About
116
Publications
53,021
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
7,357
Citations
Introduction
I am a registered adult nurse with critical care experience working in applied health research. The work I do mainly focuses upon the improvement of the health care experiences of patients living with cardiovascular disease from diagnosis to rehabilitation. Other work streams focus upon the improvement of care quality in other secondary care settings. I am an experienced external examiner (national and international experience) for PhD examination.
Current institution
Additional affiliations
July 2010 - February 2013
February 2015 - April 2015
Publications
Publications (116)
Purpose:
Person-centred physiotherapy in Intensive Care Units (ICU) supports patients' early rehabilitation. Yet little is known about the activity required to enable person-centred physiotherapy in this setting. This study explores the experiences and interpretations of people who received physiotherapy.
Methods:
A qualitative study using Inter...
Background
Extended reality (XR) interventions have the potential to benefit patients undergoing elective cardiac surgical and interventional procedures. However, there are no systematic reviews with meta‐analyses to guide clinical care.
Aim
To critically evaluate the evidence on the effectiveness of XR interventions on patient anxiety and pain an...
Cardiovascular disease and type 2 diabetes are prevalent among UK South Asians. Langar is a Sikh religious food practice that could be important in dietary health promotion. This study explored perceptions of langar, its role in health, readiness and strategies for change and whether Gurdwaras (Sikh place of worship) are able to support change. Usi...
Aim
Shared decision-making is recommended for patients considering treatment options for severe aortic stenosis (AS) and chronic coronary artery disease (CAD). This review aims to systematically identify and assess patient decision aids (PtDAs) for chronic CAD and AS and evaluate the international evidence on their effectiveness for improving the q...
Purpose:
Person-centred care is widely accepted as being central to high quality care, but little is known about how physiotherapists implement person centred rehabilitation in Intensive Care. This study explores the self-reported experiences and interpretations of physiotherapists delivering person-centred rehabilitation in this setting.
Methods...
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): General Nursing Council for England and Wales Trust
Background
The incidence of Heart Failure (HF) is increasing. Breathlessness and fatigue are symptoms that signal clinical deterioration. However, patients often do not recognise wors...
AIMS
To 1) Describe the sociodemographic and risk factor profiles of a sample of patients with coronary disease, 2) Explore associations between illness perceptions and health literacy with sociodemographic characteristics and risk factors, health-related quality of life, anxiety and depression.
METHODS AND RESULTS
Conducted as part of the ESC Pre...
Background/Aims
Coronary angiography requires a complex informed consent process as a legal and ethical requirement before treatment. This process may allow percutaneous coronary intervention to be completed as a continuation of a coronary angiography. Patients routinely consent to both interventions, but over one-quarter will only receive the diag...
Introduction:
Blended learning is an educational approach that integrates face-to-face with online instruction. This overview of existing systematic reviews aims to evaluate the impact of blended learning on educational outcomes in health care professional education, identify gaps in the current evidence, and direction for future reviews.
Methods...
Background
Research shows that people with stable angina need decision support when considering elective treatments. Initial treatment is with medicines but patients may gain further benefit with invasive percutaneous coronary intervention (PCI). Choosing between these treatments can be challenging for patients because both confer similar benefits...
Background/Aims
Coronary angiography requires a complex informed consent process as a legal and ethical requirement before treatment. This process may allow percutaneous coronary intervention to be completed as a continuation of a coronary angiography. Patients routinely consent to both interventions, but over one-quarter will only receive the diag...
Nursing assessment addresses health promotion, prevention of illness, and the nursing care of ill people. It identifies immediate and future responses to potential and actual health problems of the cardiovascular patient. Care planning aims to address problems with collaborative goals identified by the cardiovascular patient. A physical examination...
Atherosclerosis is a disease of ageing that causes coronary heart disease. Coronary artery disease can manifest as acute or chronic coronary syndromes. Rapid and accurate risk stratification and assessment of patients presenting with chest pain improves patients’ outcomes. There is no single diagnostic test for acute coronary syndromes. Accurate in...
The ESC Textbook of Cardiovascular Nursing is the official textbook of the European Society of Cardiology (ESC) Association of Cardiovascular Nursing and Allied Professions. It aims to provide in-depth learning for nurses specializing in caring for patients with coronary heart disease, heart failure, valvular disease, arrhythmias, congenital heart...
Background: Research has consistently demonstrated that preventive cardiology programs have limited success, and healthy practices among high-risk individuals remain suboptimal. Furthermore, there are no current programmes in Malta that offer support to first-degree relatives of patients with premature coronary heart disease.
