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NIHR Signal Partial knee replacements have some short-term advantages compared to total knee replacements
Replacing one side of the knee, unicompartmental knee replacement, may result in shorter hospital stays, fewer short-term complications, faster recovery and better knee function than total knee replacements. However, about 8% need revision by five years - about two to three times the rate with total knee replacements. People with pain and immobility from osteoarthritis that cannot be controlled by other treatments may be referred for knee surgery. If the damage is only to one side of the knee, ...
NIHR Signal Goal-setting can help people with early-stage dementia improve function
Goal-setting as part of cognitive rehabilitation delivered by occupational therapists helped people with early dementia progress towards independence in daily tasks, with benefits lasting for nine months. This approach focuses on the everyday tasks needing concentration and memory and prioritising those that matter most to individuals, from using the cooker or answering the phone. The intervention was well-received, but the cost-effectiveness is not clear, because quality of life continued to de...
NIHR Signal New insights into how ethnicity and culture affect maternal mental health
Ethnicity and culture can affect how and when women seek help for mental health problems before or after having a baby. Many women avoid seeking help because they feel services are not sensitive to their beliefs. Services should ensure all women, regardless of background, can access the support they need during and after pregnancy. This mixed methods systematic review of UK evidence found that many women are not aware of the help available to them, and those that are aware often view it negativ...
NIHR Signal Communication problems are top of patients’ concerns about hospital care
Patients have different concerns from clinicians when asked about problems with their care, and may identify preventable safety issues. When trained volunteers surveyed 2,471 patients from three NHS Trusts in England, 23% of patients identified concerns about their care. The biggest category of concerns related to communication, with staffing issues and ward environment the next most common and safety issues. Although the majority of safety issues were categorised as negligible or minor, they w...
NIHR Signal Training programme to improve communication between staff and patients with dementia in hospital shows promise
Communication with people with dementia can be challenging for healthcare professionals. A new two-day training programme shows potential to help professionals become more confident in managing difficult situations on the ward. After analysis of 41 videoed exchanges between 26 healthcare professionals and 26 people with dementia in acute hospitals, researchers identified particular challenges. These included requests for action, such as asking them to take a drink or get out of bed, and at the ...
NIHR Signal New strategies for maintaining blood supplies from donations may be cost-effective
Opening blood donation centres on weekday evenings and at weekends is a cost-effective way of increasing the blood supply used by hospitals in the UK. Allowing donors to give blood more often could increase supplies in the short term, but it isn’t clear if it would be cost-effective in the long-term. This NIHR-funded modelling study used data from a recent large randomised trial in the UK that investigated the safety of donating blood more frequently than current guidance allows. This was...
NIHR Signal A reflective group activity supports healthcare staff in England
Regular participation in structured organisation-wide forums, known as Schwartz Center Rounds®, helps support healthcare staff. The forums are linked with increased empathy and compassion for colleagues and patients, and they facilitate practice change. Levels of poor psychological well-being decrease in forum attendees compared with non-attendees. Originating in the US, these forums provide the opportunity for clinical and non-clinical staff, from Chief Executives to porters, to deliver en...
NIHR Signal Ways of integrating care that better coordinate services may benefit patients
New integrated care models can increase patient satisfaction, perceived quality of care and improve access to services. It is less clear whether there may be effects on hospital admissions, appointments or healthcare costs. Strong leadership and patient engagement are among factors influencing successful implementation. The NHS is undergoing reconfiguration to better coordinate services around patients. This NIHR-funded review looked at the international literature to understand how new care mo...
NIHR Signal New insights into living with inflammatory bowel disease
Living with inflammatory bowel disease as a `hidden’ condition can lead to feelings of isolation and exclusion. These experiences are characterised by exhaustion, feelings of damaged body image, loss of control and living with the fear of complications. The condition can be unpredictable and have a profound impact on quality of life, disrupting social relationships and interactions with the outside world. The ongoing emotional and psychological difficulties caused by this chronic, long te...
NIHR Signal Peer support may reduce readmissions following mental health crises
People discharged from mental health crisis teams are less likely to re-enter acute services within a year if they receive self-management support. The support in this study was provided by a peer worker, someone with experience of mental illness. The peer worker used a workbook to provide information and talk through recovery goals. The study compared this with those who had received the workbook by post. Participating adults had a range of mental illnesses and had been managed by six crisis r...
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