Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer.

BACKGROUND: Pancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease. METHODS: This study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer. RESULTS: The serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game's usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour. DISCUSSION: This study is the first to explore a serious game's utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game's potential as an accessible and convenient tool for diverse populations.

Digital education about delirium for health care professional students: a mixed methods systematic review.

BACKGROUND: Competence in delirium care begins with pre-registration education for health care professionals. Although a common complication for hospitalised patients, delirium is avoidable and reversible. Delirium requires early recognition in person-centred care. Students need to learn how to identify and effectively care for 'at risk' patients. AIM: To identify and examine literature on how pre-registration health care professional students are prepared to recognise, assess, and deliver interventions to prevent delirium in practice, using digital/web based educational interventions. METHOD: Mixed methods systematic review with narrative synthesis. A protocol was registered with PROSPERO. The review questions and search strategy were guided by the Population, Phenomena of Interest, Context (PICo) framework. The PRISMA framework guided the screening, data extraction and analysis. Database searches (MEDLINE, Web of Science, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO & Scopus) were undertaken in April 2023 for publications from 2012 to 2023. Covidence software [30] was used to extract and manage the data. Quality appraisal was guided by the Crowe Critical Appraisal Tool (CCAT) [31]. FINDINGS: Ten papers were included: mixed methods (2), qualitative (1) and quantitative (7). Medical students were the most studied group (n = 5), followed by student nurses (n = 4) and mixed nursing and medical students (n = 1). Length of learning experience varied from 12 min virtual reality (VR) to a two-week 'geriatrics' elective. Learning was enhanced by player autonomy, engagement, safety, applicability, choices, multiple perspectives and moral reasoning opportunities. DISCUSSION: Digital programmes should be visually appealing, interactive with opportunities for practice and timely appropriate feedback.

Co-design and mixed methods evaluation of an interdisciplinary digital resource for undergraduate health profession students to improve the prevention, recognition, and management of delirium in Ireland: a study protocol.

BACKGROUND: Delirium is a common symptom of acute illness which is potentially avoidable with early recognition and intervention. Despite being a growing concern globally, delirium remains underdiagnosed and poorly reported, with limited understanding of effective delirium education for undergraduate health profession students. Digital resources could be an effective approach to improving professional knowledge of delirium, but studies utilising these with more than one profession are limited, and no evidence-based, interdisciplinary, digital delirium education resources are reported. This study aims to co-design and evaluate a digital resource for undergraduate health profession students across the island of Ireland to improve their ability to prevent, recognise, and manage delirium alongside interdisciplinary colleagues. METHODS: Utilising a logic model, three workstreams have been identified. Workstream 1 will comprise three phases: (1) a systematic review identifying the format, methods, and content of existing digital delirium education interventions for health profession students, and their effect on knowledge, self-efficacy, and behavioural change; (2) focus groups with health profession students to determine awareness and experiences of delirium care; and (3) a Delphi survey informed by findings from the systematic review, focus groups, and input from the research team and expert reference group to identify resource priorities. Workstream 2 will involve the co-design of the digital resource through workshops (n = 4) with key stakeholders, including health profession students, professionals, and individuals with lived experience of delirium. Lastly, Workstream 3 will involve a mixed methods evaluation of the digital resource. Outcomes include changes to delirium knowledge and self-efficacy towards delirium care, and health profession students experience of using the resource. DISCUSSION: Given the dearth of interdisciplinary educational resources on delirium for health profession students, a co-designed, interprofessional, digital education resource will be well-positioned to shape undergraduate delirium education. This research may enhance delirium education and the self-efficacy of future health professionals in providing delirium care, thereby improving practice and patients' experiences and outcomes. TRIAL REGISTRATION: Not applicable.

Feasibility and acceptability of an education and training e-resource to support the sexuality, intimacy and relationship needs of older care home residents: a mixed methods study.

BACKGROUND: sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. OBJECTIVE: to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. METHODS: we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. RESULTS: fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. CONCLUSIONS: the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.

Nursing and midwifery students' perspectives of using digital systems on placement: A qualitative study.

