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  • 1
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2023
    In:  Journal of Crohn's and Colitis Vol. 17, No. Supplement_1 ( 2023-01-30), p. i1053-i1054
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 17, No. Supplement_1 ( 2023-01-30), p. i1053-i1054
    Abstract: Due to the chronic, relapsing and remitting disease course associated with Inflammatory Bowel Disease (IBD), self-management tools inclusive of conceptualising the problem, acknowledging the need for external help and knowing where to seek help from are essential for the management of IBD. Those living with IBD are challenged by physical symptoms and psychological and social issues that they are unable to self-solve. Help-seeking behaviour (HSB) is a relatively new concept to health services research (Cornally & McCarthy, 2011) and has been infrequently applied to the area of IBD. When IBD-related challenges are beyond self-resolution, patients require help and support from healthcare professionals (HCPs). This engagement must be facilitated at the point of issue recognition, as opposed to at crisis point. Given the dearth of research in this area, this study explored the help-seeking experiences of patients living with IBD for the challenges associated with IBD from HCPs, to enable us through understanding their experiences, how best to support help-seeking pathways and/or early interventions to assist those living with IBD to resolve issues that challenge their day-to-day lives. Methods A qualitative descriptive design (Sandelowski 2000; Neegaard et al., 2009; Sandelowski 2010) was employed as little is known regarding the help-seeking experiences of those living with IBD, their sources of help and preferred methods of seeking help. Participants were recruited purposefully from two public university hospitals in the Republic of Ireland that provide dedicated in- and out-patient care to those living with IBD. Data were collected via semi-structured one-to-one phone interviews (n=8). Results An overarching theme of ‘coming to terms with managing my IBD’ and four themes of ‘help-seeking trigger’, ‘help-seeking hesitancy’, ‘help-seeking decision pathway’ and ‘need for support’ emerged from the data by way of latent pattern content analysis. Conclusion Typically, help is sought for IBD related challenges by contacting their designated IBD nurse directly via text, the preferred method, or via phone. The majority of participants spoke of negative experiences of seeking help prior to the introduction of an IBD nurse. These may be categorised either by lack of service provision or by symptoms being dismissed or not understood by HCPs who lack expertise in the area of IBD. Triggers for seeking help are in line with the challenges identified in our earlier meta-synthesis of patients’ experiences of IBD (Byron et al. 2020) and tend to mainly be related to the physical symptoms associated with IBD as well as the medical treatments being delivered. The need for both formal and informal psychological support was identified by participants.
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2389631-0
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  • 2
    In: European Geriatric Medicine, Elsevier BV, Vol. 6, No. 5 ( 2015-10), p. 505-511
    Type of Medium: Online Resource
    ISSN: 1878-7649
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 2556794-9
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  • 3
    In: Journal of Frailty & Aging, SERDI, ( 2016), p. 1-7
    Abstract: Background: Although caregivers are important in the management of frail, community-dwelling older adults, the influence of different caregiver network types on the risk of adverse healthcare outcomes is unknown. Objective: To examine the association between caregiver type and the caregiver network subtest of The Risk Instrument for Screening in the Community (RISC), a five point Likert scale scored from one (“can manage”) to five (“absent/liability”). To measure the association between caregiver network scores and the one-year incidence of institutionalisation, hospitalisation and death. Design: Observational cohort study. Setting and Participants: Community-dwelling adults, aged 〉 65,attending health centres in Ireland,(n=779). Procedure and Measurements: The caregiver network subtest of the RISC was scored by public health nurses. Caregivers were grouped dichotomously into low-risk (score of one) or high-risk (scores two-five). Results: The majority of patients had a primary caregiver (582/779;75%), most often their child (200/582;34%). Caregiver network scores were highest, indicating greatest risk, when patients had no recognised primary caregiver and lowest when only a spouse or child was available. Despite this, patients with a caregiver were significantly more likely to be institutionalised than those where none was required or identified (11.5% versus 6.5%,p=0.047). The highest one-year incidence of adverse outcomes occurred when state provided care was the sole support; the lowest when private care was the sole support. Significantly more patients whose caregiver networks were scored high-risk required institutionalisation than low-risk networks; this association was strongest for perceived difficulty managing medical domain issues, odds ratio (OR) 3.87:(2.22-6.76). Only perceived difficulty managing ADL was significantly associated with death, OR 1.72:(1.06-2.79). There was no association between caregiver network scores and risk of hospitalisation. Conclusion: This study operationalizes a simple method to evaluate caregiver networks. Networks consisting of close family (spouse/children) and those reflecting greater socioeconomic privilege (private supports) were associated with lower incidence of adverse outcomes. Caregiver network scores better predicted institutionalisation than hospitalisation or death.
