• Prevalence of pressure ulcers in Africa: A systematic review and meta-analysis

      Anthony, Denis; Alosaimi, Dalyal; Korsah, Kwadwo; Safari, Reza; Shiferaw, Wondimeneh Shibabaw; University of Derby; College of Nursing, King Saud University, Saudi Arabia; Institute of Medicine and College of Health Sciences, Debre Berhan University, Ethiopia; School of Nursing and Midwifery, University of Ghana, Ghana (Elsevier, 2021-10-27)
      A recent global review of pressure ulcers contained no studies from Africa. To identify the prevalence and incidence of pressure ulcers in Africa. Bibliographic databases, African specific databases, grey literature. Studies with prevalence or incidence data of pressure ulcers from Africa since the year 2000. Any age, including children, in any setting, specifically including hospital patients from any clinical area but not restricted to hospital settings. Holy score for bias, Joanna Briggs Institute Critical Appraisal Instrument. We followed the PRISMA guideline for systematic reviews. We searched Embase, Medline, Scopus, CINHAL, Google Scholar, specialist African databases and grey literature for studies reporting incidence or prevalence data. Nineteen studies met the inclusion criteria and were included in the study. Point prevalence rates varied from 3.4% to 18.6% for medical/surgical and other general hospital units with a pooled prevalence of 11%, for grades II-IV 5%. For spinal injury units the pooled prevalence was 44%. Restricted to English, French and Arabic. Prevalence of pressure ulcers in Africa reported here is similar to figures from a recent review of prevalence in Europe and two recent global reviews of hospitalised patients. Prevalence of pressure ulcers in spinal cord injury patients is similar to figures from a review of developing countries. The reporting of prevalence is lacking in detail in some studies. Studies using an observational design employing physical examination of patients showed higher prevalence than those relying on other methods such as medical notes or databases. Further prevalence and incidence studies are needed in Africa. Reporting of such studies should ensure items in the “Checklist for Prevalence Studies” from Joanna Briggs Institute (or similar well regarded resources) are addressed and the PICOS model and PRISMA guidelines are employed. Systematic review registration number. Prospero registration number CRD42020180093
    • Physical activity: understanding and addressing inequalities

      Jackson, Jessica; Roscoe, Clare M. P.; Mourton, Niamh; University of Derby (Public Health England, 2021-02-22)
      This guidance can be used by local level practitioners and commissioners to begin tackling inequalities in physical activity across and within protected characteristic groups. It presents the findings of a review, analysis and research aimed at understanding the enablers, barriers and opportunities for increasing physical activity across inequality groups. Three major themes are identified as considerations for action by practitioners and commissioners: enablers, barriers, and identifying opportunity community consultation, engagement, and partnership adopting a holistic approach for protected characteristics and intersectionality The document concludes with a full set of recommendations for commissioners and practitioners to consider when designing services and interventions locally.
    • A systematic review of evidence about the role of alexithymia in chronic back pain

      Elander, James; Kapadi, Romaana; Bateman, Antony H.; University of Derby; Royal Derby Spinal Centre, University Hospitals of Derby and Burton NHS Foundation Trust (British Psychological Society, 2021-02-01)
      Individuals with alexithymia struggle to make sense of their emotions. Alexithymia has been associated with a range of physical illnesses, but may influence different illnesses differently, so to understand the role of alexithymia in illness it is important to focus on specific conditions. This article reviews evidence from ten reports published between 2000 and 2018 of studies with samples of adults with chronic back pain that used the Toronto Alexithymia Scale (TAS). The studies were conducted in Germany, Israel, Italy, Russia, Turkey and the USA. Eight studies involved clinical samples and two involved public transit workers. Studies that compared participants with high and low alexithymia consistently found associations with measures of pain. The findings show that more severe alexithymia plays a role in the experience of chronic back pain, and support the incorporation of alexithymia-related elements in interventions to help people with chronic back pain improve their emotional regulation and reduce their pain-related distress.
    • An integrative systematic review of creative arts interventions for older informal caregivers of people with neurological conditions.

