Preference for different relaxation techniques by COPD patients: comparison between six techniques.

Background: A review of the effectiveness of relaxation techniques for chronic obstructive pulmonary disease patients has shown inconsistent results, but studies have varied in terms of technique and outcome measures.

Aim: To determine patient preference for different relaxation techniques.

Methods: Chronic obstructive pulmonary disease patients were presented with six techniques via a DVD and asked to rate the techniques in terms of effectiveness, rank in order of likely use, and comment.

Understanding fear and anxiety in patients at the time of an exacerbation of chronic obstructive pulmonary disease: a qualitative study.

Objectives: To determine the importance of fear and anxiety at the time of an exacerbation of chronic obstructive pulmonary disease. To assess the influence of carers and health professionals on this fear and anxiety.

Design: A qualitative study to elicit the views of patients and their carers during a hospital admission for exacerbations of chronic obstructive pulmonary disease.

GPs prescribing of strong opioid drugs for patients with chronic non-cancer pain: a qualitative study.

Background: Chronic non-cancer pain (CNCP) is common in the UK. GPs manage most patients with such pain. Previous research has suggested that prescribing is influenced by patient and doctor factors, but less is known about the decision- making process involved in prescribing opioid drugs for CNCP.

Transferring information to an out-of-hours primary care service for patients with palliative care needs: an action research study to improve the use of handover forms.

Aim: To work with service users and providers to optimise the design and implementation of handover forms to support the transfer of information between daytime and out-of-hours primary care services for patients with palliative care needs.

Background: There is a need for improved informational continuity between daytime and out-of-hours primary care services for patients with palliative care needs. Research suggests that while handover forms are vital to ensure continuity of care, they remain underused for such patients.

Frequency of non-asthma GP visits predicts asthma exacerbations: an observational study in general practice.

Background: Being able to identify patients at risk of exacerbations is useful as it enables resources to be targeted at these patients.

Aims: To test the theoretically-derived prediction that the frequency of non-asthma related visits to the general practitioner (GP) predicts exacerbations.

Methods: Clinical and demographic data and both self-report and prescription-based adherence data were obtained from 166 patients diagnosed with asthma attending a GP clinic, all of whom were prescribed inhaled corticosteroids (ICS).

Is hospitalisation for COPD an opportunity for advance care planning? A qualitative study.

Background: It is recognised that patients with chronic obstructive pulmonary disease (COPD) should have the chance to discuss end-of-life care and advance care planning (ACP). Admission to hospital with an exacerbation may be a possible opportunity.

Aims: To examine whether an admission to hospital for an exacerbation of COPD is an opportunity for ACP and to understand, from the patient perspective, the optimum circumstances for ACP.

The experiences and needs of people seeking palliative health care out-of-hours: a qualitative study.

Aim: To explore the experiences of people with advanced cancer and/or their caregivers accessing out-of-hours care.

Background: The organisation and delivery of out-of-hours in the United Kingdom has undergone major reforms over the past three decades culminating in the new General Medical Service contract in 2004. There are concerns around continuity of care for patients with complex needs under the new arrangements.

Guidelines versus practice: UK asthma nurses often recommend intermittent, symptom-driven use of inhaled corticosteroids.

Background: Recent clinical trials suggest that intermittent use of inhaled corticosteroids (ICS) is safe for mild persistent asthma. Intermittent ICS use is inconsistent with current guidelines but is a common form of non-compliance. The aim of this study was to investigate how asthma nurses advise patients to use ICS.

Accessing out-of-hours care following implementation of the GMS contract: an observational study.

Background: There is widespread concern that the quality of out-of-hours primary care for patients with complex needs may be at risk now that the new general medical services contract (GMS) has been implemented.

Aim: To explore changes in the use of out-of-hours services around the time of implementation of the new contract for patients with complex needs, using patients with cancer as an example.

Design Of Study: Longitudinal observational study.

Palliative care in chronic obstructive pulmonary disease: a review for clinicians.

Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by airflow obstruction which ultimately kills many patients. It is common in both men and women and there is a 24-30% 5-year survival rate in the UK for those with severe disease. The annual death rate in the UK from COPD approaches that from lung cancer.

Experiences of patients requiring strong opioid drugs for chronic non-cancer pain: a patient-initiated study.

Background: Chronic non-cancer pain is an increasing problem in health care. This study was initiated by a patient wanting to discover more about the experiences of other patients requiring strong opioid analgesia for such pain.

Aim: To determine the attitudes and experiences of patients receiving long-term strong opioid medication for chronic non-cancer pain in primary care.

Questionnaire survey of women aged 56-59 years: consultations in general practice, use of hormone replacement therapy (HRT) and participation in screening programmes.

Objectives: To ascertain attitudes to consultations in general practice and the gender of the doctor. To determine whether women participate in the National Health Service (NHS) screening programmes available to them and their use of hormone replacement therapy (HRT).

Design: Postal questionnaire survey to women aged 56-59 years.

Concerning women: questionnaire survey of consultations, embarrassment, and views on confidentiality in general practice among women in their teens, thirties and fifties.

Background: Concern exists that women, and in particular teenagers, do not consult in general practice, particularly for contraception because of embarrassment and concern over confidentiality. The aim of this study was to compare reported consultation rates, embarrassment when consulting, and views on confidentiality of women in three age groups.

Methods: A postal questionnaire was used to survey women aged 16-19, 36-39 and 56-59 years attending a semi-rural practice in East Devon, UK in December 1999.

Positive experiences of teenage motherhood: a qualitative study.

Background: Teenage pregnancy is seen as a cause for concern in the United Kingdom (UK). However, there has been little research from primary care looking at teenage motherhood and its implications.

Aim: To investigate the experiences of teenage mothers in relation to their role as mothers and their expectations of their futures.

The doctor-patient relationship in US primary care.

Changes in the organization of primary care in the UK are driven by a need to improve access and availability, but doctor-patient relationships may suffer. To investigate the importance of such relationships in a different setting, we analysed focus-group data obtained in a primary care facility in the USA (Rochester, NY). The findings pointed to three key factors in these relationships-namely, an asymmetry of perceptions on the two sides, belying the notion of a meeting of experts; the importance on both sides of 'liking'; and the value set by both parties on development of trust.