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Biomedical subjects

G P Mulley

Publications and source records attributed to G P Mulley.

At least 19 recordsLinked to original sources
PubMed1998

Is the Barthel Scale appropriate in non-industrialized countries? A view of rural Pakistan.

PURPOSE: To determine if the Barthel Index, a conventional scale for assessing disability, is appropriate for stroke patients in rural Pakistan, rather than an observational study by visiting stroke patients in their homes. METHOD: Stroke patients attending hospital out patient clinics in Islamabad, together with others identified in local villages, were assessed to test the validity of the Barthel Activities of Daily Living Scale. RESULT: For each item on the disability scale, differences in local customs, lifestyle and architecture meant that the Barthel Scale was not appropriate in rural Pakistan. CONCLUSIONS: There is unlikely to be a disability scale which can be applicable universally. Care must be taken when standard scales are used for international comparisons of stroke disability.

Activities of Daily Living↗
PubMed1997

Myths of ageing.

Explore the source record for details and available documents.

Aged↗
PubMed1997

Injuries sustained by caregivers of disabled elderly people.

OBJECTIVE: to investigate the occurrence of physical injury experienced by informal caregivers whilst moving and lifting their disabled elderly dependents at home. DESIGN: a descriptive study using in-depth interviews. SETTING: departments of elderly medicine at two teaching hospitals and one district general hospital. SUBJECTS: 46 informal caregivers of elderly patients admitted under a regular hospital respite care scheme, 41 of whom were interviewed. RESULTS: most caregivers were elderly (median age 70 years), 21 having a medical condition which restricted their physical activity. Thirty one caregivers had injured themselves whilst lifting and handling their dependents. Most sustained back injuries. Eight caregivers were temporarily unable to continue caring as a result of the injuries they sustained. Sixteen patients had been injured whilst being moved by their caregivers. Only 19 caregivers had received instruction in manual handling. CONCLUSION: informal caregivers are often poorly trained and equipped and at risk of injury. To enable them to continue providing optimal care at home, their physical health should be assessed and they should be trained in safe lifting and handling techniques.

Adult↗
PubMed1997

Do it yourself: home-made aids for disabled elderly people.

We contacted the caregivers of patients admitted on a hospital respite care scheme and asked them about home-made or modified aids and appliances. Seven home-made devices were discovered and inspected. They were an electric hoist, a builder's plastic skip used as a bath, a wheelchair support and tray made out of chipboard, stair rails made from old steel pipe, an improvised commode and a modified standard commode enabling the user to be cleaned in the sitting position. Several gadgets were innovative; others were dangerous. Two caregivers had injured themselves using the improvised aids. Others were at risk of injury. With an increasing tendency for Community Agencies to charge for equipment, more caregivers may design and build their own aids-some of which may be hazardous. Health professionals who visit elderly people at home should look for home-made gadgets with a view to promoting safety and discovering innovations which may help others.

Activities of Daily Living↗
PubMed1997

An uplifting experience? Hospital passenger lifts and their suitability for disabled people.

Hospitals should be welcoming places, and disabled people should not expect difficulties when using a hospital's facilities. For some elderly and disabled people the passenger lift may be the only means of vertical movement within a building. We visited four hospitals and inspected their passenger lifts for use by disabled and elderly people. We compared our findings with those of an "ideal lift' drawn from recommendations by disabled support groups, National Health Services Estates Department and building regulations. We found that most hospital passenger lifts are inadequate for those with mobility, visual and hearing impairments. Consequently, disabled and elderly people might have problems using hospital passenger lifts, with a subsequent loss of independence. The provision of well-designed and accessible passenger lifts is central to imaginative hospital building design.

Persons with Disabilities↗
PubMed1996

Caring for Older People. Public transport.

Most older people are mobile and able to use public transport without any problems. Those who are hard of hearing or have poor vision and those with mobility problems need not be deterred from using public transport. Though the design and provision of suitable buses, taxis, and trains is not always optimum, many now have imaginative features to help older passengers. Travel by air and sea needs extra planning for disabled elderly people, but helpful advice is available and much can be done to enable even the most disabled traveller to make long journeys confidently and in comfort.

Aged↗
PubMed1994

The cold hemiplegic arm.

