Morag Farquhar | University of East Anglia (original) (raw)

Papers by Morag Farquhar

Nursing Standard, 1993

This article, which completes the research discussed in recent articles in Nursing Standard (1, 2... more This article, which completes the research discussed in recent articles in Nursing Standard (1, 2), describes the changes in the ability of very elderly frail people to go outdoors. The sample members were first interviewed in 1987 when tlxy were aged 85 or over, and followed up in 1990. Cross-sectional analyses showed that the groups who could not get outside alone or at all in either 1987 or 1990 were mote likely to lx taking prescribed medication, had poorer functional ability, reported problems with eyesight and aches!pains!stiffness in muscles/joints, had poorer emotional well-being, spent most of their days just sitting, and wanted more help ivith activities of daily living. There were, however, no differences in their social network characteristics, or their use of services.

Chronic Illness, 2021

Objectives To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow the... more Objectives To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow their support needs and the impact on care. Methods Two stage mixed-method design. Stage 1 involved sub-analyses of data from a mixed-method population-based longitudinal study exploring the needs of patients with advanced COPD. Using adapted criteria from mental health research, we identified 21 patients who disavowed their needs from the 235 patient cohort. Qualitative interview transcripts and self-report measures were analysed to compare these patients with the remaining cohort. In stage 2 focus groups (n = 2) with primary healthcare practitioners (n = 9) explored the implications of Stage 1 findings. Results Patients who disavowed their support needs described non-compliance with symptom management and avoidance of future care planning (qualitative data). Analysis of self-report measures of mental and physical health found this group reported fewer needs than the remaining sample yet w...

European Respiratory Journal, 2020

American Journal of Respiratory and Critical Care Medicine, 2017

Introduction Chronic obstructive pulmonary disease (COPD) is a chronic progressive condition with... more Introduction Chronic obstructive pulmonary disease (COPD) is a chronic progressive condition with high symptom-burden. National guidance calls for quality end-of-life care for patients with any condition, yet we rely on frameworks developed for cancer with its largely predictable trajectory. Aim To inform a new framework to improve care and support in advanced COPD. Methods The Living with Breathlessness Study was a multiple-component, population-based, mixed-method longitudinal, multiple-perspective programme to identify new evidence on health and social care needs and preferences of patients with advanced COPD and their carers. It followed more than 500 patients and carers for up to 18 months through interview and survey methods. Qualitative data on barriers and facilitators to meeting needs were collected from clinicians. Programme-wide evidence was synthesised to identify recommendations. Stakeholder views were then collected through a workshop and online survey. Results Six int...

Annals of the American Thoracic Society, 2020

PLOS ONE, 2020

To examine the use of Normalisation Process Theory (NPT) to establish if, and in what ways, the A... more To examine the use of Normalisation Process Theory (NPT) to establish if, and in what ways, the AMBER care bundle can be successfully normalised into acute hospital practice, and to identify necessary modifications to optimise its implementation. Method Multi-method process evaluation embedded within a mixed-method feasibility cluster randomised controlled trial in two district general hospitals in England. Data were collected using (i) focus groups with health professionals (HPs), (ii) semi-structured interviews with patients and/or carers, (iii) non-participant observations of multidisciplinary team meetings and (iv) patient clinical note review. Thematic analysis and descriptive statistics, with interpretation guided by NPT components (coherence; cognitive participation; collective action; reflexive monitoring). Data triangulated across sources. Results Two focus groups (26 HPs), nine non-participant observations, 12 interviews (two patients, 10 relatives), 29 clinical note reviews were conducted. While coherence was evident, with HPs recognising the value of the AMBER care bundle, cognitive participation and collective action presented challenges. Specifically: (1) HPs were unable and unwilling to

BMJ Open, 2019

ObjectivesPatient-identified need is key to delivering holistic, supportive, person-centred care,... more ObjectivesPatient-identified need is key to delivering holistic, supportive, person-centred care, but we lack tools enabling patients to express what they need to manage life with a long-term condition. The Support Needs Approach for Patients (SNAP) tool was developed to enable patients with advanced chronic obstructive pulmonary disease (COPD) identify and express their unmet support needs to healthcare professionals (HCPs), but its validity is unknown. This study aimed to establish face, content and criterion validity of the SNAP tool.DesignTwo-stage mixed-methods study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers considering appropriateness, relevance and completeness of the SNAP tool. Data were analysed using conventional content analysis. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact me...

