Faculty Publications (CoNM)
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Publication What do patients want from a digital device that supports heart failure self-management?(2024-08) Hill, LoreenaAbstract Objective: To assess patients' needs and the factors determining their acceptance of an e-Health intervention. Methods: Purposive sample of patients with heart failure, attending an outpatient consultation were invited to complete a questionnaire designed to assess their needs and acceptance of an e-Health intervention. Data analysis was performed using Chi-square tests with post-hoc corrections. Results: Response rate was 61 % (n = 101), with most patients (>70 %) indicating they could see themselves using an e-Health intervention to manage their heart failure. Participants with a healthy lifestyle (i.e., non-smoker and consumed alcohol < once/week) were more likely to have a positive attitude towards technology (p adj.=0.013). Those willing to use an e-Health intervention were convinced of its advantages by other patients with heart failure (p adj.=0.013). Advanced age, education level, employment or marital status did not influence patient attitudes toward health technology. Conclusions & practice implications: Results indicate patients have a positive attitude towards the use of e-Health interventions to enable their self-management of heart failure. These findings will inform further development and delivery strategies of e-Health interventions.Publication The lived experiences of fatigue among patients receiving haemodialysis in Oman: a qualitative exploration(2024-07) Gormley, KevinAbstract Background: Fatigue among patients with end-stage kidney disease (ESKD) receiving haemodialysis imposes a substantial burden on patients' quality of life and expected treatment outcomes. This study explores the perspective on ESKD-related fatigue and contributing factors among Omani patients receiving haemodialysis. Methods: An exploratory qualitative design was used. Participants (N = 25) were recruited from two Omani haemodialysis centres, and data were collected through semi-structured interviews, which were transcribed and analysed using a thematic analysis approach. NVivo 11 is used to manage qualitative data and create memos, nodes, and codes. Results: Findings highlighted three themes: (i)"Inevitability of fatigue," (ii)"Contributors to physical fatigue," and (iii)"Contributors to mental fatigue." Theme one alluded to the inevitability of fatigue and the unique experience encountered by patients. Theme two addressed the physical fatigue associated with ESKD-related factors, such as chronically low haemoglobin levels, and the exhausting impact caused by the frequency and travelling distance for treatment sessions. Theme three, mental fatigue, was notably driven by heightened emotional disturbance, encompassing frustration, guilt, anxiety, and distress, that in turn impacted family interactions, frequently triggering anger and remorse. Moreover, mental fatigue is a result of disturbances in expressing physical sexuality in marriage, as physical fatigue was found to be a significant contributor to unsatisfactory sexual experiences and, thus, straining the relationships between couples. Conclusions: This study offers an explanation of fatigue among Omani patients with ESKD who are receiving haemodialysis. The study emphasises close links between physiological change, the haemodialysis process, and mental tiredness, together with their contribution to supporting the need for a holistic approach and care strategies in managing these patients and promoting patient and family well-being.Publication An Exploration of the Day to Day Professional Experiences of School Nurses Globally: A Narrative Review(2024-07) Boyle, BreidgeAbstract To explore school nurses roles globally through their own perceptions of what they do and how they do it and to compare the realities for the role its representation in professional literature. A comprehensive narrative literature review, using ENTREQ guidelines, with "qualitizing" of the quantitative literature, and athematic analysis was carried out. Findings were reviewed in relation to established theory. CINAHL, Medline, Cochrane Library, and Embase were systematically searched from 2000-2021. Included studies focused on school nurses perceptions of their own practice. Five themes: direct care, health promotion, collaboration, support from school and health authorities and promoting the school nurses role were found. These themes were closely aligned to the National Association for School Nurses' framework for 21st century practice. However, the school nurses signposted areas where they need support in carrying out their job to the highest standard. School nurses are important to support the health needs of students while at school. They also, particularly in areas like the United Arab Emirates where resources are being invested in the role, have a unique role to play in health promotion, leading to improved health literacy, as positive health behaviors tend to be learned young. However, worldwide, the potential for the school nursing role needs to be recognized and supported by health and education providers, by families and within the schools for its full potential to be achieved.Publication Summer musings(2024-06) Boyle, BreidgeAbstract Reflecting on the title, I suppose that I should acknowledge that while it is summer here in the northern hemisphere, our colleagues in the south are in the depths of winter. Whatever time of year it is I hope that these offerings bring you food for thought. Starting, as usual, with review articles, Adriana Pacheco, and her colleagues from Portugal, offer us our first course, with a scoping review of music as a non-pharmacological method of pain relief in the neonate. We tend to see scoping reviews where there is little published literature and I commend them on finding 20 articles worthy of inclusion. The fact that they find a positive result for neonates but not for infants indicates that more research in needed in this very interesting area. Yu-Ju Shao and colleagues from Taiwan have started the process, showing that there is a statistical difference in the heart rate and blood oxygen levels in those babies exposed to music therapy compare to those receiving normal care. I am sure that there is more to come on this subject. On the other hand, Sin Yan Victoria Linda Fong, writing in Hong Kong, found much less literature on trauma caused by the rotation of the interface devices used when neonates require non-invasive ventilation. Again a really interesting area where there is much more research available on how well individual devices protect neonates’ noses than on the practice of alternating devices. Alternation is common practice and it is good to see evidence to support it. More is required.Publication Culture, ethnicity, and socio-economic status as determinants of the management of patients with advanced heart failure who need palliative care: A clinical consensus statement from the Heart Failure Association (HFA) of the ESC, the ESC Patient Forum, and the European Association of Palliative Care(2023) Hill, LoreenaAbstract: The delivery of effective healthcare entails