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Introduction: Most people when asked say they would prefer to die at home. However, ‘Death in Usual Place of Residence’ (DiUPR) does not give any real insight into the quality and experiences of care received. Additionally, DiUPR involves other family members resident in the home environment and their needs, preferences and experiences also need consideration.\ud \ud Aim(s) and Method(s): The aim of this work was to explore the experiences of patients and informal caregivers receiving at-home care from a specialist palliative care service. We undertook individual interviews with 11 patients and 10 significant others. We used the Pictor technique, a novel interview tool used to sensitively explore networks of support and experiences of palliative care. Interviews were analysed thematically.\ud \ud Results: Caring for a loved one at home was acknowledged as draining, but participants were effusive about the excellent at-home professional support they received from the specialist service. The care provided evidently recognised the needs of both patients and their families. Effective co-ordination of care, including liaison with other services was especially appreciated.\ud \ud Conclusion(s): With increasing trends towards DiUPR, it is vital that there are sufficient well-resourced palliative care services available in the community to support both patients and their families at the end of life. Pictor is a useful means to obtain detailed insight into individual experiences of end of life care. Care co-ordination emerged as key concern for patients receiving End of Life Care and their families.

In this article, we introduce the reader to Template Analysis, a method of thematically organising and analysing qualitative data in social science research. We outline the basic principles of the method and describe the main procedural steps involved in undertaking Template Analysis. We then use an example from our own research (the qualitative evaluation of an end of life care service in the United Kingdom) to demonstrate how Template Analysis can be successfully applied in a real world research setting.

Purpose:\ud To explore with community groups, using an asset-based approach, what local individual and community assets exist in a deprived English Local Authority area;\ud \ud To reflect with participants on how these assets might be utilised to improve health and wellbeing; \ud \ud To consider how such assets might be used to promote public health (PH) as part of changes to PH provision in the context of austerity measures and local authority budget cuts.\ud \ud Background:\ud Effective community engagement is essential if local government is to achieve public health goals (NICE, 2014). However, despite widespread acceptance of the need to enable individuals and communities to take more control over their health and lives, ‘the invaluable contributions and experiences of citizens actively involved in their own communities are rarely considered as part of the evidence base’ (Public Health England, 2015).\ud \ud There has been a recent shift in UK PH policy towards an ‘asset approach’, balancing the evidence base on health deficits (identifying problems and needs) with an equal focus on health assets (resources for creating health and wellbeing). An asset approach seeks to identify and mobilise the capacity, skills, knowledge, connections and potential in individuals, communities and organisations to create positive health and cultivate resilience.\ud \ud Methods:\ud The study used principles of action research, seeking to engage with diverse groups in the locality (professionals and community members) in a process of reflective inquiry. An initial inquiry using ‘knowledge café’ workshops with statutory and voluntary services informed the research focus. Activities included reflective group discussion, photo elicitation and interactive question and answer sessions. Focus groups were held with members of 12 diverse community initiatives, focusing on how the activities and processes involved in community group participation facilitated the health and wellbeing of community members. Data were analysed using Template Analysis.\ud \ud Conclusions:\ud Findings are organised in relation to three main areas: (i) Assets at a community level; (ii) Assets at an individual level; (iii) Making the most of assets: collaborative working between communities and others. Findings provide important insights to inform possibilities for how communities can play a more active role in responding to PH issues.\ud \ud As autonomous and independent entities, community groups described themselves as better able than public sector services to devote the time needed to really understand and respond to their community members. Professionals are seen as offering advice; peers are seen as offering choices. Traditionally ‘hard to reach’ groups may respond better to peer rather than professional assistance. Participants identified numerous mental and physical health benefits from taking part in community groups. Professionals can play an important role supporting community members to develop their own health and wellbeing initiatives. Holistic community based solutions to public health improvement may require the development of an alternative set of indicators to monitor and evaluate change focusing for example on resilience, levels of individual community involvement and peer support rather than more conventional indicators such as decrease in smoking or healthy eating. There is an important role for qualitative research in the development and evaluation of such initiatives.

