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Papers by Sonya Chelvanayagam
British Journal of Nursing, Mar 1, 2010
Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in t... more Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in MS in order to improve patients' quality of life.
British Journal of Community Nursing, 1999
ABSTRACT Faecal incontinence remains a taboo subject and patients frequently conceal their sympto... more ABSTRACT Faecal incontinence remains a taboo subject and patients frequently conceal their symptoms, because of fear and embarrassment. Sensitive and appropriate assessment will encourage people to seek advice and treatment if required. This article discusses the causes and assessment of faecal incontinence. It explains the structure and function of the anal sphincters in maintaining continence. Assessment of bowel control is discussed in depth. Questions are suggested which will help to identify problems and thereby enable access to appropriate care.
British journal of nursing (Mark Allen Publishing)
In this paper, the authors describe the use of facilitated patient groups, in the management of w... more In this paper, the authors describe the use of facilitated patient groups, in the management of women with faecal incontinence (FI). Two types of groups are discussed--a psychoeducational group and a psychotherapy group. Detailed descriptions of some of the themes which emerged in these groups are provided. The effectiveness of such groups is described, with regard to both psychological and physical functioning. Further investigation into the use of groups for this patient population is recommended.
British journal of nursing (Mark Allen Publishing)
This article examines some of the literature regarding the benefits of interprofessional educatio... more This article examines some of the literature regarding the benefits of interprofessional education (IPE) in the field of health care. These benefits in relation to service users (and carers), higher education institutions, service providers and students are all explored. Barriers to IPE are being broken down by many of the various stakeholders working towards a similar agenda. However, currently there remains some doubt as to whether IPE has a direct positive impact on the health gain of service users and carers. Research is needed to demonstrate if service users and carers benefit directly from IPE and if they do not, the reason for pursuing it needs to be questioned.
British journal of nursing (Mark Allen Publishing)
Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in t... more Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in ...
Gastrointestinal Nursing, 2012
ABSTRACT Biofeedback is a conservative treatment based on behavioural techniques, which can be us... more ABSTRACT Biofeedback is a conservative treatment based on behavioural techniques, which can be used in the management of bowel dysfunction. This article reports the results of a retrospective review of the clinical notes of 87 female patients attending a biofeedback service at St Mark’s Hospital, Harrow. The initial review was conducted to examine the incidence of polycystic ovary syndrome (PCOS) in patients attending this service. Seven percent were found to have PCOS, which is within the normal range. However, a significant proportion of patients (11.5%) had a current history of anorexia nervosa, a higher rate than in the general population, which prompted further investigation. In this article, Sonya Chelvanayagam, Julie Duncan, Brigitte Collins and Lorraine O’Brien report on the results of this review and discuss the significance of its findings.
British Journal of Community Nursing, 2014
It is estimated that more than one third of older people may experience problems with their menta... more It is estimated that more than one third of older people may experience problems with their mental health. While, in some of these cases, people will be able to self-manage with little or no support, individuals who are socially isolated or physically unwell may experience significant mental distress. Community nurses are ideally placed to identify mental health problems in patients who are housebound, and to make appropriate referrals. Yet many nurses report apprehension regarding a perceived lack of knowledge and skills in which to undertake an initial assessment. This article outlines the most common mental illnesses experienced by older people living in the community and provides guidance for community nurses on conducting an initial assessment to ensure that patients' holistic needs are met.
Journal of Wound, Ostomy and Continence Nursing, 2001
In a previous article we described a nursing assessment for adults with fecal incontinence. This ... more In a previous article we described a nursing assessment for adults with fecal incontinence. This article outlines in detail the program of care, tailored to an individual's assessed needs, that is available in the nurse-led biofeedback service for fecal incontinence at St Mark's Hospital in England. A recent evaluation of this program found that two thirds of patients reported improved fecal continence after receiving care from this service.
Journal of Wound, Ostomy and Continence Nursing, 2000
Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article descr... more Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article describes an assessment format, with a research basis when available, that has been developed in a specialist nursing clinic in the United Kingdom. The focus is on how to obtain the most useful information from the patient to plan appropriate nursing interventions. A subsequent article will describe the biofeedback program developed as part of a package of care to meet individual needs of persons with fecal incontinence.
