1
|
Anderson T, Prue G, McDowell G, Stark P, Brown Wilson C, Graham Wisener L, Kerr H, Caughers G, Rogers K, Cook L, Craig S, Alanazi A, Mitchell G. Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer. BMC Public Health 2024; 24:570. [PMID: 38388909 PMCID: PMC10885377 DOI: 10.1186/s12889-024-18050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Pancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease. METHODS This study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer. RESULTS The serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game's usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour. DISCUSSION This study is the first to explore a serious game's utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game's potential as an accessible and convenient tool for diverse populations.
Collapse
Affiliation(s)
- Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gillian Prue
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Glenn McDowell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Helen Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gemma Caughers
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Katherine Rogers
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Lana Cook
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Abdulelah Alanazi
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
- Faculty of Applied Medical Sciences, Department of Nursing, The University of Bisha, Bisha, Saudi Arabia
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| |
Collapse
|
2
|
Copeland S, Anderson T, Carter G, Brown Wilson C, Stark P, Doumas M, Rodger M, O'Shea E, Creighton L, Craig S, McMahon J, Gillis A, Crooks S, Mitchell G. Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review. Nurs Rep 2024; 14:428-443. [PMID: 38391078 PMCID: PMC10885076 DOI: 10.3390/nursrep14010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.
Collapse
Affiliation(s)
- Shannon Copeland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | | | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Mihalis Doumas
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Matthew Rodger
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Emma O'Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 YN60 Cork, Ireland
| | - Laura Creighton
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Arnelle Gillis
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Sophie Crooks
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| |
Collapse
|
3
|
Hill L, McNulty A, McMahon J, Mitchell G, Farrell C, Uchmanowicz I, Castiello T. Heart Failure Nurses within the Primary Care Setting. Card Fail Rev 2024; 10:e01. [PMID: 38464555 PMCID: PMC10918528 DOI: 10.15420/cfr.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/27/2023] [Indexed: 03/12/2024] Open
Abstract
Cardiology services within primary care often focus on disease prevention, early identification of illness and prompt referral for diagnosis and specialist treatment. Due to advances in pharmaceuticals, implantable cardiac devices and surgical interventions, individuals with heart failure are living longer, which can place a significant strain on global healthcare resources. Heart failure nurses in a primary care setting offer a wealth of clinical knowledge and expertise across all phases of the heart failure trajectory and are able to support patients, family members and other community services, including general practitioners. This review examines the recently published evidence on the current and potential future practice of heart failure nurses within primary care.
Collapse
Affiliation(s)
- Loreena Hill
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
- College of Nursing and Midwifery, Mohammed Bin Rashid UniversityDubai, United Arab Emirates
| | - Anne McNulty
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University BelfastBelfast, UK
| | - Cathy Farrell
- Errigal Chronic Disease Management Hub, LetterkennyDonegal, Ireland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wrocław Medical UniversityWrocław, Poland
- Institute of Heart Diseases, University HospitalWrocław, Poland
| | - Teresa Castiello
- Department of Cardiovascular Imaging, King's College LondonLondon, UK
| |
Collapse
|
4
|
Bodnar D, Brown NJ, Mitchell G, Hughes JA, Lourensen D, Hawkins T, Chu K. Determinants of fatigue in emergency department clinicians who wear personal protective equipment. Emerg Med Australas 2024; 36:39-46. [PMID: 37581206 DOI: 10.1111/1742-6723.14291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/23/2023] [Accepted: 07/23/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE To determine the independent predictors for clinician fatigue and decline in cognitive function following a shift in the ED during early stages of the COVID-19 pandemic. METHODS This was a prospective, quasi-experimental study conducted in a metropolitan adult tertiary-referral hospital ED over 20 weeks in 2021. The participants were ED doctors and nurses working clinical shifts in an ED isolation area or high-risk zone (HRZ) with stringent personal protective equipment (PPE). The participants' objective and subjective fatigue was measured by the Samn-Perelli fatigue score and a psychomotor vigilance 'smart game' score, respectively. Postural signs/symptoms and urine specific gravity (SG) were measured as markers of dehydration. RESULTS Sixty-three participants provided data for 263 shifts. Median (interquartile range) age was 33 (28-38) years, 73% were female. Worsening fatigue score was associated with working afternoon shifts (afternoon vs day, adjusted odds ratio [aOR] 5.16 [95% confidence interval (CI) 1.32-20.02]) and in non-HRZ locations (HRZ vs non-HRZ, aOR 0.23 [95% CI 0.06-0.87]). Worsening cognitive function (game score) was associated with new onset postural symptoms (new vs no symptoms, aOR 4.14 [95% CI 1.34-12.51]) and afternoon shifts (afternoon vs day, aOR 3.13 [95% CI 1.16-8.44]). Working in the HRZ was not associated with declining cognitive function. Thirty-four (37%) of the 92 participants had an end of shift urine SG >1.030. CONCLUSION Working afternoon shifts was associated with fatigue. There was no association between HRZ allocation and fatigue, but our study was limited by a low COVID workload and fluctuating PPE requirements in the non-HRZs. Workplace interventions that target the prevention of fatigue in ED clinicians working afternoon shifts should be prioritised.
Collapse
Affiliation(s)
- Daniel Bodnar
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Queensland Ambulance Service, Brisbane, Queensland, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - James A Hughes
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Darren Lourensen
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Tracey Hawkins
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
5
|
Chacon L, Mitchell G, Golder S. The commercial promotion of electronic cigarettes on social media and its influence on positive perceptions of vaping and vaping behaviours in Anglophone countries: A scoping review. PLOS Glob Public Health 2024; 4:e0002736. [PMID: 38232105 DOI: 10.1371/journal.pgph.0002736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/30/2023] [Indexed: 01/19/2024]
Abstract
There is ongoing scientific and policy debate about the role e-cigarettes play in tobacco control, with concerns centring around unknown long-term effects, and the potential industry co-option of harm reduction efforts, including marketing to youths. There is substantial evidence of the influence of conventional cigarette promotion on smoking behaviours in Anglophone countries, and the popularity of social networking sites, as well as the lack of marketing regulations on the commercial promotion of electronic cigarettes online, suggest an urgent need to explore this topic further. This scoping review aims to map the existing evidence related to the influence of e-cigarette commercial promotion on social media on positive perceptions of vaping and vaping behaviours in core Anglophone countries. Searches were conducted in CENTRAL, Cochrane Database of Systematic Reviews (CDSR), Embase, Epistemonikos, MEDLINE, PsycINFO and Science Citation Index, on the 21st of July 2022. From 1,385 studies, 11 articles were included in the final review, using diverse study designs, including focus groups, content analysis, cross-sectional studies, and experiments. The studies were primarily based in the U.S. and evidenced the association between the commercial promotion of e-cigarettes on social media with positive perceptions of vaping and vaping behaviours, particularly among young people, addressing diverse themes including celebrities' sponsorship, e-liquid appeal (including flavours and nicotine levels), users' engagement with ads, and other marketing strategies. Further, social networking sites commercially promoting e-cigarettes might increase positive attitudes towards vaping and vaping behaviours, particularly among youths. Future research should be conducted in broader settings, incorporate larger and diverse sample sizes, ensure research transparency, cover multiple social networking sites, emphasize ecological validity, and foment longitudinal studies.
Collapse
Affiliation(s)
- L Chacon
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - G Mitchell
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - S Golder
- Department of Health Sciences, University of York, Heslington, United Kingdom
| |
Collapse
|
6
|
Vlckova K, Gonella S, Bavelaar L, Mitchell G, Sussman T. Methodological and ethical challenges in designing and conducting research at the end of life: A systematic review of qualitative and textual evidence. Int J Nurs Pract 2023:e13224. [PMID: 38113927 DOI: 10.1111/ijn.13224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
AIM This systematic review aims to identify methodological and ethical challenges in designing and conducting research at the end of life from the perspective of researchers and provide a set of recommendations. BACKGROUND Conducting research with patients and family carers facing end-of-life issues is ethically and methodologically complex. DESIGN A systematic review was conducted. DATA SOURCES Four databases (MEDLINE, EMBASE, CINAHL, PsycInfo) were searched from inception until the end of 2021 in February 2022. REVIEW METHODS The Preferred Reporting Items for Systematic Reviews was followed, and the JBI Approach to qualitative synthesis was used for analysis. RESULTS Seventeen of 1983 studies met inclusion criteria. Data were distilled to six main themes. These included (1) the need for flexibility at all stages of the research process; (2) careful attention to timing; (3) sensitivity in approach; (4) the importance of stakeholder collaboration; (5) the need for unique researcher skills; and (6) the need to deal with the issue of missing data. CONCLUSION The findings illuminate several considerations that can inform training programmes, ethical review processes and research designs when embarking on research in this field.
Collapse
Affiliation(s)
- Karolina Vlckova
- Center for Palliative Care, Prague, The Czech Republic
- Third Faculty of Medicine, Prague, The Czech Republic
| | - Silvia Gonella
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza of Torino, Torino, Italy
| | - Laura Bavelaar
- Leiden University Medical Center, Leiden, The Netherlands
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Tamara Sussman
- School of Social Work, McGill University, Montreal, Canada
| |
Collapse
|
7
|
Craig S, Cao Y, McMahon J, Anderson T, Stark P, Brown Wilson C, Creighton L, Gonella S, Bavelaar L, Vlčková K, Mitchell G. Exploring the Holistic Needs of People Living with Cancer in Care Homes: An Integrative Review. Healthcare (Basel) 2023; 11:3166. [PMID: 38132056 PMCID: PMC10743280 DOI: 10.3390/healthcare11243166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Up to 26% of individuals residing in care homes are impacted by cancer. This underscores the importance of understanding the holistic needs of care home residents living with cancer to enhance the quality of their care. The primary objective of this integrative literature review was to consolidate the available evidence concerning the comprehensive needs of people living with cancer in care home settings, providing valuable insights into addressing their diverse needs. An integrative literature review was conducted using a systematic approach. Extensive searches were conducted in three databases, complemented by a thorough examination of grey literature and reference lists of relevant papers. The review focused on literature published between 2012 and 2022. The screening process involved two independent reviewers, with a third reviewer resolving any discrepancies. The review identified twenty research papers that met the eligibility criteria. These papers shed light on three primary themes related to the holistic needs of care home residents with cancer: physical, psychological, and end-of-life needs. Physical needs encompassed pain management, symptom control, and nutrition, while psychological needs involved social support, emotional well-being, and mental health care. End-of-life needs addressed end-of-life care and advance care planning. These themes highlight the multifaceted nature of cancer care in care homes and underscore the importance of addressing residents' holistic needs in a comprehensive and integrated manner. Improving care home education about cancer and integrating palliative and hospice services within this setting are vital for addressing the diverse needs of residents with cancer.
Collapse
Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Yanting Cao
- The Shanghai Medical College, Fudan University, Shanghai 200437, China;
- Stellar Care NW Ltd., Ellesmere Port CH65 1A, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Tara Anderson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Patrick Stark
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Christine Brown Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Laura Creighton
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| | - Silvia Gonella
- Direction of Health Professions, City of Health and Science University Hospital of Torino, Corso Bramante 88-90, 10126 Turin, Italy;
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy
| | - Laura Bavelaar
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | | | - Gary Mitchell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; (S.C.); (J.M.); (T.A.); (P.S.); (C.B.W.); (L.C.)
| |
Collapse
|
8
|
Mallon A, Mitchell G, Carter G, Francis McLaughlin D, Linden M, Brown Wilson C. Exploring Resilience in Care Home Nurses: An Online Survey. Healthcare (Basel) 2023; 11:3120. [PMID: 38132010 PMCID: PMC10742816 DOI: 10.3390/healthcare11243120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Resilience is considered a core capability for nurses in managing workplace challenges and adversity. The COVID-19 pandemic has brought care homes into the public consciousness; yet, little is known about the resilience of care home nurses and the attributes required to positively adapt in a job where pressure lies with individuals to affect whole systems. To address this gap, an online survey was undertaken to explore the levels of resilience and potential influencing factors in a sample of care home nurses in Northern Ireland between January and April 2022. The survey included the Connor-Davidson Resilience Scale, demographic questions and items relating to nursing practice and care home characteristics. Mean differences and key predictors of higher resilience were explored through statistical analysis. A moderate level of resilience was reported among the participants (n = 56). The key predictors of increased resilience were older age and higher levels of education. The pandemic has exposed systemic weakness but also the strengths and untapped potential of the care home sector. By linking the individual, family, community and organisation, care home nurses may have developed unique attributes, which could be explored and nurtured. With tailored support, which capitalises on assets, they can influence a much needed culture change, which ensures the contribution of this sector to society is recognised and valued.
