Imperial College London

DrMaryWells

Faculty of MedicineDepartment of Surgery & Cancer

Professor of Practice (Cancer Nursing)
 
 
 
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Contact

 

+44 (0)20 3311 7422mary.wells

 
 
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Location

 

Education Centre CXH Nursing DirectorateCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Publication Type
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84 results found

Saggu R, Barlow P, Butler J, Ghaem-Maghami S, Hughes C, Lagergren P, McGregor A, Shaw C, Wells Met al., 2022, Considerations for mulitmodal prehabilitation in women with gynaecological cancers: a scoping review using realist principles, BMC Women's Health, Vol: 22, Pages: 1-35, ISSN: 1472-6874

Background: There is increasing recognition that prehabilitation is important as a means of preparing patients physically and psychologically for cancer treatment. However, little is understood about the role and optimal nature of prehabilitation for gynaecological cancer patients, who usually face extensive and life-changing surgery in addition to other treatments that impact significantly on physiological and psychosexual wellbeing. Review question: This scoping review was conducted to collate the research evidence on multimodal prehabilitation in gynaecological cancers and the related barriers and facilitators to engagement and delivery that should be considered when designing a prehabilitation intervention for this group of women. Methods: Seven medical databases and four grey literature repositories were searched from database inception to September 2021. All articles, reporting on multimodal prehabilitation in gynaecological cancers were included in the final review, whether qualitative, quantitative or mixed-methods. Qualitative on unimodal interventions were also included, as these were thought to be more likely to include information about barriers and facilitators which could also be relevant to multimodal interventions. A realist framework of context, mechanism and outcome was used to assist interpretation of findings. Results: In total, 24 studies were included in the final review. The studies included the following tumour groups: ovarian only (n=12), endometrial only (n=1), mixed ovarian, endometrial, vulvar (n=5) and non-specific gynaecological tumours (n=6). There was considerable variation across studies in terms of screening for prehabilitation, delivery of prehabilitation and outcome measures. Key mechanisms and contexts influencing engagement with prehabilitation can be summarised as: 1) The role of healthcare professionals and organisations 2) Patients’ perceptions of acceptability 3) Factors influencing patient motivation 4) Prehabilita

Journal article

Wells M, 2022, Key components of successful digital remote monitoring in oncology, NATURE MEDICINE, Vol: 28, Pages: 1128-1129, ISSN: 1078-8956

Journal article

Racaru S, Saghdaoui LB, Choudhury JR, Wells M, Davies AHet al., 2022, Offloading treatment in people with diabetic foot disease: A systematic scoping review on adherence to foot offloading, DIABETES & METABOLIC SYNDROME-CLINICAL RESEARCH & REVIEWS, Vol: 16, ISSN: 1871-4021

Journal article

Strachan H, Hoskins G, Wells M, Maxwell Met al., 2022, A realist evaluation case study of the implementation of advanced nurse practitioner roles in primary care in Scotland, JOURNAL OF ADVANCED NURSING, Vol: 78, Pages: 2916-2932, ISSN: 0309-2402

Journal article

Newlands R, Duncan E, Treweek S, Elliott J, Presseau J, Bower P, MacLennan G, Ogden M, Wells M, Witham MD, Young B, Gillies Ket al., 2022, The development of theory-informed participant-centred interventions to maximise participant retention in randomised controlled trials, Trials, Vol: 23, ISSN: 1745-6215

BACKGROUND: A failure of clinical trials to retain participants can influence the trial findings and significantly impact the potential of the trial to influence clinical practice. Retention of participants involves people, often the trial participants themselves, performing a behaviour (e.g. returning a questionnaire or attending a follow-up clinic as part of the research). Most existing interventions that aim to improve the retention of trial participants fail to describe any theoretical basis for the potential effect (on behaviour) and also whether there was any patient and/or participant input during development. The aim of this study was to address these two problems by developing theory- informed, participant-centred, interventions to improve trial retention. METHODS: This study was informed by the Theoretical Domains Framework and Behaviour Change Techniques Taxonomy to match participant reported determinants of trial retention to theoretically informed behaviour change strategies. The prototype interventions were described and developed in a co-design workshop with trial participants. Acceptability and feasibility (guided by (by the Theoretical Framework of Acceptability) of two prioritised retention interventions was explored during a focus group involving a range of trial stakeholders (e.g. trial participants, trial managers, research nurses, trialists, research ethics committee members). Following focus group discussions stakeholders completed an intervention acceptability questionnaire. RESULTS: Eight trial participants contributed to the co-design of the retention interventions. Four behaviour change interventions were designed: (1) incentives and rewards for follow-up clinic attendance, (2) goal setting for improving questionnaire return, (3) participant self-monitoring to improve questionnaire return and/or clinic attendance, and (4) motivational information to improve questionnaire return and clinic attendance. Eighteen trial stakeholders discussed t

