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Why is feeding a child so difficult? This book answers a question that many parents find themselves asking on a daily basis. Hunger is a basic biological drive and eating should be an easy part of family life. But too often, it is not.... more
Why is feeding a child so difficult? This book answers a question that many parents find themselves asking on a daily basis.  Hunger is a basic biological drive and eating should be an easy part of family life.  But too often, it is not.  Based on 30 years of research into eating behaviour and 21 years being a mother, Jane Ogden offers straightforward advice about how to encourage children to develop a healthy, unproblematic approach to eating from birth through to young adulthood.

The book describes current theory and research and turns these into practical tips for use in everyday family life.  It covers how children learn to like food, how habits are formed and can be changed, what children should be eating and how this can be helped to happen without making food into an issue.  She discusses common problems that parents face such as picky eating, undereating, overeating, obesity, body image issues and eating disorders and how to deal with a child who thinks they are fat.  She also provides practical tips and solutions and some simple ways to feed a family a healthy diet. 

With insightful advice about one of the most complicated adventures in parenting this guide is a must have for any parent who wants their child’s relationship with food to thrive.
In an era of weight problems, obesity, and dangerous dieting, The Psychology of Dieting shows us that there is no such thing as a miracle diet, and that we must understand how our minds shape the food choices we make. It is written for... more
In an era of weight problems, obesity, and dangerous dieting, The Psychology of Dieting shows us that there is no such thing as a miracle diet, and that we must understand how our minds shape the food choices we make.  It is written for anyone who wants to lose weight or for those who want to help others to lose weight and maintain it in the longer term
Research Interests:
This is an open access textbook on the psychology of health and illness designed for the University of the People (UoP) but available to everyone. It consists of 8 chapters covering key theoretical perspectives; health behaviour and... more
This is an open access textbook on the psychology of health and illness designed for the University of the People (UoP) but available to everyone.  It consists of 8 chapters covering key theoretical perspectives; health behaviour and beliefs; behaviour change; becoming ill, illness beliefs, help seeking and the medical consultation; the experience of being ill, stress and pain; chronic conditions; gender and health; health outcomes and quality of life.  Please use as you like!
Feeding children should be easy. Hunger is a basic biological drive and eating should be a straight forward and fun part of family life. But so often it is not. Parents are busy, food is expensive and cooking takes time and even when... more
Feeding children should be easy.  Hunger is a basic biological drive and eating should be a straight forward and fun part of family life.  But so often it is not.  Parents are busy, food is expensive and cooking takes time and even when you have managed to prepare the family meal, children announce random likes and dislikes that seem to come out of nowhere.  And on top of all that, we have the fears of obesity and eating disorders looming in the background.  How do we get our children to eat healthily when they don’t like healthy food?  How do we get them to eat more without making them fat?  How do we keep them a normal weight without giving them an eating disorder?  How do we get them to be more active when all they want to do is watch TV or play on their phone? And what do we do about a daughter who starts to obsess about her weight?