Collapse
Affiliation(s)
- Anita Mallon
- School of Nursing & Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (G.M.); (G.C.); (D.F.M.); (M.L.)
| | | | | | | | | | - Christine Brown Wilson
- School of Nursing & Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK; (G.M.); (G.C.); (D.F.M.); (M.L.)
| |
Collapse
|
9
|
Hiskens MI, Mengistu TS, Hovinga B, Thornton N, Smith KB, Mitchell G. Epidemiology and management of traumatic brain injury in a regional Queensland Emergency Department. Australas Emerg Care 2023; 26:314-320. [PMID: 37076417 DOI: 10.1016/j.auec.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND There is a paucity of traumatic brain injury (TBI) data in Australia in the regional and rural context. This study aimed to investigate the epidemiology, severity, causes, and management of TBI in a regional north Queensland population to plan acute care, follow up, and prevention strategies. METHODS This retrospective study analysed TBI patients presenting to Mackay Base Hospital Emergency Department (ED) in 2021. We identified patients using head injury SNOMED codes, and analysed patient characteristics with descriptive and multivariable regression analysis. RESULTS There were 1120 head injury presentations, with an overall incidence of 909 per 100,000 people per year. The median (IQR) age was 18 (6-46) years. Falls were the most common injury mechanism (52.4% of presentations). 41.1% of patients had a Computed Tomography (CT) scan, while 16.5% of patients who met criteria had post traumatic amnesia (PTA) testing. Age, being male and Indigenous status were associated with higher odds of moderate to severe TBI. CONCLUSION TBI incidence in this regional population was higher than metropolitan locations. CT scan was undertaken less frequently than in comparative literature, and low rates of PTA testing were undertaken. These data provide insight to assist in planning prevention and TBI-care services.
Collapse
Affiliation(s)
- Matthew I Hiskens
- Mackay Institute of Research and Innovation (MIRI), Mackay Hospital and Health Service, Mackay, QLD 4740, Australia.
| | - Tesfaye S Mengistu
- Mackay Institute of Research and Innovation (MIRI), Mackay Hospital and Health Service, Mackay, QLD 4740, Australia; University of Queensland, School of Public Health, Herston, QLD 4006, Australia
| | - Bauke Hovinga
- Emergency Department, Mackay Hospital and Health Service, Mackay, QLD 4740, Australia
| | - Neale Thornton
- Emergency Department, Mackay Hospital and Health Service, Mackay, QLD 4740, Australia
| | - Karen B Smith
- Mackay Institute of Research and Innovation (MIRI), Mackay Hospital and Health Service, Mackay, QLD 4740, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital Emergency and Trauma Centre, Herston, QLD 4006, Australia
| |
Collapse
|
10
|
Heine J, Window P, Hacker S, Young J, Mitchell G, Roffey S, Cottrell M. Adherence to recommended guidelines for low back pain presentations to an Australian emergency department: Barriers and enablers. Australas Emerg Care 2023; 26:326-332. [PMID: 37193622 DOI: 10.1016/j.auec.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/11/2023] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE This study sought to evaluate the adherence to guidelines for the management of mechanical Low Back Pain within a single tertiary metropolitan Emergency Department setting. Our objectives were: METHODS: A two-stage multi-methods study design was undertaken. Stage 1 involved a retrospective chart audit of patients presenting with a diagnosis of mechanical Low Back Pain to establish documented adherence to clinical guidelines. Stage 2 explored clinicians' perspectives towards factors influencing adherence to the guidelines via a study-specific survey and follow up focus groups. RESULTS The audit demonstrated low adherence to the following guidelines: (i) appropriate prescription of analgesia, (ii) targeted education and advice, and (iii) attempts to mobilise. Three major themes were identified as factors influencing adherence to the guidelines: (1) clinician driven influences and factors, (2) workflow processes, and (3) patient expectations and behaviours. CONCLUSION There was low adherence to some published guidelines and factors influencing adherence to the guidelines were multi-factorial. Understanding the factors that influence care decisions and developing strategies to address these can improve Emergency Department management of mechanical Low Back Pain.
Collapse
Affiliation(s)
- Janelle Heine
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia.
| | - Peter Window
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia
| | - Sarah Hacker
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia; Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia
| | - Jordan Young
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia; University of Queensland, St Lucia, Queensland 4067, Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia; Jamieson Trauma Institute, Herston, Queensland 4006, Australia; University of Queensland, St Lucia, Queensland 4067, Australia
| | - Shea Roffey
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia
| | - Michelle Cottrell
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Butterfield St, Herston, Queensland 4006, Australia
| |
Collapse
|
11
|
Jaganathan KS, Sullivan KA, Greenslade J, McMahon KL, Mitchell G, Kerr G. Understanding the Sociocognitive Determinants Underlying Intentions to Exercise for Postconcussion Symptom Relief: An Application of the Theory of Planned Behavior. J Sport Rehabil 2023; 32:873-883. [PMID: 37591504 DOI: 10.1123/jsr.2023-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/19/2023] [Accepted: 06/19/2023] [Indexed: 08/19/2023]
Abstract
CONTEXT This study investigated individual sociocognitive factors from the theory of planned behavior and their relationship to exercise for postconcussion recovery. DESIGN AND METHODS Four hundred and fifty-nine Australian adults, two-thirds of whom had no concussion history (66%), completed an online survey of their beliefs and attitudes toward exercise for postconcussion recovery. Secondary questions evaluated program design features that could affect engagement (eg, session frequency). RESULTS Structured equation modeling found that subjective norms were the strongest significant predictor of intention to participate in exercise for postconcussion recovery. Perceived behavioral control was also a significant predictor of intention to participate but to a lesser extent. Attitude did not predict participation intention. The design features identified as key were personalization and being supervised during the program. CONCLUSIONS This study found that people's intention to participate in a program of exercise postconcussion recovery is shaped by individual psychological factors and identified program design features that could be adjusted for increased engagement. Program success could be maximized through strategies such as supporting individuals to have a stronger sense of control over their participation through the choice of session timing or frequency and harnessing the influence of significant others via supportive messaging from key professionals.
Collapse
Affiliation(s)
| | - Karen A Sullivan
- School of Psychology & Counselling, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane,Australia
| | - Jamie Greenslade
- School of Public Health and Social Work, Queensland University of Technology, Brisbane,Australia
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane,Australia
| | - Katie L McMahon
- School of Clinical Sciences, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane,Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane,Australia
| | - Graham Kerr
- School of Exercise & Nutrition Sciences, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane,Australia
| |
Collapse
|
12
|
Cameron CM, Vuong K, McWhinney B, Zournazi A, Manzanero S, Warren J, Mitchell G, Vallmuur K, Howell T, Ungerer JPJ. Factors associated with higher alcohol concentrations in emergency department presentations: PACE study. Drug Alcohol Rev 2023; 42:1796-1806. [PMID: 37703216 DOI: 10.1111/dar.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 07/10/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION The health impact from alcohol is of recognised concern, from acute intoxication as well as increased risk of chronic health issues over time. Identifying factors associated with higher alcohol consumption when presenting to the emergency department (ED) will inform public health policy and enable more targeted health care and appropriate referrals. METHODS Secondary testing of blood samples collected during routine clinical care of 1160 ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, for 10 days between 22 January and 1 February 2021. Alcohol was measured by blood ethanol (intake in recent hours) and phosphatidylethanol (PEth; intake over 2-4 weeks). Zero-inflated negative binomial regression was used to identify demographic and clinical factors associated with higher alcohol concentrations. RESULTS Males were found to have 83% higher blood ethanol and 32% higher PEth concentrations than females (adjusted rate ratio [ARR] 1.83, 95% confidence interval [CI] 1.37-2.45 and ARR 1.32, 95% CI 1.04-1.68, respectively). Blood ethanol concentrations were 3.4 times higher for those 18-44 years, compared to those aged 65+ (ARR 3.40, 95% CI 2.40-4.82) whereas PEth concentrations were found to be the highest in those aged 45-64 years, being 70% higher than those aged 65+ (ARR 1.70, 95% CI 1.19-2.44). Patients brought in involuntarily had eight-times higher blood ethanol concentrations than those who self-attended. DISCUSSION AND CONCLUSIONS This study used two alcohol markers to identify factors associated with higher alcohol concentrations in emergency presentations. The findings demonstrate how these biomarkers can provide informative data for public health responses and monitoring of alcohol use trends.
Collapse
Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kim Vuong
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | | | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Faculty of Biomedical Science, University of Queensland, Brisbane, Australia
| |
Collapse
|
13
|
Sullivan K, Jaganathan KS, Greenslade J, McMahon K, Mitchell G, Kerr G. A - 166 Predictors of Intention to Participate in Programmed Exercise for Postconcussion Recovery. Arch Clin Neuropsychol 2023; 38:1338. [PMID: 37807350 DOI: 10.1093/arclin/acad067.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVE Programmed exercise has been proposed for postconcussion recovery, but willingness to engage in such programs has not been explored. This study investigated sociocognitive factors from the Theory of Planned Behavior (TPB) and their relationship to exercise intention for postconcussion recovery (intention). METHOD Four hundred and fifty-nine adults completed an online survey (Age = 18-72 years, 34% concussion history). All participants received information about mTBI, postconcussion symptoms, and programmed exercise. The measures assessed TPB constructs including intention, and evaluated program design features that could affect engagement (e.g., session frequency). RESULTS Structured equation modelling found that intention was significantly predicted (p < 0.05) by subjective norms (strongest predictor) and perceived behavioral control (weaker predictor). Attitudes did not significantly predict intention. The model accounted for approximately half of the variance in exercise intention (R2 = 0.506). The addition of moderators (habitual exercise, concussion history) did not have any effect. Key program design features were personalization and supervision. CONCLUSIONS People's intention to undertake programmed exercise for postconcussion recovery is shaped by individual psychological factors, especially subjective norms and perceived behavioral control. This could be considered in the program design (e.g., building program connections with significant others; fostering a sense of control through personalization/session timetabling). Further research is needed to establish the effect of such additions on engagement with programmed exercise for postconcussion recovery.
Collapse
|
14
|
Crooks S, Stark P, Carlisle S, McMullan J, Copeland S, Wong WYA, Blake D, Lyons E, Campbell N, Carter G, Wilson CB, Mitchell G. Evaluation of a co-designed Parkinson's awareness audio podcast for undergraduate nursing students in Northern Ireland. BMC Nurs 2023; 22:370. [PMID: 37814245 PMCID: PMC10561504 DOI: 10.1186/s12912-023-01544-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/28/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Parkinson's Disease (PD) is a common neurological condition that often causes stiffness, tremor and slow movement. People living with PD are likely to encounter nursing students throughout their journey from pre-diagnosis to death. Despite this, there is a paucity of evidence about current practice in PD education amongst nursing students. The present study provides an evaluation of a co-designed Parkinson's Awareness audio podcast amongst nursing students in Northern Ireland. METHODS Following co-design of an audio podcast about PD, a mixed methods evaluation was carried out. 332 student nurses completed pre-/post-test questionnaires about their knowledge and perceptions of PD before and after listening to the audio podcast. Further to this, 35 student nurses participated in focus-group interviews six months following listening to explore how the podcast influenced practice. RESULTS Student nurses posted a mean score of 52% before listening to the audio podcast. This mean increased to 80% post-test. These findings were statistically significant (p < 0.001), demonstrating significant increases in PD awareness after listening. Findings from the focus groups suggested that the audio podcast improved empathy and practice towards people with PD. The findings also suggested that students perceived audio podcasts to be a good way to learn about PD. CONCLUSION Provision of a co-designed audio podcast about PD has the potential to improve student nurse knowledge and practice related to PD as evidenced in this study.
