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Biomedical subjects

Dawn Dowding

Publications and source records attributed to Dawn Dowding.

14 recordsLinked to original sources
PubMed2007

Health promotion at NHS breast cancer screening clinics in the UK.

Suboptimal diets, sedentary lifestyles, overweight and obesity expose two-thirds of women in England aged over 50 to a heightened risk of lifestyle-related morbidities. The UK's NHS Breast Cancer Screening Programme now reaches 75% of all women aged 53-64 but provides only mammography screening. This cross-sectional survey of 413 women attending two NHS breast screening clinics in North Yorkshire found that the majority of women were interested in having diet and exercise advice at screening clinics and anticipated a neutral or positive effect on their future screening appointments. Interest was highest among older, less educated and overweight women suggesting that this may be a particularly effective medium for reaching higher risk subgroups. Women showed most interest in problem-solving advice, which provided short-term, life-enhancing benefits such as looking and feeling better, having more energy, losing weight and reducing menopausal symptoms, as well as potentially reducing their disease risk. Most appeared to find doing sufficient exercise more problematic than eating healthily and this might be exacerbated by low awareness of exercise guidelines. Given a choice, preferences were to access advice in leaflets or one to one from an expert; however, many younger, professional women were also interested in computer access. Findings indicate the need first for flexible, multi-level access, combining some broad-based information dissemination with pathways to more personalized support and secondly for the relevant 'consumer benefits' associated with better diet and exercise to be promoted as well as longer-term disease prevention. Overall, this study indicates that the UK's NHS Breast Cancer Screening Programme may be uniquely placed to provide health-enhancing advice as well as mammography screening to the majority of women in England, throughout the course of their mid-life.

Aged↗
PubMed2005

A computerised guidance tree (decision aid) for hypertension, based on decision analysis: development and preliminary evaluation.

This paper discusses the piloting of a computerised decision aid that provides individualised information about hypertension to patients. The program is based on decision analysis, using decision trees as a way of structuring information. It incorporates the Framingham risk equation to assess a users' risk of coronary artery disease, together with a detailed assessment of the patient's current lifestyle and their willingness to change behaviour. Users of the program can decide how much or how little information they access. The program assesses individual's preferences for different treatment outcomes, before providing them with guidance on what might be the best treatment option for them. The program was evaluated by 10 patients with a diagnosis of mild to moderate hypertension and 8 health care professionals. Overall, both health care professionals and patients assessed the program positively. The use of a decision aid based on decision analysis may be a useful way of providing information to patients in order to promote shared decision making.

Aged↗
PubMed2005

Long- and short-term risk factors in the prediction of inpatient suicide: review of the literature.

The prediction of suicide remains a major challenge for health care professionals in inpatient settings. A clearer identification of factors specific to inpatient suicide is required to improve both practice and research within this area. This paper provides an overview of the inpatient suicide literature to date focusing on two particularly salient themes: Long term and short term prediction of suicide. Since the concept of short-term suicide risk dominates clinical practice, issues in relation to dynamic risk factors are emphasized.

Comorbidity↗
PubMed2004

The development and preliminary evaluation of a decision aid based on decision analysis for two treatment conditions: benign prostatic hyperplasia and hypertension.

This paper discusses the development and evaluation of a computerised decision aid that provides individualised information about Benign Prostatic Hyperplasia (BPH) and Hypertension to patients. The program is based on decision analysis, using decision trees as a way of providing users with information regarding the probability of different outcomes occurring, obtaining an individual evaluation of the different outcomes, before providing guidance on what might be the 'best' option for that patient. It is intended that the program can be used as the basis for helping patients to become more involved in decisions about their medical treatment. Eight health care professionals and 19 patients (9 with BPH and 10 with Hypertension) evaluated the program. Overall it was assessed positively by both health care professionals and patients. However, before it can be integrated into health care practice, the program is to be evaluated further in a randomised trial.

Aged↗
PubMed2003

Measuring the quality of judgement and decision-making in nursing.

AIM: This paper discusses measurement of the quality of judgement and decision-making in nursing research. It examines theoretical and research issues surrounding how to measure judgement accuracy as a component of evaluating decision-making in nursing practice. DISCUSSION: Judgement accuracy is discussed with reference to different methods of measurement, including comparing judgements with independent criteria and inter-judge approaches. Existing research on how judgement accuracy has been measured in nursing practice is examined. Evaluation of decisions is then discussed, including consideration of the process of decision-making and evaluating decision outcomes. Finally, existing research on decision-making in nursing is assessed and the strengths and limitations of different types of measurement discussed. CONCLUSION: We suggests that researchers examining the quality of judgement and decision-making in nursing need to be aware of both the strengths and limitations of existing methods of measurement. We also suggest that researchers need to use a number of different methods, including normative approaches such as Bayes' Theorem and Subjective Expected Utility Theory.

Decision Making↗
PubMed2002

An investigation into the accuracy of different types of thermometers.

The traditional mercury-in-glass thermometer carries the potential risk of glass breakage and mercury spillage and health-care professionals have sought an alternative. This study examined the accuracy of three other types of temperature-measurement device--disposable, digital and tympanic--when compared with standard mercury thermometer readings.

Adolescent↗
PubMedDate not supplied

Evaluating the funding and capacity of research in Scotland.

This paper will discuss the results of a scoping exercise carried out as part of a strategy to inform subsequent models of infrastructure funding. The exercise showed that Scotland has less research capacity in nursing and midwifery than the UK as a whole. Following the publication of a nursing and midwifery research strategy for Scotland, initiatives are being put in place to fund an increase in research capacity and capability in the nursing and midwifery professions.

Humans↗
PubMedDate not supplied

Using decision trees to aid decision-making in nursing.

This article discusses judgement and decision-making in nursing. It outlines an approach to analysing clinical problems known as decision analysis. It suggests decision analysis can be a useful technique for nurses to assist them with decision-making in practice.

Decision Trees↗
PubMedDate not supplied

Using judgement to improve accuracy in decision-making.

Nursing judgements are complex, often involving the need to process a large number of information cues. Key issues include how accurate they are and how we can improve levels of accuracy. Traditional approaches to the study of nursing judgement, characterised by qualitative and descriptive research, have provided valuable insights into the nature of expert nursing practice and the complexity of practice. However, they have largely failed to provide the data needed to address judgement accuracy. Social judgement analysis approaches are one way of overcoming these limitations. This paper argues that as nurses take on more roles requiring accurate judgement, it is time to increase our knowledge of judgement and ways to improve it.

Clinical Competence↗
PubMedDate not supplied

Awareness and prevention of error in clinical decision-making.

The risk of errors in the planning and delivery of health care is an inescapable feature of clinical practice for which health providers have developed sophisticated defences. However, errors still occur. This paper, the final in a four-part series on nurses' decision-making and judgement, illustrates some common pitfalls facing clinicians who have to make complex decisions and judgements, and suggests simple techniques to help combat some of the systematic errors people make when exercising judgement and making choices.

Decision Making↗