DSpace Collection: Nursing and Midwifery (Scholarly Publications)

Interventions for promoting participation in shared decision-making for children with cancer. [Protocol].

Sat, 01 Jan 2011 00:00:00 GMT

Title: Interventions for promoting participation in shared decision-making for children with cancer. [Protocol]. Author: COYNE, IMELDA Abstract: This is the protocol and there is no abstract. The objectives are as follows: To examine the effects of interventions to promote shared decision-making (SDM) for children with cancer who are aged four to 18 years. Description: PUBLISHED

A Descriptive Case Study to explore the use of Projective Techniques in the group Dramatherapy setting with women exploring their Suicidal Ideation and Depression.

Thu, 01 Jan 2009 00:00:00 GMT

Title: A Descriptive Case Study to explore the use of Projective Techniques in the group Dramatherapy setting with women exploring their Suicidal Ideation and Depression. Author: DUNNE, PADRAIG J. Abstract: A Descriptive Case Study to explore the use of Projective Techniques in the group Dramatherapy setting with women exploring their Suicidal Ideation and Depression. Author: Pàdraig J. Dunne, Clinical Dramatherapist, MA (DT), Pg. Dip, BNS Dip. NS, R.P.N. Trinity College Dublin. Contact: (01) 8963006, (086) 0456822 or email padraig.dunne@tcd.ie Aim: To explore specific projective techniques used in the Dramatherapy setting and how these techniques may benefit women suffering from depression and suicidal ideation. Background: During therapy with these women anecdotal evidence began to emerge that projective techniques within the Dramatherapy sessions were beneficial for these women to aid the expression of their thoughts and feelings in relation to their depression and suicidal ideation. Following an extensive literature review it became obvious that little existed to support this argument especially within the health care setting. The study was embarked on to bridge the gap in the research between Art therapies and Health and to explore the notion that projective techniques specifically six-part story, Art/Drawing and Small World were beneficial for this client group during the sessions. Setting: The study was conducted with specifically referred women admitted to a major Psychiatric care setting in Dublin with a DSM IV diagnosis of Depression with Suicidal Ideation. Methodology: A descriptive case study approach was used exploring vignettes and findings from several varied and inventive data collection methods deemed necessary. Including participation and observation in groups, note taking, supervision and reflection notes, verbatim statements, semi-structured interviews, the Marion Social Atom model, a client’s evaluation tool and documented feedback from clinical staff. Ethical approval was received from both the institution and through individual consent forms. Findings/ Conclusion: The findings indicated that the group focused their transformation during the therapy sessions around the use of certain projective techniques, some working better than others. The projective techniques provided a safe framework within the therapy sessions and permitted extensive exploration of suicidal ideation and depression allowing the women to name and own their thoughts and feeling in relation to their illness. The study also indicated that this type of therapy is very beneficial for clients suffering from depression. Description: PUBLISHED

A Descriptive Case Study to explore the use of Projective Techniques in the group Dramatherapy setting with women exploring their Suicidal Ideation and Depression.

Thu, 01 Jan 2009 00:00:00 GMT

Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing

Sun, 01 Jan 2012 00:00:00 GMT

Title: Cardiotocography versus intermittent auscultation of fetal heart on admission to labour ward for assessment of fetal wellbeing Author: SMITH, VALERIE C; LALOR, JOAN Abstract: Background: The admission cardiotocograph (CTG) is a commonly used screening test consisting of a short (usually 20 minutes) recording of the fetal heart rate (FHR) and uterine activity performed on the mother’s admission to the labour ward. Objectives: To compare the effects of admission CTG with intermittent auscultation of the FHR on maternal and infant outcomes for pregnant women without risk factors on their admission to the labour ward. Search methods: We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (17 May 2011) (CENTRAL) (The Cochrane Library 2011 Issue 2 of 4), MEDLINE (1966 to 17 May 2011), CINAHL (1982 to 17 May 2011), Dissertation Abstracts (1980 to 17 May 2011) and the reference list of retrieved papers. Selection criteria: All randomised and quasi-randomised trials comparing admission CTG with intermittent auscultation of the FHR for pregnant women between 37 and 42 completed weeks of pregnancy and considered to be at low risk of intrapartum fetal hypoxia and of developing complications during labour. Main results We included four trials involving more than 13,000 women. All four studies included women in labour. Overall, the studies were at low risk of bias. Although not statistically significant using a strict P < 0.05 criterion, data are consistent with women allocated to admission CTG having, on average, a higher probability of an increase in incidence of caesarean section than women allocated to intermittent auscultation (risk ratio (RR) 1.20, 95% confidence interval (CI) 1.00 to 1.44, four trials, 11,338 women, T² = 0.00, I² = 0%). There were no differences between groups in other secondary outcome measures. Authors’ conclusions: Contrary to continued use in some clinical areas, we found no evidence of benefit for the use of the admission cardiotocograph (CTG) for low-risk women on admission in labour. We found no evidence of benefit for the use of the admission CTG for low-risk women on admission in labour. Furthermore, the probability is that admission CTG increases the caesarean section rate by approximately 20%. The data lacked power to detect possible important differences in perinatal mortality. However, it is unlikely that any trial, or meta-analysis, will be adequately powered to detect such differences. The findings of this review support recommendations that the admission CTG not be used for women who are low risk on admission in labour. Women should be informed that admission CTG is likely associated with an increase in the incidence of caesarean section without evidence of benefit. Description: IN_PRESS

Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial

Sat, 01 Jan 2011 00:00:00 GMT

Title: Comparison of midwife-led and consultant-led care of healthy women at low risk of childbirth complications in the Republic of Ireland: a randomised trial Author: BEGLEY, CECILY MARION Abstract: Background: No midwifery-led units existed in Ireland before 2004. The aim of this study was to compare midwife-led (MLU) versus consultant-led (CLU) care for healthy, pregnant women without risk factors for labour and delivery. Methods: An unblinded, pragmatic randomised trial was designed, funded by the Health Service Executive (Dublin North-East). Following ethical approval, all women booking prior to 24 weeks of pregnancy at two maternity hospitals with 1,300-3,200 births annually in Ireland were assessed for trial eligibility.1,653 consenting women were centrally randomised on a 2:1 ratio to MLU or CLU care, (1101:552). 'Intention-to-treat' analysis was used to compare 9 key neonatal and maternal outcomes. Results: No statistically significant difference was found between MLU and CLU in the seven key outcomes: caesarean birth (163 [14.8%] vs 84 [15.2%]; relative risk (RR) 0.97 [95% CI 0.76 to 1.24]), induction (248 [22.5%] vs 138 [25.0%]; RR 0.90 [0.75 to 1.08]), episiotomy (126 [11.4%] vs 68 [12.3%]; RR 0.93 [0.70 to 1.23]), instrumental birth (139 [12.6%] vs 79 [14.3%]; RR 0.88 [0.68 to 1.14]), Apgar scores <8 (10 [0.9%] vs 9 [1.6%]; RR 0.56 [0.23 to 1.36]), postpartum haemorrhage (144 [13.1%] vs 75 [13.6%]; RR 0.96 [0.74 to 1.25]); breastfeeding initiation (616 [55.9%] vs 317 [57.4%]; RR 0.97 [0.89 to 1.06]). MLU women were significantly less likely to have continuous electronic fetal monitoring (397 [36.1%] vs 313 [56.7%]; RR 0.64 [0.57 to 0.71]), or augmentation of labour (436 [39.6%] vs 314 [56.9%]; RR 0.50 [0.40 to 0.61]). Conclusions: Midwife-led care, as practised in this study, is as safe as consultant-led care and is associated with less intervention during labour and delivery. Trial registration: Current Controlled Trials ISRCTN14973283 Description: PUBLISHED

Evidence for disaster risk reduction, planning and response: design of the Evidence Aid survey.

Sat, 01 Jan 2011 00:00:00 GMT

Title: Evidence for disaster risk reduction, planning and response: design of the Evidence Aid survey. Author: CLARKE, MICHAEL JOSEPH; KAYABU MAGALA'BAHA, BONNIX Abstract: Systematic reviews are now regarded as a key component of the decision making process in health care, and, increasingly, in other areas. This should also be true in disaster risk reduction, planning and response. Since the Indian Ocean tsunami in 2004, The Cochrane Collaboration and others have been working together to strengthen the use and usefulness of systematic reviews in this field, through Evidence Aid. Evidence Aid is conducting a survey to identify the attitudes of those involved in the humanitarian response to natural disasters and other crises towards systematic reviews and research in such settings; their priorities for evidence, and their preferences for how the information should be made accessible. This article contains an outline of the survey instrument, which is available in full from www.EvidenceAid.org. The preliminary findings of the survey will be published in future articles. Description: PUBLISHED

The Use of a Supplementary Online Learning Course, and its Effect on Academic Achievement within an Undergraduate Nursing Programme

