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Tariq H, Collins K, Dunn J, Tait D, Porter S. The Delphi of ORACLE: An Expert Consensus Survey for the Development of the Observational Risk Assessment of Contractures (Longitudinal Evaluation). Clin Rehabil 2024; 38:664-677. [PMID: 38332642 PMCID: PMC11005314 DOI: 10.1177/02692155241229285] [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: 09/06/2023] [Accepted: 01/12/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Despite rising prevalence rates, no standard tool is available to identify individuals at risk of developing contractures. This study aimed to gain expert consensus on items for the development of the Observational Risk Assessment Tool for Contractures: Longitudinal Evaluation (ORACLE) for care home residents. DESIGN A two-round, online modified Delphi study. PARTICIPANTS Panellists were qualified healthcare professionals with a background in physiotherapy, occupational therapy, nursing, and rehabilitation medicine. MAIN OUTCOME MEASURES In the first round, the experts were asked to rate the predesigned list of items on a Likert scale while in the second round, consensus was sought in the areas of disagreement identified in the previous round. RESULTS The two rounds of the Delphi survey included 30 and 25 panellists, respectively. The average clinical and academic experience of the panellists was 22.2 years and 10.5 years, respectively. The panel demonstrated a high level of consensus regarding the clinical factors (10 out of 15 items); preventive care approaches (9 out of 10 items), and contextual factors (12 out of 13 items) ranging from 70% to 100%. CONCLUSION This Delphi study determined expert consensus on items to be included in a contracture risk assessment tool (ORACLE). The items were related to factors associated with joint contractures, appropriate preventive care interventions, and potentially relevant contextual factors associated with care home settings. The promise of a risk assessment tool that includes these items has the capacity to reduce the risk of contracture development or progression and to trigger timely and appropriate referrals to help prevent further loss of function and independence.
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Affiliation(s)
- Hina Tariq
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Kathryn Collins
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Joel Dunn
- Community Therapy Team (Christchurch, Bournemouth & Poole), Dorset Healthcare University Foundation Trust, Poole, UK
| | - Desiree Tait
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Sam Porter
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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Baker RM, Ahmed M, Bertotti M, Cassidy J, Chipuriro R, Clewett E, Donaldson C, Elders A, Fenge LA, Fox J, Galway K, Gildea A, McGuinness A, McLean J, Manoukian S, Mason H, Morgan A, Mulholland J, O'Hare L, Paterson A, Porter S, Rendall J, Roy MJ, Seaman P, Simpson M, Steiner A, Kelly MP. Common health assets protocol: a mixed-methods, realist evaluation and economic appraisal of how community-led organisations (CLOs) impact on the health and well-being of people living in deprived areas. BMJ Open 2023; 13:e069979. [PMID: 36927592 PMCID: PMC10030928 DOI: 10.1136/bmjopen-2022-069979] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION This research investigates how community-led organisations' (CLOs') use of assets-based approaches improves health and well-being, and how that might be different in different contexts. Assets-based approaches involve 'doing with' rather than 'doing to' and bring people in communities together to achieve positive change using their own knowledge, skills and experience. Some studies have shown that such approaches can have a positive effect on health and well-being. However, research is limited, and we know little about which approaches lead to which outcomes and how different contexts might affect success. METHODS AND ANALYSIS Using a realist approach, we will work with 15 CLOs based in disadvantaged communities in England, Scotland and Northern Ireland. A realist synthesis of review papers, and a policy analysis in different contexts, precedes qualitative interviews and workshops with stakeholders, to find out how CLOs' programmes work and identify existing data. We will explore participants' experiences through: a Q methodology study; participatory photography workshops; qualitative interviews and measure outcomes using a longitudinal survey, with 225 CLO participants, to assess impact for people who connect with the CLOs. An economic analysis will estimate costs and benefits to participants, for different contexts and mechanisms. A 'Lived Experience Panel' of people connected with our CLOs as participants or volunteers, will ensure the appropriateness of the research, interpretation and reporting of findings. ETHICS AND DISSEMINATION This project, research tools and consent processes have been approved by the Glasgow Caledonian University School of Health and Life Sciences Ethics Committee, and affirmed by Ethics Committees at Bournemouth University, Queen's University Belfast and the University of East London. Common Health Assets does not involve any National Health Service sites, staff or patients.Findings will be presented through social media, project website, blogs, policy briefings, journal articles, conferences and visually in short digital stories, and photographic exhibitions.
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Affiliation(s)
- Rachel Mairi Baker
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | | | - Marcello Bertotti
- Institute for Connected Communities, University of East London, London, UK
| | - John Cassidy
- Scottish Communities for Health and Wellbeing, Glasgow, UK
| | - Rejoice Chipuriro
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Emma Clewett
- Institute for Connected Communities, University of East London, London, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Andrew Elders
- NMAHP Research Unit, Glasgow Caledonian University School of Health and Life Sciences, Glasgow, UK
| | - Lee Ann Fenge
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Julie Fox
- Annexe Communities Glasgow, Glasgow, UK
| | - Karen Galway
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Aideen Gildea
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Sarkis Manoukian
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Helen Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Antony Morgan
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Jill Mulholland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Liam O'Hare
- Innovation Zones, School of Social Science, Education and Social Work, Queen's University Belfast, Belfast, UK
| | | | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Jack Rendall
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Michael J Roy
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Peter Seaman
- Glasgow Centre for Population Health, Glasgow, UK
| | | | - Artur Steiner
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Michael P Kelly
- Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Abstract
BACKGROUND The COVID-19 pandemic has disrupted advance care planning discussions in care homes, particularly discussions involving relatives and surrogate decision makers. There is a need to collate and examine current evidence to assess the extent of the problem. AIM To examine the processes and experiences involved in advance care planning in care homes throughout the COVID-19 pandemic. DESIGN A critical realist review and synthesis. DATA SOURCES MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and May 2022. RESULTS Eleven studies were included. Communication difficulties associated with remote technologies meant that care home staff's concerns about engaging effectively with relatives further exacerbated the emotional toll of dealing with high death rates in circumstances where staff shortages stretched the capacity of those remaining to provide timely advance care planning discussions. The threat of the pandemic tended to encourage earlier and more frequent advance care planning discussions, though this tendency was partially countervailed by the difficulties that some residents and relatives had in engaging with remote communication modes. There was evidence that education and training in advance care planning increased staff's confidence and readiness to engage in care planning during pandemic conditions. CONCLUSION Results highlight part of the new context facing staff, relatives and residents in care homes, thus providing valuable insight for future intervention development required to maintain and improve the effectiveness of advance care planning in care homes during and beyond the pandemic.
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Affiliation(s)
- Adam Spacey
- School of Health and Society, University of Salford, Salford, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
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Blair C, Shields J, Mullan R, Johnston W, Davenport A, Fouque D, Kalantar-Zadeh K, Maxwell P, McKeaveney C, Noble H, Porter S, Seres D, Slee A, Swaine I, Witham M, Reid J. Exploring the lived experience of renal cachexia for individuals with end-stage renal disease and the interrelated experience of their carers: Study protocol. PLoS One 2022; 17:e0277241. [PMID: 36327348 PMCID: PMC9632830 DOI: 10.1371/journal.pone.0277241] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Renal cachexia is an important consideration in the person-centred care that is needed in end-stage renal disease (ESRD). However, given that clinical guidelines relating to renal cachexia are largely absent, this is an unmet care need. To inform guidelines and future renal service planning, there is an urgency to understand individuals’ experiences of renal cachexia and the interrelated experiences of the carers in their lives. We report here the protocol for an interpretative phenomenological study which will explore this lived experience. A purposive sampling strategy will recruit individuals living with ESRD who have cachexia and their carers. A maximum of 30 participants (15 per group) dependent on saturation will be recruited across two nephrology directorates, within two healthcare trusts in the United Kingdom. Individuals with renal cachexia undergoing haemodialysis will be recruited via clinical gatekeepers and their carers will subsequently be invited to participate in the study. Participants will be offered the opportunity to have a face-to-face, virtual or telephone interview. Interviews will be audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. NVivo, will be used for data management. Ethical approval for this study was granted by the Office for Research Ethics Committees Northern Ireland (REC Reference: 22/NI/0107). Scientific evidence tends to focus on measurable psychological, social and quality of life outcomes but there is limited research providing in-depth meaning and understanding of the views of individuals with renal disease who are experiencing renal cachexia. This information is urgently needed to better prepare healthcare providers and in turn support individuals with ESRD and their carers. This study will help healthcare providers understand what challenges individuals with ESRD, and their carers face in relation to cachexia and aims to inform future clinical practice guidelines and develop supportive interventions which recognise and respond to the needs of this population.
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Affiliation(s)
- Carolyn Blair
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Joanne Shields
- Regional Nephrology Unit, Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - Robert Mullan
- Renal Unit, Antrim Area Hospital, Northern Health & Social Care Trust, Antrim, United Kingdom
| | - William Johnston
- Northern Ireland Kidney Patients Association, Belfast, United Kingdom
| | - Andrew Davenport
- UCL Department of Renal Medicine Royal Free Hospital University College London, London, United Kingdom
| | - Denis Fouque
- Division of Nephrology, Dialysis and Nutrition, Hôpital Lyon Sud and University of Lyon, Pierre-Bénite, France
| | - Kamyar Kalantar-Zadeh
- Irvine Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Irvine, CA, United States of America
| | - Peter Maxwell
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Helen Noble
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, United Kingdom
| | - David Seres
- Institute of Human Nutrition and Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Adrian Slee
- Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Ian Swaine
- School of Human Sciences, University of Greenwich, Greenwich, United Kingdom
| | - Miles Witham
- Campus for Ageing and Vitality, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
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Porter S, Cannon E. 118 ARE CLIENTS SATISFIED WITH INTEGRATED CARE? CLIENT FEEDBACK ON DISCHARGE FROM A DOMICILIARY-BASED MULTIDISCIPLINARY INTEGRATED CARE SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.097] [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: 11/13/2022] Open
Abstract
Abstract
Background
The Integrated Care Team for Older Persons (ICTOP) team was established in November 2017. The process of client feedback was not developed at this time. Team members received feedback from clients and families in an “ad hoc” basis. There was no formalised method of collecting data. From collating this data in a formal manner, the aim was to evaluate and reflect on the data received to improve on client experience and practice development of the ICTOP Team
Methods
Qualitative study design. The feedback questionnaire was adapted from the Integrated Care Team Older Persons, Community Healthcare East. It is a seven item questionnaire with an additional section for open ended comment and or suggestion for team improvement. A client-feedback form was sent to clients discharged from the ICTOP service during the months January-August 2020 inclusive (n= 97). Completed feedback anonymised forms were received and information collated (n=56). The respondent rate was 57.7%. Thematic analysis was utilised to appraise recurring themes in the open-ended section of the completed forms
Results
All participants agreed that they were satisfied with ICTOP intervention and were involved with decisions regarding their care. 66% of Participants also provided individual comments which were overwhelmingly positive with 7% providing recommendation for service development. All Participants would recommend this team/service to another older person.
Conclusion
Older people accessing integrated care delivered in their home reported a positive experience and appreciated the MDT input. Receiving feedback on the service enables the team to understand the effect and experience of treatment, interventions and interactions with our clients.