This paper reports findings from a one-year research project funded by the Higher Education Academy (HEA) Psychology Network. The research aimed to explore the use of ‘reality television’ in teaching research ethics to Psychology undergraduates and in this paper we report on those findings that have particular relevance for qualitative research methods. Experience of teaching research ethics suggests that students can find the process of thinking through ethical issues in qualitative work quite challenging. Ethical issues in qualitative research can be subtly different from, or more complex than, those raised by quantitative studies, and yet most text books that deal with research ethics tend to focus on the latter. We will present findings from our research project which suggest that using familiar material such as TV programmes, and in particular ‘reality TV’, can be effective in helping students address ethical issues in qualitative research. Fifteen second year psychology undergraduates were shown an extract from an episode of Big Brother (Channel 4). They were then asked to discuss in small groups the ethical issues they felt it raised, and these discussions were audio recorded. Subsequently, they were asked to apply their thinking to a research brief by discussing the ethical issues it raised, suggesting ideas for design and then writing a research proposal. In this paper we report findings from the first stage of the project. We present evidence from the discussion groups indicating that the TV material had promoted an in-depth consideration of some ethical issues that can be challenging for students to address in relation to qualitative work, notably informed consent, confidentiality and risk of harm.

Type 1 Diabetes (T1D) is amongst the most common form of chronic illness affecting young people in the UK. Self- management is crucial, but managing their T1D is often difficult for young \ud people.

Background\ud Illness perceptions have been acknowledged as important influences in the course of, and recovery from, back pain. However, an in-depth exploration of the influence of illness perceptions, particularly those of ‘significant others’, on back pain incapacity has yet to be carried out.\ud Objectives\ud The aims of this pilot study are: (1) to design and validate a semi-structured interview for incapacity benefit claimants and their ‘significant others’ to explore their illness perceptions in relation to the claimant’s back condition and work function; (2) to compare the beliefs of claimants and their significant others with a view to designing a large-scale mixed-methods research project exploring the impact of significant others’ beliefs on claimants’ own beliefs about their disability and work function.\ud Method\ud Interviews will be carried out with a convenience sample of claimants (and their ‘significant others’) who are enrolled in the Lancashire Condition Management Programme. Data will be analysed using qualitative techniques, and themes will be extracted and explored in relation to disability and work function, and compared between claimants and their ‘significant others’.\ud Outcomes\ud The influence of ‘significant others’ on back pain disability is largely unexplored. This pilot study aims to provide a method which will enable further understanding of these influences, with the aim of informing future research and return-to-work programs.\ud Lay summary\ud Most people who are in receipt of incapacity benefit are now expected to take appropriate steps to prepare for work. However, there is little understanding of the individual and social influences involved in the everyday life experiences of those with disabling back pain which may act as obstacles to recovery, and\ud ultimately, a return-to-work. We are proposing to design and validate a method which will allow a more indepth examination of the illness perceptions of both individuals who are disabled due to back pain, and those of their ‘significant others’ (spouses/close family members). The findings from this study will provide a useful insight into the beliefs, perceptions and social circumstances that influence chronic back pain, and could meaningfully inform future treatment plans and intervention programmes aimed at restoring work function.

