Experiences Of Caring For People Research Articles

Informal caregivers' experiences of caring for people receiving dialysis: A mixed-methods systematic review.

Living with end stage kidney disease and having dialysis is burdensome, and there is a need for support from informal caregivers (i.e. family members and friends). Renal health professionals readily acknowledge and value the support provided by caregivers although the activities and experiences of caring for a loved-one who is receiving dialysis is less well understood. To review studies about the perspectives and experiences of family members and friends who provide support for adults receiving either haemodialysis or peritoneal dialysis. A mixed-methods systematic review was conducted. Eight databases (Medline, CINAHL, EMBASE, PsycINFO, Proquest, Web of Science, Cochrane Library and JBI library) were comprehensively searched using relevant key words for studies regardless of design published in English from January 2006 to July 2017. Twenty studies were included in this review. Informal caregivers undertake many everyday activities as well as a range of dialysis-specific activities, report an elevated level of burden, feel overwhelmed, experience social isolation, and also need to consider their own health. A unique finding was that caregivers also experienced personal growth that may defuse the impact of caregiving burden and to help them develop a sense of resilience to sustain the support through the tough times and for many years. This review substantiates that caregiver burden is due to the unrelenting nature of complex dialysis-specific activities although resilience often develops. Additional research is necessary to understand social support in this context and how health teams can assist caregivers further.

Safety, risk, and aggression: Health professionals' experiences of caring for people affected by methamphetamine when presenting for emergency care.

The crystalline form of methamphetamine, commonly known as crystal meth (crystal methamphetamine) or ICE, is a highly-addictive and powerful stimulant. Users of crystal meth often require emergency care, and are associated with a substantial burden of care by emergency care providers. The aim of the present qualitative study was to explore health professionals' experiences of providing care for patients affected by ICE who presented to the emergency department (ED). Nine semistructured interviews were conducted. The major theme, 'staying safe', was revealed, in which participants described their experiences of being exposed to potentially unsafe situations, and their responses to challenging behaviours, including aggression. The findings highlight the need for ED staff to understand the nature of ICE use and its adverse impact on the mental and physical health of users. Furthermore, it is clear that establishing and maintaining safety in the emergency care setting is of utmost importance, and should be a priority for health-care managers.

Enhancing lymphoedema patients' learning through education.

British Journal of NursingVol. 26, No. 4 Clinical FocusEnhancing lymphoedema patients' learning through educationJane WiggJane WiggSearch for more papers by this authorJane WiggPublished Online:23 Feb 2017https://doi.org/10.12968/bjon.2017.26.4.204AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Arndt MJ, Underwood B (1990) Learning style theory and patient education. J Contin Educ Nurs 21(1): 28–31 Medline, Google ScholarBelgrado JP, Vandermeeren L, Vankerckhove S et al. (2016) Near-infrared fluorescence lymphatic imaging to reconsider occlusion pressure of superficial lymphatic collectors in upper extremities of healthy volunteers. Lymphat Res Biol 14(2): 70–7. https://doi.org/https://dx.doi.org/10.1089/lrb.2015.0040 Crossref, Medline, Google ScholarBenner P (1982) From novice to expert. Am J Nurs 82(3): 402–7 Medline, Google ScholarFetzer A, Fetzer S (2015) Early lipoedema diagnosis and the RCGP e-learning course. Br J Community Nurs 20(suppl 4): S22–8. https://doi.org/https://dx.doi.org/10.12968/bjcn.2015.20.Sup4.S22. Link, Google ScholarHibbard J, Gilburt H (2014) Supporting People to Manage Their Health: An Introduction to Patient Activation. The King's Fund, London Google ScholarHoney P, Mumford A (1986) The Manual of Learning Styles. P Honey, Maidenhead Google ScholarMason VL, Upton D, White R (2008) The psychosocial impact of primary lymphoedema. Journal of Lymphoedema 3(2): 50–6 Google ScholarNational Institute for Health and Care Excellence (2012) Patient experience in adult NHS services: improving the experience of care for people using adult and NHS services. Clinical guideline 138. http://tinyurl.com/j7w2njl (accessed 25 January 2017) Google ScholarWigg J (2012) Supervised self-management of lower limb swelling using FarrowWrap. British J Community Nurs 17(4): S22-29. https://doi.org/https://dx.doi.org/10.12968/bjcn.2012.17.Sup4.S22 Link, Google ScholarWigg J (2009) A case for specialist practice. Journal of Lymphoedema 4(1): 72–8 Google Scholar FiguresReferencesRelatedDetailsCited byEmpowering patient self-management through tailored compression garment regimensJeanne Everett, Sue Lawrance, Natalie Phillips8 October 2020 | British Journal of Community Nursing, Vol. 25, No. Sup10Use of Haddenham Venex armsleeve for lymphoedema management in clinical practiceJeanne Everett, Sue Lawrance11 October 2019 | British Journal of Community Nursing, Vol. 24, No. Sup10Critical examination of skin care self-management in lymphoedemaAimee Jones, Mary Woods, Katharine Malhotra11 October 2019 | British Journal of Community Nursing, Vol. 24, No. Sup10How is lymphofluoroscopy mapping altering lymphoedema management?Jane Wigg, Garry Cooper29 September 2017 | British Journal of Community Nursing, Vol. 22, No. Sup10Haddenham easywrap as part of self-management in lymphoedema and lipoedema: The patient perspectiveNatalie Lee, Stacy Pugh, Robin Cooper29 September 2017 | British Journal of Community Nursing, Vol. 22, No. Sup10 23 February 2017Volume 26Issue 4ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 23 February 2017 Published in print 23 February 2017 Information© MA Healthcare LimitedPDF download

