Browsing by Person "Ellis, Mairghread JH"

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A journey's end, and new roads beckoning
(2008) Ellis, Mairghread JH
Accessing health information on the Internet
(2012) Ellis, Mairghread JH
With the advent of the Internet, health information has become more widely available, but questions remain over the appropriateness, accessibility, sheer volume, and quality of the materials. Here, the author provides some background on the health information-seeking behaviours of patients, and a discussion of how the healthcare professional can be an active and positive partner in the process.
Charcot neuroarthropathy patient education among podiatrists in Scotland: a modified Delphi approach.
(BioMed Central, 2018-09-24) Bullen, Benjamin; Young, Matthew; McArdle, Carla; Ellis, Mairghread JH
Background This evaluation sought to determine current Charcot neuroarthropathy (CN) diabetes patient education practices among Scottish National Health Service (NHS) and academic podiatrists and evaluate novel visual tools and develop expert consensus for future practice. Methods Questionnaires collected mixed qualitative and quantitative responses, analysed concurrently within a convergence coding matrix. Delphi methodology permitted member-checking and agreement of consensus over two rounds. Results Fourteen participants (16.28%) completed a Round One questionnaire, leading to the generation of four themes; Experience; Person-Centred Care and the Content and Context of CN patient education. Seven consensus statements were subsequently developed and six achieved over 80% agreement among 16 participants (18.60%) with a Round Two questionnaire. Respondents agreed CN patient education should be considered for all ‘At-risk’ individuals with diabetic peripheral neuropathy (DPN). Verbal metaphors, including the ‘rocker-bottom’ foot, soft or brittle bones, collapsing, walking on honeycomb and a shattering lightbulb were frequently employed. Visual tools, including visual metaphors and The Charcot Foot Thermometer, were positively evaluated and made available online. Conclusions Key findings included respondent’s belief that CN education should be considered for all individuals with DPN and the frequent use of simile, analogy and metaphor in CN education. The concept of ‘remission’ proved controversial due to its potential for misinterpretation.
Consumer health information on the WWW: An evaluation of information on verrucae
(2003-07-19) Ellis, Mairghread JH; Thomson, Colin E.
Background: Increasingly the World Wide Web (WWW) is used as a first source by individuals seeking health information, and it is actively promoted as an information source by the NHS. Objective: This study evaluated the accessibility and quality of WWW-based information about verrucae, a condition where podiatrists often encourage self-treatment. Method: Using the term verruca- a variety of searches were undertaken. Outcome measures- - quality scores for information according to developed criteria; - presence of the Health on the Net Foundation (HONcode logo), to indicate quality of website. Results: Twenty-three sites were evaluated. Overall, quality of information was low, due to lack of information, rather than inaccuracy. Consumer health websites returned the highest mean scores for information quality. Sites of academic/professional and commercial ownership contained a higher quality of information than privately owned, or NHS-owned. Three sites (13%) displayed the Health on the Net Foundation logo, indicating adherence to their ethical standards. Conclusions: Results suggest that while relevant information is available on the WWW, it is not always easy to locate. It is essential to use appropriate search terms, and to appraise every site. Healthcare practitioners may have a role to play in guiding consumers towards effective search strategies, thus ensuring safe, relevant information is accessed.
Diabetic peripheral neuropathy, is it an autoimmune disease?
