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Objectives: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities. Methods: Forty‐six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis. Results: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia. Discussion: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home. Key points: Neighbourhoods begin within homes and are interconnected. This relationship has important implications for the discourse of ageing in place.'Home' for people living with dementia holds the same meanings for those without dementia, but with some notable differences. It is important to recognise the shifting dynamics of home and to recognise the complexity of home in the context of dementia. There is not a fixed solution to the challenges of ageing at home with dementia, but support and understanding need to evolve alongside people with lived experience.Homes are a site of renegotiation where new meanings are created to reflect the changing nature of home and the lived experience of home for those with dementia.The study has provided findings through innovation in the research design. The employment of creative methods enabled people living with dementia to participate in sharing their own narratives of home.The work provides evidence where there is a current gap in understanding 'what matters' about home for people living with dementia. [ABSTRACT FROM AUTHOR]

This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely ūloa, when working with Tongan people. Ūloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of ūloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of ūloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangamālie (harmony, balance), ngāue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community. [ABSTRACT FROM AUTHOR]

This study explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector. Quantitative and qualitative data were collected through an online survey, focus group and interviews with staff and managers employed by one organisation that provided OSHC services in Sydney, Australia. This paper reports on their perceptions about implementing mandatory reporting requirements associated with the concepts of 'significant harm' and 'reportable conduct'. The aim of this paper is to engage OSHC stakeholders, including government, in reviewing child protection policies and practices to support educators in their work with children. Key findings indicate the inadequacy of available training, and the importance of relationships and communication between stakeholders, especially OSHC and school staff. This requires systemic change including raising the status of OSHC and the critical role that these educators have in supporting children's development, learning and wellbeing during the early years of school. Key Practitioner Messages: It is important that leadership supports educators to engage in respectful partnerships with families and schools to ensure child protection, and thereby child wellbeing and learning outcomesTraining in supporting children's safety and wellbeing in OSHC is critical.There is a need for a systems approach to OSHC services which places children's development, learning and wellbeing at the forefront of professional practice. 'Explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector' [ABSTRACT FROM AUTHOR]

Abstract: Background: Internationally, pharmaceutical policy has heightened expectations for community pharmacies to act as healthcare professionals, increasing the need to understand the health professional–retailer nexus. Literature suggests that pharmacy involves a dichotomy of roles including both retailing and healthcare provision, yet it is unknown whether pharmacists themselves perceive a tension between these roles and how such a tension might be managed. Aim: To explore whether there is tension between being retailers and healthcare providers in community pharmacy and to understand how any such tension is perceived and managed. Methods: Ten in‐depth semi‐structured interviews were conducted with pharmacist owners and managers of community pharmacies in New Zealand. General inductive thematic analysis was undertaken to gain insight from the data. Results: Pharmacists experienced tension between being healthcare providers and being retailers. In total, eight themes were derived from this study. Four themes emerged to describe the tension: (i) balancing roles; (ii) tension – what tension?; (iii) we give a lot for free; and (iv) too much bureaucracy and paperwork. Four themes for managing tension were identified: (i) imparting of owner beliefs; (ii) use of incentives; (iii) effective business management skills; and (iv) being entrepreneurial. Conclusion: This paper is expected to assist in helping policy‐makers and practitioners be aware of the role of tensions when policies are implemented to move pharmacists from a retailer role to healthcare provider. This paper aids in policy development and should inform professional practice and forthcoming business management training programs for community pharmacy. [ABSTRACT FROM AUTHOR]

The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non‐technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well‐established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi‐structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non‐technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre‐placement emotional intelligence training and coaching. Such training will support nursing graduates to be work‐ready upon entering the workforce. [ABSTRACT FROM AUTHOR]

This novel paper critically addresses a currently popular sex education resource which compares sexual consent to tea drinking. Drawing from a study which considered the meaning of consent through focus groups and interviews with young people and professionals, we argue that the central 'risk avoidance' message of such resources individualises the potential risks of non‐consensual sex and ignores the gendered social structures which shape interpersonal relationships. We suggest that simplifying and extrapolating sexual consent from broader cultural understandings is problematic. Conversations with young people are important, but they need to address the complexity of sexual consent, coercion and gendered sexual norms. [ABSTRACT FROM AUTHOR]

This paper draws on a British Academy (BA) funded study exploring social workers' conceptions of family using a vignette and focus groups. The policy context is discussed and the data from the BA study are then compared and contrasted with families' accounts of their own situations using the data from a separate qualitative study about child protection social work. The paper discusses the themes emerging and argues for a renewed focus on theorizing family in children's social work and the implications for practice. [ABSTRACT FROM AUTHOR]