Diseases of the Colon & Rectum, 2008
This study was designed to analyze the characteristics and the quality of reporting of randomized... more This study was designed to analyze the characteristics and the quality of reporting of randomized, controlled trials published during the last ten years on fecal incontinence. An electronic search for all randomized, controlled trials on fecal incontinence was undertaken by using the MEDLINE database via PubMed. The data collected were divided into general data, characteristics of reporting, methodology quality assessment using the Jadad scale and a validated methodology quality score (MINCIR score), evaluation of the items published in the CONSORT statement, and the journal impact factor. Reports were divided into two groups: published articles from 1996 to 2000 (Group 1), and from 2001 to 2005 (Group 2). Forty-two trials fulfilled the inclusion criteria of the study (Group 1, n = 15; and Group 2, n = 27). There were no significant differences in general characteristics of randomized, controlled trials between the two groups. In Group 2, there were a statistically significant higher number of studies that reported a flow chart (P < 0.001), written informed consent (P = 0.008), sample size calculation (P = 0.023), and withdrawals and dropouts (P < 0.001). We found a statistically significant higher score in Jadad scale (P = 0.046) and MINCIR score (P = 0.016) in the published studies in Group 2. Also we found higher journal impact factor of journals that published these randomized, controlled trials during the most recent years (P = 0.04). There is a lack of high-quality reported randomized, controlled trials on fecal incontinence during the last ten years. Reports of randomized, controlled trials involving patients with fecal incontinence published after 2001 were better reported than in the previous five years.
Interprofessional education (IPE) was first conceived in 1973 from an expert group in Geneva by t... more Interprofessional education (IPE) was first conceived in 1973 from an expert group in Geneva by the World Health Organization (WHO). WHO member states were at the time charged with implementing medical education IPE pilot projects following this and from then to today there has a been a rapid proliferation in the number of publications on the subject. IPE has generated research into its use, conferences specific to IPE, organisations dedicated to it and policy championing it. The authors question whether there has been any major shift in the silos different professions might be working in. The authors published an article on the benefits of IPE (Illingworth and Chelvanayagam, 2007). Ten years have now passed and many changes have been implemented and experienced in health and social care and therefore a review of the literature is required. Also, it is 7 years since the publication of WHO’s report outlining the role of IPE in the preparation of health professionals (WHO, 2010) and increasingly UK Government policy champions collaborative and integrated working. The conclusions from the 2007 article acknowledged the development of IPE, however it highlighted the
need for empirical evidence to demonstrate the effectiveness of IPE in service user and carer outcomes. This article will explore whether IPE has achieved the benefits discussed in the previous article and what developments have occurred since it was published.
British Journal of Nursing, Mar 1, 2010
Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in t... more Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in MS in order to improve patients' quality of life.
British Journal of Community Nursing, 1999
ABSTRACT Faecal incontinence remains a taboo subject and patients frequently conceal their sympto... more ABSTRACT Faecal incontinence remains a taboo subject and patients frequently conceal their symptoms, because of fear and embarrassment. Sensitive and appropriate assessment will encourage people to seek advice and treatment if required. This article discusses the causes and assessment of faecal incontinence. It explains the structure and function of the anal sphincters in maintaining continence. Assessment of bowel control is discussed in depth. Questions are suggested which will help to identify problems and thereby enable access to appropriate care.
British journal of nursing (Mark Allen Publishing)
In this paper, the authors describe the use of facilitated patient groups, in the management of w... more In this paper, the authors describe the use of facilitated patient groups, in the management of women with faecal incontinence (FI). Two types of groups are discussed--a psychoeducational group and a psychotherapy group. Detailed descriptions of some of the themes which emerged in these groups are provided. The effectiveness of such groups is described, with regard to both psychological and physical functioning. Further investigation into the use of groups for this patient population is recommended.
British journal of nursing (Mark Allen Publishing)
This article examines some of the literature regarding the benefits of interprofessional educatio... more This article examines some of the literature regarding the benefits of interprofessional education (IPE) in the field of health care. These benefits in relation to service users (and carers), higher education institutions, service providers and students are all explored. Barriers to IPE are being broken down by many of the various stakeholders working towards a similar agenda. However, currently there remains some doubt as to whether IPE has a direct positive impact on the health gain of service users and carers. Research is needed to demonstrate if service users and carers benefit directly from IPE and if they do not, the reason for pursuing it needs to be questioned.
British journal of nursing (Mark Allen Publishing)
Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in t... more Multiple sclerosis (MS) is a common neurological disease, estimated to affect 100,000 people in the UK. Bowel symptoms are reported to be common in MS, with constipation affecting 29-43% and faecal incontinence affecting just over 50%. Both have an impact on quality of life. Very little is known about how people with MS manage their bowels and the effectiveness of different interventions. We conducted a 2-part survey of people with MS and bowel problems. MS Society members were invited to participate in an online survey: 155 replied. 47 people additionally filled in a more detailed postal questionnaire. In this self-selected sample, 34% spend more than 30 minutes a day managing their bowel. Managing bowel function was rated as having an impact equal to mobility difficulties on quality of life. Respondents used a wide range of strategies to manage their bowel but few were rated as very helpful. There is a need for high quality research on all aspects of managing bowel dysfunction in ...