(2015-09-16) Janahi, Noor M.; Santos, Derek; Blyth, Christine; Bakhiet, Moiz; Ellis, Mairghread JH
Background: Autoimmunity has been identified in a significant number of neuropathies, such as, proximal neuropathies, and autonomic neuropathies associated with diabetes mellitus. However, possible correlations between diabetic peripheral neuropathy and autoimmunity have not yet been fully investigated. Objectives: This study was conducted to investigate whether autoimmunity is associated with the pathogenesis of human diabetic peripheral neuropathy. Research design and methods: A case-control analysis included three groups: 30 patients with diabetic peripheral neuropathy, 30 diabetic control patients without neuropathy, and 30 healthy controls. Blood analysis was conducted to compare the percentages of positive antinuclear antibodies (ANA) between the three groups. Secondary analysis investigated the correlations between the presence of autoimmune antibodies and sample demographics and neurological manifestations. This research was considered as a pilot study encouraging further investigations to take place in the near future. Results: Antinuclear antibodies were significantly present in the blood serum of patients with diabetic peripheral neuropathy in comparison to the control groups (p<. 0.001). The odds of positive values of ANA in the neuropathy group were 50 times higher when compared to control groups. Secondary analysis showed a significant correlation between the presence of ANA and the neurological manifestation of neuropathy (Neuropathy symptom score, Neuropathy disability score and Vibration Perception Threshold). Conclusion: The study demonstrated for the first time that human peripheral diabetic neuropathy may have an autoimmune aetiology. The new pathogenic factors may lead to the consideration of new management plans involving new therapeutic approaches and disease markers. 2015 Elsevier B.V.
Duality of practice in clinical research nursing
(SAGE, 2022-04-01) Hill, Gordon; Ellis, Mairghread JH; Irvine, Lindesay
Background: International evidence suggests that Clinical Research Nurses (CRN) can have a dual role incorporating both clinical care and research responsibilities. This duality of role often assists in meeting the clinical care and research needs of the participants and can contribute to the credibility of the CRN role. Conversely, it can also lead to feelings of confusion and role conflict as CRN’s time is divided. Aim: To identify and explore experiences of clinical and research roles among CRNs. This emerged as a theme in a wider research project exploring CRNs’ experiences of working with clinical nurses. Methods: Following an Interpretative Phenomenological Analysis approach, 10 CRNs participated in face-to-face semi-structured interviews. Transcribed data were analysed and a number of themes emerged. Duality of role was one of these. Findings: Findings indicated that if CRNs fulfil a dual role, this can assist in care provision, research delivery and in building positive relationships with clinical nurses. However, there were also instances when a dual role led to clinical nurses questioning the value of research and to issues with competing demands of clinical care and research. These experiences had an important impact on some of the CRNs and led to reflection on the value of their role. Conclusions: This study identifies new understandings of a dual role of the CRN. The findings will inform the preparation and practice of this group of nurses, whilst also leading to a deeper understanding of the CRN’s role in care and research delivery. It will also contribute to a wider appreciation of organisational factors and social interactions that impact on health care research.
Evaluating World Wide Web-based foot care information
(2006) Ellis, Mairghread JH; Ellis, B. M.
Here we go again: remission and re-ulceration in the diabetic foot
(SB Communications, 2018-04-25) Bullen, Benjamin; Young, Matthew; McArdle, Carla; Ellis, Mairghread JH
A case report of an individual presenting with a self-inflicted diabetes foot ulcer following inappropriate over-the-counter corn plaster use was published in the October 2016 issue of this journal (Bullen and Young, 2016). The role of low health literacy was discussed in order to optimise diabetes foot education. This update documents recurrent ulceration 1 year following initial presentation, illustrating a need for ongoing, personalised diabetes foot education for those ‘in remission’ from foot disease. The importance of patient recognition of the signs and symptoms of benign hyperkeratotic lesions and active diabetes foot disease is discussed, facilitating early presentation to podiatry services and prevention of further complications.