Practitioners' preconceived ideas about service users can lead to prejudice and labelling, and ultimately may result in biased services. This paper reports on a UK‐based qualitative research study exploring the views and experiences of practitioners working with adult victims and perpetrators of domestic violence. It examines whether or not practitioners believe that childhood experiences of witnessing domestic violence indicate the likelihood of domestic violence in adulthood. It further explores practitioners' perceptions of factors contributing to the experiences of domestic violence amongst their service users. Twelve semi‐structured interviews were conducted with practitioners working in the domestic violence field, and thematic analysis was used to analyse their responses. The data did not indicate a general consensus on the matter of children becoming victims or perpetrators based on their childhood experiences of domestic violence. Participants' responses indicated that they thought the issue was more complex. Common themes that participants consider important to children's development of healthy/unhealthy relationships in this context were identified in the data. These included: an awareness of service users' individuality; the importance of meaningful support networks; and an understanding of the risk amongst their service users to normalise abusive behaviour. '[Explores] the views and experiences of practitioners working with adult victims and perpetrators of domestic violence' Key Practitioner Messages: Not all children witnessing domestic violence will inevitably become victims or perpetrators of abuse in adulthood.Perpetrating domestic violence in adulthood is often associated with a combination of various factors and circumstances, and can rarely be attributed to just one past experience.Assessments and holistic and judgement‐free services provided by practitioners are vital for children to develop positive and healthy future relationships. [ABSTRACT FROM AUTHOR]

Grandparents whose grandchildren are exposed to domestic violence are faced with some unique challenges in their grandparenting, which have thus far been little discussed in research. This paper discusses the narratives of 10 Swedish grandparents whose grandchildren have been exposed to violence towards their mother. The aim was to explore grandparents' narrations of their responses in the face of violence, and their understanding of the role they play in their grandchildren's social networks. Two significant responses are discussed: ‘being there’ and ‘acknowledging the independence and self‐determination of the adult children’. Grandparents experienced these responses as contradictory and felt powerless when it came to their possibilities to protect their grandchildren. The paper suggests that grandparents could be a resource for domestic violence services, and social work practice needs to assess the roles of grandparents of children exposed to domestic violence. Social workers should consider the challenges these grandparents are facing and what support they may need in order to support their grandchildren. [ABSTRACT FROM AUTHOR]

Little is known about how children themselves understand their moves to and between foster homes. The data presented in this paper come from a study that sought children's views on becoming and being a foster child. A key finding of that study was how children's accounts of being fostered illustrated a high level of anxiety and concern about their moving to live with a foster family. This paper firstly explores the key issues about looked‐after children's moves. It then describes the research study undertaken, before exploring the data generated from children's accounts of their moves to a new foster home. Lastly, there is a discussion of the implications for social work practice in this area. [ABSTRACT FROM AUTHOR]

Interviews with survivors of intimate partner violence were conducted to gain information on the transition from violent relationships to new non‐violent relationships. A subset of this data was re‐analysed using Social Relational Theory to gain further insight into the roles of children and important others who were identified as impacting this transition for mothers who had exited violent relationships. This paper reviews two major themes discovered during the SRT analysis that were inherent in the women's experiences: (i) agency of children, family, peers and community and (ii) power. In addition, this paper suggests implications for research, intervention and psychotherapeutic practice. [ABSTRACT FROM AUTHOR]

Generations of parents lost to AIDS and other causes have created a vacuum of care for the orphaned children they leave behind. This crisis has resulted in rapid changes in caregiving and family life, with extended family members, having to care for orphaned children. As a result of high numbers of vulnerable orphaned children residing with kinship carers, and the fundamental importance of the relationship between carers and orphaned children, we need to understand more about these relationships. This paper explores the nature of orphaned children-kinship carer relationships in Botswana. Interview guides were used to collect data from 15 caregivers and 15 orphaned children. The results indicate that the nature of relationships between orphaned children and caregivers is influenced by the way the parties communicate, how adolescents behave and the competing responsibilities of caregivers. Lastly, the paper recommends how positive relationships can be developed and nurtured between orphaned children and their caregivers in an African setting. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores the contribution of social identity change to international students' health and well‐being. International students typically face a range of challenges from the time they leave their home country, including the need to adapt both to a new culture and norms and to a new educational landscape. Previous research informed by the Social Identity Model of Identity Change (SIMIC) suggests that during such life transitions, an individual's group memberships and associated social identities can provide a buffer against the threats to well‐being that such transitions present. To examine the relevance of SIMIC for the transitions that international students' experience, semistructured interviews were conducted with 15 international students attending an Australian university. Thematic analysis provided support for the relevance of SIMIC's social identity gain and social identity maintenance pathways in the transition and revealed a number of associated factors that acted as either facilitators (e.g., a host family that supported community integration) or barriers (e.g., experiencing culture shock) to social identity change. These findings present the first qualitative support for SIMIC within an international student population and help to flesh out the specific ways in which social identity processes contribute to both positive and negative health and well‐being outcomes. [ABSTRACT FROM AUTHOR]