Gastrointestinal Nursing, 2012
ABSTRACT Biofeedback is a conservative treatment based on behavioural techniques, which can be us... more ABSTRACT Biofeedback is a conservative treatment based on behavioural techniques, which can be used in the management of bowel dysfunction. This article reports the results of a retrospective review of the clinical notes of 87 female patients attending a biofeedback service at St Mark’s Hospital, Harrow. The initial review was conducted to examine the incidence of polycystic ovary syndrome (PCOS) in patients attending this service. Seven percent were found to have PCOS, which is within the normal range. However, a significant proportion of patients (11.5%) had a current history of anorexia nervosa, a higher rate than in the general population, which prompted further investigation. In this article, Sonya Chelvanayagam, Julie Duncan, Brigitte Collins and Lorraine O’Brien report on the results of this review and discuss the significance of its findings.
British Journal of Community Nursing, 2014
It is estimated that more than one third of older people may experience problems with their menta... more It is estimated that more than one third of older people may experience problems with their mental health. While, in some of these cases, people will be able to self-manage with little or no support, individuals who are socially isolated or physically unwell may experience significant mental distress. Community nurses are ideally placed to identify mental health problems in patients who are housebound, and to make appropriate referrals. Yet many nurses report apprehension regarding a perceived lack of knowledge and skills in which to undertake an initial assessment. This article outlines the most common mental illnesses experienced by older people living in the community and provides guidance for community nurses on conducting an initial assessment to ensure that patients' holistic needs are met.
Journal of Wound, Ostomy and Continence Nursing, 2001
In a previous article we described a nursing assessment for adults with fecal incontinence. This ... more In a previous article we described a nursing assessment for adults with fecal incontinence. This article outlines in detail the program of care, tailored to an individual's assessed needs, that is available in the nurse-led biofeedback service for fecal incontinence at St Mark's Hospital in England. A recent evaluation of this program found that two thirds of patients reported improved fecal continence after receiving care from this service.
Journal of Wound, Ostomy and Continence Nursing, 2000
Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article descr... more Fecal incontinence affects slightly more than 1% of community-dwelling adults. This article describes an assessment format, with a research basis when available, that has been developed in a specialist nursing clinic in the United Kingdom. The focus is on how to obtain the most useful information from the patient to plan appropriate nursing interventions. A subsequent article will describe the biofeedback program developed as part of a package of care to meet individual needs of persons with fecal incontinence.
Diseases of the Colon & Rectum, 2008
This study was designed to analyze the characteristics and the quality of reporting of randomized... more This study was designed to analyze the characteristics and the quality of reporting of randomized, controlled trials published during the last ten years on fecal incontinence. An electronic search for all randomized, controlled trials on fecal incontinence was undertaken by using the MEDLINE database via PubMed. The data collected were divided into general data, characteristics of reporting, methodology quality assessment using the Jadad scale and a validated methodology quality score (MINCIR score), evaluation of the items published in the CONSORT statement, and the journal impact factor. Reports were divided into two groups: published articles from 1996 to 2000 (Group 1), and from 2001 to 2005 (Group 2). Forty-two trials fulfilled the inclusion criteria of the study (Group 1, n = 15; and Group 2, n = 27). There were no significant differences in general characteristics of randomized, controlled trials between the two groups. In Group 2, there were a statistically significant higher number of studies that reported a flow chart (P < 0.001), written informed consent (P = 0.008), sample size calculation (P = 0.023), and withdrawals and dropouts (P < 0.001). We found a statistically significant higher score in Jadad scale (P = 0.046) and MINCIR score (P = 0.016) in the published studies in Group 2. Also we found higher journal impact factor of journals that published these randomized, controlled trials during the most recent years (P = 0.04). There is a lack of high-quality reported randomized, controlled trials on fecal incontinence during the last ten years. Reports of randomized, controlled trials involving patients with fecal incontinence published after 2001 were better reported than in the previous five years.
Interprofessional education (IPE) was first conceived in 1973 from an expert group in Geneva by t... more Interprofessional education (IPE) was first conceived in 1973 from an expert group in Geneva by the World Health Organization (WHO). WHO member states were at the time charged with implementing medical education IPE pilot projects following this and from then to today there has a been a rapid proliferation in the number of publications on the subject. IPE has generated research into its use, conferences specific to IPE, organisations dedicated to it and policy championing it. The authors question whether there has been any major shift in the silos different professions might be working in. The authors published an article on the benefits of IPE (Illingworth and Chelvanayagam, 2007). Ten years have now passed and many changes have been implemented and experienced in health and social care and therefore a review of the literature is required. Also, it is 7 years since the publication of WHO’s report outlining the role of IPE in the preparation of health professionals (WHO, 2010) and increasingly UK Government policy champions collaborative and integrated working. The conclusions from the 2007 article acknowledged the development of IPE, however it highlighted the
need for empirical evidence to demonstrate the effectiveness of IPE in service user and carer outcomes. This article will explore whether IPE has achieved the benefits discussed in the previous article and what developments have occurred since it was published.