This book aims to describe what constitutes a healthy diet and how to achieve this without making food an issue for your child.  It addresses many of the problems parents face when feeding their children and offers tips on how to overcome these without making matters worse.  And it looks at the ways in which we talk about food, shop and prepare food and eat food with our children and the impact this has on them as they grow up.
Research Interests:
Introduction and overview Choosing the papers The structure of this book How to use this book Section 1: The context of health psychology Mokdad, A.H., Marks, J.S., Stroup, D.F., & Gerberding, J.L. (2004). Actual causes of death in... more
Introduction and overview Choosing the papers The structure of this book How to use this book Section 1: The context of health psychology Mokdad, A.H., Marks, J.S., Stroup, D.F., & Gerberding, J.L. (2004). Actual causes of death in the United States, 2000. JAMA, 10 29:1238-45. Kaplan, R.M. (1990). Behaviour as the central outcome in health care, American Psychologist, 45: 1211-20. Section 2: Health behaviours Theoretical debates Explaining behaviour Changing behaviour Sutton, S (1998). Predicting and explaining intentions and behaviour: how well are we doing? Journal of Applied Social Psychology, 28, 1317-38. Ogden, J. (2003). Some problems with social cognition models: a pragmatic and conceptual analysis, Health Psychology, 22(4): 424-8. West, R. (2005). Time for a change: putting the Transtheoretical (Stages of Change) model to rest. Addiction, 100, 1036-1039. Armitage, C. J. (2005). Can the Theory of Planned Behaviour predict the maintenance of physical activity? Health Psychology, 24 (3), 235-245. Murgraff, V., White, D., and Phillips, K (1999). An application of protection motivation theory to riskier single occasion drinking. Psychology and Health, 14, 339-350. DiClemente, C.C., Prochaska, J.O., Fairhurst, S.K. et al. (1991) The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change, Journal of Consulting and Clinical Psychology, 59: 295-304. Wardle, J., and Beales, S. (1988). Control and loss of control over eating: an experimental investigation. Journal of Abnormal Psychology, 97, 35-40. Woodcock, A., Stenner, K., & Ingham, R. (1992). Young people talking about HIV and AIDS: Interpretations of personal risk of infection. Health Education Research: Theory and Practice, 7, 229-34. Jones, S. L., Jones, P. K. & Katz, J. (1988). Health belief model intervention to increase compliance with emergency department patients. Medical Care, 26, 1172-1184. Gollwitzer, P.M., & Sheeran, P. (2006). Implementation intentions and goal achievement: A meta-analysis of effects and processes. Advances in Experimental Social Psychology, 38, 69-119. Section 3: Health care Communication Illness cognitions Roter, D.L., Steward, M., Putnam, S.M. et al. (1997) Communication pattern of primary care physicians, Journal of the American Medical Association, 277:350-6. Mead, N. and Bower, P. (2000). Patient centredness: a conceptual framework and review of empirical literature. Social Science and Medicine, 51: 1087-110. Marteau, T.M., Senior, V., Humphries, S.E., Bobrow, M., Cranston, T., Crook, M.A., Day, L., Fernandez, M., Horne, R., Iversen, A., Jackson, Z., Lynas, J., Middleton-Price., H., Savine, R., Sikorski, J., Watson, M., Weinman, J., Wierzbicki, A. S., Wray, R. (2004). Psychological impact of genetic testing for familial hypercholesterolemia within a previously aware population: A randomized controlled trial. American Journal of Medical Genetics, 128 A, 285-293. Horne, R and Weinman. J. (2002). Self regulation and self management in Asthma: exploring the role of illness perceptions and treatment beliefs in explaining non adherence to Preventer medication. Psychology and Health, 17, 17-32. Simpson SH, Eurich DT, Majumdar SR, Padwal RS, Tsuyuki RT, Varney J, & Johnson JA (2006). A meta-analysis of the association between adherence to drug therapy and mortality. British Medical Journal. Jul 1 333(7557):15. Section 4: Stress and health Everson, S.A., Lynch, J.W., Chesney, M.A. et al. (1997) Interaction of workplace demands and cardiovascular reactivity in progression of carotid atherosclerosis: population based study, British Medical Journal, 314: 553-8. Pereira, D.B., Antoni, M. H., Danielson, A., Simon, T., Efantis-Potter, J., Carver, C.S., Duran, R.E.F., Ironson, G., Klimas, N., & O'Sullivan, M. J. (2003). Life Stress and Cervical Squamous Intraepithelial Lesions in Women with Human Papillomavirus and Human Immunodeficiency Virus. Psychosomatic Medicine, 65 (1), 1-8. Ebrecht, M., Hextall, J., Kirtley, L.G., Taylor, A., Dyson, M., & Weinman, J. (2004). Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology, 29, 798-809. Pennebaker, J.W. (1997). Writing about emotional experiences as a therapeutic process, Psychological Science, 8(3):162-6. Petrie, K.J., Booth, R.J. and Pennebaker, J.W. (1998). The immunological effects of thought suppression, Journal of Personality and Social Psychology, 75: 1264-72. Section 5: Chronic illness Eccleston, C., Morley, S., Williams, A., Yorke, L. and Mastroyannopoulou, K. (2002). Systematic review of randomised controlled trials of psychological therapy for chronic pain in children and adolescents with a subset meta-analysis of pain relief, Pain, 99(1-2): 157-65. Smith, JA. (in press) Pain as an assault on the self: An interpretative phenomenological analysis of the psychological impact of chronic benign low back pain. Psychology and Health Taylor, S.E. (1983). Adjustment to…
