Physical Health in Adults

Resources 

 

For primary care

 

• Physical conditions associated with psychosis : early interventions in psychosis: looking after bodies as well as minds. A leaflet with guidance for GPs (2009)

 

• Primary care guidance on smoking in mental health guidance for GPs on smoking in mental health. Royal College of GPs and Royal College of Psychiatrists (2008)

 

• Guidance on delivering  health checks for people with intellectual disability for GP’s and others. Issued by the RCGP and  supported by the Royal College of  Psychiatrists.

 

For patients

• NHS Choices: patient self-assessment tools for lifestyle checks. Several user- friendly self- assessment tools for alcohol consumption, body mass index and fitness:

 

• Patient.co.uk  Extensive source of information for patients and carers on medical conditions and medication. Widely used by GPs to provide information for patients.

 

• Map of Medicine: health guides for patients from NHS choices Health professionals can register to access technical information for patient care

 

• Easy Health: Information on health for people with learning disabilities with leaflets and videos

 

• Elfrieda Society: Materials by people with learning difficulties, for people with learning difficulties and for people who work with them. Leaflets on several health topics with illustrations for sale

 

• Books Beyond Words are books for people with learning disabilities on various health related topics 
   

Medication

• Only the best: Information on antipsychotic and mood stabiliser medication from RETHINK.  Free of charge if complete a brief questionnaire.

 

• Medication information for patients in easier read format: user-friendly leaflets and MP3 downloads on medication, suitable for people with limited reading skills. Click on Downloads on left side of home page

 

• Medication leaflets for patients:  Comprehensive resource from Norfolk and Waveney Mental Health Trust pharmacy information site,  with leaflets suitable for people taking psychotropic medication 

 

Smoking

• Good reasons to quit smoking: from NHS Choices website 

 

• Information about quitting smoking: quit kit, quit tools and addiction test, information from NHS Smoke-free
  

 

Physical Health Screening Tools

• Physical health check: PHC:  Assess current physical health and screening needs. Can be used by non-clinical and clinical staff, without the need for specific training for patients in the community and in hospital. Obtainable from the RETHINK website after registration

 

• Cardiff health check:  Health screening questionnaire for people with learning disabilities with a list of screening questions for physical and space to record physical examination.

 

• Physical health checks in primary care for people with learning disabilities: NHS Primary Care Commissioning website links to a suite of resources for improving the physical health of people with learning disabilities in primary care

 

• OK Health Check: Enables carers of people with learning disabilities to record their observations of the physical health of people with learning disabilities. Website gives information on how to complete the OK Health Check

 

Records and charts

• Fluid Balance Chart: Simple chart for recording fluid in-put and output from the 5 Boroughs Partnership NHS Trust

 

• MEWS or Modified Early Warning Score: Similar to PAR scores, MEWS gives the parameters for physical observations and recommends when to take action. Information from Wikipedia

 

• Patient at Risk Score (PAR score): PAR scores aid recognition of the acutely ill or ‘deteriorating’ patient. Physical observations are rated and are given a score that can be used to trigger when to call for medical assistance. If using PAR scores, staff should receive training in the PAR system. It is recommended that standard forms are used throughout an organisation. The PAR system link here has a copy of a Physical Observation chart. Other PAR systems may be available locally. Example produced by Worcestershire Mental Health Partnership NHS Trust

 

• Head Injury: Glasgow Coma Scale and Observation proforma by NICE

 

• Turning chart: Chart for recording a patient’s movement and turning regime to prevent pressure sores developing is available from the Judy Waterlow website.

 

Measurement and rating scales

Weight shape and nutritional status

 

• Body Mass Index: WHO information on categories of BMI

 

• Electronic BMI calculator

 

• BMI chart with colours

 

• BMI chart with numbers

 

• Body Shape Chart: Ashwell Shape Chart suitable for use in men and women

 

• Waist size: Chart gives normative values for different ethnic groups .

 

• Measurement of Waist Size: The National Obesity Forum: shows how to measure waist size and information on diagnosis of the Metabolic Syndrome. 

 

• Malnutrition Universal Screening Tool (MUST): Useful for routine identification of malnutrition, for those at risk of malnutrition and obesity in adults. Five steps to score risk. Measure BMI, score weight loss, score effect of acute disease, calculate overall malnutrition score and develop management plans. Tool has BMI chart and alternative measurement tools

 

• Weight And Lifestyle Inventory (WALI): Inventory of weight history, dietary history, exercise habits. Detailed assessment for assessing needs for weight management

   

Cardiovascular risk calculators

• QRISK®2 2011 Cardiac risk calculator:  Enables calculation of 10 year risk of cardiovascular events

 

• QRISK® lifetime: risk of cardiovasular events over lifetime

 

• QRISK® intervention: calculation of the risk of heart disease, stroke and diabetes over the next 10 years. This shows the effects of making changes such as stopping smoking and losing weight

 

• Primary Cardiovascular Risk Calculator:  Based on Framingham cardiovascular risk equation, adjusted for UK

 

• Venous Thromboembolism (VTE) Risk Calculator (2010): Risk calculator for VTE for hospital in-patients from the Department of Health, who recommend that all NHS hospital patients should have a VTE risk assessment.

 

• Positive Cardio Metabolic Health: A framework for early interventions for the physical health of patients taking psychotropic medication. Use the Google link and then click on the link to the pdf by Curtis et al (2010).  
   