Collapse
Affiliation(s)
- Sophie Crooks
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | - Susan Carlisle
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | - Johanna McMullan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | - Shannon Copeland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | - Wai Yee Amy Wong
- University of East Anglia, Norwich Medical School, Norwich, England
| | | | | | | | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| | | | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland.
| |
Collapse
|
15
|
Mitchell G, Stark P, Wilson CB, Tsakos G, Brocklehurst P, Lappin C, Quinn B, Holland N, McKenna G. 'Whose role is it anyway?' Experiences of community nurses in the delivery and support of oral health care for older people living at home: a grounded theory study. BMC Nurs 2023; 22:359. [PMID: 37798687 PMCID: PMC10557176 DOI: 10.1186/s12912-023-01533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Older people who receive care at home are likely to require support with oral health care. Community nurses, who are also referred to as district or home care nurses, have an important role with this population. This is because they are the healthcare professionals who are most likely to encounter this population, who may also not be receiving regular dental care or oral health promotion. However, few studies have explored community nursing experiences in the delivery and support of oral healthcare for older people living at home. METHODS A grounded theory approach was used to explore experiences of community nurses in the delivery and support of oral health care for older people living at home. Fifteen practising community nurses from the United Kingdom participated in one-to-one semi-structed interviews from May 2021 to December 2021. These interviews were audio-recorded, transcribed verbatim and analysed using constant comparative analysis. Ethical approval was obtained for this study prior to data collection. RESULTS Four categories emerged from the data to support development of the core phenomena. These four categories were: (1) Education, in relation to what community nurses knew about oral health, (2) Practice, with regards to how community nurses delivered oral health care to older people in their own home, (3) Confidence, with consideration to the extent to which this supported or impeded community nurses in providing oral healthcare to older people and (4) Motivation, in terms of the extent to which community nurses thought they could or should influence future practice improvement in the area. The core category was (C) Uncertainty as it was both present and central across all four categories and related to community nursing understanding about their specific role, and the role of other professionals, with reference to oral health of their patients. CONCLUSIONS This study reveals community nurses' uncertainty in providing oral healthcare to older adults at home. Emphasising comprehensive and continuous oral health education can boost nurses' confidence in patient support. Interprofessional collaboration and clear role definitions with oral health professionals are crucial for improving oral health outcomes in this vulnerable population.
Collapse
Grants
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- SB/A/101010662/495750 Burdett Trust for Nursing
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- COM/5611/20 HSC R&D Division, Belfast, Northern Ireland
- HSC R&D Division, Belfast, Northern Ireland
Collapse
Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Caroline Lappin
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
| | - Barry Quinn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Nicola Holland
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Gerry McKenna
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| |
Collapse
|
16
|
Crooks S, Carter G, Wilson CB, Wynne L, Stark P, Doumas M, Rodger M, O’Shea E, Mitchell G. Exploring public perceptions and awareness of Parkinson's disease: A scoping review. PLoS One 2023; 18:e0291357. [PMID: 37713383 PMCID: PMC10503766 DOI: 10.1371/journal.pone.0291357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurological disease affecting around 1% of people above sixty years old. It is characterised by both motor and non-motor symptoms including tremor, slow movement, unsteady gait, constipation and urinary incontinence. As the disease progresses, individuals living with the disease are likely to lose their independence and autonomy, subsequently affecting their quality of life. People with PD should be supported to live well within their communities but there has been limited research regarding what the public know about PD. This review aims to develop an understanding of how the public view people living with PD, which has the potential to aid the development of an educational resource for the future to improve public awareness and understanding of PD. The purpose of this scoping review is to review and synthesise the literature on the public perception and attitudes towards people living with PD and identify and describe key findings. AIM This scoping review aims to explore public perceptions and awareness of Parkinson's Disease among diverse populations, encompassing beliefs, knowledge, attitudes, and the broader societal context influencing these perceptions. METHODS A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for ScR (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO and International Bibliography of the Social Sciences). The Joanna Briggs Institute Critical Appraisal Tools (JBI) were used to assess the quality of primary studies, however, all relevant studies were considered regardless of their methodological quality. The 'Population-Concept-Context' framework was used in the screening process to identify eligible papers. RESULTS A total of 23 studies were included in the review representing global research in quantitative (n = 12) and mixed methods approaches (n = 11). All 23 studies adopted some aspect of cross-sectional design. Three themes emerged from the studies, the first being public knowledge of symptoms, causes and treatment of PD and this highlighted a lack of understanding about the disease. Secondly, the review identified public attitudes towards PD, highlighting the social consequences of the disease, including the association between PD and depression, isolation and loss of independence. Finally, the third theme highlighted that there was a paucity of educational resources available to help increase public understanding of PD. CONCLUSION Findings from this scoping review have indicated that public awareness of PD is a growing area of interest. To our knowledge, this is the first scoping review on this topic and review findings have indicated that public knowledge and attitudes towards PD vary internationally. The implications of this are that people with PD are more likely to be a marginalised group within their communities. Future research should focus on understanding the perception of the public from the perspective of people with PD, the development of interventions and awareness campaigns to promote public knowledge and attitude and further high-quality research to gauge public perceptions of PD.
Collapse
Affiliation(s)
- Sophie Crooks
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Gillian Carter
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Christine Brown Wilson
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Lisa Wynne
- Parkinson’s Association of Ireland, Dublin, Ireland
| | - Patrick Stark
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Matthew Rodger
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Emma O’Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| |
Collapse
|
17
|
Craig S, Wilson CB, Mitchell G. Translating 'dementia friends' programme to undergraduate medical and nursing practice: a qualitative exploration. BMC Med Educ 2023; 23:555. [PMID: 37550708 PMCID: PMC10408182 DOI: 10.1186/s12909-023-04561-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION Dementia awareness is a key priority of medical and nursing pre-registration education. The 'dementia friends' programme is an internationally recognised and accredited dementia awareness workshop that is led by a trained facilitator. While this programme has been associated with positive outcomes, few studies have examined how medical and nursing students apply their learning in practice after the workshop. The aim of his study was to explore how nursing and medical students apply the dementia friend's programme into practice when caring for people living with dementia. METHODS Seven focus-group interviews were conducted with 36 nursing students and 14 medical students at one university in Northern Ireland (n = 50), following 'the dementia friends programme. Interview guides were co-designed alongside people living with dementia. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was granted for this study. RESULTS Four themes emerged: 'reframing dementia', which highlighted how the education had enabled students to actively empower and support people living with dementia in practice; 'dementia friendly design', which focused on how students had modified their clinical environments when providing care for people living with dementia, 'creative communication', which considered how students had used their education to adapt their verbal and non-verbal communication with people living with dementia and 'realities of advanced dementia' which contemplated how students believed their dementia education could be improved within their current curriculum. DISCUSSION The Dementia Friends programme has actively supported nursing and medical students to improve the lives of people with dementia in their care through environmental adaptions and creative approaches to communication. This study provides an evidence base that supports the provision of 'a dementia friends programme to healthcare professional students. The study also highlights how this education can actively influence how nursing and medical students support people living with dementia in their practice in the months and years after education.
Collapse
Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland.
| | | | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern, Ireland
| |
Collapse
|
18
|
Manichaikul A, Hu X, Logan J, Kwon Y, Lima J, Jacobs D, Duprez D, Brumback L, Taylor K, Durda P, Johnson C, Cornell E, Guo X, Liu Y, Tracy R, Blackwell T, Papanicolaou G, Mitchell G, Rich S, Rotter J, Van Den Berg D, Chirinos J, Hughes T, Garrett-Bakelman F. Multi-ancestry epigenome-wide analyses identify methylated sites associated with aortic augmentation index in TOPMed MESA. Res Sq 2023:rs.3.rs-3125948. [PMID: 37502922 PMCID: PMC10371087 DOI: 10.21203/rs.3.rs-3125948/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Despite the prognostic value of arterial stiffness (AS) and pulsatile hemodynamics (PH) for cardiovascular morbidity and mortality, epigenetic modifications that contribute to AS/PH remain unknown. To gain a better understanding of the link between epigenetics (DNA methylation) and AS/PH, we examined the relationship of eight measures of AS/PH with CpG sites and co-methylated regions using multi-ancestry participants from Trans-Omics for Precision Medicine (TOPMed) Multi-Ethnic Study of Atherosclerosis (MESA) with sample sizes ranging from 438 to 874. Epigenome-wide association analysis identified one genome-wide significant CpG (cg20711926-CYP1B1) associated with aortic augmentation index (AIx). Follow-up analyses, including gene set enrichment analysis, expression quantitative trait methylation analysis, and functional enrichment analysis on differentially methylated positions and regions, further prioritized three CpGs and their annotated genes (cg23800023-ETS1, cg08426368-TGFB3, and cg17350632-HLA-DPB1) for AIx. Among these, ETS1 and TGFB3 have been previously prioritized as candidate genes. Furthermore, both ETS1 and HLA-DPB1 have significant tissue correlations between Whole Blood and Aorta in GTEx, which suggests ETS1 and HLA-DPB1 could be potential biomarkers in understanding pathophysiology of AS/PH. Overall, our findings support the possible role of epigenetic regulation via DNA methylation of specific genes associated with AIx as well as identifying potential targets for regulation of AS/PH.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Kent Taylor
- The Institute for Translational Genomics and Population Sciences
| | | | | | | | | | | | | | | | | | | | - Stephen Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia
| | - Jerome Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
| | | | | | | | | |
Collapse
|
19
|
McMahon J, Brown Wilson C, Hill L, Tierney P, Thompson DR, Cameron J, Yu D, Moser DK, Spilsbury K, Srisuk N, Schols JMGA, van der Velden M, Mitchell G. Optimising quality of life for people living with heart failure in care homes: Protocol for the co-design and feasibility testing of a digital intervention. PLoS One 2023; 18:e0288433. [PMID: 37432917 DOI: 10.1371/journal.pone.0288433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/13/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Heart failure (HF) affects up to 64.3 million people globally. Advancements in pharmaceutical, device or surgical therapies, have led to patients living longer with HF. Heart failure affects 20% of care home residents, with these individuals presenting as older, frailer, and with more complex needs compared to those living at home. Thus, improving care home staff (e.g., registered nurse and care assistant) knowledge of HF has the potential to benefit patient care and reduce acute care utilization. Our aim is to co-design, and feasibility test, a digital intervention to improve care home staff knowledge of HF and optimise quality of life for those living with the condition in long-term residential care. METHODS Using a logic model, three workstreams have been identified. Workstream 1 (WS1), comprised of three steps, will inform the 'inputs' of the model. First, qualitative interviews (n = 20) will be conducted with care home staff to identify facilitators and barriers in the provision of care to people with HF. Concurrently, a scoping review will be undertaken to synthesise current evidence of HF interventions within care homes. The last step will involve a Delphi study with 50-70 key stakeholders (for example care home staff, people with HF and their family and friends) to determine key education priorities related to HF. Using data from WS1, a digital intervention to improve care home staff knowledge and self-efficacy of HF will be co-designed in workstream 2 (WS2) alongside those living with HF or their carers, HF professionals, and care home staff. Lastly, workstream 3 (WS3) will involve mixed-methods feasibility testing of the digital intervention. Outcomes include staff knowledge on HF and self-efficacy in caring for HF residents, intervention usability, perceived benefits of the digital intervention on quality of life for care home residents, and care staff experience of implementing the intervention. DISCUSSION As HF affects many care home residents, it is vital that care home staff are equipped to support people living with HF in these settings. With limited interventional research in this area, it is envisaged that the resulting digital intervention will have relevance for HF resident care both nationally and internationally.