The current study aimed to examine predictors of reduced binge eating in patients undergoing laparoscopic adjustable gastric banding (LAGB) for severe obesity. Participants were 49 patients (13 males and 36 females) who completed measures... more
The current study aimed to examine predictors of reduced binge eating in patients undergoing laparoscopic adjustable gastric banding (LAGB) for severe obesity. Participants were 49 patients (13 males and 36 females) who completed measures of binge eating, behavioural intentions, planning and self-efficacy two weeks prior and three months after their operation. Reduced binge eating following surgery was predicted by behavioural intentions. Planning and volitional self-efficacy were unable to predict a significant amount of variance over and above intentions. The results highlight how the role of intentions must not be overlooked when investigating the prediction of health behaviour change and challenge the notion that post-intentional constructs that translate intentions into action are more important. Interventions aiming to increase preoperative levels of intention to follow the post-operative eating guidelines in patients presenting with binge eating might be a useful way of decreasing this behaviour in patients opting for LAGB surgery in order to achieve weight loss and physical well-being.
Research exploring weight bias and weight bias internalisation (WBI) is grounded upon several core measures. This study aimed to evaluate whether operationalisations of these measures matched their conceptualisations in the literature.... more
Research exploring weight bias and weight bias internalisation (WBI) is grounded upon several core measures. This study aimed to evaluate whether operationalisations of these measures matched their conceptualisations in the literature. Using a ‘closed card-sorting’ methodology, participants sorted items from the most used measures into pre-defined categories, reflecting weight bias and non-weight bias. Findings indicated a high degree of congruence between WBI conceptualisations and operationalisations, however found less congruence between weight bias conceptualisations and operationalisations, with scale-items largely sorted into non-weight bias domains. Recommendations for scale modifications and developments are presented alongside a new amalgamated weight bias scale (AWBS).
BackgroundPolycystic ovary syndrome (PCOS) is associated with wellbeing. Many women report dissatisfaction with the diagnostic process.AimThis study assessed the impact of aspects of the diagnostic consultation on subsequent... more
BackgroundPolycystic ovary syndrome (PCOS) is associated with wellbeing. Many women report dissatisfaction with the diagnostic process.AimThis study assessed the impact of aspects of the diagnostic consultation on subsequent wellbeing.Design & settingA retrospective community survey.MethodFemales with PCOS (n = 147) completed measures of aspects of the diagnostic consultation (consultation satisfaction, language used in terms of framing and focus) and current wellbeing (body esteem, quality of life).ResultsMost diagnoses took place in primary care. The majority showed a medium degree of satisfaction with the consultation. Most diagnoses were framed using a neutral term ‘raised’ but many used the more judgemental term ‘abnormal’. The majority focused on taking oral contraception and weight management. Poorer body esteem (body dissatisfaction and dieting behaviour) and poorer quality of life (self-identity, concerns about fertility, physical health, hirsutism, and overall quality of l...
This is a very reasonable book that should be read. The following may offer you the way to get this book. It is actually ease. When the other people must walk around and go outside to get the book in the book store, you can just be by... more
This is a very reasonable book that should be read. The following may offer you the way to get this book. It is actually ease. When the other people must walk around and go outside to get the book in the book store, you can just be by visiting this site. There is provided link that you can find. It will guide you to visit the book page and get the health psychology and public health. Done with the download and get this book, start to read.
Children with autism are more likely to be socially excluded than their neurotypical peers. Since the majority of children with autism attend mainstream schools, interventions are needed to improve the attitudes and behaviours of their... more
Children with autism are more likely to be socially excluded than their neurotypical peers. Since the majority of children with autism attend mainstream schools, interventions are needed to improve the attitudes and behaviours of their peers. Many studies highlight the influence of contact on positive attitudes and reduced discrimination. Group music-making provides an ideal opportunity for positive contact to occur in the classroom. This study evaluated the impact of music-based contact with autistic peers on the attitudes, emotions and behaviours of neurotypical children. Changes in those with autism were also assessed. Neurotypical participants ( n = 55) aged 10–11 years took part in an 11-week music programme designed to increase social interaction, which either did or did not include contact with autistic children ( n = 10). Measures of attitudes, emotions and behaviours were assessed at baseline and follow-up. In response to a hypothetical scenario depicting social exclusion o...