    Type of Medium: Online Resource
    ISSN: 2273-4309
    Language: Unknown
    Publisher: SERDI
    Publication Date: 2016
    detail.hit.zdb_id: 2856228-8
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  • 4
    In: Journal of Frailty & Aging, SERDI, ( 2015), p. 1-6
    Abstract: Background: Functional decline and frailty are common in community-dwelling older adults, leading to an increased risk of adverse outcomes. Objective: To examine the factors that public health nurses perceive to cause risk of three adverse outcomes: institutionalisation, hospitalisation, and death, in older adults, using the Risk Instrument for Screening in the Community (RISC). Design: A quantitative, correlational, descriptive design was used. Setting and Participants: A sample of 803 community-dwellers, aged over 65 years receiving regular follow-up by public health nurses. Procedure and Measurements: Public health nurses (n=15) scored the RISC and the Clinical Frailty Scale (CFS) on patients in their caseload. We examined and compared correlations between the severity of concern and ability of the caregiver network to manage these concerns with public health nurses’ perception of risk of the three defined adverse outcomes. Results: In total, 782 RISC scores were available. Concern was higher for the medical state domain (686/782,88%) compared with the mental state (306/782,39%) and activities of daily living (595/782,76%) domains. Concern was rated as severe for only a small percentage of patients. Perceived risk of institutionalisation had the strongest correlation with concern over patients mental state,(r=0.53), while risk of hospitalisation,(r=0.53) and death,(r=0.40) correlated most strongly with concern over the medical state. Weaker correlations were found for the other domains and RISC scores. The CFS most strongly correlated with the ADL domain,(r=0.78). Conclusion: Although the prevalence of concern was high, it was mostly rated as mild. Perceived risk of institutionalisation correlated most with concern over the ability of caregiver networks to manage patients’ mental state, while risk of hospitalisation and death correlated with patients’ medical state. The findings suggest the importance of including an assessment of the caregiver network when examining community-dwelling older adults. Validation of the RISC and public health nurses’ ratings are now required.
    Type of Medium: Online Resource
    ISSN: 2273-4309
    Language: Unknown
    Publisher: SERDI
    Publication Date: 2015
    detail.hit.zdb_id: 2856228-8
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  • 5
    In: BMJ Supportive & Palliative Care, BMJ, Vol. 5, No. Suppl 2 ( 2015-09), p. A9.1-A9
    Type of Medium: Online Resource
    ISSN: 2045-435X , 2045-4368
    Language: English
    Publisher: BMJ
    Publication Date: 2015
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  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2019
    In:  Journal of Crohn's and Colitis Vol. 13, No. Supplement_1 ( 2019-01-25), p. S561-S562
    In: Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 13, No. Supplement_1 ( 2019-01-25), p. S561-S562
    Type of Medium: Online Resource
    ISSN: 1873-9946 , 1876-4479
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2389631-0
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  • 7
    In: Journal of Frailty & Aging, SERDI, ( 2015), p. 1-10
    Abstract: Background: Frailty is increasingly common in community dwelling older adults and increases their risk of adverse outcomes. Risk assessment is implicit in the Aged Care Assessment Teams process, but few studies have considered the factors that influence the assessor’s decision making or explored the factors that may contribute to their interpretation of risk. Objective: to examine the inter-rater reliability of the Community Assessment of Risk Instrument (CARI), which is a new risk assessment instrument. Design: A cohort study was used. Setting and participants: A sample of 50 community dwelling older adults underwent comprehensive geriatric assessment by two raters: a geriatrician and a registered nurse. Procedure and measurements: Each participant was scored for risk by the two raters using the CARI. This instrument ranks risk of three adverse outcomes, namely i) institutionalisation, ii) hospitalisation and iii) death within the next year from a score of 1, which is minimal risk to 5, which is extreme risk. Inter-rater reliability was assessed with Gamma, Spearman correlation and Kappa statistics. Internal consistency was assessed with Cronbach’s