Delayed transfers of older people from hospital: Causes and policy implications.

Health and social care agencies in the UK. have been under pressure for some time to reduce delayed transfers of older people from hospital because they absorb scarce health service resources and incur a human cost through inappropriate placement. A local study based on an analysis of records and interviews with managers showed that delays reflect the complex needs of older people, and arise from financing and organisational problems at both the planning and implementation stages of a discharge.

Human rights and patients' privacy in UK hospitals.

The European Convention on Human Rights has been incorporated into UK domestic law. It gives many rights to patients within the National Health Service (NHS). This article explores the concept of patients' right to privacy.

Patients' management of migraine and chronic daily headache: a study of the members of the Migraine Action Association (United Kingdom).

Background: Many strategies are available to treat and prevent migraine and chronic daily headache (CDH). Broadly these strategies can be divided into four groups, including (i) health care consultations, (ii) medication and alternative remedies, (iii) general (acute and prophylactic) strategies, and (iv) social support.

Objective: This study aimed to compare headache management between migraine (MO), migraine with aura (MA), and those with CDH over the last 12 months.

Ergonomic methods for assessing exposure to risk factors for work-related musculoskeletal disorders.

Background: This review provides an overview of the range of methods that have been developed for the assessment of exposure to risk factors for work-related musculoskeletal disorders.

Methods: Relevant publications and material on exposure assessment techniques have been gathered for inclusion in this review.

Results: The methods have been categorized under three main headings: (1) self-reports from workers can be used to collect data on workplace exposure to both physical and psychosocial factors by using methods that include worker diaries, interviews and questionnaires; (2) observational methods that may be further subdivided between (a) simpler techniques developed for systematically recording workplace exposure that enable an observer to assess and record data on a number of factors using specifically designed pro-forma sheets for establishing priorities for workplace intervention; and (b) advanced techniques developed for the assessment of postural variation for highly dynamic activities that record data either on videotape or are computer analysed using dedicated software; (3) direct measurements using monitoring instruments that rely on sensors attached directly to the subject for the measurement of exposure variables at work.

Relatives' experiences of critical care.

This exploratory study investigates relatives' overall experiences of the critical care environment and how staff perceived these experiences. Traditionally, research in Critical Care concentrated on patients' psychological well-being or relatives' immediate needs. There is little research that addresses the relative's overall experience of events.

Patients' rights to privacy and dignity in the NHS.

Aim: To determine the extent to which patients' rights to privacy and dignity are respected in the NHS when judged against the seven factors of 'privacy and dignity' as outlined in the Essence of Care document (Department of Health (DH) 2001a).

Method: An ethnographic methodology was used. Fieldwork took place over six months in three acute wards with surgical and medical patients in a large district NHS hospital, using non-participant observation, unstructured interviews with patients (n=55) and staff (n=12), and semi-structured interviews with patients (n=18) and staff (n=22).

Nothing out of the ordinary: advanced fertility nursing practice.

This paper discusses data from a case study of fertility nursing practice. An ethnographic case study approach using participant observation and nine semi-structured interviews with staff and patients was undertaken. The data were analysed thematically and these themes are discussed in this paper.

Finding meaning in first episode psychosis: experience, agency, and the cultural repertoire.

The article examines individuals' attempts to generate meaning following their experiences with psychosis. The inquiry is based on a person-centered ethnographic study of a Danish mental health community program for early intervention in schizophrenia and involves longitudinal interviews with 15 of its participants. The article takes an existential anthropological perspective emphasizing agency and cultural phenomenology to investigate how individuals draw on resources from the cultural repertoire to make sense of personally disturbing experiences during their psychosis.

Humility and its practice in nursing.

Following a personal experience of transformation as a result of washing the feet of a terminally ill patient, an exploratory study was undertaken to investigate nurses' experience of washing patients' feet. Seven postregistration student nurses participated in the study by washing the feet of as many patients as they could over a defined period of time. They were then interviewed about the experience.

Is pain what the patient says it is? Interpreting an account of pain.

This article discusses the integrated approaches to pain that have developed within the pain medicine movement and the hospice and palliative care movement. Such approaches blend biomedical, social, emotional and spiritual aspects of the pain experience. However, patients and healthcare staff may hold different beliefs about pain, such as patients having a medical understanding about pain while healthcare practitioners may use concepts such as 'total pain' or 'psychological pain'.

Interlimb symmetry of traumatic unilateral transtibial amputees wearing two different prosthetic feet in the early rehabilitation stage.

This study evaluated the SACH and the Greissinger Plus prosthetic feet, in terms of the symmetry provided between the lower limbs, in the case of unilateral transtibial amputees 16.3 weeks from the time of limb fitting and 38.9 weeks from surgery.