This internal pilot st...
Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is high, and ACT may offer an alterna...
Aims :
Despite the high use of cardioprotective medications, the risk factor control in patients with coronary heart disease (CHD) is still inadequate. Guidelines identify healthy lifestyles as equally important in secondary prevention as pharmacotherapy. Here, we describe reasons for poor lifestyle adherence from the patient's perspective.
Metho...
Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): LHL Hospital Gardermoen Bergesen Foundation
Digital Secondary Prevention Follow-up After Percutaneous Coronary Intervention (PCI) at Home:
What are the Users Perspectives?
Background
Secondary prevention for patients with established CHD is the mainstay o...
Grounded theory (GT) is both a research method and a research methodology. There are several different ways of doing GT which reflect the different viewpoints of the originators. For those who are new to this approach to conducting qualitative research, this can be confusing. In this article, we outline the key characteristics of GT and describe th...
The knowledge, skills and attitudes taught on Advanced Life Support (ALS) courses are an important learning requirement for healthcare professionals who are involved with the care of acutely unwell patients. It is essential that the course design and delivery is appropriately planned to ensure that it optimises the learning opportunities for all le...
This article presents a collaborative educational initiative designed to enhance the learning experience for undergraduate product design students and boost their employability through an introduction to ‘real-world’ design challenges in healthcare settings. The initiative centred upon enhancing the learning experience for a cohort of 38 product de...
Background
Programmes using motivational interviewing show potential in facilitating lifestyle change, however this has not been well established and explored in individuals at risk of, yet without symptomatic pre-existent cardiovascular disease. The objective of this systematic review and meta-analysis was to determine the effectiveness of motivat...
Background:
Hospitals provide treatment to improve patient health and well-being but the characteristics of the care environment receive little attention. Excessive noise at night has a negative impact on in-patient health through disturbed sleep. To address this hospital staff must measure night-time environmental noise levels. Therefore, an unde...
A medicines helpline service, run by a hospital pharmacy department, is one intervention that may help reduce medication errors and improve patient safety. Here, the authors describe their study examining how patients utilise Mid Yorkshire Hospitals NHS Trust's medicines helpline service, in terms of the types of enquiries received and how these re...
Aims and objectives
To explore South Asians’ experience of choosing and prioritising lifestyle changes during their recovery from first myocardial infarction.
Background
Coronary heart disease continues to be a leading cause of premature death globally. South Asians’ suffer increased risk of coronary heart disease and have poorer outcomes followin...
Objective
To explore the views of primary care teams about the provision of self-management support to patients with common health problems.
Methods
Semi-structured interviews were conducted with twenty-one members of the primary care team from thirteen general practices. Interviews were transcribed verbatim, and analysed using the ‘Framework’ app...
Background
Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health.
Aims
To assess 1) in-patients sleep quality, quanti...
Aim
The aim of this study is to cross‐culturally translate and adapt the Cardiac Self‐Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients.
Method
The original English version of the Cardiac Self‐Efficacy Questionnaire was translated into Arabic following a...
Background
Anxiety is a common and distressing problem after stroke.
Aims
To undertake an updated systematic review and meta-analysis of observational studies of anxiety after stroke and integrate the findings with those reported previously.
Summary of review
Multiple databases were searched in May 2018 and 53 new studies were included following...
ABSTRACT
Background: Regular physical activity is important for patients
with established coronary heart disease as it favorably influences their coronary risk profile. General self-efficacy is a powerful predictor of health behavior change that involves increases
in physical activity levels. Few studies have simultaneously
measured physical activi...
Coronary heart disease (CHD) has no cure, and patients with myocardial infarction are at high risk for further cardiac events. Health education is a key driver for patients’ understanding and motivation for lifestyle change, but little is known about patients’ experience of such education. In this review, we aimed to explore how patients with CHD e...
Background
Percutaneous coronary intervention is a common revascularisation technique. Serious complications are uncommon, but death is one of them. Seeking informed consent in advance of percutaneous coronary intervention is mandatory. Research shows that percutaneous coronary intervention patients have inaccurate perceptions of risks, benefits an...
Background
Percutaneous Coronary Intervention (PCI) is the commonest invasive procedure in cardiology. Before treatment consent must be given. As part of this communication process patients receive information about the risks and benefits of PCI and alternative treatments. Published studies tell us that the amount and quality of the information rec...
