scholarly journals A Home-Based Couple Management Guide for Couples Affected by Dementia (DemPower): A Protocol (Preprint)

2017 ◽  
Author(s):  
Reena Lasrado ◽  
Therése Bielsten ◽  
Mark Hann ◽  
Linda Davies ◽  
James Schumm ◽  
...  
Keyword(s):  
Randomised Control Trial ◽  
Limited Attention ◽  
Post Intervention ◽  
Relational Networks ◽  
Home Based ◽  
Health And Social Care ◽  
Diagnosis Of Dementia ◽  
The Uk ◽  
Person With Dementia ◽  
Care Costs

BACKGROUND The increasing rate of dementia and high health and social care costs call for effective measures to improve public health and enhance the wellbeing of people living with dementia and their relational networks. Most post diagnostic services focus on the condition and the person with dementia with limited attention to the caring spouse/partner. The key focus of the study is to develop a guide for couples where one partner has a diagnosis of dementia. This couple-management guide is delivered in the form of an app, ‘DemPower’. OBJECTIVE The study aims to investigate the feasibility and acceptability of DemPower and assess the criteria for a full-integrated clinical and economic randomised control trial. METHODS DemPower couple-management app will be introduced to couples where one partner has dementia. The study will recruit 25 couples in the UK and 25 couples in Sweden. Couples will be given three months to engage with the app and the amount of time taken to complete the guide (it may be <3 months as well as >3) will be reviewed. A set of outcome measures will be obtained at baseline and post intervention stages. RESULTS The proposed study is at recruitment phase. The DemPower app is being introduced to couples from consultation groups at a pre-trial phase for identification of bugs and explore if any navigation challenges exist. The feasibility testing will begin in April 2018. CONCLUSIONS The study will determine how much support couples need to engage with DemPower and whether or not they make use of it in their everyday lives. If there is support for app use, a future study will assess whether it is superior to ‘usual care’. CLINICALTRIAL ISRCTN10122979

Feasibility and Acceptability of DemPower: A Couple Management App for Couples Where One Partner has a Dementia (Preprint)

2019 ◽  
Author(s):  
Reena Lasrado ◽  
Therese Bielsten ◽  
Mark Hann ◽  
James Schumm ◽  
Siobhan Reilly ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Self Management ◽  
Limited Attention ◽  
Post Intervention ◽  
Relational Networks ◽  
Health And Social Care ◽  
Diagnosis Of Dementia ◽  
Memory Clinics ◽  
Randomised Controlled ◽  
Study Participants

BACKGROUND The increasing rate of dementia and high health and social care costs call for effective measures to improve public health and enhance the wellbeing of people living with dementia and their relational networks. Most post diagnostic services focus on the condition and the person with dementia with limited attention to the spouse or partner caregiver. The key focus of the study is to develop a self-management guide for couples where one partner has a diagnosis of dementia. This couple self-management guide is delivered in the form of an app, DemPower. The contents of the app were organized into four main themes, ‘Home and Neighbourhood’, ‘Activities and Relationship’, ‘Meeting, Sharing and Caring’ ‘Communication and Emotions’. Each of these themes included a series of videos and activities for couples to do together. OBJECTIVE The study aimed to investigate the feasibility and acceptability of DemPower. METHODS The study used a non-randomized feasibility design. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. We aimed to complete the app within three months and collected usage data from the devices at the end of the study. Outcome measures were obtained at baseline and post intervention. RESULTS 21 couples completed the study (48%). Of these, 18 (86%) completed all parts of the app and each couple spent an average of 8hrs on the app during the study period. Among the four themes, ‘Home and Neighbourhood’ averaged 250 visits, ‘Activities and Relationship’ average 174 visits, ‘Meeting, Sharing and Caring’ average 160 and ‘Communication and Emotions’ received average 122 visits. Over the course of the study, participants visited suggested activities pages more frequently (average 95) than the core contents pages displaying section specific introductory videos (average 71) or videos of couples (average 69), for example taking pictures, physical exercise, talking to each other, walking, music and home adaptation checklist. CONCLUSIONS The findings suggest that the DemPower app is a useful resource for couples where one partner has a dementia and that its implementation requires the support of memory clinics to reach couples at early diagnosis. CLINICALTRIAL International Standard Randomised Controlled Trial Number (ISRCTN): 10122979; http://www.isrctn.com/ISRCTN10122979 (Archived by WebCite at http://www.webcitation.org/70rB1iWYI)

