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John Adams scans a range of journals and highlights their
relevance for nurses who work with older people
Flanagan M, Rotchell L, Fletcher J,
Schofield J (2001)
Community nurses’, home carers’
and patients’ perceptions of
factors affecting venous leg ulcer
recurrence and management of
Journal of Nursing Management 9, 3,
The two elements reported in this
paper are taken from a larger study of
issues related to venous leg ulcers and
their prevention. The first of these
concerns is the provision of an
aftercare service for older people
whose leg ulcers have healed. Focus
group methodology was employed to
elucidate the views of community
nurses and social service home carers.
The former group believed that health
promotion was largely ineffective in
reducing leg ulcer recurrence. The
application and removal of
compression stockings was regarded as
an appropriate task for home carers,
while the district nurses indicated that
they regarded the management of
active lesions as a better use of their
skills. The carers from social services, by
contrast, felt that skin care should be
the responsibility of health service
staff. The second element of the study
involved a semi-structured
questionnaire administered to 12
patients. They tended to regard skin
care as a health problem. 31
The measurement of key attributes of
the ward environment has received
much attention from researchers and
clinicians over recent years.
Observational approaches to quality
measurement, such as ‘Qualpacs’ and
‘Monitor’, have been widely used in a
range of environments in which care
is provided for older people. This
paper, derived from the author’s PhD
research, presents a measure of
patient empowerment based upon
the opinions of older patients
themselves. The development of the
Patient Empowerment Scale is
described, and the complete tool is
provided in an appendix to the paper.
The results of a study using the scale
are also described. A sample of 102
adult patients found on five hospital
wards were asked to answer the
questions it poses. The clinical areas,
situated in the English midlands,
included three medical wards, one
surgical ward, and one rehabilitation
ward for older people. The results
showed that the rehabilitation ward
was the least empowering and that
there was an inverse correlation
between participant age and
exposure to empowering care. The
paper concludes with a wide-ranging
review of the issues raised. 44
Gueldner SH, Smith CA, Neal M,
Penrod J, Ryder J, Dye M, Bramlett MH,
Hertzog L (2001)
Faulkner M (2001)
Patterns of telephone use among
A measure of patient
nursing home residents
empowerment in hospital
Journal of Gerontological Nursing 27, 5,
environments catering for older
Journal of Advanced Nursing 34, 5,
8 nursing older people july vol13 no5 2001
Opportunities for communication
form an important part of the
experience of living in a nursing
home. This American study was based
upon a detailed analysis of the
telephone calls made by three female
residents from two nursing homes
over a period of seven days. The total
conversation time recorded during
this period was 56 minutes. The
transcripts revealed a range of topics
being discussed, such as domestic
skills, the weather and travel.
Humour was a prominent aspect of
the conversations. The researchers
concluded that the telephone
appeared to be a vital
communication link between
residents and their family and
friends. 15 references.
Seddon D, Robinson CA (2001)
Carers of older people with
dementia: assessment and the
Carers Act
Health and Social Care in the
Community 9, 3, 151-158.
The Carers (Recognition and Services)
Act 1995 came into force on 1 April
1996, but has received little
attention to date in the specialist
literature. This study carried out in
Wales sought the views of senior
managers in health and social
services, care managers, and carers of
older people with dementia. The
findings revealed limited knowledge
of the Act from both carers and
professionals, and hence that it has
had minimal impact. The paper
concludes with a discussion of the
issues that will have to be addressed
before change can be brought about.
26 references.
John Adams RGN, BSc, MA is senior
lecturer at Homerton College,
Cambridge School of Health Studies
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