Collapse
Affiliation(s)
- James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | | | - Loreena Hill
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Paul Tierney
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| | - Jan Cameron
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Doris Yu
- School of Nursing, University of Hong Kong, Hong Kong, China
| | - Debra K Moser
- College of Nursing, University of Kentucky, Lexington, Kentucky, United States of America
| | - Karen Spilsbury
- School of Healthcare, University of Leeds, Leeds, United Kingdom
| | - Nittaya Srisuk
- Faculty of Nursing, Surat Thani Rajabhat University, Surat Thani, Thailand
| | - Jos M G A Schols
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Mariëlle van der Velden
- Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, United Kingdom
| |
Collapse
|
20
|
Craig S, Mitchell G, Halloran PO, Stark P, Wilson CB. Exploring the experiences of people living with dementia in Dementia Friendly Communities (DFCs) in Northern Ireland: a realist evaluation protocol. BMC Geriatr 2023; 23:361. [PMID: 37296393 PMCID: PMC10251317 DOI: 10.1186/s12877-023-04090-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The aim of this study is to 1) explore the experiences of people living with dementia interacting with DFCs and 2) identify factors that influence empower and support people living with dementia to live successfully in DFCs. The main elements of a DFC are related to people; communities; organisations and partnerships. There are over 200 organisations recognised as dementia-friendly in Northern Ireland (NI). This realist evaluation is to understand how DFCs work for people living with dementia, how positive outcomes are achieved, for whom and in what contexts do DFCs work best. METHODS A realist evaluation using case study methodology. The process evaluation includes a realist review of the literature, non-participant observation of people living with dementia in their local communities, semi-structured interviews to explore the facilitators and barriers to living well in DFCs and focus groups comprised of people living with dementia, family caregivers and people working in DFCs to support Context- Mechanisms and Outcomes (CMOs). This four-stage realist assessment cycle is used, including iterative rounds of theory development, data gathering, and theory testing. In the end, analysis will reveal context mechanisms that influence how dementia-friendly communities operate and present an initial theory of how people think, which, if adopted, may be able to alter current contexts so that "key" mechanisms are activated to generate desired outcomes. DISCUSSION To give confidence in moving from hypothetical constructions about how DFCs could function to explanations of possible or observable causal mechanisms, the realist evaluation of a complex intervention incorporates a variety of evidence and perspectives. Despite playing a significant role in a person with dementia's everyday life, it appears that little is known about how communities function to achieve intended results. Even though there has been a lot of work to pinpoint the fundamentals and crucial phases of building DFCs, it is still unclear how people living with dementia benefit the most from these communities. This study intends to advance our understanding of how outcomes are produced for people living with dementia by contributing to the underlying theory of DFCs as well as addressing the primary research objectives.
Collapse
Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Peter O' Halloran
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | | |
Collapse
|
21
|
Craig S, Stark P, Wilson CB, Carter G, Clarke S, Mitchell G. Evaluation of a dementia awareness game for undergraduate nursing students in Northern Ireland: a Pre-/Post-Test study. BMC Nurs 2023; 22:177. [PMID: 37217937 DOI: 10.1186/s12912-023-01345-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION Although it is possible to live well with dementia and many individuals with dementia lead active lives with the help of family, friends, and communities, the general impression of dementia is frequently negative. Dementia is a global health issue. Despite this, little research has been done on the effects of innovative dementia education strategies among undergraduate nursing students. The aim of this study was therefore to assess if this serious digital game, originally intended for the public, could increase knowledge about dementia in first-year nursing students. METHODS The intervention was a digital serious game called "The Dementia Game", which was available to students throughout February 2021, to a convenience sample of first-year undergraduate nursing students (n = 560) completing a BSc Honours Nursing Degree programme in one university in Northern Ireland. The game was evaluated using a pretest-posttest design. The questionnaire comprised of a 30- item true- false Alzheimer's Disease Knowledge Scale (ADKS), which covers risk factors, assessment and diagnosis, symptoms, course, life impact, caregiving and treatment and management. Data were analysed using paired t-tests and descriptive statistics. RESULTS Overall dementia knowledge increased significantly after playing the game. Pre-test to post-test increases were observed across a range of seven categories of dementia knowledge (life impact, risk factors, symptoms, treatment, assessment, caregiving and trajectory), with particularly large increases in knowledge of trajectory and risk factors, as shown using paired t-tests. All pre-test to post-test comparisons were significant at the p < 0.001 level. CONCLUSIONS A short serious digital game on dementia improved first-year student's knowledge about dementia. Undergraduate students also expressed that this approach to dementia education was effective in improving their knowledge about the disease.
Collapse
Affiliation(s)
- Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Sonya Clarke
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| |
Collapse
|
22
|
Mallon A, Mitchell G, Carter G, McLaughlin D, Wilson CB. A rapid review of evaluated interventions to inform the development of a resource to support the resilience of care home nurses. BMC Geriatr 2023; 23:275. [PMID: 37147594 PMCID: PMC10162002 DOI: 10.1186/s12877-023-03860-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGOUND Nurses working in care homes face significant challenges that are unique to that context. The importance of effective resilience building interventions as a strategy to enable recovery and growth in these times of uncertainty have been advocated. The aim of this rapid review was to inform the development of a resource to support the resilience of care home nurses. We explored existing empirical evidence as to the efficacy of resilience building interventions. undertaken with nurses. METHODS We undertook a rapid review using quantitative studies published in peer reviewed journals that reported resilience scores using a valid and reliable scale before and after an intervention aimed at supporting nurse resilience. The databases; Cumulative Index to Nursing and Allied Health Literature, Medline and PsychInfo. and the Cochrane Library were searched. The searches were restricted to studies published between January 2011 and October 2021 in the English language. Only studies that reported using a validated tool to measure resilience before and after the interventions were included. RESULTS Fifteen studies were included in this rapid review with over half of the studies taking place in the USA. No studies reported on an intervention to support resilience with care home nurses. The interventions focused primarily on hospital-based nurses in general and specialist contexts. The interventions varied in duration content and mode of delivery, with interventions incorporating mindfulness techniques, cognitive reframing and holistic approaches to building and sustaining resilience. Thirteen of the fifteen studies selected demonstrated an increase in resilience scores as measured by validated and reliable scales. Those studies incorporating 'on the job,' easily accessible practices that promote self-awareness and increase sense of control reported significant differences in pre and post intervention resilience scores. CONCLUSION Nurses continue to face significant challenges, their capacity to face these challenges can be nurtured through interventions focused on strengthening individual resources. The content, duration, and mode of delivery of interventions to support resilience should be tailored through co-design processes to ensure they are both meaningful and responsive to differing contexts and populations.
Collapse
Affiliation(s)
- Anita Mallon
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Gillian Carter
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Derek McLaughlin
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland
| | - Christine Brown Wilson
- School of Nursing and Midwifery Queens University Belfast, University Rd, Belfast, BT7 1NN, Northern Ireland.
| |
Collapse
|
23
|
Min H, Rabi Y, Wadhawan A, Bourgeat P, Dowling J, White J, Tchernegovski A, Formanek B, Schuetz M, Mitchell G, Williamson F, Hacking C, Tetsworth K, Schmutz B. Automatic classification of distal radius fracture using a two-stage ensemble deep learning framework. Phys Eng Sci Med 2023; 46:877-886. [PMID: 37103672 DOI: 10.1007/s13246-023-01261-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
Distal radius fractures (DRFs) are one of the most common types of wrist fracture and can be subdivided into intra- and extra-articular fractures. Compared with extra-articular DRFs which spare the joint surface, intra-articular DRFs extend to the articular surface and can be more difficult to treat. Identification of articular involvement can provide valuable information about the characteristics of fracture patterns. In this study, a two-stage ensemble deep learning framework was proposed to differentiate intra- and extra-articular DRFs automatically on posteroanterior (PA) view wrist X-rays. The framework firstly detects the distal radius region of interest (ROI) using an ensemble model of YOLOv5 networks, which imitates the clinicians' search pattern of zooming in on relevant regions to assess abnormalities. Secondly, an ensemble model of EfficientNet-B3 networks classifies the fractures in the detected ROIs into intra- and extra-articular. The framework achieved an area under the receiver operating characteristic curve of 0.82, an accuracy of 0.81, a true positive rate of 0.83 and a false positive rate of 0.27 (specificity of 0.73) for differentiating intra- from extra-articular DRFs. This study has demonstrated the potential in automatic DRF characterization using deep learning on clinically acquired wrist radiographs and can serve as a baseline for further research in incorporating multi-view information for fracture classification.
Collapse
Affiliation(s)
- Hang Min
- CSIRO Australian e-Health Research Centre, Herston, QLD, Australia.
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
- South Western Clinical School, University of New South Wales, Sydney, Australia.
| | - Yousef Rabi
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ashish Wadhawan
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | | | - Jason Dowling
- CSIRO Australian e-Health Research Centre, Herston, QLD, Australia
- South Western Clinical School, University of New South Wales, Sydney, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Institute of Medical Physics, The University of Sydney, Sydney, NSW, Australia
- School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia
| | - Jordy White
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
| | | | - Blake Formanek
- Ochsner Clinical School, University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - Michael Schuetz
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Centre of Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
| | - Frances Williamson
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
| | - Craig Hacking
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
| | - Kevin Tetsworth
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Beat Schmutz
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Centre of Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD, Australia
| |
Collapse
|
24
|
Vallmuur K, Mitchell G, McCreanor V, Droder B, Catchpoole J, Eley R, Smyth T. Electric personal MObility DEvices Surveillance (E-MODES) study: Injury presentations to emergency departments in Brisbane, Queensland. Injury 2023:S0020-1383(23)00378-9. [PMID: 37080882 DOI: 10.1016/j.injury.2023.04.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/05/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The rapid increase in e-mobility globally, including in Australia, has seen a concurrent increase in e-mobility-related injuries. Monitoring and understanding the patterns of injuries is essential to preserving community safety and making responsive and effective policy decisions regarding their safe use. METHODS This study reports on the first phase of the E-MODES study, a proactive injury surveillance initiative to examine the incidence and nature of injuries, their circumstances, contributing factors, and treatment, presenting to three hospital emergency departments (EDs) in Brisbane, the first Australian city to trial shared e-scooters. RESULTS During the 31-month study period, there were 1048 ED presentations related to e-mobility, the vast majority (90.8%) involving e-scooters, with males accounting for 64.3% of cases, the most common age group being 25-34 years, and weekends being the most common period of the week for presentations. The most common injury was fractures (37%), and the upper extremities and head/face were the most commonly injured body regions. CONCLUSION Contributing risk factors of alcohol use, not wearing a helmet, and speeding, were prevalent, though poorly recorded and only alcohol use proportions varied by age and gender, with males being more likely than females to have alcohol use reported. Recommendations to support e-mobility-related injury surveillance and safety outcomes include improved data standardisation and sharing.
Collapse
Affiliation(s)
- K Vallmuur
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia; Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia.
| | - G Mitchell
- Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - V McCreanor
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia; Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia
| | - B Droder
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia
| | - J Catchpoole
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia
| | - R Eley
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia
| | - T Smyth
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital, Metro North Health, Brisbane, Queensland, Australia
| |
Collapse
|
25
|
Stark P, McKenna G, Wilson CB, Tsakos G, Brocklehurst P, Lappin C, Quinn B, Holland N, Mitchell G. Evaluation of a co-designed educational e-resource about oral health for community nurses: study protocol. BMC Nurs 2023; 22:94. [PMID: 37013600 PMCID: PMC10071717 DOI: 10.1186/s12912-023-01268-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Oral health is a crucial aspect of health and wellbeing for older people. Poor oral health has been found to significantly increase the risk of chronic health conditions and poor quality of life for older people. Nurses practicing in the community are well-placed to provide oral health care to older people in their own homes, yet there has been little research in this field to develop accessible support for them to do so. Previous literature, reviewed in an earlier phase of this work, revealed that there has, historically, been a paucity of oral health care education for nurses and very few educational resources have been developed in this field. METHODS This study will evaluate an educational e-resource which has been co-designed by service users, carers and clinicians. In the first phase of research, evidence of promise will be evaluated by analysing quantitative data on community nurses' oral health attitudes and self-efficacy for oral health assessments of older people. In the second phase of research, facilitators and barriers to community nurses' provision of oral health care to older people and the acceptability of the educational e-resource will be evaluated. DISCUSSION This research will investigate the potential of an educational e-resource to improve community nurses' capabilities to deliver oral health care to older people in their own homes. This research will inform both future intervention design and understanding of community nurses' knowledge and attitudes about oral health care. Facilitators and barriers to provision of this care for older people will also be explored.
