Advice Of Health Professionals Research Articles

Pressure ulcer prevention: the role of the multidisciplinary team

Pressure ulcer prevention has long been a priority for health professionals; however, poor pressure-ulcer-related practices like poor documentation continue to be identified. Research has shown that the attitude and behaviour of some nurses towards pressure ulcer prevention are not conducive to the best possible patient outcomes.This article reviews the findings of a Straussian grounded theory study, which sought to ascertain the value that is placed on pressure ulcer prevention by nurses, but also revealed the role that other health professionals in the multidisciplinary team play in the maintenance of skin integrity. The findings of this study which are presented in this paper highlight a number of important issues. Firstly, nurses are expected to know how to prevent and manage pressure ulcers, but in reality they are very reliant on the advice and support of other health professionals to maintain their patients' skin integrity. In addition,the level of support that nurses get from other health professionals in the multidisciplinary varies tremendously. Therefore, nurses in clinical practice need to be proactive in seeking input from other health professionals, as there are many members of the multidisciplinary team who are able to give them the advice and support that they need in prevention and management.

APhA–APRS awardees describe patient care, mentoring

Pharmacy Today asked the honorees of the APhA Academy of Pharmaceutical Research & Science (APhA–APRS) to share some thoughts on their careers. The themes that emerged were patient care and mentoring the next generation. This year's winning research papers emerged from projects undertaken in graduate school or residencies. All APhA–APRS awards, except for the Ebert Prize, required APhA membership. Here are the awardees in their own words.

Interpretations of informed choice in antenatal screening: A cross-cultural, Q-methodology study

Informed choice is internationally recognised and accepted as an important aspect of ethical healthcare. In the UK, NHS antenatal screening policies state that their primary aim is to facilitate reproductive informed choices. These policies, implemented within a multiethnic population, are largely guided by the ethical principle of autonomy. This study was carried out in 2009 in the UK and used Q-methodology to explore diversity in the value attached to autonomous informed choice in antenatal screening for genetic disorders and similarities and differences in this value in women from different ethnic origins. Ninety-eight participants of African, British White, Caribbean, Chinese and Pakistani origin completed a 41-statement Q-sort in English, French, Mandarin or Urdu. Q-Factor analysis produced five statistically independent viewpoints of the value of informed choice: choice as an individual right; choice informed by religious values; choice as a shared responsibility; choice advised by health professionals; and choice within the family context. The findings show that women hold a variety of views on the nature of informed choice, and that, contradictory to policies of autonomous informed choice, many women seek and value the advice of health professionals. The findings have implications for the role of health professionals in facilitating informed choice, quality of care and equity of access.

Alcohol pricing – could it improve men's health?

AbstractThe authors give an overview of the rationale for using alcohol pricing as a public health tool. They outline the background to government alcohol strategies, review recent moves by the government to acknowledge the problem, and contrast their proposed policy to the evidence base that underpins the advice of health professionals advocating for an urgent minimum pricing policy for alcohol. Copyright © 2011 Wiley Interface Ltd

Heat waves and the heat plan

British Journal of Healthcare AssistantsVol. 5, No. 7 PolicyHeat waves and the heat planRhidian HughesRhidian HughesSearch for more papers by this authorRhidian HughesPublished Online:17 Sep 2014https://doi.org/10.12968/bjha.2011.5.7.358AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Department of Health (2010a) Heatwave: protecting health and reducing harm from extreme heat and heatwaves. The Stationery Office, London Google ScholarDepartment of Health (2010b) Heatwave: supporting vulnerable people before and during a heatwave. Advice for health and social care professionals. The Stationery Office, London Google ScholarDepartment of Health (2010c) Heatwave: supporting vulnerable people before and during a heatwave. Advice for care home managers and staff. The Stationery Office, London Google ScholarKovats RS, Johnson H, Griffiths C (2006) Mortality in southern England during the 2003 heat wave by place of death. Office of National Statistics, London Google ScholarHer Majesty's Government (2008) Climate Change Act 2008. Chapter 27. The Stationery Office, London Google ScholarMet Office (2011) Heat Health Watch. http://www.metoffice.gov.uk/weather/uk/heathealth/ (accessed seven June 2011) Google ScholarOffice of National Statistics (2006) Mortality in southern England during the 2003 heat wave by place of death. www.statistics.gov.uk/articles/hsq/1419.pdf Google Scholar FiguresReferencesRelatedDetails 13 July 2011Volume 5Issue 7ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 17 September 2014 Published in print 13 July 2011 Information© MA Healthcare LimitedPDF download

Self‐care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology

Guidelines on heart failure (HF) stress the importance of lifestyle advice, although there is little evidence that such recommendations improve symptoms or prognosis. Patients experience symptoms of different intensities which impair their daily activities and reduce the quality-of-life. To cope with their clinical condition, many patients seek advice about lifestyle and self-management strategies when in contact with medical care providers, particularly specialized HF services. Self-care management is an important part of HF treatment, thus health professionals working with patients with HF have recognized the need for more specific recommendations on lifestyle advice. The present paper summarizes the available evidence, promotes self-care management, and aims to provide practical advice for health professionals delivering care to HF patients. It also defines avenues of research to optimize self-care strategies in a number of key areas to derive further benefits.

