Social work and social care: mapping workforce engagement, relevance, experience and interest in research.

Evidence-based practice (EBP) has been promoted within social work/social care, with emerging evidence of benefit to practitioners and service users. Advocates argue that EBP enables practitioners to have the skills to interpret and evaluate evidence and be actively involved in research. This project aimed to evaluate awareness, experience/skills and value of research, and explore barriers to engagement with research. A cross-sectional survey was undertaken across a diverse range of social work/care staff at a large National Health Service (NHS) Foundation Trust and partner Local Authority. The survey included both closed and an open-ended response to facilitate a mixed method analysis. In total, 208 staff responded (55 percent response) and findings show a high rating on the relevance of research to professional development (73 percent); however, a low level of actual involvement (10 percent) and low levels of confidence/knowledge across a range of research skills. Identified barriers include a lack of knowledge on where/how to begin, lack of evidence that it improves practice, the potential to threaten practice and low capacity and time. These findings highlight a potential gap between a current drive for social work/care to be more evidenced based and the ability of social work/care to enact this approach

Telehealth cancer-related fatigue clinic model for cancer survivors: A pilot randomised controlled trial protocol (the T-CRF trial)

INTRODUCTION: Cancer-related fatigue (CRF) is one of the most common and debilitating adverse effects of cancer and its treatment reported by cancer survivors. Physical activity, psychological interventions and management of concurrent symptoms have been shown to be effective in alleviating CRF. This pilot randomised controlled trial (RCT) will determine the feasibility of a telehealth CRF clinic intervention (T-CRF) to implement evidence-based strategies and assess the impact of the intervention on CRF and other clinical factors in comparison to usual care. METHODS AND ANALYSIS: A parallel-arm (intervention vs usual care) pilot RCT will be conducted at the Princess Alexandra Hospital in Queensland, Australia. Sixty cancer survivors aged 18 years and over, who report moderate or severe fatigue on the Brief Fatigue Inventory and meet other study criteria will be recruited. Participants will be randomised (1:1) to receive the T-CRF intervention or usual care (ie, specialist-led care, with a fatigue information booklet). The intervention is a 24-week programme of three telehealth nurse-led consultations and a personalised CRF management plan. The primary objective of this pilot RCT is to determine intervention feasibility, with a secondary objective to determine preliminary clinical efficacy. Feasibility outcomes include the identification of recruitment methods; recruitment rate and uptake; attrition; adherence; fidelity; apathy; and intervention functionality, acceptability and satisfaction. Clinical and resource use outcomes include cancer survivor fatigue, symptom burden, level of physical activity, productivity loss, hospital resource utilisation and carer\u27s fatigue and productivity loss. Descriptive statistics will be used to report on feasibility and process-related elements additional to clinical and resource outcomes. ETHICS AND DISSEMINATION: This trial is prospectively registered (ACTRN12620001334998). The study protocol has been approved by the Metro South Health and Hospital Services Human Research Ethics Committee (MSHHS HREC/2020/QMS/63495). Findings will be disseminated through peer-reviewed publications, national and international conferences and seminars or workshops. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry ID: ACTRN12620001334998; Pre-results. Trial Version: Version 1.1. Last updated 10 December 2020

Head and neck lymphedema management: evaluation of a therapy program

The purpose of this pilot study was to examine a therapeutic intervention for head and neck lymphedema. The 22-week intervention involved therapist-led care and participant self-management. Effectiveness was evaluated using a previously described lymphedema assessment tool, the Assessment of Lymphedema of the Head and Neck (ALOHA) to detect change over the course of the 22 weeks of treatment, and before and after a single treatment session.A prospective observational pilot study was conducted with a cohort of 10 participants assessed. Measurements of size (tape measurements) and water content (tissue dielectric constant [TDC]) were used, per the ALOHA protocol. Participants received 13 lymphedema therapy treatments at reducing frequencies over 22 weeks and daily self-management.There was an overall significant reduction in lower neck circumference (F [2.15,19.35] = 7.11; P = .004), upper neck circumference (F [5,45] = 7.27; P