Journal article

Lorenc A, Wells M, Fulton-Lieuw T, Nankivell P, Mehanna H, Jepson M, Karwath A, Main B, Firth C, Gaunt C, Greaves C, Moore D, Watson E, Gkoutos G, Ozakinci G, Wolstenholme J, Dretzke J, Brett J, Duda J, Matheson L, Cherrill L-R, Calvert M, Kiely P, Gaunt P, Chernbumroong S, Mittal S, Thomas S, Winter S, Wong Wet al., 2022, Clinicians' views of patient-initiated follow-up in head and neck cancer: a qualitative study to inform the PETNECK2 trial, Clinical Oncology, Vol: 34, Pages: 230-240, ISSN: 0936-6555

AimsCurrent follow-up for head and neck cancer (HNC) is ineffective, expensive and fails to address patients' needs. The PETNECK2 trial will compare a new model of patient-initiated follow-up (PIFU) with routine scheduled follow-up. This article reports UK clinicians' views about HNC follow-up and PIFU, to inform the trial design.Materials and methodsOnline focus groups with surgeons (ear, nose and throat/maxillofacial), oncologists, clinical nurse specialists and allied health professionals. Clinicians were recruited from professional bodies, mailing lists and personal contacts. Focus groups explored views on current follow-up and acceptability of the proposed PIFU intervention and randomised controlled trial design (presented by the study co-chief investigator), preferences, margins of equipoise, potential organisational barriers and thoughts about the content and format of PIFU. Data were interpreted using inductive thematic analysis.ResultsEight focus groups with 34 clinicians were conducted. Clinicians highlighted already known limitations with HNC follow-up – lack of flexibility to address the wide-ranging needs of HNC patients, expense and lack of evidence – and agreed that follow-up needs to change. They were enthusiastic about the PETNECK2 trial to develop and evaluate PIFU but had concerns that PIFU may not suit disengaged patients and may aggravate patient anxiety/fear of recurrence and delay detection of recurrence. Anticipated issues with implementation included ensuring a reliable route back to clinic and workload burden on nurses and allied health professionals.ConclusionsClinicians supported the evaluation of PIFU but voiced concerns about barriers to help-seeking. An emphasis on patient engagement, psychosocial issues, symptom reporting and reliable, quick routes back to clinic will be important. Certain patient groups may be less suited to PIFU, which will be evaluated in the trial. Early, meaningful, ongoing engagement with clinical te

Journal article

Warner B, Harry A, Brett S, Wells M, Antcliffe Det al., 2022, The end is just the beginning: involvement of bereaved next of kin in qualitative research, BMJ Supportive & Palliative Care, Vol: 12, ISSN: 2045-4368

Journal article

Newington L, Alexander CM, Wells M, 2022, What is a clinical academic? Qualitative interviews with healthcare managers, research-active nurses and other research-active healthcare professionals outside medicine, Journal of Clinical Nursing, Vol: 31, Pages: 378-389, ISSN: 0962-1067

AIM AND OBJECTIVES: To explore the concept of 'clinical academic' from the perspectives of healthcare managers and research-active healthcare professionals outside medicine. BACKGROUND: Clinical academics are understood to be healthcare professionals who combine clinical and research responsibilities within their role. However, there is no agreed definition for this term either within or across nursing, midwifery and the other healthcare professions outside medicine. DESIGN: Qualitative service evaluation, reported using the COREQ checklist. METHODS: Semi-structured qualitative interviews were conducted with a purposive sample of eight healthcare managers and 12 research-active clinicians within a UK hospital group. Interviews were audio recorded, transcribed verbatim, and analysed using the Framework method. RESULTS: Clinical academics were described in four themes. Two themes explored the components of the role and the contribution of these individuals to their profession: combining clinical practice, research and education; and pushing boundaries. The third theme identified the clinical academic label as: a title that doesn't fit. The final theme examined a characteristic mindset of research-active clinicians. There were no clear differences in the perceptions of managers and research-active clinicians. CONCLUSIONS: Clinical academics were perceived as valuable members of their team and were able to push the boundaries to move their profession forward. Some research-active clinicians did not identify with the term 'clinical academic' and for some managers and research-active clinicians, the term was viewed as jargonistic. A clear and accepted definition would aid development of clinical academic career pathways and identities. It would also assist in evaluating the impact of these roles. RELEVANCE TO PRACTICE: As clinical academics roles and opportunities are being developed across the professions outside medicine, it is important to have a shared common understa

