Niall Mccrae

Niall Mccrae
King's College London | KCL · Florence Nightingale Faculty of Nursing & Midwifery

PhD, MSc, RMN

About

95
Publications
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Publications

Publications (95)
Article
Aim/objective To consider the future of nurse education and the merits of a university-based course versus vocational training. Background In the 1990s nurse training in the United Kingdom moved from an apprenticeship model to a university-based education. At about the same time, the two-tier structure of registered and enrolled nurses was abandon...
Article
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It is often said that the first casualty of war is the truth. In April 2020, soon after the global pandemic began, we speculated (McCrae & Watson, 2020) that evidence, the concrete basis of truth, may already have been abandoned in governments’ rush to act in the context of public and media alarm. However, we were merely speculating as there was li...
Chapter
There is great variation in the type and quality of research evidence. Having completed your search and assembled your studies, the next step is to critically appraise the studies to ascertain their quality. Ultimately you will be making a judgement about the overall evidence, but that comes later. You will see throughout this chapter that we make...
Chapter
History is important, because it takes a longer-term view of any human enterprise. The way that we do things today might seem quaint or perhaps ethically dubious in years to come. Knowledge of the past is not merely a retrospect, but shows a direction of travel: How can we see where we are going if we don’t know where we are coming from? So let us...
Chapter
The last major section of the review report is the discussion. This should make sense of the review findings in the broader context, considering clinical significance and presenting implications and recommendations. Crucially, the reviewer should take account of the limitations of the review and suggest further research. The discussion should not b...
Chapter
Meta-analysis is a method of combining the results of a number of quantitative studies to produce a single weighted average result. In order to undertake and to correctly interpret a meta-analysis, it is important to understand the meaning of quantitative research results, in particular the p-value and confidence interval, both of which are widely...
Chapter
Developing a search strategy can be a time-consuming process, and there is often a temptation to just jump straight into a database instead. Although many of us will begin with a very quick search to establish the amount and type of literature available, your main search needs to be carefully planned and most importantly replicable. Readers may not...
Chapter
Qualitative and quantitative research are fundamentally different, in philosophy, principles and practice. This has major implications for literature reviewing. A review of qualitative studies may be performed with no less systematic rigour than that of experimental trials, but the product will be interpretative rather than numerical. This chapter...
Chapter
If the topic of interest has been studied quantitatively and qualitatively, it may seem right to include both types of evidence. But more is not necessarily better. The challenge for a mixed-method reviewer is that quantitative and qualitative researchers ask very different questions: the former are concerned with measurable outcomes, while the lat...
Chapter
Each of us makes some impact on the world, for better or worse, but scientific researchers are among those who measure this formally (sometimes obsessively). The impact of your systematic review may be judged by the contribution that it makes to the wellbeing of relevant people. This is not easily assessed, but there are important indicators of the...
Chapter
In this chapter, we aim to make the screening process as straightforward as possible, by showing some tools and practices that can improve accuracy and efficiency. The previous chapter is vital, because often a screening exercise needs to be repeated due to necessary amendments to the search specifications. But let’s assume that you have completed...
Chapter
A systematic literature review is a logical, linear process. By ‘linear’, we mean a purposeful activity that is performed in a sequential order, in other words, a ‘step-by-step’ process. Perhaps you have found to your cost what happens when the instructions for a self-assembly item of furniture are followed in the wrong order! The term ‘logical’ ba...
Book
The systematic review is a rigorous method of collating and synthesizing evidence from multiple studies, producing a whole greater than the sum of parts. This textbook is an authoritative and accessible guide to an activity that is often found overwhelming. The authors steer readers on a logical, sequential path through the process, taking account...
Article
Background and rationale: SPECAL is a model of care for people with dementia based on a novel conceptualisation of memory and how this changes in dementia. Carers adapt their communication style to prevent distress and promote well-being for the person with dementia. However, there is limited scientific evidence on the effectiveness of SPECAL. Ai...
Article
For millennia, people have associated the Moon with human behaviour. The concept of lunacy is derived from a presumed destabilising effect on the mind, although there is limited evidence of such causation. Recent sleep research has renewed interest in lunar influence, showing qualitative and quantitative changes in sleep at full moon. This brief re...
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While becoming inextricable to our daily lives, online social media are blamed for increasing mental health problems in younger people. This systematic review synthesized evidence on the influence of social media use on depression, anxiety and psychological distress in adolescents. A search of PsycINFO, Medline, Embase, CINAHL and SSCI databases re...
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Objectives: The review aimed to 1) explore the constituents of nurse-patient therapeutic engagement on acute mental health wards; 2) map factors that influence engagement to the Theoretical Domains Framework and 3) integrate results into a conceptual model of engagement to inform the development of interventions to improve engagement. Design: A...
