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Biomedical subjects

M Nolan

Publications and source records attributed to M Nolan.

At least 19 recordsLinked to original sources
PubMed1996

Entry to care: positive choice or fait accompli? developing a more proactive nursing response to the needs of older people and their carers.

A range of issues surrounding admission to either residential or nursing home care are considered from the perspectives of older people and their family carers. Drawing on the literature and a number of studies conducted by the authors, the processes and perceptions that shape and influence admission to care are identified. On the basis of the interaction of these factors a four-stage typology of admission is suggested: the positive choice, the rationalized alternative, the discredited option, and the fait accompli. The characteristics of each admission type are discussed and the implications for professionals, particularly nurses, working with older people and their carers are addressed.

Aged↗
PubMed1996

Behavioural and Instrumental Stressors in Dementia (BISID): refocussing the assessment of caregiver need in dementia.

The importance of supporting family carers of people with dementia is well accepted and is likely to remain one of the primary areas of intervention for mental health practitioners. This article argues for a holistic assessment of need prior to designing intervention strategies. Such an assessment should include both objective and subjective stressors. Following discussion of a relevant theoretical approach to assessment, a new index for measuring behavioural and instrumental stressors is presented.

Caregivers↗
PubMed1995

Busy doing nothing: activity and interaction levels amongst differing populations of elderly patients.

This paper considers the activity and interaction levels amongst three differing populations of elderly patients (long-stay, short-stay and respite). It begins with a consideration of the literature on staff-patient interactions in care environments for elderly patients, highlighting the virtual absence of preplanned, purposeful activity. Data are then presented which suggest that, despite the emphasis nurses place on communicating with their patients, many patients continue to spend most of their time inactive. It is suggested that if the quality of care elderly patients receive is to improve, nursing staff must see the provision of activity as an integral part of their role and function.

Activities of Daily Living↗
PubMed1995

Developing a typology of family care: implications for nurses and other service providers.

The meanings attributed to the concept of care are considered. It is argued that whilst nursing has paid considerable attention to care in a professional (nursing) context, it has virtually ignored care as it is defined and construed by family carers. A new typology of family care is described which builds on the limited existing conceptual work in this area. It is further suggested that interventions which are intended to assist carers form a continuum ranging from services which are facilitative to those which are actually obstructive. In the light of these discussions, the implications of the new typology for nurses working with family carers are addressed briefly.

Caregivers↗
PubMed1995

Continuing professional education: identifying the characteristics of an effective system.

The need for a functioning system of continuing professional education (CPE) in nursing, midwifery and health visiting has received increased attention in recent years. However, whilst the literature describes a number of benefits, detailed empirical studies have been limited. There is, in particular, a dearth of information on nurses' perceptions of the important components of a CPE programme. Using the results of a recent evaluation of the Welsh National Board's Framework for Continuing Education, this paper highlights a number of key issues identified by practitioners, educators and managers throughout Wales. Using a structure-process-outcome model, attention is focused on the outcomes of CPE and the structure and process variables which facilitate or inhibit success. The results indicate a strong commitment to the principles of CPE and identify a complex range of perceived benefits. Potential barriers inhibiting both the uptake of CPE and the achievement of subsequent change are discussed and the need to create an equitable, well-resourced system is stressed.

Education, Nursing, Continuing↗
PubMed1995

Younger-onset Alzheimer's disease: learning from the experience of one spouse carer.

There are estimated to be 17,000 younger sufferers of dementia currently living in the UK. At present, individualized service and practice initiatives for younger sufferers and their carers remain fragmented and poorly developed. This is despite potential additional caregiving stressors caused by the age of onset, such as financial difficulties due to disruption in the work pattern, children still living at home, and the sufferer's decreased life expectancy. Drawing on an individual carer's personal case history, this article details a spouse carer's individual experience of her husband's decline through the stages of younger-onset Alzheimer's disease. Pointers for policy and practice for younger sufferers and their carers are drawn from this case history and a role for the community psychiatric nurse is outlined.

Adaptation, Psychological↗
PubMed1995

Assessing clinicians' consultation with people with profound learning disability: producing a rating scale.

This paper describes the development of a scale for assessing clinicians' communication with people with profound learning disability. Four psychiatrists and four nurses were assessed completing three simple non-invasive clinical procedures--blood pressure, pulse and axillary temperature--with people with profound learning disability. Videotaped assessment of consultations was performed by three experienced speech and language therapists using a previously designed scale for analysing encounters with people with mild learning disability. This led to the production of a new scale specifically for people with profound learning disability. A significant inter-rater reliability was found between the three speech therapists for total scores (rater a-b, corr = 0.654, P = 0.006; rater a-c, corr = 0.795, P = 0.0001: rater b-c, corr = 0.673, P = 0.004). Significant reliability between raters was also found for the subsections of verbal behaviour and non-verbal behaviour.

Blood Pressure↗
PubMed1995

A stitch in time. Facilitating proactive interventions with dementia caregivers: the role of community practitioners.

The role of family caregivers in supporting people with dementia in the community is beyond question. Yet, all too often, the needs of such carers are overlooked by community practitioners. This paper describes the results of a study in Wales examining the experiences of dementia caregivers with Community Practitioners. Four themes are identified which encapsulate the various difficulties carers faced. These revolve around a lack of communication, information and support. Recommentations to improve the current situation are made.

Aged↗
PubMed1995

Supporting women in labour: the doula's role.

A doula is a woman without medical experience who guides and assists a new mother in childbirth and babycare tasks. The doula's role is to hold the woman, breathe with her, smile at her and provide encouragement and reassurance. Doula support for the labouring woman may reduce catecholamine levels, thus shortening the duration of labour. Doula support can increase self-esteem in the labouring woman and facilitate her transition to motherhood. Rates of oxytocin augmentation, epidural anaesthesia and caesarean section can be reduced by doula support. Fathers may find it hard to provide doula-type support during labor because of their own emotional involvement in the birth. The introduction of doulas into labour wards could lead to reduced costs for maternity services.

Cost Savings↗
PubMed1994

Geriatric nursing: an idea whose time has gone? A polemic.

The future role of the nursing profession in providing health care for older people is considered. It is argued that, despite claims to holism, nursing has maintained a narrow focus, concentrating mainly on acute hospital care. The concepts of professional protectionism and professional reductionism are used to explain the manifest failure of nursing and other professions working with older people and their carers to place the needs of their clients at the top of their agendas. A reorientation of nursing practice is advocated in order that the profession fulfils its potential with respect to older people.

Aged↗
PubMed1994

Younger onset dementia: developing a longitudinal model as the basis for a research agenda and as a guide to interventions with sufferers and carers.

With the current emphasis on community care, the importance of dementia as an area for the interventions of community practitioners, especially nurses, cannot be overemphasized. However, despite being the subject of increasing research over recent times, a comprehensive model of the dementia experience from either the sufferer's or carer's perspective has yet to be developed. This is particularly noticeable in the case of people suffering from dementia below the age of 65. This situation is exacerbated by the lack of representative epidemiological studies which relate to the incidence or prevalence of younger onset dementia. In this paper, the current epidemiological literature on younger onset dementia is considered and the findings from previous work are used to suggest prevalence figures for Wales. A longitudinal model of the dementia experience from a sufferer's perspective is then presented as the basis for a research agenda. It is also suggested that this model, subject to empirical testing and refinement, could be used as a guide to interventions for practitioners working with the sufferers and their carers.

Caregivers↗