Health and social care costs for young adults with epilepsy in the UK

2010 ◽  
Vol 18 (5) ◽  
pp. 465-473 ◽  
Author(s):  
Jennifer Beecham ◽  
Tom Snell ◽  
Margaret Perkins ◽  
Martin Knapp
Keyword(s):  
Young Adults ◽  
Social Care ◽  
Health And Social Care ◽  
The Uk ◽  
Care Costs

scholarly journals Getting evidence into clinical practice: protocol for evaluation of the implementation of a home-based cardiac rehabilitation programme for patients with heart failure

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036137 ◽  
Author(s):  
Paulina Daw ◽  
Samantha B van Beurden ◽  
Colin Greaves ◽  
Jet J C S Veldhuijzen van Zanten ◽  
Alexander Harrison ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Data Protection ◽  
Normalisation Process Theory ◽  
South Central ◽  
Home Based ◽  
Health And Social Care ◽  
Patients With Heart Failure ◽  
The Uk

IntroductionCardiac rehabilitation (CR) improves health-related quality of life and reduces hospital admissions. However, patients with heart failure (HF) often fail to attend centre-based CR programmes. Novel ways of delivering healthcare, such as home-based CR programmes, may improve uptake of CR. Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is a new, effective and cost-effective home-based CR programme for people with HF. The aim of this prospective mixed-method implementation evaluation study is to assess the implementation of the REACH-HF CR programme in the UK National Health Service (NHS). The specific objectives are to (1) explore NHS staff perceptions of the barriers and facilitators to the implementation of REACH-HF, (2) assess the quality of delivery of the programme in real-life clinical settings, (3) consider the nature of any adaptation(s) made and how they might impact on intervention effectiveness and (4) compare real-world patient outcomes to those seen in a prior clinical trial.Methods and analysisREACH-HF will be rolled out in four NHS CR centres across the UK. Three healthcare professionals from each site will be trained to deliver the 12-week programme. In-depth qualitative interviews and focus groups will be conducted with approximately 24 NHS professionals involved in delivering or commissioning the programme. Consultations for 48 patients (12 per site) will be audio recorded and scored using an intervention fidelity checklist. Outcomes routinely recorded in the National Audit of Cardiac Rehabilitation will be analysed and compared with outcomes from a recent randomised controlled trial: the Minnesota Living with HF Questionnaire and exercise capacity (Incremental Shuttle Walk Test). Qualitative research findings will be mapped onto the Normalisation Process Theory framework and presented in the form of a narrative synthesis. Results of the study will inform national roll-out of REACH-HF.Ethics and disseminationThe study (IRAS 261723) has received ethics approval from the South Central (Hampshire B) Research Ethics Committee (19/SC/0304). Written informed consent will be obtained from all health professionals and patients participating in the study. The research team will ensure that the study is conducted in accordance with the Declaration of Helsinki, the Data Protection Act 2018, General Data Protection Regulations and in accordance with the Research Governance Framework for Health and Social Care (2005). Findings will be published in scientific peer-reviewed journals and presented at local, national and international meetings to publicise and explain the research methods and findings to key audiences to facilitate the further uptake of the REACH-HF intervention.Trial registrationISRCTN86234930.