Journal article

Newington L, Alexander C, Wells M, 2021, Would you like to be contacted about future research?, BMC Research Notes, Vol: 14, ISSN: 1756-0500

Many research participants are willing to be contacted about future research opportunities, however this question is not always asked. Furthermore, if participants do consent for contact about future research, this information is not always accessible to other research teams. We discuss our experience of recruiting individuals who have previously taken part in healthcare research and suggest potential strategies to support this process and enable greater research participation.

Journal article

Newington L, Alexander CM, Wells M, 2021, The impacts of clinical academic activity: Qualitative interviews with healthcare managers and research-active nurses, midwives, allied health professionals and pharmacists, BMJ Open, Vol: 11, ISSN: 2044-6055

Objectives: To explore the perceived impacts of clinical academic activity among the professions outside medicine.Design: Qualitative semistructured interviews.Setting and participants: There were two groups of interviewees: Research-active nurses, midwives, allied health professionals, healthcare scientists, psychologists and pharmacists (NMAHPPs) and managers of these professions. All participants were employed in a single, multisite healthcare organisation in the UK.Analysis: Interview transcripts were analysed using the framework method to identify key themes, subthemes and areas of divergence.Results: Four themes were identified. The first, cultural shifts, described the perceived improvements in the approach to patient care and research culture that were associated with clinical academic activity. The second theme explored visibility and included the positive reputation that clinical academics were identified as bringing to the organisation in contrast with perceived levels of invisibility and inaccessibility of these roles. The third theme identified the impacts of the clinical academic pathways, including the precarity of these roles. The final theme explored making impact tangible, and described interviewees’ suggestions of possible methods to record and demonstrate impact.Conclusions: Perceived positive impacts of NMAHPP clinical academic activity focused on interlinked positive changes for patients and clinical teams. This included delivery of evidence-based healthcare, patient involvement in clinical decision making and improved staff recruitment and retention. However, the positive impacts of clinical academic activity often centred around individual clinicians and did not necessarily translate throughout the organisation. The current clinical academic pathway was identified as causing tension between the perceived value of clinical academic activity and the need to find sufficient staffing to cover clinical services.

Journal article

Newington L, Wells M, Adonis A, Bolton L, Bolton Saghdaoui L, Coffey M, Crow J, Fadeeva Costa O, Hughes C, Savage M, Pakzad-Shahabi L, Alexander Cet al., 2021, A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine, BMC Health Services Research, Vol: 21, ISSN: 1472-6963

Background: There are increasing opportunities for healthcare professionals outside medicine to be involved in and lead clinical research. However, there are few roles within these professions that include time for research. In order to develop such roles, and evaluate effective use of this time, the range of impacts of this clinical academic activity need to be valued and understood by healthcare leaders and managers. To date, these impacts have not been comprehensively explored, but are suggested to extend beyond traditional quantitative impact metrics, such as publications, citations and funding awards. Methods: Ten databases, four grey literature repositories and a naïve web search engine were systematically searched for articles reporting impacts of clinical academic activity by healthcare professionals outside medicine. Specifically, this did not include the direct impacts of the research findings, rather the impacts of the research activity. All stages of the review were performed by a minimum of two reviewers and reported impacts were categorised qualitatively according to a modified VICTOR (making Visible the ImpaCT Of Research) framework. Results: Of the initial 2,704 identified articles, 20 were eligible for inclusion. Identified impacts were mapped to seven themes: impacts for patients; impacts for the service provision and workforce; impacts to research profile, culture and capacity; economic impacts; impacts on staff recruitment and retention; impacts to knowledge exchange; and impacts to the clinical academic. Conclusions: Several overlapping sub-themes were identified across the main themes. These included the challenges and benefits of balancing clinical and academic roles, the creation and implementation of new evidence, and the development of collaborations and networks. These may be key areas for organisations to explore when looking to support and increase academic activity among healthcare professionals outside medicine. The modified VICTO

