The Gold Standards Framework Hospital programme: implementation and progress.

Aim: The implementation and impact of the Gold Standards Framework Hospitals (GSFH) service development programme is described.

Background: A third of hospital inpatients may be in their last year of life when admitted to hospital. Many will be repeat and unplanned admissions.

Perceptions of hospital manual handling policy and impact on nursing team involvement in promoting patients' mobility.

Aims And Objectives: To report the findings gained from interviews with hospital nurses and care assistants, regarding the impact of hospital manual handling policies on their role in maintaining and promoting patients' mobility.

Background: Older hospitalised adults often experience deteriorations in mobility, which are often partially caused by protective or custodial care practice and environments that promote patient dependency. Hospital-induced mobility loss may be conceptualised as a problematic source of iatrogenic patient harm, worthy of attention from a patient safety standpoint.

What is the nursing team involvement in maintaining and promoting the mobility of older adults in hospital? A grounded theory study.

Aims Of The Paper: To present a grounded theory of the nursing team involvement in the process of maintaining and promoting the mobility of hospitalised older adults.

Background: Being able to mobilise is an important determinant of quality of life in late adulthood. However, advancing age is often accompanied by worsening mobility, which may deteriorate further as a result of illness and particularly hospitalisation.

All change: the lived experience of younger women with cancer of the vulva.

Aims And Objectives: To generate an understanding of the women's own perspectives of their care and address a gap in knowledge in relation to the broader impact of vulval cancer.

Background: Few people go though life without experiencing events that can change their perspective on how they see themselves, their role in society and their relationship with those around them. People are multi-dimensional, so a person with has a physical illness is also affected psychologically and sociologically.

Educating tomorrow's clinical researchers: a review of research preparation in undergraduate education.

Background: One large health region in England was experiencing difficulties in recruiting to clinical research posts which required registered nurse or allied health professional skills.

Objectives: Pre-registration preparation may influence practitioners' career choices and the study reviewed the research content in pre-registration nurse/AHP degree level programmes in the region to i) describe key features of the modules, and ii) determine the extent to which clinical research featured.

Design And Settings: There are eight universities in the region.

A survey of issues of ethnicity and culture in nursing homes in an English region: nurse managers' perspectives.

Aims: This survey explored issues of ethnicity and culture in nursing homes in one English region.

Background: The older black and minority ethnic population in the UK is increasing, and this is the first detailed study of numbers of black and minority ethnic residents in nursing homes and of managers' perceptions of their abilities to respond to residents' needs.

Design: Mixed methods.

An evaluation of the impact of the Gold Standards Framework on collaboration in end-of-life care in nursing homes. A qualitative and quantitative evaluation.

Background: In the United Kingdom approaching 20% of people aged 85 years and over live in care homes and most will die there. Improving end-of-life care is a government health priority and homes may work with primary care staff and specialist palliative practitioners to provide comprehensive end-of-life care. Consequently effective collaboration between care home and health service practitioners is vital to ensure high quality end-of-life care.

Invisibility: the lived experience of women with cancer of the vulva.

Background: This study describes an exploration of the lived experience of 13 British women with cancer of the vulva who underwent surgical treatment. A review of the literature highlighted a paucity of knowledge as many studies were conducted during the 1980s and 1990s and investigated sexual functioning only.

Objective: An interpretive phenomenological approach based on the work of Heidegger and van Manen was used to frame the study by posing the question, "What must it be like to be diagnosed with, and have surgery for a cancer of the vulva?"

Methods: The women, younger than 50 years, were identified by purposive sampling and interviewed between 6 months and 5 years after surgery.

A literature review of the impact of a diagnosis of cancer of the vulva and surgical treatment.

Aims And Objectives: This paper examines the evidence available regarding the physical, psychological and sexual consequences for women following a diagnosis and treatment for cancer of the vulva.

Background: Cancer of the vulva is a rare condition affecting approximately 1000 women in the UK each year. However, little is known about the impact of the condition as there is a limited research base to inform clinical practice.

The critical care nurse's role in end-of-life care: issues and challenges.

Aim: The purpose of this article is to discuss the challenges critical care nurses face when looking after patients needing End-of-Life (EoL) care in critical care environments.

Background: Critical care nurses frequently provide care to patients who fail to respond to treatments offered to support and prolong life. The dying phase for individuals in critical care settings, commonly after withholding/withdrawing treatment, is very short posing great demands on critical care nurses to provide physical and emotional support to both patients and their families.

Caring for families with a family history of cancer: why concerns about genetic predisposition are missing from the palliative agenda.

Care of the family is integral to palliative care, but little attention has been paid to the way nurses, or other healthcare professionals, are responding to the needs of families who are concerned about whether their family history of cancer is associated with an inherited genetic predisposition. This paper discusses how palliative care nurses perceive the care needs of patients with a family history of cancer. Data were collected through recorded, semi-structured interviews with 10 nurses who had worked in specialist palliative care.

Hospice nurses and genetics: implications for end-of-life care.