Developing a sustainable cancer educational resource for occupational therapists

Introduction: Occupational therapists have a key role in supporting people experiencing cancer and its consequences. A complex skill mix is required to fulfil this role, creating a training need for occupational therapists. Method: This study retrospectively examined the evolution and sustainability of the cancer occupational therapy interest group, a cancer educational resource for occupational therapists within public health facilities in Queensland, Australia. Development of the programme was reviewed and data were analysed to examine involvement in the programme and confidence in providing cancer services. Results: Membership of the interest group, participating locations and videoconference attendances all increased across the study period from 2012–2016. The practice areas participants most frequently reported confidence addressing were fatigue management and palliative care. Participants most frequently reported they were not confident addressing sexuality and relaxation management. Conclusion: The cancer occupational therapy interest group provides an approach that demonstrates some utility with providing education and information for occupational therapists in cancer services

Pilot study of an assessment tool for measuring head and neck lymphoedema

Head and neck lymphoedema (HNL) is a persistent symptom for many patients following head and neck cancer treatment. There is limited research into the benefits of lymphoedema treatment with this population. This pilot study (n=8) employs the Assessment of Lymphoedema of Head and Neck (ALOHA) system to evaluate treatment changes in this clinical population. The ALOHA assessment combines the use of the Princess Alexandra Hospital tape measurement system and the use of Tissue Dielectric Constant (MoistureMeterD) to measure HNL. Baseline measures were taken at the start of treatment and were repeated when the participants had reduced one level on the MD Anderson Cancer Centre HNL rating scale. The MoistureMeterD and three of the four tape measurement points showed a statistically significant change over time. This indicates the ALOHA system was useful in objectively detecting changes associated with clinical improvements

Measuring head and neck lymphedema: the "ALOHA" trial

There is no clinical assessment available to measure head and neck lymphedema. This study proposes the use of a tape measurement system and the MoistureMeterD (MMD) to evaluate head and neck lymphedema.The reliability and validity of these assessments was examined in 20 patients with head and neck lymphedema and 20 matched healthy controls.Interrater reliability for the MMD and 3 of the 4 tape measurements was excellent (intraclass correlation coefficients [ICCs] >0.90). Intrarater reliability of the MMD was 0.97. The MMD discriminated between patients with head and neck lymphedema and healthy controls, t(19) = 8.97, p < .001, whereas the tape measurements did not. Correlation between MMD score and head and neck lymphedema level ratings was significant (rho = 0.59) indicating convergent validity. Three of the tape measurements were significantly correlated with MMD scores (rho = 0.37-0.38) but not with ratings of head and neck lymphedema.The tape measurement system and MMD show potential as objective measurements of head and neck lymphedema with the exception of 1 tape measurement point

Communicating Actively Responding Empathically (CARE): Comparison of communication training workshops for health professionals working in cancer care

Accessing full-day communication skills training can be challenging for health professionals working in cancer care. This study aimed to examine the effectiveness of Communicating Actively, Responding Empathically (CARE Express), a modified 2-h communication skills training course, across measures of health professional confidence, skills and attitudes. Cancer care health professionals (n = 147) were recruited from allied health, nursing and medical disciplines, using a partial randomisation to allocate to three arms: control, two-hour training (CARE Express) and 1-day training (CARE). Perceived confidence and skills were measured by self-report using a purpose-built scale, and written responses to a challenging clinical encounter were obtained at baseline, post-training and three-months post-training. Attitudes toward psychosocial issues were evaluated with the Physician Belief Scale at baseline and 3\ua0months post-training. No changes were observed in the control group (n = 50) from baseline to 3\ua0months follow-up. Participants in the CARE Express (n = 48) and CARE (n = 49) groups had significant improvement in confidence in identifying/responding to emotions between baseline and 3\ua0months post-training (p