Collapse
Affiliation(s)
- Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Gerry McKenna
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Caroline Lappin
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
| | - Barry Quinn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Nicola Holland
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| |
Collapse
|
26
|
Javan H, Mitchell G, Pierce J, Selzman C. Acellular Human Amniotic Fluid Prevents the Development of Ischemic Heart Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
27
|
Jaganathan KS, Sullivan KA, Kinmond S, Berndt S, Street S, Haden C, Greenslade J, McMahon K, Mitchell G, Kerr G. Exercise Parameters for Postconcussion Symptom Rehabilitation: A Systematic Review. J Sport Rehabil 2023:1-10. [PMID: 36940683 DOI: 10.1123/jsr.2022-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/04/2022] [Accepted: 12/21/2022] [Indexed: 03/23/2023]
Abstract
CONTEXT Exercise rehabilitation for postconcussion symptoms (PCS) has shown some benefits in adolescent athletes; but a synthesis of evidence on exercise per se has been lacking. OBJECTIVE This systematic review aimed to determine if unimodal exercise interventions are useful to treat PCS and if so, to identify a set of clearly defined and effective exercise parameters for further research. EVIDENCE ACQUISITION Relevant health databases and clinical trial registries were searched from inception to June 2022. The searches used a combination of subject headings and keywords related to mild traumatic brain injury (mTBI), PCSs, and exercise. Two independent reviewers screened and appraised the literature. The Cochrane Collaboration's Risk of Bias-2 tool for randomized controlled trials was used to assess methodological quality of studies. EVIDENCE SYNTHESIS Seven studies were included in the review. Four studies were assessed to have a low overall risk of bias, 2 with low risk and 1 with some concerns. Participants in the studies comprised mostly adolescents with sports-related concussion. The review found exercise to be more beneficial than control conditions in 2 studies investigating acute PCS and 2 studies investigating persistent PCS. Within-group differences showing symptom improvement over time were observed in all 7 studies. In general, the review found support for programmatic exercise that commences after an initial period of rest for 24 to 48 hours. Recommendations for exercise parameters that can be explored in subsequent research include progressive aerobic exercise starting from 10 to 15 minutes at least 4 times a week, at a starting intensity of 50% HR of the subsymptom threshold, with length of program depending on recovery. CONCLUSION The evidence in support of exercise rehabilitation for PCSs is moderate based on the small pool of eligible studies. Further research can be guided by the exercise parameters identified in this review.
Collapse
Affiliation(s)
| | - Karen A Sullivan
- School of Psychology & Counseling, Queensland University of Technology, Brisbane, QLD,Australia
| | - Sally Kinmond
- School of Psychology & Counseling, Queensland University of Technology, Brisbane, QLD,Australia
| | - Sara Berndt
- School of Psychology & Counseling, Queensland University of Technology, Brisbane, QLD,Australia
| | - Steve Street
- School of Psychology & Counseling, Queensland University of Technology, Brisbane, QLD,Australia
| | - Catherine Haden
- QUT Library, Academic Division, Queensland University of Technology, Brisbane, QLD,Australia
| | - Jaimi Greenslade
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD,Australia
- Emergency and Trauma Centre, RBWH Brisbane, QLD,Australia
| | - Katie McMahon
- School of Clinical Sciences, Center for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD,Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, RBWH Brisbane, QLD,Australia
| | - Graham Kerr
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, QLD,Australia
| |
Collapse
|
28
|
Gilbert F, Mitchell G, Townsend S, Dhanani J, Sng N. Role of the emergency department in implementing an extracorporeal membrane oxygenation cardiopulmonary resuscitation. Emerg Med Australas 2023; 35:173-175. [PMID: 36216499 DOI: 10.1111/1742-6723.14100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 01/19/2023]
Abstract
The Royal Brisbane and Women's Hospital has introduced an extracorporeal membrane oxygenation (ECMO) cardiopulmonary resuscitation (E-CPR) service with collaboration between ED and ICU teams for refractory cardiac arrest patients. E-CPR is potentially beneficial to patients who do not gain return of spontaneous circulation after conventional advanced cardiac life support treatments, provided specific demographic and biochemical inclusion criteria are met. A joint ICU and ED decision is reached to commence ECMO flow. We discuss our rationale to use the ED and the emergency physician role in leading the multidisciplinary team, with ICU leading the cannulation team. The development of ED processes and the increased availability of this intervention can significantly impact the survivability of refractory cardiac arrest with good neurological outcomes.
Collapse
Affiliation(s)
- Felicity Gilbert
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Jamieson Trauma Institute, Brisbane, Queensland, Australia
| | - Shane Townsend
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jayesh Dhanani
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nicole Sng
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
29
|
Cameron CM, Vuong K, McWhinney B, Zournazi A, Manzanero S, Warren J, Mitchell G, McCreanor V, Vallmuur K, Howell T, Ungerer JPJ. Prevalence of alcohol consumption in emergency presentations: Novel approach using two biomarkers, ethanol and phosphatidylethanol. Drug Alcohol Rev 2023; 42:146-156. [PMID: 36054789 PMCID: PMC10087033 DOI: 10.1111/dar.13534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The aim was to determine the prevalence of alcohol-related presentations to an emergency department (ED) in a major Australian hospital, through a novel surveillance approach using two biomarkers, blood ethanol and phosphatidylethanol (PEth). METHODS Observational study using secondary testing of blood samples collected during routine clinical care of ED patients presenting to the Royal Brisbane and Women's Hospital in Queensland, Australia, between 22 January and 2 February 2021. Data were collected from 1160 patients during the 10-day study period. The main outcomes were the prevalence of acute alcohol intake, as determined by blood ethanol, and recent use over 2-4 weeks, as determined by PEth concentrations, for all ED presentations and different diagnostic groups. RESULTS The overall prevalence for blood ethanol was 9.3% (95% confidence interval [CI] 7.8%, 11.1%), 5.3% for general medical presentations, increasing four-fold to 22.2% for injury presentations. The overall prevalence of PEth positive samples was 32.5% (95% CI 29.9%, 35.3%) and 41.4% for injury presentations. There were 263 (25.3%) cases that tested negative for acute blood ethanol but positive for PEth concentrations indicative of significant to heavy medium-term alcohol consumption. DISCUSSION AND CONCLUSIONS This novel surveillance approach demonstrates that using blood ethanol tests in isolation significantly underestimates the prevalence of medium-term alcohol consumption in ED presentations. Prevalence of alcohol use was higher for key diagnostic groups such as injury presentations. Performing periodic measurement of both acute and medium-term alcohol consumption accurately and objectively in ED presentations, would be valuable for informing targeted public health prevention and control strategies.
Collapse
Affiliation(s)
- Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kim Vuong
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jacelle Warren
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Victoria McCreanor
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
| | | | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia.,Faculty of Biomedical Science, University of Queensland, Brisbane, Australia
| |
Collapse
|
30
|
Boots R, Xue G, Tromp D, Rawashdeh O, Bellapart J, Townsend S, Rudd M, Winter C, Mitchell G, Garner N, Clement P, Karamujic N, Zappala C. Circadian Rhythmicity of Vital Signs at Intensive Care Unit Discharge and Outcome of Traumatic Brain Injury. Am J Crit Care 2022; 31:472-482. [PMID: 36316179 DOI: 10.4037/ajcc2022821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Physiological functions with circadian rhythmicity are often disrupted during illness. OBJECTIVE To assess the utility of circadian rhythmicity of vital signs in predicting outcome of traumatic brain injury (TBI). METHODS A retrospective single-center cohort study of adult intensive care unit (ICU) patients with largely isolated TBI to explore the relationship between the circadian rhythmicity of vital signs during the last 24 hours before ICU discharge and clinical markers of TBI severity and score on the Glasgow Outcome Scale 6 months after injury (GOS-6). RESULTS The 130 study participants had a median age of 39.0 years (IQR, 23.0-59.0 years), a median Glasgow Coma Scale score at the scene of 8.0 (IQR, 3.0-13.0), and a median Rotterdam score on computed tomography of the head of 3 (IQR, 3-3), with 105 patients (80.8%) surviving to hospital discharge. Rhythmicity was present for heart rate (30.8% of patients), systolic blood pressure (26.2%), diastolic blood pressure (20.0%), and body temperature (26.9%). Independent predictors of a dichotomized GOS-6 ≥4 were the Rotterdam score (odds ratio [OR], 0.38 [95% CI, 0.18-0.81]; P = .01), Glasgow Coma Scale score at the scene (OR, 1.22 [95% CI, 1.05-1.41]; P = .008), age (OR, 0.95 [95% CI, 0.92-0.98]; P = .003), oxygen saturation <90% in the first 24 hours (OR, 0.19 [95% CI, 0.05-0.73]; P = .02), serum sodium level <130 mmol/L (OR, 0.20 [95% CI, 0.05-0.70]; P = .01), and active intracranial pressure management (OR, 0.16 [95% CI, 0.04-0.62]; P = .008), but not rhythmicity of any vital sign. CONCLUSION Circadian rhythmicity of vital signs at ICU discharge is not predictive of GOS-6 in patients with TBI.
Collapse
Affiliation(s)
- Rob Boots
- Rob Boots is an associate professor, Thoracic Medicine, Royal Brisbane and Women's Hospital, a senior specialist, Intensive Care, Bundaberg Hospital, Faculty of Medicine, The University of Queensland, Herston, and a professsor, Faculty of Medicine and Dentistry, Griffith University, Queensland, Australia
| | - George Xue
- George Xue is the medical registrar, Royal Brisbane and Women's Hospital
| | - Dirk Tromp
- Dirk Tromp is the senior radiology registrar, Royal Brisbane and Women's Hospital
| | - Oliver Rawashdeh
- Oliver Rawashdeh is director, Chronobiology and Sleep Research, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Judith Bellapart
- Judith Bellapart is a senior specialist, Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, and Burns, Trauma, and Critical Care, The University of Queensland
| | - Shane Townsend
- Shane Townsend is director, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Michael Rudd
- Michael Rudd is acting director, Trauma, Royal Brisbane and Women's Hospital
| | - Craig Winter
- Craig Winter is a staff specialist neurosurgeon, Royal Brisbane and Women's Hospital
| | - Gary Mitchell
- Gary Mitchell is a staff specialist, Emergency Medicine, Royal Brisbane and Women's Hospital
| | - Nicholas Garner
- Nicholas Garner is a PhD student, Chronobiology and Sleep Research Lab, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Pierre Clement
- Pierre Clement is a clinical information systems manager, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Nermin Karamujic
- Nermin Karamujic is a data manager and clinical information systems manager, Intensive Care Services, Royal Brisbane and Women's Hospital
| | - Christopher Zappala
- Christopher Zappala is a senior staff specialist, Thoracic Medicine, Royal Brisbane and Women's Hospital
| |
Collapse
|
31
|
Stark P, McKenna G, Wilson CB, Tsakos G, Brocklehurst P, Lappin C, Quinn B, Mitchell G. Interventions supporting community nurses in the provision of Oral healthcare to people living at home: a scoping review. BMC Nurs 2022; 21:269. [PMID: 36199087 PMCID: PMC9533519 DOI: 10.1186/s12912-022-01051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Oral health is a critical issue for public health and poor oral health is associated with significant chronic health conditions and lower quality of life. There has been little focus on providing oral health care to people who receive care in their own homes, despite the high risk of poor oral health in older people. Nurses practicing in the community are well placed to deliver this care, but little is known about how to build this capability through education or training interventions. Methods A scoping review methodology was employed to find and review studies of oral health interventions involving populations of people receiving care in their own home or those nurses who deliver this care. The research question asked what previous research tells us about oral health interventions delivered by nurses in the community. Data was extracted for four areas: setting and type of intervention, patient outcomes, changes to nursing practice and implementation and process evaluations of interventions. Results Two thousand eighty papers were found from the searches, and only nine were ultimately deemed eligible for inclusion in the review. Included studies spanned community nursing for older people (n = 3) and health visiting or community nursing for children and infants (n = 6). Patient outcomes were generally positive, but this is based on a low level of evidence. Changes to practice including increased oral health care administered by nurses were found, but this required professional support to be sustainable. Conclusions This review has found that there is a clear gap in the research around interventions designed to be used by community nurses to improve oral health care for people receiving care in their own homes. The results also suggest that any future intervention must make use of a participatory, co-design approach and consider the complex setting of nursing practice in the community and the barriers to delivering this care, such as time pressure and lack of prior experience.
