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Biomedical subjects

P Callaghan

Publications and source records attributed to P Callaghan.

At least 19 recordsLinked to original sources
PubMed2006

Service users and other stakeholders' evaluation of a liaison mental health service in an accident and emergency department and a general hospital setting.

Liaison mental health care has been an emerging specialism of mental health nursing in the UK since the early 1990s. Studies have so far looked only briefly at service user evaluation. A qualitative study involving 47 interviews with service user and professional stakeholders was undertaken to determine what is important to stakeholders in a liaison mental health-care service. The largest group of stakeholders interviewed were service users. Analysis of the data was undertaken using the service user interviews to guide the development of themes. The majority of the issues identified were raised by both service users and professionals. The three key themes were, the practicalities of the service including waiting time, the staffing profile and receiving the service, which included issues such as the opportunity to talk and outcomes. The findings provide new information regarding what service users and other stakeholders expect from a liaison mental health service and important areas to consider when offering a satisfactory service.

Attitude of Health Personnel↗
PubMed2004

Evaluating the introduction of a pilot client attachment scheme in mental health nursing education.

Client attachment (CA) allows student nurses to gain clinical experience through forming therapeutic attachments with individual clients, rather than through a series of location-based placements. This paper describes a pilot project that evaluated CA with pre-registration student mental health nurses. Using semi-structured interviews, the researchers identified the students', their supervisor's, and their clients' experiences of CA. Most participants agreed that students were able to learn relevant and appropriate clinical skills, and to consolidate experience-increasing motivation, autonomy, organizational skills, and confidence.

Attitude of Health Personnel↗
PubMed2004

Exercise: a neglected intervention in mental health care?

This paper reports the results of a literature review examining the effects of exercise on mental health and well-being. Throughout history many societies, ancient and modern, have used exercise as a means of preventing disease, and promoting health and well-being. There is evidence that exercise is beneficial for mental health; it reduces anxiety, depression, and negative mood, and improves self-esteem and cognitive functioning. Exercise is also associated with improvements in the quality of life of those living with schizophrenia. However, exercise is seldom recognized by mainstream mental health services as an effective intervention in the care and treatment of mental health problems. There is evidence to suggest that exercise may be a neglected intervention in mental health care.

Exercise Therapy↗
PubMed2003

A review of research on the structure, process and outcome of liaison mental health services.

Liaison mental health services (LMHS) developed originally to address the mental health needs of people with physical illnesses in general hospitals and more recently to work also with people with mental health problems presenting at non-mental health services. The purpose of the present paper was to review empirical research on the structure, process and outcome of liaison mental health services using systematic review methods. Following a comprehensive search strategy, the authors reviewed 48 papers published between 1975 and 2001. There is an extensive international literature on LMHS, much of which describes the structure and process of liaison work. Studies evaluating the outcomes of liaison mental health services are fewer, and handicapped by methodological flaws, some of which are serious enough to cast doubts on the reported results. Professionals and clients value LMHS. LMHS based in accident and emergency (A & E) departments appear to ease the burden of general A & E staff, help clients access mental health services and reduce re-admission rates of people with mental health problems. There is little evidence supporting one model of configuring LMHS over another.

Emergency Service, Hospital↗
PubMed2002

Safety and security policies on psychiatric acute admission wards: results from a London-wide survey.

Very little research evidence is available regarding current safety and security procedures on acute psychiatric wards. This includes controversial areas such as the temporary removal of personal property, the searching of patients and visitors, the use of alarms and modern technology, and locking of entrances to regulate those entering and leaving. This is also despite widening dismay over increasing violence within a variety of hospital settings, the comparatively high risk of physical assault faced by mental health professionals and an abundance of literature and training in regards to violence management and prevention. To gain an understanding of current safety and security measures, a London-wide survey of acute admission wards was undertaken revealing a wide variety of measures and policies in operation. Over 100 NHS and private wards were sent questionnaires; there was a response rate of 70%. Results show that a significant proportion of acute admission wards are now locked at all times and a small proportion of units have 24-hour security/reception staff on-site and a low level of modern technology usage such as CCTV and electronic access systems. There is wide variation in items banned, restrictions placed on inpatients, and the searching of patients and visitors. Two independently varying emphases of ward security policies were identifiable, the first aimed at preventing harm to patients using door security, banning of item and restrictions on inpatients. The other is aimed at reducing risks to staff via searching of patients, use of security guards and sophisticated alarm systems. There is some preliminary evidence that these security policies are differentially associated with levels of absconding and violent incidents. Further research to guide practice is urgently required.