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Affiliation(s)
- S Porter
- Integrated Care Team for Older Persons , Sligo, Ireland
| | - E Cannon
- Integrated Care Team for Older Persons , Sligo, Ireland
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Culley L, Porter S. Guest Editorial. J Res Nurs 2022; 27:198-199. [PMID: 35813179 PMCID: PMC9264420 DOI: 10.1177/17449871221093206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lorraine Culley
- Emeritus Professor, Applied Social Sciences, De Montfort University, Leicester, UK
| | - Sam Porter
- Professor, Department of Social Work and Social Sciences Bournemouth Gateway Building, Bournemouth, UK
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Tariq H, Collins K, Tait D, Dunn J, Altaf S, Porter S. Factors associated with joint contractures in adults: a systematic review with narrative synthesis. Disabil Rehabil 2022; 45:1755-1772. [PMID: 35544581 DOI: 10.1080/09638288.2022.2071480] [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] [Indexed: 11/03/2022]
Abstract
PURPOSE The primary objective of the review was to collate the available evidence on factors associated with joint contractures in adults. METHODS A systematic literature search was conducted on MEDLINE, CINAHL, AMED, and EMBASE. Studies that involved participants aged ≥18 and assessed joint contracture as a primary or secondary outcome were included. Two independent reviewers screened studies against the eligibility criteria, performed data extraction, and assessed the quality of evidence. A narrative synthesis by domain and sub-domain was undertaken. The protocol was registered on PROSPERO: CRD42019145079. RESULTS Forty-seven studies were included in the review. Identified factors were broadly classified into three major domains: sociodemographic factors, physical factors, and proxies for bed confinement. Sociodemographic factors were not associated with joint contractures. Functional ability, pain, muscle weakness, physical mobility, and bed confinement provided the most consistent evidence of association with joint contractures. The evidence regarding the relationship between spasticity and joint contractures remains unclear. Other factors might be important, but there was insufficient evidence to make inferences. CONCLUSIONS The review identified and collated evidence on factors associated with joint contractures, which can be utilised to develop effective prevention and management strategies. Implications for rehabilitationClinical interventions based on the timely identification of risks related to joint contractures in vulnerable adults have the potential to prevent or ameliorate their development or progression.Quality and consistency of care for vulnerable adults would be enhanced by developing effective joint contracture prevention and rehabilitation strategies based on the evidence presented in this review.As many vulnerable adults are located in the community or non-acute care settings, strategies should target these loci of care.Structured risk assessments that can support non-physiotherapy staff working in these loci of care to identify risks related to joint contractures would provide an important resource for risk management.
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Affiliation(s)
- Hina Tariq
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Kathryn Collins
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Desiree Tait
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Joel Dunn
- Dorset Healthcare University Foundation Trust, Poole, UK
| | - Shafaq Altaf
- Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Sam Porter
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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Gangata H, Porter S, Major K, Artz N. A core anatomy syllabus for undergraduate physiotherapy students preparing for entry-level Band-5 physiotherapist posts in the United Kingdom. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McKeaveney C, Slee A, Adamson G, Davenport A, Farrington K, Fouque D, Kalantar-Zadeh K, Mallett J, Maxwell AP, Mullan R, Noble H, O'Donoghue D, Porter S, Seres DS, Shields J, Witham M, Reid J. Using a generic definition of cachexia in patients with kidney disease receiving haemodialysis: a longitudinal (pilot) study. Nephrol Dial Transplant 2021; 36:1919-1926. [PMID: 33150449 DOI: 10.1093/ndt/gfaa174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 02/03/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Research indicates that cachexia is common among persons with chronic illnesses and is associated with increased morbidity and mortality. However, there continues to be an absence of a uniformed disease-specific definition for cachexia in chronic kidney disease (CKD) patient populations. OBJECTIVE The primary objective was to identify cachexia in patients receiving haemodialysis (HD) using a generic definition and then follow up on these patients for 12 months. METHOD This was a longitudinal study of adult chronic HD patients attending two hospital HD units in the UK. Multiple measures relevant to cachexia, including body mass index (BMI), muscle mass [mid-upper arm muscle circumference (MUAMC)], handgrip strength (HGS), fatigue [Functional Assessment of Chronic Illness Therapy (FACIT)], appetite [Functional Assessment of Anorexia/Cachexia Therapy (FAACT)] and biomarkers [C-reactive protein (CRP), serum albumin, haemoglobin and erythropoietin resistance index (ERI)] were recorded. Baseline analysis included group differences analysed using an independent t-test, dichotomized values using the χ2 test and prevalence were reported using the Statistical Package for the Social Sciences 24 (IBM, Armonk, NY, USA). Longitudinal analysis was conducted using repeated measures analysis. RESULTS A total of 106 patients (30 females and 76 males) were recruited with a mean age of 67.6 years [standard deviation (SD) 13.18] and dialysis vintage of 4.92 years (SD 6.12). At baseline, 17 patients were identified as cachectic, having had reported weight loss (e.g. >5% for >6 months) or BMI <20 kg/m2 and three or more clinical characteristics of cachexia. Seventy patients were available for analysis at 12 months (11 cachectic versus 59 not cachectic). FAACT and urea reduction ratio statistically distinguished cachectic patients (P = 0.001). However, measures of weight, BMI, MUAMC, HGS, CRP, ERI and FACIT tended to worsen in cachectic patients. CONCLUSION Globally, cachexia is a severe but frequently underrecognized problem. This is the first study to apply the defined characteristics of cachexia to a representative sample of patients receiving HD. Further, more extensive studies are required to establish a phenotype of cachexia in advanced CKD.
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Affiliation(s)
- Clare McKeaveney
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Adrian Slee
- Division of Medicine, Faculty of Medical Sciences, University College London, London, UK
| | - Gary Adamson
- School of Psychology, Ulster University, Coleraine Campus, Londonderry, UK
| | - Andrew Davenport
- UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK
| | - Ken Farrington
- Renal Unit, Lister Hospital, East and North Hertfordshire University NHS Trust, Stevenage, UK
| | - Denis Fouque
- Department of Nephrology, Centre Hospitalier Lyon Sud, University Lyon, CARMEN, Pierre-Benite, France
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension, University of California Irvine, Orange, California 92868, USA
| | - John Mallett
- School of Psychology, Ulster University, Coleraine Campus, Londonderry, UK
| | - Alexander P Maxwell
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Science, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland.,Regional Nephrology Unit, Belfast City Hospital, Belfast Health Social Care Trust, Belfast, BT9 7AB, Northern Ireland
| | - Robert Mullan
- Department of Nephrology, Antrim Area Hospital, Northern Health Social Care Trust, Antrim, BT41 2RL, Northern Ireland
| | - Helen Noble
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | | | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, UK
| | - David S Seres
- Department of Medicine, Columbia University Medical Centre / New York Presbyterian Hospital, New York, USA
| | - Joanne Shields
- Regional Nephrology Unit, Belfast City Hospital, Belfast Health Social Care Trust, Belfast, BT9 7AB, Northern Ireland
| | - Miles Witham
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
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Abstract
BACKGROUND Current evidence suggests that COVID-19 is having a negative impact on the delivery of end of life care in care homes around the world. There is a need to collate current evidence to provide a comprehensive overview to assess extent of the problem. AIM To describe and evaluate the impact of the COVID-19 pandemic on end of life care delivery in care homes. DESIGN Systematic review and narrative synthesis of studies reporting qualitative and quantitative data. DATA SOURCES The databases MEDLINE, psycINFO, SCOPUS and CINAHL were searched between December 2019 and March 2021. RESULTS Nine studies were included. For care home staff, challenges included significant increases in responsibility and exposure to death, both of which have taken an emotional toll. Results indicate that staff tended not to be offered adequate emotional support or afforded the time to grieve. For those receiving end of life care, results indicate that the end of life care that they tended to receive, especially in the form of advance planning, was disrupted by the pandemic. CONCLUSION The effect of the pandemic has been to exacerbate existing problems in the provision of end of life care in care homes for both service providers and users, making that which was previously opaque starkly visible. Future research is needed to explore the effects of the pandemic and its management on those receiving end of life care in care homes and their significant others.
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Affiliation(s)
- Adam Spacey
- School of Health and Society, University of Salford, Salford, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
| | - Michele Board
- Department of Nursing Science, Bournemouth University, Poole, UK
| | - Janet Scammell
- Department of Nursing Science, Bournemouth University, Poole, UK
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McKeaveney C, Slee A, Adamson G, Davenport A, Farrington K, Fouque D, Kalantar-Zadeh K, Mallett J, Maxwell AP, Mullan R, Noble H, O'Donoghue D, Porter S, Seres DS, Shields J, Witham M, Reid J. Erratum. Nephrol Dial Transplant 2021; 36:1554. [PMID: 33674859 DOI: 10.1093/ndt/gfaa320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Spacey A, Scammell J, Board M, Porter S. A critical realist evaluation of advance care planning in care homes. J Adv Nurs 2021; 77:2774-2784. [PMID: 33751625 DOI: 10.1111/jan.14822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 10/19/2020] [Revised: 02/12/2021] [Accepted: 02/23/2021] [Indexed: 11/30/2022]
Abstract
AIMS To evaluate care planning in advance of end-of-life care in care homes. DESIGN A qualitative study. METHODS Qualitative data were collected from January 2018-July 2019 (using focus groups and semi-structured interviews) from three care homes in the South West of England. The data were analysed using thematic analysis followed by Critical Realist Evaluation. RESULTS Participants comprised of registered nurses (N = 4), care assistants (N = 8), bereaved relatives (N = 7), and domiciliary staff (N = 3). Although the importance of advance care planning was well recognized, the emotional labour of frequently engaging in discussions about death and dying was highlighted as a problem by some care home staff. It was evident that in some cases care home staff's unmet emotional needs led them to rushing and avoiding discussions about death and dying with residents and relatives. A sparsity of mechanisms to support care home staff's emotional needs was noted across all three care homes. Furthermore, a lack of training and knowledge appeared to inhibit care home staff's ability to engage in meaningful care planning conversations with specific groups of residents such as those living with dementia. The lack of training was principally evident amongst non-registered care home staff and those with non-formal caring roles such as housekeeping. CONCLUSION There is a need for more focused education to support registered and non-registered care home staff to effectively engage in sensitive discussions about death and dying with residents. Furthermore, greater emotional support is necessary to help build workforce resilience and sustain change. IMPACT Knowledge generated from this study can be used to inform the design and development of future advance care planning interventions capable of supporting the delivery of high-quality end-of-life care in care homes.
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Affiliation(s)
- Adam Spacey
- School of Health and Society, University of Salford, Salford, UK
| | - Janet Scammell
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Michele Board
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
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Mitchell G, Porter S, Manias E. Enabling sustained communication with patients for safe and effective management of oral chemotherapy: A longitudinal ethnography. J Adv Nurs 2020; 77:899-909. [PMID: 33210337 DOI: 10.1111/jan.14634] [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] [Received: 12/27/2019] [Revised: 09/09/2020] [Accepted: 10/26/2020] [Indexed: 01/01/2023]
Abstract
AIMS To examine how patients received, understood, and acted on healthcare professional communication about their oral chemotherapeutic regimen throughout their treatment. DESIGN A longitudinal ethnographic study. METHODS Over 60 hr of observational data were recorded, in the form of field notes and audio-recordings from interactions among nine oncology doctors, six oncology nurses, eight patients, and 11 family members over a period of 6 months in outpatient departments in one hospital in Northern Ireland. Sixteen semi-structured interviews with patients and three focus groups with healthcare professionals were also carried out. This study took place from October 2013-June 2016. Data were thematically analysed. RESULTS Three themes where identified from the data. These were initiating concordance through first communication about oral chemotherapy; which focused on initial communication during oncology consultations about oral chemotherapy, sustained communication of managing chemotherapy side effects; which was about how communication processes supported timely and effective side effect management and un-sustained communication of oral chemotherapy medication-taking practice; when patients and healthcare professionals failed to communicate effectively about chemotherapy medication-taking. CONCLUSION The two most important factors in ensuring the optimal management of oral chemotherapeutic medicines are early recognition and appropriate response to side effects and the maintenance of safe and effective medication administration. This study found that oncology doctors and nurses engaged in sustained communication about the side effects of chemotherapy but did not focus their communication on safe administration after the first consultation. IMPACT Based on this evidence, we recommend that healthcare professionals who provide oral chemotherapy for home administration should review their processes and procedures. Healthcare professionals need to ensure that they embed frequent communication for the duration of treatment between themselves and patients, including open discussion and advice, about side effects and medication administration.