Political rhetoric and media reports following the August 2011 London riots in the UK drew attention to poor parenting to explain the cause of the riots, thus, a parent-blaming discourse emerged. This article presents findings from a PhD thesis about how London parents and families constructed the riots and relevant clinical implications. A separate paper focuses on the method and findings from the PhD thesis with an aim to include parent and family perspectives on the riots in the academic literature. A Foucauldian-informed thematic analysis indicated that social exclusion, gentrification, criminality, parenting, morality and neighbourhood were relevant to the 2011 London riots from interviews with parents and families. This article aims to support clinical work with parents and families, especially as clinicians were positioned as useful in supporting such groups, through the Troubled Families Programme following the London riots. Clinical implications were developed from themes about socio-political issues and parent-blaming discourses and the notion of positioning, as influenced by the Foucauldian-informed analysis adopted. Practitioner points Consider the relevance of socio-political issues and parent-blaming discourses to the August 2011 London riots., Use 'social context' questions to explore socio-political issues when conducting therapy., Use 'parenting expectations' questions to explore possible parent-blaming discourses when conducting therapy., Consider the ways in which clients may be positioned within their relationships. [ABSTRACT FROM AUTHOR]

In this paper, midwives' experiences of working with vulnerable pregnant women who were subject to child protection orders in New South Wales, Australia, and faced the possible removal of their baby at birth, known as 'assumption of care', are described. A qualitative descriptive approach was used to explore the experiences of ten midwives who had been involved in some 91 episodes of assumption of care. In-depth interviews were undertaken and thematic analysis was used to analyse the data-set. Four themes were elicited that demonstrated how midwives worked with vulnerable women and Community Services during the antenatal period. These were labelled: Reporting - Taking the first step; The woman-midwife relationship remains a priority; Jumping through the 'community service' hoops; and Crunch time: The decision... sometimes justifiable sometimes not? Even though the three-way relationship between the woman-midwife-Community Services could be confrontational, it was essential that midwives worked in a positive way with Community Services to improve outcomes for the woman and her unborn child. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Messages Working effectively with Community Services is essential. Sharing information and developing multidisciplinary approaches and pathways will produce the best outcomes for vulnerable newborns and their mothers whilst at the same time supporting health and community workers to work in a cohesive manner to provide quality care., Midwives need to be supported to stay 'woman centred'. Keeping the woman engaged in the system will help ensure the health of the foetus (baby)., Further research is needed to explore the perspectives of all those involved in assumption of care. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a scoping study into looked after children and care leavers who are parents in Wales. Eight parents engaged in a qualitative interview. Thirty-one pregnancies were discussed during the interviews: 16 live births, two ongoing pregnancies, one stillbirth, one termination and 11 miscarriages. At the point of interview, two parents continued to care for their children, but six had experienced the permanent removal of their child/ren as a result of social services intervention. Twelve of the 16 children discussed in the interviews were 'looked after' or adopted. Despite its small-scale nature, the study highlights important considerations before, during and after participants became parents. Broadly categorized, these relate to the influence of parents' childhood experiences on their capacity to be parents, the availability and adequacy of support during parenting and the ensuing impact of parenting 'success' or 'failure'. For parents who had experienced the loss of a child, some were resigned to having no further children, some continued to hope for a family in the future, while others had experienced cycles of repeated pregnancies and compulsory removals. The findings are considered in the context of related literature and suggest that increased attention is required in this under-researched but highly emotive area. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to critically examine family stigma as one form of the stigma of mental illness in child and youth mental health. Presented are the outcomes of a thematic content analysis of in-depth, semi-structured interviews conducted with seven ( n = 7) young siblings, ages 13 to 21 years old, with a brother or sister identified as having a mental-health issue. The focus of the interviews was on the ways the siblings experienced their other sibling's mental health and how those experiences shaped their sense of self and family. From the analysis, young siblings had predominately negative experiences, struggled with making sense of their brother or sister and the family as 'flawed' against the mental illness as 'bad' and experienced considerable family stress and overt family stigma. Current practice theories fail to consider the complexity of these factors and, in doing so, fail to adequately explain the nature and extent to which stigmatization occurs for immediate family members. The importance of peer support and understanding stigma in social work practice with children and their families is discussed. [ABSTRACT FROM AUTHOR]

Little is known about how mental health services consider the parenting role and the well‐being of children when assessing parents with acute mental illness. This paper investigated how crisis mental health services addressed child well‐being in the Wellington region, New Zealand. This mixed‐method case study included: (i) an audit of the electronic clinical records of all adults presenting to the crisis assessment team; (ii) interviews with 22 key informants; and (iii) a documentary review. We found that data about children were not systematically collected. Less than half of (49 of the 104) the records of patients who were parents included information on their child's well‐being; only six (6%) contained a specified plan for action. The focus for services was the adult patient. Key informants were unclear about their role. They identified inadequate training and institutional support, inflexible funding models and limited availability or inappropriateness of referral services as problems. They saw a need for children to become more visible, for collaborative working to improve the use of existing services and for new funding models, resources and roles. Existing national policy documents contained little guidance and no practice guidelines were in use. These were lost opportunities to improve support for the parenting role and promote child well‐being. [ABSTRACT FROM AUTHOR]

