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Biomedical subjects

R Newell

Publications and source records attributed to R Newell.

At least 19 recordsLinked to original sources
PubMed2004

A literature review of head and neck cancer patients information needs, experiences and views regarding decision-making.

This study reviews the body of existing research undertaken to explore head and neck cancer patients experiences of treatment for surgery, their information needs and their views regarding decision-making. Patients who suffer head and neck cancers and undergo surgery often report considerable psychological distress and impaired social functioning. To optimize survival, the decision about what treatment option to follow is often made quickly, with little support in terms of counsel or the provision of information. It is suggested that there is inadequate previous work exploring the content and delivery of information required by patients, their experiences and their views regarding decision-making to guide appropriate clinical interventions. By assimilating and critiquing existing work in this review an appropriate focus for further research is likely to be determined. An electronic search of relevant databases was undertaken including Cinahl, Medline, Psychinfo, Assia, the Cochrane Library and British Nursing Index. In addition, a grey literature search was also undertaken by hand. The search strategy was developed using recommendations from the Centre for Reviews and Dissemination 'Guidance for Those Carrying Out or Commissioning Reviews' (CRD Report Number 4, 2001). There is significant psychosocial and other functional disturbance amongst survivors of head and neck cancer surgery. Improved information giving may play a part in determining these outcomes.

Decision Making↗
PubMed2003

Dense atom clouds in a holographic atom trap.

We demonstrate the production of high-density cold 87Rb samples (2 x 10(14) atoms/cm3) in a simple optical lattice formed with YAG light that is diffracted from a holographic phase plate. A loading protocol is described that results in 10,000 atoms per 10 microm x 10 microm x 100 microm unit cell of the lattice site. Rapid free evaporation leads to a temperature of 50 microK and phase space densities of 1/150 within 50 ms. The resulting small, high-density atomic clouds are very attractive for a number of experiments, including ultracold Rydberg atom physics.

Journal Article↗
PubMed2001

Behaviour modification and gentle teaching workshops: management of children with learning disabilities exhibiting challenging behaviour and implications for learning disability nursing.

BACKGROUND: Challenging behaviours (behaviour difficulties) represent a problem of considerable clinical significance for learning disability nurses, and a source of much human distress. Gentle teaching is a relatively new approach to dealing with behavioural difficulties, and has been received with enthusiasm by clinicians, but has so far received little empirical support. The current study attempted to compare gentle teaching with a well-established alternative (behaviour modification) and a control group. OBJECTIVES: To examine the comparative effectiveness of gentle teaching, behaviour modification and control interventions for challenging behaviour amongst children with learning disabilities. DESIGN: Nonrandomized controlled trial. SETTING: Service users' homes in East Yorkshire. PARTICIPANTS: Seventy-seven children who presented with learning disabilities and challenging behaviour (behaviour difficulties) and their parents. PROCEDURE: One-day workshops in were offered by recognized authorities in either behaviour modification or gentle teaching that were not otherwise involved with the research project. Forty-one participants were recruited to the gentle teaching condition; 36 to behaviour modification; 26 to the control group. Random allocation was not possible, because of the slow uptake by interested parents. Measures was preintervention, and at assessment points up until 12 months following intervention. ANALYSIS: Quantitative analysis of pre-post differences between the groups, using t-test. RESULTS: In general, no significant differences were found between the treatment groups and controls. Significant improvements were found for both gentle teachingand behaviour modification children over controls on the AAMR ABS XVII (social engagement) subscale. Controls had more contact with medical practitioner (GP) services than behaviour modification children and less than gentle teaching children. CONCLUSION: Although very few differences were found between the three groups, those that did exist generally favoured behaviour modification. Implications for service provision and learning disability nursing practice are described.

Adolescent↗
PubMed2001

Writing academic papers: a guide for prospective authors.

As a journal Editor, I examine many papers and work alongside authors to maximize the likelihood of publication. During the course of this activity, several issues concerning writing for publication have emerged. In this article, I will use these experiences to help novice writers to prepare their work for publication. I will also draw on my personal experience as an author of academic and popular papers and as a book author and editor. If you find the article useful, please do distribute it freely amongst colleagues.