Physical activity can improve many common side effects of cancer treatment as well as improve physical function and quality of life (QOL). In addition, physical activity can improve survival rate and reduce cancer recurrence. Despite... more
Physical activity can improve many common side effects of cancer treatment as well as improve physical function and quality of life (QOL). In addition, physical activity can improve survival rate and reduce cancer recurrence. Despite these benefits, only 23% of cancer survivors in England are active to recommended levels. Cancer survivors are interested in lifestyle behavior change. Home-based interventions offer a promising means for changing physical activity behavior. Prediagnosis levels of physical activity and self-efficacy have been reported to be predictors of physical activity behavior change. The Move More Pack, which has undergone revision, is a printed resource with supporting Internet-based tools that aims to increase the physical activity of cancer survivors in the United Kingdom. The revised Move More Pack is underpinned by the theory of planned behavior and the social cognitive theory. The aim of this proposed study was to investigate the effect of the revised Move Mo...
Over recent years it has become increasingly clear that health related quality of life (HRQoL) is an important outcome for assessing the effectiveness of bariatric surgery. HRQoL can be measured using uni dimensional tools to assess... more
Over recent years it has become increasingly clear that health related quality of life (HRQoL) is an important outcome for assessing the effectiveness of bariatric surgery. HRQoL can be measured using uni dimensional tools to assess factors such as mobility, mood, self esteem or eating behavior or multidimensional tools which assess health status in the broadest sense. This chapter will present these different measurement tools and describe their use across a range of studies in the context of bariatric surgery. It will then evaluate the pros and cons of each tool and consider the issues relevant for identifying the best tool for any given situation. Finally, the chapter will conclude that there is no one measure of HRQoL that meets all research or clinical needs for bariatric surgery and that the choice of measure should take into account the definition of HRQoL being used, the function of the measure being used and the practicalities of the data collection process.
Dear Editor, Denise Ratcliffe and colleagues provide a thorough and useful critique of our paper in terms of the design of the trial and the content of the intervention [1]. In particular, they question the design in terms of the choice... more
Dear Editor, Denise Ratcliffe and colleagues provide a thorough and useful critique of our paper in terms of the design of the trial and the content of the intervention [1]. In particular, they question the design in terms of the choice of weight loss as the being primary outcome, the end point being 12 months and the content of the intervention in terms of its focus, duration, timing, and dose. As a result, they challenge our conclusion which is described as Bpsychological input for bariatric patients is not necessary or useful^. We completely agree that weight loss is not the only important outcome from bariatric surgery. We acknowledge that there are tangible psychological outcomes such as binge eating and quality of life, as well as less tangible ones such as Bfeeling supported^ and Bwelcoming the chance to talk through problems with someone^. Hence, we published our second study on these psychological outcomes [2]. We also agree that 12 months is not the end of the story for bariatric patients. However, for pragmatic reasons (i.e., funding), the end point of the study was at 12 months post-surgery. Furthermore, we recognize the limitations of the intervention arm of our trial, and it is true that the intervention could have been different (e.g., longer sessions, more frequent sessions, multidisciplinary sessions, and group session). However, we designed an intervention that we considered would be practical and deliverable by the NHS if the trial demonstrated an improvement in outcomes. Finally, we also endorse their criticism that an intervention immediately before and after surgery may not be best placed given the history of weight regain and psychological problems which tend to occur between 18 and 24 months. This was included, however, as ameans to reflect theNICE guidelines which recommend that psychological support is provided before and after surgery. We do not, however, agree with their criticism of our conclusion that Bpsychological input for bariatric patients is not necessary or useful^ as this is not our conclusion. The conclusion of our randomized controlled trial was that Bpsychological support immediately preand post-surgery was found to have no effect on weight loss at 1 year .̂ We discussed that Bpsychological support may therefore be more effective if delivered after this first year^ and that Bpsychological input may best be reserved in a targeted manner rather than being applicable to every patient in the postoperative setting^. NICE guidelines argue for psychological support preand post-surgery. NHS funding is limited and most patients are not * Jane Ogden J.Ogden@surrey.ac.uk
