• Late life acquired dual-sensory impairment: A systematic review of its impact on everyday competence

      Tiwana, Rumandeep; Benbow, Susan M.; Kingston, Paul; University of Chester (SAGE, 2016-09-29)
      The literature on the relationship between late acquired dual-sensory impairment (DSI) in older adults and the ability to remain independent is limited. A systematic search of the literature was conducted to assess the impact that late life acquired DSI in older adults has on their ability to remain independent within their homes. Exclusion and inclusion criteria were applied to the papers identified and eight qualified for inclusion in the review. Each selected paper was assessed using a quality rating scale. Country of origin, population studied, age, vision, and hearing criteria all varied between papers. They provide evidence that DSI affects everyday competence, and this effect is complicated by physical comorbidities, mental health, and social factors
    • Layers of listening: qualitative analysis of the impact of early intervention services for first-episode psychosis on carers’ experiences

      Lavis, Anna; Lester, Helen; Everard, Linda; Freemantle, Nick; Amos, Tim; Fowler, David; Hodgekins, Jo; Jones, Peter B.; Marshall, Max; Sharma, Vimal; et al. (Cambridge University Press, 2015-08)
      Background: Early Intervention Services (EIS) comprise low-stigma youth-friendly mental health teams for young people undergoing first-episode psychosis (FEP). Engaging with the family of the young person is central to EIS policy and practice. Aims: By analysing carers’ accounts of their daily lives and affective challenges during a relative’s first-episode psychosis against the background of wider research into Early Intervention Services, this paper explores relationships between carers’ experiences and EIS. Methods: Semi-structured longitudinal interviews with 80 carers of young people with FEP treated through English EIS. Results: Our data suggest that EIS successfully aid carers to support their relatives, particularly through the provision of knowledge about psychosis and medications. However, paradoxical ramifications of these service user-focused engagements also emerge; they risk leaving carers’ emotions unacknowledged and compounding an existing lack of helpseeking. Conclusions: By focusing on EIS’s engagements with carers, this paper draws attention to an urgent broader question; as a continuing emphasis on care outside the clinic space places family members at the heart of the care of those with severe mental illness, we ask: who can, and should, support carers, and in what ways?
    • Leadership

      Watts, Geoff; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses the concept of leadership and the response of the NHS to leadership demands
    • Leadership development for public health practitioners

      Wilson, Frances; Greening, Kim; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses how public health practitioners develop leadership skills with specific reference to the NHS Leadership Qualities Framework (2001).
    • Learning and teaching in social work practice

      Beverley, Audrey; Worsley, Aidan; Salford University ; University of Chester (Palgrave Macmillan, 2007-10-26)
      This book discusses the teaching and assessment of practice within the social work or social care environment. It focuses on setting the context for learning, learning partnerships, adult learning, creating and using learning opportunities, supervision, reflective practice, evidencing and assessing competence, learning in a multidisciplinary setting, and dealing with difficulties within the learning partnership.
    • Learning disability against itself: The self-injury/self-harm conundrum

      Lovell, Andy; University of Chester (Wiley, 2007-10-17)
      The article begins with a critical look at the existing literature explaining self-injury by people with significant learning disabilities and self-harm by those with mental health difficulties. It suggests that the different conceptualizations are perhaps less distinct than might initially appear, and that behavioural similarities between those with and those without learning disabilities might be greater than previously believed. The notion of 'career' is presented as a means of explaining the process by which people with learning disabilities engage in self-injury and subsequently integrate it into their lives. Data are subsequently presented from a number of life histories of people with learning disabilities to illustrate the development of self-injury over the life course. The findings of the research indicate that the development and consolidation of self-injury over time conforms to the expectations of a career and provides reason to question the contemporary separate categorization of the behaviour of people with significant learning disabilities. The evidence suggests that the relationship between self-injury and learning disability is best explicable in terms of its intelligibility, rational behaviour in the context of the individual's life.
    • Learning Disability Nursing in Secure Settings: Working with complexity

