Quality of life in long-term conditions (ViPER)

There is an increasing policy drive for nurses to encourage and operationalise self-management and collaborative partnerships with people with long-term conditions. Central to this is a development of understanding of the premises to a good quality of life. This presentation reports on a project in which the quality of life of people with Multiple Sclerosis (MS) was assessed. In parallel, the researchers examined the meaning attributed to the term in policy documentation such as the NSF for Long-Term conditions (2005) (Lhussier 2009). It emerges that quality of life is premised upon an understanding of six oppositional pairs of: • Life and death (because to talk about ‘quality of life’ is to assume a clear and fundamental difference between the two concepts) • Health and disease (because people with long-term conditions are often assumed to have a poorer quality of life) • Independence and dependence (because maintaining independence is one of the key aim of health care practice in long-term conditions) • Empowerment and disempowerment (because patient empowerment is a key policy driver) • Certainty and uncertainty (as the uncertainty of an illness trajectory impacts greatly on people’s perception of their quality of life) • Ability and disability (because disability is to be avoided for as long as possible in MS) Drawing on the data collected, this presentation aims to expose and critique these six oppositional pairs so that understanding of quality of life in long-term conditions can be enhanced and contextualised. Thus this presentation does not aim at solving definitional or measurement issues, but at engaging practitioners in critical thinking about such a key concept as quality of life. Such an engagement in questioning of pre-understandings is crucial for nursing practice to evolve and adapt to changing population needs, as the prevalence of long-term conditions continues to increase

A COMPARISON OF THE RELATIVE IMPACT OF A COGNITIVE-BEHAVIOURAL INTERVENTION CONSISTING OF AN EDUCATION COMPONENT, WITH A POSTAL EDUCATION PACKAGE, ON COPING WITH OSTEOPOROSIS

A study was carried out in order to compare the effects of a cognitive-behavioural intervention, with a postal education package, on coping with osteoporosis. Thirty osteoporosis sufferers were divided into three groups. One group received an intervention programme consisting of education, relaxation techniques, and instruction in the use of coping strategies for pain and stress. A comparison group received an education booklet on osteoporosis sent to them through the postal system. The study also included a non-treatment control group. Measures of locus of control, depression, anxiety, pain, and disease knowledge, were taken pre-and post-intervention. lt was predicted that the intervention group would report a significant decrease in external locus of control (subdivided into chance happenings, and powerful doctor control beliefs), and an increase in internal locus of control, and in disease knowledge compared to the other two groups. A significant decrease in depression, anxiety, and pain ratings was also predicted for the intervention group compared to the comparison group and the control group. It was further predicted that their would be no relationship between the age of participants, and scores on any of the outcome measures. Analyses of variance carried out on the data revealed significant differences between the groups from baseline to follow-up on some of the measures. Depression and pain ratings decreased significantly for the intervention group compared to the other two groups. Although anxiety also showed a trend to decrease for the intervention group, this result was not significant. Both internal locus of control and disease knowledge increased significantly for the intervention group compared to the other two groups. No significant differences were found post-intervention between the groups for external locus of control. Correlational analysis revealed no significant relationship between the age of participants and any of the dependent measures. These results suggest that education delivered on an individual basis as part of a cognitive behavioural-intervention is more effective in increasing disease knowledge than an education package sent to osteoporosis sufferers through the postal system. The results further suggest that adaptation to osteoporosis can be facilitated by equipping sufferers with a repertoire of cognitive-behavioural coping strategies, and that older adults are just as likely to benefit from such an approach as their younger counterparts. The results are discussed in relation to previous research findings, and suggestions for future research are put forward.Cornwall Healthcare Trus

Developing R&D capacity in a primary care trust : use of the R&D culture index

There has traditionally been a low level of engagement of primary care practitioners with research. In the UK, primary care trusts (PCTs) now have some responsibility for the encouragement of research and development in primary care. The aim of this study was to assess the current level of research activity and capacity for research within a PCT. A questionnaire, incorporating a recently developed and validated research and development culture index, was sent to all 572 health care professionals and staff under the auspices of North Tyneside Research PCT. Data analysis used nonparametric tests of association including chi-squared, Mann–Whitney U and Spearman's rank order correlation. There was a 50.3 per cent response rate to the questionnaire. Groups more likely to show an increased capacity for research included those with postgraduate qualifications and those in post for the least time. General practitioners were less likely than other professional groupings to declare personal skills or aptitude for research. The two most important factors thought to contribute towards the development of a culture of R&D were having access to people to support development and changes in professional practice and having access to training and development opportunities. The use of the R&D culture index enabled groups to be identified that may be more research interested and can therefore be targeted to increase research capacity. The R&D culture index could be used by other PCTs wishing to define and develop research capacity in primary care

A Conceptual Model on Risk Perception Among Older South Asians with Type 2 Diabetes

Research has shown that an underestimation of personal health risk can reduce the motivation to change behaviour and reduce risk factors. This paper describes a conceptual model on risk perception among older South Asian people (representing Bangladesh, India and Pakistan) with type 2 diabetes living in the UK; this model was developed using qualitative research. Risk perception in this study is interpreted in terms of risk awareness and risk engagement. This research indicated that the concordance/empowerment model of diabetes management, which advocates self-management towards long-term risk prevention, needs further exploration in older people from minority ethnic groups with type 2 diabetes

What is the meaning of filial piety for people with dementia and their family caregivers in China under the current social transitions? An interpretative phenomenological analysis

The filial piety model of family centred care has dominated Chinese society for thousands of years. The ways in which filial piety is presented are being modified and modernised as China undergoes social transitions. The study aims to understand the meaning of filial piety for people with dementia and family caregivers. Semi-structured interviews with people with dementia ( n = 10) and family caregivers ( n = 14) were conducted. Data were analysed using interpretative phenomenological analysis. Three themes emerged: (a) ‘Being filial is a cultural continuity and my future investment’. (b) ‘The changed perception and ways of being filial’. (c) ‘Filial responsibility is a social and cultural convention, but not my personal choice’. This study highlights the importance of cultural values in family care decision making and in shaping filial responsibilities. It indicates that filial obligation can be maintained through social support, even though the nature of filial piety has been changed by social transitions. </jats:p