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Secondary Care Settings (secondary + care_setting)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

What should we do about the obesity epidemic?

PRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 4 2002
Dr Julian H. Barth MD
The current increase in obesity is occurring despite increasing awareness by the population at large of the benefits of healthy eating and exercise. Although weight gain is the direct result of a mismatch in energy balance, it is important to realise that there is a complex interplay between the environment and individual biology and behaviour. Management of obesity whether in a primary or secondary care setting requires a multi-disciplinary team to produce an individualised approach to embrace food, exercise and behavioural change. The prevention of obesity requires a three-level approach. First, there needs to be a co-ordinated public health policy at national level to create an environment where it is easy to make healthy choices for physical activity and food. Second, there needs to be a policy that targets those individuals who are at risk of becoming obese and those who have lost weight to help prevent weight regain. Finally, there needs to be a systematic uptake of the established protocols for the management of individuals with obesity and its co-morbidities. The challenge in the UK is to build imaginative networks that integrate all available resources both within the NHS and without, such as sports centres, fitness clubs and slimming clubs. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Peer review in Nursing and Midwifery: a literature review

JOURNAL OF CLINICAL NURSING, Issue 4 2008
Amelia Rout MSc, BSc (Hons)
Aims and objectives., The Clinical Education Project investigated clinical education in nursing and midwifery settings. The aim of this phase was to investigate and evaluate the processes and outcomes of clinical assessment of preregistration nurses and midwives, focusing on the assessment interview, and to evaluate the feasibility of introducing peer review of the clinical assessment interview in acute clinical settings. Background., Peer review is common in many professional areas. The literature describes various applications of peer review and makes recommendations for its use. However, there is a shortage of studies investigating the use of peer review in nursing and midwifery education and practice. Design., The project involved a systematic literature review and a qualitative exploratory study. This article describes the first part of the study: a systematic literature review of peer review. The second part of the study is reported elsewhere. Methods., The systematic literature review investigated international articles written since 1994 that contained information on peer review in pre/post registration nursing and midwifery within higher education or practice. Results., From the available literature, 52 specific initiatives were analysed. The majority of articles originated in America and involved nursing staff working in secondary care settings. Fifty-one articles had missing information varying from not stating the sample size to not including information about evaluations. Conclusions., The literature review found that whilst peer review is commonplace in nursing and midwifery practice, there is a lack of robust literature about its use. Relevance to clinical practice., Peer review in clinical settings such as nursing and midwifery can facilitate the sharing of good practice and personal and professional growth. It allows participants to learn from each other and gain insight into their development. [source]

Feasibility and Acceptability of Providing Nurse Counsellor Genetics Clinics in Primary Care

NURSING & HEALTH SCIENCES, Issue 2 2006
Greta Westwood
Increasing referrals to specialist genetics services have precipitated a review of models of service delivery in the United Kingdom. Little is known about whether a change in clinic location is feasible or acceptable for the patients seen. We consider the feasibility of genetics service development and delivery in primary care and develop a questionnaire to evaluate acceptability and cost to patients. Between July 2003 and May 2004, 64 primary care appointments with a genetics nurse counsellor were offered to patients referred and registered with selected general practices. 45 (79%) patients attended their appointment and 34 (77%) returned their follow-up questionnaire. Total mean satisfaction score was high and patients were most satisfied with the information and affective domains of the appointment. 48% of patients seen by the genetics nurse counselor remained in primary care. Patients were satisfied with the travel time and distance to clinic and patient clinic costs were limited. This study shows that patients do attend genetics nurse counselor clinics in primary care, and are satisfied with the new location. A large cluster randomized controlled trial is now being conducted to obtain a controlled comparison of acceptability to patients of attending clinics in primary vs. secondary care settings. [source]

Psychological interventions for long-term conditions: a review of approaches, content and outcomes

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2008
Carol Doyle
Background.,People living with long-term conditions are more likely to see their GP and experience limitations in their daily activities (Department of Health, 2005). Psychological interventions, specifically cognitive behavioural therapy (CBT), aimed at helping people to cope and self-manage these conditions, are popular. This review aims to summarize the evidence from good-quality systematic reviews of psychological interventions to inform the management of, and future research in, patients with chronic musculoskeletal pain. Cochrane reviews were used as these are considered to be of good quality (Handoll et al., 2002).,Method.,We identified Cochrane reviews of psychological interventions for common chronic health conditions in adults across all healthcare settings. Data on intervention approach, content, delivery and outcomes were extracted and summarized.,Results.,Nine Cochrane reviews, in asthma (n = 1), diabetes (n = 2), coronary heart disease (n = 1) and chronic musculoskeletal pain (n = 5) were identified. These reviews included 131 clinical trials and over 20,200 patients. Psychological interventions were wide ranging, many using a variety of CBT, mostly delivered in secondary care settings by nurses or psychologists. Physiotherapists were involved in some studies as part of multidisciplinary teams. Due to the complexity and diversity of the interventions, individually effective components could not be identified. Interpretation of studies was difficult because of heterogeneity in intervention content, delivery and outcomes measured. Conclusion.,Physiotherapists involved in the management of long-term conditions, particularly chronic musculoskeletal pain, can perhaps learn from this evidence base. Future research should investigate the effectiveness of individual components of CBT and the role of physiotherapists in delivering this type of intervention. Copyright © 2008 John Wiley & Sons, Ltd. [source]