Interstitial cystitis or painful bladder syndrome (IC/PBS) is a chronic condition presenting with symptoms including pain, urinary urgency and urinary frequency. IC/PBS is often poorly diagnosed and many patients may have seen multiple healthcare professionals over a period of years and undergone a variety of unsuccessful treatments. The lack of a definitive definition of IC/ PBS and diagnosis of its aetiology, cause and successful treatment contributes to a poor quality of life for many patients. This article looks at the main symptoms, diagnostic techniques and treatments for the IC/PBS. The author outlines how comprehensive history taking, physical examination and appropriate clinical tests all help community nurses to arrive at an appropriate and timely diagnosis, which, when combined with individualised treatment plans, can offer patients effective relief of their symptoms.
While cancer treatment can be debilitating enough in itself, one of the lesser known side-effects is the impact it has on patients’ nutrition, including reduced appetite, nausea and changes in taste. This article takes an in-depth look at the elements that community nurses need to be aware of when managing patients undergoing treatment for cancer.
Allergic rhinitis (AR) is a common disorder which has a major impact on the lives of sufferers and families. Although currently there is no cure for this disease, a variety of therapeutic interventions can alleviate the symptoms. It is important that nurses are able to differentiate allergic and non-allergic rhinitis (NAR) from viral upper respiratory tract infections (URTIs) in order to best manage their patients. It is also necessary to ask appropriate questions of those patients attending for asthma review, as
they may have unrecognised and untreated disease. Familiarity with the range of medications and their administration is advocated. Patients with troublesome, non-responding symptoms need to be referred, as do those with red flag signs.
Compression bandages provide the mainstay of treatment for venous diseases and their sequellae of ulceration and oedema. Selection should depend not only on the effectiveness and cost of treatment, but also on patient acceptability. If correctly applied, compression bandages provide sustained graduated pressure. This article explores the negative impact that having a leg ulcer can have on patient quality of life and introduces a new, moisturising, odour-reducing inelastic two-layer compression bandaging system that aims to improve patient wellbeing and comfort which, in turn, promotes concordance.
It has been estimated that around 4% of patients on community caseloads have long-term indwelling catheters (Pomfret, 2000). Healthcare professionals have a responsibility to be aware of the different closed drainage systems available, so that they can offer patients choices to suit their lifestyle and preferences. Leg bags are one option, which can be customised to maximise patient comfort and dignity. This paper discusses the impact that urinary incontinence can have on patient quality of life, and one range of leg bags that has been developed to meet patients’ specific needs.
Literature has shown that patients with leg ulcers can have a significantly poorer quality of life compared to those without leg ulcers. In addition, research has identified problematic relationships between patients with leg ulcers and practitioners, such as community nurses. The author contends that this mismatch needs to be addressed in order to improve patient quality of life through leg ulcer bandaging. He makes several recommendations for practice and highlights that community practitioners need to use innovative practice to help improve the quality of leg ulcer bandaging care they deliver. The overall aim of this article is to establish the extent of community practitioners’ understanding of the impact of leg ulcer bandaging on patient quality of life.
Edwin Tapiwa Chamanga, Tissue Viability Service Lead, Ipswich Hospital NHS Trust
In a short reflective exercise, the introduction of disposable Negative Pressure Wound Therapy (NPWT) was shown to improve the patient experience of being managed in the community with a complex wound. District nurses and treatment room staff found the system easy to use and in their view, it extended the interval required between dressing changes and time taken to carry out wound care. This article considers the benefits of NPWT, illustrating these with patient reflections and comments.
Lynne Watret RGN, MA, MN, PGCert TLHE CNS Tissue Viability, Primary Care, Greater Glasgow & Clyde Health Board.
Article accepted for publication: January 2012
Psoriasis is a common, recurring inflammatory condition that affects the skin, scalp and joints. It can have a profound effect on an individual’s self-image, self-esteem, and sense of well-being and can negatively affect all aspects of life.
This paper will outline the physiological and psychological impact of psoriasis on the individual and discuss its subsequent impact on adherence to treatment. It will also examine the benefits of self-management of long-term conditions, such as psoriasis and look at the role nurses can play in helping to support self-management.
Susan Maguire, RN, BA (Hons), Professional Officer, British Dermatological Nursing Group, 88 Kingsway, London WC2B 6AA
Article accepted for publication: February 2012
Collette Hoare discusses the emotional, psychological and social issues which play a part in the treatment of atopic eczema.
Collette Hoare BSc, is a Information Co-ordinator at the National Eczema Society, London.
Article accepted for publication February 2001.
Barbara Holtom reviews the literature and discusses if it is possible to plan individualised catheter changes for patients
Barbara Holtom RGN, DNCert, Dip Prof Studies (Nursing) is a Senior Community Night Sister. Article accepted for publication: October 2003