The life expectancy of people living with mental illness is significantly shorter than that of the rest of the population. Despite the profound impact of physical health issues on both quality of life and life expectancy, the perspectives of mental health consumers have yet to be thoroughly explored. Furthermore, research has focused far more on describing barriers than on identifying solutions. This paper reports on findings from a qualitative exploratory research study, with the aim to examine the potential role of a specialist nurse with advanced physical health-care skills. Focus groups were conducted with 31 consumers. Data were analysed thematically. The concept of a role like this was supported; however, participants stressed: (i) the importance of integration between health professionals and various components of the health-care system; and (ii) the need for culture change for nurses to work from a less medically-dominated approach. Previous research literature suggests that a nursing position dedicated to physical health care and coordination might produce positive outcomes for mental health consumers. The findings from the current research project emphasize the need for consumers to be identified as key stakeholders in a solution-focused approach to improved physical health care for mental health consumers. [ABSTRACT FROM AUTHOR]

The study examined the effects of transition employment support to two cohorts of young people who were in their last year in school or college in 2005/2006 and 2006/ 2007. This paper reports the views of carers, teachers and support workers of the impact this additional support made to the young people. Analysis of the data reveals a difference between the views of carers and those of professionals. The paper argues that these differences may reflect different understandings of the aim and purpose of transition support and which may make it difficult to achieve a smooth transition for all stakeholders when not taken into account. This may have implications for how to structure and deliver transition support, some of which are being outlined in the discussion. [ABSTRACT FROM AUTHOR]

Medical Education 2011: : 455-463 This paper aims to consider why general practitioners (GPs) teach, in particular by defining the longitudinal supervisory relationships between rural clinician-preceptors and students. A total of 41 individual semi-structured interviews were conducted with GPs, practice managers and students. All interviews were audiotaped, transcribed and analysed for emergent themes. In this study preceptors identified many ways in which precepting added value to their roles. However, themes relating to the doctor-student relationship were central to GP preceptors' experiences. These developed in chronological order and resulted in changes in the triangular relationship between doctor, patient and student in the consultation. Interpretive findings identify that the motivators for precepting represent a group of constantly changing interconnected factors that contribute to the defining of preceptors as central members of their professional community of practice. This critical finding challenges the simplistic organisational concept that universities can recruit and retain GPs by offering increased rewards. This paper introduces four clinical preceptor models, which involve the roles of, respectively: the student-observer; the teacher-healer; the doctor-orchestrator, and the doctor-advisor. Symbiosis between student learning and patient care was found to occur in the doctor-orchestrator model. The evolution of doctor-student relationships in long-term student placements explains how students become more useful over the academic year and sheds light on how GPs are changed through precepting as part of the complex process by which they come to recognise themselves as central members of the rural generalist community. [ABSTRACT FROM AUTHOR]

There is a driving force within current UK child welfare policies which promotes a strengths led approach to both assessment and care planning for children in need. Social policy emphasizes the importance of tangible outcomes such as education achievement, which have been enshrined in statute. However, other developmental outcomes, such as identity, are subordinated. Notwithstanding the relevance of these more concrete indicators, this paper suggests that this focus has left a gap at theoretical, strategic and operational levels relating to more psychosocial aspects of human growth and development, such as identity. This paper seeks to redress that gap by considering identity as both a process and an outcome. Following a review of the literature on identity development, it presents an analysis of semi-structured interviews with 13 young people and their social workers. The findings show how young people's identity is shaped by their relationships, can be a protective mechanism, and deferred or put on standby. In the concluding discussion the implications for social work practice are highlighted. [ABSTRACT FROM AUTHOR]

The paper summarises the main findings obtained in a wide study on the construction of deviant actions' narratives. In this paper, we focused on two topics: both topics are crucial to suggest new directions in investigative psychology. Narratives provide investigative psychologists with new sets of tools to define criminal profiles, such as narrative profiling. This paper deals with a qualitative investigation undertaken by collecting narrative interviews. These interviews were conducted with 34 prisoners held in two penal institutes in Rome and their goal was to reveal the typical form of constructing accounts taken in a non-investigative context. The specific aim of the project was to show whether differences exist in the narrative accounts provided by perpetrators of crime considering two factors: the type of crime committed and the experience in the deviance arena, which are hypothesised to shape narrations. Interviews were analysed with particular reference to the ‘Evaluation model’ by W. Labov. Participants were divided into three groups on the basis of the type of experience in the deviant field (professionals, intermediates and amateurs) and into four groups according to the crime committed (homicide, robbery and theft, and crimes linked to drugs and fencing). The results show the significant existence of clear differences in the reconstruction of the crime committed compared to the experience of the protagonist. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Children taken into care and custody are arguably the most vulnerable and problematic groups within the wider debate and responses developing to the ‘troubled families’ agenda in England. They represent what the state most wants to avoid when it intervenes in the life of a family. This paper is based on an analysis of the service involvement and needs of the 196 children taken into care or custody over a 3‐year period (2008–2011) in one city local authority in England. The research was undertaken to inform the response to prevention of entry into care and custody which was the original focus of the most intensive part of the troubled families programme in the city. Interviews with 10 senior professionals from a range of agencies involved in setting up this local programme, explored the way the emerging troubled families agenda was shaping ideas about the understanding of and response to the needs of these children and their families. Key findings of the study illustrate the range and complexity of need as well as the sequence and amount of agency involvement. Professionals were often critical of the thinking behind the troubled families agenda, but were positive and creative about new ways of working with these families. [ABSTRACT FROM AUTHOR]

