Chronic enterocutaneous fistula: management in the community settingDespite being aggravating and potentially embarrassing, enterocutaneous fistulas can be successfully managed, with patients being able to resume many of their normal daily activities while the fistula continues to drain. Nevertheless, the management of enterocutaneous fistulas in the community can pose many challenges to nurses, the most common being peri-fistula moisture-associated skin damage. This article presents fistula management plans, which can facilitate the long-term support of these patients, promoting patient comfort and adherence to treatment.
Compassion-focused self-help for psychological distress associated with skin conditions: a randomized feasibility trialObjective: This study tested the feasibility of a self-help intervention based on Compassion-Focused Theory (CFT), and estimated treatment effects in a population of adults with skin conditions and associated psychological distress. Design: A randomized-controlled design was used, with 176 participants being allocated to either CFT-based self-help or a waitlist control group, who received usual medical care. The two-week intervention was provided by email. Main Outcome Measures: Treatment adherence and attrition rates were calculated, and effectiveness was estimated using measures of perceived stress, anxiety, depression, dermatology-specific quality of life and self-compassion. Results: Eighty-seven participants completed the post-intervention questionnaires (51%), and practiced on a median of 9/14 days. Study completers demonstrated significant, moderate improvements on measures of stress, anxiety, depression, self-compassion and dermatology-specific quality of life, relative to controls. In intention-to-treat (ITT) analyses, these findings remained significant, however effect sizes reduced from moderate to small. Conclusions: The findings indicate that CFT self-help shows promise in the treatment of psychological distress associated with skin conditions, however further testing of the intervention is not feasible without significant methodological changes, including the method of treatment delivery. Future studies should also include a follow-up period, as the duration of treatment effects could not be shown.
Working as a tissue viability nurse in offender healthThis article outlines my journey from tissue viability specialist nurse in the community to tissue viability specialist nurse in offender health and the challenges I have encountered along the way. Since coming into this post, I have concentrated on pressure ulcer risk assessment, leg ulcer management, documentation and staff training. The patients I have been involved with have a variety of wounds that can be quite complex in nature. Intravenous drug use is an ongoing problem and, as a consequence, some of our patients have complicated leg ulcers. Although the service is still developing, progress has been made and we are now looking to expand the team. References