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Affiliation(s)
- Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Sam Porter
- Department of Social Sciences & Social Work, Bournemouth University, Poole, UK
| | - Elizabeth Manias
- School of Nursing & Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Burwood, Vic., Australia
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14
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Gujral D, Nazir S, Hunter B, McNaught P, Williams L, Porter S, Coughlan S, Cleator S. PO-0930: Wide tangents versus volumetric arc therapy to treat the internal mammary chain using breath hold. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00947-6] [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: 10/22/2022]
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15
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Slee A, McKeaveney C, Adamson G, Davenport A, Farrington K, Fouque D, Kalantar-Zadeh K, Mallett J, Maxwell AP, Mullan R, Noble H, O'Donoghue D, Porter S, Seres DS, Shields J, Witham M, Reid J. Estimating the Prevalence of Muscle Wasting, Weakness, and Sarcopenia in Hemodialysis Patients. J Ren Nutr 2020; 30:313-321. [DOI: 10.1053/j.jrn.2019.09.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/26/2019] [Accepted: 09/08/2019] [Indexed: 11/11/2022] Open
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16
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Seres D, Mckeaveney C, Adamson G, Davenport A, Farrington K, Fouque D, Kalanter-Zadeh K, Mallett J, Maxwell P, Mullan R, Nobel H, O'Donoghue D, Porter S, Shields J, Slee A, Witham M, Reid J. Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa055_029] [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: 11/14/2022] Open
Abstract
Abstract
Objectives
This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis.
Methods
Patients receiving haemodialysis (n = 87, mean age 65.9 +/− 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted.
Results
The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01).
Conclusions
This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies.
Funding Sources
Public Health Agency; Northern Ireland Kidney Research Fund.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Peter Maxwell
- Queens University Belfast & Regional Nephrology Unit, Belfast City Hospital, Belfast, UK
| | - Robert Mullan
- Nephrology Department, Northern Health & Social Care Trust, UK
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17
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Spacey A, Scammell J, Board M, Porter S. Systematic critical realist review of interventions designed to improve end-of-life care in care homes. Nurs Health Sci 2019; 22:343-354. [PMID: 31797527 DOI: 10.1111/nhs.12665] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 07/10/2019] [Revised: 09/28/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022]
Abstract
The demand for high-quality end-of-life care is rising. Frequently evidenced concerns about the provision of end-of-life in care homes relate to inter-disciplinary communication and engagement in advance care planning. A number of interventions employing different mechanisms have been designed to address these issues. Therefore, the aim of this systematic critical realist review was to describe and explain the effectiveness of interventions designed to improve end-of-life care in care homes. Electronic searches were conducted in ScienceDirect, MEDLINE, PubMed, PsychINFO, and CINAHL from January 2000 to August 2018. Forty one studies were included in the review. While most of the evidence identified in this review was not strong, there was evidence to suggest that education and inter-professional collaboration can be effective intervention mechanisms for improving end-of-life care in care homes. High staff turnover was a significant contextual mechanism impacting on the sustainability of interventions. In terms of human agency, it is important to note a consistent finding related to the dedication and enthusiasm of care home staff who deliver end-of-life care.
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Affiliation(s)
- Adam Spacey
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Janet Scammell
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Michele Board
- Department of Adult Nursing, Bournemouth University, Poole, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
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18
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Porter S. Commentary: A qualitative examination of the perceived impact of bureaucratic managerialism on evidence-based practice implementation in Nigeria: a collective case study. J Res Nurs 2019; 24:647-648. [DOI: 10.1177/1744987119883695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Sam Porter
- Professor of Nursing Sociology, Head of Department of Social Sciences and Social Work, Bournemouth University, UK
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19
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Gordon DT, Okuma K, DeVries JW, Fukuhara K, Jacob W, Kuriyama N, Li BW, Matsuda I, McMonagle K, Parr GD, Porter S, Strong S, Sugimoto T, Tsuji K, Wolf B. Determination of Total Dietary Fiber in Selected Foods Containing Resistant Maltodextrin by Enzymatic-Gravimetric Method and Liquid Chromatography: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.435] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A method was developed for determination of total dietary fiber (TDF) in foods containing resistant maltodextrin (RMD) which includes nondigestible carbohydrates that are not fully recovered as dietary fiber by conventional TDF methods such as AOAC 985.29 or 991.43. Because the average molecular weight (MW) of RMD is 2000 daltons, lower MW soluble dietary fiber components do not precipitate in 78% ethanol; therefore, RMD is not completely quantitated as dietary fiber by current AOAC methods. The accuracy and precision of the method was evaluated through an AOAC collaborative study. Ten laboratories participated and assayed 12 test portions (6 blind duplicates) containing RMD. The 6 test pairs ranged from 1.5 to 100% RMD. The method consisted of the following steps: (1) The insoluble dietary fiber (IDF) and high MW soluble dietary fiber (HMWSDF) were determined by AOAC 985.29. (2) Ion exchange resins were used to remove salts and proteins contained in the AOAC 985.29 filtrates (including ethanol and acetone). (3) The amount of low MWRMD (LMWRMD) in the filtrates were determined by liquid chromatography. (4) The TDF was calculated by summation of the IDF, HMWSDF, and LMWRMD fractions having nondigestible carbohydrates with a degree of polymerization of 3 and higher. Repeatability standard deviations (RSDr) were 1.33–7.46%, calculated by including outliers, and 1.33–6.10%, calculated by not including outliers. Reproducibility standard deviations (RSDR) were 2.48–9.39%, calculated by including outliers, and 1.79–9.39%, calculated by not including outliers. This method is recommended for adoption as Official First Action.
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Affiliation(s)
- Dennis T Gordon
- North Dakota State University, Department of Cereal Science, Harris Hall 110, Fargo, ND 58105
| | - Kazuhiro Okuma
- Matsutani Chemical Industry Co., Ltd., Research Laboratory, 5-3 Kitaitami, Itami City, Hyogo, Japan 664-8508
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20
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Berry SE, Bruce JH, Steenson S, Stanner S, Buttriss JL, Spiro A, Gibson PS, Bowler I, Dionisi F, Farrell L, Glass A, Lovegrove JA, Nicholas J, Peacock E, Porter S, Mensink RP, L Hall W. Interesterified fats: What are they and why are they used? A briefing report from the Roundtable on Interesterified Fats in Foods. NUTR BULL 2019. [DOI: 10.1111/nbu.12397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | - A. Spiro
- British Nutrition Foundation London UK
| | | | | | | | | | - A. Glass
- Food and Drink Federation London UK
| | | | | | | | - S. Porter
- British Dietetic Association Birmingham UK
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21
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Affiliation(s)
- Sam Porter
- Faculty of Health and Social Sciences Bournemouth University Poole UK
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22
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Ruane‐McAteer E, Porter S, O'Sullivan J, Dempster M, Prue G. Investigating the psychological impact of active surveillance or active treatment in newly diagnosed favorable‐risk prostate cancer patients: A 9‐month longitudinal study. Psychooncology 2019; 28:1743-1752. [DOI: 10.1002/pon.5161] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/12/2019] [Accepted: 06/20/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Eimear Ruane‐McAteer
- School of Nursing and Midwifery, Medical Biology CentreQueen's University Belfast Belfast UK
| | - Sam Porter
- Department of Social Sciences and Social WorkBournemouth University Bournemouth UK
| | - Joe O'Sullivan
- The Northern Ireland Cancer CentreBelfast City Hospital Belfast UK
- Centre for Cancer Research and Cell BiologyQueen's University Belfast Belfast UK
| | | | - Gillian Prue
- School of Nursing and Midwifery, Medical Biology CentreQueen's University Belfast Belfast UK
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23
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Mc Veigh C, Reid J, Larkin P, Porter S, Hudson P. Palliative care for people with non-malignant respiratory disease and their carers: a review of the current evidence. J Res Nurs 2019; 24:420-430. [PMID: 34394556 DOI: 10.1177/1744987119840066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Internationally, non-malignant respiratory disease is on the increase. However, although palliative care is recommended as an appropriate healthcare option for this client group, evidence suggests that these patients and their carers do not receive the same standards of palliative care as patients with a malignant lung condition. Aim The aim of this review was to provide a critical overview of the current evidence base in relation to the palliative service provision for people with non-malignant respiratory disease and their carers. Methods A review of the literature was conducted in July 2015 and updated in October 2017 and focused on the palliative care service provision for patients with interstitial lung disease, chronic obstructive pulmonary disease and bronchiectasis. Results In total, 71 empirical studies were included in the review and grouped into two main themes: patient and carer's bio-psychosocial symptom needs and management, and palliative care service provision for patients with non-malignant respiratory disease and their carers. Conclusion The majority of palliative research focuses on patients with a diagnosis of chronic obstructive pulmonary disease. A deeper insight is required into the palliative service provision experienced by those with other forms of non-malignant respiratory disease such as bronchiectasis and interstitial lung disease.
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Affiliation(s)
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, UK
| | - Philip Larkin
- School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, UK
| | - Peter Hudson
- Centre for Palliative Care, Vincent's University Hospital, Melbourne, Australia
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24
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Kirkwood J, Graham-Wisener L, McConnell T, Porter S, Reid J, Craig N, Dunlop C, Gordon C, Thomas D, Godsal J, Vorster A. The MusiQual treatment manual for music therapy in a palliative care inpatient setting. British Journal of Music Therapy 2019. [DOI: 10.1177/1359457519834533] [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]
Abstract
This article presents the treatment manual developed during the MusiQual feasibility study carried out in Belfast by Queen’s University Belfast, Every Day Harmony Music Therapy, and Marie Curie Northern Ireland. The MusiQual study considered the feasibility of a multicentre randomised trial to evaluate the effectiveness of music therapy in improving the quality of life of hospice inpatients (protocol: McConnell et al. results: Porter et al.). The procedures in the manual are based fully on those implemented by the Music Therapists during the feasibility study, and it also incorporates the theoretical model defined and published following the realist review of the literature (McConnell and Porter). The manual is presented in the format in which it would be used in the potential future phase III multicentre randomised control trial. It represents a flexible approach to provide enough scope for practicing therapists to adapt their interventions to individual clients as is best practice in music therapy. It aims to provide stable guidelines both to ensure treatment fidelity in a future trial of music therapy for palliative care inpatients and to act as a relevant guide for Music Therapists practicing in this field.