Work integrated learning (WIL) provides a plausible mechanism to develop the skills knowledge, competence, and experience (Bates, 2008; Boud & Falichikov, 2006; Collin & Tynjala, 2003; Crebert et al., 2004; Rhodes & Shiel, 2007), which increase employability and lead to more satisfying careers (Bates, 2008) in a competitive labour market (CBI/UUK, 2009). The occupational and academic impact of work integrated learning including better careers, salaries and degree outcomes are beginning to be established (Powell et al., 2008). In addition a range of personal skills and professional competencies have been cited as outcomes of work integrated learning, such as improved decision making, interpersonal and self management skills (Costley, 2007; Crebert et al., 2004), the application of theoretical knowledge in workplace environments, professional networking, professional behaviour, and leadership (Costley, 2007; Dreuth & Deuth-Fewell, 2002; Lizzio & Wilson, 2004; Rickard, 2002). \ud \ud However, the psychological outcomes of work integrated learning are not yet fully established or understood and have been contested by some (Allen & van der Velden, 2007). The impact of work integrated learning on traits such as hope, self efficacy and self concept have yet to be researched. \ud \ud Aims and Objectives\ud In this emerging area of research interest, the aim of this study is an examination of the relationship between work integrated learning and the psychological variables believed to play an important role for graduate success in the subsequent transition to the labour market.\ud \ud The objectives of this project are to determine if there are significant psychological outcome differences in self-concept, self-efficacy, hope, procrastination, and study skills/work ethic between students who pursue WIL and students who pursue a more traditional degree programme. \ud \ud Methodology\ud \ud Using a cross sectional analysis of a large sample of undergraduate students at the University of Huddersfield. Undergraduates in all years of study, pursuing both traditional and WIL degrees, from all schools, will be invited to participate in the study. Demographic information including information regarding educational attainment, work related activity and subject area will be collected. In addition the following measures will be used: \ud \ud • Trait Hope Scale (THS: Snyder et al., 1991), which measures hopes and goals.\ud • Procrastination Assessment Scale – Students (PASS: Solomon & Rothblum, 1984), which measures procrastination, the postponement of goals and tasks.\ud • Self-Description Questionnaire III (SDQ-III: Marsh & O’Neill, 1984), which measures self-concept.\ud • College Academic Self-Efficacy Scale (CASES: Owen & Froman, 1988), which measures the degree of confidence participants believe they have in various academic settings.\ud • Motivated Strategies for Learning Questionnaire (MSLQ: Pintrich, Smith, Garcia, & McKeachie, 1993), which measures study skills and motivation.\ud \ud Although the results unique to Huddersfield students will be presented in this session, the project itself is part of a much larger international comparative research study, designed and led by Drysdale et al. at the University of Waterloo (Canada) examining psychological outcomes on a global level. Other partners include University West (Sweden), University of Central Florida (USA), and Liverpool John Moores University (UK). Logistics of being involved in a large international project will be discussed.\ud \ud Conclusions\ud As this study is a work-in-progress, results and conclusions will be available and submitted as part of the full paper in August.

Background\ud The costs of reduced work capacity due to persistent back pain (PBP) greatly outweigh direct medical costs. It is acknowledged that psychosocial factors influence work outcomes in PBP, but influences in the home environment remain largely unexplored. The aims of this pilot study were to explore in-depth beliefs held about PBP by both patients and their significant others, and to identify potential associations between these beliefs and differences in patients' work participation outcomes.\ud \ud Methods\ud The Illness Perception Questionnaire (IPQ-R; Moss-Morris et al., 2002) was used as a guide to construct interviews carried out with 10 patients with comparable PBP and their significant others. Five patients were still in employment, five had ceased work due to their PBP. Data were analysed using Template Analysis (e.g. King, 2012).\ud \ud Findings\ud There were clear differences between groups in terms of beliefs about causality, recurrence and condition management. Issues around social acceptance of ill health and beliefs about appropriate roles and responsibility in terms of condition management emerged as key themes. \ud \ud Discussion\ud Findings illustrate the complexity of long-term chronic health conditions such as PBP and provide an insight into some of the wider social influences that may impact on functional outcomes. Significant others share, and may reinforce, some important beliefs held by PBP patients about their condition. Identifying potentially unhelpful cognitions and behavioural responses could help in the design of family intervention programmes aimed at improving work participation outcomes in PBP.

