Development of self-management in pediatric inflammatory bowel disease: a qualitative exploration

Background: Self-management programs in pediatric chronic conditions, such as asthma and diabetes were effective in improving health-related outcomes. Similarly, self-management in the context of adult in inflammatory bowel disease (IBD) safely reduced healthcare costs. Nevertheless, evidence on self-management in pediatric IBD is scant. This study aims to explore self-management in pediatric IBD by exploring the childhood experience of IBD and how it is understood by the participants. Methods: Using a constructivist grounded theory approach, seven participants aged 8-17 years old were recruited in a tertiary metropolitan pediatric IBD center. Semi-structured interviews using topic guides and optional draw-and-write methods were used for data collection. Multi-level coding and constant comparison methods were utilised during data analysis. Results: The pediatric IBD self-management theory described the phenomenon of self-management through the relationship of categories that emerged from the study. Self-management starts off as a parent-dominant process that progressed to a more autonomous form with increasing disease experience. The experience was described as filled with struggles and a developing sense of control in managing these struggles. Autonomous self-management developed from the interaction of information, insight and integration. Enablers and deterrents were the contextual factors that influenced the development of self-management. Conclusions: Establishing identity both as a psychosocial developmental task and a disease-specific task is the core of self-management in childhood IBD. Future self-management programs should explore the role of structures around the child (family, school and healthcare systems) and the implementation of a proactive philosophy of involving children in managing their condition

The mental health associate practitioner pathway

Building and maintaining a qualified workforce of committed staff is one of the greatest challenges facing the NHS . Providing specialist care to people experiencing mental distress is difficult, demanding work and requires exceptionally dedicated, caring individuals. The Associate Practitioner role has been developed to address this demand. The Assistant Practitioner is defined as a worker who competently delivers health and social care to and for people, with the level of knowledge and skill beyond that of the traditional healthcare assistant or support worker ( Skills for Health 2009). A research project was undertaken to evaluate the Mental Health Associate Practitioner programme delivered by the Faculty of Health, Social Care and Education at Kingston University and St George’s, University of London. The programme was delivered full time over two years with 40/60 balance between theory and practice, with emphasis on work based learning. A longitudinal evaluation research study was undertaken, using mixed-methods concurrent triangulation design. Data was collected from the 7 learners through questionnaires, at three different points in time: pre-programme, at mid-point and at the end of the programme. The questionnaires included both quantitative and qualitative questions. SPSS version 23 and 24 was used to analyse the quantitative data of the questionnaires. Descriptive statistical analyses were conducted, reporting on frequencies of responses and means. Psychometric analysis of the questionnaires (measuring internal consistency using Cronbach’ Alpha) were also undertaken. Thematic analyses was used to analyse the qualitative data. Findings revealed learners’ engagement with the programme and its activities, the learners’ perceptions of the value of the programme, the impact of the programme on learners’ attitudes, knowledge and skills and the sustainability of the programme. Overall, learners reported good levels of satisfaction with the course and enhanced knowledge and skills, particularly around physical health care

Catching them early : identifying potential early-career leavers

This article describes a small-scale quantitative study that explored levels of satisfaction within a sample of student teachers at two points in time. A first questionnaire was completed during students’ final year at an English university and comprised of questions relating to their satisfaction with school experience. A second was conducted mid-way through their subsequent Newly Qualified Teacher (NQT) year, asking similar questions to the first, but applicable to their NQT school. Data indicated that a notable proportion of NQTs had considered leaving the teaching profession since they had qualified. Significantly, it was possible to identify these individuals from the rest of the student cohort by examining their responses from the first questionnaire. This indicates that teachers in danger of leaving the teaching profession at an early stage in their post-qualification career could potentially be recognized during their university training. Finally, issues surrounding the overt labelling of students as being a ‘leaving risk’ are discussed

