Research by the University of South Wales has increased awareness of Alcohol Related Brain Damage (ARBD) nationally and internationally and informed regional and national government policy and professional practice.
ARBD is an under-recognised but treatable condition associated with debilitating cognitive and physical deficits. Despite this just 16% of sufferers are diagnosed due to a lack of reliable evidence of ARBD prevalence, lack of awareness and understanding of the condition, and an inconsistent approach to treatment due to the absence of an adequate treatment model. The Welsh Government prioritised the issue of alcohol misuse and in 2014 Public Health Wales identified a need to address an absence of evidence and understanding around the condition.
Since 2015, the Addictions Research Group at USW co-led by Professor Bev John and Professor Gareth Roderique-Davies, has researched the prevalence, detection, diagnosis and treatment of ARBD in order to improve accurate identification, assessment and treatment. In May 2018 John and Roderique-Davies were invited to join the Project Board for the Welsh Government’s Substance Misuse Treatment Framework for alcohol-related brain damage (ARBD).
USW’s research has underpinned the Welsh Government’s Substance Misuse Treatment Framework (SMTF) which provides evidence-based guidelines for health and social care commissioners and providers to deliver high quality, sustainable and equitable prevention and treatment services. The Welsh Government SMTF is now being used to guide the ARBD section of the UK Public Health and Departments of Health development of UK clinical treatment guidelines for alcohol.
A key recommendation of the SMTF is to raise awareness of ARBD and provide education and training for health professionals and service providers. In line with this recommendation, USW worked collaboratively with partners The Pobl Group, the largest not-for-profit Housing Association in Wales which supports 10,000 individuals at risk of ARBD, to deliver organisational change by developing and facilitating an in-house training programme. Training has now been delivered to over 700 staff in the support arm within The Pobl Group and plans are in place to extend the programme to staff in the Care Arm. In recognition of its importance, this programme has been officially endorsed by the Royal College of Psychiatrists in Wales.
Collaborative research by the University of South Wales with educators and stakeholders across Europe has raised awareness of the importance of spiritual care for the nursing and midwifery professions, and changed and enhanced education, policy, and practice of nursing and other health care professions nationally and internationally.
Spiritual care is an important part of holistic person-centred care but has been neglected within nurse/midwifery undergraduate education, despite statutory requirements for nurses and midwives to demonstrate competency. There was no agreed definition of spirituality and spiritual care or evidence based spiritual care competency (SCC) standard and little was known about the impact on patients of nurses providing spiritual care. A novel programme of research at USW spanning 14 years, led by Professor Linda Ross has been instrumental in addressing this need.
In 2016, Prof Ross co-led the EPICC Project (Enhancing Nurses and Midwives Competence in Providing Spiritual Care Through Innovative Education and Compassionate Care). The project worked co-productively with educators in 21 European countries and over 60 stakeholders to build consensus of how spirituality and spiritual care are defined for nurse/midwifery education across Europe. It developed the first Spiritual Care Education Standard and Gold Standard Matrix for Spiritual Care Education, as well as a Toolkit to support teaching and learning, and network and website to promote best practice.
In Wales, the EPICC Standard has been embedded within pre-registration nursing curricula and in Europe, it has changed pre-registration nursing curricula in 23 universities and teaching in 26 universities in 16 countries. EPICC has also changed policy relating to the education and practice of healthcare professions beyond nursing in Wales, England and Europe and is now a mandatory requirement of the Health Education and Improvement Wales (HEIW) commissioned pre-registration contracts for midwifery and allied health. EPICC is also raising awareness of the importance of spirituality within nursing and midwifery globally through its 77 network members across 23 countries including Brazil, China, Venezuela, USA, Canada and Kenya.
Research by the University of South Wales in collaboration with Abertawe Bro Morgannwg University Health Board, Hywel Dda Morgannwg University Health Board has transformed health visitor professional practice in Wales.
Family resilience is the “ability of a family to respond positively to an adverse situation and emerge from the situation feeling strengthened, more resourceful and more confident”. Welsh Government policy to address health inequalities aims to build family resilience through early intervention and prevention (Wellbeing of Future Generations Act 2015; Social Services & Wellbeing Act 2014).
Health visitors play a crucial role in promoting and building family resilience by supporting children and their families in the early years. The ability to assess family resilience is essential in order to support families experiencing difficulties and improve child health and development. However, no rigorous, robust evidence-based tools were available and there were concerns that some families might not be able to access support or that resources were not targeted where they were most needed.
In 2014, researchers at USW led by Professor Carolyn Wallace in partnership with Abertawe Bro Morgannwg and Hywel Dda University Health Boards and health visitors, developed an innovative, validated, evidence-based instrument to assess family resilience to address this need. The Family Resilience Assessment Instrument and Tool (FRAIT) informs heath visitors’ professional judgment when working with children and their families. It aids identification of protective factors within families as well as additional needs, alongside potential safeguarding concerns. It also helps health visitors to identify insufficient services in specific locations and work with local communities and agencies to rectify this.
FRAIT was incorporated into the Welsh Government Healthy Child Wales Programme(2016) and became a mandatory tool in October 2017. Since 2017, over 1000 heath visitors have been trained to use FRAIT and all Welsh universities teaching student health visitors have embedded FRAIT in their curricula. FRAIT is now used by every health visitor in Wales at key stages throughout a child’s first five years of life. Work is ongoing to develop a digital version (eFRAIT) to improve data collection, and to disseminate the tool both nationally and internationally, most recently in India.