Veronica Thomas - Academia.edu (original) (raw)
Papers by Veronica Thomas
Journal of Advanced Nursing, 1998
The role of cognitive-behavioural therapy in the management of pain in patients with sickle cell ... more The role of cognitive-behavioural therapy in the management of pain in patients with sickle cell disease Painful crisis is the most common manifestation of sickle cell disease and accounts for the second greatest number of admissions with an average length of stay of 7 days in central London. Despite this frequency of admissions, the management of pain is fraught with problems. This is not surprising since the psychological challenges presented by sickle cell disease are manifold, resulting in significant psychological distress for some individuals. This paper considers the literature on the psychosocial impact of sickle cell disease, and the American research evidence which suggests that pain management strategies that incorporate a psychological intervention can significantly reduce psychological distress as well as hospital admissions. Britain has been slow to incorporate psychology in the pain management strategies, and we have embarked on research to fill this gap. Although this research constitutes work in progress, an argument is put forward for utilizing the cognitive-behavioural perspective in the management of pain in sickle cell disease and we conclude by giving a brief summary of pilot work which is both the foundation and justification for the current ongoing research.
Journal of Advanced Nursing, 1993
Simple way to get the amazing book from experienced author? Why not? The way is very simple if yo... more Simple way to get the amazing book from experienced author? Why not? The way is very simple if you get the book right here. You need only the book soft files right here. It is based on the links that are published in this website. By visiting the link, you can gain the book directly. And here, you will find out many kinds of the books written by the professional writers from all world places.
Ethnicity & Health, 2001
The aim of the present study was to investigate the economic validity of using a psychological in... more The aim of the present study was to investigate the economic validity of using a psychological intervention in the management of sickle cell disease (SCD). Thomas et al. (Br J Health Psychol 1999; 4: 209-29) concluded that cognitive-behaviour therapy (CBT) appears to be immediately effective for the management of SCD pain in terms of reducing psychological distress pain as well as improving coping. The costs of management of SCD were evaluated using a societal viewpoint. This approach includes health and social services as well as costs privately borne by informal carers, but it did not include the economic loss due to patients' foregone earnings. Cost profiles were constructed for each patient taking account of cost generating events 12 months before and 12 months after CBT. The hypothesis of the present study, stating that CBT is economically efficient, was confirmed. However, analysis of longitudinal data suggests that CBT is most cost-effective during the first 6 months after the intervention. The present findings suggest the need for CBT to be integrated into the normal package of care available for all patients with SCD. The clinical implication is that CBT should be routinely offered to patients on a 6-monthly basis.
British Journal of Anaesthesia, 1995
We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping styl... more We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patientcontrolled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or im injections (IMI). Pain was assessed using the short form McGill pain questionnaire at 6, 18 and 24 h after operation, and by recording the amount of analgesic consumed in the first 24 h after surgery. Both state anxiety and coping style were significant predictors of postoperative pain, irrespective of the method of analgesia used. Patients using PCA experienced significantly better pain control than those receiving IMI. However, it was those with high levels of state anxiety who experienced the greatest reduction in pain with PCA. In addition to achieving better pain control, patients who received PCA used significantly less analgesia and were discharged earlier than patients who received IMI.
ISRN nephrology, 2013
Background. A needs assessment was conducted on renal patients registered to a leading hospital t... more Background. A needs assessment was conducted on renal patients registered to a leading hospital trust in London in order to explore their psychological, social, and spiritual needs. The aim of the needs assessment was to create an evidence base for the development of a comprehensive health psychology service to run concurrently with a renal counselling support service within the department. Methodology. This study utilised a series of semistructured face-to-face interviews and focus groups with renal patients and their carers, to explore how ESRD impacted quality of life. Results. A thematic analysis was undertaken. Seven emergent themes were identified that influenced the quality of life of people with EDRD: physiological impact, impact of treatment, impact on daily life, psychological impact, impact on relationships, social impact and coping responses. Conclusion. The needs assessment clearly identified that ESRD carries with it emotional, physical, psychological, social, and exis...
