PubMed Health⌕ Search

Biomedical subjects

C Macduff

Publications and source records attributed to C Macduff.

10 recordsLinked to original sources
PubMed2003

The effectiveness of scalp cooling in preventing alopecia for patients receiving epirubicin and docetaxel.

The aim of this study was to establish the effectiveness of scalp cooling in preventing alopecia for patients with breast cancer who received the trial combination chemotherapy of Epirubicin and Docetaxel. Doubt remains about the general effectiveness of scalp cooling in preventing hair loss for patients receiving chemotherapy. There is very little information available about its specific effectiveness with combinations of Taxanes and Anthracycline drugs. Of the 40 patients who received this drug combination, 10 were included in a pilot study whereas the remaining 30 constituted the main study sample. A randomized controlled study was undertaken whereby the intervention group received scalp cooling via gel cool caps and the control group received no specific preventative intervention. Nurses assessed participants' hair loss using a modified version of the WHO scale at seven time points and also recorded hair loss photographically. Two independent experts rated the photographs using the same scale. Patients self-reported in relation to overall hair loss, hair condition, levels of emotional upset, negativity about appearance, hair re-growth and wig use. Significantly greater hair loss was apparent in the control group during most of the treatment period. However, the level of protection afforded by the cool caps was relatively poor with this chemotherapy combination. The marginal benefits of scalp cooling in this context must be clearly explained to patients.

Alopecia↗
PubMed2001

Opportunity for audit: establishing and monitoring the use of protocols for nurse-led treatments of minor injuries.

During the last three years an integrated initiative has evolved in the casualty units of nine community hospitals in the Grampian region of Scotland. This has involved the development of nurse-led treatments for minor injuries based on a large number of assessment/treatment protocols. This paper describes how this change was used as an opportunity to initiate audit within clinical practice. Methods of auditing the use of the new protocols are detailed and baseline results are reported and discussed. In this way it is hoped that nurses involved in similar developments can learn from the strengths and weaknesses of this initiative.

Clinical Protocols↗
PubMed2000

Respondent-generated quality of life measures: useful tools for nursing or more fool's gold?

Within health services research the quest for better ways of measuring quality of life as an outcome variable continues apace. Recent developments in this area have seen increasing attempts to incorporate individually generated content and values into quality of life measures while retaining valid psychometric measurement properties. Following a brief overview of current conceptual approaches to quality of life measurement, this paper reviews the development of two leading Respondent-generated instruments: the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) and the Patient Generated Index (PGI). The relative strengths and weaknesses of these tools and their potential applications for nursing and nursing research are appraised. These measures both address and manifest a number of fundamental conceptual and methodological problems, and represent an innovative attempt to square the quantitative--qualitative circle. As such they offer challenging opportunities for nursing at a number of levels. Their elicitation and quantification of individual components of quality of life offer opportunities for nurses to plan care and goal set with patients. As yet, however, the validity, reliability, responsiveness and practicality of these instruments as outcome measures are debatable and require further testing. Nurse researchers could contribute to this process by using Respondent-generated measures as an adjunct to existing, established tools in outcome studies. Moreover, nursing is well placed to investigate and debate the validity of the conceptual assumptions underpinning these new instruments.

Attitude to Health↗
PubMed1998

The problem of measuring change in individual health-related quality of life by postal questionnaire: use of the patient-generated index in a disabled population.

The Patient-generated Index (PGI) is a health-related quality of life (HRQoL) measure which asks respondents to nominate the areas of their lives which are most affected by their health condition, so that they can then rate the severity of the effects and weight their relative importance. It is unusual amongst such measures in that it is designed for postal administration. This study assessed the ability of the revised PGI to measure change in HRQoL in a population of 161 people who had previously been identified as having limiting long-term illness. A questionnaire, including a revised version of the PGI and the developmental version of the SF-36, was mailed at two time points (T1 and T2), 4.5 months apart. The PGI was subsequently assessed in terms of practicality, validity, reliability and responsiveness. At T1, 62% of those who felt that they still had a health problem affecting their life completed the PGI correctly. These people were significantly younger and had spent longer in education than the remaining 38%. Only 19 respondents completed the PGI correctly on both occasions, rendering reliability and responsiveness testing inconclusive. The value of the PGI is significantly diminished by the fact that many people cannot complete it correctly. Future development of the instrument is appraised in the context of related measurement methods.

Activities of Daily Living↗
PubMed1997

Meeting the mother man: rediscovering Walt Whitman, writer and nurse.

Despite a long history of men working as nurses, there is a dearth of prominent male role models in nursing history. This article reevaluates the legacy left for nursing by Walt Whitman, the famous American writer who spent three years visiting hospitals and doing voluntary nursing work during the American Civil War. Whitman's nursing practice and beliefs are examined in historical context. His motivation is also explored and related to current perspectives on males in nursing. Whitman emerges as a singular man with a talent for caring and communicating its value. He is posited as a significant figure in the history of males in nursing, whose status as a gay archetype required further research. His writings comprise a substantial legacy for the whole nursing community.

History, 19th Century↗
PubMed1997

Stroke services in general practice--are they satisfactory?