Journal article

Newlands R, Duncan E, Presseau J, Treweek S, Lawrie L, Bower P, Elliott J, Francis J, MacLennan G, Ogden M, Wells M, Witham MD, Young B, Gillies Ket al., 2021, Why trials lose participants: A multitrial investigation of participants perspectives using the theoretical domains framework, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 137, Pages: 1-13, ISSN: 0895-4356

Journal article

Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, Martin G, Clarke J, Sounderajah V, Markar S, Przybylowicz J, Chan YH, Sia C-H, Chua YX, Sim K, Lim L, Tan L, Tan M, Sharma V, Ooi S, Beatty JW, Flott K, Mason S, Chidambaram S, Yalamanchili S, Zbikowska G, Fedorowski J, Dykowska G, Wells M, Purkayastha S, Kinross Jet al., 2021, Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study, PLoS One, Vol: 16, Pages: 1-18, ISSN: 1932-6203

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49–2.95), nurse (OR 1.38; 95% CI 1.04–1.84), and ‘other clinical’ (OR 2.02; 95% CI 1.45–2.82); being redeployed (OR 1.27; 95% CI 1.02–1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98–2.99), anxiety (OR 4.87; 95% CI 3.92–6.06) and depression (OR 4.06; 95% CI 3.04–5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51–0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22–0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gende

Journal article

Biagioli V, Drury A, Wells M, Eicher M, Kelly Det al., 2021, Self-care and cancer: Comment on Riegel et al. (2020) ‘Characteristics of self-care interventions for patients with a chronic condition: A scoping review’, International Journal of Nursing Studies, Vol: 115, Pages: 103877-103877, ISSN: 0020-7489

Journal article

Cunningham KB, Kroll T, Wells M, 2021, First steps in identifying and addressing loneliness in the context of COVID-19, Perspectives in Public Health, Pages: 1-2, ISSN: 1757-9139

Journal article

Castro-Sanchez E, Russell AM, Dolman L, Wells Met al., 2021, What place does nurse-led research have in the COVID-19 pandemic?, INTERNATIONAL NURSING REVIEW, Vol: 68, Pages: 214-218, ISSN: 0020-8132

Journal article

Castro-Sanchez E, Alexander CM, Atchison C, Patel D, Leung W, Calamita ME, Garcia DM, Cimpeanu C, Mumbwatasai JM, Ramid D, Doherty K, Grewal HS, Otter JA, Wells EMet al., 2020, Evaluation of a personal protective equipment (PPE) support programme ('PPE Helpers') for staff during the COVID-19 pandemic in London, Journal of Hospital Infection, Vol: 109, Pages: 68-7, ISSN: 0195-6701

BackgroundThe COVID-19 pandemic has presented one of the biggest challenges to healthcare providers worldwide. The appropriate use of Personal Protective Equipment (PPE) has been essential to ensuring staff and patient safety. To counteract sub-optimal PPE practice, a PPE helper programme was developed at a large London hospital group. Based on a behaviour change model of Capability, Opportunity and Motivation (COM-B), the programme provided PPE support, advice and education to ward staff.AimEvaluation of the PPE Helper Programme.MethodsClinical and non-clinical ward staff completed a questionnaire informed by the Theoretical Domains Framework and COM-B. The questionnaire was available in paper and electronic versions. Quantitative responses were analysed using descriptive and non-parametric statistics, free-text responses were analysed thematically.FindingsOver a six-week period, PPE helpers made 268 ward visits. Overall, 261 questionnaires were available for analysis. Across the Trust, 68% of respondents reported having had contact with a PPE helper. Staff who had encountered a PPE helper responded significantly more positively to a range of statements about using PPE than those who had not. Black and Minority Ethnic (BAME) staff were significantly more anxious in relation to the adequacy of PPE. Non-clinical and redeployed staff (e.g. domestic staff) were most positive about the impact of PPE helpers. Free-text comments showed that staff found the programme supportive and would have liked it earlier in the pandemic.ConclusionA PPE Helper programme is a feasible and beneficial intervention for providing support, advice and education to ward staff during infectious disease outbreaks.