Article
Newspapers are influential sources of information and opinion on mental health, but careless reporting may reinforce stigma. This review examined portrayals of mental disorder in Saudi Arabian newspapers. A cross-sectional sample (N = 200) of relevant articles was obtained from four of the most popular newspapers. These were categorised for descrip...
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A mental health crisis in younger people has become an established fact. Like manmade global warming, one might get the impression that ‘the science is settled’. Yet popular media reports present scant evidence for a surge in psychiatric disorder. Snowflakes are only as real as we perceive. This article is protected by copyright. All rights reserve...
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In a referendum on 23nd June 2016 the people of the UK voted to leave the European Union (EU). The phenomenon known as Brexit did not come out of nowhere: according to Clarke, Whiteley and Goodwin (2017), it marked a culmination of social and political trends emerging over many years. Moreover, there is resonance far beyond the UK, with tensions be...
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Further comment/dialogue between Haddad and McCrae & Appasamy
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Concerns are increasingly raised in academic and lay literature about the impact of the internet on young people’s well-being. This systematic review examined empirical research on the relationship between social media use and depressive symptoms in the child and adolescent population. A systematic search of Medline, PsycInfo and Embase databases y...
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Opinion piece by McCrae & Appasamy; linked critical commentary by Haddad
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Pertinent questions, you might think. Yet in my experience, as a nurse educator and extracurricular historian of mental health nursing, they are not readily answerable by qualified or budding practitioners. The first would expose a remarkable lack of celebrated figures in our field. General nursing has its heroine in Florence Nightingale, but askin...
Article
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With 'fake news' virulently disseminated on the internet, we should all be on the lookout for misleading or false information. In nursing, the doctrine of evidence-based practice depends on the quality of evidence, and research findings or theoretical argument should not be accepted uncritically, just because they appear in trusted journals. I rais...
Article
Introduction: Despite indications that therapeutic interaction is beneficial for patients and for nurses' job satisfaction in acute psychiatric care, research shows a small amount of nurses' time is spent on such activity. Aims: This study investigated the actual and potential therapeutic role of the mental health nurse in psychiatric intensive...
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After initiating a system of nursing and nurse training in general hospitals, Florence Nightingale turned her attention to infirmaries for the poor in the 1860s. St Marylebone Infirmary in London benefited from one of the first Nightingale schools in a Poor Law institution. Formal training raised the quality of care and offered a professional caree...
Article
This article discusses the implementation of the Rapid Assessment, Interface and Discharge (RAID) model of psychiatric liaison and its potential for acute hospitals
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The Lagos shuttle it's called. Every week several passengers arrive at Gatwick or Heathrow from Nigeria in the late stages of pregnancy.
Article
With a spring in his step, lecturer Jeroen Ensink left his suburban London home to post cards to his many friends around the world, announcing the arrival of his baby daughter. Seconds later his life was over. A young man had pounced, and in a state of frenzy, savagely stabbed his random victim (Daily Mail, 4 January 2016). As psychiatric patient F...
Article
Nursing for people with mental health problems was very different 40 years ago. Although British minister of health Enoch Powell had signalled the demise of the former asylums in a speech in 1961, a decade later, these large institutions continued to house over a 100,000 patients. Community psychiatric nurses were rare. This article is protected by...
Article
The history of the National Health Service in Britain is a history of immigration. Many of the hospitals taken over by the NHS in 1948 were in a dilapidated state, and staff shortages were reaching critical levels. From the 1950s onwards, thousands of young women and men were lured to nursing in Britain from the pink-shaded areas of the globe - the...
Article
Nursing students are a rich source of fresh perspectives on mental healthcare. While their clinical placement experiences are mostly positive, they sometimes find a lack of therapeutic engagement with patients on acute psychiatric wards. In this article, selections from a student's diary are presented
Article
Background: Grounded theory is a distinct method of qualitative research, where core features are theoretical sampling and constant comparative analysis. However, inconsistent application of these activities has been observed in published studies. Aim: This review assessed the use of theoretical sampling in grounded theory studies in nursing jou...
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I AM writing this column as junior doctors prepare to walk out for a second day of industrial action over proposed changes to their contract.
Book
From their beginnings as the asylum attendants of the 19th century, mental health nurses have come a long way. This comprehensive volume is the first book in over twenty years to explore the history of mental health nursing, and during this period the landscape has transformed as the large institutions have been replaced by services in the communit...
Article
Suicide is a global problem in prisons. As in society generally, gay men in prison have a higher risk of attempting suicide compared with their heterosexual peers. The Howard League for Penal Reform Sex in Prison Commission 2015 reveals a pervasive culture of consensual and coercive sexual relations, with gay men more likely to be targeted for unso...