Nurses' moral experiences of assisted death: A meta-synthesis of qualitative research.

Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses' experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses' experiences of caring for people who request this option. To synthesize what has been learned about nurses' experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who undertake this type of care. Qualitative meta-synthesis. Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. The moral experience of the nurse is (1) defined by a profound sense of responsibility, (2) shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and (3) sustained by intra-team moral and emotional support. The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses' moral agency that operate in everyday end-of-life care. Research ethics board approval was not required for this synthesis of previously published literature. In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded.

Nurses' experience of caring for people with intellectual disability and dementia

To explore nurses' experiences of caring for older people with intellectual disability and dementia. Ageing and dementia prevalence is increasing along with the life expectancy of people with intellectual disability. As a population group, people with intellectual disability have a high prevalence of dementia, which is higher within the subpopulation of Down syndrome. People with intellectual disability live in residential care, community or residential settings, and nurses are required to adapt their practices to meet the changed needs of the individual. A qualitative Husserlian descriptive phenomenological methodology facilitated the researcher to become absorbed in the quintessence of meaning and explore nurses' experience of working with older people with intellectual disability and dementia. Ethical approval was obtained, and data were collected utilising semistructured interviews (n=11). Interviews were transcribed and analysed using Colaizzi's framework for data analysis. Three key themes were identified: 'knowledge of dementia', 'person-centred care' and 'transitioning within the service'. The study highlights the need for proactive planning, life story books of the patient, and funding to support client and staff. Overall, the study highlights the importance of knowing the person, supporting the individual and recognising presenting behaviours as outside the control of the individual. This article presents the experiences of nurses caring for the older person with intellectual disability and dementia. Transitions are often very difficult for both the person and their peers, and they experience benefit from the efforts of a multidisciplinary team facilitating a person-centred approach.

Clozapine users in Australia: their characteristics and experiences of care based on data from the 2010 National Survey of High Impact Psychosis.

Clozapine is the most effective medication for treatment refractory schizophrenia. However, descriptions of the mental health and comorbidity profile and care experiences of people on clozapine in routine clinical settings are scarce. Using data from the 2010 Australian Survey of High Impact Psychosis, we aimed to examine the proportion of people using clozapine, and to compare clozapine users with other antipsychotic users on demographic, mental health, adverse drug reaction, polypharmacy and treatment satisfaction variables. Data describing 1049 people with a diagnosis of schizophrenia or schizoaffective disorder, who reported taking any antipsychotic medication in the previous 4 weeks, were drawn from a representative Australian survey of people with psychotic disorders in contact with mental health services in the previous 12 months. We compared participants taking clozapine (n = 257, 22.4%) with those taking other antipsychotic medications, on a range of demographic, clinical and treatment-related indicators. One quarter of participants were on clozapine. Of participants with a chronic course of illness, only one third were on clozapine. After adjusting for diagnosis and illness chronicity, participants taking clozapine had significantly lower odds of current alcohol, cannabis and other drug use despite similar lifetime odds. Metabolic syndrome and diabetes were more common among people taking clozapine; chronic pain was less common. Psychotropic polypharmacy did not differ between groups. Consistent with international evidence of clozapine underutilisation, a large number of participants with chronic illness and high symptom burden were not taking clozapine. The lower probabilities of current substance use and chronic pain among clozapine users warrant further study.