Blood
Introduction Women with Sickle Cell Disease (SCD) have been reported to have delayed menarche, in... more Introduction Women with Sickle Cell Disease (SCD) have been reported to have delayed menarche, increased rates of miscarriage & still birth. There is little evidence of the impact of SCD severity on fertility, or of patients’ attitudes towards their fertility. Methods Following IRB approval, an anonymised questionnaire was distributed to female patients over the age of 16 attending an SCD clinic. This included questions on menarche, fertility, reproductive history & clinical severity. We also surveyed attitudes to fertility & the role of fertility treatment. Results 101 women gave informed consent & returned the survey of whom 68 (67%) had sickle cell anaemia (HbSS), 31 (31%) had HbSC & 2 (2%) HbSß0 thalassaemia (HbSß0thal), the group mean age was 38yrs (range 17-74). 46 patients had severe disease phenotype (criteria for severity: ≥3 hospital admissions per year / ≥2 episodes of acute chest crisis/ ≥6 crisis at home per year or on Hydroxycarbamide (HU) therapy), 78% (36/46) had HbS...
Http Www Libreriasaulamedica Com, 1997
International Journal of Palliative Nursing, 2000
It is well established that the treatment of pain is improved by the incorporation of psychologic... more It is well established that the treatment of pain is improved by the incorporation of psychological, social and behavioural components in that treatment (Rosenthiel and Keefe), 1983). However, until very recently, the management of sickle cell disease (SCD) in British hospitals has focused exclusively on the physical dimension of pain (Thomas et al, 1998). Although pain is wrong (vaso-occlusive crisis), every individual reacts in a different way. This reaction is influenced in part by immediate role models, usually within the family, and by a person's cognition (thought patterns, beliefs and expectations) in relation to the pain. This paper presents research that has shown that cognitive behavioural therapy (CBT) in SCD is an effective aid in the treatment of chronic pain, reducing psychological distress and boosting confidence.
British Journal of Community Health Nursing, 1996
The sickle cell population is rapidly increasing, yet the interface between hospital and communit... more The sickle cell population is rapidly increasing, yet the interface between hospital and community care remains fragmented and uncoordinated. Historically the care for patients with sickle cell disease has been predominantly hospital-based, because of the perceived complexity of the illness and the need to be linked with specialist haematology departments. However, there is evidence to suggest that the needs of sickle cell patients are not being adequately addressed by this narrow focus. Moreover, there is a general feeling amongst clinicians in London that this group of patients has become dependent upon hospital-based services. If such dependency exists then it occurs primarily because there are limited services available to patients in the community.This paper discusses the current management issues and resultant problems which arise from inadequate and poorly functioning community care pathways. It is suggested that immeasurable benefits can accrue for individual sufferers and families if services are...
International Journal of Nursing Studies, 2005
This study sought to explore the impact of psychological variables anxiety and depression on pain... more This study sought to explore the impact of psychological variables anxiety and depression on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4-6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and a third of the sample experienced levels of anxiety in psychiatric proportions whilst under a third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care.
Social science & medicine (1982), 1991
Investigations of ethnic differences in pain experience have been largely confined to the hospita... more Investigations of ethnic differences in pain experience have been largely confined to the hospital or laboratory. Such studies are limited by the potentially confounding effects of the expectation of pain in the former and of little or no pain in the latter. The present investigation overcomes some of these methodological problems by studying ethnic differences in pain experience following ear-piercing. Afro-West Indian, Anglo-Saxon and Asian subjects (n = 84) completed a pain questionnaire and two rating scales after ear-piercing. Half the subjects were told the study was about pain and half that it was concerned with sensation. There were highly significant ethnic differences in pain ratings. The pain condition produced higher ratings than the sensation condition but there were no significant sex differences. The results are discussed in the context of subjects' ratings of their parents' attitudes to minor injury and their own ability to cope with pain. It is argued that i...
Psychological Medicine, 1995
Journal of Advanced Nursing, 1994
The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need ... more The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need to have an understanding of the social and cultural determinants of health and illness. There is as yet little evidence of what might constitute good practice in this area and it is difficult to ascertain why this basic philosophy is not translated into action. Indeed, the nursing and midwifery professions' ability to deliver adequate and appropriate health care more generally to Britain's multiracial, multicultural population has been questioned. This literature review presents evidence which strongly suggests that although we are living in a multicultural society patients from minority ethnic groups are additionally disadvantaged because the initiatives by nurses, and others working in the National Health Service, to meet their health care needs are inadequate and often inappropriate.