Authorship↗
PubMed2000

Evaluation of a self-help leaflet in treatment of social difficulties following facial disfigurement.

Psychological difficulty, particularly in social situations, is widely reported by disfigured people, but many receive no formal psychological treatment. This study randomly allocated 106 facially disfigured people either to receive a self-help leaflet offering cognitive-behavioural guidance or not. Participants were assessed pre-treatment and at 3 month follow-up. The untreated group then received the leaflet. Participants in the leaflet group fared better than controls on 3 of the 9 scales employed (Social Leisure [SAQ] (t=2.31, p=0.012), HADS anxiety (t=2.22, p=0.015), HADS depression (t=1.83, p=0.036). There is support for a cognitive-behavioural approach and the usefulness of self-help instructions in addressing the social difficulties of facially disfigured people. The approach merits further development and investigation.

Adaptation, Psychological↗
PubMed2000

British nurses in behavioural psychotherapy: a 25-year follow-up.

BACKGROUND: The National Service Framework for Mental Health has emphasized the need to prioritize the provision of cognitive behaviour therapy as the central evidence-based non-pharmacological intervention for mental health problems. For 25 years one programme (English National Board Course No. 650--Diploma in Behavioural Cognitive Therapy, formerly called Nursing in Behavioural Psychotherapy) has trained nurses in such methods. This is the only programme in nursing which qualifies graduates to be fully certified as a cognitive behaviour therapist by the British Association of Behavioural Psychotherapy and by the United Kingdom Council for Psychotherapy. The practice of these nurse therapists (most commonly known as nurse behaviour therapists, NBTs) is the most rigorously evaluated in mental health nursing, with several randomized controlled trials to testify to clinical and economic efficacy. AIM: The aim of this study is to continue the systematic follow-up of all NBT graduates previously undertaken in two earlier surveys published in 1986 and 1994. These previous surveys examined clinical practice, organizational context and career and professional development issues. This up-to-date picture of NBTs will provide useful baselines for the implementation of the National Service Framework, and may be used by the Department of Health, education providers and services. METHOD: A postal survey (using the same template for categories of information as the two earlier surveys) was used and questionnaires were sent to 237 of the 274 trained NBTs whose name appears on the Central NBT Register, maintained at the Institute of Psychiatry/Maudsley Training Centre. RESULTS: One hundred and five of 230 eligible respondents (45.6%) returned questionnaires and additional data were obtained from 27 NBTs who provided information to the Register in the year before the survey. Thus, some data were available for 57% of the sample. As in earlier surveys, it was found that the majority of therapists remain in clinical practice, undertake substantial further education and training and are involved in research and teaching as part of their overall role. The two central developments are an increasing move towards working in primary care and an increased emphasis on cognitive interventions. NBTs complete a substantial number of treatments per year and increasingly treat clients with difficulties not encountered during their basic training. NBTs now receive much more supervision than in previous surveys and continue to use valid and reliable measures of change in practice. However, the number of NBTs remains small and the impact on potential populations who would benefit from effective psychological interventions is minimal. This paper discusses the implications for service delivery.

Behavior Therapy↗
PubMed2000

Psychological difficulties amongst plastic surgery ex-patients following surgery to the face: a survey.

Qualitative accounts suggest that social difficulties are a major source of psychological disturbance to disfigured people. However, there have been few systematic investigations of their psychological and social difficulties, and those which do exist are usually small studies with methodological difficulties. Social skills training and cognitive-behavioural therapy are promising interventions, particularly if it can be demonstrated that anxiety is a major element of the psychological difficulties experienced by disfigured people.A postal survey was sent to all ex-patients at a plastic surgery clinic who received plastic surgery to the face between 6 months and 5 years 6 months prior to the date of the survey. Of these, 105 ex-patients returned questionnaires, representing a 41.8% response rate. Respondents did not differ from non-respondents according to age, sex or diagnosis. The majority of respondents were not experiencing psychological difficulty, but GHQ caseness, HAD anxiety and HAD depression scores were generally higher than in general population samples. Their levels of social phobia appeared higher than prevalence in the general population, although direct comparison is hampered by the different instruments used. Women showed greater disturbance than men on many of the scales used, and patients who had undergone surgery for revision of scars showed greater disturbance than those who had undergone surgery for cancer. The current study may be considered more representative of disfigured people than previous surveys, since its subjects were neither awaiting nor receiving treatment, although the response rate was still low. Contrary to assertions in previous studies, standardised measures detected dysphoria in this sample. Anxiety, particularly in social situations, with associated phobic avoidance, was the most frequently reported difficulty, with depression considerably less common. Given the success of cognitive-behaviour therapy in addressing such difficulties, both via formal therapy and self-help methods, there are clear implications for treatment from this finding.