Collapse
Affiliation(s)
- Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Gerry McKenna
- Centre for Public Health, Belfast, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Caroline Lappin
- Department of Health, Castle Buildings, Stormont, Belfast, Northern Ireland
| | - Barry Quinn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| |
Collapse
|
32
|
Thomas SM, Parker A, Fortune J, Mitchell G, Hezam A, Jiang Y, de Groh M, Anderson K, Gauthier-Beaupré A, Barker J, Watt J, Straus SE, Tricco AC. Global evidence on falls and subsequent social isolation in older adults: a scoping review. BMJ Open 2022; 12:e062124. [PMID: 36175106 PMCID: PMC9528590 DOI: 10.1136/bmjopen-2022-062124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Falls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation. OBJECTIVE To summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review. ELIGIBILITY CRITERIA Studies were eligible for inclusion if the population had a mean age of 60 years or older, they examined falls and subsequent social isolation, loneliness, fear of falling or risk factors and were primary studies (eg, experimental, quasi-experimental, observational and qualitative). SOURCES OF EVIDENCE MEDLINE, CINAHL, Embase, Ageline and grey literature from inception until 11 January 2021. CHARTING METHODS A screening and charting form was developed and pilot-tested. Subsequently, two reviewers screened citations and full-text articles, and charted the evidence. RESULTS After screening 4993 citations and 304 full-text articles, 39 studies were included in this review. Participants had a history of falling (range: 11% to 100%). Most studies were conducted in Europe (44%) and North America (33%) and were of the cross-sectional study design (66.7%), in the community (79%). Studies utilised 15 different scales. Six studies examined risk factors for social isolation and activity restriction associated with fear of falling. Six studies reported mental health outcomes related to falls and subsequent social isolation. CONCLUSIONS Consistency in outcome measurement is recommended, as multiple outcomes were used across the included studies. Further research is warranted in this area, given the ageing population and the importance of falls and social isolation to the health of older adults. SCOPING REVIEW REGISTRATION NUMBER 10.17605/OSF.IO/2R8HM.
Collapse
Affiliation(s)
- Sonia M Thomas
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amanda Parker
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jennifer Fortune
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Areej Hezam
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Ying Jiang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Kerry Anderson
- Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Amélie Gauthier-Beaupré
- Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Joan Barker
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Epidemiology Division and Institute for Health, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
33
|
Dodd S, Carter G, Christie A, Mitchell G. Exploring nurse and nursing student experience of using an artist-produced photobook to learn about dementia. BMC Nurs 2022; 21:237. [PMID: 36008807 PMCID: PMC9406272 DOI: 10.1186/s12912-022-00991-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background Improving understanding about dementia in nursing is a priority area for educators and policymakers. This is due to poor professional understanding about dementia and suboptimal healthcare practice. While many educational interventions exist, there has been a paucity of research which has considered the use of artist-produced photobooks to improve knowledge and understanding about dementia. The aim of this study is to understand the impact of an artist-produced photobook on nurses’ attitudes and beliefs about dementia. Results Following a thematic analysis of four focus group interviews with 22 nurses and nursing students from Northern Ireland, three themes emerged. Theme one was about how the artist-produced photobook helped participants to humanise the person living with dementia. Theme two related to how the artist-produced photobook supported participants to actively construct their own meanings about dementia based on their previous professional and personal experiences. Theme three explored how an artist-produced photobook could be successfully used to complement existing dementia education in the future. Conclusions Using an artist-produced photobook was an innovative way to learn about dementia for nurses and nursing students. The photobook functioned as a tool underpinned by arts-based pedagogy (ABP), supporting nurses to understand the person behind the dementia disease. As such, an artist-produced photobook has the potential to be a useful complementary resource for supporting professional education about dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00991-2.
Collapse
Affiliation(s)
- Savannah Dodd
- School of History, Anthropology, Philosophy, and Politics, Queen's University Belfast, 25 University Square, County Antrim, Belfast, BT7 1NN, Northern Ireland, UK.
| | - Gillian Carter
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Belfast, BT9 7BL, Northern Ireland, UK
| | - Andrena Christie
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Belfast, BT9 7BL, Northern Ireland, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Belfast, BT9 7BL, Northern Ireland, UK
| |
Collapse
|
34
|
Jaganathan KS, Sullivan K, Kinmond S, Berndt S, Street S, Haden C, Greenslade J, McMahon K, Mitchell G, Kerr G. A-284 A Systematic Review of Exercise for the Management of Post-Concussion Symptoms. Arch Clin Neuropsychol 2022. [DOI: 10.1093/arclin/acac060.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective: Exercise rehabilitation for post-concussion symptoms (PCS) has shown benefits, but a synthesis of evidence has been lacking. This systematic review aimed to review the evidence from randomised control trials (RCTs) of exercise-only interventions for PCS and identify the most promising parameters for further investigation.
Data Selection: Electronic databases (CINAHL, EBSCOhost, MEDLINE, etc) and trial registries (ProQuest Dissertation & Theses Global Database, etc) were searched from inception to November 2020. Keyword searches was carried out using terms specifying “mild traumatic brain injury”, “post-concussion symptoms”, and “exercise”. Only RCTs using solely exercise interventions and published in English were considered. Studies with multi-disciplinary interventions were excluded. Two independent researchers screened and reviewed the literature. Methodological quality was assessed using the Cochrane’s Risk-of-Bias-2 tool. Eight studies were identified for the final review.
Data Synthesis: The review found moderate support for exercise interventions to be effective in treating PCS. Based on the 8 studies, exercise programs that led to favourable outcomes commenced after an initial period of rest for 24-48 hours post-concussion, used progressive aerobic exercise for at least 4 times a week for 10-15 minutes during each session, required an intensity of at least 50% of the heart rate of the sub-symptom threshold, and lasted for at least 4 weeks or resolution of symptoms.
Conclusions: Exercise rehabilitation for PCS may be beneficial but further research is required on wider population groups apart from adolescents and athletes before more generalised recommendations can be made.
Collapse
|
35
|
Linden MA, Mitchell G, Carlisle S, Rainey D, Mulvenna C, Monaghan C. Recruiting males to the nursing profession: acceptability testing of the 'Make a Difference with Nursing' intervention for post-primary school students. BMC Nurs 2022; 21:173. [PMID: 35786441 PMCID: PMC9251953 DOI: 10.1186/s12912-022-00956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background The nursing profession is facing a worldwide recruitment shortage which could be partially addressed by recruiting more males. However, in many developed countries numbers of male nurses have traditionally been low. To address this issue we developed and tested a post-primary school-based intervention to recruit more males into the nursing profession. Methods Participants included thirty-four female students drawn from an all-girls post-primary school, fifty-one males from an all-boys post-primary school and seven males and fifteen females drawn from a mixed gender post-primary school, all located in Northern Ireland. Participants were all sixteen years of age and were in receipt of careers education. The intervention titled ‘Make a Difference with Nursing’ was co-designed with careers teachers, nurses and post-primary school students. This video based intervention was created to fit within existing career lessons and featured nursing staff and students describing their experiences of the profession. Participants completed the six domains of Nursing as a Career Choice Questionnaire prior to viewing the intervention and again after viewing. Results Positive and statistically significant increases in perceptions of the nursing profession were found between pre and post test scores across all six domains. No statistically significant differences in perceptions were found between males and females after watching the intervention. Comparison by school type showed statistically significant differences on the domains of prior healthcare exposure (p = 0.046; 95% CI -0.19 to 3.79) and job prospects (p = 0.005; 95% CI 1.04 to 7.01). Students from the all-girls school rated these more positively than those from the all-boys and mixed-gender schools. Conclusions A short video presentation to post-primary school students is capable of changing how they perceive the nursing profession. Students expressed surprise over the variety of professional nursing roles suggesting that many were not well informed about the realities of nursing. Providing tailored resources for use in careers lessons can better educate students and teachers about nursing and provide positive portrayals of male role models in the profession.
Collapse
Affiliation(s)
- Mark A Linden
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Susan Carlisle
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Debbie Rainey
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Caroline Mulvenna
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Catherine Monaghan
- School of Nursing & Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
| |
Collapse
|
36
|
Cousins E, Preston N, Doherty J, Varey S, Harding A, McCann A, Harrison Dening K, Finucane A, Carter G, Mitchell G, Brazil K. Implementing and evaluating online advance care planning training in UK nursing homes during COVID-19: findings from the Necessary Discussions multi-site case study project. BMC Geriatr 2022; 22:419. [PMID: 35562712 PMCID: PMC9098790 DOI: 10.1186/s12877-022-03099-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advance care planning in nursing homes is important to ensure the wishes and preferences of residents are recorded, especially during the COVID-19 pandemic. However, care staff and family members frequently report feeling unprepared for these conversations. More resources are needed to support them with these necessary discussions. This research aimed to develop, implement and evaluate a website intervention for care staff and family members to provide training and information about advance care planning during COVID-19. METHODS The research was a primarily qualitative case study design, comprising multiple UK nursing home cases. Data collection included semi-structured interviews with care staff and family members which were coded and analysed thematically. A narrative synthesis was produced for each case, culminating in a thematic cross-case analysis of the total findings. Theoretical propositions were refined throughout the research. RESULTS Eight nursing homes took part in the study, involving 35 care staff and 19 family members. Findings were reported according to the RE-AIM framework which identified the reach, effectiveness, adoption, implementation and maintenance of the intervention. Themes included: website content that was well received; suggestions for improvement; implementation barriers and facilitators; examples of organisational and personal impact. CONCLUSIONS Four theoretical propositions relating to advance care planning in nursing homes are presented, relating to: training and information needs, accessibility, context, and encouraging conversations. Implications for practice and training include an awareness of diverse learning styles, re-enforcing the right to be involved in advance care planning and encouraging opportunities for facilitated discussion. TRIAL REGISTRATION ISRCTN registry (ID 18003630 ) on 19.05.21.
Collapse
Affiliation(s)
- Emily Cousins
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Julie Doherty
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Sandra Varey
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Andrew Harding
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Adrienne McCann
- Innovation Value Institute, Maynooth University, Maynooth & Age Friendly Ireland, Ireland
| | - Karen Harrison Dening
- School of Nursing and Midwifery, Faculty of Health and Life Sciences, De Montfort University, Leicester & Dementia UK, London, UK
| | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh & Marie Curie Hospice Edinburgh, Edinburgh, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
| |
Collapse
|
37
|
Bertenshaw C, Mitchell G, McKinlay A, Cameron C, Vallmuur K, Smyth T, Witts M. DINED (Delivery-related INjuries in the Emergency Department) part 2: A chart review of risk factors and injuries affecting food delivery riders. Emerg Med Australas 2022; 34:744-750. [PMID: 35411724 DOI: 10.1111/1742-6723.13976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to examine patterns of injury, the impact of these injuries on patients and identification of potentially modifiable contributing factors through industry regulation reforms and education. METHODS Food delivery rider (FDR)-related presentations to the Royal Brisbane and Women's Hospital Emergency and Trauma Centre for a year from September 2020 were identified. Data collected included patient and incident demographics: time, type and location of injuries, investigations and care required, length of stay, admission requirements and follow up. RESULTS The cohort included 81.8% male with a mean age of 25.2 years. Most injuries occurred on the road from a collision with a vehicle. The most common injury was fractures. Incidence increased on weekends and during the evening. More than half the cohort were admitted to hospital. Only 22.7% of patients were eligible for workers compensation and less than half were covered by Medicare. The majority (72.7%) of cases involved non-resident riders from other countries. CONCLUSION The majority of FDRs presenting with injuries are not Australian citizens and less than half were Medicare eligible potentially contributing to inadequate access to care especially fracture follow up. There were spikes in injuries occurring at night, weekends and during periods of pandemic associated lockdowns demonstrating an increased usage of delivery services during these times. Results highlight injury patterns experienced by delivery riders and potentially modifiable risk factors for this rapidly growing area of employment within the gig economy.