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IMAGINE THAT you have been struggling with depression and your doctor has referred you for cognitive behaviour therapy (CBT). Such treatment is provided on the NHS through the Improving Access to Psychological Therapies (IAPT) programme. But there is a catch; you have been placed on a three-month waiting list.
Article
Rationale and aimClear and logical eligibility criteria are fundamental to the design and conduct of a systematic review. This methodological review examined the quality of reporting and application of eligibility criteria in systematic reviews published in three leading medical journals.Methods All systematic reviews in the BMJ, JAMA and The Lance...
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THE BED manager scanned the whiteboard in the busy office of an acute psychiatric ward. 'What about this man, WL?' she asked. 'He's been in for nearly two weeks. Can he go on weekend leave?' The nurse in charge was sceptical, but an urgent admission was imminent, and there was no room. So WL was informed that he was ready for a trial period at home...
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Background: Improving access to psychological therapies (IAPT) is a major programme in England to treat common mental health problems, mainly through cognitive behaviour therapy. In 2012, a Pathfinder scheme was launched to develop interventions for people with chronic physical health conditions or medically-unexplained symptoms. Aim: This quali...
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IS THE culture in health care discriminatory? A recent report by the Care Quality Commission (CQC) ( 2014 ) highlights the issue of staff equality as reflected in its inspection metrics. According to the report, NHS managers are disproportionately white, while staff from black and minority ethnic (BME) backgrounds are over-represented in disciplina...
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CHICKEN STEW or vegetable lasagne? In hospitals or care homes, this may not simply be a matter of asking what people want for lunch. Under the terms of the Mental Capacity Act 2005 (MCA), nurses must check that the person making the choice has decision-making capacity, and, if in doubt, conduct an on-the-spot assessment. By law, competence for cons...
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Female genital mutilation (FGM) has become a major issue worldwide, including the UK, where the number of women and girls affected has grown. This ritual practice is common in communities originating in parts of Africa and Asia. Although FGM is illegal and causes lasting physical and psychological harm, healthcare services have lacked a robust resp...
Article
Systematic reviews of literature are increasingly important in healthcare. While reviewers are expected to follow reporting guidelines, inconsistencies may be observed in presentation of reviews, potentially detracting from the credibility of findings. Predetermined eligibility criteria are fundamental to the systematic process of reviewing, and sh...
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Depression is a very common disorder with both psychological and biological manifestations. The prevailing rationale for antidepressant drug treatment is the serotonin hypothesis, but this is no longer accepted as an adequate explanation for depressive disorder. The role of other neurotransmitters such as glutamate may be important, but there is mu...
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Religiosity is a prominent feature of the Geschwind syndrome, a behavioural pattern found in some cases of temporal lobe epilepsy. Since the 1950s, when Wilder Penfield induced spiritual feelings by experimental manipulation of the temporal lobes, development of brain imaging technology has revealed neural correlates of intense emotional states, sp...
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Mental nursing has continued to be neglected in the history of psychiatry. This paper considers the impact of a decade of radical developments on the role and outlook of nurses in British mental hospitals during the 1930s. The Mental Treatment Act 1930 introduced voluntary admission for early, supposedly treatable cases, although there was paucity...
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Protected engagement time in mental health inpatient units is a fixed period each day during which administrative activities and visiting are suspended so that nurses can focus on individual patient contact. However, there are a number of barriers to implementing this strategy effectively, which include high workloads, staff shortages and lack of s...
Article
Accelerated mental health nurse training attracts talented graduates, many with a psychology degree. Our study shows that such trainees feel incompatible with the nursing culture. Consequently, professional identification is inhibited, and on qualifying these nurses may choose to develop their careers elsewhere. Nurse educators and mentors should p...
Article
A PIGEON landed on the window ledge of Ward 1B at Denbigh Mental Hospital. Bill warned the nurses to watch out: the winged observer was a German spy.
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Recent scandals in the NHS have undermined confidence in this institution. A key factor in substandard care is the competing demands on practitioners. Individualised care may be hindered by paternalism and collective organisation, while practitioners are expected to pursue evidence-based practice and person-centred care without acknowledging their...
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REVERED OR reviled, the late Margaret Thatcher transformed UK society, with opinion divided on whether it was for the better or worse. Among other things, her government devised the healthcare purchaser-provide split, enacted under her successor John Major in 1991, which heralded a new era in health service management.
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Depression is common in dementia, causing considerable distress and other negative impacts. Treating it is a clinical priority, but the evidence base is sparse and equivocal. This trial aimed to determine clinical effectiveness of sertraline and mirtazapine in reducing depression 13 weeks post randomisation compared with placebo. Multicentre, paral...
