The present paper reports on a qualitative research project designed to expose the presently unrecognised minutiae of community nurses' work with cancer patients at home, and to identify the ways in which these, combined to form comprehensive care episodes, contribute to physical and psychosocial well-being. The project was conducted in two locations in New South Wales, Australia, one metropolitan and one rural. The research model focused on particular nurse-patient encounters, and involved pre- and post-encounter interviews with nurses, post-encounter interviews with patients and carers, and observation of the encounters themselves. Participants included generalist community nurses, cancer patients being cared for at home, and their primary carers where appropriate. This research demonstrates that regular contact with generalist community nurses is associated with a strong sense of security about the immediate situation for home-based cancer patients and their primary carers. This sense of security is a significant component of patient and carer physical and psychosocial well-being, and may have implications for health services utilisation. In the present paper, the authors outline the factors underpinning this sense of security, and argue that these findings contribute important new knowledge that is vital for contemporary debates about role responsibilities and continuity of care for cancer patients.
Background: More research is needed in lymphoedema management to strengthen the evidence base and ensure patients receive clinically and cost-effective treatment. It is critical that patients and clinicians are involved in prioritising research to ensure it reflects their needs and is not biased by commercial interests. This study aimed to set the research priorities for lymphoedema management in the United Kingdom, through collaboration with patients, carers and clinicians. Methods and Results: Following the James Lind Alliance's methodology, a national survey was conducted to identify unanswered questions about lymphoedema management from the perspective of patients, carers and clinicians. These were collated and verified against an in-depth evidence review. Unanswered questions were formatted into broad research questions, which were prioritised by a purposive sample of patients, carers and clinicians using an online Delphi survey. The initial survey generated 631 submissions from 213 participants including 108 patients, 9 carers and 88 clinicians. Of these 485 met inclusion criteria and were grouped into 12 overarching themes. The evidence review demonstrated that 101 submissions were answered by existing research and identified an additional 78 questions. The remaining unanswered submissions were collated into 126 broad research questions which were prioritised over four rounds of the Delphi survey to produce the top 10 priorities. Conclusions: This study is the first to attempt to systematically identify research priorities for lymphoedema management in the United Kingdom, from the perspective of patients, carers and clinicians. The results provide guidance for 4 researchers and funders to ensure future research meets the needs of those living with lymphoedema.
Keywords skin integrity, champion, model of care, mental health, drug and alcohol For referencing Monaro S et al. Mental health drug & alcohol skin integrity champions as part of a district-wide model of care for wound prevention and management.
It is essential to raise awareness of the health and social needs of trans individuals. This article presents the barriers that trans people may encounter when accessing healthcare services and offers practical recommendations on how holistic care may be achieved.
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