Adolescent↗
PubMed2000

Phobic nature of social difficulty in facially disfigured people.

BACKGROUND: Over 390,000 people in the UK are disfigured. Facial disfigurement distresses sufferers markedly but has been studied little. AIMS: To compare fearful avoidance of people with a facial disfigurement with that of a group of patients with phobia. METHOD: Comparison of Fear Questionnaire agoraphobia, social phobia and anxiety depression sub-scale scores of 112 facially disfigured people (who scored high on Fear Questionnaire problem severity in three survey studies) with those of 66 out-patients with agoraphobia and 68 out-patients with social phobia. RESULTS: Facially disfigured people and patients with social phobia had similar Fear Questionnaire scores. In contrast, facially disfigured people scored lower on the agoraphobia sub-score but higher on the social phobia sub-score than did patients with agoraphobia. CONCLUSIONS: Facially disfigured people with psychological difficulties resembled people with social phobia on Fear Questionnaire social phobia, agoraphobia and anxiety/depression sub-scores but were less agoraphobic and more socially phobic than were people with agoraphobia. Facially disfigured people thus appeared to be socially phobic and to deserve the cognitive--behavioural therapy that is effective for such phobias.

Adaptation, Psychological↗
PubMed1999

Media reviews

Explore the source record for details and available documents.

Journal Article↗
PubMed1999

The use of brief written educational material to promote reflection amongst trained nurses: a pilot study.

The UKCC (1995) suggest that in order for nurses to maintain their registration, they must maintain a personal professional profile via reflection, and there are numerous approaches to the teaching of reflection. Similarly, several models of reflection exist. However, much of this activity has occurred without attempts to establish the effectiveness of either reflection or attempts to teach it. The current study attempted to examine whether written educational material could significantly improve nurses' reflective ability. Nineteen practising nurses were recruited from a variety of sources and offered an educational package, largely based on Boud et al. (1985) model of reflection in learning. In a repeated measures design study, these participants completed a reflective exercise before and after offering of the educational material. Their scripts were rated, using Wong et al.'s (1995) tool, by three raters, two of whom were unaware of whether the scripts were completed before or after offering of the educational material. An initial analysis showed that there were no statistically significant changes in subjects' reflective ability following education. However, removal from the analysis of 6 participants who had a pre-test ability at the highest possible level (and for whom no improvement was, therefore, possible) resulted in a significant improvement in participants' ability from pre- to post-test (z = -2.4450, P = 0.0145). Interrater reliability calculated using Cronbach's Alpha was 0.7210 for pretest reflective accounts and 0.7369 for post-test reflective accounts.

Adult↗
PubMed1997

Perceptions of the body interior by children with asthma and children with no known chronic disease.

Comparatively little is known about how children perceive their internal bodies. In particular there is a lack of British studies, both of children's normal perceptions and in children experiencing chronic ill health. Such studies are important if information is to be given to children in the most effective way. The current study presents the results of an investigation of 72 children, 36 of whom were chronic asthma sufferers, whilst the others had no known chronic disease. Children at ages 5-6 years, 7-8 years and 10-11 years were asked to draw their internal body parts and to answer questions about the functioning of nine body organs. Data were analysed to examine the effect of age, sex and presence of asthma on the children's responses. Five-year-olds knew significantly less about their lungs than did other groups, boys identified muscle and ribs more frequently than girls, and there was an increase in levels of conceptualisation with age. There were no significant differences between asthmatic and non-asthmatic children. The findings are considered with particular reference to their importance for nursing practice.

