International Perspectives of Nurses, Midwives and Allied Health Professionals Clinical Academic Roles: Are We at Tipping Point?

Healthcare research activity improves patient outcomes. Nurses, Midwives and Allied Health Professions (NMAHPs) make an important contribution to clinical research. Within the United Kingdom (UK), there is a 25-year history of increasing healthcare research capacity and capability through clinical academic roles. Medical colleagues were the first to introduce the role in 2005. In 2007, a national policy identified inequalities in access to and success of research training fellowships between medical and nursing healthcare professionals. This was followed by a number of national initiatives, which continue to evolve to the present day. There is evidence that the UK has reached the ‘tipping point’ to increase NMAHP research capacity and capability through clinical academic roles. Despite these initiatives substantial gaps remain. Outside, the UK, the term ‘clinical academic’ is not well understood. There is evidence of the presence of senior clinical academic roles, a clinical professor within Australia and the United States, for example, but there is a lack of opportunities and of a formulised research training pathway at a junior level. There is interest and appreciation of the NMAHP research-active clinical academic within the clinical setting in the Nordic countries and China, but the pace of change is slow due to co-existing priorities involving change and innovation. There is a need to develop and agree both national and international definitions that describes the NMAHP research-focused clinical academic role activity

International perspectives of nurses, midwives and allied health professionals clinical academic roles: Are we at tipping point?

© 2019 Debbie Carrick-Sen, Ann Moore, Patricia Davidson, Han Gendong, & Debra Jackson. Healthcare research activity improves patient outcomes. Nurses, Midwives and Allied Health Professions (NMAHPs) make an important contribution to clinical research. Within the United Kingdom (UK), there is a 25-year history of increasing healthcare research capacity and capability through clinical academic roles. Medical colleagues were the first to introduce the role in 2005. In 2007, a national policy identified inequalities in access to and success of research training fellowships between medical and nursing healthcare professionals. This was followed by a number of national initiatives, which continue to evolve to the present day. There is evidence that the UK has reached the 'tipping point' to increase NMAHP research capacity and capability through clinical academic roles. Despite these initiatives substantial gaps remain. Outside, the UK, the term 'clinical academic' is not well understood. There is evidence of the presence of senior clinical academic roles, a clinical professor within Australia and the United States, for example, but there is a lack of opportunities and of a formulised research training pathway at a junior level. There is interest and appreciation of the NMAHP research-active clinical academic within the clinical setting in the Nordic countries and China, but the pace of change is slow due to co-existing priorities involving change and innovation. There is a need to develop and agree both national and international definitions that describes the NMAHP research-focused clinical academic role activity

Interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency : a systematic review

Objective: The incidence of adrenal crisis remains high, particularly for people with primary adrenal insufficiency, despite the introduction of behavioural interventions. The present study aimed to identify and evaluate available evidence of interventions aiming to prevent adrenal crisis in primary adrenal insufficiency. Design: Systematic review of literature and theoretical mapping. Methods: MEDLINE, MEDLINE in Process, EMBASE, ERIC, Cochrane CENTRAL, CINAHL, PsycINFO, the Health Management Information Consortium (HMIC) and trial registries were searched from inception to November 2021. Three reviewers independently selected studies and extracted data. Two reviewers appraised the studies for risk of bias. Results: Seven observational or mixed methods studies were identified where interventions were designed to prevent adrenal crisis in adrenal insufficiency. Patient education was the focus of all interventions and utilised the same two behaviour change techniques, instruction on how to perform a behaviour’ and ‘pharmacological support’. Barrier and facilitator themes aiding or hindering the intervention included: knowledge, behaviour, emotions, skills, social influences and environmental context and resources. Most studies did not measure effectiveness and assessment of knowledge was variable across studies. Study quality was moderate. Conclusion: This is an emerging field with limited studies available. Further research is required in relation to the development and assessment of different behaviour change interventions to prevent adrenal crisis

Hyperemesis in Pregnancy Study: a pilot randomised controlled trial of midwife-led outpatient care

Objective To assess the feasibility of implementing a complex intervention involving rapid intravenous rehydration and ongoing midwifery support as compared to routine in-patient care for women suffering from severe nausea and vomiting in pregnancy, (NVP)/hyperemesis gravidarum (HG). Study design 53 pregnant women attending the Maternity Assessment Unit (MAU), Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK with moderate-severe NVP, (as determined by a Pregnancy Unique Quantification of Emesis and Vomiting [PUQE] score ≥nine), consented to participate in this pilot randomised controlled trial (RCT). Subsequently 27 were randomised to the intervention group, 26 to the control group. Women in the intervention group received rapid rehydration (three litres Hartman's solution over 6 h) and symptom relief on the MAU followed by ongoing midwifery telephone support. The control group were admitted to the antenatal ward for routine in-patient care. Quality of life (QoL) determined by SF36.V2 score and PUQE score were measured 7 days following randomisation. Completion rates, readmission rate, length of hospital stay and pregnancy outcomes data were collected. Results Groups were comparable at baseline. Questionnaire two return rate was disappointing, only 18 women in the control group (69%) and 13 women in the intervention groups (44%). Nonetheless there were no differences between groups on Day 7 in terms of QoL, mean PUQE score, satisfaction with care, obstetric and neonatal outcomes or readmission rates. However, total combined admission time was higher in the control group (94 h versus 27 h, p = 0.001). Conclusions This study suggests that day-case management plus ongoing midwifery support may be an effective alternative for treating women with severe NVP/HG. A larger trial is needed to determine if this intervention affects women's QoL

Exploring risk, prevention and educational approaches for the non-diabetic offspring of patients with type 2 diabetes - a qualitative study

AIM: To understand the knowledge and perceptions of type 2 diabetes and to explore preferable educational strategies in the non-diabetic offspring of patients with the disease. BACKGROUND: Type 2 diabetes is an increasingly prevalent disease with significant long-term consequences. Offspring of patients with type 2 diabetes have an increased risk of developing the disease compared with the general population. Previous studies have shown that offspring have a poor perception of their own risk. DESIGN: A qualitative study was carried out using semi-structured one-to-one interviews. Analysis was completed using a structured framework approach. METHODS: Research was carried out during January-March 2011 in the north east of UK. Six offspring of patients diagnosed with the disease were interviewed. RESULTS: Participants balanced positive and negative aspects of their lifestyle behaviours to estimate their own risk. They had adequate knowledge of healthy lifestyle behaviours, but were uncertain about the long-term effects and seriousness of the disease and the role of inheritance. Behavioural changes at an individual level would only be motivated by an event, which would impact on their own health. Participants believed that 'fear'-based strategies to health promotion would be most effective to encourage behaviour change. CONCLUSION: Knowledge of individual risk and why diabetes was serious was limited and variable. The health behaviours of this at-risk group were complex. Nurses engaged in the care of at-risk individuals must take this complexity into account when developing and implementing multi-faceted strategies to improve awareness

Diabetes knowledge in patients' adult offspring

BACKGROUND Adult children of people with type 2 diabetes have a greater risk of developing the condition than the general population. AIM To understand what this at-risk group knows about the disease and to explore what types of education they feel will help improve their understanding of it. METHODS A qualitative study was carried out using semi-structured, one-to-one interviews from January until March 2011 with six adult children of patients diagnosed with type 2 diabetes. RESULTS Participants attempted to estimate their risk of developing the disease by weighing up the positive and negative aspects of their lifestyle behaviour. They had adequate knowledge of healthy lifestyle behaviour but were uncertain about the long-term effects and seriousness of type 2 diabetes and the role of inheritance. They suggested changing their behaviour would only be motivated by an event that had a direct negative impact on their own health and believed "fear"-based health promotion strategies would be the most effective way to change the behaviour of others at risk. CONCLUSIONS Participants' knowledge of their individual risk and why diabetes was serious was poor. The health behaviours of this at-risk group were complicated. Nurses caring for patients at risk of developing type 2 diabetes must take this complexity into account when developing and implementing ways to improve awareness and knowledge