Challenges Resources

Maintaining an ideal weight is difficult for many people. For those who have reduced energy requirements, such as people with a spinal cord injury (SCI), maintaining a healthy weight can be more challenging. There are many barriers, including difficulties with increasing energy expenditure. This article discusses these challenges along with the increased health risks of diabetes and coronary heart disease seen within this population. Through a review of the literature, some practical solutions are provided. These include having weight management programmes starting soon after injury, education including carers’, and focusing on behavioural change techniques as part of a multidisciplinary approach to encouraging a healthy lifestyle, lifelong.

Community nurses are well placed to provide information about travel to people living with a stoma. Although much of the advice seems like common sense, learning to live with a stoma and adapt the stoma into lifestyles can be difficult. Patients often want advice and reassurance that they can travel — be this on foot, by car, boat or aeroplane. There is a great deal of information on the internet from support groups, which is often reviewed by healthcare professionals and people living with a stoma to ensure accuracy. There is also information available from stoma appliance manufacturers and dispensers on their websites. Healthcare professionals need to advocate caution in using other sites that may be the opinion of just one person and may not offer a balanced view. However, in general, community nurses can encourage travelling as a safe and enjoyable way to live after stoma forming surgery.

Maureen Benbow reflects on changing and current trends in relation to the emergence of the nursing specialty of tissue viability and how this has influenced the quality of patient care.
Maureen Benbow MSc, BA, RGN, HERC is Senior Lecturer at the University of Chester.
Article accepted for publication: December 2006

Nadia Dossa discusses the issues and challenges surrounding the work that community nurses often face on a night to night basis. The article will explore their role in light of traditional workings and what the future holds for the out of hour's services, in light of governmental policies and the recent white paper, (DoH, 2006).
Nadia Dossa BSc (Hons) Specialist Practitioner/District Nurse, Dip HE, RGN is a Lecturer Primary care & Public Health, Faculty of Health and Human Sciences, Thames Valley University
Article accepted for publication: January 2007