Telemedicine in Cancer Care

2018 ◽  
pp. 540-545 ◽  
Author(s):  
S. Joseph Sirintrapun ◽  
Ana Maria Lopez
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Symptom Management ◽  
Lifestyle Modification ◽  
Clinical Settings ◽  
Home Based ◽  
Home Based Care ◽  
Care Costs ◽  
Improve Access

Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient’s electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.

scholarly journals When “Good Enough” Isn’t Good Enough: Interdisciplinary Perspectives on Caring for Adults Using Substances at the End of Life

2021 ◽  
Author(s):  
Lorna Templeton ◽  
Sarah Galvani ◽  
Marian Peacock
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Structured Interview ◽  
Life Care ◽  
Snowball Sampling ◽  
Policy And Practice ◽  
Template Analysis ◽  
Health And Social Care ◽  
The Uk ◽  
Key Terms

AbstractThis paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely “Definitions and perceptions of key terms” in end of life care and substance use sectors, and “Service commissioning and delivery.” The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives.

scholarly journals Psychosocial impact on frontline health and social care professionals in the UK during the COVID-19 pandemic: a qualitative interview study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047353
Author(s):  
Henry Aughterson ◽  
Alison R McKinlay ◽  
Daisy Fancourt ◽  
Alexandra Burton
Keyword(s):  
Personal Growth ◽  
Social Care ◽  
Well Being ◽  
Work Conditions ◽  
Individual Interviews ◽  
Work Related ◽  
Qualitative Interview Study ◽  
Health And Social Care ◽  
Communication Challenges ◽  
The Uk

ObjectivesTo explore the psychosocial well-being of health and social care professionals working during the COVID-19 pandemic.DesignThis was a qualitative study deploying in-depth, individual interviews, which were audio-recorded and transcribed verbatim. Thematic analysis was used for coding.ParticipantsThis study involved 25 participants from a range of frontline professions in health and social care.SettingInterviews were conducted over the phone or video call, depending on participant preference.ResultsFrom the analysis, we identified 5 overarching themes: communication challenges, work-related stressors, support structures, personal growth and individual resilience. The participants expressed difficulties such as communication challenges and changing work conditions, but also positive factors such as increased team unity at work, and a greater reflection on what matters in life.ConclusionsThis study provides evidence on the support needs of health and social care professionals amid continued and future disruptions caused by the pandemic. It also elucidates some of the successful strategies (such as mindfulness, hobbies, restricting news intake, virtual socialising activities) deployed by health and social care professionals that can support their resilience and well-being and be used to guide future interventions.

Pilot evaluation of a group stabilisation intervention for refugees and asylum seekers with PTSD

2021 ◽  
pp. 1-6
Author(s):  
Mary Griggs ◽  
Cheng Liu ◽  
Kate Cooper
Keyword(s):  
Repeated Measures ◽  
Asylum Seekers ◽  
Preliminary Evidence ◽  
Behavioural Therapy ◽  
Post Traumatic Stress ◽  
Group Setting ◽  
Post Intervention ◽  
Treatment Delivery ◽  
Cognitive Behavioural ◽  
The Uk

Abstract Background: Post-traumatic stress disorder (PTSD) is commonly experienced by asylum seekers and refugees (ASR). Evidence supports the use of cognitive behavioural therapy-based treatments, but not in group format for this population. However, group-based treatments are frequently used as a first-line intervention in the UK. Aims: This study investigated the feasibility of delivering a group-based, manualised stabilisation course specifically developed for ASR. The second aim was to evaluate the use of routine outcome measures (ROMs) to capture psychological change in this population. Method: Eighty-two participants from 22 countries attended the 8-session Moving On After Trauma (MOAT) group-based stabilisation treatment. PHQ-9, GAD-7, IES-R and idiosyncratic outcomes were administered pre- and post-intervention. Results: Seventy-one per cent of participants (n = 58) attended five or more of the treatment sessions. While completion rates of the ROMs were poor – measures were completed at pre- and post-intervention for 46% participants (n = 38) – a repeated-measures MANOVA indicated significant improvements in depression (p = .001, ηp2 = .262), anxiety (p = .000, ηp2 = .390), PTSD (p = .001, ηp2 = .393) and idiosyncratic measures (p = .000, ηp2 = .593) following the intervention. Conclusions: Preliminary evidence indicates that ASR who attended a low-intensity, group-based stabilisation group for PTSD experienced lower mental health scores post-group, although the lack of a comparison group means these results should be interpreted with caution. There are significant challenges in administering ROMs to individuals who speak many different languages, in a group setting. Nonetheless, groups have benefits including efficiency of treatment delivery which should also be considered.

