Biomedical subjects

Sally Kendall

Publications and source records attributed to Sally Kendall.

10 recordsLinked to original sources

PubMed2007

Factors influencing the development of evidence-based practice: a research tool.

AIM: The paper reports a study to develop and test a tool for assessing a range of factors influencing the development of evidence-based practice among clinical nurses. BACKGROUND: Achieving evidence-based practice is a goal in nursing frequently cited by the profession and in government health policy directives. Assessing factors influencing the achievement of this goal, however, is complex. Consideration needs to be given to a range of factors, including different types of evidence used to inform practice, barriers to achieving evidence-based practice, and the skills required by nurses to implement evidence-based care. METHODS: Measurement scales currently available to investigate the use of evidence in nursing practice focus on nurses' sources of knowledge and on barriers to the use of research evidence. A new, wider ranging Developing Evidence-Based Practice questionnaire was developed and tested for its measurement properties in two studies. In study 1, a sample of 598 nurses working at two hospitals in one strategic health authority in northern England was surveyed. In study 2, a slightly expanded version of the questionnaire was employed in a survey of 689 community nurses in 12 primary care organizations in two strategic health authorities, one in northern England and the other in southern England. FINDINGS: The measurement characteristics of the new questionnaire were shown to be acceptable. Ten significant, and readily interpretable, factors were seen to underlie nurses' relation to evidence-based practice. CONCLUSION: Strategies to promote evidence-based practice need to take account of the differing needs of nurses and focus on a range of sources of evidence. The Developing Evidence-Based Practice questionnaire can assist in assessing the specific 'evidencing' tendencies of any given group of nurses.

Clinical Nursing Research↗

PubMed2007

Increased cancer risk in patients referred to hospital with suspected fibromyalgia.

OBJECTIVE: To analyze whether fibromyalgia (FM) and FM-like symptoms are related to an increased incidence of cancer. METHODS: We identified 1361 patients referred on suspicion of FM in the period 1984-99 from hospital records. Following the American College of Rheumatology (ACR) criteria, patients were divided into subgroups with and without confirmed FM. The cohort was followed to the end of 1999 and linked to the files of the Danish Cancer Register. Site-specific standardized incidence ratios (SIR) were calculated. RESULTS: We found no association between FM and cancer in 1132 female patients with confirmed FM at our institution (SIR 1.2, 95% CI 0.8-1.8). In 106 women referred for muscle pain and/or tenderness who did not meet the criteria for FM, an increased overall SIR was observed (SIR 2.5, 95% CI 1.2-4.6), with increased risk for breast cancer (SIR 4.8, 95% CI 1.6-11.3) and lymphatic and hematological cancers (SIR 10.6, 95% CI 1.2-38.2). There were 4 lung cancers in 84 men with confirmed FM (SIR 12.6, 95% CI 3.4-32.4). CONCLUSION: Neither confirmed FM nor those without confirmed FM predicted cancer. An increased risk of breast cancer was found among those who did not meet the ACR criteria for FM. These patients should be investigated if they develop any new or warning symptoms of malignancy, and treating physicians should be vigilant with screening procedures such as mammography.

Adult↗

PubMed2005

Nurses' responses to expert patients: the rhetoric and reality of self-management in long-term conditions: a grounded theory study.

BACKGROUND: Against the backdrop in the western world of increasing prevalence of chronic disease, active and informed patients and a policy emphasis on self-management, this English study explored health professionals' responses to expert patients. OBJECTIVES: To: DESIGN: A grounded theory approach was utilised with two concurrent data strands. SETTING: A relatively affluent English county including community, primary and secondary care settings. PARTICIPANTS: Via purposeful and theoretical sampling 100 health professionals (nurses, doctors, physiotherapists) and 100 adults affected by chronic disease participated. METHODS: Focus groups, interviews and observation. RESULTS: Nurses were found to be most anxious about expert patients when compared to other professionals, which appeared to be linked with a lack of professional confidence and unfounded fears regarding litigation. However, nurse specialists often provided a negative case for this. As a whole, nurses were most able to meet the emotional needs of patients, but apart from nurse specialists did not articulate this as a skill. CONCLUSION: Apart from nurse specialists the majority of nurses appeared limited in appropriately facilitating self-management. It is suggested that this is linked to an ongoing nursing culture of patient as passive, an over-emphasis on empirical knowledge and a feeling of vulnerability on the nurses' part towards expert patients. The findings also indicate a rhetoric rather than reality of autonomous nursing roles within the chronic disease management agenda.

