Background Approximately, half of stroke survivors experience fatigue. Fatigue may persist for ma... more Background Approximately, half of stroke survivors experience fatigue. Fatigue may persist for many months and interferes with participation in everyday activities and has a negative impact on social and family relationships, return to work, and quality of life. Fatigue is among the top 10 priorities for ‘Life after Stroke’ research for stroke survivors, carers, and clinicians. We previously developed and tested in a small uncontrolled pilot study a manualised, clinical psychologist-delivered, face-to-face intervention, informed by cognitive behavioural therapy (CBT). We then adapted it for delivery by trained therapists via telephone. We now aim to test the feasibility of this approach in a parallel group, randomised controlled feasibility trial (Post Stroke Intervention Trial In Fatigue, POSITIF). Methods/design POSITIF aims to recruit 75 stroke survivors between 3 months and 2 years post-stroke who would like treatment for their fatigue. Eligible consenting stroke survivors will ...
Background In the UK managers from multiple organisations are commonly tasked with collectively d... more Background In the UK managers from multiple organisations are commonly tasked with collectively devising and implementing local health and wellbeing policies as a way of addressing increasing demand for healthcare. This requires them to create knowledge together but relatively little is known about how this occurs. This paper reports the results of research into how managers collectively create knowledge in order to address local health and wellbeing challenges. Methods We undertook a case study in three sites in England. Using statistical network modelling we identified clusters of actors and interviewed managers from heterogeneous clusters about their collective activities. We used interview and documentary data to construct accounts of collective knowledge creation. Findings Managers simultaneously work across stable bureaucratic networks and temporary taskforces in order to create and implement local health and wellbeing policy. They collectively create knowledge by enacting net...
PURPOSE: We aimed to estimate the prevalence and types of anxiety disorders diagnosed according t... more PURPOSE: We aimed to estimate the prevalence and types of anxiety disorders diagnosed according to standardized criteria in cancer patients, to compare screening tools in detecting them, and to examine their demographic, oncologic, and psychosocial associations. METHODS: In this cross-sectional observational study of 178 subjects with lymphoma, renal cell carcinoma, malignant melanoma, or plasma cell dyscrasia, we related responses to questionnaires (administered by computer touch-screen) measuring psychological symptoms, quality of life (QOL), and social support to standardized psychiatric interviews and cancer management. RESULTS: Forty-eight percent of subjects reported sufficient anxiety for anxiety disorder to be considered. At subsequent diagnostic interview, 18% fulfilled International Classification of Disorders, 10th Revision criteria for anxiety disorder, including 6% of patients who reported low levels of anxiety by questionnaire. When subjects reported anxiety by questio...
Introduction This paper summarises the research evidence presented in a recent issue of EVective ... more Introduction This paper summarises the research evidence presented in a recent issue of EVective Health Care on deliberate self harm. Deliberate self harm is one of the top five reasons for acute medical admissions in the UK. The term deliberate self harm includes intentional self poisoning or self injury (such as cutting), irrespective of the apparent purpose of the act. Self poisoning is the most common form of deliberate self harm. Most cases of deliberate self poisoning present to general hospitals; in the UK there are more than 150 000 such attendances annually. The most common substances ingested are analgesics, particularly paracetamol and paracetamol containing compounds. Prevalence rates for self harm have been rising continuously since the mid-1980s to an estimated 400 per 100 000 population each year. 5 This incidence is higher than most others recorded in Europe. EVective intervention after an episode of self harm is important because these individuals are at high risk o...
Serenity Integrated Monitoring (SIM) involved the police and mental health crisis services workin... more Serenity Integrated Monitoring (SIM) involved the police and mental health crisis services working in a single team, developing case management plans that allowed a seamless move from offers of therapeutic engagement (by the mental health team) to use of coercive measures (by the police) with those who persisted with frequent crisis presentations. Withdrawn after widespread criticism, the scheme raises important questions – about the practice of mental health professionals who are involved in decisions about using criminal sanctions for people presenting in crisis, about the ethical and legal status of the sharing of confidential clinical information with the police, and about the processes that professional bodies use in promoting, monitoring and responding to controversial service developments.
SummarySafety planning is recommended as a part of the response to everybody who presents after s... more SummarySafety planning is recommended as a part of the response to everybody who presents after self-harm, although there is surprisingly little evidence for its effectiveness. There is potential for such plans to be experienced as unhelpful if patients are not genuinely involved in their production and if the plan does not include information about meaningful sources of support. Staff training is needed to ensure that plans are delivered in a collaborative way and self-harm services need to be improved nationally if such plans are to be effective.
Purpose The purpose of this paper is to explore the challenges that are experienced by staff resp... more Purpose The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals. Design/methodology/approach Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98). Findings Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern. Research limitations/...