Journal of Advanced Nursing, 1994
Journal of Advanced Nursing, 2000
The haemoglobin disorders are among the most common genetically inherited conditions within the U... more The haemoglobin disorders are among the most common genetically inherited conditions within the United Kingdom. Individuals who are fully affected have severely impaired health while carriers may be faced with difficult reproductive decisions although generally they are well. Policy makers agree that counselling for families at risk should be undertaken in primary care settings and since the early 1980s this service has been undertaken mainly by specialist haemoglobinopathy nurse counsellors. Despite a number of government reports and recommendations for best practice, problems with service provision continue to be highlighted. However, there is little documented information about the work undertaken by the counsellors or how they perceive their role. A descriptive study was therefore conducted to fill this gap. It took the form of a questionnaire survey undertaken with 26 counsellors. The results were analysed by content and used to develop an interview schedule which was employed to obtain more detailed information from staff in four centres. The counsellors suggested that most of their time was spent in client-centred activities and most clients were first seen antenatally. However, there were significant barriers which prevented optimal service provision. These included: problems of communication with other health professionals, obtaining laboratory results crucial to the early identification of couples at risk, late referral from general practitioners and poor facilities for administration, especially maintaining computer databases essential for record keeping. Developing and obtaining written information suitable for families was particularly time-consuming.
Journal of Advanced Nursing, 2006
Communication skills and cultural awareness courses for healthcare professionals who care for pat... more Communication skills and cultural awareness courses for healthcare professionals who care for patients with sickle cell disease Aims. This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease. Background. Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice. Methods. Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3-and 6-month postintervention. Findings. A repeated measures ANOVA ANOVA revealed a statistically significant increase in confidence from pre-to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse. Conclusion. The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.
Journal of Advanced Nursing, 1994
This quasi-experimental study compared the degree of satisfaction with nursing care among patient... more This quasi-experimental study compared the degree of satisfaction with nursing care among patients receiving post-operative pain relief via patient-controlled analgesia (PCA) and those receiving traditional intramuscular injection (IMI) regimes. This study, which involved a total of 79 adult patients (mainly female) undergoing major abdominal surgery, was comprised of two main parts. First, the amount of time taken by nurses to carry out pain control procedures on 11 matched pairs of PCA and traditional patients was recorded. Second, all patients were asked to fill in a questionnaire regarding their satisfaction with the quality of nursing care they had received on their third post-operative day. The findings indicated that PCA did save time and this time saving could improve the nursing care quality of the whole ward, though not necessarily resulting in higher satisfaction amongst those patients who used PCA. Interestingly, younger and the more highly educated patients were found to be especially critical and be less satisfied with care. The implications for nursing practice and management are addressed, with special emphasis placed on the notion that time saved with PCA should be used to increase patient-nurse contact and should not be used to compensate for a reduction in nursing staff.
Expert Review of Pharmacoeconomics & Outcomes Research, 2009
Sickle cell disease (SCD) is the most common inherited disease worldwide and is responsible for a... more Sickle cell disease (SCD) is the most common inherited disease worldwide and is responsible for a massive health burden. Its main clinical feature is severe pain that is unpredictable and recurrent, and this, in addition to the other acute and chronic features of SCD, may have a huge impact on the quality of life of both the patient and their families and carers. We consider medical and psychological methods of pain management in SCD, drawing on recently published UK Standards of Care, and also consider the effect of SCD on quality of life.