The paper analyses children's experiences of (in)security in cases of post-separation stalking and asks how children can be safeguarded under such circumstances. Children are at particular risk when the family is stalked by the biological father or stepfather. This qualitative study draws on data collected from 13 children using three different methods: therapeutically-oriented group sessions, interviews with the children and a series of ten mother and child therapy sessions. Supplementing these data are insights gained from interviews with 18 women/mothers, the main targets of the stalking. The analysis of the narratives distinguishes three overlapping forms of security - eroded, lost and reconstructed - in which the degree of trust and extent of knowledge are the main elements. Children feel insecurity to different degrees and experiences of (in)security may vary even from child to child in the same family. The findings highlight the crucial importance of considering a child's relationship to his or her mother, siblings and trusted adults when intervening in stalking. Loved ones, day care and school staff, and social welfare workers have a significant role to play in reconstructing and strengthening children's security. The study suggests that this can be done through 'safety talk' with a mother and her children. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages In cases of post-separation stalking of the family, children's security can appear in three forms: eroded, lost and reconstructed., Feelings of insecurity vary and can appear to differing degrees within the same family., It is important in safeguarding children to lighten the burden that they take upon themselves of reconstructing security for themselves and their loved ones., Practitioners can play a significant role by providing space for and facilitating 'safety talk' between children and their mothers. [ABSTRACT FROM AUTHOR]

The management of consumer-related risk is paramount in a secure forensic mental health facility. However, the consequent risk aversion presents a major barrier to consumers forming sexual relationships in a manner that is open and accepted. Investigation of the views of nurses working in forensic mental health settings on this topic is limited, and even more so for consumers of services. This qualitative exploratory study was undertaken to elicit the views of consumers and nurses about forming sexual relationships within this long-term and secure setting. Individual in-depth interviews were conducted with 12 nurses and 10 consumers. The benefits of, and barriers to, sexual relationships was identified as a major theme, and these findings are the focus of this paper. Nurse responses included the subthemes 'supportive factors' and 'potential dangers', reflecting their qualified support. Consumer responses included the subthemes 'therapeutic', 'feeling normal', 'restrictions and barriers', and 'lack of support and secrecy'. The importance of sexual relationships was clearly articulated, as was the difficulties in forming and maintaining them within the forensic setting. More open discussion about this commonly-avoided issue and the education of nurses and other health professionals is required. [ABSTRACT FROM AUTHOR]

Little is known about the impact of living with pulmonary hypertension. This paper reports data exploring the experience of living with pulmonary hypertension. Qualitative, semistructured, one-to-one interviews were conducted in participants' homes to understand their experiences of living with pulmonary hypertension. Thematic analysis was used to identify codes and generate themes from the interview data. The identification of initial codes was conducted independently by the first author, and checked by the second. Thirty patients recruited through the pulmonary hypertension descriptions of living with pulmonary hypertension are presented under five themes that center on the invisibility of pulmonary hypertension, and its complex treatment are presented: (i) living with a hidden illness; (ii) being on a symptomology rollercoaster; (iii) expectations from treatments; (iv) treatment burden; and (v) awareness of financial burden of treatments. Key findings included daily challenges of living with a rare condition that is largely 'hidden' and its related complex treatment regimes. People with pulmonary hypertension would benefit if more healthcare professionals, as well as family and friends, would validate their condition and provide them with appropriate support. [ABSTRACT FROM AUTHOR]

Background Exercise has traditionally been an important part of the treatment of ankylosing spondylitis (AS) in order to maintain spinal mobility. Additionally, anti-tumour necrosis factor-alpha (TNFα) medication has been proven highly effective in treating the condition. Over recent years, a few papers have shown the synergistic effect of combining anti-TNFα medication with rehabilitation. There is minimal evidence on the perceptions of AS patients on how the medication has affected their exercise behaviour. The aim of the present study was to explore the effects of anti-TNFα medication on exercise behaviour in patients with AS. Method A qualitative approach was adopted to provide a holistic understanding of participants' exercise behaviour while on anti-TNFα medication. Semi-structured interviews were undertaken and transcribed verbatim. Data were analysed using thematic network analysis. Ethical approval and informed consent were obtained. Results Twenty participants (age range 26-74, disease duration 3-36 years) who had been on the medication for over a year described how their exercise behaviour had improved since being on the medication. They highlighted their motivation and incentives to continue with an exercise programme. The participants had reinstated previous sporting activities, started new ones and regularly undertook physiotherapy exercises. Conclusion The present study provides evidence of the long-term effects of anti-TNFα medication on the exercise behaviour of AS patients. It shows that AS patients are able to sustain a regular exercise programme over a number of years, provides insight into what motivates them to exercise and reveals the incentives that have influenced their choice of activity. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Patients regularly abscond from mental health units and at times the consequences for patients and for others can be serious. The police are involved with absconding events, but are rarely considered in the mental health literature. In most jurisdictions, the police can take missing person reports for involuntary patients whose whereabouts are unknown and there are genuine concerns for their safety or welfare. Those people remain active cases for the police until located. This paper presents extracts of 25 police officers' narratives from a qualitative research project. Officers viewed absconding as a regular event, and workload burden that was exacerbated when mental health staff rarely initiated any search for the absconded patient and abdicated responsibility too quickly to the police. The officers were concerned about communication with mental health services and reported that information about the absconded patient could be inadequate or not given to police, and police often were not informed when the patient was found or discharged. Improved liaison and cooperative working that promote effective communication could strengthen police and mental health nursing collaboration and ensure better outcomes for patients. [ABSTRACT FROM AUTHOR]