Musculoskeletal

• Falls Risk Asessment Tool (FRAT):  For identifying fracture risk factors and calculating risk of falls for older adults

 

• Falls Risk Assessment Tool (FRAT) Australian version.

 

• Fracture Risk Assessment Tool (FRAX®) : WHO fracture risk assessment calculator available from web. Suitable for use in UK and other versions are available for use in several countries

 

• Physical Activity Readiness Questionnaire (PAR-Q):  The PAR-Q questionnaires are mainly administered by exercise professionals to assess a person’s physical health before taking exercise, to identify contraindications to exercise and to identify people who should seek a medical opinion before exercise.  A standard PAR-Q can be adapted for use in mental health in-patient settings e.g. by adding questions on psychotropic medication.  

 

• This questionnaire has 7 questions for people aged 15-69, and is published by Canadian Society for Exercise Physiology. A PAR-Q from a commercial website has 16 questions, in black and white, on a single page
  
  

Pain

• The Pain Score and Measuring Pain: rating scales to measure  various outcomes e.g. levels of sedation or motor blockade
   
• Pain Rating Scale: From the British Pain Society- self-report of levels of pain and distress from the British Pain Society

 

• Pictorial Images Images for rating levels of pain

 

• Visual Analogue Visual rating scale for pain

 

• Back pain: Oswestry Disability Index - measures disability in a number of functions such as walking, standing and has been used for over 25 years in clinical and research settings
  
• Pain recognition in people with learning disabilities for health professionals

 

Pressure Ulcers

• Waterlow Score: Pressure ulcer risk assessment tool is widely used by nurses  For side one and side two of the same document). It is applicable in primary and secondary care settings including mental health settings. 

 

• Turning Chart available from Waterlow website for recording nursing interventions to turn patients

 

• EPUAP: European Pressure Ulcer Grading tool: Pictures and diagrams to grade severity of pressure ulcers
  

 

 

Respiratory Function

• Spirometry Reference Value Calculator:  Too specialist for use by most mental health professionals but included to raise awareness of respiratory function tests 
  

 

Side Effects of Psychotropic Medication

• Barnes Akathisia Rating Scale: to assess the severity of akathisia (restlessness, secondary to treatment with psychotropic medication) 

 

• Abnormal Involuntary Movement Scale (AIMS): The AIMs measures involuntary movements.  This version is attributed to the National Institute of Mental Health (2000)

 

• Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS): Comprehensive rating scale for the assessment of several side effects from psychotropic medication. Can be self-administered

 

• Simpson-Angus Rating Scale: rates extrapyramidal symptoms from the side effects of psychotropic medication.

 

• Lundbeck Institute: Numerous rating scales can be found on this website for mental state, quality of life and side effects of psychotropic medication

 

Sexual Health

• Arizona Sexual Experience Rating Scale: rates sexual satisfaction and libido

 

Senses

• Hearing Screening Questionnaire:  Ten ways to recognise deafness and indicates when a formal hearing test is advisable.  National Institute of Health and National Institute on Deafness and Other Communication Disorders·    

    

• Eye tests: Entitlement to FREE eye tests on the NHS from NHS Choices.  

 

Motor and Process Skills

• Assessment&nbs p;of Motor and Process Skills (AMPS); Screening tool widely used by occupational therapists. It has to be purchased and is updated from the website

 

• Mobility Assessment Tool for High Functioning (HI-MAT): This tool can be used to test mobility with sections for assessing various motor skills

 

Sleep Apnoea

• Epworth Sleepiness Scale.  Sleep apnoea is associated with obesity. To identify excessive sleepiness use this scale (range for scores 0-24), scores >9 indicate a high risk of sleep apnoea

 

• Epworth Sleepiness Scale Pictorial version from British Lung Foundation

 

• Sleep Apnoea BMJ article Easily missed? Obstructive sleep apnoea in adults

 

Facilitating communication for people with learning difficulties

 

• Makaton uses signs and symbols to teach communication, language and literacy skills to people with communication and learning difficulties. Official website with all resources

 

• Widgit Symbols have been designed in collaboration with language and communication experts, and enable individuals of all ages with communication challenges, learning difficulties and English as an Additional Language (EAL) to gain access to written information and communicate more independently. 

 

• Change People is a charity run by people with Learning Disabilities for people with Learning Disabilies. Health related pictures and many other resources that can be purchased to use in easy read literature
  
• Books Beyond Words (BBW)  Royal College of Psychiatrists’ is a series of picture books that has been developed to make communicating easier for these people, and to enable discussion about difficult topics. Supporting text and guidelines are also provided for carers, supporters and professionals. The series covers many health related topics and is particularly useful for people with learning (intellectual) difficulties.

 

• Easy-Read-Online makes websites, web pages and other digital applications that are easy for people who have difficulty in reading and writing

 

• Dobson's Choice is an off shoot of easy read, to help people with learning disabilities to use computers and to find websites that are good for them.

 

• Making written information easier to understand for people with learning disabilities: with information on creating easy read literature

 

• Communication matters is the UK Chapter of the International Society for Augmentative and Alternative Communication.  Website offering information and down loadable leaflets on communication:

 

• FAIR Multimedia publishes a range of health materials specifically designed for people with learning disabilities

 

• Plain English Campaign: Information and advice on using plain English. Downloadable software and leaflets

 

• Communication toolkits and advice sheets from the Keele University School of Nursing and Midwifery

 

 

Further reading >

 

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