Exploring factors that infuence HRQoL for people living with Parkinson’s in one region of Ireland: A cross-sectional study

Background: The diversity of symptoms associated with Parkinson’s and their impact on functioning have led to an  increased interest in exploring factors that impact Health-Related Quality of Life (HRQoL). Although the experience  of Parkinson’s is unique, some symptoms have a greater impact than others, e.g. depression. Moreover, as the risk of  Parkinson’s increases with age, the fnancial and public health impact of this condition is likely to increase, particularly  within the context of a globally ageing population. In Ireland, research is ongoing in the pursuit of causes and efective  treatments for Parkinson’s; however, its impact on everyday living, functioning, and HRQoL is largely under-examined.  This study aims to describe factors that infuence HRQoL for people with Parkinson’s (PwP) in one region of Ireland. Methods: A cross-sectional postal survey was conducted among people living with Parkinson’s (n=208) in one  area of Ireland. This survey included socio-demographic questions, Nonmotor Symptoms Questionnaire for Parkinson’s disease (NMSQuest), the Geriatric Depression Scale (GDS-15), and the Parkinson’s disease Questionnaire (PDQ?39). Statistical analysis was conducted using SPSS, IBM version 25 (SPSS Inc., Chicago, II, USA). Results: Participants refected a predominantly older population who were married, and lived in their own homes  (91%). Participants diagnosed the longest reported poorer HRQoL regarding mobility, activities of daily living, emo?tional well-being, social support, cognition, communication domains and overall HRQoL. Lower HRQoL correlated  with higher depression scores p<0.001 and participants in the lower HRQoL cohort experienced 2.25 times more  non-motor symptoms (NMSs) than participants with higher HRQoL. Hierarchical multiple linear regression analysis  predicted Geriatric Depression Scale (GDS15) score, NMS burden, and years since diagnosis to negatively impact  HRQoL. Principal component analysis (PCA) also indicated that for the population in this study, components measuring 1) independence/dependence 2) stigma 3) emotional well-being, and 4) pain were central to explaining core  aspects of participants’ HRQoL. Conclusions: Findings highlighted the negative impact of longer disease duration, NMS burden, depression, mobility impairments, and perceived dependence on HRQoL for PwP. The positive infuence of perceived independence,  social engagement along with close supportive relationships were also identifed as key components determining  HRQoL. Findings emphasised the importance of long-term healthcare commitment to sustaining social and community supports and therapeutic, rehabilitative initiatives to augment HRQoL for PwP </p

Psychosocial vulnerability among carers of persons living with a chronic illness: a scoping review

Aims: To outline and examine evidence related to the meaning of ‘psychosocial vulnerability’ among caregivers of persons with chronic illnesses. Background: The number of informal caregivers continues to rise globally. Their risk of psychosocial vulnerability is frequently overlooked, but understanding their psychosocial vulnerability may offer insights into meeting their needs. Design: Scoping review following the PRISMA 2020 extension guidelines. Data sources: The databases CINAHL, Embase, Medline/Pubmed, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Lenus and ProQuest were systematically searched to identify original research. No date limit was set, and 23 studies were included. Review methods: A five-step approach using the Arksey and O'Malley framework. Thematic analysis guided data analysis. Results: Carers' psychosocial vulnerability occurs when they experience barriers to resources while access and use of supports reduce risk. Antecedents of psychosocial vulnerability include a carer's age and sex, socioeconomic status and their health and wellbeing. Psychosocial vulnerability affects carers' relationships and causes personal losses. Conclusions: The concept of carers' psychosocial vulnerability is complex. Recognition of carers at risk for psychosocial vulnerability would help nurses direct relevant support and information to carers who need it most

Opening windows behind closed doors: reflections on working qualitatively during a pandemic

The contribution of qualitative evidence in epidemic and pandemic research has been articulated in previous editorials of this journal (Teti et al., 2020) and attention given to the pivotal role of qualitative methods in identifying social responses to COVID-19 (Vindrola-Padros et al., 2020). In addition, we feel it is also timely to explore the concept of “team” during this period and what adaptations pandemic restrictions has brought to how teams organize themselves, interact and the benefits and challenges that this brings. In this editorial, we reflect on our experiences of being part of a team conducting qualitative research during a pandemic, which has affected every aspect of our lives. Something this significant creates an opportunity for new learning. We consider what we have learned during this time and what aspects we can use to inform and enrich u