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25
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Porter S. Commentary: Sexuality as taboo: using interpretative phenomenological analysis and a Foucauldian lens to explore fathers' practices in talking to their children about puberty, relationships and reproduction. J Res Nurs 2019; 24:34-35. [PMID: 34394502 DOI: 10.1177/1744987118819365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sam Porter
- Professor of Nursing Sociology, Department of Social Sciences and Social Work, Bournemouth University, UK
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26
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Rafkin L, Sosenko JM, Kenyon NS, Santiago I, Krischer JP, Bundy B, Abbondondolo M, Dixit S, Pasha M, King K, Adcock H, Atterberry L, Fox K, Englert N, Mauras J, Permuy K, Sikes T, Adams T, Berhe B, Guendling L, McLennan L, Paganessi C, Murphy M, Draznin M, Kamboj S, Sheppard V, Lewis L, Coates W, Amado D, Moore G, Babar J, Bedard D, Brenson-Hughes J, Cernich M, Clements R, Duprau S, Goodman L, Hester L, Huerta-Saenz A, Asif I, Karmazin T, Letjen S, Raman D, Morin W, Bestermann E, Morawski J, White A, Brockmyer R, Bays S, Campbell A, Boonstra M, Stapleton N, Stone A, Donoho H, Everett H, Hensley M, Johnson C, Marshall N, Skirvin P, Taylor R, Williams L, Burroughs C, Ray C, Wolverton D, Nickels C, Dothard P, Speiser M, Pellizzari L, Bokor K, Izuora S, Abdelnour P, Cummings S, Cuthbertson D, Paynor M, Leahy M, Riedl S, Shockley R, Saad T, Briones S, Casella C, Herz K, Walsh J, Greening F, Deemer M, Hay S, Hunt N, Sikotra L, Simons D, Karounos R, Oremus L, Dye L, Myers D, Ballard W, Miers R, Eberhard C, Sparks K, Thraikill K, Edwards J, Fowlkes S, Kemp A, Morales L, Holland L, Johnson P, Paul A, Ghatak K, Fiske S, Phelen H, Leyland T, Henderson D, Brenner E, Oppenheimer I, Mamkin C, Moniz C, Clarson M, Lovell A, Peters V, Ford J, Ruelas D, Borut D, Burt M, Jordan S, Castilla P, Flores M, Ruiz L, Hanson J, Green-Blair R, Sheridan K, Garmeson J, Wintergerst G, Pierce A, Omoruyi M, Foster S, Kingery A, Lunsford I, Cervantes T, Parker P, Price J, Urben I, Guillette H, Doughty H, Haydock V, Parker P, Bergman S, Duncum C, Rodda A, Perelman R, Calendo C, Barrera E, Arce-Nunez Y, Geyer S, Martinez M, De la Portilla I, Cardenas L, Garrido M, Villar R, Lorini E, Calandra G, D’Annuzio K, Perri N, Minuto C, Hays B, Rebora R, Callegari O, Ali J, Kramer B, Auble S, Cabrera P, Donohoue R, Fiallo-Scharer M, Hessner P, Wolfgram A, Henderson C, Kansra N, Bettin R, McCuller A, Miller S, Accacha J, Corrigan E, Fiore R, Levine T, Mahoney C, Polychronakos V, Henry M, Gagne H, Starkman M, Fox D, Chin F, Melchionne L, Silverman I, Marshall L, Cerracchio J, Cruz A, Viswanathan J, Heyman K, Wilson S, Chalew S, Valley S, Layburn A, Lala P, Clesi M, Genet G, Uwaifo A, Charron T, Allerton W, Hsiao B, Cefalu L, Melendez-Ramirez R, Richards C, Alleyn E, Gustafson M, Lizanna J, Wahlen S, Aleiwe M, Hansen H, Wahlen C, Karges C, Levy A, Bonaccorso R, Rapaport Y, Tomer D, Chia M, Goldis L, Iazzetti M, Klein C, Levister L, Waldman E, Keaton N, Wallach M, Regelmann Z, Antal M, Aranda C, Reynholds A, Vinik P, Barlow M, Bourcier M, Nevoret J, Couper S, Kinderman A, Beresford N, Thalagne H, Roper J, Gibbons J, Hill S, Balleaut C, Brennan J, Ellis-Gage L, Fear T, Gray L, Law P, Jones C, McNerney L, Pointer N, Price K, Few D, Tomlinson N, Leech D, Wake C, Owens M, Burns J, Leinbach A, Wotherspoon A, Murray K, Short G, Curry S, Kelsey J, Lawson J, Porter S, Stevens E, Thomson S, Winship L, Liu S, Wynn E, Wiltshire J, Krebs P, Cresswell H, Faherty C, Ross L, Denvir J, Drew T, Randell P, Mansell S, Lloyd J, Bell S, Butler Y, Hooton H, Navarra A, Roper G, Babington L, Crate H, Cripps A, Ledlie C, Moulds R, Malloy J, Norton B, Petrova O, Silkstone C, Smith K, Ghai M, Murray V, Viswanathan M, Henegan O, Kawadry J, Olson L, Maddox K, Patterson T, Ahmad B, Flores D, Domek S, Domek K, Copeland M, George J, Less T, Davis M, Short A, Martin J, Dwarakanathan P, O’Donnell B, Boerner L, Larson M, Phillips M, Rendell K, Larson C, Smith K, Zebrowski L, Kuechenmeister M, Miller J, Thevarayapillai M, Daniels H, Speer N, Forghani R, Quintana C, Reh A, Bhangoo P, Desrosiers L, Ireland T, Misla C, Milliot E, Torres S, Wells J, Villar M, Yu D, Berry D, Cook J, Soder A, Powell M, Ng M, Morrison Z, Moore M, Haslam M, Lawson B, Bradley J, Courtney C, Richardson C, Watson E, Keely D, DeCurtis M, Vaccarcello-Cruz Z, Torres K, Muller S, Sandberg H, Hsiang B, Joy D, McCormick A, Powell H, Jones J, Bell S, Hargadon S, Hudson M, Kummer S, Nguyen T, Sauder E, Sutton K, Gensel R, Aguirre-Castaneda V, Benavides, Lopez D, Hemp S, Allen J, Stear E, Davis T, O’Donnell R, Jones A, Roberts J, Dart N, Paramalingam L, Levitt Katz N, Chaudhary K, Murphy S, Willi B, Schwartzman C, Kapadia D, Roberts A, Larson D, McClellan G, Shaibai L, Kelley G, Villa C, Kelley R, Diamond M, Kabbani T, Dajani F, Hoekstra M, Sadler K, Magorno J, Holst V, Chauhan N, Wilson P, Bononi M, Sperl A, Millward M, Eaton L, Dean J, Olshan H, Stavros T, Renna C, Milliard, Brodksy L, Bacon J, Quintos L, Topor S, Bialo B, Bancroft A, Soto W, Lagarde H, Tamura R, Lockemer T, Vanderploeg M, Ibrahim M, Huie V, Sanchez R, Edelen R, Marchiando J, Palmer T, Repas M, Wasson P, Wood K, Auker J, Culbertson T, Kieffer D, Voorhees T, Borgwardt L, DeRaad K, Eckert E, Isaacson H, Kuhn A, Carroll M, Xu P, Schubert G, Francis S, Hagan T, Le M, Penn E, Wickham C, Leyva K, Rivera J, Padilla I, Rodriguez N, Young K, Jospe J, Czyzyk B, Johnson U, Nadgir N, Marlen G, Prakasam C, Rieger N, Glaser E, Heiser B, Harris C, Alies P, Foster H, Slater K, Wheeler D, Donaldson M, Murray D, Hale R, Tragus D, Word J, Lynch L, Pankratz W, Badias F, Rogers R, Newfield S, Holland M, Hashiguchi M, Gottschalk A, Philis-Tsimikas R, Rosal S, Franklin S, Guardado N, Bohannon M, Baker A, Garcia T, Aguinaldo J, Phan V, Barraza D, Cohen J, Pinsker U, Khan J, Wiley L, Jovanovic P, Misra M, Bassi M, Wright D, Cohen K, Huang M, Skiles S, Maxcy C, Pihoker K, Cochrane J, Fosse S, Kearns M, Klingsheim N, Beam C, Wright L, Viles H, Smith S, Heller M, Cunningham A, Daniels L, Zeiden J, Field R, Walker K, Griffin L, Boulware D, Bartholow C, Erickson J, Howard B, Krabbenhoft C, Sandman A, Vanveldhuizen J, Wurlger A, Zimmerman K, Hanisch L, Davis-Keppen A, Bounmananh L, Cotterill J, Kirby M, Harris A, Schmidt C, Kishiyama C, Flores J, Milton W, Martin C, Whysham A, Yerka T, Bream S, Freels J, Hassing J, Webster R, Green P, Carter J, Galloway D, Hoelzer S, Roberts S, Said P, Sullivan H, Freeman D, Allen E, Reiter E, Feinberg C, 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Frank E, Liu J, Perry J, Pyle R, Rigby A, Riley K, Soto A, Gitelman S, Adi S, Anderson M, Berhel A, Breen K, Fraser K, Gerard-Gonzalez A, Jossan P, Lustig R, Moassesfar S, Mugg A, Ng D, Prahalod P, Rangel-Lugo M, Sanda S, Tarkoff J, Torok C, Wesch R, Aslan I, Buchanan J, Cordier J, Hamilton C, Hawkins L, Ho T, Jain A, Ko K, Lee T, Phelps S, Rosenthal S, Sahakitrungruang T, Stehl L, Taylor L, Wertz M, Wong J, Philipson L, Briars R, Devine N, Littlejohn E, Grant T, Gottlieb P, Klingensmith G, Steck A, Alkanani A, Bautista K, Bedoy R, Blau A, Burke B, Cory L, Dang M, Fitzgerald-Miller L, Fouts A, Gage V, Garg S, Gesauldo P, Gutin R, Hayes C, Hoffman M, Ketchum K, Logsden-Sackett N, Maahs D, Messer L, Meyers L, Michels A, Peacock S, Rewers M, Rodriguez P, Sepulbeda F, Sippl R, Steck A, Taki I, Tran BK, Tran T, Wadwa RP, Zeitler P, Barker J, Barry S, Birks L, Bomsburger L, Bookert T, Briggs L, Burdick P, Cabrera R, Chase P, Cobry E, Conley A, Cook G, Daniels J, DiDomenico D, Eckert J, Ehler A, Eisenbarth G, Fain P, Fiallo-Scharer R, Frank N, Goettle H, Haarhues M, Harris S, Horton L, Hutton J, Jeffrrey J, Jenison R, Jones K, Kastelic W, King MA, Lehr D, Lungaro J, Mason K, Maurer H, Nguyen L, Proto A, Realsen J, Schmitt K, Schwartz M, Skovgaard S, Smith J, Vanderwel B, Voelmle M, Wagner R, Wallace A, Walravens P, Weiner L, Westerhoff B, Westfall E, Widmer K, Wright H, Schatz D, Abraham A, Atkinson M, Cintron M, Clare-Salzler M, Ferguson J, Haller M, Hosford J, Mancini D, Rohrs H, Silverstein J, Thomas J, Winter W, Cole G, Cook R, Coy R, Hicks E, Lewis N, Marks J, Pugliese A, Blaschke C, Matheson D, Pugliese A, Sanders-Branca N, Ray Arce LA, Cisneros M, Sabbag S, Moran A, Gibson C, Fife B, Hering B, Kwong C, Leschyshyn J, Nathan B, Pappenfus B, Street A, Boes MA, Peterson Eck S, Finney L, Albright Fischer T, Martin A, Jacqueline Muzamhindo C, Rhodes M, Smith J, Wagner J, Wood B, Becker D, Delallo K, Diaz A, Elnyczky B, Libman I, Pasek B, Riley K, Trucco M, Copemen B, Gwynn D, Toledo F, Rodriguez H, Bollepalli S, Diamond F, Eyth E, Henson D, Lenz A, Shulman D, Raskin P, Adhikari S, Dickson B, Dunnigan E, Lingvay I, Pruneda L, Ramos-Roman M, Raskin P, Rhee C, Richard J, Siegelman M, Sturges D, Sumpter K, White P, Alford M, Arthur J, Aviles-Santa ML, Cordova E, Davis R, Fernandez S, Fordan S, Hardin T, Jacobs A, Kaloyanova P, Lukacova-Zib I, Mirfakhraee S, Mohan A, Noto H, Smith O, Torres N, Wherrett D, Balmer D, Eisel L, Kovalakovska R, Mehan M, Sultan F, Ahenkorah B, Cevallos J, Razack N, Jo Ricci M, Rhode A, Srikandarajah M, Steger R, Russell WE, Black M, Brendle F, Brown A, Moore D, Pittel E, Robertson A, Shannon A, Thomas JW, Herold K, Feldman L, Sherwin R, Tamborlane W, Weinzimer S, Toppari J, Kallio T, Kärkkäinen M, Mäntymäki E, Niininen T, Nurmi B, Rajala P, Romo M, Suomenrinne S, Näntö-Salonen K, Simell O, Simell T, Bosi E, Battaglia M, Bianconi E, Bonfanti R, Grogan P, Laurenzi A, Martinenghi S, Meschi F, Pastore M, Falqui L, Teresa Muscato M, Viscardi M, Bingley P, Castleden H, Farthing N, Loud S, Matthews C, McGhee J, Morgan A, Pollitt J, Elliot-Jones R, Wheaton C, Knip M, Siljander H, Suomalainen H, Colman P, Healy F, Mesfin S, Redl L, Wentworth J, Willis J, Farley M, Harrison L, Perry