alpha. Results: There were 30 female (mean age 82.23 years) and 20 male (mean age 81.75 years) participants. Items within domains showed good-excellent agreement. The gamma statistic was 〉 0.77 on 6/7 Mental State items, 14/15 items in the Activities of Daily Living domain. In the Medical domain, 6/9 items had Gamma scores 〉 0.80. The global domain scores correlated well, 0.88, 0.72 and 0.87. Caregiver network scores were 0.71, 0.73 and 0.51 for the three domains. Inter-rater reliability scores for global risk scales were 0.86 (institutionalisation) and 0.78 (death). The gamma statistic for hospitalisation was 0.29, indicative of lower inter-rater reliability. Cronbach’s alpha was 0.86 and 0.83 for the Activities of Daily Living domain, 0.51 and 0.42 for the Mental state domain and 0.23 and 0.10 for the Medical state domain. Conclusions: Overall, the instrument shows good inter-rater reliability. Poor correlations on some items relate to poor communication of clinical data and variable interpretation based on professional background. Lack of internal consistency in the medical condition domain confirms the discrete nature of these variables.
    Type of Medium: Online Resource
    ISSN: 2273-4309
    Language: Unknown
    Publisher: SERDI
    Publication Date: 2015
    detail.hit.zdb_id: 2856228-8
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  • 8
    Online Resource
    Online Resource
    Wiley ; 2011
    In:  European Journal of Pain Supplements Vol. 5, No. S1 ( 2011-09), p. 153-154
    In: European Journal of Pain Supplements, Wiley, Vol. 5, No. S1 ( 2011-09), p. 153-154
    Type of Medium: Online Resource
    ISSN: 1754-3207
    Language: English
    Publisher: Wiley
    Publication Date: 2011
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  • 9
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2017
    In:  Innovation in Aging Vol. 1, No. suppl_1 ( 2017-07-01), p. 371-371
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 1, No. suppl_1 ( 2017-07-01), p. 371-371
    Type of Medium: Online Resource
    ISSN: 2399-5300
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2905697-4
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  • 10
    In: Age and Ageing, Oxford University Press (OUP), Vol. 51, No. Supplement_3 ( 2022-10-25)
    Abstract: Ethics are the set of moral principles that guide a person’s behaviour. Ethical issues are a key component of healthcare and frequently arise in the management of hospitalized older patients. To improve decision-making and reduce burden on individual hospital staff, Clinical Ethics Support Services (CESS) have been widely-integrated into care pathways internationally. However, the need for CESS has received little attention in Irish hospitals. Methods A cross-sectional analysis of the ethical situation and CESS readiness at a tertiary hospital in Ireland was collected from July-October 2021 and in February 2022 via hard copies and online collection (SurveyMonkey). Both clinical (medicine, nursing other patient care role) and non-clinical (administrative, clerical, ICT, HR, general support staff and management) staff participated. Descriptive statistics were assessed taking the valid percentages, mean 5-item Likert scores and Friedman Test mean rank for ten ranked statements. Results In total, 199 people (13% response rate) completed the survey. Staff were largely (76%) clinical and the majority were qualified & gt;10 years (57%). In all, 78% reported that ethical issues arise in the role (83% clinical staff, 59% non-clinical staff). Most (63%) were unsure who to contact about ethical concerns, instead seeking informal advice from colleagues ( & gt;90%). The majority of participants were interested in additional ethical training, especially on decision-making capacity (mean interest 4.18 out of 5), strategies for working with challenging patient/family situations (4.07 out of 5) and end-of-life care (4.06 out of 5). Out of ten options assessed, participants preferenced the development of a formal clinical ethics committee over education and training or the provision of educational materials. Conclusion Ethical issues commonly arise when caring for older hospitalized patients. This study found a perceived need and widespread interest in additional education as well as formal approaches to develop a hospital-based CESS, centred around a formal committee structure.
    Type of Medium: Online Resource
    ISSN: 0002-0729 , 1468-2834
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2065766-3
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