the configuration and resourcing of health economies to address the burden of disease, including acute and chronic heart failure, that affects local populations. Increasing migration is leading to more multicultural and ethnically diverse societies worldwide, with migration research suggesting that minority populations are often subject to discrimination, socio-economic disadvantage, and inequity of access to optimal clinical support. Within these contexts, the provision of person-centred care requires medical and nursing staff to be aware of and become adept in navigating the nuances of cultural diversity, and how that can impact some individuals and families entrusted to their care. This paper will examine current evidence, provide practical guidance, and signpost professionals on developing cultural competence within the setting of patients with advanced heart failure who may benefit from palliative care.Publication Players' and parents' perceptions of injury in elite Northern Irish schools’ rugby — A qualitative study(2023) Wilson, IseultObjectives: To explore schools' rugby players' and their parents’ perceptions of injury. Design: A qualitative study using focus groups. Setting: Schools who compete in the Ulster Schools’ Cup competition. Participants: 13 players and 9 parents. Outcome measures: A thematic analysis approach was used to examine players' and parents’ beliefs and attitudes towards injury, return to play and injury risk. Results: Findings suggest schools' rugby players and their parents are aware of injury risk in the schoolboy game. They are aware of concussion injury but are less aware of musculoskeletal injury. Parents' perceptions of injury are based on their experience of their sons’ injuries. Parents are unaware of return to play strategies for musculoskeletal injury. Conclusions: Schools' rugby players and their parents are aware of injury to some extent, however players' and parents’ knowledge and understanding of injury is based on and informed by personal experience, not the evidence base. Whist they are aware of injury, many players will seek to push their fears to the back of their mind. However, for those players who have suffered severe injury, they are concerned about the risk of reinjury.Publication Risk and Management of Patients with Cancer and Heart Disease(2023) Hill, LoreenaAbstract: Cancer and cardiovascular disease are two of the leading causes of global mortality and morbidity. Medical research has generated powerful lifesaving treatments for patients with cancer; however, such treatments may sometimes be at the expense of the patient’s myocardium, leading to heart failure. Anti-cancer drugs, including anthracyclines, can result in deleterious cardiac effects, significantly impacting patients’ functional capacity, mental well-being, and quality of life. Recognizing this, recent international guidelines and expert papers published recommendations on risk stratification and care delivery, including that of cardio-oncology services. This review will summarize key evidence with a focus on anthracycline therapy, providing clinical guidance for the non-oncology professional caring for a patient with cancer and heart failure.Publication Closing out 2022(2022-12) Boyle, BreidgeIntroduction: As we close out the final December 2022 issue of the Journal of Neonatal Nursing (JNN), we are happy to present a greater than ever volume of articles for perusing! We have been blessed with record numbers of submitted manuscripts in 2022 allowing us to publish more evidence in a timely fashion. This jam-packed issue includes 3 reviews and 10 original manuscripts. Our first review is from the University Hospital Waterford in Ireland and is presented by authors Cunningham, Patton, Moore, O’Connor, Bux, and Nugent. Kangaroo care has multiple physiological, developmental, and psychological benefits for neonates. The purpose of their Evidence Review was to review past and current kangaroo care practices and explore the literature relating to improving kangaroo care for preterm infants.Publication Using natural language processing in facilitating pre-hospital telephone triage of emergency calls(2022-09) Gormley, Kevin; Isaac, JollyIntroduction: Natural language processing (NLP) is an area of computer science that involves the use of computers to understand human language and semantics (meaning) and to offer consistent and reliable responses. There is good evidence of significant advancement in the use of NLP technology in dealing with acutely ill patients in hospital (such as differential diagnosis assistance, clinical decision-making and treatment options). Further technical development and research into the use of NLP could enable further improvements in the quality of pre-hospital emergency care. The aim of this literature review was to explore the opportunities and potential obstacles in implementing NLP during this phase of emergency care and to question if NLP could contribute towards improving the process of nature of call screening (NoCS) to enable earlier recognition of life-threatening situations during telephone triage of emergency calls. Methods: A systematic search strategy using two electronic databases (CINAHL and MEDLINE) was conducted in December 2021. The PRISMA systematic approach was used to conduct a review of the literature, and selected studies were identified and used to support a critical review of the actual and potential use of NLP for the call-taking phase of emergency care. Results: An initial search offered 204 records: 23 remained after eliminating duplicates and a consideration of title and abstracts. A further 16 full-text articles were deemed ineligible (not related to the subject under investigation), leaving seven included studies. Following a thematic review of these studies two themes emerged, that are considered individually and together: (i) use of NLP for dealing with out-of-hospital cardiac arrest and (ii) responding to increased accuracy of NLP. Conclusions: NLP has the potential to reduce or eliminate human bias during the emergency triage assessment process and contribute towards improving triage accuracy in pre-hospital decision-making and an early identification and categorisation of life-threatening conditions. Evidence to date is mostly linked to cardiac arrest identification; this review proposes that during the call-taking phase NLP should be extended to include further medical emergencies (including fracture/trauma, stroke and ketoacidosis). Further research is indicated to test the reliability of these findings and a proportionate introduction of NLP simultaneous with increased quality and reliability.Publication On family-centred and child-centred care - And the moral distress therein(2022) Boyle, BreidgeOn family-centred and child-centred care - And the moral distress thereinPublication Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis(2021) Gormley, KevinObjective: Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. Methods: A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. Results: Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31–40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. Conclusion: Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.