Many social scientists are in agreement that, at least in contemporary industrialised societies, the construction and expression of personal identity is becoming more dependent upon material goods and possessions. In regard to clothing, we are accustomed to the idea that the things we wear express the kind of person we are, or would like to be seen as, and the notion that many women are fascinated by shoes has entered popular consciousness

Given the success and popularity of reality TV, particularly with young audiences, we felt there was an opportunity to use this material in teaching. There is a growing literature demonstrating that material from popular TV can be an effective component of undergraduate teaching, including psychology. The idea was to show students a brief extract from a reality TV programme, to ask them to discuss the ethical issues they think it raises, and then to give them opportunities to apply their thinking to psychological research. The students evaluated these sessions very positively. The students commented that they found this a very engaging way of learning about research ethics, and we have since used this material in teaching research ethics to our psychology undergraduates as part of their Research Methods course. The findings from both our qualitative and quantitative analyses give support to the view that students can indeed benefit from using TV material. We intend to continue using this material in our teaching and to monitor its success.

Collaborative working between different professionals is a crucial part of contemporary health and social care and essential to the provision of good quality care for patients and their families. However, given the complexities of many cases, researching the experiences of those involved – be they professionals, patients or carers – can be challenging. In our experience, whilst health and social care staff are generally very aware of the rhetoric around the importance of good collaboration, when asked about their own involvement in and understanding of collaborative working, they can sometimes present an “official” explanation or ideal version, rather than an account of their own direct lived experience of the phenomenon (Ross et al., 2005). Often, for experienced professionals, the way they work with others (professional or lay) has become so habitual and taken for granted that it is quite difficult to reflect on in any depth whenquestioned by an interviewer. \ud \ud The Pictor technique developed in direct response to these challenges. Pictor is a simple yet effective technique which is able to successfully address some of the significant methodological challenges presented in the exploration of collaborative working in health care settings. The Pictor technique has its intellectual origins in phenomenological readings of personal construct theory by more recent scholars such as Butt (2003). PCT suggests that as human beings we are essentially meaning-makers, formulating our own personal hypotheses or “constructs” to explain our world. This meaning making process (referred to in PCT as ‘construing’) \ud Involves the whole person, and happens not “inside” the person but through his or her actions and interactions in and with the world.\ud \ud Put briefly, the Pictor technique requires the research interviewee to choose a case of collaborative working in which they are, or have been, involved. They are provided with a set of arrow-shaped ‘Post It’ notes and asked to lay them out on a large sheet of paper in a manner that helps them tell the story of their case, with the arrows representing people and/or agencies involved in the case. The interviewer uses the “chart” so produced to probe the participant on their experiences.\ud \ud We used Pictor in a large scale qualitative research project exploring how different professionals collaborate in the care of patients with cancer and other long term conditions. We conducted 78 Pictor interviews with a wide variety of stakeholders including different nursing professionals, a wide range of professionals with whom they interact, patients themselves and their close others. There were important differences in the ways in which different professional groups represented cases using Pictor, which can be understood in terms of role perceptions, aspects of service organisation and also wider societal perceptions of different types of illness. We discuss how the use of Pictor facilitated description of and reflection on complex cases across our different participant types.