It’s time we talked about Charcot foot: Results of a podiatry patient education questionnaire
(Wounds Group, 2019-09-01) Bullen, Benjamin; Young, Matthew; McArdle, Carla; Ellis, Mairghread JH
In contrast with diabetic foot ulceration (DFU) and lower-extremity amputation (LEA), current Scottish patient information leaflets reserve Charcot foot education for individuals ‘In Remission’ from, or with active, Charcot foot. A small group of Scottish NHS podiatrists recently agreed Charcot foot education should be delivered to all ‘At-risk’ individuals with diabetic peripheral neuropathy. This study sought to compare discussion about diabetes foot disease and Charcot foot between ‘At-risk’ and ‘In Remission’ groups among this cohort. Fourteen participants completed an ‘At-risk’ component of the Charcot foot patient education questionnaire, while six also completed an ‘In Remission’ component. Topics investigated for both groups included DFU and LEA risk, footwear and insoles, and signs of infection and Charcot foot. Frequency of discussion data was captured with a five-point Likert scale. Median response and interquartile range (IQR) were described and compared between groups. Median values and IQR for discussion of DFU and LEA risk were 5 (IQR 1) and 3 (IQR 1.25) respectively for ‘At-risk’ groups, and 5 (IQR 0.25) and 3 (IQR 2), respectively, among the ‘In Remission’ group. For discussion of footwear and insoles, the median response was 4 (IQR 1) for ‘At-risk’ and 5 (IQR 1) for ‘In Remission’ groups, reversed for discussion of signs of infection. The greatest between-group discrepancy was found for discussion of Charcot foot, with median responses and IQR found to be 3 (IQR 2) and 5 (IQR 0.25) for ‘At-risk’ and ‘In Remission’ groups, respectively. This discrepancy has potential implications for Charcot foot educational strategies, audit and research. It is proposed that ‘always’ should be the benchmark for frequency of Charcot foot education, not just for those ‘In Remission’ but also those ‘At risk’.
Latex glove sensitivity: An overview for podiatrists
(Society of Chiropodists & Podiatrists, 2000-10) Ellis, Mairghread JH
Latex sensitivity has become recognised as an international public health issue. It is especially serious for those in the healthcare professions, due to the regular use of latex gloves. It is vital that gloves do not impart any harm either to the person wearing them or to the patient being touched. However, evidence in the podiatry profession suggests that skin problems associated with glove use and sensitivity to latex may be a significant problem.
MIS Distal Metatarsal Metaphyseal Osteotomy in the treatment of metatarsalgia: MOXFQ patient reported outcomes
(Elsevier, 2020-01-24) McMurrich, William; Peters, A.; Ellis, Mairghread JH; Baer, Gill; MacDonald, D.; Shalaby, H.; McKinley, J. C.
Introduction The aim of this paper is to present validated patient reported outcomes for MIS Distal Metatarsal Metaphyseal Osteotomy (DMMO) in the treatment of metatarsalgia. We aim to evaluate the DMMO procedure, report patient satisfaction with the operated foot and report any complications of this procedure.
Overcoming barriers to self-management: The person-centred diabetes foot behavioural agreement
(Elsevier, 2019-01-11) Bullen, Benjamin; Young, Matthew; McArdle, Carla; Ellis, Mairghread JH
Objective - Behavioural agreements have been proposed as a clinical strategy for improving concordance with diabetes foot self-management practices, both for individuals ‘At-risk’ of, and with active, diabetes foot disease. This narrative review sought to explore the potential supportive role of person-centred diabetes foot behavioural agreements in promoting protective foot self-management behaviours among ‘At-risk’ individuals. Conclusions - Health care professionals (HCPs) involved in diabetes foot risk stratification and management dedicate considerable time, effort and resources to the prevention of diabetic foot ulcers (DFU) and lower extremity amputation (LEA) and are uniquely placed to deliver person-centred diabetes self-management education and support (DSMES) interventions. Written, verbal and non-verbal agreements are consistent with a wider global move toward DSMES approaches, respectful of people’s preferences, and supporting them to undertake protective self-care behaviours. Practice implications - It is theorised that clear communication of the roles of the person with diabetes, their family or carers and HCPs may improve concordance with self-management behaviours. Rather than a punitive measure or means of facilitating discharge of ‘non-concordant’ individuals, person-centred behavioural agreements should be framed positively, as a means of delineating, prescribing and supporting individual diabetes foot-care responsibilities. This is an area worthy of further research.