C, Williams F, Mayo A, Paxton J, Thompson V, Volin L, Fenton C, Carr L, Lemon E, Swank M, Luidens M, Salgam M, Sharma V, Schade D, King C, Carano R, Heiden J, Means N, Holman L, Thomas I, Madrigal D, Muth T, Martin C, Plunkett C, Ramm C, Auchus R, Lane W, Avots E, Buford M, Hale C, Hoyle J, Lane B, Muir A, Shuler S, Raviele N, Ivie E, Jenkins M, Lindsley K, Hansen I, Fadoju D, Felner E, Bode B, Hosey R, Sax J, Jefferies C, Mannering S, Prentis R, She J, Stachura M, Hopkins D, Williams J, Steed L, Asatapova E, Nunez S, Knight S, Dixon P, Ching J, Donner T, Longnecker S, Abel K, Arcara K, Blackman S, Clark L, Cooke D, Plotnick L, Levin P, Bromberger L, Klein K, Sadurska K, Allen C, Michaud D, Snodgrass H, Burghen G, Chatha S, Clark C, 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Madison M, Rincon M, Carlucci R, Shridharani B, Rusk E, Tessman D, Huffman H, Abrams B, Biederman M, Jones V, Leathers W, Brickman P, Petrie D, Zimmerman J, Howard L, Miller R, Alemzadeh D, Mihailescu R, Melgozza-Walker N, Abdulla C, Boucher-Berry D, Ize-Ludlow R, Levy C, Swenson, Brousell N, Crimmins D, Edler T, Weis C, Schultz D, Rogers D, Latham C, Mawhorter C, Switzer W, Spencer P, Konstantnopoulus S, Broder J, Klein L, Knight L, Szadek G, Welnick B, Thompson R, Hoffman A, Revell J, Cherko K, Carter E, Gilson J, Haines G, Arthur B, Bowen W, Zipf P, Graves R, Lozano D, Seiple K, Spicer A, Chang J, Fregosi J, Harbinson C, Paulson S, Stalters P, Wright D, Zlock A, Freeth J, Victory H, Maheshwari A, Maheshwari T, Holmstrom J, Bueno R, Arguello J, Ahern L, Noreika V, Watson S, Hourse P, Breyer C, Kissel Y, Nicholson M, Pfeifer S, Almazan J, Bajaj M, Quinn K, Funk J, McCance E, Moreno R, Veintimilla A, Wells J, Cook S, Trunnel J, Henske S, Desai K, Frizelis F, Khan R, Sjoberg K, Allen P, Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Mitchell G, Porter S, Manias E. From telling to sharing to silence: A longitudinal ethnography of professional‐patient communication about oral chemotherapy for colorectal cancer. Psychooncology 2018; 28:336-342. [DOI: 10.1002/pon.4945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 11/02/2018] [Accepted: 11/13/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Gary Mitchell
- School of Nursing and MidwiferyQueen's University Belfast Belfast Northern Ireland, UK
| | - Sam Porter
- Department of Social Sciences & Social WorkBournemouth University Dorset England, UK
| | - Elizabeth Manias
- School of Nursing & Midwifery, Centre for Quality and Patient Safety ResearchDeakin University Melbourne Australia
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Porter S, McConnell T, Graham-Wisener L, Regan J, McKeown M, Kirkwood J, Clarke M, Gardner E, Dorman S, McGrillen K, Reid J. A randomised controlled pilot and feasibility study of music therapy for improving the quality of life of hospice inpatients. BMC Palliat Care 2018; 17:125. [PMID: 30482192 PMCID: PMC6260709 DOI: 10.1186/s12904-018-0378-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 11/13/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Evidence about the effectiveness of music therapy for improving the quality of life of palliative care patients is positive but weak in terms of risk of bias. METHODS This study aimed to determine the feasibility of a randomised controlled trial to evaluate the effectiveness of music therapy for improving the quality of life of hospice inpatients, as measured by the McGill Quality of Life questionnaire. Objectives included recruitment of 52 participants over 12 months and provision of data to support the calculation of the required sample size for a definitive randomised trial, taking into account the retention rates of recruited participants; and evaluation of the viability of the intervention and the acceptability of the assessment tool. The design was a single-centre, researcher-blinded randomised pilot and feasibility study involving two parallel groups. Participants were recruited from one inpatient hospice unit in Northern Ireland. Eligibility criteria were an Eastern Cooperative Oncology Group performance status of two or lower and an Abbreviated Mental Test score of seven or more. Consenting patients were randomly allocated to the intervention or control group using a 1:1 allocation ratio. The intervention group received up to six individual music therapy sessions over 3 weeks in addition to usual care. The control group received usual care only. RESULTS Fifty one participants were recruited over 12 months. Twenty five were allocated to the intervention group and 26 to the control group. Seventy one percent of participants were lost to follow up by week 3, the proposed primary endpoint. The primary endpoint was moved from week 3, when 71% were lost to follow up to week 1, when 33% were lost. The McGill Quality of Life questionnaire was generally acceptable to participants. In order to detect a small to moderate effect size of 0.3, a fully powered study would require the recruitment of 698 participants. CONCLUSIONS A Phase III randomised controlled trial to evaluate the effectiveness of music therapy in improving the quality of life of hospice inpatients is feasible. TRIAL REGISTRATION ClinicalTrials.gov: NCT02791048 . Registered 6 June 2016.
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Affiliation(s)
- Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, England
| | - Tracey McConnell
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, Northern Ireland
| | | | - Joan Regan
- School of Psychology, Queen’s University, Belfast, Northern Ireland
| | - Miriam McKeown
- School of Psychology, Queen’s University, Belfast, Northern Ireland
| | - Jenny Kirkwood
- Every Day Harmony Music Therapy, Belfast, Northern Ireland
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland
| | - Evie Gardner
- Northern Ireland Clinical Trials Unit, Belfast, Northern Ireland
| | | | - Kerry McGrillen
- School of Psychology, Queen’s University, Belfast, Northern Ireland
| | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland
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Corry M, Porter S, McKenna H. The redundancy of positivism as a paradigm for nursing research. Nurs Philos 2018; 20:e12230. [DOI: 10.1111/nup.12230] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/05/2018] [Accepted: 10/05/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Margarita Corry
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Sam Porter
- Department of Social Sciences and Social Work; Bournemouth University; Bournemouth UK
| | - Hugh McKenna
- Institute of Nursing and Health Research; Ulster University; Jordanstown UK
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Porter S. Review: Evaluation of individuals' health beliefs and their association with testicular self-examination: adult sample from Amasya. J Res Nurs 2018; 23:518-519. [PMID: 34394467 DOI: 10.1177/1744987118791376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sam Porter
- Professor, Department of Social Sciences and Social Work, Bournemouth University, UK
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Culley L, Porter S. Special Collection Editorial: grounded theory. J Res Nurs 2018; 23:468-475. [PMID: 34394461 DOI: 10.1177/1744987118791375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lorraine Culley
- Emeritus Professor of Social Science and Health, De Montfort University, Leicester, UK
| | - Sam Porter
- Professor of Nursing Sociology, Bournemouth University, Bournemouth, UK
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Graham-Wisener L, Reid J, McConnell T, McGrillen K, Kirkwood J, McKeown M, Clarke M, Regan J, Hughes N, Porter S. 23 Findings from a pilot and feasibility trial of a music therapy intervention in specialist palliative care. BMJ Support Palliat Care 2018. [DOI: 10.1136/bmjspcare-2018-mariecurie.23] [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: 11/03/2022]
Abstract
IntroductionMusic therapy aligns to the holistic approach to palliative and end-of-life care (PEOLC) with increased prevalence in PEOLC settings (Graham-Wisener et al. 2018). Despite this there is a dearth of high-quality evidence examining the impact of music therapy towards end of life on quality of life (McConnell et al. 2016).AimsThe aim of this pilot and feasibility study was to: test procedures; outcomes and validated tools; estimate recruitment and attrition rates; and calculate the sample size required for a phase III randomised controlled trial.MethodsA single-centre pilot and feasibility trial with patients admitted to a specialist palliative care inpatient unit within the United Kingdom. Participants were randomised (1:1) to either a music therapy intervention of two 30–45 min sessions of music therapy per week for three consecutive weeks or usual care. The primary outcome measure was to evaualte the feasibility of administering the McGill Quality of Life Questionnaire (MQoL) baseline with follow-up measures at one, three and five weeks.Results51 participants were recruited to the trial over a 12 month period. Feasibility of administering music therapy intervention and attrition rates identified one-week follow-up as an appropriate primary outcome. Results suggest a likely effect on MQoL total score between intervention and control arms in particular the existential subscale.ConclusionThe current study resolved a number of issues towards informing robust procedures for a phase III RCT. This data is urgently needed to ensure an evidence-based decision on inclusion of music therapy in palliative care services.References. Graham-Wisener L, Watts G, Kirkwood J, Harrison C, McEwan J, Porter S, Reid J, McConnell TH. Music therapy in UK palliative and end-of-life care: A service evaluation. BMJ supportive & palliative care2018.. McConnell T, Scott D, Porter S. Music therapy for end-of-life care: An updated systematic review. Palliative Medicine2016;30(9):877–883.