      Irons, J Yoon; Garip, Gulcan; Cross, Ainslea J; Sheffield, David; Bird, Jamie; University of Derby (PloS, 2020-12-07)
      We aimed to assess and synthesise the current state of quantitative and qualitative research concerning creative arts interventions for older informal caregivers of people with neurological conditions. A systematic search was employed to identify studies that examined creative arts interventions for older informal caregivers, which were synthesised in this integrative review. We searched the following databases: MEDLINE, PubMed, EBSCO, CINAHL, EMBASE, PsycINFO, Cochrane Library, Scopus, Web of Science, and Google Scholar. We also backwards searched references of all relevant studies and inspected trials registers. Of the 516 studies identified, 17 were included: one was quantitative, nine were qualitative and seven used mixed methods. All included quantitative studies were pilot or feasibility studies employing pre- and post-test design with small sample sizes. Studies varied in relation to the type of creative intervention and evaluation methods, which precluded meta-analysis. Large effect sizes were detected in wellbeing measures following singing and art interventions. The qualitative synthesis highlighted that interventions created space for caregivers to make sense of, accept and adapt to their identity as a caregiver. Personal developments, such as learning new skills, were viewed positively by caregivers as well as welcoming the opportunity to gain cognitive and behavioural skills, and having opportunities to unload emotions in a safe space were important to caregivers. Group creative interventions were particularly helpful in creating social connections with their care-recipients and other caregivers. The current review revealed all creative interventions focused on caregivers of people living with dementia; subsequently, this identified gaps in the evidence of creative interventions for informal caregivers of other neurological conditions. There are encouraging preliminary data on music and art interventions, however, little data exists on other art forms, e.g., drama, dance. Creative interventions may appeal to many caregivers, offering a range of psycho-social benefits. The findings of the current review open the way for future research to develop appropriate and creative arts programmes and to test their efficacy with robust tools.
    • Florence Nightingale (1820–1910) – what does history say about her feminism?

      Hogan, Susan; University of Derby (Informa UK Limited, 2020-11-28)
      Is Florence Nightingale becoming unfashionable? The UK’s largest union UNISON voted to drop the use of Nightingale’s image for their union as she was considered to be unrepresentative of modern nursing. One of those backing the motion is on record as saying, ‘All over Eastern Europe, statues of Lenin are being taken off their pedestals, dismantled and pulled off to be cut up.… It is in the same vein that we must enter the new Millennium, start to exorcise the myth of Florence Nightingale’. This paper will discuss modern attitudes to Nightingale in terms of her feminism (not a term she used of herself) and survey scholarly articles that address Nightingale in relation to the position of women. It ends with reflections on the iconography of notable women.
    • Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction

      Safari, Reza; University of Derby (SAGE Publications, 2020-11-08)
      The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.
    • "I don’t want to hold your hand": Can Covid-19 public health messages delivered through songs?

      Sheffield, David; Irons, J Yoon; University of Derby (The British Psychological Society, 2020-10-28)
      In response to the outbreak of Covid-19, governments around the world have published their guidelines including rigorous hand washing, respiratory etiquette, social distancing and restrictions in movements and gatherings (European Centre for Disease Prevention and Control, 2020). Songs have been used to share key advice since the start of the outbreak in many countries (Hui, 2020). In the UK, the first advice proffered concerned rigorous hand washing.
    • How healthcare providers’ own death anxiety influences their communication with patients in end-of-life care: A thematic analysis

      Clare, Emma; Elander, James; Baraniak, Amy; University of Derby (Informa UK Limited, 2020-10-27)
      Healthcare providers’ own death anxiety can influence end-of-life communication. We interviewed nine palliative care health providers about their experiences of providing end-of-life care. Participants also completed the Revised Death Anxiety Scale. A thematic analysis of the interview transcripts identified one theme labelled ‘avoidant coping’ and another labelled ‘death anxiety awareness’, which are presented in the context of the participants’ own Revised Death Anxiety Scale scores. The findings show that avoidant death anxiety coping can compromise end-of-life communication, but that greater awareness of death anxiety can help overcome avoidant coping. The findings can inform potential improvements in healthcare practice and training.
    • Using behavioural insights to reduce sugar in primary school children's packed lunches in derby; A cluster randomised controlled trial