Patients' experiences of post radiotherapy skin reactions
(2009) Ellis, Mairghread JH; Blyth, Christine; Boyle, Louise; Dunphy, Michelle; Hornsby, C.; Fletcher, J.
Presentation of doctoral research
(2008) Ellis, Mairghread JH
Professionalism within Podiatric practice
(2009) Ellis, Mairghread JH
Background: Podiatry aims and professes to undertake patient-centred practice. However, no podiatric literature was sourced that examines or discusses that most central component of our practice - the nature of our relationship with our patients; nor has any published research specifically focussed on this area. Aim: This study aimed to explore the nature of the patient-podiatrist relationship from the perspective of both private and National Health Service practitioners. Methodological approach: A phenomenological approach, with a hermeneutic focus, was utilised to construct meaning and understanding from the data of semi-structured interviews with eight participants. The researcher acknowledges herself as situated within the research, and a reflexive approach is demonstrated throughout. Iterative thematic analysis was undertaken to enable development of meaning and understanding. Findings: Findings were developed into six categories - relationship, engagement, role, image, reward and personal development, coming together in one overarching theme, that of professionalism. Discussion and application: Professionalism is discussed through the concept of macro- and micro-professionalism. The patient-podiatrist relationship can be a lens through which to consider aspects of micro-professionalism. This research proposes that professionalism be redefined from an explicit and public corporate concept, to its demonstration at an individual level - accepting that it is indeed professional to 'care', both for and about the patient, and that caring is beneficial to both patient and practitioner.
Qualitative exploration of patient and healthcare professional perspectives on barriers and facilitators to foot self-care behaviors in diabetes
(BMJ Publishing Group, 2022-11-14) Hill, Andrew; Ellis, Mairghread JH; Gillison, Fiona
Introduction Diabetic foot ulcers contribute significantly to morbidity and mortality associated with diabetes, but are preventable with good foot self-care. This study sought to explore the perspectives of patients and healthcare professionals (HCPs) on barriers and/or facilitators to foot self-care behaviors in diabetes and areas of consensus and/or tension between patient and HCP perspectives. Research design and methods This was a sequential, qualitative study that used a hermeneutic phenomenological approach. Phase I involved nine in-depth, semi-structured patient interviews. Phase II involved seven in-depth semi-structured interviews with HCPs (podiatrists, diabetes nurses, foot health practitioners (FHPs) and general practitioners (GPs)). In phase III, findings from phases I and II were brought back to two patient interview groups (five patients in total) to try and identify any areas of consensus and tension between HCP and patient perspectives. Results Patient and HCP perspectives had several areas of alignment: concerns over consequences of diabetes complications; the importance of patient education and frustrations around aspects of health service delivery. There were also some notable tensions identified: mixed messaging from HCPs around whose responsibility patient foot health is; and who patients should initially consult following the development of a foot problem. Overall, patients expressed that motivation to undertake good foot self-care behaviors was generated from their lived experiences, and was enhanced when this aligned with the information they received from HCPs. HCPs appeared to attribute lack of patient motivation to lack of knowledge, which was not raised by patients. Conclusions This study has identified points of misalignment between the views of patients and practitioners that may help to explain why adherence to foot self-care among patients with diabetes is low. Our results suggest that better outcomes may stem from HCPs focusing on supporting autonomous motivation for self-care and enhancing the rationale through referencing patients’ own experience rather than focussing on increasing patient knowledge. Renewed focus on consistency of messaging by HCPs around the roles and responsibilities relating to foot health in diabetes, and the benefit of foot-specific training being provided to non-foot specialist HCPs may also help to improve uptake and adherence to foot self-care behaviors in diabetes.
