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Biomedical subjects

I Baguley

Publications and source records attributed to I Baguley.

10 recordsLinked to original sources

The clinical activity of mental health nurse lecturers.

Concerns have been expressed about the ability of mental health lecturers to prepare practitioners with the skills, knowledge and attitudes needed to implement the National Service Framework for mental health. Specifically mental health nurse lecturers have been criticized for lacking clinical competence and credibility, and for being out of touch with developments in service delivery. This paper presents a selection of findings from a recent review into the clinical activity of mental health lecturers in higher education institutions in England. The issues discussed include roles in practice, questioning the value of face-to-face clinical work, the benefits of being clinically active, the difficulties of clinical academic roles, barriers to maintaining clinical activity, questioning the quality of the clinical workforce, and finally strategies to facilitate clinical activity. Whilst there is support among mental health nurse lecturers for the need to engage with practice at some level, there are inconsistencies in the ways that this is being achieved. Lecturers are, however, getting together to debate how best to keep up with changes in mental health practice and delivery.

Clinical Competence↗

Movement of the endotracheal tube during laparoscopic hernia repair.

BACKGROUND: Laparoscopic surgery is not without its problems, and one of the less known is cephalad displacement of the carina and relative movement of the endotracheal tube in the trachea. The aetiology of this is presumably a consequence of both pneumoperitoneum and the Trendelenburg position frequently adopted during laparoscopic surgery. METHOD: We studied 30 patients undergoing laparoscopic hernia repair utilising 10 degrees of Trendelenburg position and an intra-abdominal inflation pressure of between 12 and 15 mm Hg (mean 13.6 mm Hg). We measured the distance between the tip of the endotracheal tube and the carina using a fibreoptic bronchoscope. RESULT: This distance decreased only slightly, from a mean (SD) of 39.6 (13) mm after intubation, to 38.9 (12.6) mm after adoption of Trendelenburg tilt and pneumoperitoneum. This did not represent a statistically significant change (P=0.09). CONCLUSION: We conclude that the endotracheal tube does not routinely migrate towards the carina when laparoscopic hernia repair is performed under these conditions.

Adult↗

Long-term mortality trends in patients with traumatic brain injury.

Comparison of long-term mortality rates between patients with traumatic brain injury (TBI) and the general population has not been adequately investigated. This project aimed to obtain information on the long-term mortality rate of patients with TBI. Using a rehabilitation database of a major teaching hospital, the search identified 476 patients, of whom 27 were deceased. This mortality rate (5.7%) was compared with the expected mortality rate for an equivalent population without TBI (1.5%) using Australian Life Table data. It was found that patients with TBI had a significantly higher mortality rate than the general population (chi2 = 12.2, p < 0.001). Possible reasons for this finding are discussed.

Adult↗

Coping style and post-traumatic stress disorder following severe traumatic brain injury.

There is increasing evidence that a proportion of severe traumatically brain injured (TBI) patients do suffer post-traumatic stress disorder (PTSD). The aim of this study was to investigate the predictors of PTSD following severe TBI in a sample of 96 patients who sustained a severe TBI, of whom 27% satisfied diagnostic criteria for PTSD. The Post-traumatic Stress Disorder Interview, the Coping Style Questionnaire, and the Functional Assessment Measure was administered to these patients 6 months after hospital discharge. Avoidant coping style, behavioural coping style, and a history of prior unemployment were the significant predictors of PTSD severity. These findings indicate that reduction of PTSD and management of severe TBI may be facilitated by teaching patients more adaptive coping strategies.

Adaptation, Psychological↗

The clinical skills of community psychiatric nurses working with patients who have severe and enduring mental health problems: an empirical analysis.

This study describes the use of reliable scales to rate the clinical skills of mental health nurses when working with individuals and families with severe mental health problems. The Cognitive Therapy Scale and the Schizophrenia Family Work Scale were adapted for the study and were shown to have good inter-rater reliability when assessing audio-taped interviews carried out by mental health nurses during their usual course of work with patients with severe mental health problems and their families. The sample of mental health nurses studied were shown to have significantly better general therapy skills than specific cognitive therapy technical skills. The implications for training are discussed.

Clinical Competence↗

Psychological methods of treating hallucinations and delusions: 1.

This article, the first in a two-part series, describes how the neuro-biological, social and environmental factors involved in the course and treatment of schizophrenia have helped to establish a pathway to recovery or remission that does not embrace pharmacological therapy alone. Research into drug-resistant symptoms and poor adherence rates (Curson et al, 1985) demands effective alternatives and additions to more traditional approaches to treatment such as medication. The second part of the article describes how evidence-based psychological interventions were used to help a client suffering from treatment-resistant delusions, allied to a chaotic lifestyle and substance misuse, that had previously presented a substantial challenge to the mental health services.

Adaptation, Psychological↗

Hallucinations and delusions. 2: A dual diagnosis case study.

This article, the second of two parts, describes how evidence-based psychological interventions were used to help a client suffering from treatment-resistant delusions and substance misuse, allied to a chaotic lifestyle, that had previously presented a substantial challenge to services. The first part (Vol 8(15): 998-1002) Investigated how the neurobiological, social and environmental factors involved in the course and treatment of schizophrenia have helped to establish a pathway to recovery or remission that does not involve pharmacological therapy alone.

Adaptation, Psychological↗

Snap decisions.

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Family↗