Objective:
High levels of environmental noise in hospitals disturbs sleep. We aimed to identify, critically appraise and summarise primary research that reports studies that tested interventions to reduce night-time noise levels in ward-settings.
Design:
Systematic review and meta-analysis in accordance with Preferred Reporting Items for Systema...
Background::
patient involvement in the design, planning and delivery of health services is acknowledged to be a local and national priority.
Aims::
to improve service quality through a quality improvement initiative to explore patient preferences for involvement in health services design, planning and delivery.
Methods::
a questionnaire was d...
Objective: To systematically identify, synthesise and evaluate the strength of the international evidence on copy letter practice. Methods: A systematic search identified original research studies on copy letters. Searches were limited by date and language as permitted in rapid review methods guidance. Article screening, data extraction and strengt...
Background:
Mechanical ventilation is a routine intervention for the critically ill but patients' experiences of this intervention are largely hidden from clinicians. A comprehensive understanding of Intensive Care Units survivors' accounts is required to provide health professionals with evidence about the patients' experience to deliver patient-...
Objective:
To provide an in-depth understanding of patients' views about the impact of transcatheter aortic valve implantation on self-reported quality of life.
Background:
Transcatheter aortic valve implantation is considered to be the gold standard of care for inoperable patients diagnosed with severe symptomatic aortic stenosis. Mid- to long-...
Context • Increasing numbers of people worldwide live with a long-term health condition (LTC). Finding new ways to support people diagnosed with LTCs is important, both to improve their health-related quality of life and to manage the demands on health services that their conditions present. This effort includes a recognition of the importance of i...
Aims and objectives:
This critical review examines the extent that individualised education helps reduce depression, anxiety and improves self-care for people who've undergone Coronary Artery Bypass Graft surgery (CABG).
Background:
Individualised discharge planning is increasingly important following cardiac surgery due to recurrent admissions...
Background:
Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required.
Aim:
To undertake a systematic review and met...
Background: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. Aim: To undertake a systematic review and meta-a...
Cardiovascular disease accounts for 17,500 deaths globally, representing nearly half of all non-communicable disease deaths. The World Health Organization has set nine lifestyle, risk factor and medicines targets to achieve by 2025 with the aim of reducing premature mortality from non-communicable diseases by 25%. In order to succeed in this, we ne...
Objective
Informed consent is central to ethical medical practice, but little is known about how the process takes place in clinical practice. Percutaneous coronary intervention (PCI) is a common revascularisation procedure. Studies report that patients overestimate benefits, forget the risks and are unaware of alternative treatments. The aim of th...
Objective:
To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate.
Methods:
A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017...
Background:
Heart failure (HF) is a complex and highly debilitating clinical syndrome. International guidelines identify the optimum clinical management of patients living with HF in primary care but translation of these into practice remains inadequate. The aim of this service evaluation is to measure standards of HF diagnosis and management, befo...
Background:
Cardiac catheterization is the standard procedure for the diagnosis of coronary heart disease. The threat physically and emotionally from this procedure can affect the patient's perception of their health. The heightened psychological distress associated with this diagnostic procedure can cause adverse patient outcomes. Non-pharmacolog...
Background: Cardiac catheterization is the standard procedure for the diagnosis of coronary heart disease. The threat physically and emotionally from this procedure can affect the patient’s perception of their health. The heightened psychological distress associated with this diagnostic procedure can cause adverse patient outcomes. Non-pharmacologi...
Aim:
To explore how practising mindfulness affects people's experiences of living with a long-term condition.
Background:
Increasing evidence suggest that mindfulness meditation-based interventions benefit people with long-term conditions, particularly in terms of psychological well-being. Most evidence, however, relates to short-term outcomes a...
Recent advances in care and management of heart failure have improved outcome, largely as a result of the developing evidence basis for medications, implantable devices and the organization of heart failure follow-up. Such developments have also increased the complexity of delivering and coordinating care. This has led to a change to the way in whi...
Background:
The traditional use of physically focused outcome measures fails to capture holistic, quality of life issues of importance to patients. The relatively recent, rapidly growing interest in patient-reported outcome measures (PROMs) attests to this and clinicians are faced with difficult decisions regarding their choice and use.
Aims:
Th...
Objective:
To assess the quality, readability and coverage of website information about herbal remedies for menopausal symptoms.
Study design:
A purposive sample of commercial and non-commercial websites was assessed for quality (DISCERN), readability (SMOG) and information coverage.