'Helicobacter pylori' : nurses' perceptions of diagnosis and treatment in adults

Background Helicobacter pylori is a bacterium that lives in the stomach’s gastric mucosa layer. H. pylori is a carcinogen that increases the risk of stomach and duodenum ulcers, gastro-oesophageal reflux disease and stomach cancer. Prevalence rates of H. pylori are higher in people with a learning disability than in the general population; however, despite the increased risk of H. pylori in people with a learning disability there is a lack of literature that applies specifically to this population and their families or carers. Aim To explore issues related to the diagnosis and treatment of H. pylori in people with a learning disability by examining the attitudes, beliefs, experiences and behaviours of staff working with people with a learning disability who are undergoing assessment and/or treatment for H. pylori. Another aim of this study was to understand the barriers to using preventive strategies, completing assessments and treating H. pylori in people with a learning disability. Method Focus groups were conducted with 16 staff members from two learning disability services. Before the focus groups, staff members were sent an information sheet with facts about H. pylori in people with a learning disability. Transcribed focus group discussions were analysed to identify themes. Results Staff reported issues with identifying accurate prevalence figures for H. pylori in people with a learning disability in their services due to the limited number of people who had undergone assessment. Identifying the signs and symptoms of H. pylori was also challenging for staff due to communication difficulties with people with a learning disability, or because the individual had minor symptoms or was asymptomatic. Other staff said that symptoms could be attributed to the side effects of medicines. Staff believed that people with a learning disability should be treated for H. pylori, given the associated risks of the bacterium, but that the lack of guidance on re-testing after treatment meant it was challenging to incorporate re-testing into care planning. Conclusion Little consideration has been given to the presence of H. pylori in people with a learning disability over the past decade, despite the fact it is an important health concern that can be identified and treated. Staff, carers and people with a learning disability should discuss with their GP having a blood, stool or breath test to check for H. pylori. Adding assessment for H. pylori to annual health checks will ensure screening becomes routine and may reduce complications or signs and symptoms, such as reflux and bloating

Catching them early: Promoting teacher retention by identifying potential early-career leavers

The paper describes a study that assesses the feasibility of identifying signs of teacher dissatisfaction at the earliest stage. ITT students were questioned about their satisfaction with their school during their time at university, and again during their NQT year. Their responses were compared in order to see whether NQTs who subsequently consider leaving the profession can be spotted a year earlier during university training, so that remedial action can be taken in university

Student nurse selection and predictability of academic success : the Multiple Mini Interview project

BACKGROUND: With recent reports of public enquiries into failure to care, universities are under pressure to ensure that candidates selected for undergraduate nursing programmes demonstrate academic potential as well as characteristics and values such as compassion, empathy and integrity. The Multiple Mini Interview (MMI) was used in one university as a way of ensuring that candidates had the appropriate numeracy and literacy skills as well as a range of communication, empathy, decision-making and problem-solving skills as well as ethical insights and integrity, initiative and team-work. OBJECTIVES: To ascertain whether there is evidence of bias in MMIs (gender, age, nationality and location of secondary education) and to determine the extent to which the MMI is predictive of academic success in nursing. DESIGN: A longitudinal retrospective analysis of student demographics, MMI data and the assessment marks for years 1, 2 and 3. SETTINGS: One university in southwest London. PARTICIPANTS: One cohort of students who commenced their programme in September 2011, including students in all four fields of nursing (adult, child, mental health and learning disability). METHODS: Inferential statistics and a Bayesian Multilevel Model. RESULTS: MMI in conjunction with MMI numeracy test and MMI literacy test shows little or no bias in terms of ages, gender, nationality or location of secondary school education. Although MMI in conjunction with numeracy and literacy testing is predictive of academic success, it is only weakly predictive. CONCLUSIONS: The MMI used in conjunction with literacy and numeracy testing appears to be a successful technique for selecting candidates for nursing. However, other selection methods such as psychological profiling or testing of emotional intelligence may add to the extent to which selection methods are predictive of academic success on nursing