Journal article

Grant A, Bugge C, Wells M, 2020, Designing process evaluations using case study to explore the context of complex interventions evaluated in trials, Trials, Vol: 21, Pages: 1-10, ISSN: 1745-6215

BackgroundProcess evaluations are an important component of an effectiveness evaluation as they focus on understanding the relationship between interventions and context to explain how and why interventions work or fail, and whether they can be transferred to other settings and populations. However, historically, context has not been sufficiently explored and reported resulting in the poor uptake of trial results. Therefore, suitable methodologies are needed to guide the investigation of context. Case study is one appropriate methodology, but there is little guidance about what case study design can offer the study of context in trials. We address this gap in the literature by presenting a number of important considerations for process evaluation using a case study design.Main textIn this paper, we define context, the relationship between complex interventions and context, and describe case study design methodology. A well-designed process evaluation using case study should consider the following core components: the purpose; definition of the intervention; the trial design, the case, the theories or logic models underpinning the intervention, the sampling approach and the conceptual or theoretical framework. We describe each of these in detail and highlight with examples from recently published process evaluations.ConclusionsThere are a number of approaches to process evaluation design in the literature; however, there is a paucity of research on what case study design can offer process evaluations. We argue that case study is one of the best research designs to underpin process evaluations, to capture the dynamic and complex relationship between intervention and context during implementation. We provide a comprehensive overview of the issues for process evaluation design to consider when using a case study design.

Journal article

Brett J, Davies EL, Matley F, Aveyard P, Wells M, Foxcroft D, Nicholson B, De Silva Minor S, Sinclair L, Jakes S, Watson Eet al., 2020, Electronic cigarettes as a smoking cessation aid for patients with cancer: beliefs and behaviours of clinicians in the UK., BMJ Open, Vol: 10, Pages: 1-9, ISSN: 2044-6055

OBJECTIVES: To explore UK clinicians' beliefs and behaviours around recommending e-cigarettes as a smoking cessation aid for patients with cancer. DESIGN: Cross-sectional online survey. SETTING: England, Wales, Scotland and Northern Ireland. PARTICIPANTS: Clinicians involved in the care of patients with cancer. PRIMARY AND SECONDARY OUTCOMES: Behavioural Change Wheel capability, opportunity and motivation to perform a behaviour, knowledge, beliefs, current practice around e-cigarettes and other smoking cessation practices. METHOD: Clinicians (n=506) completed an online survey to assess beliefs and behaviours around e-cigarettes and other smoking cessation practices for patients with cancer. Behavioural factors associated with recommending e-cigarettes in practice were assessed. RESULTS: 29% of clinicians would not recommend e-cigarettes to patients with cancer who continue to smoke. Factors associated with recommendation include smoking cessation knowledge (OR 1.56, 95% CI 1.01 to 2.44) and e-cigarette knowledge (OR 1.64, 95% CI 1.06 to 2.55), engagement with patients regarding smoking cessation (OR 2.12, 95% CI 1.12 to 4.03), belief in the effectiveness of e-cigarettes (OR 2.36 95% CI 1.61 to 3.47) and belief in sufficient evidence on e-cigarettes (OR 2.08 95% CI 1.10 to 4.00) and how comfortable they felt discussing e-cigarettes with patients (OR 1.57 95% CI 1.04 to 2.36). CONCLUSION: Many clinicians providing cancer care to patients who smoke do not recommend e-cigarettes as a smoking cessation aid and were unaware of national guidance supporting recommendation of e-cigarettes as a smoking cessation aid.

Journal article

Albert J, Wells M, 2020, The Acton Model: support for women with female genital mutilation, British Journal of Midwifery, Vol: 28, Pages: 697-708, ISSN: 0969-4900

