Singing for Lung Health: service evaluation of the British Lung Foundation programme.

AIMS: Singing for Lung Health (SLH) is a novel intervention for individuals with respiratory disease. Qualitative results suggest benefits to physical, mental and emotional health. Limited data also suggest objective improvements in measures of quality of life with SLH are achievable. It is not known how effective the SLH groups supported by the British Lung Foundation (BLF) in the UK are. The objective was to understand the clinical impact SLH has on individuals with respiratory disease. METHODS: The BLF conducted a questionnaire survey of singers with respiratory disease from new SLH groups set up in 2016-2017. Questionnaires were administered prior to participants' first session and after 12 weeks of singing. Health-related quality of life, patient activation, anxiety and breathlessness outcomes were included. Healthcare resource utilisation including general practitioner (GP) visits, hospitalisations and frequency of inhaler use were recorded. RESULTS: A total of 228 singers participated from 26 SLH groups in the UK. Participants were 70.7 (10.1) years old, 156 (68.4%) were female and 114 (47.5%) had chronic obstructive pulmonary disease (COPD). In all, 113 (49.5%) participants provided 12-week data. There were significant improvements in COPD Assessment Test (CAT) score (Mean = -1.4, CI: (-0.25 to -2.48) ( p = .017)). Furthermore, 45% of singers reported reduced GP visits ( p ≤ .001) and 18% reported reduced hospital admissions ( p = .01). However, there were no significant improvements in general quality of life, anxiety, patient activation, breathlessness or inhaler use. Baseline characteristics were not significantly different between people who completed the 12-week evaluation and those who did not. CONCLUSIONS: This service evaluation found that participants in SLH groups report improvement in respiratory health-related quality of life and a reduction in healthcare utilisation. SLH has potential economic and health benefits. Therefore, to confirm these findings, these endpoints should be evaluated further in large-scale randomised controlled trials (RCTs).

Fuzzy thinking.

Philosophical analysis is increasingly applied to nursing issues. Whereas pre-analytical discussions might be sloppy, analysis should bring rigour. This paper explores some mistakes and misconceptions concerning nurse-related reasonings. It uses, as a running theme, a recent paper in the Journal of Advanced Nursing by Rolfe. The mistakes and misleadings to be found in the paper are not uncommon; so the paper's correction quest aims more widely than single author critique. The mistakes and misconceptions could initially appear abstract and without practical outcome; in order to avoid the threatened appearance, a nursing case study is presented, displaying some undesirable consequences for a nurse who is misled by her reading. It is hoped that this paper shows how some accuracy may be well leading.

Equipment costs. Slow on the uptake.

The failure of hospitals to analyse the costs and benefits of equipment is costing the NHS millions. Hospitals should analyse the relative merits of buying and hiring special equipment, such as beds, for reducing pressure sores. The Department of Health should produce best buy guides for equipment.

Nursing knowledge: the role of Plato in wound care.

Using wound care as an example, the author reflects on the knowledge and skills practised by nurses in nursing and research. He emphasises reflecting on practice, and introduces the importance of non-existent states of affairs, the grasp of which is essential in analysing what it is to act in patients' best interests.

Anti-heart antibodies in cardiac allograft recipients.

Serum antibodies reactive with rat cardiac and skeletal muscle were found by indirect immunofluorescence in 11 of 16 heart transplant patients receiving heterologous antithymocyte globulin and 1 of 5 patients receiving cyclosporin A. These antibodies appeared de novo following transplantation and were present for variable lengths of time. Antibodies reactive with rat liver, stomach and kidney were also found in several patients, 9 out of 16 patients receiving equine globulin had antibodies directed against components of the microvasculature, including endothelial, smooth muscle and vessel wall connective tissue. Analysis of antibody kinetics and acute cardiac rejection did not reveal any well-defined associations, though anti-heart antibodies were present in 4 of 6 patients who died from acute rejection.