Category Archives: Publications

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CaHRU newsletter (Winter 2017/18)

CaHRU_logotypeThe latest edition of the CaHRU Newsletter (Winter 2017/18) was published in March 2018. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/CaHRU-Newsletter-Winter-2017-18.pdf” width=”640″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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New study from CaHRU on caregivers for people with dementia

brainA qualitative study exploring the experiences and perceptions of informal carers of people with dementia when interacting with health care services was published this month in the journal Dementia. The study entitled ‘Caregivers’ interactions with health care services – Mediator of stress or added strain? Experiences and perceptions of informal caregivers of people with dementia – A qualitative study’ was undertaken by Despina Laparidou (lead author), Dr Jo Middlemass, Professor Terence Karran and Prof Niro Siriwardena.

IMG_0923The study explored carers’ unmet needs for both information/knowledge about dementia and support from healthcare services. The researchers found that carers would greatly benefit from detailed information on disease progression, guidelines and tips on dealing with challenging behaviours, as well as information on financial and legal advice. Carers also felt that health and social care services are often fragmented, making it harder for them to receive the support they need and want.

CaHRU_logotypeAt the same time, healthcare professionals stated that while they have a theoretical knowledge of the disease, they felt they often lack knowledge of how it is to live with dementia, which can make it difficult to know how best to support carers. Another interesting finding of the study was that having carers keep a daily diary of symptoms and behaviour could help to empower carers and facilitate communications with healthcare professionals.

The research team hopes to expand this study and develop an educational intervention for informal carers of people with dementia.

By Despina Laparidou

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New study on health-related causes of gambling in older adults

Courtesy of Wellcome Images

Courtesy of Wellcome Images

Dr Julie Pattinson from the Community and Health Research Unit (CaHRU) at University of Lincoln, recently published an article in the Journal of Behavioral Addictions. The article, entitled ‘Age-related physical and psychological vulnerability as pathways to problem gambling in older adults’, was co-authored by, Dr Adrian Parke, University of Lincoln, Professor Mark Griffiths, Nottingham Trent University and Dr David Keatley, University of Lincoln. This is Julie’s third publication following her PhD thesis on ‘British older adult gambling behaviour; evaluating psychological and physical health as predictive risk for problem gambling.’

JuliePattinsonThe study background discussed clinical treatment and preventative efforts, and highlights the need to understand the pathways to late-life gambling disorder. The study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association. In total, 595 older adults aged 64-94 years were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling.

Courtesy of Wellcome Images

Courtesy of Wellcome Images

Pathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but these relationships were mediated by both anxiety and depression symptoms. The study indicated that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent upon deteriorating physical well-being and social support. Furthermore, when individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches. Full text available at: http://akademiai.com/doi/pdf/10.1556/2006.7.2018.18

By Dr Julie Pattinson

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New CaHRU study on Community First Responders in Lincolnshire published

vhp2An interview study exploring the experiences of Community First Responders (CFRs) in Lincolnshire as well as their relationship with patients and the ambulance service (http://rdcu.be/GkCl) was published this month in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine The study entitled, ‘Perceptions and experiences of community first responders on their role and relationships: qualitative interview study‘ was undertaken by Viet-Hai Phung, Ian Trueman, Fiona Togher, Dr Roderick Ørner and Professor Niro Siriwardena, with valuable input from Dr Simon Topham, medical director of LIVES. It follows on from a scoping review of CFR schemes that was published in the same journal in 2017.’

The interviews reinforced the themes that the scoping review identified. Participants became CFRs mainly for altruistic Nreasons, to help others and put something back into their community. Ths contributed to their sense of personal satisfaction and helped maintain their involvement over time. CFRs valued scenario-based training and while some were keen to access additional training to enable them to attend a greater variety of incidents, others stressed the importance of maintaining existing practice and improving their communication skills. They were often first on scene, which they recognised could take an emotional toll, but for which they found informal support mechanisms helpful. Participants felt a lack of public recognition and sometimes were undervalued by ambulance staff, which they thought arose from a lack of clarity over their purpose and responsibilities.

NIn terms of future development, CFR schemes should consider the varying training, development and support needs of staff. CFRs wanted schemes to be complementary but distinct from ambulance services. Further information on outcomes and costs of the CFR contribution to prehospital care is needed to inform future how schemes operate. It is important that they maintain their local identity. To do so, they will need to respond to local needs.

By Viet-Hai Phung

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Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne