Rebecca Maguire

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease with considerable impacts for patients and those care for them. Little work has explored the needs and experiences of individuals with COPD (IwCOPD) in an Irish context. This study focused on IwCOPD and caregiver experiences during and after the pandemic, with an aim of establishing what supports would be most beneficial in their daily lives. Semi-structured interviews were conducted with five IwCOPD and two informal family caregivers between March–October 2023, with findings analysed using reflexive thematic analysis. Four themes were identified: (1) Limitations and loss, (2) The pandemic as an uncontrollable environmental power, (3) Acceptance of the disease and (4) Challenges of healthcare management. Findings have implications for those supporting IwCOPD, highlighting a clear need for information, especially at the time of diagnosis. The needs of family members and current or future caregivers should also be considered.

Aims: Expectations of counselling play a key role in predicting service engagement and therapeutic outcomes, but the nature and associates of student counselling expectations have been underexplored to date. This study aimed to investigate the nature and associates of student counselling services in Ireland among those who had and had not previously engaged with these services. Methods: A mixed methods survey of students in Ireland ( N = 113) collected data on student counselling expectations and engagement, along with measures of well‐being, optimism, social support and attitudes towards psychotherapy. Current and retrospective expectations were compared for those with previous counselling experiences, while hierarchical multiple regression (HRM) analysis explored sociodemographic and psychosocial predictors of expectations. Reflexive thematic analysis examined the nature and change in expectations as captured in open‐text responses. Results: Attitudes towards seeking professional help significantly predicted expectations (β = 0.488, p < 0.001), with the HRM model predicting 24.8% of the variance in expectations overall. While current engagement with psychological support was positively associated with expectations, there was no significant difference observed between current and retrospective expectations in the group that had previous experience of student counselling. Themes identified varied instances of both positive and negative expectations, which were influenced by both internal and external sources. Discussion: Findings suggest that fostering and maintaining positive, yet realistic, expectations is crucial in providing an effective counselling service while both negative and unrealistic expectations should be managed to ensure beneficial and meaningful therapeutic outcomes for students engaging in an already overprescribed, stretched service.

Aim: To explore the experiences of individuals with Chronic Obstructive Pulmonary Disease (IwCOPD) and their caregivers during the COVID‐19 pandemic. Design: Systematic review, adhering to PRISMA guidelines (PROSPERO ID: CRD42022327424). Data Sources: PsycINFO, PubMed, EMBASE and Web of Science. Methods: Databases were searched in April 2022 using keywords relating to COPD, caregivers/patients and COVID‐19. Studies collecting data on experiences of IwCOPD or their informal caregivers during the COVID‐19 pandemic were included. Following screening and quality appraisal by two reviewers, a qualitative synthesis was conducted. Results: Of 2931 abstracts screened, 24 articles met the inclusion criteria. For IwCOPD, pandemic impacts on physical and mental health were found, including fears of contracting COVID‐19, changes in exacerbation levels, reductions in physical activity, and increases in depression and anxiety. Changes to healthcare management, including access to telemedicine, and positive adaptations, such as increased medication adherence, self‐preservation and self‐care, were also reported in the studies reviewed. Caregivers expressed fear of their care recipient contracting COVID‐19 and changes in the home environment. Conclusion: While the pandemic led to considerable negative experiences for IwCOPD, review findings suggest that some positive experiences were also reported. Implications for Profession and/or Patient Care: Findings may help inform the development of physical and mental health supports for IwCOPD and their caregivers. Impact: This study sheds light on the limited evidence regarding experiences of IwCOPD and their caregivers during the height of the COVID‐19 pandemic. As many IwCOPD continue to be impacted by COVID‐19, these findings have the potential to inform healthcare providers how they may better support IwCOPD and their caregivers in numerous aspects of their healthcare management and their daily lives. Patient or Public Contribution: The lead author's experience as a COPD caregiver acted as Public and Patient involvement input. What Does This Paper Contribute to the Wider Global Clinical Community?: (1) The review sheds light on the considerable impact the pandemic had on the mental and physical health of IwCOPD. (2) It identifies vulnerable areas where support could be improved for IwCOPD and their caregivers, and how support could be improved. Relevancy to Nursing Open: People with chronic obstructive pulmonary disease require considerable care and support from nursing professionals. This review highlights the care needs and support that may be beneficial for this group and is relevant to Nursing Open on nursing practice and research.

Peer support may help improve the wellbeing of informal caregivers, although little work has explored this in the context of multiple sclerosis (MS). This study explored peer support needs and experiences among MS caregivers in Ireland. A cross-sectional mixed methods survey of 27 MS caregivers, designed with public and patient involvement, measured peer support engagement, sociodemographic and care characteristics, caregiver burden, social support, loneliness and wellbeing. Data were analysed using descriptive, correlational and content analysis. Most caregivers expressed a desire for peer support, with few having participated in online or in-person peer support. Barriers to engagement included a lack of promotion of opportunities. While low levels of social support and wellbeing were reported, no clear associations between peer support needs and these variables were identified. Although peer support shows promise, more research and improvements in the provision of MS caregiver peer support are needed.