AIM: To explore undergraduate nursing and midwifery student perspectives of using digital patient systems on clinical placements. DESIGN: This was an interpretative qualitative design study. METHODS: Undergraduate nursing and midwifery students in a large Australian metropolitan university were invited to participate in two focus groups from April to June 2019. Twenty (20) students participated and data on their perspective of using digital systems on placement were collected. Thematic analysis using NVivo 12 software was undertaken. FINDINGS: Students identified benefits and challenges when moving between paper records and digital systems. Whilst paper reporting was more efficient for some processes, the students recognised the advantages of digital technology, such as enabling greater confidentiality and consolidation of patient data in one place. However, they also reported difficulty with student access and the size of the portal digital workstation at the bedside. Generally, the lack of preparation and access was considered frustrating and mitigated some of the benefits described when using digital systems. CONCLUSIONS: Nursing and midwifery students prefer to be prepared for both paper and digital record keeping. Whilst students identify the benefits of digital platforms, not having direct access mitigates the benefits of these systems. Students identified the use of simulation and interactive modules prior to commencement of clinical practice to enable them to feel more confident with using the systems in patient care. IMPACT: Health care students require direct access to digital health platforms whilst on clinical placement to facilitate their learning. Higher Education Institutions (HEIs) are in a unique position to work with health care providers to better prepare health care professionals, including nurses and midwives, to work with digital health care systems. Further research is needed to develop the educational preparation for nurses, midwives, and other health care professionals to work with digital systems in practice.

A scoping review of education and training resources supporting care home staff in facilitating residents' sexuality, intimacy and relational needs.

BACKGROUND: Having positive intimate, sexual and relational experiences is an important issue for older adults in care settings, yet little is known on the extent to which nursing staff and care workers have received education or training in addressing and meeting these needs among older residents. This scoping review aimed to identify and examine what education and training resources exist to assist nursing staff and care workers to meet their residents' needs in this area. METHODS AND ANALYSIS: Using the Arksey and O'Malley framework, we systematically searched papers and grey literature to identify education interventions and resources that aimed to facilitate care home staff to meet their residents' sexuality, intimacy and relational needs. RESULTS: Eleven studies (one dissertation) and three education resources met the inclusion criteria; most were conducted in the USA and Australia. Across the studies and resources identified, the education content was mixed and the methodology, presentation, design and duration varied widely. The focus of the education interventions and resources was to increase knowledge and improve and/or change attitudes towards the: (i) sexual expression of older people living in residential aged care, (ii) sexuality and ageing and (iii) expression of sexuality in people with dementia. CONCLUSION: Few education interventions and training resources were identified. The findings suggest that education interventions can improve knowledge and/or change care staff attitudes, in the short-term, towards older people's sexuality, intimacy and relational needs in care home settings, which can lead to facilitating staff to enhance person-centred care in this area of need.

Emphasise capability, not disability: exploring public perceptions, facilitators and barriers to living well with dementia in Northern Ireland.

BACKGROUND: Improving public knowledge and understanding about dementia has been identified as a priority area by people living with the condition, researchers, educators, and policymakers for several years. Societies that have a better understanding of the condition are more likely to enable people living with dementia to enjoy a better quality of life. The aim of this study was to explore current public perceptions of dementia along with the facilitators and barriers to living well from the perspective of people living with the condition in Northern Ireland. METHODS: Four focus group interviews were conducted with a total of 20 people living with dementia across three Northern Irish Counties in June 2019. These interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Ethical approval was obtained for this study prior to data collection. FINDINGS: Following thematic analysis, three themes emerged in relation to barriers and facilitators to living well with dementia. These were: 'Emphasis on Disability NOT Capability', which highlighted societal misconceptions about the activities and modes of life which people with dementia could or could not do; 'Normalise Dementia - We Don't Want a Fool's Pardon', which focused on how the public could encourage people living with the condition to enjoy greater independence, and 'Dementia isn't a Death Sentence', which considered how professionals, family members and friends treated the person after diagnosis. CONCLUSIONS: Public perceptions about dementia have the potential to act as both facilitators and barriers to living well with dementia. People with dementia stated that they are more likely sustain wellbeing when they are valued and can maintain independence. On the contrary, poor public and professional attitudes to dementia had the potential to disempower people living with dementia.

Evaluation of a co-produced delirium awareness programme for undergraduate nursing students in Northern Ireland: a pre-test/post-test study.

