Retrospective evaluation of the Complementary Health and Wellbeing (CHW) service delivered at the Christie NHS trust UK.

INTRODUCTION: The Complementary Health and Wellbeing service has been offering integrative therapies to cancer patients at The Christie Hospital NHS Trust since 1997 and has not undergone an external service evaluation in that time. It is considered a pioneering service. METHOD: An external academic was invited to undertake a service evaluation based on information and experiences since the implementation of services changes as the result of the COVID 19 pandemic. Service users and therapists were interviewed along with review of quality control data and documentation. RESULTS: Eighteen staff and eight patients were interviewed showing a high functioning and valuable service, offering a range of services to meet the needs of both inoutpatient and outpatient services. All staff are qualified and passionate, with a significant number of research outputs. However, the service is at capacity, and must rethink some delivery to ensure long term sustainability. Services offered include acupuncture, aromatherapy, massage, talking therapies and motivational behavioural changes. There is a high degree of patient satisfaction as the therapies help them manage their life affecting side effects, however accessing or being aware of the service before treatment commenced was a concern for patients. DISCUSSION: The Complementary Health and Wellbeing Service is well resourced, with all staff paid employees of the NHS trust funded via a charitable part of the trust. There is a self-funding education unit to provide staff training with participants coming from around the world. The therapists are expert practitioners who have undergone specialist training to work in this unique environment, however capacity to meet the needs of the service is limited, and there are gaps in the way patient evaluations are collected, which needs to be addressed for long term viability and future benchmarking. The changes to service to adapt to COVID-19 have become embedded within the service.

Broken nurses: an interrogation of the impact of the Great War (1914-1918) on the health of New Zealand nurses who served - a cohort comparison study.

INTRODUCTION: New Zealand's initial contribution of 50 nurses to WWI was thought to be sufficient. However, by the time of Armistice Day, at least 550 nurses had served for the New Zealand Army Nursing Service. According to diaries and records, many arrived back broken with a wide disparity in care. No formal analysis of this exists to understand the impact in more detail. The hypothesis is that the nurses who served the longest would carry a higher sickness burden and have a shorter life span than those nurses who had a shorter length of service. METHODS: Service files of the first 50 nurses were analysed and compared with the last 50 nurses who served while war was still active. Data from each nurse's file were confirmed with other sources for age, length and type of service, sickness, date of death and any other notable events. RESULTS: The first cohort of nurses (N=50) had longer periods of sickness, with a higher number of illnesses related to overcrowding, overwork (nervous disorders) and poor hygiene. The first cohort also were awarded many medals of merit, indicative of the extreme conditions they were working in. Individual nurses experienced poor medical treatment on their return to New Zealand. The last cohort (N=50) experienced fewer incidences and different types of sickness, with Spanish Influenza having an impact on serving nurses near the end of the war. In addition, the second cohort died younger compared with the first cohort, and none received medals of merit. CONCLUSIONS: This analysis has identified that many New Zealand nurses experienced severe health effects due to their service, and their health needs were poorly considered on their return to New Zealand. The Matron in Chief and others battled to have the nurses cared for appropriately. These lessons remain as valid now as they did in 1918.

Trajectories of Successful Aging Among Older Adults in Aotearoa New Zealand.

Successful aging was defined as having no multimorbidity, high functional capacity, active life engagement, and good health-related quality of life. This study analyzed data from 1433 older adults who were followed up for 12 years across seven waves from the New Zealand Health, Work and Retirement study by examining the trajectories of successful aging. Latent growth curve modeling was used to assess the growth factors of successful aging trajectories of older adults. The mean successful aging score was 3.53 (range: 0-6) in 2006 and linearly declined by 0.064 units every year. Those with higher successful aging scores at baseline had a slower decline. Successful aging scores were lower among females, Maori, and those aged 65 years and above at baseline. The findings from this study suggest that gender and ethnic inequalities play significant roles in successful aging among older adults in New Zealand.

Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005.

Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005-2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.