Background This paper focuses on the relationships between health 'policy' as it is embodied in official documentation, and health 'practice' as reported and reflected on in the talk of policy-makers, health professionals and patients. The specific context for the study involves a comparison of policies relating to the secondary prevention of coronary heart disease (CHD) in the two jurisdictions of Ireland - involving as they do a predominantly state funded (National Health Service) system in the north and a mixed health-care economy in the south. The key question is to determine how the detail of health policy as contained in policy documents connects to and gets translated into practice and action. Methods The data sources for the study include relevant health-care policy documents ( N = 5) and progress reports ( N = 6) in the two Irish jurisdictions, and semi-structured interviews with a range of policy-makers ( N = 28), practice nurses (14), general practitioners (12) and patients (13) to explore their awareness of the documents' contents and how they saw the impact of 'policy' on primary care practice. Results The findings suggest that although strategic policy documents can be useful for highlighting and channelling attention to health issues that require concerted action, they have little impact on what either professionals or lay people do. Conclusion To influence the latter and to encourage a systematic approach to the delivery of health care it seems likely that contractual arrangements - specifying tasks to be undertaken and methods for monitoring and reporting on activity - are required. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study investigating clinical psychology programme selectors' perceptions of psychological 'woundedness' in the autobiographical narratives of applicants for clinical psychology training. Woundedness was here defined in terms of the ongoing or residual psychological impact of adverse experiences and psychic conflicts. Ten selectors were presented with a sample of applicants' written autobiographical narratives, differentiated by the conspicuous presence or absence of psychological woundedness. The selectors, who were not informed of the specific aims of the study, ranked applicant protocols and were interviewed individually about their impressions of the protocols and the criteria that they used to rank them. Most selectors were positively biased toward 'wounded' narratives and suspicious of those in which woundedness was manifestly absent. Although generally disposed to favour wounded applicants, how woundedness was presented, rather than the mere presence of it, was a discriminating feature in selectors' appraisal of wounded narratives. Selectors were concerned that unresolved woundedness may compromise applicants' professional boundaries, impair self-reflective capacity and lead to damaging countertransference enactments. The relative extent to which applicant woundedness appeared to be resolved was significant in selectors' assessment of applicants' clinical training potential. A distinction is thus proposed between obstructive and facilitative woundedness in clinical psychology applicants. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message A sample of clinical psychology programme selectors identified psychological woundedness as a significant feature in applicant autobiographies., Selectors favoured applicant autobiographies showing evidence of woundedness., The distinction between obstructive and facilitative woundedness is important in how the selector sample evaluated woundedness. [ABSTRACT FROM AUTHOR]

Accessible Summary In the UK, more people with learning disabilities have the chance to have more choice and control over their lives., One big issue for many people with learning disabilities is that they should have control over their own money., There can be quite a lot of problems for people with learning disabilities around managing money. Staff do not always know how best to help. Banks and building societies are not always helpful or accessible., Giving people more choice or control over their money does not always mean that things will be better for people with learning disabilities., People with learning difficulties need better kinds of support to have choice and control over their money., Summary In the UK, policy on adult social care places an emphasis on maximising choice and control for service users, including people with learning disabilities. The shift from the provision of organised services for groups of people to offering individual and personal budgets and pots of money for people to buy their own services has major implications for the way in which people with learning disabilities are offered the opportunity to be much more 'hands-on' with managing their own financial affairs. Some of the financial implications of personalisation are arguably quite complex, and it is not clear how well people with learning disabilities are being supported with this. This paper highlights some key and emerging issues on the topic of money and personalisation and draws on interviews with a range of staff in learning disability services and highlights their views, hopes and concerns about the best ways to support people with money matters. The response of mainstream financial institutions to the needs of people with learning disabilities and the political and economic context in which the personalisation agenda is developing are also discussed. [ABSTRACT FROM AUTHOR]