BACKGROUND: Delirium is recognised internationally as a common disorder that causes acute deterioration in a person's cognitive abilities. Healthcare professionals play a key role in the early identification and management of delirium and effective education can support timely recognition and treatment. There is currently a lack of research exploring the delirium education provided to undergraduate nursing students. The aim of this study was to evaluate the effectiveness of a co-produced delirium awareness programme on undergraduate nursing students in Northern Ireland. METHODS: The intervention was a 2-h delirium workshop, delivered in April 2019, to a convenience sample of year one undergraduate nursing students (n = 206) completing a BSc Honours Nursing degree programme in a Northern Ireland University. The workshop focused on four core elements: defining delirium, reflecting on practice, recognition of delirium and management of delirium. Participants completed a 35-item true-false Delirium Knowledge Questionnaire (DKQ) at baseline and post intervention using Socrative, a cloud-based student response system. In addition, students also completed a short questionnaire at baseline and post-workshop, designed by the authors, to ascertain perceived confidence about caring for people with delirium. Data were analysed using paired t-tests and descriptive statistics. RESULTS: In the DKQ, Scores were normally distributed around the mean at baseline (71.89%) and post intervention (81.89%). Students improved across all three core areas in the post-test questionnaire, demonstrating improvements in knowledge about symptoms of delirium (7.32% increase), causes and risk factors of delirium (17.91% increase) and management of delirium (5.72% increase). In relation to perceived confidence, students reported a 60.20% increase in confidence related to recognition of delirium, a 49.51% increase in relation to delirium management and a 45.04% increase their ability to communicate about delirium. Both questionnaires were statistically significant (P < 0.01). CONCLUSIONS: A 2-h workshop on delirium improved first year student nurse knowledge about delirium. Nursing students expressed that this approach to delirium education enabled collective thinking about how knowledge could be transferred into individual practises. Students also stated that learning incorporating the voice of the person who has experienced delirium, was an effective and powerful way to deliver education.

Moving beyond 'safety' versus 'autonomy': a qualitative exploration of the ethics of using monitoring technologies in long-term dementia care.

BACKGROUND: Use of monitoring technologies (e.g. wearable or environmental sensors) in long-term care generates extensive ethical debate, primarily about their potential to enhance resident safety weighed against concerns about their impacts upon resident autonomy. There are a number of other ethical aspects which are far less debated, including questions about the monitoring of the workforce, and equality of access to technologies. In this paper, we explore the extent to which remote monitoring of the workforce, and equality of access to technologies, were seen to influence the implementation of monitoring technologies within long-term care facilities. METHODS: An embedded multiple-case study design was used with three dementia-specialist care facilities in England that had experience using a range of monitoring technologies. Data were collected through 175 h' observation of daily practice, semi-structured interviews with 36 staff, residents and relatives, and examination of organisational documentation and technology manufacturer literature. Data were analysed using Framework Analysis. RESULTS: Use of technologies for workforce monitoring was understood in relation to the ethical obligations to fulfil a duty of care to residents. There was little recognition of any negative implications for the workforce, but staff were susceptible to rumours that technologies were being used for performance management even when this was not the case. There were questions about how far data collected by monitoring technologies could constitute 'evidence' of appropriate care delivery. Equality and access to technologies involved a need to compromise between generic designs that were not universally suitable, but were more affordable than bespoke designs. Contracts with suppliers imposed limitations on product choice. CONCLUSIONS: There is an urgent need for greater consideration of the ethical and legal implications that remote technological monitoring might have upon workforce morale, recruitment and retention. Ensuring variety of technological design to facilitate equitable access for residents is financially extremely challenging. It is possible that considerations of equitable access are not deemed a priority due to the current generation of residents' low levels of technological familiarity and expectation. It might be overstated and unrealistic to view expensive technologies as the pinnacle of innovative practice in care homes.

Openness, inclusion and transparency in the practice of public involvement in research: A reflective exercise to develop best practice recommendations.