Journal of Advanced Nursing, 1998
The role of cognitive-behavioural therapy in the management of pain in patients with sickle cell ... more The role of cognitive-behavioural therapy in the management of pain in patients with sickle cell disease Painful crisis is the most common manifestation of sickle cell disease and accounts for the second greatest number of admissions with an average length of stay of 7 days in central London. Despite this frequency of admissions, the management of pain is fraught with problems. This is not surprising since the psychological challenges presented by sickle cell disease are manifold, resulting in significant psychological distress for some individuals. This paper considers the literature on the psychosocial impact of sickle cell disease, and the American research evidence which suggests that pain management strategies that incorporate a psychological intervention can significantly reduce psychological distress as well as hospital admissions. Britain has been slow to incorporate psychology in the pain management strategies, and we have embarked on research to fill this gap. Although this research constitutes work in progress, an argument is put forward for utilizing the cognitive-behavioural perspective in the management of pain in sickle cell disease and we conclude by giving a brief summary of pilot work which is both the foundation and justification for the current ongoing research.
Journal of Advanced Nursing, 1993
Simple way to get the amazing book from experienced author? Why not? The way is very simple if yo... more Simple way to get the amazing book from experienced author? Why not? The way is very simple if you get the book right here. You need only the book soft files right here. It is based on the links that are published in this website. By visiting the link, you can gain the book directly. And here, you will find out many kinds of the books written by the professional writers from all world places.
Ethnicity & Health, 2001
The aim of the present study was to investigate the economic validity of using a psychological in... more The aim of the present study was to investigate the economic validity of using a psychological intervention in the management of sickle cell disease (SCD). Thomas et al. (Br J Health Psychol 1999; 4: 209-29) concluded that cognitive-behaviour therapy (CBT) appears to be immediately effective for the management of SCD pain in terms of reducing psychological distress pain as well as improving coping. The costs of management of SCD were evaluated using a societal viewpoint. This approach includes health and social services as well as costs privately borne by informal carers, but it did not include the economic loss due to patients' foregone earnings. Cost profiles were constructed for each patient taking account of cost generating events 12 months before and 12 months after CBT. The hypothesis of the present study, stating that CBT is economically efficient, was confirmed. However, analysis of longitudinal data suggests that CBT is most cost-effective during the first 6 months after the intervention. The present findings suggest the need for CBT to be integrated into the normal package of care available for all patients with SCD. The clinical implication is that CBT should be routinely offered to patients on a 6-monthly basis.
British Journal of Anaesthesia, 1995
We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping styl... more We have evaluated the level of state and trait anxiety, neuroticism, extroversion and coping style as predictors of the effectiveness of patientcontrolled analgesia (PCA) in 110 patients undergoing total abdominal hysterectomy. After operation patients were allocated to receive pain control with either PCA or im injections (IMI). Pain was assessed using the short form McGill pain questionnaire at 6, 18 and 24 h after operation, and by recording the amount of analgesic consumed in the first 24 h after surgery. Both state anxiety and coping style were significant predictors of postoperative pain, irrespective of the method of analgesia used. Patients using PCA experienced significantly better pain control than those receiving IMI. However, it was those with high levels of state anxiety who experienced the greatest reduction in pain with PCA. In addition to achieving better pain control, patients who received PCA used significantly less analgesia and were discharged earlier than patients who received IMI.
ISRN nephrology, 2013
Background. A needs assessment was conducted on renal patients registered to a leading hospital t... more Background. A needs assessment was conducted on renal patients registered to a leading hospital trust in London in order to explore their psychological, social, and spiritual needs. The aim of the needs assessment was to create an evidence base for the development of a comprehensive health psychology service to run concurrently with a renal counselling support service within the department. Methodology. This study utilised a series of semistructured face-to-face interviews and focus groups with renal patients and their carers, to explore how ESRD impacted quality of life. Results. A thematic analysis was undertaken. Seven emergent themes were identified that influenced the quality of life of people with EDRD: physiological impact, impact of treatment, impact on daily life, psychological impact, impact on relationships, social impact and coping responses. Conclusion. The needs assessment clearly identified that ESRD carries with it emotional, physical, psychological, social, and exis...