Admitting Department, Hospital↗
PubMed2002

A pilot study of the effects of cognitive-behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease.

Forty-six Chinese patients with symptomatic human immunodeficiency virus (HIV) participated in a comparative study assessing the effectiveness of cognitive-behavioral group therapy (CBT) and peer support/counseling group therapy (PSC) in relation to improving mood and quality of life and decreasing uncertainty in illness as compared to a group receiving routine treatment with no formal psychosocial intervention. The CBT group consisted of 10 subjects, the PSC group of 10 subjects, and the comparison group of 26 subjects. There was a 24% attrition rate. The intervention groups received 12 weekly sessions of therapy over 3 months. Assessment of mood states was carried out before randomization (baseline data), immediately postintervention (3-month time point) and followed-up 3 months later (6-month time point). Assessment of quality of life and uncertainty in illness was carried out before randomization and at the 6-month follow-up time point. Results indicated that the mood of the participants in the CBT group improved in terms of anger, tension-anxiety, depression, confusion, and overall mood. The quality of life in this group was significantly improved compared to the other two groups, as was uncertainty in illness. In the PSC group a worsening of psychologic functioning was observed immediately postintervention, but this picture dramatically improved at the follow-up assessment with improvements of up to 34%. Quality of life also improved over time in this group by almost 5%, but results did not reach statistical significance. This study demonstrated that psychologic interventions could decrease psychologic distress and improve quality of life in symptomatic HIV patients, indicating their use should be incorporated in the management of care of people living with HIV/AIDS.

Adult↗
PubMed2001

The effect of videotaped or written information on Chinese gastroscopy patients' clinical outcomes.

The researchers compared videotaped information with specific written information on Chinese out-patients' post-gastroscopy anxiety and satisfaction levels. We randomly allocated 30 out-patients having scheduled gastroscopy to receive videotaped or detailed written information, and assessed the effect of the information on patients' post-gastroscopy BP, pulse and self-reported anxiety and satisfaction levels. Patients receiving videotaped information had better post-gastroscopy outcomes on all measures, but the results were not statistically significant. BP and Pulse rates increased after the intervention within each group but the changes were statistically significant in the group receiving detailed written information only. A-state scores decreased in both groups after the intervention but these changes were not statistically significant. Education and age significantly influenced post-gastroscopy state anxiety scores. The researchers conclude that information may have little effect on Chinese gastroscopy patients' outcomes, irrespective of the method of providing it. Education and age may influence patients' reports of anxiety.

Adult↗
PubMed2001

Characteristics of an Accident and Emergency liaison mental health service in East London.

AIM OF THE STUDY: To analyse the work of a liaison mental health service at the Accident and Emergency (A & E) department of a hospital in East London. BACKGROUND: The English National Service Frameworks (NSF) for Mental Health recommend that A & E departments provide liaison mental health services and this study reports how a service in East London is responding to this challenge. RESEARCH METHODS: Data were collected during a 14-month period using a specially designed audit form. RESULTS: The typical referral was aged 36, of either sex, United Kingdom (UK) non-White with a diagnosis of depression. The majority of referrals were in the afternoon and seen immediately. A slight majority were known to mental health services; many were new referrals. Older and male clients were more likely, and Bengali and other Asian clients were less likely, to be registered with a psychiatrist. There were seasonal variations in referral type. Emergency referrals tended to have a diagnosis of schizophrenia; urgent and non-urgent referrals were more likely to be depressed. The outcome for the majority of referrals was referral to appropriate community services. The majority of non-clinical referrals were for advice, information and support. DISCUSSION AND CONCLUSIONS: The service seems a useful resource for A & E staff, and clients with mental health problems. The service is a channel through which people access mental health services and appears to address the NSF for Mental Health.

Adult↗
PubMed2001

Assessment of needs of adult symptomatic HIV patients in Hong Kong.