Main outcome measures:
Non-parametric and parametric tests w...
Recent advances in care and management of heart failure have improved outcome, largely as a result of the developing evidence basis for medications, implantable devices and the organization of heart failure follow-up. Such developments have also increased the complexity of delivering and coordinating care. This has led to a change to the way in whi...
Poster presentation ESC 2015 Experiences of informed consent for PCI/coronary angioplasty: an interview study
Commentary on: Lo SH, Chau JP, Woo J, et al. Adherence to antihypertensive medication in older adults with hypertension. J Cardiovasc Nurs 2015. Published Online First: 13 Mar 2015. doi:10.1097/JCN.0000000000000251
Medication adherence is commonplace with around 40–45% of patients prescribed cardiovascular therapies classified as non-adherent.1 ,2...
Introduction Heart failure (HF) is a complex and highly debilitating clinical syndrome. Clear guidelines identify the optimum management of patients living with HF in primary settings but implementation of these is suboptimal.
Aim The aim of this service improvement project was to develop a tool kit, The Greater Manchester Heart Failure Investigati...
Background: The European Society of Cardiology and the Council on Cardiovascular Nursing and Allied Professions share a vision; to decrease the burden of cardiovascular disease in Europe. Nurses represent the largest sector of the health professional workforce and have a significant contribution to make, which has not yet been fully realised. Recen...
Background:
The European Society of Cardiology and the Council on Cardiovascular Nursing and Allied Professions share a vision; to decrease the burden of cardiovascular disease in Europe. Nurses represent the largest sector of the health professional workforce and have a significant contribution to make, which has not yet been fully realised. Rece...
Several surveys demonstrated in the past a large heterogeneity of cardiology training and education in European countries. Taking into consideration the reality of the free movement of doctors and patients across borders, the cardiology community feels a strong need for the harmonisation of training and education of European health professionals. T...
Background
Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing...
Background
Coronary angioplasty is a common procedure that requires a short hospital stay. A pre-angioplasty clinic offers the opportunity to address unmet health information needs and provide tailored patient information. A person-centred DVD was developed and sent out to patients prior to attendance at a pre-angioplasty clinic, which enabled atte...
This article explores the characteristics of qualitative research and its potential value for research in cardiac nursing, using short illustrative examples. It begins by clarifying the focus and world view of qualitative research, elaborating on its underlying methodology and methods. Insight is provided into the range of methods of data collectio...
The symptom burden of heart failure is significant and impacts upon health-related quality of life. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is widely used in clinical practice to measure self-reported health-related quality of life, but the psychometric properties of the instrument are not fully elucidated. To address this gap...
Background
Nurses represent the largest sector of the workforce caring for people with cardiovascular disease in Europe. Little is known about the post-registration education provided to nurses working within this specialty. The aim of this descriptive cross sectional survey was to describe the structure, content, teaching, learning, assessment and...
Background and purpose:
Negative psychological outcomes occur frequently after stroke; however, there is uncertainty regarding the occurrence of anxiety disorders and anxiety symptoms after stroke. A systematic review of observational studies was conducted that assessed the frequency of anxiety in stroke patients using a diagnostic or screening to...
To review and synthesise, systematically, the research findings regarding motivational interviewing and to inform education, research and practice in relation to cardiovascular health.
Motivational interviewing is designed to engage ambivalent or resistant clients in the process of health behaviour change, and it has been widely used in different c...
Felicity Astin presents questions for the critical reader to bear in mind when assessing a piece of published qualitative research.
Felicity Astin and Andrew F Long present an introduction to the philosophy and concepts of qualitative research, including some of the methodologies and methods that may be used
This paper is a report of a study to explore patients' experiences of primary angioplasty and assess their illness perceptions during early recovery.
Primary angioplasty is recognized as the gold standard treatment for patients with ST elevation myocardial infarction, yet little is known about patients' experiences of this treatment. Recent policy...
Felicity Astin outlines the implications for cardiac nursing of the findings of the final report from the National Infarct Angioplasty Project, just published in October.
As early recovery is a challenging period for cardiac patients who frequently have 'unmet' health information needs, the objective of this study was to explore the information needs of patients treated with primary angioplasty for heart attack.
Qualitative methodology using semi-structured interviews with 29 patients recruited from a specialist Eng...
Felicity Astin gives us a flavour of events at the annual meeting of the ESC Council on Cardiovascular Nursing and Allied Professions, held on March 14–15 2008
Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change....