      Bunten, Amanda; Porter, Lucy; Burgess-Allen, Jilla; Howell-Jones, Rebecca; Jackson, Jessica; Ward, Derek; Staples, Vicki; Staples, Paul; Rowthorn, Harriet; Saei, Ayoub; et al. (Elsevier BV, 2020-10-08)
      Children's packed lunches contain more sugar than school-provided meals. Interventions to improve the provision of healthier packed lunches have modest effects on lunch contents. This cluster randomised controlled trial tested an intervention to encourage healthier provision of packed lunches by parents of primary school children in Derby. Schools were randomised to intervention (n = 8) or control (n = 9) using blocked random allocation. In the intervention group, parents of children who brought packed lunches to school in years 3–6 (age 7–11 years) received three bundles of materials (including packed lunch planner, shopping list, information on sugar content of popular lunchbox items and suggestions for healthier swap alternatives) in bookbags/lunchboxes over a 4-week period. Control parents received no materials. Photos of lunchbox contents were taken at baseline, immediately post-intervention and at three-month follow-up. A parental survey aimed to assess capability, opportunity and motivation for packing a healthier lunchbox. No intervention effects were observed for primary outcomes (presence and number of sugary snacks or chilled sugary desserts). The intervention had a significant impact on one secondary outcome (increased number of healthier “swap” items suggested in intervention materials) immediately post-intervention, but this effect had disappeared at three-month follow-up. No intervention effects were found on survey variables. Parent comments revealed that materials were either received positively (as they reinforced existing behaviours) or negatively (as they were not perceived to be helpful or appropriate). The results of this study suggest that providing educational materials and resources to parents of primary school children in Derby was not sufficient to increase provision of healthier packed lunches. Future research should investigate how behavioural science can support families to improve the nutritional content of primary school children's lunchboxes.
    • Development of NURSE education in Saudi Arabia, Jordan and Ghana: From undergraduate to doctoral programmes

      Anthony, Denis; Alosaimi, Dalyal; Dyson, Sue; Saleh, Mohammad; Korsah, Kwadwo; University of Derby; King Saud University, Saudi Arabia; University of Ghana, Ghana; University of Jordan, Jordan (Elseiver, 2020-08-18)
      Doctoral programmes in nursing have a long history in the US where traditional research based PhDs and more clinically based doctoral programmes are common. In the rest of the world PhDs are better accepted though professional doctorates with a thesis component are common in the UK. In countries with newly established or planned doctoral programmes in nursing the research PhD seems the degree of choice. Here we discuss developments in Jordan, Saudi Arabia and Ghana. This study used official documents, strategic plans, curriculum developments and other documentary evidence from Saudi Arabia, Jordan and Ghana. We compared doctoral programmes and development with other countries by reference to the literature. We offer the example of public health and non-communicable diseases in particular as one area where doctorally trained nurses applying international standards in collaboration internationally may be of benefit.
    • Arts in health: Pregnancy, birth & new parenthood

      Hogan, Susan; University of Derby (Routledge, 2020-08-06)
      Art making offers a means for women to express and understand their changed sense of self-identity and sexuality as a result of pregnancy and motherhood. This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book introduces readers to the various ways in which art is being used with women who are experiencing different stages of childbearing–who may be unable to conceive and are struggling with infertility treatment, or experience miscarriage and loss, or are facing other issues of adjustment. It acknowledges that ideals around pregnancy and childbirth are highly contested, that this contestation, coupled with the very liminality of the event itself is challenging, if not potentially destabilising for new mothers and their partners. The English political activist and law reporter Vanessa Olorenshaw has pointed out that motherhood demands interdependence and sits uncomfortably with the dominant neo-liberal ideology of ‘self’ and ‘individualism’ as the core objects of a happy selfhood.
    • Developing an Australia wide approach to IPE leadership and sustainability

