Compassionate wound care: An integrated intervention for people who self-injure

This article discusses how an integrated physical, psychological and social approach to wound care can help improve the quality of life for people who self-injure. The health professional should demonstrate compassion while teaching the person who self-injures how to provide their own wound care. Compassionate care may help the patient improve their self-compassion and reduce shame associated with this coping strategy, which may in turn avoid exacerbating self-harm when seeking healthcare

Patient and general practitioner attitudes to taking medication to prevent cardiovascular disease after receiving detailed information on risks and benefits of treatment: a qualitative study

Abstract Background There are now effective drugs to prevent cardiovascular disease and guidelines recommend their use. Patients do not always choose to accept preventive medication at levels of risk reduction recommended in guidelines. The purpose of the study was to identify and explore the attitudes of patients and general practitioners towards preventative medication for cardiovascular disease (CVD) after they have received information about it; to identify implications for practice and prescribing. Methods Qualitative interviews with GPs and patients following presentation of in depth information about CVD risks and the absolute effects of medication. Setting: GP practices in Birmingham, United Kingdom. Results In both populations: wide variation on attitudes to preventative medication; concerns about unnecessary drug taking & side effects; preferring to consider lifestyle changes first. In patient population: whatever their attitudes to medication were, the vast majority explained that they would ultimately do what their GP recommended; there was some misunderstanding of the distinction between curative and preventative medication. A common theme was the degree of trust in their doctors' judgement and recommendations, which contrasted with scepticism of the role of pharmaceutical companies and academics. Scepticism in guidelines was also common among doctors although many nevertheless recommended treatment for their patients Conclusions A guideline approach to prescribing preventative medication could be against the interests and preferences of the patient. GPs must take extra care to explain what preventative medication is and why it is recommended, attempt to discern preferences and make recommendations balancing these potentially conflicting concerns.</p

Secure pathways for women in the UK::lessons from the women’s enhanced medium secure services (WEMSS) pilots

Women’s enhanced medium secure services (WEMSS) is a model of care aimed at providing a more appropriate level of security for women and, in so doing, reducing the number of women in high secure psychiatric services. In 2007, three Department of Health commissioned WEMSS pilots became operational. This study compared the clinical outcomes of women in WEMSS with control women in six standard medium secure services and one high secure service matched on key clinical and risk characteristics, in order to examine their pathways of care. Our findings confirm that the WEMSS pilots were successful in transitioning women from high secure services who had previously been thought unsuitable for medium secure services. However, WEMSS showed no additional clinical benefit, suggesting that these women could be cared for equally well within standard medium secure services. We make recommendations about WEMSS and the future shape of women’s secure care in England