Age Factors↗
PubMed1997

Evaluation of stress prevention and management workshops in the community.

Little emphasis has been placed by clinicians on the need for routine evaluation of outcomes of community mental health nursing interventions. Although numerous descriptive studies exist, there is little systematic evaluation of the work of community mental health nurses, and this problem is particularly acute in the field of preventative work. This paper presents the results of a small initiative to incorporate outcome evaluation into the clinical work of a community mental health team. Ninety-nine participants in a series of stress management workshops completed stress questionnaires before a series of 2-day workshops and were followed up at between 3 and 6 months afterwards. At follow-up, participants reported greater gains in terms of stress management than did no-treatment controls. The study offers tentative evidence for the effectiveness of community mental health nurses in offering effective preventative interventions and also indicates that such interventions are amenable to outcome evaluation within the context of routine clinical practice.

Burnout, Professional↗
PubMed1996

Nurses' awareness of restraint use with elderly people in Greece and the U.K.: a cross-cultural pilot study.

The use of restraints in hospitalised elderly people is a contentious but poorly-documented issue and many gaps remain in the literature. Despite the growth of the elderly population, there has been little attempt to safeguard their rights in relation to appropriate care whilst in hospital. Furthermore, little is known about the attitudes of nurses in the U.K. towards the use of restraints in the older population, and there is an almost total absence of cross-cultural studies. The current study is a small pilot study of nurses' attitudes towards and knowledge of restraint use with older patients. A structured questionnaire was given to 39 U.K. and 11 Greek trained nurses who were working in acute care settings where elderly patients were cared for, with the aim of identifying their perceptions and experiences of the use of restraints in their clinical settings. Although numbers were small, a number of differences between the two groups were found, and there were indications of further differences. These issues are examined, with particular reference to the need for education, restraint policies and multidisciplinary decision-making about restraint use. Some major principles which should be included in cross-cultural studies are also discussed.

Adult↗
PubMed1996

A discussion of some of the literature relating to history, repair and consequences of perineal trauma.

OBJECTIVE: to review the key literature on perineal trauma, discussing the historical background, the materials and techniques used, the possible consequences of repair and assess midwives' current and potential contribution to perineal repair. LITERATURE SEARCH: the literature was identified using conventional search techniques: Midwifery Information Resource Service (MIDIRS) and the Cochrane Pregnancy and Childbirth Database. Keywords used during the search were: episiotomy, perineal trauma and adverse effects. Associated keywords words were sexuality, pain and psychology. KEY CONCLUSIONS: current practice in the UK is inconsistent with the available evidence, perineal trauma can cause long term problems, and midwives are in an ideal position to take forward evidence-based perineal repair. IMPLICATIONS FOR PRACTICE: midwives need adequate education and training in perineal repair but are likely to be more effective in performing the repair. Systematic evaluation of the impact of extending midwives' influence in this area is essential.

Episiotomy↗
PubMed1994

British nurses in behavioural psychotherapy: a 20-year follow-up.

A postal survey was carried out of all nurse behaviour therapists trained on the English National Board for Nursing, Midwifery and Health Visiting course in adult behavioural psychotherapy (ENB 650) since its inception at Maudsley Hospital London, in 1972. All trained therapists currently in practice in the UK were surveyed, and 113 of 142 eligible respondents returned questionnaires. These were examined to elicit the professional profiles and working practices of the therapists, and to identify similarities and differences between therapists trained in the four training centres in the UK. It was found that the majority of nurse therapists remain in clinical practice after training, and continue to further their education and clinical expertise. There has been a general shift towards cognitive and short-term interventions, and towards practice based on primary care, with general practitioners providing most referrals. There were significant differences between the centres in terms of a number of the therapeutic techniques used, diagnostic categories of clients seen, and several elements of working practice, including referral source and numbers of clients seen and treated. The implications of the findings for clinical practice and for nursing in behaviour therapy are discussed.

Behavior Therapy↗