors of genitourinary cancer. The study incorporated the views of patients and subject specialists (lymphoedema and urology) in the design of a patient questionnaire based on the literature. Views on comprehensiveness, relevance of content, ease of understanding and perceived acceptability to patients were collated. The findings informed the development of the next iteration of the questionnaire. The overall view of participants was that the development and application of such a tool was of great clinical value and the Lymphoedema Genito-Urinary Cancer Questionnaire (LGUCQ) has significant potential for further development as a research tool to inform prevalence of this under-reported condition.

Compression moves on: advances in care are changing practice

index (BMI) of our population continues to rise, nurses in almost all areas of health care are increasingly faced with managing the heavy limbs and skin problems typical of chronic oedema. Any swelling persisting beyond 3 months is defined as chronic oedema (Moffatt et al, 2003; Lymphoedema Framework, 2006) and is indicative of a lymphatic system that is no longer able to deal with the fluid load, whatever the cause (Mortimer and Rockson, 2014). While insufficiency of the veins or lymphatics is the primary cause, obesity is a known contributor. Lymphoedema brings a 71-fold increased risk over normal (Dupuy et al, 1999), with 29% having a recurrent episode within 12 months (Moffatt et al, 2003). Cellulitis admissions already account for 2–3% of all hospital admissions (Halpern et al, 2008) and the resultant costs are estimated to be in the millions. Research has shown that early identification and management of lymphoedema reduces the morbidity, improves outcomes and reduces health and social costs Compression moves on: advances in care are changing practice

Interprofessional education (IPE) in clinical practice for pre-registration nursing students: A structured literature review

OBJECTIVES To explore the experiences of nursing students after clinical IPE activities through a review of contemporary literature then use the context of nursing programmes in Singapore to consider the transferability of the findings. DESIGN Structured literature review. DATA SOURCES A search of international qualitative literature no older than five years and published in English was conducted on CINAHL, Embase, Medline and Pubmed. REVIEW METHODS A systematic and structured approach was guided by Coopers five-step approach to review the literature. The Critical Appraisal Skills Programme qualitative checklist and the Appraisal of Guidelines Research & Evaluation reporting checklist were used to critically appraise literature in this review. RESULTS 13 papers were included for qualitative synthesis. The literature most commonly reported that students had a better understanding of professional roles, improved communication and teamwork. In contrast, the most commonly reported negative experience involved some examples of disparity within the team. CONCLUSION Overall findings show that positive student experiences outweigh negative ones. Nursing programmes might be able to reap similar outcomes subject to contextual and cultural differences. However, further research is recommended before IPE in clinical practice is implemented in current nursing programmes in the local setting.

The Lymphoedema Genitourinary Cancer Questionnaire in urology follow-up clinics

Is the Lymphoedema Genitourinary Cancer Questionnaire (LGUCQ) useful to men treated for genitourinary cancer through facilitating symptom disclosure? Lymphoedema can be debilitating and progressive and its association with bladder, prostate, testicular and penile cancer, either as a consequence of treatment or progressive disease is well recognized. However, lymphoedema is generally unrecognized during follow‐up. Research on genitourinary cancer‐related lymphoedema is sparse with a lack of reliable prevalence figures. A lack of empirical understanding of the experiences of these men led to the development of the LGUCQ, a simple two‐sided tool to facilitate self‐reporting of symptoms and difficulties associated with lymphoedema. Related pilot work suggests that written self‐report tools enable men to disclose more sensitive information than they would verbally. However, the LGUCQ had not been formally evaluated in an uro‐oncology department to identify the benefits from the perspective of the patients and health professionals. Thematic analysis of completed LGUCQs and interviews with patients and staff were performed. Emergent themes included the perceived barriers to symptom disclosure, the LGUCQ as facilitator and pragmatic addition, the support needs of patients and health professionals and refinements required for roll out. Issues limiting identification of lymphoedema within uro‐oncology services existed. Findings suggest the inclusion of the LGUCQ within uro‐oncology clinics could lead to earlier identification of lymphoedema. Patients could identify genital oedema problems with the LGUCQ increasing prompt and accurate disclosure and normalizing the experience.