Adaptation, Psychological↗

PubMed2005

A qualitative study exploring the experiences and views of mothers, health visitors and family support centre workers on the challenges and difficulties of parenting.

Successive policy documents have referred to the need to support parents as an approach to reducing social exclusion, behaviour problems among young people and crime rates. Much of the rhetoric focuses on professional intervention, and there is less attention paid to the views and experiences of parents themselves. The present study explores the experiences and views of mothers, health visitors and family support centre workers who work with parents on the challenges and difficulties of parenting children under the age of 6 years. It provides an appreciation of their views on effective parenting and how parents can be helped to feel more effective in the parenting role. Focus groups, which were exploratory and interactive in form, were conducted across three primary care trusts in Hertfordshire, UK. Three samples were purposively selected in order to examine the range and diversity of experiences and views about parenting, and included the parents of children up to the age of 6 years, health visitors and family support centre workers. The mothers were those waiting to attend a parenting programme, and included first-time mothers and those with more than one child. The health visitors and family support workers had a range of experience in working with parents and children, and included those who were facilitating parenting programmes and those who were not. A number of themes emerged surrounding the challenges and difficulties of parenting and effective parenting, including expectations of others, establishing routines, play, behavioural issues and discipline, empathy, and communication. Similar themes emerged from all groups; however, there were qualitative differences between parents and professionals in the way in which these issues were expressed. Key statements from the parent focus groups have been developed into self-efficacy statements, which will be used as input to the development of a tool to measure the effectiveness of parenting programmes.

Adult↗

PubMed2005

Developing and validating a tool to measure parenting self-efficacy.

AIMS: This paper reports the development of a tool to measure parenting self-efficacy as an aid to evaluating parenting programmes. BACKGROUND: Whilst there has been increasing interest in parenting programmes from parents, government and professionals, there is a lack of rigorous evaluation studies of their effectiveness, particularly their longer-term outcomes. Equally, there is little research evidence of the views and experiences of parents themselves. It is important to develop robust outcome measures which draw on well-developed theoretical constructs to measure parents' perceived abilities to manage their children based on their own views and experiences. Self-efficacy, a self-perception of one's ability to perform competently and effectively in a particular task or setting, may provide such a framework. METHODS: Data from 12 focus groups conducted with parents and parenting programme facilitators informed the development of the tool. A thematic analysis of the focus group transcripts identified key items to be included in the self-efficacy instrument, and these were developed into 82 Likert-format statements. A multi-method approach was used to test the instrument for validity and reliability. FINDINGS: Nine domain specific sub-scales of parenting were identified from the analysis of the focus group data. Internal reliability coefficients for the subscales ranged from 0.80 to 0.89, and the overall scale reliability was 0.94. External reliability coefficients ranged from rs = 0.58 (n = 19, P < 0.01) to rs = 0.88 (n = 19, P < 0.01). CONCLUSION: A valid and reliable tool to measure parenting self-efficacy has been developed, which will aid evaluation of parenting programmes.

Adult↗

PubMed2005

A critical account of obtaining research governance approval.

Research governance strategies, as currently operated are potentially limiting the conduct of research, especially multi-centre studies. The authors provide an overview of the current research governance framework in the UK and, using the example of one study as an illustrative case, describe and discuss a research team's experience of gaining research governance approval for a multi-centre study.

Data Collection↗

PubMed2005

The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review.

