British journal of nursing (Mark Allen Publishing)最新文献

Background: Neurodermatitis is characterised by chronic itching and scratching. It greatly affects patients' quality of life, causing physical, emotional and social challenges. While dermatological treatments have improved, traditional therapies often fall short of meeting individual patient needs, especially in managing the persistent urge to scratch, which worsens the condition. The objective of this review study was to analyse the impact of tailored interventions on symptom reduction, particularly itching and excoriation.

Method: The research question formulation on PICO served as the foundation for the search approach. Key words were searched in different combinations from the popular databases Scopus, PubMed, Web of Science and Cochrane Library. Boolean operators (AND and OR and NOT) and keywords were employed in the search, to avoid oversaturating the data. Some 12 full-text articles were selected for the study.

Result: These findings provide encouraging evidence for the potential effectiveness of tailored approaches in managing neurodermatitis, in terms of reducing the symptoms of the urge to scratch. They emphasise the need for further research to validate and optimise these interventions. Adherence to treatment and high user satisfaction were prominent outcomes, with tailored interventions enhancing adherence.

Conclusion: Interventions customised to individual patient needs, such as tailored therapeutic regimens, combination therapies, counselling and biologic treatments, are highly effective in reducing excoriation urges, improving skin healing and enhancing quality of life. These approaches foster better adherence and satisfaction among patients. Future research should aim to optimise these strategies and to bridge existing gaps, ultimately enhancing outcomes and quality of life for individuals with neurodermatitis.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses the concept of blame in relation to NHS patient safety and clinical negligence litigation.

Rachel Tyrrell-Kirk and her daughter Keely Kirk share their experiences of being nursing students at the University of York at the same time.

Wound care presents a significant, yet often under-prioritised, challenge within the UK healthcare system. Despite affecting millions of patients and costing the NHS an estimated £8.3 billion annually (based on data primarily from England), wound management remains highly variable across regions, specialties, and care settings throughout the UK. This article explores the impact of inconsistent clinical practice, the economic implications of chronic and non-healing wounds, and the inequities experienced by patients, especially those with complex care needs. It also highlights the absence of a UK wound care database, which would enable the systemic and standardised monitoring of patient numbers, wound type prevalence, healing rates, and complications. A national wound care database would support quality assurance through the monitoring of outcomes, allow for benchmarking among healthcare providers as well as supporting the provision of robust data for research. Furthermore, it would strengthen healthcare policy, guideline development and support more efficient allocation of resources and commissioning across the four nations of the UK. This lack of coordinated data hinders meaningful research and service planning, quality improvement, equitable evidence-based care, and the opportunity to inform appropriate commissioning and targeted investment. Key strategies are proposed including the adoption of standardised pathways, investment in education, and the development of a UK-wide data infrastructure to support a more coordinated, evidence-based, and cost-effective approach to wound care in the UK.

As the global population ages, the prevalence of complex wounds and delayed healing is becoming a significant concern. Ageing leads to physiological changes such as reduced skin elasticity, weakened immune responses and slower cellular regeneration, all of which delay wound healing. Frailty, marked by reduced physiological reserves and heightened vulnerability to stressors, worsens these issues. Together, ageing and frailty increase the risk of tissue breakdown, infection rates, prolonged healing times and rising healthcare costs. This article examines the relationship between ageing, frailty, increased risk of wounds and wound healing, drawing on recent research to highlight key challenges. It also provides evidence-based recommendations for practice, highlighting the importance of preventive strategies and holistic wound assessment. The findings emphasise the importance of a proactive approach to improve clinical outcomes in older, frail populations while ensuring efficient use of healthcare resources.

Wound pain continues to be challenging for health professionals and patients. Patients report that it is the most difficult part of their wound-healing journey, subsequently affecting their quality of life. Key to providing a patient-centred plan of care are robust holistic and wound pain assessments, along with the identification of factors that can impact on the wound-healing journey. This article provides some key information from research, highlighting the differences between general pain and wound pain, the categorisation of types of pain, assessment tools, what types of procedures can impact and cause trauma and further pain, along with both pharmacological and non-pharmacological pain-management techniques.

Non-healing wounds remain a persistent and costly challenge within UK healthcare. These wounds, which fail to follow a timely and orderly healing process, are frequently linked to systemic comorbidities, delayed assessment and fragmented care. This article explores the underlying pathophysiology of non-healing wounds and provides an evidence-informed overview of their assessment and management. Drawing on current guidance and clinical literature, the article examines the importance of holistic patient evaluation, accurate diagnosis and systems-based understanding of delayed wound healing. Factors such as age, comorbidity, lifestyle, medication and psychosocial context are discussed alongside the clinical characteristics of the wound itself. The role of timely diagnostic investigations and appropriate dressing selection is also considered. Emphasis is placed on improving assessment standards and promoting structured clinical reasoning to support recovery, prevent complications and reduce the burden on services. A comprehensive, person-centred approach is essential to improving outcomes in patients with complex wounds.