A pilot survey of physical activity in men with an intellectual disability

People with intellectual disability are reported as a sedentary population with increased risks of poor health due to an inactive and sedentary lifestyle. As the benefits of physical activity are acknowledged, measuring physical activity accurately is important to help identify reasons for low and high physical activity in order to assist and maintain recommended levels for optimal health. This paper reports a pilot study undertaken to validate the use of a physical activity monitor (Sensewear Armband) and the International Physical Activity Questionnaire (IPAQ) as instruments for measuring and exploring physical activity of men with intellectual disability. The design was a one group descriptive study and data were collected over a 7 day period from 17 men. The Sensewear Armband enabled continuous and long-term measurement of 14 objective physical activity metrics. The IPAQ examined details of physical activity reported over the 7 days. Equivalent results were found in both instruments indicating a positive correlation between the Sensewear Armband and the IPAQ. The results show 50% have low activity levels and the national recommended physical activity levels been achieved at a very low active intensity. No sustainable high physical activity intensity levels were recorded. The results confirmed the Sensewear Armband and the IPAQ as a practical means of measuring and understanding physical activity levels of men with intellectual disability

Guest editorial: Promoting cultural competency in the nursing care of LGBT patients

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.none- editoria

A qualitative study of advanced nurse practitioners’ use of physical assessment skills in the community: shifting skills across professional boundaries

Aim To explore multiple perspectives on the use of physical assessment skills by Advanced Nurse Practitioners in the UK Background Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by Advanced Nurse Practitioners' on the community. Design Case study Methodology and methods. A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March and August 2013. Participants included nurses, doctors, nurse educators and managers Findings Physical assessment skills education at Universities are part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence capability and performance with physical assessment skills are an expectation of advanced nursing practice. Conclusions These skills are used successfully by community Advanced Nurse Practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in post-graduate education. Relevance to clinical practice. • Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK • Shared sets of clinical assessment competencies between disciplines have better outcomes for patients • Levels of assessment competence can depend on the professional attributes of individual practitioners • Unsupportive learning cultures can hinder professional development of advanced nursing practic

Self-Tracking, Governmentality, and Nursing and Midwifery Council's (2016) Revalidation Policy

In April 2016 the Nursing and Midwifery Council (NMC) introduced a new revalidation continuous professional development (CPD) policy. This policy states that revalidation is the responsibility of nurses, and although employers are urged to support the revalidation process, the NMC clearly states that employers have no legal requirement to provide either time or funds for the CPD activities of nurses and midwives (NMC, 2014, 2016; Royal College of Nursing, 2016). The aim of this professional development policy is to ensure that nurses and midwives maintain their professional competency and to promote public safety and confidence in nurses and midwives. A closer look at the process of revalidation suggests that several measures have been introduced to ensure that nurses and midwives conform to the CPD policy, and this paper examines the influence of governmentality and neoliberalism on the NMC's self-tracking revalidation policy. It will be recommended that the responsibility for the revalidation process should be shared by nurses, midwives, and their employers, and that time and money should be allocated for the professional development of nurses and midwives

Shall I tell my mentor? Exploring the mentor-student relationship and its impact on students’ raising concerns on clinical placement

Aims To explore student nurses' and nurse mentors' perceptions and experiences of raising concerns on clinical placement and the influence (if any) of their relationship on this process. A secondary aim is to consider the above, from a regulatory perspective in light of current literature and policy developments. Background Raising concerns whilst on clinical placement has been shown to be challenging for student nurses internationally. Registered nurses in the UK (in this case called “nurse mentors”) facilitate learning and assessment in practice. However, limited research exists on the influence of the relationship between the nurse mentor and student nurse on the raising concerns process. Design A qualitative approach was used to undertake secondary thematic analysis of interview data. The primary data set was generated during a PhD study, focusing on the mentor–student dynamic and the possible influence of this relationship on students' raising concerns. Methods 30 individual semi‐structured interviews were subjected to concurrent and thematic analysis. Interviews were undertaken with student nurses (n = 16) and nurse mentors (n = 14) between April 2016–January 2018. The COREQ 32‐item checklist was used during the preparation of this article. Findings The following three interrelated analytical themes were generated from the data, “developing a mentor‐student relationship," “keeping your mentor sweet” and “the mentor role in the raising concerns process.” Conclusion Our analysis of participants' experiences and perceptions offers an original contribution to understanding the factors associated with student nurses raising concerns in practice. Student nurses and most mentors believed that students should be encouraged and supported to raise concerns, but students' decisions were strongly influenced by their perceptions of the immediate interpersonal and educational context. Similar barriers to raising concerns have been shown to exist regardless of geographical boundaries, therefore the findings of this study are nationally and internationally relevant

The role of nurses in alcohol and drug treatment services: a resource for commissioners, providers and clinicians