<jats:sec><jats:title>Objectives</jats:title><jats:p> To identify the presenting characteristics, needs and clinical management of non-pregnant women with female genital mutilation who attended the Sunflower clinic, a midwife-led specialist service. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> This was a retrospective case series review examining referral patterns, clinical findings and subsequent management between 1 April 2018 and 31 March 2019.The review was conducted at a multi-disciplinary female genital mutilation clinic for non-pregnant women aged 18 years and over in West London. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> There were 182 attendances at the clinic (88 new patients; 94 follow-up appointments). Almost half (52%) had type 3 mutilation, 32% had type 2; 9% had a history of type 3; 5% had type 1; one had type 4 and one declined assessment. A total of 35 women (40%) disclosed at least one psychological symptom (such as depression, anxiety, flashbacks, nightmares) during initial consultation. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Non-pregnant women attending female genital mutilation services present with a wide range of psychological and physical problems. Holistic woman-centred models of care appear to facilitate access to deinfibulation and counselling, which in turn may reduce long-term costs to the NHS. Safeguarding is an intrinsic part of midwives' work and is sometimes complex. The authors recommend a revision of the World Health Organization classifications to specify partial or total removal of the clitoral glans (rather than the clitoris as a whole) as this is inaccurate and may have a negative psychological impact for women. </jats:p></jats:sec>

Journal article

Denning M, Goh ET, Scott A, Martin G, Markar S, Flott K, Mason S, Przybylowicz J, Almonte M, Clarke J, Winter Beatty J, Chidambaram S, Yalamanchili S, Yong-Qiang Tan B, Kanneganti A, Sounderajah V, Wells M, Purkayastha S, Kinross Jet al., 2020, What has been the impact of Covid-19 on Safety Culture? A case study from a large metropolitan teaching hospital, International Journal of Environmental Research and Public Health, Vol: 17, Pages: 1-14, ISSN: 1660-4601

Covid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and in turn patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture. The Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture at a large UK healthcare trust during Covid-19. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was also examined. SAQ scores of doctors and 'other clinical staff', were relatively higher than the nursing group. During Covid-19, on univariate regression analysis, female gender, age 40-49 years, non-white ethnicity, and nursing job role were all associated with lower SAQ scores. Training and support for redeployment were associated with higher SAQ scores. On multivariate analysis, non-disclosed gender (-0.13), non-disclosed ethnicity (-0.11), nursing role (-0.15), and support (0.29) persisted to significance. A significant decrease (p<0.003) was seen in error reporting after the onset of the Covid-19 pandemic. This is the first study to investigate SAQ during Covid-19. Differences in SAQ scores were observed during Covid-19 between professional groups when compared to baseline. Reductions in incident reporting were also seen. These changes may reflect perception of risk, changes in volume or nature of work. High-quality support for redeployed staff may be associated with improved safety perception during future pandemics.

Journal article

Saghdaoui LB, Onida S, Davies AH, Wells Met al., 2020, Why nurses in primary care need to be research active: the case of venous leg ulceration., Br J Community Nurs, Vol: 25, Pages: 422-428, ISSN: 1462-4753

Venous leg ulceration (VLU) is predominantly managed in primary care by district nurses, however much of the research takes place in secondary care. This study aimed to identify to what extent nurses are involved in publishing VLU research and to ascertain how much VLU research is conducted in primary care. Three searches of literature published between 2015 and 2020 were undertaken, reviewing VLU publications on interventions, quality of life and qualitative research. Some 37% of intervention studies had one or more nurse authors, compared with 65% of quality of life studies and 86% of qualitative research publications. Of papers that providing details of recruitment, 39% of intervention and quality of life studies included primary care as a recruitment setting. Qualitative studies were more likely to recruit from primary as well as secondary care (50%). Nurses are involved in leading VLU research but are more likely to publish quality of life and qualitative research than intervention studies. The majority of nurse authors in this field are based in academic institutions. A minority of studies utilise primary care as a recruitment setting for VLU research. More must be done to enable VLU research in community settings and to promote the involvement of clinical nurses in research.

Journal article

Leon-Villapalos C, Wells M, Brett S, 2020, An exploratory study of staff perceptions of shift safety in the critical care unit and routinely available data on workforce, patient and organisational factors, BMJ Open, Vol: 10, ISSN: 2044-6055