Fri, 01 Jan 2010 00:00:00 GMT

Title: The Use of a Supplementary Online Learning Course, and its Effect on Academic Achievement within an Undergraduate Nursing Programme Author: MC KEE, GABRIELLE; ADAMS, AUDREY Abstract: Background: There has been much research into innovations, quality, barriers and satisfaction with online learning. In the rush for development however, there has been little empirical evidence of the effectiveness of online courses in promoting student learning. Study Aim: The aim of this study was to examine the influence of an online learning course on student exam results. Methods: The study design was a cross-sectional survey. The online learning course was supplementary material for a first year biological sciences module in a four year nursing degree programme. Students’ access to the course was monitored automatically throughout the academic year. Student exam results and profile were collated from the School database. The data was analysed using SPSS version 16. Results: 195 students participated in the study of which 95% were female and 36% mature students. The sample consisted of students from two strands of the degree: General nursing (84%) and Intellectual Disability (ID) nursing (16%). There was a significant difference in the exam results of General and ID nursing students. There was a significant difference in the usage of the online course depending on mode of entry to the degree programme with mature students making greater use of the online learning course. Spearman's correlation identified a very significant relationship between exam results and usage of the online course (n = 185, r = 0.288, p = 0.0001 (one tailed)). This indicated that usage of the online course accounted for 8% of the variability in exam results. Conclusions: This study would appear to indicate that usage of the online course was related to improved higher exam results as students who used it most had better exam results. These findings go some way in establishing the evidence that is needed to justify the time, effort and cost of the implementing online courses. Description: PUBLISHED

Methodology in conducting a systematic review of systematic reviews of healthcare interventions.

Sat, 01 Jan 2011 00:00:00 GMT

Title: Methodology in conducting a systematic review of systematic reviews of healthcare interventions. Author: SMITH, VALERIE; BEGLEY, CECILY MARION Abstract: Background: Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need. Methods: The methods used to identify and appraise published and unpublished reviews systematically, drawing on our experiences and good practice in the conduct and reporting of systematic reviews are described. The process of identifying and appraising all published reviews allows researchers to describe the quality of this evidence base, summarise and compare the review’s conclusions and discuss the strength of these conclusions. Results: Methodological challenges and possible solutions are described within the context of (i) sources, (ii) study selection, (iii) quality assessment (i.e. the extent of searching undertaken for the reviews, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias and assessment of heterogeneity), (iv) presentation of results, and (v) implications for practice and research. Conclusion: Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic. The methods described here should help clinicians to review and appraise published reviews systematically, and aid evidence-based clinical decision-making. Description: PUBLISHED

Children's experiences of hospitalisation.

Sun, 01 Jan 2006 00:00:00 GMT

Title: Children's experiences of hospitalisation. Author: COYNE, IMELDA Abstract: This article reports on children’s experiences of hospitalisation. Data were collected via semi-structured interviews with eleven children aged 7-14 years from four paediatric units in England. The children identified a range of fears and concerns, which included: separation from parents and family; unfamiliar environment; investigations and treatments; and loss of self-determination. Children’s loss of self-determination over personal needs exacerbated their fears and concerns. It needs to be recognised that compliance with hospital routines is a variable, which influences children’s reaction to hospitalisation. Findings clearly indicate that children need adequate information tailored to their needs, that their views are sought in the planning and delivery of their care and that hospital environments need to be made more child-centred. Interventions designed to reduce children's stress during hospitalisation are not only likely to decrease their stress at the time, but they are also likely to influence how future experiences are appraised and managed. Description: PUBLISHED

Can you believe what you read in the papers?

Thu, 01 Jan 2009 00:00:00 GMT

Title: Can you believe what you read in the papers? Author: CLARKE, MICHAEL JOSEPH Abstract: The number of reports of clinical trials grows by hundreds every week. However, this does not mean that people making decisions about healthcare are finding it easier to obtain reliable knowledge for these decisions. Some of the information is unreliable. Systematic reviews are helping to resolve this by bringing together the research on a topic, appraising and summarising it. But the quality of these reviews depends greatly on the quality of the studies, and this usually means the quality of their reports. If there are fundamental flaws within a study, such as the use of inappropriate 'randomisation' techniques in the context of reviews of the effects of interventions, the reviewers will not be able to fix these. Worse still, if they are not aware of underlying flaws, they might make incorrect judgements about the quality of the research in their review. A study by Wu and colleagues of 'randomised trials' from China provides a reminder of the cautious approach needed by users of scientific articles. They contacted the authors of more than 2000 research articles, which purported to be reports of randomised trials; and concluded that ten of every 11 studies claiming to be a randomised trial probably did not use random allocation. Better education of researchers, peer reviewers and editors about what is, and is not, a properly randomised trial is needed; along with better reporting of the details for how participants were allocated to the different interventions. Systematic reviewers must be cautious in making assumptions about the conduct of trials based on simple phrases about the trial methodology, rather than a full description of the methods actually used. It's not that you can't believe anything that you read in the papers, just that you cannot believe everything. Description: PUBLISHED