The long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidus
(2012-09) Coutts, A.; Kilmartin, T. E.; Ellis, Mairghread JH
Background: The Keller arthroplasty has been used to treat painful conditions of the first MTP joint for over 100 years. More recently the procedure has fallen out of favour, due to a high incidence of transfer metatarsalgia and poor function of the first MTP joint post-operatively. Objective: This study sought to review the place for Keller arthroplasty in the management of hallux rigidus by considering outcomes from the patient's perspective. Methods: From 1997 to 2005, 104 patients (131 feet) underwent a Keller excisional arthroplasty for the treatment of hallux rigidus. All subjects were classed as grade III on the Hattrup and Johnson scale of joint classification and had a primary complaint of painful hallux rigidus. The American orthopaedic foot and ankle scale was applied pre-operatively and post-operatively. Thirty-two participants (42 feet) were available for a final review (6 male feet and 34 female feet). The range of follow up was 36-154 months with a mean average follow up of 92 months (7.6 years). The age range at the time of surgery was 42-78 years with a mean average age of 62 years at surgery and 69 years and eight months at review. Results: Seventy-six percent of participants were completely satisfied, 21.5% satisfied with reservations and 2.5% were dissatisfied. High levels of satisfaction were recorded for pain relief, activity levels and overall patient satisfaction. Ninety-five percent of participants reported their symptoms were improved at long-term follow up compared to pre operatively; however 9.5% of the group complained of transfer metatarsalgia. Nineteen percent of participants, all female, were not happy with the cosmetic appearance of their foot. The mean pre-operative AOFAS clinical rating scale scores was 38. At final follow up the mean score was 89. Conclusion: The Keller excisional arthroplasty is a simple reliable procedure for the treatment of severe hallux rigidus. Furthermore, it is effective in achieving pain-free movement of the first MTP joint, but carries a risk of creating transfer metatarsalgia. For nearly 20% of participants post-operative cosmetic appearance was disappointing. 2012 Elsevier Ltd. All rights reserved
The nature of decision making within a specialist diabetes multidisciplinary team: a qualitative approach
(Society of Chiropodists & Podiatrists, 2012-12) Thomson, S. J.; Ellis, Mairghread JH
The opinions and attitudes of HPC registered level 4 podiatry students towards professionalism pre- and post- work placement: a qualitative study
(Institute of Chiropodists and Podiatrists, 2012-03) Ellis, Mairghread JH; Speers, Alex; Waring, Jenny L.
The patient podiatrist relationship - contextualising professionalism within the clinical encounter
(2007) Ellis, Mairghread JH
Introduction Patients are the key resource of health care practitioners, and much emphasis is laid on partnerships of care, with the patient being informed, autonomous and empowered. Many questions arise from current practice - are podiatrists fully embracing this model of practice? Do patients fully engage with their practitioner? How do podiatrists feel that patients perceive us? Research in nursing and occupational therapy stresses that practitioners must 'connect' with patients, and at times act as chameleons, changing to match the environment of each patient encounter (Aranda and Street, 1999; Rosa and Hasselkus, 1996). This study aimed to explore podiatrist's perceptions and experiences of the relationship they hold with their patients. Methods A phenomenological approach, informed by Gadamers's hermeneutic philosophy for gaining meaning and understanding was utilised, with the researcher's influence as 'native' being accepted in co-construction and interpretation of data from 8 Podiatrists in Central Scotland (4NHS, 4 private practitioners). Corec and QMU granted ethical permissions. Results Six categories of meaning emerged: relationship, engagement, role, image, reward and personal development. This fed into one overarching theme - Professionalism. Discussion Theories of dramaturgy (Goffman, 1959) and Liminality (Turner, 1969) are used to interpret and explain the findings. Baldwin's (2006) model of professionalism is utilised to demonstrate that phronesis (practical wisdom) and tacit knowledge are important and undervalued aspects of professionalism, alongside episteme (knowledge) and techne (profession specific skills). The study findings suggest a model of professionalism which focuses on the individual patient - practitioner interaction, with phronesis being a more important element of professionalism than traditional models have accepted.