New leadership model for learning disability nursing.

Could learning disability nurses hold the key to a new direction of care and leadership? Jim Blair, writing in Learning Disability Practice, says there must be a response to the inquiry into premature deaths of people with learning disabilities. One way for a new form of leadership could be band 8 nurses practising at consultant level. With their experiences of caring for people with learning disabilities, nurse consultants can shape service delivery and pathways to enhance quality of care, reduce poor practices and avoidable deaths.

How do emergency ambulance paramedics view the care they provide to people who self harm?: Ways and means

The UK has one of the highest rates of self harm (SH) in Europe, and almost four times more people die by suicide than in road traffic collisions. Emergency ambulance paramedics are often the first health professionals involved in the care of people who have self-harmed, yet little is known about the care provided or issues raised in these encounters. The aim of this study is to explore paramedics' perceptions and experiences of caring for people who SH, to inform education and policy. Semi structured interviews were conducted with paramedics, and themes generated by constant comparison coding. This paper reports two emerging themes: Firstly, professional, legal, clinical and ethical tensions, linked to limited decision support, referral options and education. The second theme of relationships with police, revealed practices and surreptitious strategies related to care and detention, aimed at overcoming complexities of care. In the absence of tailored education, guidance or support for self-harm care, ‘ways and means’ have evolved which may negatively influence care and challenge ethical and legal frameworks. There is an urgent need to include evidence from this study in revised guidance and educational materials for paramedics working with people who self-harm in the prehospital emergency setting.

Personal care assistants' experiences of caring for people on home mechanical ventilation.

The aim of this study was to describe personal care assistants' (PCA) experiences of working with a ventilator-assisted person at home. Data were collected from fifteen audiotaped semistructured interviews with PCAs supporting a child or adult using home mechanical ventilation (HMV). Thirteen women and two men participated; their working experience with HMV users ranged from one to 17 years (median 6 years). Data were subjected to qualitative content analysis in an inductive and interpretive manner. Five categories emerged from the data: Being part of a complex work situation; Taking on a multidimensional responsibility; Caring carried out in someone's home; Creating boundaries in an environment with indistinct limits; and Being close to another's body and soul. The participants felt very close to the person they worked with, both physically and emotionally. They had a great responsibility and therefore a commensurate need for support, guidance and a well-functioning organisation around the HMV user. There is international consensus that advanced home care will continue to expand and personal care assistance is key in this development. We suggest that one way to move forward for PCAs working with HMV users is to create multiprofessional teams led by a key-person who coordinates the individual needs. More research is needed within this area from a broad perspective including the HMV-assisted persons, relatives, personal care assistants and management organisations.

A systematic literature review on nurses' and health care support workers' experiences of caring for people with dementia on orthopaedic wards.

To review literature on nurses' and health care workers' experiences of caring for people with dementia on orthopaedic wards. Dementia is a condition that affects a large number of the older population worldwide. It is estimated that there are 47·5 million people worldwide living with dementia with 4·6 million new cases being diagnosed annually. This number is said to increase to 75·6 million by 2030 and triple by 2050. It is also acknowledged that older people are at a greater risk of falls that are a devastating problem causing a tremendous amount of morbidity, mortality and use of health care services (Rubestein, Age and Ageing, 35, 2006, 37). Falls usually result from identified risk factors such as weakness, unsteady gait, confusion and certain medication. Therefore, it is reasonable to assume that a large population of older people suffering from dementia may be admitted to orthopaedic wards with various injuries. Nurse and support health workers may experience a range of difficulties when caring for this population of patients. A systematic review. An extensive literature search using; CINAHL, MEDLINE, Academic Search Complete, National Health Service Evidence, websites like Department of Health, Dementia and Alzheimer's Society. The search generated several articles on dementia in general, however, only 14 articles dealing with care of these people in an acute hospital setting were found. No studies dealing with the care of people with dementia on orthopaedic wards were found; therefore, this review has taken a generalist nature and applies the findings to orthopaedic wards. The main themes identified from the review were: challenging behaviour and unsuitable care environment; lack of education on dementia; strain from nursing patients with dementia; and ethical dilemmas arising from care of people with dementia. It would be an over-simplification to say that the care of people with dementia on medical wards is the same as the care of trauma patients with dementia. Therefore, there is a need for a study to explore nurses' and health care worker's experiences of caring for trauma patients with dementia on orthopaedic wards. The results of this study could provide guidance on the effective care of people with dementia on orthopaedic wards.

