Wellbeing in Long-Term Conditions Research Development Group

The Wellbeing in Long-Term Conditions Research Development Group is a new and rapidly expanding team within the Faculty of Health and Social Care.

The aim of the group is to undertake and disseminate high quality research studies which have distinct relevance to clinical practice. We work nationally and internationally in collaboration with public representatives, charitable organisations, partner academic institutions, clinical colleagues and industry to achieve our aims.

We have a particular interest how behavioural management principles can be utilised to support people with long-term skin conditions to self-manage as effectively as possible.

Staff team

Lead

Steven Ersser: Dean of the Faculty of Health and Social Care and Professor of Nursing and Dermatology Care.

Core team

Sue Beacock: Associate Dean Learning and Teaching

Dr Fiona Cowdell: Senior Research Fellow

Tracey Heath: Lecturer, Director: Centre for Leadership, Innovation and Change through Knowledge Transfer (CLICK)

Dr Lesley Hughes: Senior Lecturer

Jane Wray: Senior Research Fellow

Doctoral Students

Jill Brooks (Proctor & Gamble Studentship)

Norma Buttigieg

Corrine Ward

Visiting Faculty

Dr Helen Farasat, Senior Lecturer, School of Health and Social Care, Bournemouth University Dr Rod Tucker, Community Pharmacist

Current studies

The Eczema Education Programme

We are working with colleagues at Bournemouth University to lead a collaborative evaluation of the Eczema Education Programme. This programme seeks to improve the education of parents of children with atopic eczema.

The Programme is led by the St John’s Institute of Dermatology at the Guy’s and St Thomas’ Hospital Trust. In conjunction with Lambeth Primary Care Trust, the initiative and study is being rolled out across the borough. This is one of the largest eczema education programmes in Europe, involving up to 750 parents across 53 health centres, and is nurse led.

The evaluation team is examining the patterns of referral and areas such as the impact of child quality of life and parental self efficacy. The project involves the development, testing and finalising of the Parental Self-efficacy in Eczema Care Index (PESECI). The evaluation work is being led by Professor Steven Ersser with support from Dr Helen Farasat.

The programme and evaluation are supported by a grant of £345,000 from the Guy’s and St Thomas’ Charitable Trust.

The EEP Programme is led by Karina Jackson, Consultant Nurse, St.John’s Institute of Dermatology London and the evaluation is led by Professor Ersser, with the assistance of Dr Helen Farasat, Visiting Research Fellow, University of Hull and Senior Lecturer in Children’s Nursing, Bournemouth University.

The Person–Centred Dermatology Self–Care Index – A new tool for Practice

The Person–Centred Dermatology Self–Care Index (PeDeSI) is a validated tool we have developed to help clinicians to make a systematic and accurate assessment of the education and support needs of adults with long–term skin conditions to enable them to self–manage as effectively as possible.

It has been developed by Professor Ersser and Dr Cowdell in collaboration with patient representatives and colleagues from practice and industry and has been extensively tested in clinical practice.

The Index has ten items and should be competed with patients to enhance the concordance process. The index is accompanied by a user guide which provides instructions of how it may be used most effectively.

The Person–Centred Dermatology Self–Care Index – Going Live!

To maximise access to the PeDeSI an academic team led by Dr Fiona Cowdell has worked with Cotoco, specialists in digital technology and Julie van Onselen, Independent Dermatology Specialist Nurse, to develop web-based support materials specifically to develop people’s competence and confidence to manage their skin condition.

This enhancement has been largely funded by the Technology Strategy Board. The software toolkit is an innovative way to deliver personalised information that can be used by patients wherever they are. The toolkit can also be used by healthcare professionals, who may not be experts in dealing with the specific condition. This system will have the capability to be used both on and offline.

The web-based toolkit is designed to take the user on a journey that starts with improving understanding of their condition, through practical day to day management of it, and culminates in producing a personalised action plan. A recent feasibility study investigated the impact the toolkit using pre and post PeDeSI scores.

A significant improvement in ability to self-manage was detected and with about half of participants (45.3%) reporting it had made a difference to how they manage their condition. This feasibility study showed promising results which require further testing in practice.

Reviews

The group are now updating their Cochrane Review on Psychological and Educational Interventions for Atopic Eczema in Children (lead Professor Steven Ersser) and are planning to complete a Cochrane Review assessing of the Effects of Skin Cleansers Versus Soap and Water on the Skin Condition of Older People in Hospital and Residential Care Settings (lead Dr Fiona Cowdell).