Orlistat is currently the only prescribed form of pharmacological management for obesity and functions by reducing the amount of fat absorbed from food eaten. Although frequently prescribed, there is marked variability in outcomes. A... more
Orlistat is currently the only prescribed form of pharmacological management for obesity and functions by reducing the amount of fat absorbed from food eaten. Although frequently prescribed, there is marked variability in outcomes. A total of 10 participants’ experiences of gaining weight after taking orlistat were analysed using thematic analysis. Participants attributed their failed weight loss to mechanisms of the medication, emphasised a medical model of obesity with barriers to their weight loss and other weight-loss methods which had also failed. Overall, their weight gain was considered an inevitable part of their self-identity, reflecting their self-fulfilling prophecy of being a perpetual dieter.
In light of the failure of psychological approaches to obesity some clinicians and patients are turning to surgery. The present qualitative study aimed to explore... more
In light of the failure of psychological approaches to obesity some clinicians and patients are turning to surgery. The present qualitative study aimed to explore patients' experiences of having obesity surgery and in-depth interviews were carried out with 15 men and women, who had had surgery in the past four years. The data were analysed using Interpretative Phenomenological Analysis (IPA). The patients described their experiences in terms of four broad themes: personal weight histories; the decision-making process, which involved general motivations such as worries about health and specific triggers such as symptoms; the impact of surgery on eating behaviour and their relationship with food; the impact of weight loss on health status, self-esteem and relationships with others. The central theme of control permeated all areas of the interviews. The current clinical climate highlights the importance of self-control and patient choice as the path to patient empowerment. Obesity surgery illustrates that in contrast to this perspective, imposed control and limited choice can sometimes paradoxically result in a renewed sense of control.
Background: Although bariatric surgery is considered the most effective form of obesity management, some patients describe how their psychological issues remain neglected. This study evaluated patients’ feedback on additional... more
Background: Although bariatric surgery is considered the most effective form of obesity management, some patients describe how their psychological issues remain neglected. This study evaluated patients’ feedback on additional psychological support (bariatric rehabilitation service, BRS) received as part of a trial and experiences of the bariatric surgical pathway. Method: 24 months after surgery patients were sent a short survey, using rating scales and open text boxes, for feedback on actual and ideal timing and content of additional support (n=68). Additionally, 16 patients participated in telephone interviews concerning their experiences of surgery. Findings: A large majority of those who received the BRS reported satisfaction with the service’s timing and content. But, regardless of condition, the majority reported wanting further psychological support up to 24 months post-operatively. A minority stated their problems were not emotional therefore additional support was unnecessary. Discussion: Given the variability in feedback, psychological support before and after surgery could be delivered in relation to individual patient need rather than blanket provision. Further research is needed to determine the optimal timing and who would benefit most from added support.
PurposeThe purpose of this paper is to evaluate the impact on stress and work-related outcomes of an app-delivered mindfulness-based program (MBP; Headspace®) offered to employees in a UK higher education (HE)... more
PurposeThe purpose of this paper is to evaluate the impact on stress and work-related outcomes of an app-delivered mindfulness-based program (MBP; Headspace®) offered to employees in a UK higher education (HE) institution.Design/methodology/approachUsing a randomized waitlist control trial design, participants were randomly allocated to be offered a mindfulness-based program (MBP) immediately for 2 months or after a waiting list period of 2 months (WLC). Data were analyzed using Intention to Treat (ITT; MBP n = 62; WLC n = 63); with supplementary analysis restricting to those who completed all measures; (MBP n = 45; WLC n = 56) and then further restricting the MBP group to those who completed at least foundation level 1 of the app; (MBP n = 31; WLC n = 56).FindingsThe ITT analysis showed significant increases in several aspects of mindfulness and a significant reduction in perceived stress but no significant effects for work-related outcomes. Analysis restricted to MBP participants ...
Background: Health Psychology aims to improve patient health outcomes through research and practice. Methods: This paper will present a bibliometric analysis of a number of data bases (media data, academic journals, citation indices, NHS... more