"No Right Place to Die": Nursing Attitudes and Needs in Caring for People With Serious Mental Illness at End-of-Life.

Approximately 6% of the U.S. population suffer from a serious mental illness (SMI). People with SMI reportedly die 20 to 25 years earlier than the general population. To explore both hospice/palliative care nurses' and psychiatric/mental health nurses' attitudes and needs toward people with SMI at the end-of-life. A qualitative study following a phenomenological approach was used to interview hospice/palliative care nurses and psychiatric nurses about the experience of caring for people with SMI at the end-of-life; a total of 20 nurses were interviewed. Interviews were analyzed and coded, and themes were identified. Six themes were identified: stigma of mental illness, effect of SMI symptoms on communication and trust, chaotic family systems, advocacy issues around pain and comfort, need for formal support, no right place to die. Participants discussed the need for better education and collaboration between psychiatric and palliative care nurses as well as the need for ongoing support.

Student nurses’ experience of and attitudes towards care of the dying: A cross-sectional study

Background: Nurses are the professional group with the greatest contact with those at the end of life and their attitudes towards the care of the dying is important in care delivery. Aim: We investigated the relationship between student nurses’ attitudes towards care of the dying and (1) demographics, (2) course factors and (3) experience of caring for people who are dying. Design: A cross-sectional survey using the Frommelt’s Attitude Toward Care of the Dying scale to measure respondents’ attitudes. Setting/participants: Nursing students studying at a university in the United Kingdom. Results: A total of 567 completed questionnaires were returned, with 91.9% of respondents being classed as having a positive attitude towards care of the dying (Frommelt’s Attitude Toward Care of the Dying score ⩾65). In adjusted analysis, higher (more positive) Frommelt’s Attitude Toward Care of the Dying scores were associated with time on course and experience of caring for the dying. Third-year students had a score of 2.18 points greater than those in their first year (95% confidence interval: 0.36–4.01, p = 0.017). The adjusted differences in scores were 2.22 points greater for those who had prepared a dead body (95% confidence interval: 0.57–3.87, p = 0.008), 2.95 points greater for those who had cared for a dying patient (95% confidence interval: 1.09–4.08, p = 0.002) and 2.03 points greater for those who had cared for a dying relative or friend (95% confidence interval: 0.69–3.37, p = 0.003). Conclusion: The length of time in education and practical experience of caring for dying individuals are independently associated with positive attitudes towards care of the dying among student nurses.

Measures of Quality of Care for People with HIV: A Scoping Review of Performance Indicators for Primary Care.

The healthcare of people with HIV is transitioning from specialty care to the primary healthcare (PHC) system. However, many of the performance indicators used to measure the quality of HIV care pre-date this transition. The goal of this work was to examine how existing HIV care performance indicators measure the comprehensive and longitudinal care offered in a PHC setting. A scoping review consisting of peer-reviewed and grey literature searches was performed. Two reviewers evaluated study eligibility and indicators in documents meeting inclusion criteria were extracted into a database. Indicators were matched to a PHC performance measurement framework to determine their applicability for evaluating quality of care in the PHC setting. The literature search identified 221 publications, of which 47 met inclusion criteria. 1184 indicators were extracted and removal of duplicates left 558 unique indicators. A majority of the 558 indicators fell under the ‘secondary prevention’ (12%) and ‘care of chronic conditions’ (33%) domains when indicators were matched to the PHC performance framework. Despite the imbalance, nearly all performance domains in the PHC framework were populated by at least one indicator with significant concentrations in domains such as patient-provider relationship, patient satisfaction, population and community characteristics, and access to care. Existing performance frameworks for the care of people with HIV provide a comprehensive set of indicators that align well with a PHC performance framework. Nonetheless, some important elements of care, such as patient-reported outcomes, are poorly covered by existing indicators. Advancing our understanding of how the experience of care for people with HIV is impacted by changes in health services delivery, specifically more care within the PHC system, will require performance indicators to capture this aspect of HIV care.