Ethno-Cultural Variations in the Experience and Meaning of Mental Illness and Treatment: Implications for Access and Utilization

We conducted a study to investigate how understandings of mental illness and responses to mental health services vary along ethno-racial lines. Participants were 25 African American, Latino, and Euro-American inner-city residents in Hartford Connecticut diagnosed with severe mental illness and currently enrolled in a larger study of a community mental health center. Data were collected through 18 months of ethnographic work in the community. Overall, Euro-Americans participants were most aligned with professional disease-oriented perspectives on severe mental illness and sought the advice and counsel of mental health professionals. African-American and Latino participants emphasized non-biomedical interpretations of behavioral, emotional, and cognitive problems and were critical of mental health services. Participants across the sample expressed expectations and experiences of psychiatric stigma. Although Euro-Americans were aware of the risk of social rejection because of mental illness, psychiatric stigma did not form a core focus of their narrative accounts. By contrast, stigma was a prominent theme in the narrative accounts of African Americans, for whom severe mental illness was considered to constitute private "family business." For Latino participants, the cultural category of nervios appeared to hold little stigma, whereas psychiatric clinical labels were potentially very socially damaging. Our findings provide further empirical support for differences in symptom interpretation and definitions of illness among persons from diverse ethno-racial backgrounds. First-person perspectives on contemporary mental health discourses and practices hold implications for differential acceptability of mental health care that may inform variations in access and utilization of services in diverse populations.

From inside the bubble: migrants’ perceptions of communication with the cancer team

Migrants with cancer struggle to communicate with their health care team. This study aimed to identify health-care related unmet needs and communication issues for migrants who develop cancer and factors associated with these challenges. In this paper, the findings related to communication issues are presented. Seventy-three cancer patients diagnosed within the previous 3 years and 18 carers, who had migrated to Australia and spoke the designated languages, participated in focus groups or structured interviews. Participants were recruited from ethnic community support organisations, support groups and Oncology clinics within three metropolitan hospitals in two states of Australia. Focus groups and semi-structured interviews were conducted in participants' own language or English as preferred, audio-taped, transcribed and translated into English and analysed using qualitative methods. Four themes emerged: (1) cultural isolation, alienation and identification; (2) language and communication difficulties; (3) interpreter issues; and (4) advice for health professionals. Participants, especially those less acculturated, described feeling alone and misunderstood, failing to comprehend medical instructions, being unable to communicate questions and concerns and a lack of consistency in interpreters and interpretation. Migrants with cancer experience additional challenges to those of native-born patients. Participants provided cogent advice regarding optimal communication with people from their culture. There is clearly a need to develop strategies to increase the cultural competence of care to people from different countries.

Misconceptions about High-Fructose Corn Syrup: Is It Uniquely Responsible for Obesity, Reactive Dicarbonyl Compounds, and Advanced Glycation Endproducts?

Misconceptions about high-fructose corn syrup (HFCS) abound in the scientific literature, the advice of health professionals to their patients, media reporting, product advertising, and the irrational behavior of consumers. Foremost among these is the misconception that HFCS has a unique and substantive responsibility for the current obesity crisis. Inaccurate information from ostensibly reliable sources and selective presentation of research data gathered under extreme experimental conditions, representing neither the human diet nor HFCS, have misled the uninformed and created an atmosphere of distrust and avoidance for what, by all rights, should be considered a safe and innocuous sweetener. In the first part of this article, common misconceptions about the composition, functionality, metabolism, and use of HFCS and its purported link to obesity are identified and corrected. In the second part, an emerging misconception, that HFCS in carbonated soft drinks contributes materially to physiological levels of reactive dicarbonyl compounds and advanced glycation endproducts, is addressed in detail, and evidence is presented that HFCS does not pose a unique dietary risk in healthy individuals or diabetics.

