Information in radiotherapy for men with localised prostate cancer: An integrative review.

Introduction: Men with prostate cancer may receive radiotherapy as part of their management. They encounter a range of information related to radiotherapy, and a crucial role for therapeutic radiographers and other healthcare practitioners is ensuring patients receive appropriate information related to their treatment. This integrative review aims to identify, synthesise and analyse literature reporting experiences of men with localised prostate cancer related to information in radiotherapy.

You cannot choose your family: sociological ambivalence in the hemodialysis unit.

Living with end-stage renal disease is challenging and requires a great deal of self-management, but little is known about the experiences of patients and staff around the subject. We held six focus groups in three hemodialysis units, each unit hosting 1 staff and 1 patient focus group. A total of 15 staff members and 15 patients participated.

Evaluation of services for children with complex needs: mapping service provision in one NHS Trust.

Aim: The aim of this paper is to identify and descriptively map the key characteristics of the model of service delivery in operation, and to explore the user, carer and professional experience of service provision. This included an exploration of congruity and mismatch between the different stakeholder groups.

Background: In the United Kingdom (UK), 15% of the children under five years of age and 20% of the 5 to 15-year age group are reported to have a complex long-term condition, with the likelihood of having a condition increasing according to socio-economic circumstances.

The anatomy, physiology and pathogenesis of a significant untoward incident.

This paper provides a structured chronology of an investigation into a significant untoward incident in an elderly care ward. Using Reason's Swiss Cheese Model, which has become one of the dominant paradigms for analysing clinical and patient safety incidents, it charts the interplay of national and local policies resulting in unsafe practice. A qualitative approach was used in this multidimensional investigation.

Case management in long term conditions: an inconsistent journey?

This paper sets out to assess the evidence of the use of a case management approach when dealing with long term conditions in the UK. It draws on published papers, some of which emulated or adapted strategies that were used in the USA. The review found that despite there being a unified definition of case management, patients and carers reported benefits of being case managed.

The health of a nation: perspectives from Cuba's national health system.

This paper focuses on the current healthcare system in Cuba and provides a description of an alternative healthcare provision. The information is based on a visit to the country in 2007 as a member of a health study tour. The purpose of the visit was to explore the functioning of a population-based health service and to interview key people.

Improving health and care for patients by redesigning services: the development and implementation of a clinical assessment service in Harrow Primary Care Trust.

The redesign of healthcare services in Harrow Primary Care Trust is due to a number of drivers including: centrally imposed targets as outlined in various policy documents; shifting the balance of care; service delivery in a challenging financial climate; response to national consultations which indicate that patients want services nearer to home; and local and national knowledge of providing different types of services. A local enhanced scheme was devised by the trust to support general practitioners to follow care pathways using evidence-based literature, best practice and discussions with clinicians, nurses and patient representatives. The result was an ambitious and innovative service which has attracted attention from neighbouring London primary care trusts, which are seeking to replicate the model.

The use of cognitive continuum theory and patient scenarios to explore nurse prescribers' pharmacological knowledge and decision-making.

Background: Nurses have been involved in prescribing in England since 1996, and to date over 41,000 nurses are registered with the Nursing and Midwifery Council as prescribers. The majority of evaluative research on nurse prescribing is descriptive and relies on self-report and assessment of patient satisfaction.

Objectives: To explore and test nurse prescribers' pharmacological knowledge and decision-making.

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.

A qualitative study of the impact of the implementation of advanced access in primary healthcare on the working lives of general practice staff.

Background: The North American model of 'advanced access' has been emulated by the National Primary Care Collaborative in the UK as a way of improving patients' access in primary care. The aim of this study was to explore the impact of the implementation of advanced access on the working lives of general practice staff.

Methods: A qualitative study design, using semi-structured interviews, was conducted with 18 general practice staff: 6 GPs, 6 practice managers and 6 receptionists.

Decision-making in primary care: outcomes from a study using patient scenarios.

Background: Various documents emphasize the importance of new roles and new ways of working to modernise delivery of health service and improve the public's health. In particular nurse practitioners are seen as crucial in the modernization process.

Aim: This paper reports the outcomes of a study conducted in 1998 to ascertain the differences, if any, in the decision-making processes of nurse practitioners and general practitioners for diagnosis and treatment when given the same patient scenarios.

Access to primary care: decision making by GP receptionists.

Current government strategy emphasizes the importance of widening access to health service to better serve the users of the system. There is also burgeoning empirical evidence in decision-making in health care. Yet despite this, little attention has been given to the decision-making of a key group of workers--general practice receptionists.