064. The Social Care Experiences of People with Rheumatoid Arthritis

064. The Social Care Experiences of People with Rheumatoid Arthritis

Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis.

Informal caregiving is an integral part of the care of people with severe mental illness, but the support needs of those providing such care are not often met. To determine whether interventions provided to people caring for those with severe mental illness improve the experience of caring and reduce caregiver burden. We conducted a systematic review and meta-analyses of randomised controlled trials (RCTs) of interventions delivered by health and social care services to informal carers (i.e. family or friends who provide support to someone with severe mental illness). Twenty-one RCTs with 1589 carers were included in the review. There was evidence suggesting that the carers' experience of care was improved at the end of the intervention by psychoeducation (standardised mean difference -1.03, 95% CI -1.69 to -0.36) and support groups (SMD = -1.16, 95% CI -1.96 to -0.36). Psychoeducation had a benefit on psychological distress more than 6 months later (SMD = -1.79, 95% CI -3.01 to -0.56) but not immediately post-intervention. Support interventions had a beneficial effect on psychological distress at the end of the intervention (SMD = -0.99, 95% CI -1.48 to -0.49) as did problem-solving bibliotherapy (SMD = -1.57, 95% CI -1.79 to -1.35); these effects were maintained at follow-up. The quality of the evidence was mainly low and very low. Evidence for combining these interventions and for self-help and self-management was inconclusive. Carer-focused interventions appear to improve the experience of caring and quality of life and reduce psychological distress of those caring for people with severe mental illness, and these benefits may be gained in first-episode psychosis. Interventions for carers should be considered as part of integrated services for people with severe mental health problems.

The experience of care for people affected by mesothelioma

Sally Moore and colleagues discuss an analysis of feedback received from the first National Mesothelioma Experience Survey in the UK

What counts cannot be counted and what is counted often doesn't count: Is the NHS making effective use of patient experience data?

