Search PubMed⌕ Search

Biomedical subjects

T Hutchison

Publications and source records attributed to T Hutchison.

14 recordsLinked to original sources

Using simulated patients in a multiprofessional communications skills programme: reflections from the programme facilitators.

This paper discusses a multiprofessional, 4-day communication skills programme in which participants explore the challenges of communicating with cancer patients and their families. Effective communication and skilled emotional support are essential prerequisites for high quality care in oncology and palliative care settings. This aspect of care presents major challenges to nurses and other health care professionals. It is acknowledged that health professionals often lack the requisite skills to communicate meaningfully with this patient group and that tangible benefits accrue from training in this area. Using simulated patients, structured feedback and small group discussions, this multiprofessional programme seeks to provide a forum that enables participants to acquire confidence and competence in a safe, comfortable and non-threatening environment. The programme structure presents several challenges in terms of providing a learning experience that addresses the diverse educational of a heterogeneous learning group. Participants' comments and programme facilitators reflections suggest that the programme is successful in addressing these challenges and providing a meaningful learning experience.

Clinical Competence↗

Survey of UK computerised special needs registers.

A postal survey of all computerised children's disability registers in the UK was undertaken in 1996. Information was returned from 155 of 166 districts (93%). The implementation of computerised special needs registers is a continuing nationwide trend. Although there is evidence of successful use of registers both as an individual and as a population service planning tool, a high percentage of existing registers are functioning in a way which is far short of their potential for research, audit, and planning. Registers which work well have been set up with expertise, have staff enthusiastic about data entry, and are well supported for data output and software modification. There should be continued cooperative work towards a national consensus on the categories of disability and definition of severity of disability used in these registers.

Child↗

Development and satisfaction with individual programme planning in a disability service.

A consumer survey of a preschool disability service identified parents who did not feel their concerns were fully understood by professionals, nor felt involved or in agreement with treatment decisions, nor that services were provided in a coordinated way. A system of individual programme planning (IPP) was introduced in order to address these issues and other shortfalls of the existing service. Information was obtained from 96% of parents and 87% of professionals who attended IPP meetings over a four month period. Overall satisfaction was high (92% of parents: 96% of professionals). Parents now felt fully involved in decision making, 80% felt their views were understood and 100% agreed with treatment goals. Dissatisfaction was expressed with meeting attendance, the marginalisation of parents, and the timing and chairing of meetings. Consumer satisfaction surveys are recommended for use in highlighting areas of service shortfall, to direct and evaluate service change, and to monitor quality.

Child, Preschool↗

Improved primary care does not prevent the admission of children to hospital.

In Nottingham Health District a study has been carried out whose aims were: (1) to compare acute paediatric medical admissions in 1985 with those in 1975 and to relate any differences to changes in services; (2) to measure the numbers of preventable admissions, working on the hypothesis that this would give an indication of the performance of community services. A structured questionnaire was completed with parents, and information obtained from notes of all children admitted with acute medical problems during October 1985. Results were compared with a similar study undertaken in 1975 by Wynne and Hull1 on children from the same catchment area. Further information for all health districts in Trent Region was obtained from Hospital Activity Analysis data relating to these 10 years. There has been a 100% increase in children's admissions in Nottingham, with similar increases throughout Trent Region. Apart from ingestions, there are increases in every diagnostic category, with a 6-fold increase in the admission rate for lower respiratory tract problems, mostly asthma and wheeze. Only 9% were classified as 'social admissions'. The idea of certain admissions being preventable is not a useful concept. Improvements in primary care have not been accompanied by a fall in hospital admissions.

Adolescent↗

Dermatologic lesions in a transplant population.

Many authors have reported an increase in the incidence of skin neoplasia in renal transplant patients. Two hundred and twenty-three patients, who received a renal transplants between 1965 and 1984, were examined for the presence of skin lesions. There was a high incidence of simple warts (24%) and hyperkeratoses (21%). Frank malignancy had developed in 9 patients; this is more than 4 times the expected incidence for the population of Northern Ireland.

Adolescent↗

Developmental screening and surveillance.

This article reviews the practice of and state of knowledge concerning developmental screening and surveillance of preschool children in the UK. It includes testing for defects of hearing and vision but does not constitute a "how-to-do-it" guide. This is available elsewhere (Egan et al, 1969; Sheridan, 1975).

Child Development↗

A training procedure for immunization.

A booklet on child immunization and a training procedure using a video have been developed in a health authority. The initiative has proven highly acceptable and has resulted in a demonstrable increase in professional knowledge and in vaccine uptake. Further initiatives are described.

Child↗

Mutiny over Bounty?

Bounty Services Ltd advertise commercial products on postnatal wards of hospitals throughout Britain by means of free gifts. Since the " Bounty lady" is apparently well known to nursing staff but may have gone unnoticed by paediatricians and obstetricians an investigation was conducted of the quality of the gifts and the nature of the company. With two exceptions the samples and promotional leaflets were sound, and mothers apparently enjoyed receiving them. Educational pamphlets distributed with the gifts were excellent, and cine films shown to the mothers were of good quality and informative about basic parental skills. Bounty , however, operates by exerting commercial pressure on new mothers at a time when they are most vulnerable and distributes materials among them without consultation with medical staff. Most of the mothers questioned assumed that the service was being provided by the NHS. The Bounty service may or may not be perceived as a satisfactory operation but details should be known to paediatricians and obstetricians; any action to be taken might be decided locally after discussion in individual hospitals or districts.

Advertising↗

Pain, control over treatment, and compliance in dialysis and transplant patients.

Pain was surveyed via structured interview and the McGill Pain Questionnaire in 53 dialysis and 27 transplant patients. Increased patient control over the dialysis procedure was not associated with a reduction in pain though perceived control may have been. Compliance with the dialysis regimen did not predict pain and the validity of the category "dialysis headache" was questioned. Overall, transplant recipients did not report significantly less pain than dialysis patients. Self-reported depression was correlated positively with pain. The clinical implications of these findings are discussed.

Adult↗