Objectives To explore bedside professional reported (BPR) perceptions of safety in intensive care staff and the relationships between BPR safety, staffing, patient and work environment characteristics.Design An exploratory study of self-recorded staff perceptions of shift safety and routinely collected data.Setting A large teaching hospital comprising 70 critical care beds.Participants All clinical staff working in adult critical care.Interventions Staff recorded whether their shift felt ‘safe, unsafe or very unsafe’ for 29 consecutive days. We explored these perceptions and relationships between them and routine data on staffing, patient and environmental characteristics.Outcome measures Relationships between BPR safety and staffing, patient and work environment characteristics.Results 2836 BPR scores were recorded over 29 consecutive days (response rate 57.7%). Perceptions of safety varied between staff, including within the same shift. There was no correlation between perceptions of safety and two measures of staffing: care hours per patient day (r=0.13 p=0.108) and Safecare Allocate (r=−0.19 p=0.013). We found a significant, positive relationship between perceptions of safety and the percentage of level 3 (most severely ill) patients (r=0.32, p=0.0001). There was a significant inverse relationship between perceptions of safety and the percentage of level 1 patients on a shift (r=−0.42, p<0.0001). Perceptions of safety correlated negatively with increased numbers of patients (r=−0.44, p=0.0006) and higher percentage of patients located side rooms (r=0.63, p<0.0001). We found a significant relationship between perceptions of safety and the percentage of staff with a specialist critical care course (r=0.42. p=0.0001).Conclusion Existing staffing models, which are primarily influenced by staff-to-patient ratios, may not be sensitive to patient need. Other factors may be important drivers of staff perceptions of safety and should b

Journal article

Torrens C, Campbell P, Hoskins G, Strachan H, Wells M, Cunningham M, Bottone H, Polson R, Maxwell Met al., 2020, Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review, INTERNATIONAL JOURNAL OF NURSING STUDIES, Vol: 104, ISSN: 0020-7489

Journal article

Martins A, Bennister L, Fern LA, Gerrand C, Onasanya M, Storey L, Wells M, Whelan JS, Windsor R, Woodford J, Taylor RMet al., 2020, Development of a patient-reported experience questionnaire for patients with sarcoma: the Sarcoma Assessment Measure (SAM), QUALITY OF LIFE RESEARCH, Vol: 29, Pages: 2287-2297, ISSN: 0962-9343

Journal article

Martins A, Whelan JS, Bennister L, Fern LA, Gerrand C, Onasanya M, Storey L, Wells M, Windsor R, Woodford J, Taylor RMet al., 2019, Qualitative study exploring patients experiences of being diagnosed and living with primary bone cancer in the UK, BMJ OPEN, Vol: 9, ISSN: 2044-6055

Journal article

Patterson J, Toft K, McAuley F, King E, McLachlan K, Roe JWG, Wells Met al., 2019, Feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing following prophylactic swallowing rehabilitation in head and neck cancer, CLINICAL OTOLARYNGOLOGY, Vol: 44, Pages: 549-556, ISSN: 1749-4478

Journal article

Storey L, Fern LA, Martins A, Wells M, Bennister L, Gerrand C, Onasanya M, Whelan JS, Windsor R, Woodford J, Taylor RMet al., 2019, A critical review of the impact of sarcoma on psychosocial wellbeing, Sarcoma, Vol: 2019, ISSN: 1357-714X

Background. Previous reviews of outcomes in specific sarcoma populations suggest patients have poor quality of life. In most of these reviews, there is a predominant focus on physical function rather than psychosocial outcome. The aim of this review was to describe the psychosocial impact of diagnosis and treatment on patients with all types of sarcoma. Methods. Searches were conducted through six electronic databases for publications of any study design using a validated patient-reported outcome measure reporting the psychosocial impact in this population. Results. Eighty-Two studies fulfilled the inclusion criteria. Most (65%) were assessed of being of reasonable quality. The most common aspect of psychosocial wellbeing measured was quality of life (80%). Due to the heterogeneity of methods, outcomes, and populations, it was not possible to make definitive conclusions. It seems there is an improvement in the physical aspects of quality of life over time but not in psychosocial function or mental health. There was no change in mental health scores, but patients reported an improvement in adjusting to normal life. There are no differences according to the type of surgery patients receive, and psychosocial outcomes tend to be poorer than the general population. There is no consistency in identifying the factors that predict/influence psychosocial wellbeing. Conclusion. The published literature does not provide a clear understanding of the impact of sarcoma diagnosis and treatment on psychosocial wellbeing. Instead, the review demonstrates a need for well-designed studies in this area and a more consistent approach to the measurement of patient-reported outcomes, which include psychosocial domains. Recommendations for future research have been proposed.

Journal article

Lang H, France EF, Williams B, Humphris G, Wells Met al., 2018, The existence and importance of patients' mental images of their head and neck cancer: A qualitative study, PLOS ONE, Vol: 13, ISSN: 1932-6203

Journal article

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