Background Approximately, half of stroke survivors experience fatigue. Fatigue may persist for ma... more Background Approximately, half of stroke survivors experience fatigue. Fatigue may persist for many months and interferes with participation in everyday activities and has a negative impact on social and family relationships, return to work, and quality of life. Fatigue is among the top 10 priorities for ‘Life after Stroke’ research for stroke survivors, carers, and clinicians. We previously developed and tested in a small uncontrolled pilot study a manualised, clinical psychologist-delivered, face-to-face intervention, informed by cognitive behavioural therapy (CBT). We then adapted it for delivery by trained therapists via telephone. We now aim to test the feasibility of this approach in a parallel group, randomised controlled feasibility trial (Post Stroke Intervention Trial In Fatigue, POSITIF). Methods/design POSITIF aims to recruit 75 stroke survivors between 3 months and 2 years post-stroke who would like treatment for their fatigue. Eligible consenting stroke survivors will ...
Background In the UK managers from multiple organisations are commonly tasked with collectively d... more Background In the UK managers from multiple organisations are commonly tasked with collectively devising and implementing local health and wellbeing policies as a way of addressing increasing demand for healthcare. This requires them to create knowledge together but relatively little is known about how this occurs. This paper reports the results of research into how managers collectively create knowledge in order to address local health and wellbeing challenges. Methods We undertook a case study in three sites in England. Using statistical network modelling we identified clusters of actors and interviewed managers from heterogeneous clusters about their collective activities. We used interview and documentary data to construct accounts of collective knowledge creation. Findings Managers simultaneously work across stable bureaucratic networks and temporary taskforces in order to create and implement local health and wellbeing policy. They collectively create knowledge by enacting net...
PURPOSE: We aimed to estimate the prevalence and types of anxiety disorders diagnosed according t... more PURPOSE: We aimed to estimate the prevalence and types of anxiety disorders diagnosed according to standardized criteria in cancer patients, to compare screening tools in detecting them, and to examine their demographic, oncologic, and psychosocial associations. METHODS: In this cross-sectional observational study of 178 subjects with lymphoma, renal cell carcinoma, malignant melanoma, or plasma cell dyscrasia, we related responses to questionnaires (administered by computer touch-screen) measuring psychological symptoms, quality of life (QOL), and social support to standardized psychiatric interviews and cancer management. RESULTS: Forty-eight percent of subjects reported sufficient anxiety for anxiety disorder to be considered. At subsequent diagnostic interview, 18% fulfilled International Classification of Disorders, 10th Revision criteria for anxiety disorder, including 6% of patients who reported low levels of anxiety by questionnaire. When subjects reported anxiety by questio...
Introduction This paper summarises the research evidence presented in a recent issue of EVective ... more Introduction This paper summarises the research evidence presented in a recent issue of EVective Health Care on deliberate self harm. Deliberate self harm is one of the top five reasons for acute medical admissions in the UK. The term deliberate self harm includes intentional self poisoning or self injury (such as cutting), irrespective of the apparent purpose of the act. Self poisoning is the most common form of deliberate self harm. Most cases of deliberate self poisoning present to general hospitals; in the UK there are more than 150 000 such attendances annually. The most common substances ingested are analgesics, particularly paracetamol and paracetamol containing compounds. Prevalence rates for self harm have been rising continuously since the mid-1980s to an estimated 400 per 100 000 population each year. 5 This incidence is higher than most others recorded in Europe. EVective intervention after an episode of self harm is important because these individuals are at high risk o...
Serenity Integrated Monitoring (SIM) involved the police and mental health crisis services workin... more Serenity Integrated Monitoring (SIM) involved the police and mental health crisis services working in a single team, developing case management plans that allowed a seamless move from offers of therapeutic engagement (by the mental health team) to use of coercive measures (by the police) with those who persisted with frequent crisis presentations. Withdrawn after widespread criticism, the scheme raises important questions – about the practice of mental health professionals who are involved in decisions about using criminal sanctions for people presenting in crisis, about the ethical and legal status of the sharing of confidential clinical information with the police, and about the processes that professional bodies use in promoting, monitoring and responding to controversial service developments.
SummarySafety planning is recommended as a part of the response to everybody who presents after s... more SummarySafety planning is recommended as a part of the response to everybody who presents after self-harm, although there is surprisingly little evidence for its effectiveness. There is potential for such plans to be experienced as unhelpful if patients are not genuinely involved in their production and if the plan does not include information about meaningful sources of support. Staff training is needed to ensure that plans are delivered in a collaborative way and self-harm services need to be improved nationally if such plans are to be effective.
Purpose The purpose of this paper is to explore the challenges that are experienced by staff resp... more Purpose The purpose of this paper is to explore the challenges that are experienced by staff responsible for commissioning liaison psychiatry services and to establish if these are shared by other health professionals. Design/methodology/approach Using a mixed-methods design, the findings from a mental health commissioner workshop (n = 12) were used to construct a survey that was distributed to health care professionals using an opportunistic framework (n = 98). Findings Four key themes emerged from the workshop, which was tested using the survey. The importance of secure funding; a better understanding of health care systems and pathways; partnership working and co-production and; access to mental health clinical information in general hospitals. There was broad convergence between commissioners, mental health clinicians and managers, except in relation to gathering and sharing of data. This suggests that poor communication between professionals is of concern. Research limitations/...
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