• The feasibility of nurse-delivered, low-intensity cognitive behavioural therapy for irritable bowel syndrome.

      Dainty, Andrew; Hunt, Melissa; Holtham, Elizabeth; Kinsella, Philip; Timmons, Stephen; Fox, Mark; Callaghan, Patrick; University of Derby; University of Pennsylvania; University of Nottingham; et al. (Mark Allen Group, 2017-11-16)
      Introduction: This study assessed the feasibility of nurse-delivered cognitive behavioural therapy (CBT) for the treatment of irritable bowel syndrome (IBS). Methods and analysis: A mixed-method design was used, and 20 participants were randomly allocated to high-intensity CBT (n=5), guided self-help (n=5), self-help only (n=5) or treatment as usual (n=5). Ten intervention participants completed semi-structured interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using group thematic analysis. Results: Barriers to the interventions were lack of therapist contact, negative preconceptions about treatment and factors relating to supporting materials. Treatment facilitators included therapist-facilitated relaxation, narratives located within self-help materials and social support mechanisms. Conclusion: Further development of the low-intensity interventions in collaboration with service users is required to improve intervention acceptability and relevance.
    • Feeling unsafe in the healthcare setting: patients' perspectives

      Kenward, Linda; Whiffin, Charlotte Jane; Spalek, Basia; University of Derby; University of Cumbria (Mark Allen Healthcare, 2017-02-09)
      This literature review aimed to discover the factors that contribute to patients feeling unsafe in the healthcare setting. Electronic searches were undertaken using three databases to examine publications from 2002 to 2016. The design used a modified Cooper's (1982) five-stage integrative review method. Fourteen articles were identified, producing seven themes: information and communication, loss of control, staff presence, impersonal care, patients' vulnerable emotional and physical state, not being taken seriously, and the patient perception of of a lack of staff experience, knowledge, proactivity and interest. The findings suggest that, in maintaining a quality service for patients, nurses can contribute to the reduction of patients' feelings of being unsafe and vulnerable. Patients do not just feel unsafe when errors occur, but also when service quality is noticeably poor. Where lack of quality is perceived as an indication of potential threat, this lack may contribute to patients feeling unsafe within the healthcare setting
    • FibroScan: assessing cirrhosis and advanced fibrosis with vibration-controlled transient elastography

      Mortimore, Gerri; University of Derby (Mark Allen, 2016-12)
      There are many causes of liver disease that can lead to progressive fibrosis and cirrhosis of the liver; chronic liver disease is the third most common cause of death for people under 65 in the UK. Advanced fibrosis and cirrhosis can be asymptomatic, making diagnosis difficult without the aid of the ‘gold standard’ biopsy to assess liver architecture. However, there are many disadvantages associated with this invasive procedure, and so researchers, over the past 15 years, have developed and patented a noninvasive device for measuring liver stiffness and scarring called a FibroScan. This device uses vibration-controlled transient elastography to send sound waves through the liver, from which a reading is taken. A higher reading correlates with an increased likelihood of fibrosis and cirrhosis. This technology is efficient, easy to use and provides immediate results. It allows clinicians to estimate the degree of liver damage, aiding management, treatment and prognosis. It is also an effective monitoring tool that allows liver health to be checked at allotted periods.
    • Gallstone disease.

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2015-12)
    • Gallstone disease: diagnosis and management.

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2014-10)
    • Genetic haemochromatosis.

      Mortimore, Gerri; Woodward, Amelia; University of Derby (2018-07-10)
      Genetic Haemochromatosis (GH) is the most common inherited disorder in Caucasians affecting 1:200 in the UK. GH causes the body to absorb too much iron from the diet which over times can lead to systemic iron overload. Treatment involves weekly removal of blood termed venesection. There is little research that examines patients thoughts and feelings of being diagnosed with this life long disease which requires life long treatment in the form of venesections. Exploring the patients symptoms prior to and after venesection has not been fully studied
    • Genetic haemochromatosis: A qualitative exploration of patients' experience of diagnosis in primary care

      Mortimore, Gerri; Woodward, Amelia; University of Derby (Royal College of General Practitioner's Annual Primary Care Conference, 2019-10-24)
      Genetic haemochromatosis (GH) is the most common inherited genetic disorder in Caucasians (Bacon et al. 2011), and commonly affects Northern Europeans, especially those with Celtic or Nordic descent, with a ratio of approximately 1:220 - 250 people (Fitzsimmons et al. 2018; Phatak et al., 2008;). Despite the prevalence of GH only 1:5000 people are diagnosed with it (Haemochromatosis UK [HUK] 2019; British Liver Trust [BLT] 2017). In GH the body absorbs excess iron which can lead to systematic iron overload within the liver and other internal organs such as the pancreas, heart and joints; eventually causing inflammation and tissue damage. Early symptoms are non specific such as fatigue, abdominal and joint pain and as such, may be considered inconsequential by GP’s, resulting in a delay in diagnosis and treatment. To date there has been little research examining patient’s thoughts and experiences of being diagnosed with GH, a disorder which requires life long treatment with venesection, and which may lead to cirrhosis of the liver and increased risk of hepatocellular carcinoma (Ulvik 2015). Data was collected using semi-structured interviews with a sample of 22 patients with haemochromatosis who responded to a poster advertising the study. The interview covered their experience of diagnosis and treatment and the effect it was having on their lives. Patients had been diagnosed between a year and more than 30 years The interviews were recorded and transcribed verbatim. Analysis of the data was conducted using thematic analyis. Many of the patients felt that GPs lacked knowledge of genetic haemochromatosis and talked about how GPs were unable to give them any detailed information about the disease Early detection and treatment for GH depends on increased knowledge of GPs. This qualitative study identified that patients perceive there to be gaps in understanding GH diagnosis and treatment. Ensuring GPs are aware of GH and the strategies for diagnosis could result in improved patient care. These findings indicate that improved education for GPs regarding GH may be beneficial in order to improve patient care for this condition and potentially reduce delays in diagnosis.
    • Genetic haemochromatosis: diagnosing and treating hereditary iron overload.