CONTEXT: Reflective accounts of public involvement in research (PI) are important for helping researchers plan and deliver more effective PI activities. In particular, there is a need to address power differentials between team members that can prohibit effective and meaningful involvement. OBJECTIVE: To critically reflect on the PI practices that underpinned our research project on intimacy and sexuality in care homes, to develop a series of recommendations for improving future PI activities. SETTING: The research team comprised five academics from nursing, public health, sociology and psychology, and two members of the public with experience of sex education, and lesbian, gay, bisexual and trans issues in older populations. In order to address power differentials within the group, we developed an approach to PI practice that was grounded in values of openness, inclusion and transparency. METHOD: Reflective commentaries on the strengths and weaknesses of the team's approach to PI were gathered through interviews and open-ended questionnaires with research team members. These views were collated and discussed at a workshop comprising research team members and an additional member of the public to generate recommendations for future PI practice. RESULTS: A number of strengths and limitations of our approach to PI were identified. Clear recommendations for improving PI practice were developed for three broad areas of identified difficulty: (i) communication within and between meetings; (ii) the roles and responsibilities of team members; and (iii) PI resources and productivity. DISCUSSION AND CONCLUSION: These recommendations add to the developing body of guidance for conducting effective PI.

The challenges and opportunities in researching intimacy and sexuality in care homes accommodating older people: a feasibility study.

AIM: To explore the challenges of conducting research on sexuality and intimacy among older care home residents. BACKGROUND: Sexuality and intimacy are neglected in care policies and practices. DESIGN: Qualitative analytical study drawing on poststructuralist theorizing. METHODS: Semi-structured interviews were conducted with residents and spouses (n = 6) and care staff (n = 16) in two care homes in Northwest England in 2014. The sample was obtained through a network of 'research-ready' care homes. Thematic analysis was used to make sense of narratives with the aid of NVivo10. RESULTS: Participant responses highlight the workings of ageist erotophobic discourse that undergirds the assumption of residents (and old people generally) as postsexual. This materialized in reservations about the research ranging from opposition on moral grounds to doubts about its feasibility given the age-group concerned. However, residents and care home staff can also draw on counter-discourses that resist/challenge ageist erotophobic thinking, which materialized in methodological and ethical recommendations. CONCLUSION: Participants generally agreed with the principle of the research and made recommendations that could counter/resist ageist erotophobic governance and guide researchers on sampling, style of questioning and communicating with (prospective) study participants on a sensitive subject.

Strategies designed to help healthcare professionals to recruit participants to research studies.

BACKGROUND: Identifying and approaching eligible participants for recruitment to research studies usually relies on healthcare professionals. This process is sometimes hampered by deliberate or inadvertent gatekeeping that can introduce bias into patient selection. OBJECTIVES: Our primary objective was to identify and assess the effect of strategies designed to help healthcare professionals to recruit participants to research studies. SEARCH METHODS: We performed searches on 5 January 2015 in the following electronic databases: Cochrane Methodology Register, CENTRAL, MEDLINE, EMBASE, CINAHL, British Nursing Index, PsycINFO, ASSIA and Web of Science (SSCI, SCI-EXPANDED) from 1985 onwards. We checked the reference lists of all included studies and relevant review articles and did citation tracking through Web of Science for all included studies. SELECTION CRITERIA: We selected all studies that evaluated a strategy to identify and recruit participants for research via healthcare professionals and provided pre-post comparison data on recruitment rates. DATA COLLECTION AND ANALYSIS: Two review authors independently screened search results for potential eligibility, read full papers, applied the selection criteria and extracted data. We calculated risk ratios for each study to indicate the effect of each strategy. MAIN RESULTS: Eleven studies met our eligibility criteria and all were at medium or high risk of bias. Only five studies gave the total number of participants (totalling 7372 participants). Three studies used a randomised design, with the others using pre-post comparisons. Several different strategies were investigated. Four studies examined the impact of additional visits or information for the study site, with no increases in recruitment demonstrated. Increased recruitment rates were reported in two studies that used a dedicated clinical recruiter, and five studies that introduced an automated alert system for identifying eligible participants. The studies were embedded into trials evaluating care in oncology mainly but also in emergency departments, diabetes and lower back pain. AUTHORS' CONCLUSIONS: There is no strong evidence for any single strategy to help healthcare professionals to recruit participants in research studies. Additional visits or information did not appear to increase recruitment by healthcare professionals. The most promising strategies appear to be those with a dedicated resource (e.g. a clinical recruiter or automated alert system) for identifying suitable participants that reduced the demand on healthcare professionals, but these were assessed in studies at high risk of bias.

Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review.

BACKGROUND: Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS: A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS: Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION: This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.

The senses in practice: enhancing the quality of care for residents with dementia in care homes.