ABSTRACT The moral importance of the 'intention-foresight' distinction has long been a matter of philosophical controversy, particularly in the context of end-of-life care. Previous empirical research in Australia has suggested that general physicians and surgeons may use analgesic or sedative infusions with ambiguous intentions, their actions sometimes approximating 'slow euthanasia'. In this paper, we report findings from a qualitative study of 18 Australian palliative care medical specialists, using in-depth interviews to address the use of sedation at the end of life. The majority of subjects were agnostic or atheistic. In contrast to their colleagues in acute medical practice, these Australian palliative care specialists were almost unanimously committed to distinguishing their actions from euthanasia. This commitment appeared to arise principally from the need to maintain a clear professional role, and not obviously from an ideological opposition to euthanasia. While some respondents acknowledged that there are difficult cases that require considered reflection upon one's intention, and where there may be some 'mental gymnastics,' the nearly unanimous view was that it is important, even in these difficult cases, to cultivate an intention that focuses exclusively on the relief of symptoms. We present four narratives of 'terminal' sedation - cases where sedation was administered in significant doses just before death, and may well have hastened death. Considerable ambiguities of intention were evident in some instances, but the discussion around these clearly exceptional cases illustrates the importance of intention to palliative care specialists in maintaining their professional roles. [ABSTRACT FROM AUTHOR]

Most humans desire a good death, but the nursing literature on culture-specific responses to older life, especially on issues of death and dying among Japanese Americans, is still limited. The pattern of beliefs about a good death held by elderly Japanese Americans living in Hawaii was explored. A qualitative study using ethnography and in-depth interviewing was employed. Eighteen healthy and active elderly participants were interviewed, and data analyzed using ethnography to extract categories and themes, and four supplementary interviews with experts were held for triangulation of the data. Four themes emerged, however, in this paper, the predominate one, not being a burden to family, was discussed. The participants believed burdening someone in their culture has an extremely negative implication. Sufficient preparation for older life and death, family support, friends support, and finance were their strategies to avoid being a burden. Nurses need to understand that the concept of good death is unique to every culture. Such knowledge will help them to plan and provide appropriate end-of-life care, and will reduce the risk of living wills being ignored. [ABSTRACT FROM AUTHOR]

Most of the literature on paediatric oncology treatment has provided descriptions of children's everyday lives that are circumscribed to periods of hospitalisation. In this paper, I argue that the political and economic context where children receive oncology treatment as well as the particular trajectories of their families influence their experiences. The narratives from children receiving treatment in three public hospitals in Buenos Aires, Argentina, were collected. Their stories indicate that issues such as the interruption of school, the separation of family members, the expenses incurred during treatment, and barriers to care influence the everyday lives of children and should be included in paediatric oncology research. © 2011 The Author(s). Children & Society © 2011 National Children's Bureau and Blackwell Publishing Limited [ABSTRACT FROM AUTHOR]

The double-burden problem of malnutrition in many developing countries is occurring against a backdrop of complex changes in the socio-economic and cultural environment. One such change is the increasing rate of female employment, a change that has attracted researchers to explore the possible relationships between maternal employment and child nutritional status. The present study employs a qualitative approach to explore the socio-economic and cultural environments that may influence child-care practices in families of working and non-working mothers with children of different nutritional status and types of domestic caregiver. It was conducted in Depok, a satellite city of Jakarta, Indonesia, and was designed as a case study involving 26 middle class families. The children were categorized as underweight, normal weight and obese, and caregivers were grouped as family and domestic paid caregivers. Twenty-six mothers and 18 caregivers were interviewed. Data were analysed by the constant comparative approach. The study identified five emerging themes, consisting of reason for working and not working, support for mother and caregivers, decision maker on child food, maternal self-confidence and access to resources. It confirmed that mothers and caregivers need support and adequate resources to perform child-care practices regardless of the child nutritional and maternal working status. Further research is required into how Indonesian mothers across a range of socio-economic strata can have increased options for quality child-care arrangements and support with child feeding. Additionally, this paper discussed the importance of enhanced dissemination of health information addressing both child underweight and obesity problems. [ABSTRACT FROM AUTHOR]

Aim: To explore therapeutic activities and psychological interventions used by experienced cognitive behavioural and psychodynamic therapists to treat clients with medically unexplained symptoms (MUS). Method: Twelve in‐depth, semi‐structured, qualitative interviews with psychotherapists, recruited from two British National Health Service (NHS) Departments were conducted. Interview transcripts were analysed using grounded theory. Findings: Therapists from two modalities share the following therapeutic activities and psychological interventions in their work with MUS clients: working together with clients, sensitive, empathic responding and building trust, being flexible with techniques, keeping an open mind and multi‐disciplinary cooperation. They also use modality specific interventions discussed in this paper. Even though participants experienced difficulties in forming alliances with MUS clients early on in their work, they expressed the importance of nurturing hope, empowering and engaging clients in jointly constructing understandings, which helps symptom management. [ABSTRACT FROM AUTHOR]

Research which involves disabled children and young people now constitutes a fairly well-established body of work in the social sciences. However, discussion on the role of the (normally adult) researcher has arguably been marginalised in the much-needed exploration of disabled children's 'voices'. Drawing on a qualitative study of the transition to adulthood for young men with Duchenne muscular dystrophy, this paper reflects on the interview 'encounter' between the interviewer, young men and their families. It suggests that we may learn more about the experiences of disabled children and young people if we can find ways of describing the co-production of responses, non-responses and meaning within research interviews. [ABSTRACT FROM AUTHOR]