Collapse
Affiliation(s)
- Claire Bertenshaw
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Queensland Ambulance Service, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,The University of Queensland, Brisbane, Queensland, Australia.,Jamieson Trauma Institute, Brisbane, Queensland, Australia
| | - Andrew McKinlay
- The University of Queensland, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Cate Cameron
- Jamieson Trauma Institute, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kirsten Vallmuur
- Jamieson Trauma Institute, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Tanya Smyth
- Jamieson Trauma Institute, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Morgan Witts
- The University of Queensland, Brisbane, Queensland, Australia.,Jamieson Trauma Institute, Brisbane, Queensland, Australia.,Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| |
Collapse
|
38
|
Affiliation(s)
- Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| |
Collapse
|
39
|
Galeotti M, Mitchell G, Tomlinson M, Aventin Á. Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review. BMC Pregnancy Childbirth 2022; 22:270. [PMID: 35361132 PMCID: PMC8974061 DOI: 10.1186/s12884-022-04585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Miscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner's miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research. AIMS The aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings. METHODS A systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity organisation websites, Google, and OpenGrey. A Mixed Methods appraisal tool (MMAT) and AACODS checklist were used to assess the quality of primary studies. RESULTS Thirty studies were included in this review representing qualitative (N = 21), quantitative (N = 7), and mixed-methods (N = 2) research from eleven countries. Findings indicated that women and men's emotional wellbeing is influenced by interactions with health professionals, provision of information, and the hospital environment. Parents' experiences in hospitals were characterised by a perceived lack of understanding among healthcare professionals of the significance of their loss and emotional support required. Parents reported that their distress was exacerbated by a lack of information, support, and feelings of isolation in the aftermath of miscarriage. Further, concerns were expressed about the hospital environment, in particular the lack of privacy. CONCLUSION Women and men are dissatisfied with the emotional support received in hospital settings and describe a number of hospital-related factors as exacerbators of emotional distress. IMPLICATIONS FOR PRACTICE This review highlights the need for hospitals to take evidence-informed action to improve emotional support services for people experiencing miscarriage within their services.
Collapse
Affiliation(s)
- Martina Galeotti
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Mark Tomlinson
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK.,Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Áine Aventin
- School of Nursing & Midwifery, Queen's University Belfast, Belfast, Northern Ireland, UK
| |
Collapse
|
40
|
Tricco AC, Thomas SM, Radhakrishnan A, Ramkissoon N, Mitchell G, Fortune J, Jiang Y, de Groh M, Anderson K, Barker J, Gauthier-Beaupré A, Watt J, Straus SE. Interventions for social isolation in older adults who have experienced a fall: a systematic review. BMJ Open 2022; 12:e056540. [PMID: 35264363 PMCID: PMC8915346 DOI: 10.1136/bmjopen-2021-056540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall. DESIGN Systematic review. DATA SOURCES MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to February 2020). METHODS Studies were eligible if they described any intervention for social isolation in older adults living in a community setting who experienced a fall, and reported outcomes related to social isolation or loneliness.Two independent reviewers screened citations, abstracted data and appraised risk of bias using the Cochrane risk of bias tool. The results were summarised descriptively. RESULTS After screening 4069 citations and 55 full-text articles, four studies were included. The four studies varied in study design, including a randomised controlled trial, non-randomised controlled trial, an uncontrolled before-after study and a quasiexperimental study. Interventions varied widely, and included singing in a choir, a patient-centred, interprofessional primary care team-based approach, a multifactorial assessment targeting fall risk, appropriate medication use, loneliness and frailty, and a community-based care model that included comprehensive assessments and multilevel care coordination. Outcome measures varied and included scales for loneliness, social isolation, social interaction, social networks and social satisfaction. Mixed results were found, with three studies reporting no differences in social isolation or loneliness after the intervention. Only the multifactorial assessment intervention demonstrated a small positive effect on loneliness compared with the control group after adjustment (B=-0.18, 95% CI -0.35 to -0.02). CONCLUSIONS Few studies examined the interventions for social isolation or loneliness in older adults who experienced a fall. More research is warranted in this area. PROSPERO REGISTRATION NUMBER CRD42020198487.
Collapse
Affiliation(s)
- Andrea C Tricco
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Epidemiology Division and Institute for Health, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sonia M Thomas
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amruta Radhakrishnan
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Naveeta Ramkissoon
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Ireland
| | - Jennifer Fortune
- Department of Public Health and Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Ying Jiang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret de Groh
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Kerry Anderson
- Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Joan Barker
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amélie Gauthier-Beaupré
- Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Watt
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
41
|
Gonella S, Mitchell G, Bavelaar L, Conti A, Vanalli M, Basso I, Cornally N. Interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes: A mixed-methods systematic review. Palliat Med 2022; 36:268-291. [PMID: 34965759 DOI: 10.1177/02692163211066733] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most people with dementia transition into nursing homes as their disease progresses. Their family caregivers often continue to be involved in their relative's care and experience high level of strain at the end of life. AIM To gather and synthesize information on interventions to support family caregivers of people with advanced dementia at the end of life in nursing homes and provide a set of recommendations for practice. DESIGN Mixed-Methods Systematic Review (PROSPERO no. CRD42020217854) with convergent integrated approach. DATA SOURCES Five electronic databases were searched from inception in November 2020. Published qualitative, quantitative, and mixed-method studies of interventions to support family caregivers of people with advanced dementia at the end of life in nursing home were included. No language or temporal limits were applied. RESULTS In all, 11 studies met the inclusion criteria. Data synthesis resulted in three integrated findings: (i) healthcare professionals should engage family caregivers in ongoing dialog and provide adequate time and space for sensitive discussions; (ii) end-of-life discussions should be face-to-face and supported by written information whose timing of supply may vary according to family caregivers' preferences and the organizational policies and cultural context; and (iii) family caregivers should be provided structured psychoeducational programs tailored to their specific needs and/or regular family meetings about dementia care at the end of life. CONCLUSION The findings provide useful information on which interventions may benefit family caregivers of people with advanced dementia at the end of life and where, when, and how they should be provided.
Collapse
Affiliation(s)
- Silvia Gonella
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy.,Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Gary Mitchell
- School of Nursing & Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, Northern Ireland
| | - Laura Bavelaar
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Alessio Conti
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Mariangela Vanalli
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, Roma, Italy
| | - Ines Basso
- School of Nursing, Azienda Ospedaliera "SS Antonio e Biagio e Cesare Arrigo," Alessandria, Italy
| | - Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| |
Collapse
|
42
|
McKinlay A, Mitchell G, Bertenshaw C. Review article: DINED (Delivery-related INjuries in the Emergency Department) part 1: A scoping review of risk factors and injuries affecting food delivery riders. Emerg Med Australas 2022; 34:150-156. [PMID: 35037394 DOI: 10.1111/1742-6723.13927] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/01/2021] [Accepted: 12/04/2021] [Indexed: 11/29/2022]
Abstract
This scoping review describes the current state of research about two-wheeled delivery riders who have been injured while performing commercial food delivery. The key areas of interest are the patterns of injury, associated risk factors and current gaps in knowledge. Five databases were searched to identify key papers that describe injuries to two-wheeled food delivery riders. Papers were assessed for quality and eligibility and key information was extracted relating to patterns of injury and risk factors. From an initial 264 records from PubMed, Embase, CINAHL, Scopus and SafetyLit, studies were screened by title, abstract and full text to yield 12 key papers for analysis. No papers reporting on Australian data were identified. Men comprise over 85% of workers in the food delivery industry. The average age of injured riders varies by country, but is commonly under 30 years old. Most injuries are lower limb musculoskeletal injuries, although there are no consistent data about frequency, severity or cost to the healthcare system. Twenty-three key risk factors were categorised according to rider characteristics, working conditions and environmental factors. The most common risk factors were younger age, lack of driving experience, time-pressured work and inadequate protective gear. There are very few publications describing food delivery rider injuries and risk factors. This is an emerging industry in which the worker population may be younger and more vulnerable. Given the different legal and cultural contexts across different countries, Australian-specific research is needed.
Collapse
Affiliation(s)
- Andrew McKinlay
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,The University of Queensland, Brisbane, Queensland, Australia.,Jamieson Trauma Institute, Brisbane, Queensland, Australia
| | - Claire Bertenshaw
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Queensland Ambulance Service, Brisbane, Queensland, Australia
| |
Collapse
|
43
|
Vuong KA, Manzanero S, Ungerer JPJ, Mitchell G, McWhinney B, Vallmuur K, Warren J, McCreanor V, Howell T, Pollard C, Schuetz M, Zournazi A, Cameron CM. Prevalence of Alcohol Consumption in Emergency department presentations (PACE) in Queensland, Australia, using alcohol biomarkers ethanol and phosphatidylethanol: an observational study protocol. BMJ Open 2021; 11:e047887. [PMID: 34753753 PMCID: PMC8578965 DOI: 10.1136/bmjopen-2020-047887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Alcohol use in patients presenting to the emergency department (ED) is a significant problem in many countries. There is a need for valid and reliable surveillance of the prevalence of alcohol use in patients presenting to the ED, to provide a more complete picture of the risk factors and inform targeted public health interventions. This PACE study will use two biomarkers, blood ethanol and phosphatidylethanol (PEth), to determine the patterns, presence and level of alcohol use in patients presenting to an Australian ED. METHODS AND ANALYSIS This is an observational prevalence study involving the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women's Hospital (RBWH) Emergency and Trauma Centre (ETC). Samples will be tested for acute and medium-term alcohol intake using the two biomarkers blood ethanol and PEth respectively, over one collection period of 10-12 days. Descriptive statistics such as frequencies, percentages, means, SD, medians and IQRs, will be used to describe the prevalence, pattern and distribution of acute and medium-term alcohol intake in the study sample. The correlation between acute and medium-term alcohol intake levels will also be examined. ETHICS AND DISSEMINATION This study has been approved by the RBWH Human Research Ethics Committee (reference, LNR/2019/QRBW/56859). Findings will be disseminated to key stakeholders such as RBWH ETC, Australasian College for Emergency Medicine, Royal Australasian College of Surgeons, Statewide Clinical Networks, and used to inform clinicians and hospital services. Findings will be submitted for publication in peer-reviewed journals and presentation at appropriate conferences.
Collapse
Affiliation(s)
- Kim A Vuong
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Accident Research and Road Safety - Queensland (CARRS-Q), Queensland University of Technology, Brisbane, Queensland, Australia
| | - Silvia Manzanero
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jacobus P J Ungerer
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- Faculty of Biomedical Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Mitchell
- Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Brett McWhinney
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Kirsten Vallmuur
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Jacelle Warren
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Victoria McCreanor
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | | | - Clifford Pollard
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Michael Schuetz
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Anna Zournazi
- Chemical Pathology, Pathology Queensland, Queensland Health, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| | - Cate M Cameron
- Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia
- Jamieson Trauma Institute, Royal Brisbane & Women's Hospital (RBWH), Metro North Health, Brisbane, Queensland, Australia
| |
Collapse
|
44
|
Carter G, Brown Wilson C, Mitchell G. The effectiveness of a digital game to improve public perception of dementia: A pretest-posttest evaluation. PLoS One 2021; 16:e0257337. [PMID: 34624040 PMCID: PMC8500403 DOI: 10.1371/journal.pone.0257337] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/30/2021] [Indexed: 12/04/2022] Open
Abstract
The global impact of dementia is a key healthcare priority, and although it is possible to live well with dementia, public perception is often negative. Serious digital games are becoming a credible delivery method to educate/train individuals in the business and health sectors and to challenge perceptions. The main objective of the study was to evaluate the effectiveness of a digital game prototype on individual attitudes towards dementia. A digital game to improve public knowledge and understanding about dementia (www.dementiagame.com) was co-designed with people living with dementia and student nurses. The Game was evaluated using a pretest-posttest design. Participants for the evaluation were recruited via social media in one UK university and completed the Approaches to Dementia Questionnaire (ADQ) before and after playing the game. Overall, 457 individuals completed both pre and post test questionnaires. The total ADQ score demonstrated a significant improvement in positive attitudes (p < 0.001), and both subscales of Hope and Recognition of Personhood also saw significant improvements (p < 0.001). The use of a serious digital game has demonstrated a significant effect on the respondents’ perceptions of dementia. Overall, there was a more positive view of the abilities of people with dementia and what their capabilities were. They were also more likely to be recognised as unique individuals with the same values as any other person. The benefit of using digital gaming to improve perceptions of dementia has been demonstrated, nonetheless further research is required to reach a more diverse population and test as a Randomised Control Trial to provide definitive evidence for use in policy and practice.