Changing the way we advise patients on use of topical steroids

AbstractPatients are confused about the appropriate application of topical steroids and may worry unnecessarily. In this article, a working group of dermatology experts provide advice for health professionals on how best to advise patients on their effective use. Copyright © 2009 Wiley Interface Ltd

Kidnapping and hostage-taking: a review of effects, coping and resilience

Although the history of kidnapping and hostage-taking is a very long one, it is only relatively recently that there has been a systematic attempt to understand the effects, both long-term and short-term, on individuals and their families. This is an important issue for clinical and academic reasons. The advice of mental health professionals is sought with increasing frequency with regard to the strategic management of hostage incidents and the clinical management of those who have been abducted. There is evidence to suggest that how best to help those who have been taken hostage is a sensitive and complex matter, and those who deal with such individuals should be as well informed as possible since such events can have long-term adverse consequences, particularly on young children. This paper addresses the following: the background in terms of the history of this phenomenon, the motives behind it and the authorities' responses thereto; the psychological and physical effects of being taken hostage; coping and survival strategies; issues which require further research.

Time Between Schizophrenia Onset and First Request for Disability Status in France and Associated Patient Characteristics

This study examined a sample of French persons with schizophrenia to explore the occupational history between onset of illness and first request for disability status, the duration of this period, and the demographic and clinical characteristics associated with a long duration. Persons with schizophrenia or schizoaffective disorder (N=110) requesting a disability allowance or the status of disabled worker for the first time were assessed by using a standardized questionnaire that collected information on clinical, occupational, and income history. Characteristics associated with a long duration were explored by using multivariate analyses. The majority of persons (92%) worked at least once during their lifetime, but this proportion fell dramatically to less than half after the onset of illness. Nearly half of the participants did not receive any income outside of financial support from the family after the onset of illness. The median delay between the onset of illness and the first request for disability status was four years. The characteristics independently predicting a long duration (that is, any time longer than the median, or four or more years) of the period between illness onset and first request were older age, higher educational level, a longer period of working after illness onset, and more than one psychiatric hospitalization. Professionals who choose to delay requesting disability benefits for their clients in order to promote social rehabilitation may paradoxically exacerbate the social consequences of the disease because of clients' lack of resources. Future studies should further explore the implicit and explicit criteria used by mental health professionals and social workers in deciding whether a person with schizophrenia should request disability benefits.

A summary of the symposium “Current strategies in the prevention and treatment of obesity”

This symposium addressed important issues related to the prevention and treatment of obesity and provided practical advice for health professionals. The importance of the maintenance of long-term lifestyle changes were emphasized throughout the symposium as being an integral component to the maintenance of healthy body masses.

A descriptive account of New Zealand mothers’ responses to open-ended questions on their breast feeding experiences

Objective To describe the breast feeding experiences of mothers in New Zealand. Design Descriptive, qualitative study. After a previous quantitative analysis of a questionnaire, the open-ended responses by the women were examined using a thematic analysis approach. Setting Hawke's Bay, New Zealand. Participants 153 primiparous and multiparous breast feeding women aged between 20 and 49 years, who had had a caesarean section or vaginal birth between 4 months and 3 years previously. Findings Themes identified during the data analysis are as follows: persistence, determination, confidence and satisfaction; pain and limitation of mothering activities; conflicting advice and professionalism; and others’ expectations. Conclusions Breast feeding experience could be detrimentally affected by physical factors, inconsistent health-professional support and others’ expectations. Negative influences, however, were likely to be overcome by persistence, determination, confidence and satisfaction. Implications for practice Implications for midwifery practice from the study iterate the importance of consistency of advice and skills of health professionals, of listening and understanding women's responses to early breast feeding assistance and giving continuous encouragement and support throughout their breast feeding experience. To meet these recommendations, breast feeding education for health professionals needs to include technical expertise and communication skills. Recommendations for further research from this study include investigations into why women commit to breast feeding and an exploration of women's perceptions of midwives’ breast feeding support.

Health Disparities in Lifestyle Choices Among Hypertensive Korean Americans, Non-Hispanic Whites, and Blacks

To describe medication profile, diet, and exercise/physical activity in hypertensive Korean Americans, a convenience sample of 100 hypertensive Korean Americans (KAs) at two KA health clinics were interviewed by bilingual Korean nurses using questions from the 1988-1994 Third National Health and Nutrition Examination Survey (NHANES III). One hundred age- and gender-matched hypertensive non-Hispanic Whites and 100 Blacks were randomly selected from the NHANES III dataset, and results were compared to describe the health disparities in lifestyle choices among the three groups. The medication profile among the three groups was similar. A majority of members of all three groups had been told by health professionals to exercise for hypertension. KAs made significantly less effort to reduce salt in their diets than did members of the other two groups (p < .05). Fewer KAs than non-Hispanic Whites or Blacks were following their health professionals'advice to control or lose weight for their high blood cholesterol levels. KAs had the lowest body mass index and were older and more educated than members of the other two groups. KAs' primary reasons for using the KA clinic were the respect they received and the use of the Korean language. KA health professionals need to teach their patients more about the importance of health-promoting lifestyles for hypertension and its contributing factors. More KA hypertensive patients should follow the advice of health professionals on healthy lifestyles. Nurses should continue to treat patients with respect and provide care with sensitivity to language needs of patients.