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Abstract
AIMS To analyse published ranking tables on academics' h-index scores to establish whether male nursing academics are disproportionately represented in these tables compared with their representation across the whole profession. BACKGROUND Previous studies have identified a disproportionate representation of UK male nursing academics in publishing in comparison to their US counterparts. DESIGN Secondary statistical analysis, which involved comparative correlation of proportions. METHODS Four papers from the UK, Canada and Australia containing h-index ranking tables and published between 2010-2017, were re-analysed in June 2017 to identify authors' sex. Pearson's chi-squared test was applied to ascertain whether the number of men included in the tables was statistically proportionate to the number of men on the pertinent national professional register. FINDINGS There was a disproportionate number of men with high h-index scores in the UK and Canadian data sets, compared with the proportion of men on the pertinent national registers. The number of men in the Australian data set was proportionate with the number of men on the nursing register. There was a disproportionate number of male professors in UK universities. CONCLUSION The influence of men over nursing publishing in the UK and Canada outweighs their representation across the whole profession. Similarly, in the UK, men's representation in the professoriate is disproportionately great. However, the Australian results suggest that gender inequality is not inevitable and that it is possible to create more egalitarian nursing cultures. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sam Porter
- Professor of Nursing Sociology, Faculty of Health and Social Sciences, Bournemouth University
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Leao JC, Marques C, Duarte A, de Almeida OP, Porter S, Gueiros LA. Chikungunya fever: General and oral healthcare implications. Oral Dis 2018; 24:233-237. [PMID: 29480628 DOI: 10.1111/odi.12777] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 08/15/2017] [Accepted: 08/20/2017] [Indexed: 12/11/2022]
Abstract
Chikungunya virus (CHIKV) was first isolated in humans in 1952, following an epidemic in Tanzania. The origin of the name means "to bend forward or become contorted," in reference to the posture adopted by patients due to the joint pain that occurs during the infection. Epidemiology data suggest that by the end of 2015, about 1.6 million people had been infected with CHIKV. The acute period of the disease is characterized by high fever, myalgia, joint pain, and severe and disabling polyarthritis, sometimes accompanied by headache, backache, and maculopapular rash, predominantly on the thorax. Around half of the patients will progress to the subacute and chronic phases, that is manifested by persistent polyarthritis/polyarthralgia, accompanied by morning stiffness and fatigue, which could remain for years. Oral features may include gingivitis possibly as a consequence of arthralgia of the hands leading to limited oral health measures as well as burning sensation and oral mucosal ulceration. Treatment in the acute phase includes acetaminophen, and weak opioids (tramadol or codeine) should be used in cases of severe or refractory pain. For patients who have progressed to the subacute stage and who have not had notable benefit from common analgesics or opioids, NSAIDs, or adjunctive pain medications (anticonvulsants or antidepressants) may be of benefit. In patients with moderate-to-severe musculoskeletal pain or in those who cannot be given or tolerate NSIADs or opiates, prednisolone should be prescribed.
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Affiliation(s)
- J C Leao
- Oral Medicine Unit, Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil
| | - Cdl Marques
- Rheumatology Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Albp Duarte
- Rheumatology Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - O P de Almeida
- Área de Patologia, Departamento de Diagnóstico Oral, Facldade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - S Porter
- UCL Eastman Dental Institute, Oral Theme of the UCL/UCLH NIHR Biomedical Research Centre, London, UK
| | - L A Gueiros
- Oral Medicine Unit, Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Recife, Brazil
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Graham-Wisener L, Watts G, Kirkwood J, Harrison C, McEwan J, Porter S, Reid J, McConnell TH. Music therapy in UK palliative and end-of-life care: a service evaluation. BMJ Support Palliat Care 2018; 8:282-284. [DOI: 10.1136/bmjspcare-2018-001510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 02/14/2018] [Indexed: 11/04/2022]
Abstract
Music therapy aligns to the holistic approach to palliative and end-of-life care (PEOLC), with an emergent evidence base reporting positive effect on a range of health-related outcomes for both patient and family carer alongside high client demand. However, the current service provision and the role of music therapists in supporting individuals receiving PEOLC in the UK is currently unknown.ObjectivesThis service evaluation aims to identify the provision, role and perceived impact of UK music therapists in supporting patients receiving PEOLC, their families and health and social care professionals.MethodsA survey was distributed to the British Association for Music Therapy (BAMT) member mailing list in July 2017. BAMT is the professional body for Health and Care Professions Council registered music therapists in the UK.ResultsFifty respondents identified themselves as music therapists currently working with clients receiving PEOLC. The respondents largely reported (84.7%) less than 10 years of experience working in PEOLC settings, with only a minority receiving statutory funding for their role. Music therapists most commonly reported supporting adults with neurological conditions, cancers and dementia.ConclusionsAlthough promising that evidence suggests provision of music therapy in UK PEOLC settings in the past 10 years to have increased, lack of sustainable funding suggests the role to not be consistently accessible in PEOLC.
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Reid J, Noble HR, Adamson G, Davenport A, Farrington K, Fouque D, Kalantar-Zadeh K, Mallett J, McKeaveney C, Porter S, Seres DS, Shields J, Slee A, Witham MD, Maxwell AP. Establishing a clinical phenotype for cachexia in end stage kidney disease - study protocol. BMC Nephrol 2018; 19:38. [PMID: 29439674 PMCID: PMC5812213 DOI: 10.1186/s12882-018-0819-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/02/2017] [Accepted: 01/17/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Surveys using traditional measures of nutritional status indicate that muscle wasting is common among persons with end-stage kidney disease (ESKD). Up to 75% of adults undergoing maintenance dialysis show some evidence of muscle wasting. ESKD is associated with an increase in inflammatory cytokines and can result in cachexia, with the loss of muscle and fat stores. At present, only limited data are available on the classification of wasting experienced by persons with ESKD. Individuals with ESKD often exhibit symptoms of anorexia, loss of lean muscle mass and altered energy expenditure. These symptoms are consistent with the syndrome of cachexia observed in other chronic diseases, such as cancer, heart failure, and acquired immune deficiency syndrome. While definitions of cachexia have been developed for some diseases, such as cardiac failure and cancer, no specific cachexia definition has been established for chronic kidney disease. The importance of developing a definition of cachexia in a population with ESKD is underscored by the negative impact that symptoms of cachexia have on quality of life and the association of cachexia with a substantially increased risk of premature mortality. The aim of this study is to determine the clinical phenotype of cachexia specific to individuals with ESKD. METHODS A longitudinal study which will recruit adult patients with ESKD receiving haemodialysis attending a Regional Nephrology Unit within the United Kingdom. Patients will be followed 2 monthly over 12 months and measurements of weight; lean muscle mass (bioelectrical impedance, mid upper arm muscle circumference and tricep skin fold thickness); muscle strength (hand held dynamometer), fatigue, anorexia and quality of life collected. We will determine if they experience (and to what degree) the known characteristics associated with cachexia. DISCUSSION Cachexia is a debilitating condition associated with an extremely poor outcome. Definitions of cachexia in chronic illnesses are required to reflect specific nuances associated with each disease. These discrete cachexia definitions help with the precision of research and the subsequent clinical interventions to improve outcomes for patients suffering from cachexia. The absence of a definition for cachexia in an ESKD population makes it particularly difficult to study the incidence of cachexia or potential treatments, as there are no standardised inclusion criteria for patients with ESKD who have cachexia. Outcomes from this study will provide much needed data to inform development and testing of potential treatment modalities, aimed at enhancing current clinical practice, policy and education.
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Affiliation(s)
- Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast Medical Biology Centre, 97 Lisburn Rd, Belfast, BT9 7BL, UK.
| | - Helen R Noble
- School of Nursing and Midwifery, Queen's University Belfast Medical Biology Centre, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - Gary Adamson
- School of Psychology, Ulster University Magee Campus, Londonderry, BT48 7JL, UK
| | - Andrew Davenport
- UCL Centre for Nephrology, Royal Free Hospital, University College London, Pond Street, London, NW3 2QG, UK
| | - Ken Farrington
- East and North Hertfordshire University NHS Trust, Lister Hospital, Coreys Mill Lane, Stevenage, SG1 4AB, UK
| | - Denis Fouque
- Department of Nephrology, Université de Lyon, UCBL, Carmen, Centre Hospitalier Lyon Sud, F-69495, Pierre-Bénite, France
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension, Pediatrics and Public Health, University of California, Los Angeles, USA
| | - John Mallett
- School of Psychology, Ulster University Magee Campus, Londonderry, BT48 7JL, UK
| | - C McKeaveney
- School of Nursing and Midwifery, Queen's University Belfast Medical Biology Centre, 97 Lisburn Rd, Belfast, BT9 7BL, UK
| | - S Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - David S Seres
- Columbia University Medical Centre, NY Presbyterian Hospital, New York, USA
| | - Joanne Shields
- Regional Nephrology Unit, Belfast City Hospital, Belfast HSC Trust, Belfast, UK
| | - Adrian Slee
- UCL, Faculty of Medical Sciences, Gower St, Bloomsbury, London, WC1E 6BT, UK
| | - Miles D Witham
- School of Medicine, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Alexander P Maxwell
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast and Regional Nephrology Unit, Belfast City Hospital, Belfast HSC Trust, Belfast, UK
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Byrne A, McNeill J, Rogers K, Porter S. Impact of Enquiry Based Learning (EBL) on student midwife praxis. Midwifery 2018; 58:83-85. [PMID: 29306739 DOI: 10.1016/j.midw.2017.12.025] [Citation(s) in RCA: 3] [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] [Received: 09/14/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
Abstract
Midwifery training in Ireland moved to Higher Education in 2006. This shift established a physical and educational separation of theory and practice. The adoption of Enquiry Based Learning (EBL) by one Irish midwifery education institution attempted to address this division. Enquiry Based Learning (EBL) has the potential to develop student reflexivity and evidence assimilation across the career-span and may therefore enhance student praxis. EBL has been championed as an example of an educational model that supports praxis, helping to create competent practitioners through the use of authentic learning scenarios that address the theory practice divide. The current research study represents the first formal evaluation of EBL in undergraduate midwifery education in the South of Ireland. The study was a mixed-methods design that utilised focus groups, interviews and survey to ascertain the opinions of first exposure to EBL amongst a cohort of first year student midwives. Findings demonstrate the value of EBL in enhancing student midwife praxis.
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Affiliation(s)
- Anita Byrne
- School of Health and Science, Dundalk Institute of Technology, Ireland.
| | - Jennifer McNeill
- School of Nursing and Midwifery, Queens University Belfast, Northern Ireland, UK
| | - Katherine Rogers
- School of Nursing and Midwifery, Queens University Belfast, Northern Ireland, UK
| | - Sam Porter
- Social Work&Social Sciences, Bournemouth University, United Kingdom
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Abi Aoun M, Walter H, Dickens E, Mahgoub M, Varadhan B, Porter S, Sridhar T, Fennell D, Ahmed S. Recruitment and outcome of lung cancer patients to clinical trials within the Department of Medical Oncology at University Hospitals Leicester. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30129-6] [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: 11/30/2022]
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Porter S, McConnell T, Clarke M, Kirkwood J, Hughes N, Graham-Wisener L, Regan J, McKeown M, McGrillen K, Reid J. A critical realist evaluation of a music therapy intervention in palliative care. BMC Palliat Care 2017; 16:70. [PMID: 29221475 PMCID: PMC5723094 DOI: 10.1186/s12904-017-0253-5] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 11/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). METHODS Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy's impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention. RESULTS Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients' responses helped identify specific benefits for different types of patients. CONCLUSIONS There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.