      Moran, Monica; Forman, Dawn; O’Keefe, Maree; Steketee, Carole; Rogers, Gary D.; Dunston, Roger; University of Western Australia, Geraldton, Australia; University of Derby; University of Adelaide, Australia; University of Notre Dame, Fremantle, Australia; et al. (Springer International Publishing, 2020-07-28)
      Australia is a country and a continent. Whilst health standards are ranked amongst the best in the world, its immense size and distributed population creates unique challenges for the delivery of integrated health and social care services.
    • Developing and maintaining leadership, resilience and sustainability in interprofessional collaboration

      Forman, Dawn; University of Derby (Springer International Publishing, 2020-07-28)
      Interprofessional collaboration has grown significantly in health care organisations, becoming a critical part of the way in which health and social care is delivered. It is now seen as an essential part of effective health care delivery. Health professionals can be assigned to designated teams due to the increasing complexity of health care delivery, or more commonly a number of professionals with different expertise work together in collaborations which can be configured over some distance (Thistlethwaite, Dunston, & Yassine in Journal of Interprofessional Care 32:745–751, 2019).
    • Governance options for effective interprofessional education: Exposing the gap between education and healthcare services

      O’Keefe, Maree; Forman, Dawn; Moran, Monica; Steketee, Carole; The University of Adelaide, Australia; University of Derby; The University of Western, Australia; The University of Notre Dame Australia (Informa UK Limited, 2020-07-24)
      The increase in interprofessional models of collaborative practice and identification of health services as interprofessional organisations, sits somewhat awkwardly with traditional governance systems for both health services and educational institutions. Whereas health services have a primary focus on assuring competence and safety for health care practice, educational institutions have a primary focus on assuring academic standards within specific qualifications. Bridging the gap between these two systems with a workable option has proven challenging, especially in relation to interprofessional education (IPE). Given the need to ensure ‘work ready’ graduates within a more interprofessional and collaborative workforce, it is important to review the quality assurance governance models that are in place and to consider which of these existing governance systems, if either, is the more appropriate model for enabling and supporting IPE. This paper describes current issues in relation to governance for quality assurance, summarises the current state of research in the field and discusses potential governance options moving forward. Given that existing governance models are not meeting the challenges of IPE, there is a need to achieve greater alignment between the academic and health service governing systems.
    • Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

      Shoesmith, Wendy; Chua, Sze Hung; Giridharan, Beena; Forman, Dawn; Fyfe, Sue; University Malaysia Sabah, Kota Kinabalu, Malaysia; Ministry of Health, Kota Kinabalu, Malaysia; Curtin University, Miri, Sarawak, Malaysia; University of Derby (Springer Science and Business Media LLC, 2020-06-19)
      There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia. In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers. The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute). This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.
    • Digital-based self-management interventions for people with osteoarthritis: Systematic review with meta-analysis

      Safari, Reza; Jackson, Jessica; Sheffield, David; University of Derby (JMIR Publications Inc., 2020-06)
      Osteoarthritis (OA) is not curable but the symptoms can be managed through Self-management programmes. Due to the growing burden of arthritis to the health system, and the need to ensure high quality integrated services, delivering Self-management programmes through digital technologies could be an economic and effective community-based model of care. To analyze the effectiveness of digital-based self-management programs on patient outcomes in people with OA. Seven online databases and three grey literature databases were searched for randomized controlled trials (RCT) assessing digital-based structured self-management programs (D-SMP) on self-reported outcomes including pain, function, disability, and health-related quality of life in people with OA. Two reviewers independently screened the search results and reference list of identified papers and related reviews. Data about the intervention components and delivery, and behavioral change techniques were extracted. Meta-analysis, risk of bias sensitivity analysis and subgroup analysis were performed where appropriate. The GRADE approach was used to assess the quality of evidence. Eight studies were eligible including 2687 people with OA. Self-management programs were delivered via telephone plus audio/video, internet or mobile app. D-SMP compared to Treatment As Usual control group resulted in a significant, homogeneous, moderate reduction in pain (SMD -0.28, 95% CI -0.38 to -0.18) and improvement in physical function (-0.26 95% CI -0.35 to -0.16) at post-treatment. The D-SMP effect reduced slightly at 12 months follow-up but remained significant and moderate. Using the GRADE approach, the quality of evidence was rated as ‘moderate’. D-SMPs may result in a moderate improvement in pain symptoms and function in people with OA delivered. Further research is required to confirm the findings of the review and assess the effects of D-SMPs on other health-related outcomes. Clinical Trial: PROSPERO: CRD42018089322
    • Against all odds—why UK mothers’ breastfeeding beyond infancy are turning to their international peers for emotional and informative support

