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Biomedical subjects

Tina Koch

Publications and source records attributed to Tina Koch.

24 records · Page 2Linked to original sources

Older people seeking solutions to constipation: the laxative mire.

This article reports an extensive descriptive survey of 90 older people (65+ years) living in the community who sought through in-depth, semistructured interviews to explore their experiences and responses to constipation. The composite story of these older people is that seeking a solution to constipation may be fraught with great difficulty. Most commonly tried are laxatives, yet laxative use can be like a mire. The older people tend to be uncertain of which way to turn to avoid getting stuck in a murky conglomeration of laxative options. The imperative for self-management of constipation is strong amongst most of the older people and the process in which they engage when seeking for a solution is discussed. There is an evident frustrating lack of readily identifiable and accessible services and information that could help them navigate successfully through or around this mire. "Through the mire" would be the appropriate use of suitable laxatives with minimal side-effects. "Around the mire" would be the gaining of useful solutions other than laxative use. Solutions may be strategies to prevent constipation or to treat constipation. The needs of these older people seeking solutions to constipation are grouped into two main categories: provision of accessible, empathetic and useful advice about affordable solution choices, and accessibility to solutions, including laxatives, where evidence-based knowledge informs selection or prescription of the solution. Eight major recommendations, including research suggestions, are offered for consideration.

Adaptation, Psychological↗

Faecal impaction: older people's experiences and nursing practice.

A number of authors have identified the paucity of evidence available to inform community nursing practice in relation to faecal impaction. Little is known of its incidence or its impact. In an attempt to address this, this article reports part of an extensive descriptive survey in Australia that sought to explore the experience of, and response to, constipation of older people living in the community. The focus here is the participants' experience of extreme constipation in the form of faecal impaction and obstipation (obstinate constipation). Faecal impaction was found to cause great discomfort and distress, often leading to obstipation. The imperative for self-management of constipation was strong, and laxative use frequent. However, manual evacuation was often necessary, either by self or others. This article discusses the results in relation to a recent emergence of concern in the US and UK about how faecal impaction and obstipation should be treated by community nurses.

Aged↗

Quality of life issues identified by palliative care clients using two tools.

Reported are issues impacting upon the Quality of Life (QoL) of 59 palliative care clients within a district nursing service. These issues reinforce the emerging conceptualisation of QoL as being subjective and multidimensional. The issues were identified during a trial of two QoL assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL). In this era of considerable concern about QoL for the terminally ill, the article's intent is to present the QoL issues identfied, the grades of impact and priority for improvement of the issues according to the clients, and to discuss these aspects. This information can inform the assessment of palliative care clients (the CGI tool was found ideal for such an assessment), and may also inform further research on the QoL of palliative care clients.

Activities of Daily Living↗

Compromising and containing: self-management strategies used by men and women who live with multiple sclerosis and urinary incontinence.

This study aimed to expose the experiences of men and women living with Multiple Sclerosis (MS) and how they manage the challenge of urinary incontinence in their lives. We explore the commonalities and diversities between men and women living with MS and urinary incontinence and conclude the paper by making recommendations for nursing practice.

Adult↗

Caregivers talk about experiences of caring for an older person with dementia.

This study explored caregivers' experiences of caring for an older person with dementia by listening to the voices of 15 carers to identify successful management strategies. Some successful management strategies did emerge none saw their approach as a 'successful strategy', just that things worked on certain days. It is suggested that families can be prepared for a 'career' in caring and that early assessment and diagnosis is essential.

Activities of Daily Living↗

Using caregivers-as-proxies to retrospectively assess and measure quality of dying of palliative care clients.

This study evaluated two quality-of-life assessment and measurement tools, the Client Generated Index and the McGill Quality of Life questionnaire, within palliative care nursing. Primarily tested was the feasibility of the tools to assess clients' QOL at admission and, if necessary, when their condition altered. The reliability of the tools has previously been ascertained Additionally, quality of dying during the last two days of life for 14 participants who died during the study was assessed and measured retrospectively by these tools, using the client's nominated caregiver as proxy for the client. It is this second focus that we report on here. The reasons why proxy assessment and measurement of client QOD was not useful or feasible are discussed.

Adult↗