Institute of Applied Health Research

The aims of this systematic review of reviews were to identify, appraise, synthesise and contextualise a range of guidance, guidelines, review-level evidence of effectiveness (or ineffectiveness) and pertinent evaluation evidence on prevention of HIV transmission in MSM. Specifically, the objectives of the review were to:• Use systematic review methods to identify, retrieve and critically appraise review-level evidence of effectiveness of HIV prevention among MSM.• Identify relevant aspects of published guidance and guidelines ...

Aim: This study aimed to explore stroke nurses' knowledge and practice in relation to the provision of secondary prevention lifestyle information following stroke. Design: Cross-sectional survey methods were used. Participants were members of the Scottish Stroke Nurse Forum (n= 97). Methods: A self-completed questionnaire was used to collect the data, with descriptive statistics summarizing the results. Results: Respondents stated that they assessed lifestyle risk factors following stroke; however, they focused on some but not all ...

Purpose: This study explored the experience of stroke from the perspective of family members of young adults who have had a stroke. Gaining understanding of the short, medium and long-term needs and desired rehabilitation outcomes of family members assisted identification of appropriate familycentred multidisciplinary rehabilitation interventions. Method: A qualitative approach based on Merleau-Ponty's existential phenomenology enabled exploration of family members' experience of stroke. Eleven family members, including parents, spouses, children and siblings, participated in 24 interviews over 2 years. A subsequent iterative process of critical reflection was used to identify family-centred needs, priorities and associated rehabilitation outcomes. Results: Within a thematic framework, family members' experience was conceptualised as Disruption of Temporal Being. Against this overarching theme or (back)ground, figural themes were identified: Uncertainty, Disrupted and Altered Relationships, and Situatedness. In addition, sixteen short, medium and long-term effects of stroke were identified along with associated family-centred needs and rehabilitation outcomes. Conclusion: An empathetic understanding of the experience of stroke from the perspective of family members, combined with research evidence and professional expertise enables the multidisciplinary rehabilitation team to deliver tailored interventions based on identified needs and priorities, and negotiation of mutually agreed goals.

Purpose. This study sought to understand the experience of living and coping with nocturia, from the perspective of community-living older men and women. Method. Individual semi-structured interviews were undertaken with 32 older people with self-reported nocturia of twice nightly or more. Results. Four key characteristics of nocturia were identified. Nocturia was described as simultaneously debilitating, frustrating, distressing and puzzling. It impacted on sleep patterns and quality, personal relationships and increased the fear of falling among older people when rising to use the toilet at night. Previously unrecognised variability and unpredictability in the condition were highlighted features. Nocturia was not prioritised for health intervention. There were gender differences in initial help-seeking however once prostate disease was eliminated, self-management strategies to cope with the effects of nocturia were the norm.

neous demands and expectations. Currently, society demands participation in a large social environment and this is reflected in stroke patients' priorities. This analogy could enable medical professionals to better understand the social impact of stroke, and consequently offer appropriate interventions to improve rehabilitation outcomes for individual patients.

Background Involving patients in the determination of their care is increasingly important, and health-care professionals worldwide have recognized a need for clinical outcome measures and interventions that facilitate patient-centred care delivery in a range of settings.

This paper presents the process, results and findings of an inclusive systematic review method, which informed the development of an evidence-based, interdisciplinary definition of patient-centred stroke care. The review was undertaken as an integral element of an evidence building/evidence synthesising doctoral research programme.

Background Recent epidemiological studies have demonstrated an association between perceived psychological stress and ischemic stroke. A feature of stroke is recurrence; 30-40% within five-years following first transient ischemic attack/ stroke. Equipping patients with skills and coping strategies to help reduce or manage perceived psychological stress may represent an important secondary prevention intervention. Mindfulness-based interventions are structured, group-based self-management programmes with potential to help people with long-term conditions cope better with physical, psychological, or emotional distress. Review evidence suggests significant benefits across a range of physical and mental health problems. However, we could find no evidence synthesis relating specifically to the benefits of mindfulness-based interventions following transient ischemic attack/stroke. Aim The review aims to evaluate the benefits of mindfulnessbased interventions following transient ischemic attack/ stroke. Methods Six major databases were searched using subject headings and key words. Papers were screened using reviewspecific criteria. Critical appraisal and data extraction were conducted independently by two reviewers. Statistical metaanalysis was not possible; therefore findings are presented in narrative form. Results Four studies involving 160 participants were reviewed. Three papers reported mindfulness-based interventions delivered to groups; one paper reported a mindfulnessbased intervention which was delivered one to one. The results demonstrate a positive trend in favor of the benefits of mindfulness-based interventions across a range of psychological, physiological, and psychosocial outcomes including anxiety, depression, mental fatigue, blood pressure, perceived health, and quality of life. No evidence of harm was found. Conclusion Following transient ischemic attack/stroke, people may derive a range of benefits from mindfulness-based interventions; however, further methodologically robust trials are required.

Disability Living Allowance (DLA) is a UK social security benefit designed to meet the extra costs associated with disability. It has been suggested that some people with disabilities who are eligible for DLA do not claim the benefit, and amongst those who do claim there are inconsistencies of award decision-making. The aim of this research was to establish the level of knowledge relating to DLA amongst disabled people in Scotland and to explore the process of application from the perspective of those involved. Questionnaires were distributed through voluntary organizations. Six hundred and six completed questionnaires were received.