Commissioners and providers of alcohol and drugs services need to respond to an increasingly complex need in the populations they serve1. This requires services to be competent in identifying and responding to a wide range of health and social care needs and be able to support people to access treatment for co-existing physical and mental health issues, to enable recovery. This resource has been written by the Royal College of Nursing, the Association of Nurses in Substance Abuse (ANSA), the National Substance Misuse Non-Medical Prescribing Forum, and Public Health England. It describes the many possible roles of nurses in alcohol and drug treatment in England. It is one of a series of PHE-supported briefings on the roles of professions working in alcohol and drug treatment services, in the community and in secondary care2,3,4 and should be read in conjunction with them. This resource is to assist commissioners and providers of specialist adult alcohol and drug treatment services to identify the right workforce to meet the needs of their local populations. It does not address the wider role of nurses across other areas of health and social care, such as midwives, who make a significant contribution to the care of people who misuse alcohol and drugs, and their families. It outlines: •the roles of nurses working in alcohol and drug treatment including the contribution they can make to health and social care outcomes•the added value nurses can bring to alcohol and drug treatment•the competencies and skills that should be expected of nurses working in alcohol and drug treatment •what is required to develop and maintain these competencies potential added value of nurses is determined by the level of experience and training. Experienced nurses will be able to provide advanced clinical interventions and respond to more complex physical and mental health needs. It is important that the roles of nurses are not considered in isolation, but as a key part of a multidisciplinary team, responding to locally identified need

The crisis of public sector trade unionism: evidence from the Mid Staffordshire hospital crisis

This article contends that there is a growing, if uneven, crisis in public sector trade unionism masked by relatively high membership figures that obscure a weakening of trade unions in the workplace, leaving hollowed out organisation vulnerable to further legislative and employer-led onslaughts. The weakening is not inevitable but to overcome it requires a refocusing of organising efforts on the everyday concerns of members such as understaffing and the provision of better public services. Only with an engaged membership will national issues and wider campaigns have material force. Having outlined a general argument, the article takes as illustrative the nature and performance of trade unions, and particularly UNISON, during the Mid Staffordshire hospital crisis

Nurses' experiences of communicating respect to patients: Influences and challenges

A qualitative study utilizing Interpretive Phenomenological Analysis of a sample of nursing interviews to explore the ways in which respect is conceptualized and communicated to patients.Background: Respectful care is central to ethical codes of practice and optimal patient care, but little is known about the influences on and challenges in communicating respect. Research question: What are the intra- and inter-personal influences on nurses’ communication of respect? Research design and participants: Semi-structured interviews with 12 hospital-based UK registered nurses were analysed using interpretative phenomenological analysis to explore their experiences of communicating respect to patients and associated influences. Ethical considerations: The study was approved by the Institutional ethics board and National Health Service Trust. Findings: Three interconnected superordinate themes were identified: ‘private self: personal attitudes’, ‘outward self: showing respect’ and ‘reputational self: being perceived as respectful’. Respectful communication involved a complex set of influences, including attitudes of respect towards patients, needs and goals, beliefs around the nature of respectful communication, skills and influencing sociocultural factors. A tension between the outward self as intended and perceived presented challenges for nurses’ reputational self as respectful, with negative implications for patient care. Discussion: The study offers an in-depth understanding of intra- and inter-personal influences on communicating respect, and sheds light on challenges involved, helping provide practical insights to support respectful care. Conclusion: Findings stress the need for improved conceptualisations of respect in healthcare settings to formally recognise the complex attitudinal and socially constructed nature of respect and for appropriate professional training to improve its communicatio

A constructivist grounded theory study to explore compassion through the perceptions of individuals who have experienced nursing care

Aim: To explore compassion from the perceptions of individuals with personal experience of nursing care. Background: Although compassion is considered integral to professional nursing, increasing reports of care experiences illustrating a lack of compassion have challenged this. Despite political and professional guidance to reaffirm compassion as an underpinning philosophy of contemporary nursing practice, this provides limited insight into what compassion may involve. Contemporary evidence to inform understanding of compassion predominately arises from the professional perspective. This knowledge gap supported the rationale to explore compassion from the individual perspective. Design: Constructivist grounded theory, underpinned by the theoretical perspectives of symbolic interactionism and social constructionism. Methods: Data was collected via eleven individual interviews, a focus group discussion and three additional individual interviews during 2013-2015. Initial and focused coding, constant comparative analysis, conceptual mapping, theoretical memos and diagrams supported data analysis until theoretical sufficiency was determined. Findings: Inter-related data categories emerged: Self-Propensity for Compassion, Attributes for Compassion, Socialising for Compassion, Conditions for Compassion and Humanising for Compassion (core category). Conclusion: Compassion is a complex phenomenon, constructed by individuals through their personal experiences of nursing care and life experiences in the social world. In this study, participants perceived that compassion was fundamentally embodied by experiences of a humanising approach to nursing care. These humanising experiences were thought to be influenced by biological, psychological and socio-contextual factors. The study provides additional insight into compassion that requires further investigation with individuals in other care contexts, nurses and health care professionals