A cross-sectional survey was designed to assess the physical, psychosocial, health behaviour and informational needs of symptomatic HIV patients in Hong Kong, using both quantitative and qualitative data collection methods. Forty-six consenting adults from an outpatient clinic of a hospital in Hong Kong participated in the study. Results showed that up to 67.3% of the sample had partially or completely unmet needs in one or more areas of functioning. Major needs were related to income, social networking, family processes, money management and financial assistance. Only half the sample was satisfied with the information received related to their HIV infection and its management. Unsafe sexual practices were common, as well as smoking. Meeting these needs through policy making or practice could contribute to the enhancement of the quality of care and support provided to people living with HIV/AIDS in Hong Kong.

Adult↗
PubMed2001

Correlates of quality of life in symptomatic HIV patients living in Hong Kong.

This cross-sectional study assessed quality of life (QOL), coping styles, mood and uncertainty in illness in a non-random sample of 46 (out of 91 eligible) symptomatic HIV patients living in Hong Kong. QOL was moderate and the main concerns were related to the environmental aspects of QOL, spirituality and social relationships. Considerable mood disturbance was demonstrated in the sample, especially with regards to depression, fatigue and tension/anxiety. High levels of uncertainty in illness were also reported. A median split of the uncertainty score demonstrated that high uncertainty was related to lower levels of overall QOL (p = 0.04), higher psychological dysfunction (p = 0.05), worse adjustment with the environment (p < 0.001) and higher mood disturbance (p = 0.008). The sample predominantly used internal coping, which also correlated well with higher QOL scores. Through regression analysis it was shown that QOL could be predicted with the combined effects of uncertainty in illness and fatigue (adjusted R2 = 0.51, p < 0.001). Findings indicate that efforts should be directed towards improving QOL issues in the Chinese HIV patients and interventions could be introduced to alleviate those factors that were found to affect QOL. It is suggested that such interventions may include group or individual psychological therapies, management of fatigue and teaching patients more effective coping techniques.

Adaptation, Psychological↗
PubMed2000

Factors related to stress and coping among Chinese nurses in Hong Kong.

Few empirical studies have investigated the issues linked to Hong Kong nurses work-related health. The present study investigated factors related to stress and coping among Chinese nurses in Hong Kong. The researchers employed a cross-sectional survey and made within-group comparisons of nurses' stress and coping. Using stratified random sampling the researchers selected nurses from the mailing list of a local professional organization. One hundred and sixty-eight (33.6%) nurses responded. Nurses reported lower stress levels than other workers assessed with the same measure. Paediatric nurses reported the highest stress levels. Nurses at the lower grades reported higher stress levels than nurses at the higher grades. Single nurses had marginally higher stress scores than married nurses and females had slightly higher stress scores than males. However, none of these results were statistically significant. The respondents' major sources of stress were related to nursing issues like too much work, interpersonal relationships, and dealing with hospital administration. The respondents coped with their stresses by seeking support from friends and colleagues, using different cognitive strategies and through leisure activities. There was a statistically significant link between the respondents' stress and sickness levels. The results raise issues about the nature of nurses' working experiences.

Adaptation, Psychological↗
PubMed2000

The effect of isoniazid on BCG-induced toxicity in patients with superficial bladder cancer.

The use of bacillus Calmette-Guérin in the treatment of transitional cell cancer of the bladder has caused concern because of its associated adverse effects. We conducted a randomized prospective, double-blind, multicentre study to determine whether isoniazid prophylaxis could reduce BCG-induced toxicity without compromising its immunotherapeutic effects. Patients (n = 160) with histologically documented urothelial cancer (pTa-T1, pTis, G1-3) were treated with 6 weekly instillations of BCG Connaught strain, 81 mg, administered concomitantly with a 3-day course of isoniazid (300 mg o.d.) or placebo. Side-effects were recorded with each treatment and at follow-up. Of the patients treated with isoniazid, 19% remained free from side-effects, compared with 16% of the placebo group. Local side-effects confined to the bladder were significantly lower among those receiving isoniazid (35% vs. 48%, p < 0.01). Local side-effects together with systemic adverse effects such as fever, nausea or skin rash were experienced by 30% of patients in each arm. There were no differences in tumour recurrence between the two patient groups. Concomitant isoniazid reduces the local, but not the systemic side-effects of topically applied BCG without compromising the antitumour effect on superficial, transitional cell cancer of the bladder during a follow-up period that now exceeds 2 years.