Peer support may improve wellbeing in people with multiple sclerosis (PwMS). This study examined associations between peer support, social support, loneliness and wellbeing in PwMS, along with sociodemographic and health predictors of peer support need and engagement in online and in-person contexts. A cross-sectional survey, co-designed with public and patient involvement, was deployed among 218 PwMS in Ireland, with regression analyses used to explore predictors of needs for, and engagement with, peer support. Increasing disability levels and fewer years with MS were associated with higher peer support need. Wellbeing was significantly yet weakly positively correlated with in-person peer support engagement ( r _s = 0.1967, p = 0.005). However, only loneliness and social support were significant predictors of wellbeing, accounting for approximately 40% of the variance. Overall, PwMS need peer support, yet reported low engagement with peers. While no clear associations with wellbeing were established, findings suggest that peer support may improve psychosocial experiences in MS.

Background: Anxiety is a common experience among people with multiple sclerosis (PwMS). While it is known that engaging in exercise has a number of benefits, the role played by exercise in reducing anxiety has received less attention in this context. Understanding the effect of exercise on anxiety, the predictors of this change. and participant experiences will help to further develop programmes which can support PwMS. Aim: This study used a pre/post evaluation design (1) to assess the efficacy of a structured physiotherapist-led online exercise programme (MoveSmart) on anxiety in PwMS living in Ireland, (2) to identify the role of sociodemographic, health and psychological factors in predicting baseline anxiety, (3) to investigate how changes in these factors predict changes anxiety following completion of the programme, and (4) to explore the experiences of participants with the programme. Method: Data from 284 PwMS who took part in a 10-week programme between January 2021 and June 2022 were analysed. Participants provided sociodemographic and health information at baseline and completed measures of psychological factors at baseline and again on completion of the programme. Change in anxiety scores were analysed using hierarchical regression analysis. Follow-up focus groups were conducted with 25 participants to explore their experiences of taking part in the programme, with data analysed using reflexive thematic analysis. Results: Participation in the MoveSmart programme was associated with significant reductions in anxiety. Younger age, lower disability, higher Multiple Sclerosis Impact Scale-29 physical scores and higher fatigue were significantly associated with higher baseline anxiety scores, and changes in the physical impact of MS predicted changes in anxiety scores. Key themes identified through thematic analysis included ‘Benefits of peer support’, ‘Benefits of goal setting’, ‘Noticed improvements’ and ‘Praise for programme execution’. Conclusion: Participation in a physiotherapist-led structured exercise programme resulted in significant improvements in anxiety, in part through reducing the impact of physical MS symptoms. Qualitative results suggest that peer support and goal-related coaching may have contributed to reductions in anxiety.

Background: Connected health (CH) interventions may improve psychological wellbeing and quality of life (QoL) in caregivers and people with multiple sclerosis (MS); however, this impact has not been rigorously evaluated. This systematic review aims to synthesize the literature assessing CH technology's impact on psychological wellbeing and/or QoL of people with MS (PwMS) and/or their caregivers. Methods: This systematic review's protocol is registered with International Prospective Register of Systematic Reviews (PROSPERO) with identification number CRD42023402434. CINAHL, Web of Science, PubMed, Embase, and PsycINFO databases were searched with terms relating to (a) CH; (b) MS; (c) psychological wellbeing/QoL; and (d) caregivers/people with MS. Of 2821 screened articles, 47 met the eligibility criteria, with just three including MS caregivers. Results: Heterogenous interventions supporting self-management ( n = 20 studies), education ( n = 17 studies), psychological ( n = 14 studies) or physical ( n = 9 studies) rehabilitation and peer support ( n = 5 studies) were found. CH technologies had mixed effectiveness in improving psychological and QoL outcomes, with results potentially impacted by technology type, intervention and target group. The study's findings have limited generalizability to improve access across sub-national locations, with no studies disaggregating between urban and rural residence and the majority conducted in the USA and Western Europe. Conclusion: CH technologies show promise in improving psychological wellbeing and QoL among PwMS and their caregivers. However, this necessitates further study comparing connected health and MS subtypes to improve reproducibility and effectiveness.

Caring for children with type 1 diabetes (T1D) can require around-the-clock attention but there is little acknowledgment of the impact that nocturnal caregiving can have on caregivers in clinical care provision. This systematic review aimed to (1) explicate nocturnal caregiving practice (NCP) by identifying and synthesising peer-reviewed research to establish the prevalence and nature of NCP, (2) explore the impacts of NCP for caregivers, (3) evaluate the perceived value of technology for supporting NCP, and (4) examine potential solutions for mitigating NCP burden. In January, 2022, the databases CINAHL, MEDLINE, Web of Science, PsycINFO, Scopus and EMBASE were searched to identify peer-reviewed studies, published in English since 1997, which addressed NCP for juveniles with T1D. Quantitative, qualitative and mixed-methods studies were included. Risk of bias analysis was carried out using the quality assessment with diverse studies tool. Where possible, quantitative data were aggregated. Qualitative data was subjected to a narrative synthesis, using thematic analysis. Thirty-one studies met inclusion criteria, comprising 3,547 caregivers. 88% of caregivers engaged in NCP, though frequency was variable. Over 50% of participants (19-80%) failed to get adequate sleep and 54% reported poor sleep quality. Qualitative testimony detailed adverse impacts of NCP; exhaustion, difficulty making illness-management decisions, negative impacts on mood and physical health. Benefits from technology were equivocal. Evidence regarding predictors and associations for NCP, such as patient age, was contradictory. 83% of authors recommended that sleep be routinely addressed in clinic, which is not current practice. This review provides clear evidence that NCP in T1D is pervasive with significant negative impacts on caregivers. These secondary impacts of juvenile T1D need to be acknowledged so that care guidelines can be modified and psychosocial supports can be developed for use in clinical treatment environments.