Missed nursing care and nurses' intention to leave: an integrative review

Aim To identify the factors that are associated with missed nursing care and the nurses’ intention to leave. Background Errors and mistakes are an inevitable part of work, but there is increased evidence that missed care is a concerning issue affecting nurses’ ability to effectively coordinate, provide and evaluate care interventions delivered to patients globally. Evaluation An integrative review of qualitative and quantitative studies examining the consequences of missed nursing care, including intention to leave. Key issues Eight papers met the inclusion criteria. Thematic analysis generated three themes: Prevalence of missed nursing care, Factors associated with missed nursing care, Factors that impact on missed care and influence the intention to leave. Conclusion The outcomes of this review demonstrate the need for critical interventions to address the factors that can impact the provision of high‐quality nursing care. Implications for Practice Missed nursing care is not only a patient safety issue but may also contribute to the inadequate staffing levels. And, better understanding of the factors that affect the intention to leave by nurse managers can stimulate the development of appropriate leadership styles in combination with adjustment of workplace to prevent intention to leave

Double-tap interaction as an actuation mechanism for on-demand cueing in parkinson’s disease

Freezing of Gait (FoG) is one of the most debilitating symptoms of Parkinson’s disease and is an important contributor to falls. When the management of freezing episodes cannot be achieved through medication or surgery, non-pharmacological methods, such as cueing, have emerged as effective techniques, which ameliorates FoG. The use of On-Demand cueing systems (systems that only provide cueing stimuli during a FoG episode) has received attention in recent years. For such systems, the most common method of triggering the onset of cueing stimuli, utilize autonomous real-time FoG detection algorithms. In this article, we assessed the potential of a simple double-tap gesture interaction to trigger the onset of cueing stimuli. The intended purpose of our study was to validate the use of double-tap gesture interaction to facilitate Self-activated On-Demand cueing. We present analyses that assess if PwP can perform a double-tap gesture, if the gesture can be detected using an accelerometer’s embedded gestural interaction recognition function and if the action of performing the gesture aggravates FoG episodes. Our results demonstrate that a double-tap gesture may provide an effective actuation method for triggering On-Demand cueing. This opens up the potential future development of self-activated cueing devices as a method of On-Demand cueing for PwP and others

Fourth year intellectual disability student nurses’ journey and future work intention: a qualitative study

Background: The aim of this qualitative study is to explore the views and experiences of fnal year BSc intellectual  disability nursing students’ journey, future work plans and examine factors infuencing their migration intentions fol‑ lowing graduation. Methods: A qualitative component of a mixed methods study where a focus group interview was conducted with  fnal year BSc intellectual disability nursing students (n=10) from one University in Ireland in June 2019. A topic guide  was utilised, and participant’s were interviewed about their programme, future work plans and migration intentions.  An inductive approach was utilised, and data were analysed using a pre-existing framework for initial coding and  thematic development. Dufy’s conceptual model of identity transformation provided a structure to analyse the data  and map themes onto the conceptual framework. Results: The fndings were mapped onto the fve stages of Dufy’s (2013) conceptual model of identity transforma‑ tion: Pre-Entry; Reafrming; Surmounting; Stabilising and Actualising. Findings indicate that further work is required to  promote intellectual disability nursing and address professional esteem issues, support for education and professional  development, such as providing career guidance opportunities prior to course completion, development of clinical  skills within their education programme and support for the professional development of new graduates. Participant’s  identifed uncertainty about career opportunities and saw scope for future professional development opportunities  particularly in community-based work. Conclusion: This study has identifed that fnal year intellectual disability nursing students are uncertain about career  options and opportunities for intellectual disability nurses in other country’s. There is an urgent need for the intellectual disability nursing profession to articulate their practice and advocate for their role and contribution to the care of  people with intellectual disability. This study identifed a clear need for direction and information regarding intellectual disability nursing roles and career opportunities </p

Exploring the impact of COVID-19 on home care workers: A qualitative study

This qualitative study aimed to gain insight into the impact of COVID-19 on Home Care Workers (HCWs). During COVID-19 HCWs provided a lifeline for home care clients to support older people remaining living in their own homes. With a high-risk client base, HCWs were one of the few (Health and Social Care Professional) HSCPs to continue providing home-based care throughout COVID-19. Despite these contributions HCWs provided for aging in place during COVID-19, a paucity of research exists in relation to the challenges and impact of the pandemic on HCWs. Three in-person focus groups were conducted (n=23). Two main themes were produced guided by a Reflexive Thematic Analysis approach to enable the researchers to best represent the participants experiences: Challenges and concerns to the personal and private lives of HCWs and Navigating home-based complexities of HCWs workplace during COVID-19. health care challenges to minimize impact to HCWs issues to create a safe workplace for HCWs.</p

A technological review of wearable cueing devices addressing freezing of gait in Parkinson’s disease

Freezing of gait is one of the most debilitating symptoms of Parkinson’s disease and is an important contributor to falls, leading to it being a major cause of hospitalization and nursing home admissions. When the management of freezing episodes cannot be achieved through medication or surgery, non-pharmacological methods such as cueing have received attention in recent years. Novel cueing systems were developed over the last decade and have been evaluated predominantly in laboratory settings. However, to provide benefit to people with Parkinson’s and improve their quality of life, these systems must have the potential to be used at home as a self-administer intervention. This paper aims to provide a technological review of the literature related to wearable cueing systems and it focuses on current auditory, visual and somatosensory cueing systems, which may provide a suitable intervention for use in home-based environments. The paper describes the technical operation and effectiveness of the different cueing systems in overcoming freezing of gait. The “What Works Clearinghouse (WWC)” tool was used to assess the quality of each study described. The paper findings should prove instructive for further researchers looking to enhance the effectiveness of future cueing systems

Final year undergraduate nursing and midwifery students’ perspectives on simulation-based education: a cross-sectional study

Background: Simulation-based education is a teaching and learning approach that can enhance learning experiences for students on healthcare programmes. Within undergraduate nursing and midwifery education, simulation can support students in developing graduate attributes necessary to become practice-ready professionals. This paper reports on the evaluation of a simulation-based education initiative, which was introduced to support fnal year undergraduate nursing and midwifery students in preparation for their upcoming clinical internship in practice. Methods: This study aimed to evaluate a simulation-based education initiative from the perspectives of fnal year undergraduate nursing and midwifery students (N= 95). An online survey, using the validated Simulation Efectiveness Tool – Modifed (SET-M), was distributed to fnal year nursing and midwifery students at one university in Ireland. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS). Results: The results of the study highlight fnal year nursing and midwifery students’ perceptions, experiences, and satisfaction with learning in a simulated environment. Students reported their simulation-based learning experiences as worthwhile, motivating, and as important opportunities to build on previous learning, increase confdence and gain experience in preparation for real-life practice. Students reported feeling more confdent in their assessment skills, in providing care and interventions in responding to changes in a person’s health status. All students reported that the simulation-based learning experiences enabled them to think more critically about the clinical case scenarios and critically question their actions and decision-making processes. Pre-briefng and debriefng sessions were highlighted as important aspects of the simulation which helped to increase student confdence and cultivate meaningful learning. Conclusion: Simulation-based education is a valuable teaching and learning modality, particularly for fnal year students who are transitioning to real-life clinical practice. Student-centred simulation-based learning experiences can cultivate professional development and support learners in their transition from university student to healthcare professional.</p

Risk of bias assessment of sequence generation: a study of 100 systematic reviews of trials

Background: Systematic reviews of randomised trials guide policy and healthcare decisions. Yet, we observed that some reviews judge randomised trials as high or unclear risk of bias (ROB) for sequence generation, potentially introducing bias. However, to date, the extent of this issue has not been well examined. We evaluated the consistency in the ROB assessment for sequence generation of randomised trials in Cochrane and non-Cochrane reviews, and explored the reviewers’ judgement of the quality of evidence for the related outcomes. Methods: Cochrane intervention reviews (01/01/2017–31/03/2017) were retrieved from the Cochrane Database of Systematic Reviews. We also searched for systematic reviews in ten general medical journals with highest impact factors (01/01/2016–31/03/2017). We examined the proportion of reviews that rated the sequence generation domain as high, low or unclear risk of selection bias. For reviews that had rated any randomised trials as high or unclear risk of bias, we examined the proportion that had assessed the quality of evidence. Results: Overall, 100 systematic reviews were included in our analysis. We evaluated 64 Cochrane reviews which comprised of 984 randomised trials; 0.8% (n = 8) and 52.2% (n = 514) were rated as high and unclear ROB for sequence generation respectively. We further evaluated 36 non-Cochrane reviews which comprised of 1376 trials; 5.8% (n = 80) and 39.6% (n = 545) were rated as high and unclear ROB respectively. Ninety percent (n = 10) of non- Cochrane reviews which rated randomised trials as high ROB for sequence generation did not report an underlying reason. All Cochrane reviews assessed the quality of evidence (GRADE). For the non-Cochrane reviews, only just over half had assessed the quality of evidence. Conclusion: Systematic reviews of interventions frequently rate randomised trials as high or unclear ROB for sequence generation. In general, Cochrane reviews were more transparent than non-Cochrane reviews in ROB and quality of evidence assessment. The scientific community should more strongly promote consistent ROB assessment for sequence generation to minimise selection bias and support transparent quality of evidence assessment. Consistency ensures that appropriate conclusions are drawn from the data