Administration, Intravesical↗
PubMed2000

Soothing pain-elicited distress in Chinese neonates.

OBJECTIVE: To test the effect of nonnutritive sucking (NNS), music therapy (MT), and combined NNS and MT (NNS + MT), versus no intervention, on heart rate, transcutaneous oxygen (TcPaO(2)) levels, and pain behavior of neonates in intensive care units having blood taken by a heel-stick procedure. METHODOLOGY: A within-subjects, counter-balancing, repeated-measures design conducted in a government-funded hospital in Hong Kong, comparing TcPaO(2) levels, heart rate, and pain behavior outcomes in 27 neonates. RESULTS: Repeated-measures multivariate analysis of variance revealed statistically significant differences in outcomes across all interventions (Wilk's lambda =.142; F [3,27] = 31.82; eta2 =.47). One-way analysis of variance revealed that the 3 comfort interventions significantly reduced neonates' heart rate (Wilk's lambda =.647; F [2,27] = 18.93; eta2 =.35), improved their TcPaO(2) levels (Wilk's lambda =.481; F [2,27] = 37.42; eta2 =.51), and reduced their pain behavior (Wilk's lambda =.312; F [2,27] = 76.42; eta2 =.68). Posthoc scheffe tests revealed that NNS + MT had the strongest effect on neonates' TcPaO(2) levels and pain behavior; MT alone had the strongest effect on neonates' heart rate. CONCLUSIONS: Health professionals using NNS + MT when doing heel-sticks can improve the TcPaO(2) levels of neonates and reduce their pain. Using MT alone can improve the heart rate of neonates.

Blood Specimen Collection↗
PubMed1999

Health beliefs and their influence on United Kingdom nurses' health-related behaviours.

BACKGROUND: Because there is a demonstrated empirical link between nurses' personal health habits and their tendency to raise health issues with clients, researchers suggest that nurses can improve their health promotion role if they adopt health-related behaviours. Few researchers, however, have identified the factors that influence nurses' health-related behaviours. AIMS: To describe nurses' beliefs about the importance of health-related behaviours, and investigate the relationship between these beliefs and their health-related behaviours. DESIGN: A cross-sectional survey from which nested-case control comparisons were made. SAMPLE: One hundred and thirteen nurses attending tertiary level education courses in London and Essex. MEASURES: Health Behaviour Survey and a scale measuring nurses' beliefs about the importance of health-related behaviours. RESULTS: Nurses' health beliefs significantly influenced the practice of 14 health-related behaviours. CONCLUSIONS: The findings from this study support the view that nurses' practice of many behaviours linked to health and longevity are influenced significantly by their beliefs about the importance of these behaviours. Changing nurses' beliefs about the importance of health-related behaviours through specific health promotion sessions are meaningful as they may improve nurses' health promotion role.

Adult↗
PubMed1998

The effectiveness of tutorials in behavioural sciences for nurses: an action learning project.

As the first round of an action research project, this paper describes a between-methods triangulation process which examines the effectiveness of tutorials in a post-registration nursing degree course. The major concerns of the research team were with student learning approaches and student satisfaction. The research utilized a pre-/post-test experimental design as well as descriptive designs including non-participant observation of tutorials, tutor journal keeping and student interviews, to study the effects of a change from theory-based to learning process-based tutorials. The experimental design utilized the 'study process questionnaire' and the 'approaches to study inventory'. Two experimental groups showed a significant change in pre-/post-test scores. The qualitative data indicated that there were differences in the ways in which these two groups operated. The qualitative data also indicated that students were largely subscribing to achieving approaches and that satisfaction with tutorials was mainly related to relevance to the previous lecture as well as the perceived contribution to course assessment. As a consequence of this study it was concluded that the efficiency of tutorials could be increased by reducing the number of assignments, designing a set of specific tutorial activities that integrate theory and process, and having an explicit tutorial group formation policy.

Behavioral Sciences↗