Blood
Introduction Women with Sickle Cell Disease (SCD) have been reported to have delayed menarche, in... more Introduction Women with Sickle Cell Disease (SCD) have been reported to have delayed menarche, increased rates of miscarriage & still birth. There is little evidence of the impact of SCD severity on fertility, or of patients’ attitudes towards their fertility. Methods Following IRB approval, an anonymised questionnaire was distributed to female patients over the age of 16 attending an SCD clinic. This included questions on menarche, fertility, reproductive history & clinical severity. We also surveyed attitudes to fertility & the role of fertility treatment. Results 101 women gave informed consent & returned the survey of whom 68 (67%) had sickle cell anaemia (HbSS), 31 (31%) had HbSC & 2 (2%) HbSß0 thalassaemia (HbSß0thal), the group mean age was 38yrs (range 17-74). 46 patients had severe disease phenotype (criteria for severity: ≥3 hospital admissions per year / ≥2 episodes of acute chest crisis/ ≥6 crisis at home per year or on Hydroxycarbamide (HU) therapy), 78% (36/46) had HbS...
Http Www Libreriasaulamedica Com, 1997
International Journal of Palliative Nursing, 2000
It is well established that the treatment of pain is improved by the incorporation of psychologic... more It is well established that the treatment of pain is improved by the incorporation of psychological, social and behavioural components in that treatment (Rosenthiel and Keefe), 1983). However, until very recently, the management of sickle cell disease (SCD) in British hospitals has focused exclusively on the physical dimension of pain (Thomas et al, 1998). Although pain is wrong (vaso-occlusive crisis), every individual reacts in a different way. This reaction is influenced in part by immediate role models, usually within the family, and by a person's cognition (thought patterns, beliefs and expectations) in relation to the pain. This paper presents research that has shown that cognitive behavioural therapy (CBT) in SCD is an effective aid in the treatment of chronic pain, reducing psychological distress and boosting confidence.
British Journal of Community Health Nursing, 1996
The sickle cell population is rapidly increasing, yet the interface between hospital and communit... more The sickle cell population is rapidly increasing, yet the interface between hospital and community care remains fragmented and uncoordinated. Historically the care for patients with sickle cell disease has been predominantly hospital-based, because of the perceived complexity of the illness and the need to be linked with specialist haematology departments. However, there is evidence to suggest that the needs of sickle cell patients are not being adequately addressed by this narrow focus. Moreover, there is a general feeling amongst clinicians in London that this group of patients has become dependent upon hospital-based services. If such dependency exists then it occurs primarily because there are limited services available to patients in the community.This paper discusses the current management issues and resultant problems which arise from inadequate and poorly functioning community care pathways. It is suggested that immeasurable benefits can accrue for individual sufferers and families if services are...
International Journal of Nursing Studies, 2005
This study sought to explore the impact of psychological variables anxiety and depression on pain... more This study sought to explore the impact of psychological variables anxiety and depression on pain experience over time following surgery. Eighty-five women having major gynaecological surgery were assessed for anxiety, depression and pain after surgery. To gain further understanding, 37 patients participated in a semi-structured taped telephone interview 4-6 weeks post-operatively. Pre-operative anxiety was found to be predictive of post-operative anxiety on Day 2, with patients who experienced high levels of anxiety before surgery continuing to feel anxious afterwards. By Day 4 both anxiety and depression scores increased as pain increased and a third of the sample experienced levels of anxiety in psychiatric proportions whilst under a third experienced similar levels of depression. These findings have significant implications for the provision of acute pain management after surgery. Future research and those managing acute pain services need to consider the multidimensional effect of acute pain and the interface between primary and secondary care.
Social science & medicine (1982), 1991
Investigations of ethnic differences in pain experience have been largely confined to the hospita... more Investigations of ethnic differences in pain experience have been largely confined to the hospital or laboratory. Such studies are limited by the potentially confounding effects of the expectation of pain in the former and of little or no pain in the latter. The present investigation overcomes some of these methodological problems by studying ethnic differences in pain experience following ear-piercing. Afro-West Indian, Anglo-Saxon and Asian subjects (n = 84) completed a pain questionnaire and two rating scales after ear-piercing. Half the subjects were told the study was about pain and half that it was concerned with sensation. There were highly significant ethnic differences in pain ratings. The pain condition produced higher ratings than the sensation condition but there were no significant sex differences. The results are discussed in the context of subjects' ratings of their parents' attitudes to minor injury and their own ability to cope with pain. It is argued that i...
