Long-term conditions Resources

As the UK population ages and greater numbers of people are living with long-term conditions (Office for National Statistics [ONS], 2014), increasing numbers of people are subsequently at risk of developing pressure ulcers (PUs). PUs are painful, costly and can negatively affect patient quality of life. They are particularly prevalent in the community setting, leading to high-costs in treatments, especially in those suffering from a chronic condition (Jaul et al, 2018). The prevention of PUs is therefore a key global care quality indicator, which is the focus of considerable quality improvements in primary care. Identifying a patient at risk of developing PUs is an action that should be undertaken at the first community visit. Nursing care to prevent PUs needs to be systematically planned, implemented and evaluated, following assessment of the patient and their
circumstances. As demonstrated by Clarkson et al (2019), integrating an interprofessional approach can reduce the severity of PUs in the community. There are a wide range of resources required to help prevent PUs, including nursing time, ensuring effective patient repositioning and risk assessment, as well as delivering the most appropriate pressure-relieving surfaces (Dealey et al, 2012).

There are currently 15 million people in England who have a longterm condition, which is defined as one which currently has no cure other than drugs and symptomatic management (Bennett et al, 2012). At present, the UK population is affected by the Covid-19 pandemic, and those with a long-term condition have been advised to selfisolate to prevent being infected by the virus (Department of Health [DH], 2020). This paper explores some of the effects of stress and anxiety with reference to Covid-19, as well as how the pandemic has affected the community nurse’s role.

Many government and healthcare strategies now advocate supporting self-care in the management of long-term conditions (LTCs). This approach has been driven by the increasing number of poly-morbid, obese and elderly people in the UK, which is putting an immense strain on already stretched health and social care resources. The emphasis on promoting self-care throughout the illness trajectory has been a pivotal aspect of nursing care for more than 50 years and this approach in the management of chronic oedema has always been a key aspect of treatment plans by specialists in this field. Practitioners need to be skilled in assessing the self-care needs of patients and to be ready to adopt this approach and provide appropriate support. This article gives an overview of self-care for people with chronic oedema and focuses on how nurses can encourage and support patients to do this. A case study demonstrates the importance of thorough and accurate assessment to encourage self-care and health behaviour change.

While lifestyle-related conditions such as heart disease, obesity and diabetes are on the rise, district nurse numbers are falling. At the same time, traditional methods for providing lifestyle advice on factors such as smoking, alcohol intake and exercise have proven to be ineffective. This article examines how a technique called motivational interviewing, which seeks to build a partnership with the client, can promote positive change by strengthening the person's own motivation to change.

Wendy Parkinson asks if in view of the increasingly complex care being delivered in the community setting can the exisiting community nurse workforce meet the challenges.
Wendy Parkinson RGN, BSc (Hons), MSc is a Managed Care Nurse Specialist, Portsmouth City PCT.
Article accepted for publication: March 2006