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Background: Depression is a common and costly comorbidity in dementia. There are very few data on the cost-effectiveness of antidepressants for depression in dementia and their effects on carer outcomes. Aims: To evaluate the cost-effectiveness of sertraline and mirtazapine compared with placebo for depression in dementia. Method: A pragmatic,...
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Profound spiritual experiences have been observed as a trait of temporal lobe epilepsy (TLE), as described in the Geschwind syndrome. This systematic review considers the evidence for ictal and interictal religiosity, and the neurological, psychiatric and cultural factors. Research in this area is at an early stage of development, with indications...
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Background: The Mental Health Research Network and Dementia and Neurodegenerative Diseases Research Network were established in the UK to increase research capacity and activity; the former in mental health generally, and the latter specifically in neurodegenerative disorders including dementia. Little evidence exists on the impact of these networ...
Article
This paper presents a discussion of the role of nursing models and theory in the modern clinical environment. Models of nursing have had limited success in bridging the gap between theory and practice. Literature on nursing models and theory since the 1950s, from health and social care databases. Arguments against nursing theory are challenged. In...
Article
Depression is common in dementia but the evidence base for appropriate drug treatment is sparse and equivocal. We aimed to assess efficacy and safety of two of the most commonly prescribed drugs, sertraline and mirtazapine, compared with placebo. We undertook the parallel-group, double-blind, placebo-controlled, Health Technology Assessment Study o...
Article
Despite a consensus on the need to expand and improve mental health care for older people, evidence on models of service development is limited. Referring to two case studies, this paper considers how evaluation of service innovations can inform policy and practice. Evaluation should entail a dual concern with measurement and meaning in judging the...
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This paper describes an evaluation of a redevelopment program in a mental health service for older people, stimulated by U.K. Department of Health policy. IQCOL (Improving Quality of Care for Older People in Lambeth) was a two-year program to modernize and expand an inner-city service, with objectives to improve access, embed new functions, and tun...
Article
This chapter reviews nonelectrical convulsive therapy (non-ECT) procedures, including pentylenetetrazol (PTZ) and cyclohexylethyltriazol, flurothyl inhalation, and insulin coma therapy, which also had epileptoid effects. Evidence from the period of application is presented, followed by a contemporary analysis of therapeutic mechanisms. Factors are...
Article
Despite the expanding deployment of support workers in mental health services, little evidence exists on what managers and professional practitioners should expect of such staff in community settings. This case study evaluated the introduction of support workers in community mental health teams for older adults. A multiple method design engaged sup...
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This survey of beer advertising in football programmes illuminates how the rationalisation of the British brewing industry in the 1960s severed the links between beer and football in local identity. The supremacy of national brands is considered against the parochial allegiances of football supporters, and wider trends in an increasingly cosmopolit...
Article
Qualitative data typically contain multiple identifiable characteristics about people, places and events, in the unique voice of each participant. This short report considers sensitivity and security of audio-recordings, drawing attention to a lack of guidelines for researchers on the preservation or destruction of such data. The authors urge debat...
Article
Research in mental health services for working-age adults has repeatedly shown that work is found more satisfying, if more stressful, by community practitioners than by hospital-based staff. This study examined whether similar differences exist in services for older adults and how this might be influenced by the high proportion of nonprofessionally...
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In the annals of psychiatric treatment, the advent of Cardiazol therapy has been afforded merely passing mention as a stepping-stone to the development of electroconvulsive therapy. Yet in the 1930s it was the most widely used of the major somatic treatment innovations in Britain's public mental hospitals, where its relative simplicity and safety g...
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Statutory and voluntary social services provide care and support for vast numbers of vulnerable older adults, yet little is known about how social care practitioners respond to depression in this high risk population. This study elicited the perceptions and conceptualizations of this condition among social care staff, and views on how the response...
Article
Social workers have undoubtedly played a significant role in mental-health care in Britain. Yet their contribution to the mental-health knowledge base is decidedly meagre compared to the prolific research activity of psychiatry and allied health professions. A qualitative study was conducted on the research potential of mental-health social work, b...
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Routine distribution of alcoholic beverages to mental hospital patients would be a fanciful prospect today, yet in the formative decades of lunatic asylums, beer was standard issue. A staple item in the supposedly healthy Victorian asylum diet, beer also served as inducement for patient labour. Around the mid-1880s, this commodity was abolished thr...

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Project
A mixed-methods study that explores the actual and potential therapeutic role of the mental health nurse in psychiatric intensive care. The study used semi-structured interviews with patients and staff, and structured observations to explore the research question.