BACKGROUND: In recent years there has been a growth in the use of the telephone consultation for healthcare problems. This has developed, in part, as a response to increased demand for GP and accident and emergency department care. AIM: To assess the effects of telephone consultation and triage on safety, service use, and patient satisfaction. DESIGN OF STUDY: We looked at randomised controlled trials, controlled studies, controlled before/after studies, and interrupted time series of telephone consultation or triage in a general healthcare setting. SETTING: All healthcare settings were included but the majority of studies were in primary care. METHOD: We searched the Cochrane Central Register of Controlled Trials, EPOC specialised register, PubMed, EMBASE, CINAHL, SIGLE, and the National Research Register and checked reference lists of identified studies and review articles. Two reviewers independently screened studies for inclusion, extracted data, and assessed study quality. RESULTS: Nine studies met our inclusion criteria: five randomised controlled trials; one controlled trial; and three interrupted time series. Six studies compared telephone consultation with normal care; four by a doctor, one by a nurse, and one by a clinic clerk. Three of five studies found a significant decrease in visits to GPs but two found an increase in return consultations. In general at least 50% (range = 25.5-72.2%) of calls were handled by telephone consultation alone. Of seven studies reporting accident and emergency department visits, six showed no difference between the groups and one--of nurse telephone consultation--found an increase. Two studies reported deaths and found no difference between nurse telephone consultation and normal care. CONCLUSIONS: Although telephone consultation appears to have the potential to reduce GP workload, questions remain about its effect on service use. Further rigorous evaluation is needed with emphasis on service use, safety, cost, and patient satisfaction.

Controlled Clinical Trials as Topic↗

PubMed2004

The information needs of carers of adults diagnosed with epilepsy.

AIM: The aim of the study was to explore the information needs of informal carers, and how information from health professionals can become more effective for families caring for people with epilepsy. METHODS: A combined methodology was used, comprising an interview study and a survey. Twelve in-depth interviews with carers were carried out. The questionnaire was developed using the interview data, to which 70 carers responded. RESULTS: Four main themes have been drawn from the study. Carers' of people with epilepsy have a need for improved and more appropriate levels of information giving by health professionals in both primary and secondary care. Carers' perceived self-efficacy expectations in seeking information are positive but they do not always feel listened to. Carers' prefer to receive information in a one-to-one setting but also need information from formats other than leaflets. Carers' perceive barriers to having their information needs met, such as their needs being unrecognised in relation to the person with epilepsy.

Adult↗

PubMedDate not supplied

Psychological impact of colostomy pouch change and disposal.

This article presents some of the findings from a multicentre cross-sectional correlational study to evaluate the relationship between colostomy pouch change and disposal practices and the patient's psychological wellbeing. Five questionnaires were used in a one-off interview with 86 patients. Patients were assessed at between one and four months postoperatively. Results from the Pouch Change and Disposal questionnaire showed that only 25% of patients found disposal of used appliances the most difficult part of their pouch change and disposal routine. Half felt that their body was out of their control and 33% reported avoiding social and leisure activities due to what was involved in their pouch change and disposal routine. Patients cited several factors, such as minimizing odour and having an appliance that could flush away, as factors which would help them to stop avoiding these activities. Stoma care nurses have a unique opportunity to improve the psychological wellbeing of their patients by considering the aspects of pouch change and disposal that pose the greatest challenge to individuals. Use of a modified version of the Pouch Change and Disposal questionnaire may be a useful tool in identifying those at risk of impaired quality of life.

Activities of Daily Living↗

PubMedDate not supplied

Perceptions of control in patients with rheumatoid arthritis.

Forty patients with rheumatoid arthritis were randomly recruited from an outpatient population for an in-depth, qualitative interview. The aim was to identify factors that influence whether patients feel they have any control over their condition. The data were analysed using Colaizzi's procedural steps. Four major categories that positively influence perceptions of control were identified. These were the reduction of physical symptoms, the matching of social support with perceived need, the provision of information, and the nature of the clinical consultation.

Adaptation, Psychological↗