Anxiety and depression on an acute respiratory ward.

OBJECTIVES: Psychological difficulties are a common complication among patients with respiratory disease, and are associated with poorer health outcomes and increased use of healthcare. As prevalence studies typically sample patients from community settings, this study aimed to explore the extent and nature of psychological difficulties during acute hospital admission. METHODS: A case example of an acute respiratory ward is presented. In total, 41 acute respiratory inpatients completed standardised measures of depression, anxiety, and health anxiety. RESULTS: Rates of clinically significant depression, anxiety, and health anxiety were 71%, 40%, and 21%, respectively, with 76% of participants showing clinically significant scores on at least one measure. Comparison to existing literature suggests depression rates may be elevated in the acute inpatient context. The difficulties experienced encompassed both contextual factors related to being in hospital and broader health concerns. CONCLUSION: We suggest that psychological distress may be particularly prevalent in inpatient settings and that larger-scale studies are warranted.

Multidisciplinary meetings as an effective clinical intervention.

When used well, multidisciplinary meetings can function in the same way as other clinical interventions to improve communication, efficiency and outcomes. They help break down barriers, manage difficult emotions, and benefit service users and staff. But it is imperative that they are well prepared, well attended, and that the purpose and agenda are agreed. It is also vital to have an efficient chair and that meetings take place in an environment where feelings can be shared openly and respected. Services should recognise and address relevant training and support requirements.

Preparing staff to provide bereavement support.

An in-service training programme was developed to meet the needs of an NHS palliative care service for children and young people, specifically focused on bereavement work. A training day was held every six months that allowed staff to share and support each other's practice and to consider how best practice could be promoted. Each training day was evaluated by attendees, who were asked to rate the usefulness of the day and give qualitative feedback. After four training days had been completed, staff views on the impact and benefits of the programme were sought using a questionnaire that incorporated a set of statements highlighting factors important to good bereavement care. Participant evaluations indicated that the aims of the training days were being met. Responses to the questionnaire were positive, both in terms of improvement and positive outcomes in the workplace. Ongoing training and support as well as clinical supervision are essential to maintain good practice in palliative and bereavement care.