      Lovell, Andy; University of Chester (Wiley, 2017-01-04)
      This editorial argues that current changes in secure learning disability provision, particularly the twin imperatives to reduce in-patient beds and simultaneously restrict the use of physical interventions, have implications for direct nursing care. These implications revolve around the increased complexity of the backgrounds of those with a learning disability currently requiring secure care. Learning disability nursing needs to examine its skill and knowledge base and look seriously at the value of psychiatric nursing as a means of addressing current deficits.
    • Learning environments

      McIntosh, Annette; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses the importance of appropriate learning environments for students, particularly in clinical practice where it is the joint responsibility of academic staff and practitioners.
    • Learning styles

      Hulme, Moira; Hulme, Robert I.; University of Glasgow; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses learning styles inventories and how critical engagements by practitioners with the evidential base of learning styles is necessary to prevent application of labels that might restrict the potential of each learner.
    • Legal and ethical matters

      Deacon, Maureen; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to discuss how practitioners can work ethically and legally in the best interests of adult patients; explain the principal legal and ethical issues of health inequalities and discrimination, consent and capacity, and advanced care planning; and discuss the matter of self-neglect and capacity.
    • The lived experience of UK street-based sex workers and the health consequences: An exploratory study

      Mellor, Rebecca; Lovell, Andy; Wirral Primary Care Trust ; University of Chester (2011-07-03)
      The complex, difficult lives and subsequent health issues of street-based female sex workers are well documented. This paper explores the health needs of a group of sex workers in one geographical locality in the north-west of England. Interviews were conducted with a number of women currently engaged in sex work, with the aim of identifying factors maintaining them in this work and examining their experience of health and health-related services. A thematic analysis revealed considerable life circumstance complexity, with violence, drugs, alcohol and housing problems being prevalent factors. The combination of such factors compounds the likelihood of the women's social exclusion. Other themes related to the casual perception the women had of their own health needs, their generally poor experience of services and the demonstrable impact of one specific service in supporting a group so reluctant to engage. The study suggests poor understanding of the complex needs of street-based sex workers by both services and professionals, particularly a failure to engage with the reality of these women's lives and the factors that maintain them in this work.
    • Lived experiences of negative symptoms in first-episode psychosis: A qualitative secondary analysis

      Gee, Brioney; Hodgekins, Jo; Lavis, Anna; Notley, Caitlin; Birchwood, Max; Everard, Linda; Freemantle, Nick; Jones, Peter B.; Singh, Swaran P.; Amos, Tim; et al. (Wiley, 2018-03-24)
    • The Long-Arm Approach to Placement Supervision and Assessment

      Knight, Kate H; Whaley, Viki; Bailey-McHale, Rebecca; Simpson, Angela; Hay, Jonathon; University of Chester (British Journal of Nursing, 2022-02-26)
      In response, to the regulatory changes that require health and/or social care registrants to supervise and assess students on practice placements (NMC, 2018), the University of Chester’s (UoC) Faculty of Health and Social Care (H&SC) has developed an innovative long-arm practice supervision model, which supports the development of these types of practice placements as HUBs and also funds the registrants to deliver it, ensuring optimum support for students and the practice area.
    • Long-term outcomes from prophylactic or episodic treatment of haemophilia A: A systematic review.