Breastfeeding and Health Professionals in Britain, New Zealand and the United States, 1900–1970

Modern medical opinion is almost universally in favour of breastfeeding as the best food for newborn infants. Yet this was not always the case. American social historian Rima Apple has argued convincingly that medical attitudes in the United States undermined breastfeeding in the first half of the twentieth-century. She explains how the concept of “scientific motherhood”, successfully promoted by the medical profession during the first half of the twentieth century, “fostered the acceptance of, when not the wholesale commitment to, bottle feeding under physician-supervision”. In her recent book on breastfeeding in the United States, Jacqueline Wolf argues that while many doctors in the United States supported breastfeeding, they inadvertently undermined it by advocating routine feeding and by providing a viable alternative through milk formulas. Considering the experience of breastfeeding in two further environments, Britain and New Zealand, contributes to the discussion of the role of health professionals in promoting breastfeeding. Doctors in Britain and New Zealand did not promote the move from breast to bottle, as Apple found in America. Nor did they appear to undermine breastfeeding by their advocacy of routine feeding. The decline in breastfeeding occurred later than in America. It coincided with the new fashion for “demand feeding”, and with a new movement to medicalize breastfeeding itself. A study of breastfeeding in different countries and over time indicates that the attitudes and advice of health professionals were significant factors in the success or otherwise of breastfeeding.

A Neurologist's Advice for Mental Health Professionals on the Use of QEEG and Neurofeedback

I am a practicing neurologist. I graduated from medical school in 1960 and finished my residency in 1965. I had the usual electroencephalography (EEG) training during my residency which involved three months of reading EEGs side by side with an electroencephalographer (Ralph Druckman). I learned EEG by the apprentice method. At first, he would point out what was real and what was artifact. Then he began to point out various transients and to ask what they represented (artifact, normal physiology, or some type of pathology). At first, he would dictate the reports, always emphasizing the clinical relevance of the findings and suggesting possible treatment. Recognition of epileptiform activity was strongly emphasized, as well as recognition of focal or generalized slow wave activity. The importance of digital analyses and databases was not yet recognized (paper EEG only). When I finished my residency, I entered academic medicine and the EEGs were read by more thoroughly trained (board certified) electroenephalographers. Later I became associated with an epilepsy monitoring unit, took additional training in EEG, and became board certified in EEG. Then, I began to read EEGs on a daily basis, eventually interpreting several thousand. When the first QEEG machines came out, I got one and learned about the additional difficulties of using and interpreting QEEGs. The QEEG databases and discriminants developed by E. Roy John (John, Prichep, Fridman, & Easton, 1988) proved more helpful than raw EEG in differential diagnosis of nonepileptic problems (dementia versus depression, unipolar versus bipolar depression, multi-infarct dementia versus Alzheimer’s, performance anxiety versus ADD, etc.). Later work by Suffin and Emory (1995) showed that QEEG

Setting up a health education website: practical advice for health professionals

Recently, both popular and professional publications about health care have begun to express enthusiasm for the Internet as a source of medical information and possibly of psychological support for those with serious illnesses. However, there are pitfalls for practitioners and researchers who seek to capitalise on these patient education possibilities. We describe here the process and mixed outcomes of the efforts of a multidisciplinary team to set up and evaluate a website for rural women with breast cancer. We provide recommendations for other health professionals contemplating similar ventures, and also identify some future steps to develop and research this potentially valuable form of patient education and support.

Why Rural Elders Drive Against Advice

The purpose of this study was to describe the reasons rural elders continue to drive against the advice of health professionals, family, or friends. Interviews were conducted with a convenience sample of 45 older adults living in isolated communities with populations ranging from 225 to 8,700 residents. Findings suggest that declining health was the primary reason the participants were advised to stop driving. They refused to do so because they did not believe they were unsafe, valued their independence, and feared isolation if they could not drive. Significant reassurance that they would not be forgotten would be required for them to stop driving.

Why Rural Elders Drive Against Advice

The purpose of this study was to describe the reasons rural elders continue to drive against the advice of health professionals, family, or friends. Interviews were conducted with a convenience sample of 45 older adults living in isolated communities with populations ranging from 225 to 8,700 residents. Findings suggest that declining health was the primary reason the participants were advised to stop driving. They refused to do so because they did not believe they were unsafe, valued their independence, and feared isolation if they could not drive. Significant reassurance that they would not be forgotten would be required for them to stop driving.