scholarly journals Multi-Component Physical Activity Interventions in the UK Must Consider Determinants of Activity to Increase Effectiveness

2021 ◽  
Vol 6 (3) ◽  
pp. 56
Author(s):  
Mark A. Faghy ◽  
Kirsty E. Armstrong-Booth ◽  
Vicki Staples ◽  
Micheal J. Duncan ◽  
Clare M. P. Roscoe
Keyword(s):  
Physical Activity ◽  
Theoretical Basis ◽  
School Setting ◽  
School Age Children ◽  
Moderate Activity ◽  
Activity Levels ◽  
Daily Consumption ◽  
Post Intervention ◽  
Light Activity ◽  
The Uk

Interventions to increase physical activity in children have adopted broad approaches and achieved varying success. There is a need to adopt approaches underpinned with a theoretical basis. Accordingly, the aim here was to implement and evaluate a 12-week intervention designed using the concepts of the COM-B model to determine the effect this has on physical activity levels. One hundred and forty-seven school-age children (mean age 8.9 ± 1.3 years) took part in a 12-week program delivered in a school setting. Topics included physical activity, healthy eating, sleep quality and reducing screen time/sedentary activities when not in school. A sample of participants wore a wrist-worn accelerometer for seven days pre-and post-intervention (N = 11). The physical activity frequency was unchanged (2.9 ± 1.0 AU) when compared with post-intervention values (3.1 ± 0.8 AU, mean increase 6.8 ± 3.7%, p > 0.05). Changes were observed in the daily consumption of fruit and vegetables (pre-intervention 44.6% vs. post-intervention 60.2%, p < 0.05). Sedentary time, light activity, moderate activity and vigorous activity were unchanged post-intervention (p > 0.05). There is a need to adopt a broader approach that incorporates a theoretical basis and considers the complex ways by which physical activity behaviours are influenced.

scholarly journals Effectiveness of Home-Based Occupational Therapy on COPM Performance and Satisfaction Scores in Patients with COPD

2020 ◽  
pp. 000841742097112
Author(s):  
Eleonore H. Koolen ◽  
Martijn A. Spruit ◽  
Marianne de Man ◽  
Jeanine C. Antons ◽  
Elieke Nijhuis ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Integrated Management ◽  
Performance Measure ◽  
Occupational Performance ◽  
Post Intervention ◽  
Canadian Occupational Performance Measure ◽  
Home Based ◽  
Copd Patients ◽  
The Mean ◽  
Mean Differences

Background. Occupational therapy (OT) may be an important intervention in patients with COPD, but studies show conflicting results. Purpose. To evaluate the effectiveness of home-based monodisciplinary OT in COPD patients Method. We conducted an observational clinical study. Main outcomes were the mean differences in the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores, pre and post intervention. Findings. Pre- and postintervention data were obtained from 41 patients. Statistically significant increases were observed in COPM performance (5.0 ± 1.1 versus 6.9 ± 0.9; P<0.001) and satisfaction (4.6 ± 1.3 versus 6.9 ± 1.0; P<0.001). The most frequently reported occupational performance problems were found in the domains of productivity (47%) and mobility (40%), fewer in self-care (10%) and the least in leisure (3%). Implications. Home-based monodisciplinary OT can contribute significantly to the improvement of daily functioning of patients with COPD. OT should therefore be considered more often as part of the integrated management of these patients.

scholarly journals Feasibility study of the Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use among young women

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicola Knights ◽  
Nicole Stone ◽  
Tom Nadarzynski ◽  
Katherine Brown ◽  
Katie Newby ◽  
...  
Keyword(s):  
Condom Use ◽  
Feasibility Study ◽  
Young Women ◽  
Self Efficacy ◽  
Repeated Measures ◽  
Recruitment Strategy ◽  
Consistent Condom ◽  
Post Intervention ◽  
Study Objective ◽  
Home Based

Abstract Background Male condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16–25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK). Methods A repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention. Results Fifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention. Conclusions HERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.

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