      O'Hara, Jamie; Sima, C. S.; Frimpter, J.; Paliargues, F.; Chu, P.; Presch, I (2018-07-13)
      Evaluating treatment success in patients with haemophilia A (HA) remains a vigorous debate, especially concerning the interpretation of results from clinical and observational research. The benefits of short-term prophylaxis are well established, but long-term outcomes, particularly related to humanistic and economic burden, are not as well understood. We conducted a systematic literature review to evaluate the association of episodic or prophylactic bleed control with long-term clinical, humanistic and economic outcomes. Studies published in English between 1 January 2006 and 15 December 2016 were included. Participants had HA (with or without inhibitors), received prophylactic or episodic treatment and had at least 4 years of treatment or follow-up. Results were analysed qualitatively with descriptive findings. A total of 2091 records were screened, resulting in 19 studies from 20 publications for inclusion. Most studies included children (84%), were limited to patients with severe disease (74%) and were conducted in Europe or North America (89%). Ten studies (53%) included patients with inhibitors. Median study follow-up ranged from 5 to 19 years. Long-term bleeding and haemarthrosis outcomes were consistently better for patients receiving prophylaxis, who also required fewer hospitalizations or surgeries. Health-related quality of life, functionality and productivity were generally more favourable in patients receiving prophylaxis. Quantitative comparisons were not feasible due to the lack of consistency in endpoint collection and reporting among studies. This systematic review confirmed that the benefits of prophylactic treatment on short-term outcomes translate to broader long-term clinical, humanistic and economic benefits. Better harmonization of data collection and outcome assessments across both registries and clinical studies is needed to allow for effective comparisons across studies and across data sources. [Abstract copyright: © 2018 John Wiley & Sons Ltd.]
    • Looking into the LGB affirmative therapies over the last fifty years – a mixed method review synthesis

      Broadway-Horner, Matthew; Kar, Anindya; University of Chester; Advanced Neuropsychiatry Institute, Kolkata (Taylor and Francis, 2022-04-04)
      In the past few decades, affirmative therapies for sexual minorities have burgeoned. These are appropriate therapies but often there is a lack of adequate research. We set out to study the research evidence available. For this mixed-methods review, we identified 15 studies looking into the experiences of lesbian, gay and bisexual people in psychological therapies. These included nine qualitative, five quantitative and one mixed-method study. The minority stress hypothesis may explain some of the major difficulties LGB individuals face. Studies showed computer-based therapies may reduce or even eliminate unhelpful responses on part of the therapist. Challenges related to confidentiality and privacy in this context remain. Therapists may focus on minority stress but other stressors and not just discrimination may contribute to various mental health problems and their clinical presence. And finally, divergent findings found internalized homophobia may best explain discrimination-based minority stress and that therapist self-disclosure of own sexuality produced better results than the therapists who did not self-disclose. These findings are discussed and future directions for research are identified.
    • Loss, grief and bereavement

      Woodhouse, Jan; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses how loss is multi-factorial and starts early in the disease process. There are physical and psychological aspects to grief and bereavement, indicators of complicated grief, and strategies to acknowledge grief.
    • Lyme’s Disease: Recognition and Management for Emergency Nurses

      McGhee, Stephen; Visovsky, Constance; Zambroski, Cheryl; Finnegan, Alan; University of South Florida; University of Chester (RCN Publishing, 2018-08-04)
      Over the last 10 years there has been a significant rise in the numbers of patients who present to the Emergency Department (ED) with a diagnosis of Lyme disease. Although some patients may remain asymptomatic a significant number of patients present with a rash focused around a previous tick bite. Others may present with a wide range of debilitating symptoms that can be very problematic, if left untreated. Due to the growing prevalence of Lyme disease within the United Kingdom (UK) and the US, this article offers an overview of the vector borne nature of this illness and provides the Emergency Nurse with information on the pathophysiology, prevention, presenting symptoms, and management of Lyme disease.
    • Maintaining a safe environment