BACKGROUND AND PURPOSE: Vasomotor changes occur in the arm after hemiplegic stroke. Previous studies have provided conflicting results, with most showing an increase in skin temperature of the hemiplegic arm. However, a number of patients complain of distressing coldness of the hemiplegic arm. METHODS: Eleven patients with symptomatic coldness and 10 patients with hemiplegia but no coldness were recruited. The severity of the symptom of coldness was compared by questionnaire with other common symptoms after stroke. A thermographic camera was used to record the finger skin temperature response to cold stress. Blood flow to both hands was also measured simultaneously by means of two plethysmographs. In all patients there were no symptoms in the unaffected arm, and this was used as a control. RESULTS: The symptom of coldness rated highly compared with other symptoms. In the symptomatic group the finger temperature on the hemiplegic side was lower at rest (median difference at rest, 0.65 degrees C; P < .0001) and at all times after cold stress. In the asymptomatic group the fingers on the hemiplegic side were colder at rest and after initial cooling (median temperature difference, 0.2 degrees C) but at no other time. Hand blood flow on the hemiplegic side was also decreased in the symptomatic group by 35%. This was not seen in the asymptomatic group. CONCLUSIONS: Coldness of the hand may be a severe and distressing symptom in some patients after hemiplegia. Symptomatic patients have lower finger skin temperatures at rest and after standard cold stress. These symptomatic patients also had reduced blood flow to the hemiplegic hand.

Aged↗
PubMed1993

Commodes: inconvenient conveniences.

OBJECTIVES: To investigate use of commodes and attitudes of users and carers to them. DESIGN: Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS: 140 users of a commode and 105 of their carers. RESULTS: Main reasons for being supplied with a commode were impaired mobility (130 subjects), difficulty in climbing stairs (128), and urinary incontinence (127). Main concerns of users and carers were lack of privacy (120 subjects felt embarrassed about using their commode, and 96 would not use it if someone was present); unpleasant smells (especially for 20 subjects who were confined to one room); physical appearance of commode chair (101 users said it had an unfavourable appearance, and 44 had tried to disguise it); and lack of follow up after commode was supplied (only 15 users and carers knew who to contact if there were problems). Users generally either had very positive or very negative attitudes to their commodes but most carers viewed them very negatively, especially with regard to cleaning them. CONCLUSIONS: Health professionals should be aware of people's need for privacy when advising them where to keep their commode. A standard commode is inappropriate for people confined to one room, and alternatives such as a chemical toilet should be considered. Regular follow up is needed to identify any problems such as uncomfortable or unsafe chairs. More thought should be given to the appearance of commodes in their design.

Aged↗
PubMed1993

Questions people ask about stroke.

BACKGROUND AND PURPOSE: We sought to identify the type and frequency of questions asked about stroke by patients, relatives, and caregivers. METHODS: All stroke-related inquiries made to Stroke Association Advice Centers in the United Kingdom during a 4-month period were recorded. RESULTS: During the study period, 1,397 people asked 1,908 questions. Nearly one quarter needed more information about the nature of stroke. The other most common inquiries concerned help at home (with many expressing concern about their current level of community support), requests for information about stroke clubs, speech difficulties, rehabilitation, personality changes, and depression. CONCLUSIONS: Knowledge of the questions asked should enable health professionals to provide better information to stroke victims and allow modification of stroke information pamphlets.

Age Factors↗
PubMed1992

A survey of hospital toilet facilities.

OBJECTIVE: To assess the quality of toilet facilities available for disabled people in a large provincial teaching hospital. DESIGN: Survey of toilet facilities for patients on the wards and in the outpatient department. SETTING: Teaching hospital in Leeds. RESULTS: Although the quality of toilet facilities varied, none met the standards recommended by the British Standards Institution. The worst facilities were found on a ward accommodating elderly patients, where the toilets were unsuitable for use by disabled people and bedside commodes had to be used instead. CONCLUSION: Toilet provision within a major hospital failed to meet standards required for disabled people. Admission to hospital may therefore result in loss of independence and dignity. If hospitals are to be centres of excellence, greater consideration must be given to the requirements of disabled people in the design of new wards, and current inadequate facilities should be upgraded.

Architectural Accessibility↗
PubMed1992

Practical problems with eye-drops among elderly ophthalmology outpatients.

Many elderly patients have eye-drops prescribed. We have examined the abilities in eye drop application of 43 consecutive outpatients aged 75 years or more who completed a questionnaire and demonstrated their technique in eye-drop application. Less than one-third of patients applied drops themselves, the rest relying on others; one-third of this group lived alone. The majority of patients experienced some difficulty with the application of their drops and it was estimated that half of those who usually applied their own treatment were unlikely to succeed in instilling a drop into the conjunctival sac. Few patients had been prescribed aids or appliances to improve their eye-drop application technique.

Aged↗