AIM: The study aimed to develop, deliver, and evaluate a training programme in care homes to enhance the quality of care for people living with dementia based on the principles of relationship-centred care expressed through the Senses Framework. BACKGROUND: There are increasing numbers of people living with dementia worldwide with a growing proportion requiring residential long-term care. This makes the quest for enhancing the quality of care and quality of life for people with dementia ever more pressing. DESIGN: A mixed-methods design was used adopting a Practice Development approach. The findings from one care home in the North West of England are reported. METHODS: Eight facilitated workshops based on the principles of relationship-centred care were completed and evaluated in 2010, using pre- and postintervention design. A focus group was undertaken with staff on completion of the study to gain a more comprehensive understanding of the practice/training context, augmented by case examples of changes in practice identified from the study workshops. RESULTS: Structured questionnaires were used to profile the care home before and after the training. Following the workshops, staff felt more able to collect and use biographical information. In particular, staff reported how this information supported them to initiate meaningful conversations with the person with dementia as part of everyday care routines, thus improving overall feelings of well-being. CONCLUSION: Using a biographical approach to care planning structured through the Senses Framework helped staff to develop a greater understanding of the person with dementia.

A Scoping Review of eProfessionalism in Healthcare Education Literature.

OBJECTIVE: This study sought to answer the research question, 'How does eProfessionalism manifest in health profession student behaviors?' Key areas explored were how the concept of eProfessionalism is defined in empirical studies, healthcare profession student and educator perceptions of how online behaviors reflected eProfessionalism, and how eProfessionalism as a construct might assist healthcare students to understand the implications of their online behaviors. METHODS: Scoping reviews are used in research areas where there is limited evidence available. This review followed a systematic process using the extended Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, which included clear inclusion/exclusion criteria, and a process of charting, collating, and summarizing the results from searching 8 databases. RESULTS: In total, 38 papers are included in this review primarily reflecting the professions of pharmacy medicine, nursing/midwifery, and dentistry. Five key themes were identified: defining eProfessionalism; online behavior; student/faculty perceptions of eProfessionalism in social media use; students not making a connection between personal use and online professional identity; and guidelines and training. CONCLUSION: This review suggests that health professions students struggle with blurred boundaries between personal and professional online presence, particularly concerning social media. Despite guidelines some students demonstrate unprofessional behaviors online suggesting further support is required for students to demonstrate eProfessionalism when engaging in digital environments.

Exploring Resilience in Care Home Nurses: An Online Survey.

Resilience is considered a core capability for nurses in managing workplace challenges and adversity. The COVID-19 pandemic has brought care homes into the public consciousness; yet, little is known about the resilience of care home nurses and the attributes required to positively adapt in a job where pressure lies with individuals to affect whole systems. To address this gap, an online survey was undertaken to explore the levels of resilience and potential influencing factors in a sample of care home nurses in Northern Ireland between January and April 2022. The survey included the Connor-Davidson Resilience Scale, demographic questions and items relating to nursing practice and care home characteristics. Mean differences and key predictors of higher resilience were explored through statistical analysis. A moderate level of resilience was reported among the participants (n = 56). The key predictors of increased resilience were older age and higher levels of education. The pandemic has exposed systemic weakness but also the strengths and untapped potential of the care home sector. By linking the individual, family, community and organisation, care home nurses may have developed unique attributes, which could be explored and nurtured. With tailored support, which capitalises on assets, they can influence a much needed culture change, which ensures the contribution of this sector to society is recognised and valued.

Exploring the Holistic Needs of People Living with Cancer in Care Homes: An Integrative Review.

Up to 26% of individuals residing in care homes are impacted by cancer. This underscores the importance of understanding the holistic needs of care home residents living with cancer to enhance the quality of their care. The primary objective of this integrative literature review was to consolidate the available evidence concerning the comprehensive needs of people living with cancer in care home settings, providing valuable insights into addressing their diverse needs. An integrative literature review was conducted using a systematic approach. Extensive searches were conducted in three databases, complemented by a thorough examination of grey literature and reference lists of relevant papers. The review focused on literature published between 2012 and 2022. The screening process involved two independent reviewers, with a third reviewer resolving any discrepancies. The review identified twenty research papers that met the eligibility criteria. These papers shed light on three primary themes related to the holistic needs of care home residents with cancer: physical, psychological, and end-of-life needs. Physical needs encompassed pain management, symptom control, and nutrition, while psychological needs involved social support, emotional well-being, and mental health care. End-of-life needs addressed end-of-life care and advance care planning. These themes highlight the multifaceted nature of cancer care in care homes and underscore the importance of addressing residents' holistic needs in a comprehensive and integrated manner. Improving care home education about cancer and integrating palliative and hospice services within this setting are vital for addressing the diverse needs of residents with cancer.