Palliative Medicine, 2019

Background: Holistic breathlessness services have been developed for people with advanced disease... more Background: Holistic breathlessness services have been developed for people with advanced disease and chronic breathlessness, leading to improved psychological aspects of breathlessness and health. The extent to which patient characteristics influence outcomes is unclear. Aim: To identify patient characteristics predicting outcomes of mastery and distress due to breathlessness following holistic breathlessness services. Design: Secondary analysis of pooled individual patient data from three clinical trials. Our primary analysis assessed predictors of clinically important improvements in Chronic Respiratory Questionnaire mastery scores (+0.5 point), and our secondary analysis predictors of improvements in Numerical Rating Scale distress due to breathlessness (−1 point). Variables significantly related to improvement in univariate models were considered in separate backwards stepwise logistic regression models. Participants: The dataset comprised 259 participants (118 female; mean (st...

The Lancet Respiratory Medicine, 2018

The European respiratory journal, 2017

This study explored the benefits of a hand-held fan as perceived by patients with chronic breathl... more This study explored the benefits of a hand-held fan as perceived by patients with chronic breathlessness and their carers.A secondary multimethod analysis was conducted of interview data collected in three clinical trials. Two researchers independently coded level of benefit qualitatively reported by each patient. Univariate and multivariate statistics were used to explore perceived benefit as a factor of sex, age and diagnosis. Qualitative analysis used an integrative method.133 patients commented on the fan, of whom 72 had a carer. Diagnoses included nonmalignant (n=91, 68.4%) and malignant (n=21, 15.8%) conditions. Of 111 patients who provided codable data, four (3.6%) perceived no benefit, 16 (14.4%) were uncertain, 80 (72.0%) perceived some benefit and 11 (10.0%) perceived very substantial benefit. Multivariate analysis was inconclusive. Benefit was described in terms of shorter recovery time, especially after activity. 10 (7.5%) patients said the fan reduced their need for hom...

Encyclopedia of Geropsychology, 2016

Journal of Pain and Symptom Management, 2017

Palliative Care in Respiratory Disease

Carers play a vital role in supportive, palliative and EOL care for patients with advanced respir... more Carers play a vital role in supportive, palliative and EOL care for patients with advanced respiratory conditions. They enable patients to be cared for, and even die, in their place of choice. However, this caring role comes at a cost in terms of psychosocial distress, physical and psychological health impacts (including carer mortality), and pressure on finances. Ensuring that carers are supported can ameliorate these effects. Healthcare professionals must respond to policy rhetoric and be dramatically better at identifying carers, working with them to assess and prioritise their support needs, and responding to and reviewing those needs. Evidence-based tools and approaches exist and can help, but are not a one-off exercise. Carers' needs may change as the patient's condition (or location of care) changes, or as carer health or systems change. Carers' needs may also exist beyond the patient's death. Clinical and academic researchers need to robustly develop and evaluate interventions for carers and include appropriate carer outcomes in evaluations of patient-targeted interventions.

Palliative Medicine, 2002

New updated! The latest book from a very famous author finally comes out. Book of chronic and ter... more New updated! The latest book from a very famous author finally comes out. Book of chronic and terminal illness new perspectives on caring and carers, as an amazing reference becomes what you need to get. What's for is this book? Are you still thinking for what the book is? Well, this is what you probably will get. You should have made proper choices for your better life. Book, as a source that may involve the facts, opinion, literature, religion, and many others are the great friends to join with.