Health and Social Care Unpublished
This collection contains all non-formally published outputs within the department from University of Chester academic staff and other individuals who assert an affiliation to the University of Chester.
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Patient experience of electroconvulsive therapy (ECT): A systematic reviewIn the United Kingdom, electroconvulsive therapy (can be administered according to NICE guidelines for depression, catatonia or severe/prolonged mania (2003 NICE, 2009). ECT was first used in the United Kingdom in 1939 Kalinowsky 1939 and its application and practice has been developed and modernised since. There is a considerable body of research into the efficacy of ECT, and the Royal College of Psychiatrists report that in 2018/2019 68 of patients were much or very much improved following ECT (RCPsych, 2020). It is known however that both public perception and media portrayal of ECT is generally negative (Griffiths and O’Neill Kerr, 2019). Discussion This review highlights patient experiences of ECT through the identification of seven themes The findings suggest that patient experience of ECT includes themes of fear, consent, decision making and autonomy. Patients were found to experience fear and anxiety in regards to the procedure, and studies described patients being poorly informed about ECT. Issues around the consent process were highlighted including those in which patients did not feel they had a choice with regards to treatment ECT was associated with memory loss and cognitive impairment which were captured in patient experience following treatment. In many studies however, ECT was also found to be a tolerable and effective treatment with an improvement in symptoms and patient satisfaction reported The experience of ECT was affected by knowledge and information provision and high standards of service provision, including supportive nursing.
An investigation into intellectual disability nursing interventions and their impactAims To identify nursing-led and / or nursing centred interventions that are in place to address the challenging and changing needs of people with intellectual disabilities (IDs). To identify areas of good care delivery, innovative practices, and possible gaps in the provision of care for individuals with IDs. Research questions The research sought to answer the following questions; What nursing led / nursing centred interventions are in place to respond to the changing needs of people with ID in the UK? Are there examples of service redesign to meet future needs? How could ID nurses better contribute to these interventions? Where in the UK are these interventions taking place? What is the impact of these interventions? Impacts of ID nursing interventions We used Braun and Clarke (2006)’s framework to analyse the data and we identified 13 themes of these impacts; Having a voice. Increased independence and choice. Improved health and quality of life. Improved access to health and social care services. Improved standards, quality of care, and patient experience. Improved awareness of the needs of people with intellectual disabilities. Reduced health inequalities and risks. Making reasonable adjustments. Improved transitions. Improved family life. Improved healthcare outcomes. Increased community presence and inclusion. Improved mental health and reduced challenging behaviour. Conclusions ID nurses implement a wide range of emerging interventions working in multi-disciplinary teams. They practice in a wide range of settings in the UK and other countries. More work is needed in order to better understand the reasons for the limited involvement of ID nurses with pregnant women with IDs and in end-of-life care. The variation in understanding the interventions undertaken by ID nurses between countries need to be further investigated.
Scoping review: contribution of intellectual disability nursesAims and objectives The objective of this scoping literature review was to summarise evidence on the contribution of intellectual disability (ID) nurses to improving the health and well-being of children, adults and older people with IDs, now and for the future. Review question The scoping literature reviews seeks to answer the following question; What ID nursing-led interventions are in place to respond to the changing needs of people living with IDs, and what is the impact of these interventions Conclusions The limited number of publications identifying the interventions undertaken by ID nurses in relation to maternity, children, older adults and end of life care need to be addressed by the profession. The lack of evidence to demonstrate the impact and effectiveness of interventions undertaken by ID nurses pose a challenge for intellectual disability nurses and the profession, whose wider contribution is ambiguous in wider health and social care practice. The interventions undertaken by ID nurses need to be understood in the context of the complexity and changing needs of people with IDs, as well as the introduction of the new NMC standards for pre-registration nurse education in the UK. Recommendations Given the complexity of health, poorer health, higher rates of co-morbidity, inequalities in health, poor access to health services and higher rates of premature mortality experienced by people with IDs, we recommend that urgent research is undertaken to further clarify ID nurse interventions, more specifically in relation to maternity, children, older adult, and end of life care.