Optimising quality of life for people living with heart failure in care homes: Protocol for the co-design and feasibility testing of a digital intervention.

BACKGROUND: Heart failure (HF) affects up to 64.3 million people globally. Advancements in pharmaceutical, device or surgical therapies, have led to patients living longer with HF. Heart failure affects 20% of care home residents, with these individuals presenting as older, frailer, and with more complex needs compared to those living at home. Thus, improving care home staff (e.g., registered nurse and care assistant) knowledge of HF has the potential to benefit patient care and reduce acute care utilization. Our aim is to co-design, and feasibility test, a digital intervention to improve care home staff knowledge of HF and optimise quality of life for those living with the condition in long-term residential care. METHODS: Using a logic model, three workstreams have been identified. Workstream 1 (WS1), comprised of three steps, will inform the 'inputs' of the model. First, qualitative interviews (n = 20) will be conducted with care home staff to identify facilitators and barriers in the provision of care to people with HF. Concurrently, a scoping review will be undertaken to synthesise current evidence of HF interventions within care homes. The last step will involve a Delphi study with 50-70 key stakeholders (for example care home staff, people with HF and their family and friends) to determine key education priorities related to HF. Using data from WS1, a digital intervention to improve care home staff knowledge and self-efficacy of HF will be co-designed in workstream 2 (WS2) alongside those living with HF or their carers, HF professionals, and care home staff. Lastly, workstream 3 (WS3) will involve mixed-methods feasibility testing of the digital intervention. Outcomes include staff knowledge on HF and self-efficacy in caring for HF residents, intervention usability, perceived benefits of the digital intervention on quality of life for care home residents, and care staff experience of implementing the intervention. DISCUSSION: As HF affects many care home residents, it is vital that care home staff are equipped to support people living with HF in these settings. With limited interventional research in this area, it is envisaged that the resulting digital intervention will have relevance for HF resident care both nationally and internationally.

Supporting older people experiencing anxiety through non-pharmacological interventions.

Anxiety is a debilitating condition that adversely affects people's quality of life. It is challenging to differentiate anxiety from other physical and mental health conditions in older people, particularly those with co-morbid dementia or depression. The coronavirus 2019 pandemic has compounded social isolation and loneliness in older people, causing increased levels of anxiety. Nurses need to be able to detect and assess anxiety in older people and offer short, low-intensity interventions to support older people's mental health or refer them to specialist assessment and treatment. While research on anxiety in older people is lacking, cognitive behavioural therapy, mindfulness, yoga, music therapy and pleasant activities have shown potential as non-pharmacological interventions for alleviating anxiety in older people. This article explores the role of nurses in identifying when an older person may be experiencing anxiety and then choosing the optimal non-pharmacological intervention to support them.

The effectiveness of a digital game to improve public perception of dementia: A pretest-posttest evaluation.

The global impact of dementia is a key healthcare priority, and although it is possible to live well with dementia, public perception is often negative. Serious digital games are becoming a credible delivery method to educate/train individuals in the business and health sectors and to challenge perceptions. The main objective of the study was to evaluate the effectiveness of a digital game prototype on individual attitudes towards dementia. A digital game to improve public knowledge and understanding about dementia (www.dementiagame.com) was co-designed with people living with dementia and student nurses. The Game was evaluated using a pretest-posttest design. Participants for the evaluation were recruited via social media in one UK university and completed the Approaches to Dementia Questionnaire (ADQ) before and after playing the game. Overall, 457 individuals completed both pre and post test questionnaires. The total ADQ score demonstrated a significant improvement in positive attitudes (p < 0.001), and both subscales of Hope and Recognition of Personhood also saw significant improvements (p < 0.001). The use of a serious digital game has demonstrated a significant effect on the respondents' perceptions of dementia. Overall, there was a more positive view of the abilities of people with dementia and what their capabilities were. They were also more likely to be recognised as unique individuals with the same values as any other person. The benefit of using digital gaming to improve perceptions of dementia has been demonstrated, nonetheless further research is required to reach a more diverse population and test as a Randomised Control Trial to provide definitive evidence for use in policy and practice.