International Journal of Therapy and RehabilitationVol. 22, No. 3 OpinionWhat counts cannot be counted and what is counted often doesn't count: Is the NHS making effective use of patient experience data?Liz LivingstoneLiz LivingstoneSearch for more papers by this authorLiz LivingstonePublished Online:4 Mar 2015https://doi.org/10.12968/ijtr.2015.22.3.108AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Collins A (2014) Measuring What Matters to Patients at the Frontline. Webinar. http://bit.ly/1c22lUF (accessed 24 February 2015) Google ScholarCoulter A, Fitzpatrick R, Cornwell J (2009) Measures of Patients' Experience in Hospital: Purpose, Methods and Uses. http://bit.ly/1MPA2Yw (accessed 24 February 2015) Google ScholarCoulter A, Locock L, Ziebland S, Calabrese J (2014) Collecting data on patient experience is not enough: They must be used to improve care. BMJ 348: g2225 Crossref, Google Scholarde Silva D (2013) Measuring Patient Experience. Evidence Scan No 18. http://bit.ly/1DQ643N (accessed 24 February 2015) Google ScholarDepartment of Health (1997) The New NHS. The Stationery Office, London Google ScholarDepartment of Health (2010) Equity and Excellence: Liberating the NHS. The Stationery Office, London Google ScholarDepartment of Health (2012) Statistical Bulletin: Overall Patent Experience Scores. http://bit.ly/1EOmnLD (accessed 24 February 2015) Google ScholarDepartment of Health (2013) The NHS Constitution. http://bit.ly/IZREDI (accessed 24 February 2015) Google ScholarFrancis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. The Stationery Office, London Google ScholarGraham C, MacCormick S (2012) Overarching Questions for Patient Surveys: Development Report for the Care Quality Commission. http://bit.ly/1C1tzV8 (accessed 24 February 2015) Google ScholarKnightley-Day T (2012) A Response to the Overarching Questions for Patient Surveys: Development Report for the Care Quality Commission (CQC). http://bit.ly/1GqrGCf (accessed 24 February 2015) Google ScholarThe King's Fund (2012) The Friends and Family Test: Will Hospitals Raise Their Game? http://bit.ly/1JJgKos (accessed 24 February 2015) Google ScholarThe King's Fund (2013) What is Experience-Based Co-Design? http://bit.ly/1LB4X7i (accessed 24 February 2015) Google ScholarNational Institute for Health and Care Excellence (2012) Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services. http://www.nice.org.uk/guidance/cg138 (accessed 24 February 2015) Google ScholarNHS England (2013) The NHS Friends and Family Test. http://bit.ly/1kCaT7N (accessed 24 February 2015) Google ScholarNHS England (2014a) Friends and Family Test Data. http://bit.ly/19fAyhG (accessed 24 February 2015) Google ScholarNHS England (2014b) Statistical Commentary: Friends and Family Test. http://bit.ly/17VcIrz (accessed 24 February 2015) Google ScholarNHS Institute (2013) Transforming Patient Experience: The Essential Guide. http://bit.ly/1BPTy3G (accessed 24 February 2015) Google ScholarNHS Surveys (2014) Improving Healthcare: How Surveys Help Improve Healthcare. http://bit.ly/1BoM5Jj (accessed 24 February 2015) Google ScholarSheffield Teaching Hospital (2013) Patient Experience Report. http://bit.ly/1DQwW3U (accessed 24 February 2015) Google ScholarThorlby R, Maybin J, eds (2010) A High Performing NHS? A Review of Progress 1997–2010. The King's Fund, London Google Scholar FiguresReferencesRelatedDetailsCited byProgress in applying patient experience in nursing quality improvementChinese Nursing Research, Vol. 4, No. 1 2 March 2015Volume 22Issue 3ISSN (online): 1759-779X Metrics History Published online 4 March 2015 Published in print 2 March 2015 Information© MA Healthcare LimitedPDF download

Ongoing challenges responding to behavioural and psychological symptoms of dementia.

Mid- to late-stage dementia is often characterized by behavioural and psychological symptoms, including, but not limited to physical and verbal aggression. Although there is a considerable research about the prevalence, aetiology, and management of behavioural and psychological symptoms of dementia, there is limited research about the experience of caring for people with such symptoms in long-term aged care facilities. The aims of the study were to describe: (i) nurses' experiences of caring for people with behavioural and psychological symptoms of dementia in long-term aged care facilities, and (ii) strategies nurses used to deal with these symptoms. A qualitative exploratory and descriptive design, involving focus group interviews with 30 nurses from three long-term aged care units in Australia. The transcripts were analysed using inductive content analysis. The findings revealed five interrelated themes: (i) working under difficult conditions, (ii) behavioural and psychological symptoms of dementia: an everyday encounter, (iii) making sense of behavioural and psychological symptoms of dementia, (iv) attempting to manage behavioural and psychological symptoms of dementia, and (v) feeling undervalued. This study highlighted the difficult conditions under which nurses worked and the complexity of caring for individuals who have behavioural and psychological symptoms of dementia. Organizational efforts to enhance the quality of care for individuals with behavioural and psychological symptoms of dementia in long-term aged care facilities should extend beyond staff education to heed nurses' concerns about organizational barriers to interpersonal care.

Transforming dementia care in an NHS trust.

Walsall Healthcare NHS Trust was one of nine trusts selected to take part in the RCN development programme transforming dementia care in hospitals during 2013. The programme aimed to improve the experience of care for people with dementia and their carers in hospital. This article outlines a two-day training programme delivered to staff on two pilot wards with a larger cohort of adults with dementia than other wards in Manor Hospital. A range of staff were trained including nurses, clinical support workers and allied health professionals and also, in a bespoke format, housekeepers, porters and security staff. The programme has led to a noticeable cultural change and significantly improved care and management of patients with cognitive impairment and/or dementia on the two pilot wards. As a result, the training programme has been implemented more widely across the hospital.

Primary care experiences of people with multiple long-term illnesses

Primary care experiences of people with multiple long-term illnesses