Collapse
Affiliation(s)
- Gillian Carter
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
| | | | - Gary Mitchell
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| |
Collapse
|
45
|
Harding A, Preston N, Doherty J, Cousins E, Varey S, McCann A, Dening KH, Finucane A, Carter G, Mitchell G, Brazil K. Developing and evaluating online COVID-centric advance care planning training and information resources for nursing staff and family members in nursing homes: the necessary discussions study protocol. BMC Geriatr 2021; 21:456. [PMID: 34372794 PMCID: PMC8350283 DOI: 10.1186/s12877-021-02398-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022] Open
Abstract
Background Nursing home residents are typically older adults with high levels of chronic illness and impairment. As such, they are particularly susceptible to severe complications and mortality from COVID-19. Since all nursing home residents are at increased risk, nursing home care staff need to know what residents would want to happen should they become infected with COVID-19. This study aims to develop and evaluate advance care planning (ACP) COVID-centric online training and information resources for nursing home staff and family members of residents, to improve care at the end of life during a COVID-19 outbreak. Based on the findings we will develop implementation guidelines for nursing homes to ensure wider impact and application during the pandemic and beyond. Methods The content of the training and information resources will be based on a rapid review of literature and guidance on ACP in the context of COVID-19 and consultation with the study expert reference group. An integrated communications company will then work alongside the research team to design the online training and information resources. To evaluate the resources, we will employ a multiple case study design where a nursing home (defined as an institutional setting in which nursing care is provided to older adults on-site 24 h a day) will be the unit of analysis or ‘case’. The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will guide the evaluation of implementation of the training and information resources. We will recruit and interview staff and family members from between 6 and 9 nursing homes across Northern Ireland, England and Scotland and gather quantitative data from a feedback survey included in the training and information resources. Discussion The Necessary Discussions study is very timely given the challenging experiences of nursing homes, their staff, residents and their family members during the COVID-19 pandemic. It meets a key need and addresses an important gap in research and practice. The training and information resources will be ‘COVID-centric’, but they will also have a longstanding relevance for future ACP practice in UK care homes. Trial registration ISRCTN registry (ID 18003630) on 19.05.21
Collapse
Affiliation(s)
- Andrew Harding
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Nancy Preston
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Julie Doherty
- School of Nursing and Midwifery, Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Emily Cousins
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Sandra Varey
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Adrienne McCann
- School of Nursing and Midwifery, Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Karen Harrison Dening
- School of Nursing and Midwifery, Faculty of Health and Life Sciences, De Montfort University, Leicester & Dementia UK, London, UK
| | - Anne Finucane
- Clinical Psychology, University of Edinburgh, Edinburgh & Marie Curie Hospice Edinburgh, Edinburgh, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK
| | - Kevin Brazil
- School of Nursing and Midwifery, Centre for Evidence and Social Innovation, Queen's University Belfast, Belfast, UK.
| |
Collapse
|
46
|
Mitchell G, Taylor J, Jin G, Snelling R. A review of minor traumatic brain injury presentations and their management in Brisbane emergency departments. Journal of Concussion 2021. [DOI: 10.1177/20597002211006551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective A retrospective audit of minor traumatic brain injury presentations to three Brisbane emergency departments aiming to assess rates of CT scans and compliance with the Canadian CT Head Rule (CCTHR), as well as reviewing the demographics of patients and their management. Method Minor traumatic brain injury presentations to the Emergency departments of the Royal Brisbane and Women’s Hospital, Redcliffe Hospital and Queen Elizabeth II Hospital between July 1st and August 30th, 2019 were identified via diagnosis searches in patient tracking systems. Data collected included patient demographics, use of CT scans and Abbreviated Westmead Post Traumatic Amnesia Scale assessment, length of stay and discharge advice regarding return to sport. Results 200 minor traumatic brain injury presentations were included. 75% of patients received a CT head with only 9% of these found to be non-compliant with the CCTHR. The most common indications for CTs were age >65, GCS <15 at 2 hours post injury and anticoagulation. Only 40% of patients that qualified for A-WTPAS received the assessment. 18% of presentations were due to sporting injuries and 69% were not given return to play advice. The average length of stay was 250 minutes with 41.5% of presentations longer than 4 hours. 99% of the patients were discharged home from the ED with 1% admitted. Conclusion The study characterised minor traumatic brain injury management across three emergency departments and showed that most patients received CT head scans that were indicated. However, other areas of management such as A-WPTAs and return to play advice must be improved.
Collapse
Affiliation(s)
- Gary Mitchell
- Royal Brisbane and Women's Hospital Emergency and Trauma Centre, Herston QLD, Australia
| | - Jack Taylor
- Royal Brisbane and Women's Hospital Emergency and Trauma Centre, Herston QLD, Australia
| | - Gilbert Jin
- Redcliffe Hospital Emergency Department, Redcliffe QLD, Australia
| | - Rahul Snelling
- Royal Brisbane and Women's Hospital Emergency and Trauma Centre, Herston QLD, Australia
| |
Collapse
|
47
|
Mitchell G, Scott J, Carter G, Wilson CB. Evaluation of a delirium awareness podcast for undergraduate nursing students in Northern Ireland: a pre-/post-test study. BMC Nurs 2021; 20:20. [PMID: 33441119 PMCID: PMC7804906 DOI: 10.1186/s12912-021-00543-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Delirium is a common disorder affecting several people in primary, secondary, and tertiary settings. The condition is frequently under-diagnosed leading to long-lasting physical and cognitive impairment or premature death. Despite this, there has been limited research on the impact of innovative approaches to delirium education amongst undergraduate nursing students. The aim of this study was to evaluate the effect of a delirium awareness podcast on undergraduate nursing student knowledge and confidence related to the condition in Northern Ireland. METHODS The intervention was a 60-min delirium awareness podcast, available throughout May 2020, to a convenience sample of year one undergraduate nursing students (n = 320) completing a BSc Honours Nursing degree programme in a Northern Ireland University. The podcast focused on how nursing students could effectively recognise, manage, and prevent delirium. Participants had a period of 4 weeks to listen to the podcast and complete the pre and post questionnaires. The questionnaires were comprised of a 35-item true-false Delirium Knowledge Questionnaire (DKQ), a 3-item questionnaire about professional confidence and a 7-item questionnaire evaluating the use of podcasting as an approach to promote knowledge and confidence about delirium. Data were analysed using paired t-tests and descriptive statistics. RESULTS Students improved across all three core areas in the post-test questionnaire, demonstrating improvements in knowledge about symptoms of delirium (7.78% increase), causes and risk factors of delirium (13.34% increase) and management of delirium (12.81% increase). In relation to perceived confidence, students reported a 46.50% increase in confidence related to recognition of delirium, a 48.32% increase in relation to delirium management and a 50.71% increase their ability to communicate about delirium. Both questionnaires were statistically significant (P < 0.001). The final questionnaire illustrated that nursing students positively evaluated the use of podcast for promoting their knowledge and confidence about delirium and 96.32% of nursing students believed that the podcast met their learning needs about delirium. CONCLUSIONS A 60-min podcast on delirium improved first year student nurse knowledge about delirium. Nursing students also expressed that this approach to delirium education was effective in their learning about the condition.
Collapse
Affiliation(s)
- Gary Mitchell
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast, County Antrim BT9 7BL Northern Ireland
| | - Jessica Scott
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast, County Antrim BT9 7BL Northern Ireland
| | - Gillian Carter
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast, County Antrim BT9 7BL Northern Ireland
| | - Christine Brown Wilson
- Queen’s University Belfast, School of Nursing and Midwifery, Medical Biology Centre, 97 Lisburn Road, Belfast, County Antrim BT9 7BL Northern Ireland
| |
Collapse
|
48
|
Mitchell G, McTurk V, Carter G, Brown-Wilson C. Emphasise capability, not disability: exploring public perceptions, facilitators and barriers to living well with dementia in Northern Ireland. BMC Geriatr 2020; 20:525. [PMID: 33272207 PMCID: PMC7713159 DOI: 10.1186/s12877-020-01933-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/26/2020] [Indexed: 11/21/2022] Open
Abstract
Background Improving public knowledge and understanding about dementia has been identified as a priority area by people living with the condition, researchers, educators, and policymakers for several years. Societies that have a better understanding of the condition are more likely to enable people living with dementia to enjoy a better quality of life. The aim of this study was to explore current public perceptions of dementia along with the facilitators and barriers to living well from the perspective of people living with the condition in Northern Ireland. Methods Four focus group interviews were conducted with a total of 20 people living with dementia across three Northern Irish Counties in June 2019. These interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was obtained for this study prior to data collection. Findings Following thematic analysis, three themes emerged in relation to barriers and facilitators to living well with dementia. These were: ‘Emphasis on Disability NOT Capability’, which highlighted societal misconceptions about the activities and modes of life which people with dementia could or could not do; ‘Normalise Dementia – We Don’t Want a Fool’s Pardon’, which focused on how the public could encourage people living with the condition to enjoy greater independence, and ‘Dementia isn’t a Death Sentence’, which considered how professionals, family members and friends treated the person after diagnosis. Conclusions Public perceptions about dementia have the potential to act as both facilitators and barriers to living well with dementia. People with dementia stated that they are more likely sustain wellbeing when they are valued and can maintain independence. On the contrary, poor public and professional attitudes to dementia had the potential to disempower people living with dementia.
Collapse
Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL.
| | - Victoria McTurk
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
| | - Gillian Carter
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
| | - Christine Brown-Wilson
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, County Antrim, Northern Ireland, BT9 7BL
| |
Collapse
|
49
|
McGowan K, Phillips T, Gielis E, Dover T, Mitchell G, Mutch A, Sexton C, Sowa PM, Ivanovski S. Developing a prototype for integrated dental and diabetes care: understanding needs and priorities. Aust Dent J 2020; 66:41-48. [PMID: 33159320 DOI: 10.1111/adj.12804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Periodontal treatment may be a useful adjunct to medical management of diabetes; however, oral health has not been integrated into multidisciplinary diabetes care in Australia. This study aimed to understand the needs of patients and staff at a diabetes clinic to inform a prototype of integrated dental and diabetes care. METHODS Quantitative and qualitative data were collected from patients and staff at West Moreton Diabetes Clinic (WMDC) between September-October 2019. Clinical information, survey responses and dental screening results were analysed for 41 patients. Semi-structured interviews were held with six patients and a focus group with seven staff. RESULTS Most patients (83%) had not seen a dentist in the previous year. Of the 37 patients with remaining natural teeth, 84% required periodontal assessment and 46% had multiple carious lesions. Unmet treatment needs and rates of access were similar for private and public dental patients. Staff and patients reported high levels of support for incorporation of dental care at WMDC. CONCLUSIONS Integrating oral health into diabetes management is well-supported by patients and staff to address significant unmet dental needs for both public and private dental patients. Incorporating dental screening/services within diabetes clinics may increase uptake and improve awareness of its importance in diabetes management.
Collapse
Affiliation(s)
- K McGowan
- Oral Health Service, West Moreton Health, Ipswich, Queensland, Australia.,School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - T Phillips
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - E Gielis
- Oral Health Service, West Moreton Health, Ipswich, Queensland, Australia
| | - T Dover
- Department of Medicine, Ipswich Hospital, West Moreton Health, Ipswich, Queensland, Australia.,School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - G Mitchell
- School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - A Mutch
- School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - C Sexton
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| | - P M Sowa
- Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, Australia
| | - S Ivanovski
- School of Dentistry, University of Queensland, Herston, Queensland, Australia
| |
Collapse
|
50
|
Foeller ME, Nosrat C, Krystosik A, Noel T, Gérardin P, Cudjoe N, Mapp-Alexander V, Mitchell G, Macpherson C, Waechter R, LaBeaud AD. Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study. BJOG 2020; 128:1077-1086. [PMID: 33040457 DOI: 10.1111/1471-0528.16562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN Retrospective observational study. SETTING Grenada. POPULATION Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
Collapse
Affiliation(s)
- M E Foeller
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - C Nosrat
- Program in Human Biology, Stanford University, Stanford, CA, USA
| | - A Krystosik
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| | - T Noel
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - P Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion.,Unité Mixte 134 PIMIT (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Sainte Clotilde, Réunion
| | - N Cudjoe
- Windward Islands Research and Education Foundation, True Blue, Grenada
| | - V Mapp-Alexander
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - G Mitchell
- Ministry of Health, St. Georges, Grenada
| | - C Macpherson
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - R Waechter
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - A D LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| |
Collapse
|