Planned studies

We are building our programme of research and are currently seeking funding for a range of studies focusing on:

• Behavioural change for wellbeing
• Self-management
• Skin health & skin integrity

With particular emphasis on

• needs assessment
• intervention development
• service delivery strategies

Links

Our staff have active links with many key external organisations including

• North & East Yorkshire and Northern Lincolnshire Comprehensive Local Research Network, Regional Dermatology Speciality Group
• The Centre for Evidence Based Dermatology, University of Nottingham
• British Dermatological Nursing Group · United Kingdom Dermatology Clinical Trials Network
• St John’s Institute of Dermatology, King’s College London (Professor Ersser, Visiting Academic)
• Division of Nursing and Dermatology, University of Cape Town (Professor Ersser, Honorary Professor)
• International Skin Care Nursing Group (Professor Ersser, Founder and Chair 1999-2010

Recent publications

• Cowdell, F. 2011 Older People, Personal Hygiene and Skin Care Med-Surg Nursing 20(5), 235- 240
• Cowdell, F. 2010 Promoting skin health in older people Nursing Older People 22(10), 21-25
• Cowdell, F. 2010 Self-managing skin conditions GP on-line http://www.gponline.com/Clinical/article/1044850/Self-managing-skin-conditions/
• Cowdell, F. 2009 Quality of Life and Self-Management in Psoriasis MIMS Dermatology 5(3), 15-17
• Cowdell, F. 2009 Care and Management of Pruritus in Older People Nursing Older People 21 (7) 35-41
• Crickmore, D. Wray, J. 2009 Education and training for learning disability practice: Key messages from contemporary literature, Journal of Intellectual Disabilities 13 (4) 291-304.
• Ersser, S. Cowdell, F. Latter, S. Nicholls, P. Healy, E. 2011 A randomised pilot controlled study to examine the feasibility of an educational nursing intervention to improve self-management practices in patients with mild-moderate psoriasis. Journal of the European Academy of Dermatology and Venereology (DOI: 10.1111/j.1468-3083.2011.04158.x)
• Ersser, S. Kaur, V. Kelly, P. Langoen, A. Maguire, S. Nicol, N. Page, B. Ward, C. 2011. The contribution of the nursing service worldwide and its capacity to benefit within the dermatology field. International Journal of Dermatology 50 (5) 582-589
• Ersser, S. Eleftheriadou, V. Whitten, M. Gawkroder, D. Batchelor, J. Corne, J. Lamb, B. Ravenscroft, J. Thomas, K. 2011 Future research into the treatment of vitiligo: where should our priorities lie? Results of the vitiligo priority setting partnership. British Journal of Dermatology, 164 (3) 530-536.
• Ersser, S. 2011 Nurse prescribing, concordance and therapeutic consultation. British Journal of Dermatology 164 (2) 236-237.
• Ersser, S. Cowdell, F. Healy, E. Latter, S. 2010 Self-Management Experiences in Adults with Mild-Moderate Psoriasis: An Exploratory Study and Implications for Improved Support British Journal of Dermatology 163(5) 1044-1049
• Ersser, S. Latter, S. Sibley, A., Satherley, P. Welbourne, S. 2007 Psychological and educational interventions for atopic eczema in children. Cochrane Database of Systematic Reviews Issue 3. Art. No.: CD004054. DOI: 10.1002/14651858.CD004054.pub2
• Storr, H. Wray, J. Draper, P. 2011 Supporting disabled student nurses from registration to qualification: A review of the United Kingdom (UK) literature. Nurse Education Today (doi:10.1016/j.nedt.2010.11.022)
• Wray, J. Aspland, A. Taghzouit, J. Pace, K. Harrison, P. 2011 Screening for specific learning difficulties (SpLD): The impact upon the progression of pre-registration nursing students, Nurse Education Today (doi:10.1016/j.nedt.2011.01.021)
• Wray, J. Aspland, J. Gibson, H. Watson, R. Stimpson, A. 2009 Wealth of Knowledge: Findings from the employment experiences of older nurses, midwives and the NHS project. International Journal of Nursing Studies 46 977–985
• Wray, J. 2009 Complementary and alternative therapies in Oxford Handbook of Learning and Intellectual Disability Nursing Gates, B, Barr, O. (eds). Oxford: Oxford University Press
• Wray, J. Aspland, J. Gibson, H. Watson, R. Stimpson, A. 2009 The working experience of older nurses and midwives in the NHS. in Chiva, A. Manthorpe, J. (eds) Older Workers in Europe, Maidenhead, Berkshire: Open University Press.
• Wray, J.2009 Gentle Teaching. in Oxford Handbook of Learning and Intellectual Disability Nursing Gates, B. Barr, O. (eds). Oxford: Oxford University Press
• Wray,J.Walker, L.Fell, B. 2008 Student nurses’ attitudes to vulnerable groups: a study examining the impact of a social inclusion module, Nurse Education Today, 28, 513-520.