Aim: The overall aim of this study is to determine hospice nurses' perception of the importance of genetics to hospice care provision and their personal level of confidence in carrying out genetics-related activities within an end-of-life care context.

Background: Hospices nurses regularly care for patients and their families affected by inherited genetic conditions (e.g.

Searching: the lived experience of women with cancer of the vulva.

Although the physical adverse effects following surgery for vulval cancer may readily be described, little is known about the psychological, emotional, and social impact. A review of the literature revealed a paucity of studies, as this condition is rare. To explore the lived experiences of women in the United Kingdom with vulval cancer, a qualitative research study was undertaken using the research methodology of interpretive phenomenology, based on the work of Heidegger (The Essence of Human Freedom.

Cancer genetic predisposition: information needs of patients irrespective of risk level.

Increased insight into the information needs of people about cancer genetic predisposition could allow materials to be developed to improve decision-making for those at high risk, whilst those at lower risk could have their anxiety reduced without the need for referral to genetics services. This study aimed to identify information needs of patients concerned about a genetic predisposition to cancer, and explore how this varied according to risk perception, cancer worry, personal motivation and demographics. Stage 1 used semi-structured telephone interviews pre and post participants' genetic risk assessment.

An evaluation of the impact of a tracheostomy weaning protocol on extubation time.

Background: To avoid the possible complications of prolonged intubation, it is necessary and advisable to attempt weaning from the tracheostomy tube at the earliest opportunity. However, while weaning protocols have proven successful in reducing ventilation time of critical care patients, there is little evidence of their use and impact on tracheostomy tube weaning time.

Aims: This pilot study sought to determine if the introduction of a new tracheostomy weaning protocol would reduce the time to extubation of the tracheostomy.

Children affected by genetic conditions in end-of-life care. Part 2: findings and discussion.

Background: Many children cared for in hospice settings are affected by a genetic condition. Therefore, children's hospice nurses require knowledge and awareness of the issues faced by families affected.

Aim: The authors carried out a study to ascertain how important children's hospice nurses perceived genetics to be within care provision generally and explore how confident they were personally in meeting these care needs.

Delivering 'Gold Standards' in end-of-life care in care homes: a question of teamwork?

Aim: This paper reports findings from a study which investigated the introduction of the Gold Standards Framework for improving end-of-life care into care homes in England.

Background: The Gold Standards Framework was developed in primary care to improve the care provided for people at the end-of-life. Following its successful introduction to this setting it was adapted and implemented in care homes.

Children affected by genetic conditions in end-of-life care. Part 1: Development of a study.

Background: Many children receiving hospice care are affected by inherited genetic conditions. To provide appropriate care, children's hospice nurses require knowledge and awareness of the issues faced by the child and their family along with the implications of having, or being at risk from, an inherited genetic condition. Little is currently known about the competence levels of children's hospice nurses to support these children and their families.

Quality of life after liver transplantation for hepatitis C infection.

Introduction: Transplantation is a life-saving option for patients with liver disease. However, recovery is variable. Impairments in physical health, emotional wellbeing and quality of life are reported.

Patient self-injection of methotrexate for inflammatory arthritis: a study evaluating the introduction of a new type of syringe and exploring patients' sense of empowerment.

Objectives: To evaluate the introduction of a new type of syringe for patients on a self-injection of methotrexate (MTX) programme and explore patients' sense of empowerment relating to the self-injection of MTX.

Methods: Data were collected using a postal questionnaire, which yielded quantitative and qualitative data. The questionnaire was sent to all eligible patients in the primary care setting who self-injected MTX (n=24).

Psychosocial impact of the lack of information given at referral about familial risk for cancer.

We aimed to identify patient' information and communication needs irrespective of their risk level, when they are referred for genetic risk assessment and genetic counselling for a predisposition to cancer. Semi-structured telephone interviews were conducted with a purposive sample of individuals referred to a clinical genetics unit for a risk assessment of their genetic predisposition to either breast, ovarian or colorectal cancer and stratified by their level of risk. Triangulation was achieved by focus groups conducted with specialist genetic health professionals.

The increasing use of reiki as a complementary therapy in specialist palliative care.

Palliative medicine and complementary therapies (CTs) have developed within the NHS as parallel philosophies of care. As a result, the last decade has seen an increase in the integration and usage of CTs, as adjunct therapies to conventional medical treatment. Documented benefits of relaxation, decreased perception of pain, reduced anxiety and improved sense of wellbeing have been shown to enable an enhanced quality of life, where curative treatment is no longer an option.

Rheumatology: a study of patient satisfaction with follow-up monitoring care.

Background: This paper reports the findings of a quantitative study to determine the satisfaction of rheumatology patients receiving follow-up monitoring care within primary and secondary locations.

Aims And Objectives: The aim of the study was to compare and contrast the satisfaction of patients with rheumatoid arthritis following two different routes of care. The objective was to explore the dimensions of care identified in an earlier qualitative study.