      Chapman, Hazel M.; Whittam, Susan; University of Chester (Elsevier, 2019-03-30)
      INTRODUCTION Managing our own safety is thought to be a basic survival skill, which all individuals possess. We are not aware of managing our physiological homeostasis (for example, ensuring that our body cells are supplied with sufficient oxygen to produce the energy they need to function), and spend years learning to calculate and avoid risk from the external environment, The ability to control safety, including physiological homeostasis, and using physical ability and intellectual ability to manage risk, depends on a person’s stage in their lifespan development, their physical and mental wellbeing, their cognitive ability and the ability to control environmental factors such as housing, traffic, pollutants and even conflict. Throughout the world there are many differences in the types of hazards and risks that people are exposed to and just as many differences in the way that people manage their own safety. The inclusion of this AL in the Roper et al (1996, 2000) model is to draw your attention to the importance of being able to recognise the threats that exist to human survival and wellbeing and identify the impact that this may have upon any individual at any given time in their lives. In order to develop the knowledge that you need to apply it to your nursing practice, you will also need to read about the underlying physiology (how the body functions), pathophysiology (the disease process), psychology (thoughts, feelings and behaviours) and nursing practice in more depth. Several health psychology and psychology for nursing texts are referred to throughout this chapter, but physiology, pathophysiology and nursing practice are underpinned by core texts (Brooker & Nicol, 2011; Waugh & Grant, 2014). By understanding the processes involved in maintaining a safe internal and external environment for the person, you will learn to assess risk and plan care to maintain the safety of your patients. The model helps us to develop our understanding by focusing upon three key areas: • the human body's ability to protect itself and the biological mechanisms that it employs to carry this out • the ability that individuals have to make choices and take action to keep safe and free from danger • the identification and understanding of the dangers and hazards that exist in the surrounding environment (including the health care environment) and how they pose a threat to individual safety and wellbeing. These three areas will be discussed throughout this chapter within the framework of the model and will help to develop an understanding of the AL and enable nursing interventions to be as individualised and effective as possible. Often concern for our own health and safety only becomes heightened when we become ill, have an accident or hear about a tragedy or event that has had terrible human consequences. However, patient safety is essential for high quality health care, and a requirement in the United Kingdom Code for Nurses, Midwives and Health Visitors (Nursing and Midwifery Council, 2015) is to make the care and safety of people our main concern. Therefore, in nursing, we need to be able to assess and prevent risk, whether it arises from the person’s own health needs, or from the care we give and the way in which we give it. By using the framework of the Roper et al (1996, 2000) model in the following way we can begin to examine and identify how complex and varied health and safety issues really are and also identify the interrelatedness that exists between the other ALs. This chapter will therefore focus on the following: 1 The model of living • maintaining a safe environment in health and illness across the lifespan • dependence and independence in the activity of maintaining a safe environment • factors influencing the activity of maintaining a safe environment. 2 The model for nursing • the nursing care of individuals with health problems that affect their ability to undertake the activity of maintaining a safe environment • understanding of the hazards in the health care setting and how to promote patient safety effectively
    • Making normal birth a reality

      Steen, Mary; Walsh, Denis; University of Central Lancashire/Royal College of Midwives (APEO - Associacao Portuguesa Enfermeiros Obstetras, 2007-05-05)
      This article describes and discusses an conference paper given at the Dia Internacional do Enfermeiro de Saude Materna e Obstetrica, Viseu, Portugal. It highlights that many childbearing women in the 21st century now fear birth and the RCM's concerns that both women and maternity care professionals have become more dependent on technology during childbirth. This instigated the RCM's campaign for normal birth, which aims to inspire and support normal birth practice to maximise opportunities for women to experience normal birth and to reduce unncessary medical interventions. The importance of being with woman is stressed and a social model versus medical model of care is compared. Midwife's skills such as 'sussing out labour' and 'intuition' is explored as is 'working with pain' rather than a pain relief approach and 'holistic approaches to support normal birth practices are also discussed. In particular, active birth and the use of complementary therapies are reviewed. Midwives around the world can play an important role in making normal birth a reality once again.
    • Making sense of complexity: a qualitative investigation into forensic learning disability nurses' interpretation of the contribution of personal history to offending behaviour

      Skellern, Joanne; Lovell, Andrew; University of Chester; University of Derby
      Background: There is growing recognition that an individual’s personal history can be extremely influential in shaping his/her future experience, though there has been limited exploration in the context of learning disability and offending behaviour. Method: Research questions related to participant interpretation of offending behaviour and individual and service responses. A series of focus groups comprising learning disability forensic nurses were conducted across all secure settings, high, medium and low. Results: Three themes were produced: interpreting offending behaviour; the impact of personal history; responding therapeutically. The difficulties relating to understanding the relationship between offending behaviour and personal history significantly informed the construction of the most effective therapeutic relationships. Conclusions: An increased focus on the impact of someone’s background might inform nursing as it seeks to deliver care to individuals with increasingly complex needs in a time of service transition.