Background: Health Psychology aims to improve patient health outcomes through research and practice. Methods: This paper will present a bibliometric analysis of a number of data bases (media data, academic journals, citation indices, NHS data) to explore the association between 4 research areas in health psychology and key health outcomes. In particular, it will focus on research exploring help seeking and early warning signs, adherence to medication, the doctor patient relationship and behaviour change. Results: The paper will argue that although we aim to promote health, many of our research perspectives may do harm by flooding the health care system with the worried well (who are seeking help for trivial problems), creating side effects to medication (by promoting adherence to drugs with poor NNTs), eradicating the placebo effect (by encouraging patient centred care) and not changing behaviour (by creating a one size fixes all approach). Discussion: It will conclude that health p...
Research shows that the attitudes of children and adolescents towards bullying are influenced by the school environment and their peer groups. Given the increased vulnerability to bullying for autistic children, this study explored... more
Research shows that the attitudes of children and adolescents towards bullying are influenced by the school environment and their peer groups. Given the increased vulnerability to bullying for autistic children, this study explored whether neurotypical children’s attitudes towards bullying and autism varied according to school exposure and personal contact with autistic people. Survey data were collected at the beginning and end of the school year from 775 children aged 11–12 years, from six schools: three with specialist centres for autism and three without. Participants read vignettes depicting bullying scenarios then completed measures of their attitudes in relation to the vignette and towards autism. Children from centre schools showed a greater increase in prosocial emotions towards bullying. For children from non-centre schools, an interaction showed a decrease in prosocial emotions except in response to social exclusion of an autistic child. Increases in personal contact show...
SummaryBackgroundEmerging research highlights how, due to demographic changes in horse owner populations in Western societies, complex owner–horse relationships are leading to inappropriate horse care, including overnutrition, which in... more
SummaryBackgroundEmerging research highlights how, due to demographic changes in horse owner populations in Western societies, complex owner–horse relationships are leading to inappropriate horse care, including overnutrition, which in turn can lead to laminitis. Farriers, due to their regular visits, may be in a position to support owners in dealing with this problem.ObjectivesThis study explored whether UK farriers have a role in working with horse owners to support horse welfare and prevent laminitis.Study designGrounded theory analysis, a qualitative methodology.MethodsSemi‐structured interviews were conducted with 12 farriers and 11 horse owners. The interviews were transcribed verbatim and systematically analysed, using an inductive coding approach.ResultsThe analysis of the farrier and horse owner interview data revealed farriers and horse owners undertake a contracting process leading to either a task‐focussed or holistic care‐focussed approach. Either approach can be satisf...
BackgroundHigh levels of anxiety during surgery are associated with poorer post‐surgical outcomes. This prospective, non‐blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction... more
BackgroundHigh levels of anxiety during surgery are associated with poorer post‐surgical outcomes. This prospective, non‐blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction interventions for anxiety and pain management during minimally invasive venous surgery under local anaesthetic.Methods407 patients presenting with varicose veins at a private clinic, were randomized to one of four intraoperative distraction interventions or treatment as usual. All participants received endovenous thermoablation and/or phlebectomies of varicose veins. After losses to follow‐up, 398 participants were entered into the analysis. Participants were randomly allocated to one of the following intraoperative distraction techniques: patient selected music (n = 85), patient selected DVD (n = 85), interaction with nurses (n = 81), touch (stress balls) (n = 80) or treatment as usual (TAU, n = 76). The state scale of the STAI, the Short‐form McGill pain questionnaire and numeric rating scales were used to assess intraoperative pain and anxiety.ResultsIntraoperative anxiety ratings were significantly lower when participants interacted with nurses, used stress balls or watched a DVD during surgery compared to treatment as usual. Intraoperative pain ratings were significantly lower than treatment as usual when participants interacted with nurses or used stress balls during surgery. Patients' satisfaction was not significantly impacted by intraoperative distractions.ConclusionsThe use of simple intraoperative distraction techniques, particularly interacting with nurses, using stress balls or watching a DVD during surgery conducted under local anaesthetic can significantly improve patients' experiences.