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Affiliation(s)
- Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, Northern Ireland
| | - Tracey McConnell
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland
| | - Jenny Kirkwood
- Every Day Harmony Music Therapy, Belfast, Northern Ireland
| | - Naomi Hughes
- Every Day Harmony Music Therapy, Belfast, Northern Ireland
| | | | - Joan Regan
- Marie Curie Hospice Belfast, Marie Curie, Northern Ireland
| | - Miriam McKeown
- Marie Curie Hospice Belfast, Marie Curie, Northern Ireland
| | | | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, Northern Ireland
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Mc Veigh C, Reid J, Larkin P, Porter S, Hudson P. The experience of palliative care service provision for people with non-malignant respiratory disease and their family carers: An all-Ireland qualitative study. J Adv Nurs 2017; 74:383-394. [PMID: 28910509 DOI: 10.1111/jan.13453] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 08/04/2017] [Indexed: 11/25/2022]
Abstract
AIM To explore specialist and generalist palliative care provision for people with non-malignant respiratory disease, in rural and urban areas in the North and Republic of Ireland. BACKGROUND Globally, palliative care is recommended as an appropriate healthcare option for people with advanced non-malignant lung disease. Yet, there is limited evidence regarding the integration of palliative care for this client group. DESIGN Qualitative study. METHODS Convenience sample of 17 bereaved carers and 18 healthcare professionals recruited from two rural and two urban sites on the Island of Ireland. Data were collected throughout 2012 and 2013 through semi-structured interviews with carers of patients with Chronic Obstructive Pulmonary Disease (N = 12), interstitial lung disease (N = 4) or bronchiectasis (N = 1) who had died 3-18 months previously; and four focus groups with healthcare professionals. Data were analysed using a thematic analysis framework. RESULTS Carers' interviews yielded three overarching themes: (1) lack of preparedness for death, due to ambiguity regarding disease trajectory; (2) lack of consistency in palliative care delivery, in relation with the receipt of generalist and specialist palliative care; and (3) role ambiguity, related to their caregiving role. Focus groups identified two overarching themes: (1) barriers to appropriate palliative care; and (2) the future direction of palliative care for patient with non-malignant respiratory disease. CONCLUSION The uncertain disease trajectory was not only experienced by carers but also healthcare professionals. Although referral to specialist palliative care services was perceived as increasing, the availability and coordination of generalist and specialist palliative care services were fragmented and varied dependent on geographical location.
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Affiliation(s)
- Clare Mc Veigh
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Philip Larkin
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, UK
| | - Peter Hudson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.,St Vincent's University Hospital and University of Melbourne, Melbourne, Vic., Australia
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McGaughey J, O'Halloran P, Porter S, Blackwood B. Early warning systems and rapid response to the deteriorating patient in hospital: A systematic realist review. J Adv Nurs 2017; 73:2877-2891. [DOI: 10.1111/jan.13398] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Jennifer McGaughey
- School of Nursing & Midwifery; Medical Biology Centre; Queen's University Belfast; Belfast UK
| | - Peter O'Halloran
- School of Nursing & Midwifery; Queen's University of Belfast; Belfast UK
| | - Sam Porter
- Department of Social Sciences and Social Work; Bournemouth University; Poole UK
| | - Bronagh Blackwood
- School of Medicine, Dentistry & Biomedical Sciences; Centre for Experimental Medicine; Queen's University Belfast; Belfast UK
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Carrier E, Picozzi V, Pishvaian M, Mody K, Winter J, Glaspy J, Larson T, Conway W, Lipson K, Porter S, Kouchakji E. Anti-CTGF human recombinant monoclonal antibody pamrevlumab increases resectability and resection rate when combined with gemcitabine/Nab-paclitaxel in the treatment of locally advanced pancreatic cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wiriyakijja P, Fedele S, Porter S, Mercadante V, Ni Riordain R. Patient-reported outcome measures in recurrent aphthous stomatitis: A critical assessment of quality properties. Oral Dis 2017; 23:1168-1179. [PMID: 28779517 DOI: 10.1111/odi.12726] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/18/2017] [Revised: 07/17/2017] [Accepted: 07/30/2017] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To analyse the range of existing patient-reported outcome measures (PROMs) used in studies of recurrent aphthous stomatitis (RAS) and to evaluate their quality properties via the assessment of psychometric properties and interpretability. MATERIALS AND METHODS Electronic databases were searched to identify relevant publications related to PROMs used in RAS. Publications were selected based on predefined criteria. All identified PROMs were then classified by measuring concepts and assessed for instrument characteristics and evidence for quality properties for RAS patients. RESULTS Twenty-eight PROMs were used in studies of RAS patients. Instruments focused upon oral symptoms (n = 4), psychosocial status (n = 15) and quality of life (n = 9). Five PROMs (Oral Health-related Quality of Life-UK, Chronic Oral Mucosal Disease Questionnaire, Oral Health Impact Profile-14, Medical Outcome Study Short Form-36 and Mumcu's composite index) were found to have some evidence of psychometric performance. No PROMs showed evidence for interpretability of their scores in RAS patients. CONCLUSION There was a wide range of PROMs used in clinical studies of RAS. The majority of these PROMs lack evidence of measurement properties and interpretability for RAS patients. Further studies are required to confirm whether these instruments are suitable and useful for this patient group.
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Affiliation(s)
- P Wiriyakijja
- UCL Eastman Dental Institute, London, UK.,Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Fedele
- UCL Eastman Dental Institute, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - S Porter
- UCL Eastman Dental Institute, London, UK
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McGaughey J, O'Halloran P, Porter S, Trinder J, Blackwood B. Early warning systems and rapid response to the deteriorating patient in hospital: A realist evaluation. J Adv Nurs 2017. [PMID: 28637090 DOI: 10.1111/jan.13367] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM To test the Rapid Response Systems programme theory against actual practice components of the Rapid Response Systems implemented to identify those contexts and mechanisms which have an impact on the successful achievement of desired outcomes in practice. BACKGROUND Rapid Response Systems allow deteriorating patients to be recognized using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN Realist evaluation. METHODS The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation. We used various mixed methods including individual and focus group interviews, observation of nursing practice between June-November 2010 and document analysis of Early Warning Systems audit data between May-October 2010 and hospital acute care training records over 4.5 years from 2003-2008. Data were analysed using NiVivo8 and SPPS. RESULTS A cross-case analysis highlighted similar patterns of factors which enabled or constrained successful recognition, referral and response to deteriorating patients in practice. Key enabling factors were the use of clinical judgement by experienced nurses and the empowerment of nurses as a result of organizational change associated with implementation of Early Warning System protocols. Key constraining factors were low staffing and inappropriate skill mix levels, rigid implementation of protocols and culturally embedded suboptimal communication processes. CONCLUSION Successful implementation of Rapid Response Systems was dependent on adopting organizational and cultural changes that facilitated staff empowerment, flexible implementation of protocols and ongoing experiential learning.
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Affiliation(s)
- Jennifer McGaughey
- School of Nursing & Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Peter O'Halloran
- School of Nursing & Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, UK
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Poole, Dorset, UK
| | - John Trinder
- Anaesthesia and Intensive Care Medicine, Ulster Hospital, South Eastern Health & Social Care Trust, Dundonald, Belfast, UK
| | - Bronagh Blackwood
- School of Medicine, Dentistry & Biomedical Sciences, Centre for Experimental Medicine, Queen's University Belfast, Belfast, UK
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Porter S, Torres I, Panenka W, Rajwani Z, Fawcett D, Hyder A, Virji-Babul N. Changes in brain-behavior relationships following a 3-month pilot cognitive intervention program for adults with traumatic brain injury. Heliyon 2017; 3:e00373. [PMID: 28795168 PMCID: PMC5545767 DOI: 10.1016/j.heliyon.2017.e00373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 06/17/2017] [Revised: 06/22/2017] [Accepted: 07/27/2017] [Indexed: 01/21/2023] Open
Abstract
Facilitating functional recovery following brain injury is a key goal of neurorehabilitation. Direct, objective measures of changes in the brain are critical to understanding how and when meaningful changes occur, however, assessing neuroplasticity using brain based results remains a significant challenge. Little is known about the underlying changes in functional brain networks that correlate with cognitive outcomes in traumatic brain injury (TBI). The purpose of this pilot study was to assess the feasibility of an intensive three month cognitive intervention program in individuals with chronic TBI and to evaluate the effects of this intervention on brain-behavioral relationships. We used tools from graph theory to evaluate changes in global and local brain network features prior to and following cognitive intervention. Network metrics were calculated from resting state electroencephalographic (EEG) recordings from 10 adult participants with mild to severe brain injury and 11 age and gender matched healthy controls. Local graph metrics showed hyper-connectivity in the right inferior frontal gyrus and hypo-connectivity in the left inferior frontal gyrus in the TBI group at baseline in comparison with the control group. Following the intervention, there was a statistically significant increase in the composite cognitive score in the TBI participants and a statistically significant decrease in functional connectivity in the right inferior frontal gyrus. In addition, there was evidence of changes in the brain-behavior relationships following intervention. The results from this pilot study provide preliminary evidence for functional network reorganization that parallels cognitive improvements after cognitive rehabilitation in individuals with chronic TBI.