ABSTRACT Children of parents with mental illness have been identified as a hidden population within mental health services, despite many clients being parents. In Australia, children of parents with a mental illness have been the focus of initiatives aimed at promoting their health and well-being and developing family-focused services. However, there has been little focus on children visiting acute inpatient mental health facilities. The aim of this study was to understand the experiences of children, their parents and carers, and staff when children visit, to better inform service planning. A qualitative exploratory research framework was used, and data were gathered through interviews. This paper presents the findings from the perspective of staff. Findings indicated that staff experienced being in a dilemma about children visiting and there were barriers to implementing family-friendly services. While staff mostly agreed in principle that children's visiting was beneficial, there was a lack of local policy and guidelines, and ad hoc arrangements existed. In addition, staff were unsure of their role with children, felt ill-equipped to talk to children about mental illness; and lacked knowledge of age-appropriate resources. Models of inpatient care need to be developed with a family focus that acknowledges the parental roles of clients and supports children visiting. [ABSTRACT FROM AUTHOR]

Medical Education 2011: 45: 995-1005 Context A particularly onerous aspect of the transition from medical student to practising doctor concerns the necessity to be able to rapidly identify acutely unwell patients and initiate appropriate resuscitation. These are skills in which many graduates feel poorly prepared and are considered by some to be best learned on the job. This constructivist study investigated the factors that influence the behaviour of junior doctors in this context and initiated the development of a framework that promotes understanding of this important area. Methods Focus groups involving 36 clinicians with a variety of clinical experience were conducted and analysed using a qualitative, grounded theory approach. The complex relationships between emergent themes guided the development of a framework that was refined and validated by further interviews with participants. Results Six main themes, grouped under three broad headings, emerged from the data: 'transferring knowledge into practice' and 'decision making and uncertainty' (cognitive challenges); 'acts and omissions' and 'identity and expectations' (roles and responsibilities), and, finally, 'the medical hierarchy' and 'performing under stress' (environmental factors). The framework presented within this paper illustrates the complex relationships between these factors. Conclusions Although the potential of metacognitive strategies to reduce medical error is acknowledged, the framework promotes looking beyond the individual to consider the contributions to patient safety of identity issues, role uncertainty and the hierarchical clinical environment. A more distributed approach to situation awareness may help junior doctors to better tolerate complexity and uncertainty. The efficacy of simulation as an educational strategy may be improved by finding ways to recreate the hierarchical and stressful environment in which junior doctors practise. Junior doctors should be aware of the impact of affect and emotion on behaviour, and clinical supervisors should strive to ensure that roles and responsibilities are explicitly discussed. [ABSTRACT FROM AUTHOR]

Quality relationships form the backbone of social work with children and their families. They are particularly relevant in the close, intimate work with looked-after children who have identified how important it is to them that their relationship with their social worker is positive, warm and meaningful. It is accepted that in order to achieve and maintain successful and meaningful relationships, practitioners need to engage at an emotional as well as a professional level. All too often this requires a trade-off between organizational efficiency and the emotional work of caring for looked-after children. Therefore, it would appear the role of corporate parent is increasingly difficult, involving complex decisions about how practitioners might best spend their time, where their loyalties lie and the quality and direction of the final output. Using data from a series of interviews with practitioners, this paper explores the difficulties of maintaining active emotional engagement with children using the sociological concept of emotional labour. [ABSTRACT FROM AUTHOR]

Accessible summary • This study is about the life stories of six older people with Down’s syndrome who spent some part of their childhoods in institutionalised settings. • They have interesting and moving stories to tell about their lives. They talked about their childhood and current lives, their likes and dislikes, their strengths and difficulties and their hopes and dreams. They also spoke about the important people in their lives. • The participants did not talk about themselves as being ‘old’, ‘disabled’ or as having ‘Down’s syndrome’. They talked about themselves in other ways, such as being ‘normal’, being a ‘man’ or a ‘beautiful lady’. • The researcher learnt about herself whilst doing this study. She learned about the value of taking time to listen to people and she reflected on her own life story. This paper is a narrative analysis of the accounts of six older people with Down’s syndrome who spent part of their childhood in institutional environments. The study aimed to find out how the participants talked about themselves. Different types of narrative analysis were used, including those of Murray ( Qualitative psychology: a practical guide to research methods, London, UK, Sage, 2003), Gergen & Gergen ( Hist Social Psychol, Hillsdale, NJ, Erlbaum, 1984) and Labov & Waletsky ( Essays on the verbal and visual arts, Seattle, University of Washington Press, 1967). All of the participants spoke about their childhood, current and future lives. Most participants were able to reflect upon their strengths, limitations and hopes. The analysis highlighted the commonalities across the accounts: loss, abuse, health, significant others, transition, resilience and identity. Significantly, none of the participants identified themselves as having ‘Down’s syndrome’ or a ‘learning disability,’ nor did they identify with being ‘older’. Instead, individuals identified themselves in relation to gender and social roles. The accounts varied in terms of their form, structure, coherence and reflexive capacity. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]