      Jackson, Jessica; Hallam, Jenny; University of Derby (Informa UK Limited, 2020-04-01)
      The health benefits of breastfeeding are well documented and current recommendations are that women should breastfeed their child for two years and beyond. Despite this the UK has the lowest initiation breastfeeding rates in the world. Additionally, a considerably small percentage of women who do successfully initiate go on to breastfeed past infancy. This could in part be explained by the lack of support women receive when breastfeeding an older child. In this study we provide insight into women’s experiences of healthcare interventions during the transition from breastfeeding an infant to a toddler. We conducted semi-structured interviews with 24 women with experience of breastfeeding at least one child past the age of twelve months. We used a theory driven thematic analysis to identify pertinent themes that ran through the interviews. As mothers progressed through their breastfeeding journey they faced increased social stigma. They also experienced a change in attitudes from healthcare professionals as support was replaced by judgement. This negatively impacted upon trust in healthcare professionals and the advice they offered. In response, the women turned to volunteering organizations and closed social media groups for emotional support and healthcare advice. These women experienced specific issues regarding breastfeeding in toddlerhood as opposed to infancy. They needed specialized interventions tailored for this. Social media was highlighted as a useful platform for supporting women who breastfeed beyond infancy. It allowed these women to feel part of a supportive international community and gain access to practical advice. Healthcare professionals should explore ways to engage in digital platforms to provide support to mothers’ breastfeeding beyond infancy.
    • Photography

      Hogan, Susan; University of Derby (Routledge, 2020-02-24)
    • Group singing improves quality of life for people with Parkinson’s: an international study

      Irons, J. Yoon; Hancox, Grenville; Vella-Burrows, Trish; Han, E-Y; Chong, H-J; Sheffield, David; Stewart, Donald E; University of Derby; Sing to Beat Parkinson's, Cantata Canterbury Trust; Canterbury Christ Church University, Kent; et al. (Taylor & Francis, 2020-02-05)
      Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson’s (PwPs) in Australia, UK and South Korea. The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson’s health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p < .05. ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson’s. The findings are encouraging and warrant further research using more robust designs.
    • Learning and change within person-centred therapy: Views of expert therapists

      Renger, Sue; Macaskill, Ann; Naylor, Bill; Sheffield Hallam University; University of Derby (Wiley, 2020-01-12)
      Traditionally in Person-centred Therapy (PCT) clients are counselled for as long as required. It is a non-directive process. Recently, financial constraints have introduced time limits for therapy in health care, so it seemed appropriate to revisit the practice of PCT in the current UK context. The aim was to explore the concepts of learning and change within PCT and to consider whether learning is facilitated. Five experienced person-centred therapists, who were involved in educating therapists, participated in semi-structured interviews. Questions explored their views on learning and change in therapy, whether learning processes can be facilitated in PCT - both philosophically and practically, and the outcomes of PCT. Therapists were not specifically asked about time pressure but rather it was left to see if it emerged as an issue. Ten major themes emerged; learning and change, goals, learning process, PCT process, issues on non-directivity, questioning, outcomes, assessment and diagnosis, and other methods used. The issue of time pressure permeated many of these themes. Views were often contradictory reflecting the inconclusive views in the literature, particularly in relation to how clients learn and the relationship between change and learning.