      Mortimore, Gerri; University of Derby (Mark Allen Group, 2017-12)
      Genetic haemochromatosis (GH) is the most common inherited genetic disorder in caucasians, affecting approximately 1 in every 200–250 people. It leads to an increased absorption and deposition of iron, and if it is untreated it can cause systemic iron overload in some patients. This iron overload can cause inflammation and tissue damage to multiple organs, with the potential to lead to heart disease, diabetes and cirrhosis of the liver. Despite being a common condition, it is thought to be under diagnosed. However, it is known that some patients with a diagnosis of GH will present with cirrhosis at a young age, while others are virtually asymptomatic. Symptoms can be generalised, and diagnosis is made on blood tests. Treatment for GH requires the removal of blood, known as venesection. Approximately 400–500mls are removed at a time, and this procedure can be undertaken weekly until ferritin levels are brought down to 50 µg/l or below.
    • Genetic Haemochromatosis: research question

      Mortimore, Gerri; Woodward, Amelia; University of Derby (RCN and haemochromatosis society, 2019-04-12)
      There is little research which examines patient’s thoughts and feelings of being diagnosed with a life-long disorder which requires life-long treatment in the form of venesection and which may lead to cirrhosis of the liver. Exploring patient symptoms prior to, and after venesections has not been studied fully, nor the implication if they are diagnosed with cirrhosis. In the initial phase of the disease venesections are undertaken weekly for many weeks/months. This may have a huge impact re time off work to attend treatment, cost of parking at the hospital etc. Understanding the effect of this on patients will enable the NHS to improve patient care.
    • Getting the most out of your clinical placement.

      Whitehead, Bill; University of Derby (Macmillan Publishing Ltd., 2013-09-18)
      This article discusses what to expect from clinical placements, what you will learn, techniques to enhance your experience, and handling a placement that is not going well.
    • Growing older with post-traumatic stress disorder.

      Curran, Bernard; Collier, Elizabeth; University of Salford (Wiley, 2016-05-12)
      Ageing with mental illness is a neglected area of research and policy. People who grow older to later life with on-going mental health problems may not have their needs well understood. This understanding is important if mental health services are to ensure direct or indirect age discrimination is avoided. This paper discusses the issues of ageing with mental illness over a prolonged period of time with a focus on one person’s story, Bernard, of ageing with post-traumatic stress disorder in the UK. Implications for practice are discussed in the context of life course, recovery, self-help and preventing suicide. The narrative illustrates how time, memory and meaning interweave and how ageing with mental illness become part of a person’s ongoing identity.
    • Guest editorial

      Skellern, Joanne; University of Chester (Emerald, 2016-06-13)
    • Haemochromatosis: what is it and could you have it?

      Mortimore, Gerri; University of Derby (University of Derby, 2018-07-26)
      Genetic haemochromatosis is the most common inherited genetic disorder among Northern Europeans, thought to affect 1:200 people in the UK. despite this, most people have never heard of the condition. Gerri Mortimore, lecturer in Post-registration \health Care at the \University of Derby, looks at the health implications of this disorder.
    • Health and alcohol use: Educational innovations

      Clark, Charlotte; University of Suffolk (Taylor and Francis, 2009-07-12)
      General Nurses consider that higher priority should be given in pre‐registration training to care of the alcohol patient in the general practice area. Discuss how education and service can work together to provide positive learning experiences which will enable novice nurses to become proficient in the care of the patient whose health is affected by alcohol use.
    • A history of nurse education and the clinical nurse educator

      Whitehead, Bill; University of Derby (Routledge, 2019-11-26)
      This chapter discusses the potential roles which will be engendered by the new Nursing and Midwifery Council standards and framework for nurse education. Woven throughout the account will be the clinical nurse educator roles which have fulfilled the need for student nurses to receive clinical training and education in practice. The beginning of apprenticeship nurse education appears to be a good starting point, whichever explanation is selected for this phenomenon. The General Nursing Council syllabus and final examination instructions were highly prescriptive to provide national conformity of education and achievement. This included the use of a nationally agreed “nurse’s chart” which was designed to record when the probationer had achieved proficiency in a list of procedures. A logical consequence of single status for initial registration was that nurse educators, who had for decades been divided into clinical teacher and nurse tutors, should both be given the same status.
    • How discrimination affects access to health care for transgender people.