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Affiliation(s)
- S. Porter
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Canada
| | - I.J. Torres
- Department of Psychiatry, University of British Columbia
| | - W. Panenka
- Department of Psychiatry, University of British Columbia
- British Columbia Provincial Neuropsychiatry Program
| | - Z. Rajwani
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia
| | - D. Fawcett
- Department of Psychiatry, University of British Columbia
| | - A. Hyder
- Graduate Program in Neuroscience, University of British Columbia
| | - N. Virji-Babul
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia
- Department of Physical Therapy, University of British Columbia, Canada
- Corresponding author at: Dept. of Physical Therapy, University of British Columbia, 212–2177 Westbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
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Veigh CM, Reid J, Larkin P, Porter S, Hudson P. The provision of generalist and specialist palliative care for patients with non-malignant respiratory disease in the North and Republic of Ireland: a qualitative study. BMC Palliat Care 2017; 17:6. [PMID: 28693466 PMCID: PMC5504568 DOI: 10.1186/s12904-017-0220-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 12/10/2016] [Accepted: 06/29/2017] [Indexed: 12/18/2022] Open
Abstract
Background Previous research and key guidelines have suggested potential models of palliative care for patients with COPD and interstitial lung disease. However, these recommendations are often not effectively implemented in clinical practice and are void of guidance regarding palliative care for patients with bronchiectasis, another form of non-malignant respiratory disease. The aim of this research was to explore generalist and specialist palliative care service provision for people with non-malignant respiratory disease in the North and Republic of Ireland. Methods Qualitative study involving a convenience sample of 17 bereaved carers and 18 healthcare professionals recruited from 2 rural and 2 urban sites on the Island of Ireland. Data collection consisted of semi-structured interviews with carers of patients with COPD, interstitial lung disease or bronchiectasis who had died 3–18 months previously; and 4 focus groups with healthcare professionals. Data analysed using thematic analysis. Results Findings highlighted the lack of a clear model of holistic care delivery for patients with non-malignant respiratory disease and illuminated the varying levels of palliative care provision this client group experienced. Additionally, ambiguity amongst healthcare professionals regarding prognostication illuminated the importance of the provision of palliative care being based on patient need, not prognosis. This research developed a potential model of palliative care which may help healthcare professionals introduce palliative care, and specialist respiratory care, early in the disease trajectory of non-malignant respiratory disease, whilst also encouraging the involvement of specialist palliative care for complex symptom management. Conclusion This research provides an important insight into a potential model of palliative care for people with non-malignant respiratory disease, inclusive of bronchiectasis. However, the feasibility of integrating this model into clinical practice requires further exploration. Electronic supplementary material The online version of this article (doi:10.1186/s12904-017-0220-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Clare Mc Veigh
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
| | - Philip Larkin
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Dorset, UK
| | - Peter Hudson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland.,Centre for Palliative Care, c/o St Vincent's University Hospital and University of Melbourne, Melbourne, Australia
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Porter S, McConnell T, McLaughlin K, Lynn F, Cardwell C, Braiden HJ, Boylan J, Holmes V. Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial. J Child Psychol Psychiatry 2017; 58:586-594. [PMID: 27786359 DOI: 10.1111/jcpp.12656] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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] [Accepted: 08/26/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although music therapy (MT) is considered an effective intervention for young people with mental health needs, its efficacy in clinical settings is unclear. We therefore examined the efficacy of MT in clinical practice. METHODS Two hundred and fifty-one child (8-16 years, with social, emotional, behavioural and developmental difficulties) and parent dyads from six Child and Adolescent Mental Health Service community care facilities in Northern Ireland were randomised to 12 weekly sessions of MT plus usual care [n = 123; 76 in final analyses] or usual care alone [n = 128; 105 in final analyses]. Follow-up occurred at 13 weeks and 26 weeks postrandomisation. Primary outcome was improvement in communication (Social Skills Improvement System Rating Scales) (SSIS) at 13 weeks. Secondary outcomes included social functioning, self-esteem, depression and family functioning. RESULTS There was no significant difference for the child SSIS at week 13 (adjusted difference in mean 2.4; 95% CI -1.2 to 6.1; p = .19) or for the guardian SSIS (0.5; 95% CI -2.9 to 3.8; p = .78). However, for participants aged 13 and over in the intervention group, the child SSIS communication was significantly improved (6.1, 95% CI 1.6 to 10.5; p = .007) but not the guardian SSIS (1.1; 95% CI -2.9 to 5.2; p = .59). Overall, self-esteem was significantly improved and depression scores were significantly lower at week 13. There was no significant difference in family or social functioning at week 13. CONCLUSIONS While the findings provide some evidence for the integration of music therapy into clinical practice, differences relating to subgroups and secondary outcomes indicate the need for further study. ISRCTN Register; ISRCTN96352204.
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Affiliation(s)
- Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, Bournemouth, UK
| | - Tracey McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Fiona Lynn
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Christopher Cardwell
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - Jackie Boylan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Valerie Holmes
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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Abstract
Background Some realists have criticised randomised controlled trials for their inability to explain the causal relations that they identify; to take into account the influence of the social context of the interventions they evaluate; and to account for individual difference. However, among realists, there is controversy over whether it is possible to improve trials by making them realist, or whether realism and the philosophical assumptions underlying trials are incompatible. This paper contributes to the debate in Trials on this issue. The debate thus far has concentrated on the possibility of combining trial methodology with that of realist evaluation. Main body We concur with the contention that it is not feasible to combine randomised controlled trial design with the realist evaluation approach. However, we argue that a different variant of realism, critical realism, provides a more appropriate theoretical grounding for realist trials. In contrast to realist evaluation, which regards social mechanisms as an amalgam of social resources and people’s reasoning, critical realism insists on their distinction. It does so on the basis of its assertion of the need to distinguish between social structures (in which resources lie) and human agency (which is at least partly guided by reasoning). From this perspective, conceiving of social mechanisms as external to participants can be seen as a valid methodological strategy for supplementing the exclusive concentration of trials on outcomes. While accepting realist evaluation’s insistence that causality in open systems involves a configuration of multiple generative mechanisms, we adopt the critical realist interpretation of the experimental method, which sees it as creating artificial closure in order to identify the effects of specific causal mechanisms. If randomised controlled trials can be regarded as epidemiological proxies that substitute probabilistic controls over extraneous factors for closed experiments, their examination of the powers of discrete mechanisms through observation of the variation of outcomes is appropriate. Conclusion While there are still issues to be resolved, critical realist randomised controlled trials are possible and have the potential to overcome some of the difficulties faced by traditional trial designs in accounting for the influence of social context and individual interpretation.
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Affiliation(s)
- Sam Porter
- Department of Social Sciences and Social Work, Bournemouth University, R203, Royal London House, Christchurch Road, BH1 3LT, Bournemouth, UK
| | - Tracey McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT7 1NN, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT7 1NN, UK.
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Fung P, Bedogni G, Bedogni A, Petrie A, Porter S, Campisi G, Bagan J, Fusco V, Saia G, Acham S, Musto P, Petrucci MT, Diz P, Colella G, Mignogna MD, Pentenero M, Arduino P, Lodi G, Maiorana C, Manfredi M, Hallberg P, Wadelius M, Takaoka K, Leung YY, Bonacina R, Schiødt M, Lakatos P, Taylor T, De Riu G, Favini G, Rogers SN, Pirmohamed M, Nicoletti P, Fedele S. Time to onset of bisphosphonate-related osteonecrosis of the jaws: a multicentre retrospective cohort study. Oral Dis 2017; 23:477-483. [PMID: 28039941 DOI: 10.1111/odi.12632] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [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: 08/12/2016] [Revised: 12/04/2016] [Accepted: 12/20/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of bisphosphonates (BP). Although the risk of ONJ increases with increasing duration of BP treatment, there are currently no reliable estimates of the ONJ time to onset (TTO). The objective of this study was to estimate the TTO and associated risk factors in BP-treated patients. SUBJECTS AND METHODS Retrospective analysis of data from 22 secondary care centres in seven countries relevant to 349 patients who developed BP-related ONJ between 2004 and 2012. RESULTS The median (95%CI) TTO was 6.0 years in patients treated with alendronate (n = 88) and 2.2 years in those treated with zoledronate (n = 218). Multivariable Cox regression showed that dentoalveolar surgery was inversely associated, and the use of antiangiogenics directly associated, with the TTO in patients with cancer treated with zoledronate. CONCLUSIONS The incidence of ONJ increases with the duration of BP therapy, with notable differences observed with respect to BP type and potency, route of administration and underlying disease. When data are stratified by BP type, a time of 6.0 and 2.2 years of oral alendronate and intravenous zoledronate therapy, respectively, is required for 50% of patients to develop ONJ. After stratification by disease, a time of 5.3 and 2.2 years of BP therapy is required for 50% of patients with osteoporosis and cancer, respectively, to develop ONJ. These findings have significant implications for the design of future clinical studies and the development of risk-reduction strategies aimed at either assessing or modulating the risk of ONJ associated with BP.
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Affiliation(s)
- Ppl Fung
- University College London/University College London Hospital Eastman Dental Institute and Hospital, London, UK
| | - G Bedogni
- Clinical Epidemiology Unit, Liver Research Centre, Basovizza, Trieste, Italy
| | - A Bedogni
- Department of Maxillofacial Surgery, University of Verona, Italy.,Department of Maxillofacial Surgery, University of Padua, Italy
| | - A Petrie
- University College London/University College London Hospital Eastman Dental Institute and Hospital, London, UK
| | - S Porter
- University College London/University College London Hospital Eastman Dental Institute and Hospital, London, UK
| | - G Campisi
- Dip. Discipline Chirurgiche, Oncologiche e Stomatologiche, University of Palermo, Italy
| | - J Bagan
- Department of Oral and Maxillofacial Surgery, Oral Medicine, University General Hospital, Valencia University, Spain
| | - V Fusco
- Medical Oncology Unit, Department of Oncology and Haematology, Ospedale SS Antonio e Biagio e C Arrigo, Alessandria, Italy
| | - G Saia
- Department of Maxillofacial Surgery, University of Padua, Italy
| | - S Acham
- Department of Oral Surgery and Orthodontics, University Clinic of Dental Health and Oral Medicine, Medical University of Graz, Austria
| | - P Musto
- Scientific Direction, Referral Cancer Center of Basilicata, IRCCS, Rionero in Vulture, Potenza, Italy
| | - M T Petrucci
- Department of Cellular Biotechnologies and Haematology, "Sapienza" University, Rome, Italy
| | - P Diz
- School of Medicine and Dentistry, Santiago de Compostela University, Spain
| | - G Colella
- Department of Medical, Surgical and Dental Specialties, Second University of Naples, Italy
| | - M D Mignogna
- Head & Neck Clinical Section, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
| | - M Pentenero
- Oral Medicine and Oral Oncology Unit, Department of Oncology, University of Turin, Italy
| | - P Arduino
- CIR Dental School, University of Turin, Italy
| | - G Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Italy
| | - C Maiorana
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Fondazione IRCCS Policlinico Cà Granda, Ospedale Maggiore Policlinico, University of Milan, Italy
| | - M Manfredi
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali - S.Bi.Bi.T., Unità di Odontostomatologia, Parma University, Italy
| | - P Hallberg
- Clinical Pharmacology and Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Sweden
| | - M Wadelius
- Clinical Pharmacology and Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Sweden
| | - K Takaoka
- Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Y Y Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - R Bonacina
- Department of Dentistry, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - M Schiødt
- Department of Oral and Maxillofacial Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - P Lakatos
- First Department of Medicine, Semmelweis University Medical School, Budapest, Hungary
| | - T Taylor
- Department of Oral Surgery, King's College Hospital, London, UK
| | - G De Riu
- Department of Maxillofacial Surgery, University Hospital of Sassari, Italy
| | - G Favini
- Department of Dentistry, San Francesco Hospital, Nuoro, Italy
| | - S N Rogers
- University Hospital Aintree, Liverpool, UK
| | - M Pirmohamed
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - P Nicoletti
- Department of Systems Biology, Columbia University, New York, NY, USA
| | | | - S Fedele
- University College London/University College London Hospital Eastman Dental Institute and Hospital, London, UK.,NIHR University College London Hospitals Biomedical Research Centre, London, UK
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McConnell T, Porter S. The experience of providing end of life care at a children's hospice: a qualitative study. BMC Palliat Care 2017; 16:15. [PMID: 28193270 PMCID: PMC5307784 DOI: 10.1186/s12904-017-0189-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 02/02/2017] [Indexed: 12/05/2022] Open
Abstract
Background More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a children’s hospice. Methods Qualitative research incorporating interviews and a focus group. Data were analysed using thematic analysis. Purposeful sampling led to a total of 15 care team staff recruited from a children’s hospice offering palliative and specialist care to life-limited children and young people. Results The hospice setting provides a model of excellence in supporting staff and mitigating challenging aspects of their role, which includes peer/organisational support, and regular ongoing training in key aspects of children’s palliative care. Key recommendations for improving their experience included advanced communication training and knowledge sharing with other children’s palliative care specialists within the acute setting. Conclusions Service and policy initiatives should encourage open, informal peer/organisational support among the wider children’s palliative care sector. Further research should focus on paediatric palliative care education, particularly in relation to symptom management and communication at end-of-life, harnessing the expertise and breadth of knowledge that could be shared between children’s hospices and hospital settings. Electronic supplementary material The online version of this article (doi:10.1186/s12904-017-0189-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tracey McConnell
- School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, United Kingdom.
| | - Sam Porter
- Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB, UK
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