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Aims and objectives: To gain insight into the experience of living with varicose veins and undergoing minimally invasive surgery under local anaesthesia in a private clinic. Background: Minimally invasive surgery under local anaesthesia... more
Aims and objectives: To gain insight into the experience of living with varicose veins and undergoing minimally invasive surgery under local anaesthesia in a private clinic.

Background: Minimally invasive surgery under local anaesthesia is replacing traditional surgical stripping for the treatment for varicose veins. Conscious surgery has previously been associated with elevated levels of anxiety and some associated pain. There is limited research exploring the experiences of patients undergoing varicose vein surgery under local anaesthesia.

Design: Qualitative semi-structured interviews with 20 patients who took part in a mixed methods study exploring the effects of distraction on intra-operative pain and anxiety.

Methods: Participants were interviewed eight weeks post surgery about their experiences before, during and after surgery. Interviews were analysed using thematic analysis.

Results: Four themes were captured (1) negative emotions associated with symptoms, (2) unpreparedness for the surgical process, (3) feeling cared for and (4) improvements in well-being. An overarching theme of relationships was identified. Overall, varicose veins had a detrimental impact on quality of life prior to surgery. Patients felt unprepared for their procedure and experienced the operation as anxiety provoking and uncomfortable. This was much helped by the support of nursing staff in the theatre. Post surgery, patients' quality of life was reported as improved.

Conclusions: More emphasis needs to be placed on preparing patients for surgery under local anaesthesia. The role of the nurse is central to creating a caring, relaxed environment which could improve patient experience.

Relevance to clinical practice: Patients' experiences of varicose veins and their treatment both influence, and are influenced by relationships with others at all stages of the management process. Nurses play an important role in improving patient experience during surgery and care needs to be taken to ensure that patients understand and accept the processes of surgery and recovery.
Background: High levels of anxiety during surgery are associated with poorer post-surgical outcomes. This prospective, non-blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction... more
Background: High levels of anxiety during surgery are associated with poorer post-surgical outcomes. This prospective, non-blinded randomized controlled trial aimed to compare the effectiveness of four intraoperative distraction interventions for anxiety and pain management during minimally invasive venous surgery under local anaesthetic.

Methods: 407 patients presenting with varicose veins at a private clinic, were randomized to one of four intraoperative distraction interventions or treatment as usual. All participants received endovenous thermoablation and/or phlebectomies of varicose veins. After losses to follow-up, 398 participants were entered into the analysis. Participants were randomly allocated to one of the following intraoperative distraction techniques: patient selected music (n = 85), patient selected DVD (n = 85), interaction with nurses (n = 81), touch (stress balls) (n = 80) or treatment as usual (TAU, n = 76). The state scale of the STAI, the Short-form McGill pain questionnaire and numeric rating scales were used to assess intraoperative pain and anxiety.

Results: Intraoperative anxiety ratings were significantly lower when participants interacted with nurses, used stress balls or watched a DVD during surgery compared to treatment as usual. Intraoperative pain ratings were significantly lower than treatment as usual when participants interacted with nurses or used stress balls during surgery. Patients' satisfaction was not significantly impacted by intraoperative distractions.

Conclusions: The use of simple intraoperative distraction techniques, particularly interacting with nurses, using stress balls or watching a DVD during surgery conducted under local anaesthetic can significantly improve patients' experiences.
Objectives: Leg ulcers are known to have a profound effect on patients' quality of life; however, the influence of different treatment approaches is unclear. This review aims to evaluate the comparative impact of conservative treatments... more
Objectives: Leg ulcers are known to have a profound effect on patients' quality of life; however, the influence of different treatment approaches is unclear. This review aims to evaluate the comparative impact of conservative treatments and superficial venous surgery, for venous leg ulcers, on patients' Quality of Life.

Data sources: Three electronic databases (PsycInfo, Medline and CINAHL), and reference lists of relevant articles, were searched. A total of 209 articles were initially identified, and 16 articles were included in the review.

Results: The results lend cautious support to the suggestion that all treatments have a positive effect on quality of life, regardless of type, whilst wound status also appears to be an important factor.

Conclusions: Some evidence suggests that surgical treatment methods may lead to greater improvements in patients' quality of life than compression bandaging alone; however, future research may focus on the psychological mechanisms underlying such changes.