      Watkinson, Debbie; Sunderland, Claire; University of Derby (EMAP publishing limited, 2017-03-20)
    • How to conduct a systematic search for a systematic literature review

      Whiffin, charlotte; University of Derby (iOH: The Association of OH & Wellbeing Professionals, 2020)
    • The impact on relationships following disclosure of transgenderism: a wife’s tale.

      Watts, Carol; Collier, Elizabeth; Ashmore, Russell; Watts, Pippa; University of Salford (Wiley, 2017-05-19)
      What is known on the subject? • The experiences of transgender people are becoming increasingly more visible in popular culture, biographical literature and the media. • The topic has received little attention within the psychiatric and mental health nursing literature. • There is a paucity of literature exploring the impact on relationships following a disclosure of transgenderism. What does this paper add to existing knowledge? • A narrative account of the consequences for the wife of one transwoman and their relationships with friends and family following the disclosure of transgenderism. • The article identifies a range of issues that require further attention in relation to healthcare provision. These include the: mental health needs of partners and spouses; attitudes of healthcare professionals towards transgender issues; and the adequacy of the formal support offered to partners and spouses of transgender people. What are the implications for practice? • There is a need for healthcare practitioners to explore their understanding of transgender issues and how these may impact on the mental health of partners and spouses. • It is important that healthcare professionals provide a hopeful and supportive environment to enable couples to explore their relationships following disclosure of transgenderism.
    • Implementing real talk: interprofessional education intervention enabling clinicians to develop confidence in open and honest conversations about dying

      Watson, Sharan; Whittaker, Becky; University of Derby; Loughborough University (BMJ, 2020-03-18)
      National reports highlight the need to break down the barriers between the evidence to practice gap in talking with patients about dying. Our programme of research incorporates evidence and video clips from UK hospice consultations. Real Talk is designed to fit into existing communication skills training, disseminated across diverse interprofessional groups/settings, aiming to promote confidence and competence. Real Talk holds great promise because: practicalities of short video clips ensure flexibility for practitioners to engage in detailed conversation and debate, enhancing the learning potential in any environment; the depth of evidence underpinning our resources helps demystify complex communication strategies, promoting confidence when talking about dying; clinicians using the resources span diverse professional groups and clinical settings helping promote talk in broaching dying and planning ahead with diagnostic uncertainty.
    • Innovative learning from simulated patient complaints

      Collins, Guy; Brown, Jo; University of Derby (NET - Networking for Education in Healthcare, 2015-09-09)
      Repeated inquiries have highlighted issues with patient safety, communication and the exploration of complaints, emphasising the interplay between each in securing the optimum patients’ journey through health and social care provision (Francis 2013, Keogh 2013). The Care Quality Commission (2014) highlighted that every concern or complaint is an opportunity to improve. A complaint may signal a problem, with the potential to help save lives, and well-handled concerns can help to improve the quality of patient care. Despite these potential benefits there is a wide variation in how complaints are handled or the fostering of an open culture where all complaints are welcomed and learnt from. The University of Derby in delivering pre-registration nursing education utilises simulation to explore patient complaints in order to facilitate recognition of the value they offer, providing transferability to enhance nursing practice and improve patient safety. The simulated experience consists of examining the reasons for complaints; impacts upon service users; lessons for nurses and other health professionals; means of address and preventing repetition of similar incidents;enhancements for practice and lessons for organisations. As part of this process the inclusion and effects of Human Factors are explored from the inception of the simulation experience. Students’ simulate three phases: root cause analysis; the development of a response letter; and a proposal for practice enhancement. These are all subsequently explored via a simulated Boardroom experience. This consists of a panel of allocated ‘experts’ to which the students’ present their findings and recommendations to enhance potential future patient experience and safety. Robust exploration of students’ thought processes and actions are incorporated within this experience via questioning, observation and reflections of the panel. Resulting from this simulation, students develop key transferrable skills: critical thinking; team working; leadership; knowledge of systems and processes; communication skills; customer care; quality assurance, governance and promoting patient safety that are mapped against the competencies outlined in the Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. This experience and feedback is recorded within each students practice document. This is used for subsequent review by their practice mentor, and can be used as part of their practice assessment at the applicable progression point. Learning from service user complaints is high on the agendas of commissioners and healthcare providers. This simulated experience has the potential to be transferred in to not only nursing practice but also any other healthcare professional pre-registration education and continued professional development. References Care Quality Commission (2014) Complaints Matter. Newcastle Upon Tyne: CQC. Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery Office. Keogh, B. (2013) Review into the Quality of Care and Treatment Provided by 14 Hospital Trusts in England: An overview report. London: The Stationary Office. Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. London: NMC. Key words: • simulation • complaints • patient safety • enhancing practice. Bullet points that indicate how your work contributes to knowledge development: • innovative approaches to teaching and learning through the application of simulated complaints • enhancement of patient safety and the quality of care • development of transferable competence for nursing practice.