Relationship between illness representation and self-efficacy.

Aim: This paper reports a patient survey exploring the possible relationship between illness perception and self-efficacy following a cardiac event, and the implications this could have for nursing practice.

Background: Cardiac rehabilitation guidelines endorse the need to improve psychological care; suggesting that individualized support will improve the effectiveness of cardiac rehabilitation. Surveys, however, continue to identify that psychosocial factors are poorly assessed.

Migraine and chronic daily headache management: a qualitative study of patients' perceptions.

Aim: The aim of the study was to gain insight into the patients' perceptions of migraine and chronic daily headache (CDH) management.

Methods: Thirteen, semi-structured and individual interviews with seven migraine and five CDH patients were carried out and analysed in QSR NUD*IST5, using a grounded theory methodology.

Results: The participants described using five areas of management: 1) health care use; 2) medication use; 3) alternative therapies; 4) social support; and 5) lifestyle and self-help.

Implementation of capecitabine (Xeloda) into a cancer centre: UK experience.

Switching patients from intravenous 5-FU/LV to oral capecitabine (Xeloda) for the treatment of metastatic colorectal cancer is associated with a reduction in the need for hospitalisations to manage 5-FU-associated delivery and complications, with resulting healthcare savings. However, implementing oral therapy with capecitabine within a cancer centre in the UK has required a considerable change in attitude within healthcare services. The resulting need for patients to take an active role in their treatment, and the co-ordination and monitoring of such a service at home has raised issues for chemotherapy services.

An analysis of information available to relatives in intensive care.

The Comprehensive Critical Care Review published by the Government in 2000 acknowledges that patients are part of family units and critical illness has an extended impact. It outlines information that should be provided to relatives and suggests recommendations be implemented within 3-5 years. The aim of this study was to gauge an overall view of provisions available across general Intensive Care Units in England for relatives, by conducting an analysis of information available and unit policies, and to see the extent that government guidelines have been adhered to.

Preliminary study of the prevalence of speech and language difficulties in young offenders.

Background: There are no systematic surveys of the UK prison population, but data from several sources suggest that a significant number of prisoners might have limitations in their speech, language and communication abilities.

Aim: To examine the hypothesis that compared with the general population, a significantly larger number of the prison population has speech, language and communication difficulties.

Methods & Procedures: A survey of 10% of the young offenders within one young offender's institution was conducted.

Cardiac rehabilitation: the importance of patient expectations--a practitioner survey.

Background: Numerous cardiac rehabilitation national guidelines consistently endorse the need for psychological support to create effective individualized care. Recent surveys suggest that the psychological factors remain poorly assessed and the measurement of psychological parameters remains patchy.

Aim: To examine cardiac rehabilitation practitioners' perception and understanding of the importance of patient expectations and their capacity to assess and utilize these expectations to develop individualized care.

Patients' decision-making for migraine and chronic daily headache management. A qualitative study.

The objective of this study was to gain insight into the patients' decision-making for migraine and chronic daily headache management. Patients were recruited by theoretical sampling in Surrey (UK). Semi-structured and tape-recorded interviews (n = 13) were conducted, transcribed verbatim, coded and analysed according to the grounded theory methodology.

Breaking bad news revisited: the push for negotiated disclosure and changing practice implications.

This article revisits the ethical, legal, professional and emotional issues involved with disclosing bad news. The authors examine the push for disclosure that has come from a number of quarters in the UK, including ethical and legal challenges, in particular the Bristol Royal Inquiry Report, professional codes of conduct, health policy and the expectations of the public. The contribution of nurses to breaking bad news is not widely discussed in the literature.

Promoting the dignity of the child in hospital.

This article aims to deconstruct the concept of dignity in a way that is meaningful, in particular to nurses and other health workers who seek to promote the dignity of children in their care. Despite the emphasis in a variety of codes and policies to promote dignity, there is a lack of a clear definition of dignity in the literature. In particular there is little reference to dignity, theoretically or empirically, as it relates to children.

Management by nurses of primary headache: a pilot study.

Primary headache is a very common condition and one that nurses encounter in many different care settings. Yet there is a lack of evidence as to whether advice given to sufferers is effective and what improvements may be expected in the condition. The aim of this study was to evaluate the advice given by a nurse to primary headache sufferers.

A new capillary viscometer for small samples of whole blood.

A new capillary viscometer is described in which a column of blood is discharged under a constant pressure, producing a variety of shear stresses during a single test. Measurement of the viscosity of Newtonian sucrose solutions showed good agreement between the viscosity determined from the new system and the expected values. The viscosity of whole blood was measured in a cone-and-plate viscometer at a wide range of shear rates and characterized using a power law model; good agreement was obtained between the capillary and rotational results at low and medium shear rates.