Biomedical subjects

Andrew McVicar

Publications and source records attributed to Andrew McVicar.

4 recordsLinked to original sources

PubMed2007

Self-help groups as mutual support: what do carers value?

The literature suggests that the United Kingdom, in common with Europe, North America, Canada and Scandinavia, has seen significant growth in single-issue self-help/mutual aid groups concerned with health and social care issues since the 1970s, but there is only ad hoc academic and policy interest in such groups in the United Kingdom. This article presents findings from a doctoral study with two self-help/mutual aid groups for carers in South-East England. The data are drawn from semistructured interviews with 15 active members which explored reasons for joining, benefits derived from membership, and perceived differences between support gained by membership and their relationship with professionals. Most group members had prior experience of voluntary work/activity, which influenced their decision to join, often prompted by a failure of the 'usual' support network of family/friends to cope or adjust to the carer's needs. Members reported personal gains of empathy, emotional information, experiential knowledge and practical information, based on a core value of reciprocity through peer support. It is this latter benefit that sets apart membership of self-help groups from groups supported by professionals who may not appreciate the scope and breadth of carers' responsibilities, or of the importance of their relationship with the person for whom they care. In this way, self-help groups offered additional, but not alternative, 'space' that enabled members to transcend their traditional role as a 'carer'. It is concluded that self-help/mutual aid groups, based on reciprocal peer support, offer a valuable type of resource in the community that is not replicable in professional-client relations. The findings have contemporary relevance given the raft of new policies which value the experiential knowledge built by both individual and collectives of carers.

Adaptation, Psychological↗

PubMed2004

CSF circulation disorders: measuring progress in patients through quality of life and hope.

BACKGROUND: Cerebrospinal fluid circulation disorders are complex and multifaceted conditions making reliable assessment of progress problematic. AIMS AND OBJECTIVES: It is the aim of this paper to explore how efficient measures of quality of life and hope might be used to assess clinical progress for patients with disorders of cerebrospinal fluid circulation. It will be argued that a single-item 10-point quality of life scale and the Herth Hope Index are as effective at measuring progress as the more widely used, but considerably more complex, Short-Form 36. DESIGN: Patients attending a cerebrospinal fluid clinic were sent a questionnaire containing the three measures of progress. Questionnaires were returned in a stamp-addressed envelope to allow initial analysis before the clinic appointment and to enable discussion of results during the clinic appointment. Patients were also assessed using the Mini-Mental State Examination during the clinic appointment. METHODS: The relationship between the three measures of progress was calculated using Spearman's rank order correlation. Correlations of 0.40-0.70 are considered modest and correlations of 0.70 are considered strong; 5% levels of significance are considered significant and 1% levels are highly significant. Internal consistency of the Short-Form 36 was assessed using Cronbach's alpha coefficient. Reliability was considered acceptable for dimension comparisons when alpha > 0.70. RESULTS: All patients were diagnosed with benign intracranial hypertension (n = 74), congenital hydrocephalus (n = 35) or normal pressure hydrocephalus (n = 171). There was a modest to strong correlation between the quality of life-10 and all eight dimensions of the Short-Form 36 for benign intracranial hypertension and congenital hydrocephalus patients. A slightly weaker correlation was demonstrated in seven of the eight Short-Form 36 dimensions for normal pressure hydrocephalus patients. Normal pressure hydrocephalus patients scored significantly lower on the Mini-Mental State Examination, which may contribute to explaining the weaker correlation between the three measures and the weaker internal consistency between the dimensions with the Short-Form 36. Conclusions. This paper demonstrates that efficient indicators of progress (quality of life-10 and Herth Hope Index) can be as effective at assessing clinical progress as more complex indicators (Short-Form 36) in patients who do not demonstrate cognitive deficit. RELEVANCE TO CLINICAL PRACTICE: For clinical application, the Short-Form 36 is too long, difficult to complete, score and analyse for these patient groups. Quality of life-10 and Herth Hope Index could provide efficient and effective measures of clinical progress but this requires further psychometric examination.

Activities of Daily Living↗

PubMed2003

Workplace stress in nursing: a literature review.

BACKGROUND: Stress perception is highly subjective, and so the complexity of nursing practice may result in variation between nurses in their identification of sources of stress, especially when the workplace and roles of nurses are changing, as is currently occurring in the United Kingdom health service. This could have implications for measures being introduced to address problems of stress in nursing. AIMS: To identify nurses' perceptions of workplace stress, consider the potential effectiveness of initiatives to reduce distress, and identify directions for future research. METHOD: A literature search from January 1985 to April 2003 was conducted using the key words nursing, stress, distress, stress management, job satisfaction, staff turnover and coping to identify research on sources of stress in adult and child care nursing. Recent (post-1997) United Kingdom Department of Health documents and literature about the views of practitioners was also consulted. FINDINGS: Workload, leadership/management style, professional conflict and emotional cost of caring have been the main sources of distress for nurses for many years, but there is disagreement as to the magnitude of their impact. Lack of reward and shiftworking may also now be displacing some of the other issues in order of ranking. Organizational interventions are targeted at most but not all of these sources, and their effectiveness is likely to be limited, at least in the short to medium term. Individuals must be supported better, but this is hindered by lack of understanding of how sources of stress vary between different practice areas, lack of predictive power of assessment tools, and a lack of understanding of how personal and workplace factors interact. CONCLUSIONS: Stress intervention measures should focus on stress prevention for individuals as well as tackling organizational issues. Achieving this will require further comparative studies, and new tools to evaluate the intensity of individual distress.

Humans↗

PubMedDate not supplied

Making the most of research opportunities for nursing.

The Department of Health (2005) consultation document Best Research for Best Health: A New National Health Service Research Strategy offers both opportunities for the future development of nursing research and threats to its future. Lessons from the history of health research reforms in the UK suggest that it will take time for any benefits to become obvious and that only some members of the research community will receive funding. In the past few years the quality, potential leadership and skills base for nursing research have shown unprecedented improvements. Combined with a professional understanding of nurses' careers in both practice and education, the proposed new strategy could work to the advantage of nurses and the patients who rely on their expertise. It is, however, essential that the experience and ambitions of as many nurses as possible now feed into this consultation process.

Academies and Institutes↗