Health promotion: influenza vaccination
Seasonal influenza places a substantial burden on the elderly population, with approximately 90% of UK influenzarelated deaths occurring in adults aged 65 years and over. Vaccination remains the best way of preventing influenza disease and it is particularly important for this age group. However, the seasonal influenza vaccines currently available in the UK confer suboptimal levels of immunogenicity and efficacy in adults aged 65 years and above, primarily due to immunosenescence, i.e. weakening of the immune system, which occurs with age. There is a clear need for more effective vaccines that induce stronger immune responses and provide higher rates of protection in the elderly. This paper addresses the issues around seasonal influenza vaccination in older adults, and provides best practice points for the general practice nursing community in managing the unique needs of elderly individuals.
Ninety-three percent of elderly adults (over 65) living with malnutrition are residing in the community (Age UK, 2017), and at least one in 10 visits to a general practitioner are by adults that are experiencing malnutrition (British Association of Parenteral and Enteral Nutrition [BAPEN], 2015). General practice nurses (GPNs) will be exposed to patients with acute conditions such as a chest infection or a pressure ulcer, or chronic conditions such as chronic obstructive pulmonary disease [COPD), chronic kidney disease and dementia, which increase their risk of malnutrition. Oral nutritional supplementation is one of the treatments available to treat malnutrition. This article discusses the identification of malnutrition, treatment and appropriate prescribing, through initiation, monitoring and cessation of oral nutritional supplementation.
Pre-travel vaccine recommendations require a full individualised risk assessment. The traveller should then be informed about the specificity of the vaccines they should consider and told about their benefits and limitations. They should also be made aware of issues around certificate requirements and if these will apply to them. A well-informed traveller will understand that, although important, vaccines do not remove the need for precautions with food, water, insect bites and activities that increase risk. Routine immunisations and those recommended for special risk groups should not be neglected in favour of more rare and exotic vaccines. This article focuses on indications for travel vaccines only.
The impact skin disease has on the psychological wellbeing, social functioning and everyday activities of patients and their families and carers is often trivialised and given low priority. The quality of life of people with skin diseases such as psoriasis, atopic eczema and acne can be significantly impaired, and such impairment can be greater at times than for life-threatening conditions such as cancers (Schofield et al, 2009). Living with a family member with a skin condition impacts on many aspects of life, with issues such as leisure time (26%), social life (48%) and holidays (46%) highlighted as adversely affecting family life (Basra and Findlay, 2007). This paper provides practical advice and guidance that general practice nurses (GPNs) can give parents when planning leisure and holiday time with their children.
The first article in this two-part series on skin cancer highlighted the importance of educating the general public about the causes of skin cancer, as well as outlining preventative measures to reduce its incidence and help them respond appropriately to the initial signs (Alexander, 2016). This second article focuses on individuals who are at higher risk of developing skin cancer and looks at how education can help them to make informed choices about their exposure to ultraviolet (UV) radiation to reduce their chances of developing skin cancer.
The aim of this two-part article is to highlight an area of cancer which holds promise in the form of overall reduction in incidence and mortality rates dependent on a few factors. These factors include education of the general public about the causes of skin cancer and preventative measures to reduce skin cancer, identification of high risk groups, and finally how to respond appropriately to the first signs of skin cancer. This first part identifies known causes and highlights signs and symptoms of skin cancer and why early detection and treatment is essential for improving overall survival outcomes. The second part in the series will focus on individuals within the population who are at higher risk of developing skin cancer and look at how education can enable people to make informed choices about their exposure
to ultraviolet (UV) radiation to reduce their chances of developing skin cancer.
The NHS agenda is increasingly focused on promoting self-care for patients with long-term conditions and
healthcare professionals are being encouraged to empower patients to become equal partners in their care. This
article discusses some of the self-care strategies that patients with venous leg ulceration (VLU) can undertake
to promote healing or prevent recurrence. The evidence base to support the effectiveness of these activities will
also be discussed. Furthermore, with the very real shift in wound care from the domain of specialist nurses to
clinicians working in primary care, namely general practice nurses (GPNs) (Guest et al, 2015), it is vital that they are
prepared and trained to care for patients with venous leg ulcers, the number of which is likely to rise with an ageing
population (Atkin and Tickle, 2016).
Obesity and its consequences, such as diabetes and cardiovascular disease (CVD), have significant health and NHS cost implications. Relatively small reductions in weight (around 5–10%) have clinically important benefits (Pietrzykowska, 2016), but long-term weight loss maintenance is challenging. Behaviour change interventions have been identified as key for use in weight loss by authorities such as the National Institute for Health and Care Excellence (NICE, 2014). In particular, motivational interviewing (MI) — a form of behaviour change — has been identified as a successful approach to changing health behaviours (Rollnick and Miller, 2013).There is an abundance of evidence showing that just telling people what to do does not work as a way to change patients’ behaviour in order to achieve health gains (NICE, 2014). Furthermore, there is emerging evidence that MI does work and leads to long-term health gains. This article provides an overview of MI to help general practice nurses (GPNs) in their day-to-day practice.