BACKGROUND: The contribution of general practice and primary care teams to stroke care has received surprisingly little attention despite research evidence on the importance of coordinated care. AIM: To determine general practitioners' (GPs') and their patients' satisfaction with hospital and community services for stroke patients in Grampian Region, Scotland. METHOD: A questionnaire survey of 138 stroke patients and their GPs was carried out six weeks after each patient was discharged home between June 1995 and January 1996. Outcomes measured were GP and patient satisfaction with services, Barthel Index, Hospital Anxiety and Depression scores, London Handicap Score, and Homsat and Hospsat scores (satisfaction with stroke services). RESULTS: Response rates of 95% (131) for GPs and 91% (125) for patients were obtained. GPs and patients were generally satisfied with services. Stroke patients were more likely to have had contact with their GP than with any other service. Adverse comments from GPs focused on problems with hospital discharge letters. At six weeks, patients received an average of 2.5 community services and 1.5 hospital services, but there was wide variation across disability groups. CONCLUSIONS: Levels of satisfaction were high, but the wide range and variation in services used by patients emphasized the complexity of the primary care of stroke patients; the need for coordination, review and effective links with hospital; and the key role of the GP.

Aged↗
PubMed1996

Unplanned readmissions of elderly patients.

OBJECTIVE: This study was undertaken to determine the prevalence of unplanned readmissions in Geriatric Medicine in Aberdeen and to examine their nature in order to establish how many of them were avoidable. DESIGN: Patients living within Aberdeen who were discharged from Care of the Elderly Assessment Wards in one hospital between 1 August 1994 and 31 January 1995 were identified. Any subsequent unplanned readmissions of this population to any local hospital within 28 days were identified and formed the study's sample. Subsequent comparison with the non-readmitted population yielded readmission rates. The nature of each episode was investigated by obtaining a wide range of data (e.g. from medical and nursing notes) soon after readmission and by the audit team subsequently identifying principal and associated causative factors. A questionnaire was also sent to the discharging consultant and the patient's GP seeking opinions on whether readmission was avoidable and these were weighted equally with the audit team's opinion in order to establish avoidability. SETTING: The patients were all discharged from the nine Care of the Elderly Assessment wards at Woodend Hospital in Aberdeen and readmitted to any NHS hospital within Aberdeen. SUBJECTS: The subjects were patients living within Aberdeen who satisfied the above criteria. RESULTS: There were 109 episodes of readmission resulting from 713 discharges, making a readmission rate of 15.3%. The readmitted population was elderly with multiple medical problems; 50% lived alone. In 87% of cases the principal causative factor in readmission was medical, most commonly involving relapse of illness. The remaining 13% were 'social' in nature. Response rates to the questionnaire by GP's and Consultants were excellent (96% and 99% respectively) and 34 cases emerged where either party, or both, thought readmission to be avoidable. These cases were subject to further review by the audit team and in this way 16 of the 34 cases were judged to be avoidable. The main area for improvement was considered to be pre-discharge assessment of home circumstances. CONCLUSION: The majority of unplanned readmissions were medical in nature and unavoidable. The use of rates of unplanned readmission as a measure of clinical outcome in care of the elderly is unsatisfactory as they do not accurately reflect the quality of in-patient care.

Aged↗
PubMedDate not supplied

Telemedicine in rural care. Part 1: Developing and evaluating a nurse-led initiative.

AIM: To develop and evaluate a nurse-led telemedicine service over a six-month period, linking the senior citizens of a rural village with the town-based general practice. METHOD: Patients, doctors and nurses were asked to complete a questionnaire following video-link sessions. Interviews were also carried out at home with patients, while interviews with nurses and doctors took place in the workplace. RESULTS: Of the 173 consultations with villagers aged over 65, 29 (17 per cent) were conducted by video-link. All those who used this service were sent questionnaires and 18 were returned (62 per cent). Seven of the patients who had received one video-link consultation were interviewed in their homes. All of the patients initially found the video consultation experience strange. Generally, patients found the nurses to have a pivotal role in explaining the service and interpreting their needs. All those interviewed said they would use the service again. The GPs spoke favourably of the service and said that it had saved them time. The nurses involved were positive about the service. Negative comments generally related to technology, for example picture and sound quality. CONCLUSION: All involved in the nurse-led telemedicine service viewed it favourably and patients said that they would use it again. Part two, to be published in next week's Nursing Standard, will discuss the findings of the evaluation in relation to the wider picture of nursing involvement in teleconsultation.

Aged↗
PubMedDate not supplied

Telemedicine in rural care. Part 2: Assessing the wider issues.

BACKGROUND: The first article about this development (Macduff et al 2001) described the evolution of a nurse-led telemedicine service in the village of Hamlet (population 1,600), north-east Scotland, and presented the findings of an evaluation study. In this second article, those findings are discussed in relation to the wider picture of nursing involvement in teleconsultation. The village has no medical practice or pharmacy and the majority of Hamlet's residents aged over 65 are registered with the Bradieslea Road surgery, one of three general practices six miles away in the town of Bradieslea. The community nursing service is based in small rooms at a sheltered housing complex in the village. This service covers all patients in the Hamlet area. It is staffed by one full-time district nurse/health visitor (who acts as team leader) and one part-time district nurse. Both are qualified nurse prescribers. CONCLUSION: Opportunities now exist for nurses to use teleconsultation for the benefit of their patients. A systematic development of this type of nursing role through integration with broader service development would be valuable.

Aged↗