Psychological Medicine, 1995
Journal of Advanced Nursing, 1994
The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need ... more The UKCC Code of Professional Conduct for nurses, midwives and health visitors stresses the need to have an understanding of the social and cultural determinants of health and illness. There is as yet little evidence of what might constitute good practice in this area and it is difficult to ascertain why this basic philosophy is not translated into action. Indeed, the nursing and midwifery professions' ability to deliver adequate and appropriate health care more generally to Britain's multiracial, multicultural population has been questioned. This literature review presents evidence which strongly suggests that although we are living in a multicultural society patients from minority ethnic groups are additionally disadvantaged because the initiatives by nurses, and others working in the National Health Service, to meet their health care needs are inadequate and often inappropriate.
Journal of Advanced Nursing, 1994
Journal of Advanced Nursing, 2000
The haemoglobin disorders are among the most common genetically inherited conditions within the U... more The haemoglobin disorders are among the most common genetically inherited conditions within the United Kingdom. Individuals who are fully affected have severely impaired health while carriers may be faced with difficult reproductive decisions although generally they are well. Policy makers agree that counselling for families at risk should be undertaken in primary care settings and since the early 1980s this service has been undertaken mainly by specialist haemoglobinopathy nurse counsellors. Despite a number of government reports and recommendations for best practice, problems with service provision continue to be highlighted. However, there is little documented information about the work undertaken by the counsellors or how they perceive their role. A descriptive study was therefore conducted to fill this gap. It took the form of a questionnaire survey undertaken with 26 counsellors. The results were analysed by content and used to develop an interview schedule which was employed to obtain more detailed information from staff in four centres. The counsellors suggested that most of their time was spent in client-centred activities and most clients were first seen antenatally. However, there were significant barriers which prevented optimal service provision. These included: problems of communication with other health professionals, obtaining laboratory results crucial to the early identification of couples at risk, late referral from general practitioners and poor facilities for administration, especially maintaining computer databases essential for record keeping. Developing and obtaining written information suitable for families was particularly time-consuming.
Journal of Advanced Nursing, 2006
Communication skills and cultural awareness courses for healthcare professionals who care for pat... more Communication skills and cultural awareness courses for healthcare professionals who care for patients with sickle cell disease Aims. This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease. Background. Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice. Methods. Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3-and 6-month postintervention. Findings. A repeated measures ANOVA ANOVA revealed a statistically significant increase in confidence from pre-to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse. Conclusion. The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.
Journal of Advanced Nursing, 1994
This quasi-experimental study compared the degree of satisfaction with nursing care among patient... more This quasi-experimental study compared the degree of satisfaction with nursing care among patients receiving post-operative pain relief via patient-controlled analgesia (PCA) and those receiving traditional intramuscular injection (IMI) regimes. This study, which involved a total of 79 adult patients (mainly female) undergoing major abdominal surgery, was comprised of two main parts. First, the amount of time taken by nurses to carry out pain control procedures on 11 matched pairs of PCA and traditional patients was recorded. Second, all patients were asked to fill in a questionnaire regarding their satisfaction with the quality of nursing care they had received on their third post-operative day. The findings indicated that PCA did save time and this time saving could improve the nursing care quality of the whole ward, though not necessarily resulting in higher satisfaction amongst those patients who used PCA. Interestingly, younger and the more highly educated patients were found to be especially critical and be less satisfied with care. The implications for nursing practice and management are addressed, with special emphasis placed on the notion that time saved with PCA should be used to increase patient-nurse contact and should not be used to compensate for a reduction in nursing staff.
Expert Review of Pharmacoeconomics & Outcomes Research, 2009
Sickle cell disease (SCD) is the most common inherited disease worldwide and is responsible for a... more Sickle cell disease (SCD) is the most common inherited disease worldwide and is responsible for a massive health burden. Its main clinical feature is severe pain that is unpredictable and recurrent, and this, in addition to the other acute and chronic features of SCD, may have a huge impact on the quality of life of both the patient and their families and carers. We consider medical and psychological methods of pain management in SCD, drawing on recently published UK Standards of Care, and also consider the effect of SCD on quality of life.