Background\ud \ud \ud Although there is now a focus on the positive, health-enhancing aspects of work and activity (Waddell & Burton, 2006), it is also acknowledged that there are a wide range of psychosocial factors that act as obstacles to recovery and work participation which require a more in-depth understanding (Nicholas, 2010). People with persisting low back pain (and other illnesses) who are receiving benefits because they cannot work are now being encouraged and helped to return to employment, in line with the UK government's welfare reform agenda. Individual and social influences involved in the everyday life experiences of beneficiaries with persisting low back pain which may act as obstacles to recovery and work participation. However, there is little understanding of these influences. In this exploratory study, we used qualitative methods to facilitate an in-depth examination of the illness beliefs of those close to back pain patients (their ‘significant others’), considering how these might influence both patients’ own beliefs about their condition and work participation.\ud \ud Methods\ud \ud \ud In-depth interviews were conducted with nine patients reporting non-specific low back pain of more than three months duration and their significant others (closest adult family member) (n = 18). The self-regulatory model (SRM) (Leventhal et al., 1984) was used as a guide to organise the interview schedule and interview transcripts were analysed using template analysis (e.g. King, 2004). Analysis focused on the significant other interview data and we sought to identify themes which demonstrated clear contrasts between dyads in which the patient had or had not remained in employment.\ud \ud Findings\ud \ud \ud Three overarching themes are presented and discussed: (1) the extent of impact on patient activity (including employment); (2) treatment expectations; (3) patient identity. Overall, the significant others of patients who were out of work due to their back problem tended to emphasise the extreme consequences of the patient’s back pain on every aspect of their lives. They described the back pain as preventing the patient from doing things, even though closer analysis of the detail suggested that in fact the patient was able to undertake everyday activities, albeit at a lower functioning level than prior to symptom onset. Significant others of patients who remained in employment focused instead on what the patient could still do. In terms of treatment expectations, significant others of out of work patients appeared to believe that their relatives needed to be pain-free in order to resume participation in normal life, and equated only complete removal of pain with treatment success. In contrast, significant others in the employed sample tended to talk in terms of ‘management’ rather than ‘cure’, and were more accepting of the possibility that options available to manage pain were unlikely to provide complete relief of the patient’s pain symptoms. These attitudes were further reflected in participants’ beliefs about patient identity: significant others of employed patients described their relative in heroic terms; significant others of out of work patients described the patient as disabled and a blameless victim. \ud \ud Discussion\ud \ud \ud Previous studies have shown that the impact of musculoskeletal pain and disability is greatest among socially disadvantaged populations, and among those with low education levels, and that low income and low educational attainment are the socioeconomic variables most consistently found to be associated with higher prevalence and severity of musculoskeletal problems (Carr & Klaber Moffett, 2005). The present study also suggests that socio-economic status has an important role to play in work participation outcomes. In this study, those who had remained in employment had higher status jobs and were more able to negotiate necessary flexibility and role adaptations to enable them to continue in work despite their pain. The role of good existing relationships, particularly with line managers in this context, was apparent.\ud \ud In terms of treatment expectations, significant others in the employed sample were more accepting when medical professionals were perceived as unable to provide answers in terms of a full explanation of the problem, or to provide a curative treatment. In contrast, significant others of those patients who were out of work were dissatisfied with treatment and sceptical of healthcare providers because patients were still experiencing pain, ultimately equating their relative’s recovery with being ‘cured’. Expectations about treatment have been proposed to be one of the major influences on outcome for patients with chronic low back pain, and the results from this study suggest that the treatment expectations held by significant others could further reinforce patient expectations, acting as wider psychosocial obstacles to recovery. \ud \ud There was a notable difference in the way that the two samples described how the patient’s back problem had impacted on both the patient’s identity and on their activities. The significant others of working patients tended to emphasise what the patient could do despite their back pain and attributed this to the patient’s admirable personal characteristics, describing them as heroic and stoical. In contrast, the significant others of non-working patients emphasised the extent to which the back pain prevented the patient doing things and descriptions of patient identity focused on them as a victim, anticipating and rebuffing potential accusations of personal responsibility and blame. \ud \ud Undertaken as it was in the context of changes to the welfare system in the United Kingdom, this work has potential implications for understanding how patients and their families may respond to the changes, and how that may impact on work participation outcomes. Our findings suggest that, if left to their own devices, there may be a danger that patients who feel that there are insurmountable obstacles to a return to their previous employment and who believe themselves to face socio-cultural scepticism about their condition, along with widespread ill-feeling towards the unemployed, may become entrenched in a position whereby it becomes all the more important to be seen as completely disabled, thus limiting their activity and their chances of any return to work. We discuss current reports and policy initiatives which recommend a focus on what patients can do, rather than what they cannot and note that our results support these initiatives. In addition, our findings, although preliminary and exploratory, emphasise the importance of taking social and environmental factors into account and we suggest that significant others may have an important role to play in this context.

I’m going to present findings from a study using grids gathered in workshop at International PCP Congress, Venice 2009 and at a further workshop in UK, which built on an earlier pilot study. We presented the findings from this pilot study at the International PCP Congress in Venice, 2009. It was based on the idea that the construction and expression of personal identity is becoming more dependent upon material goods and possessions and we are accustomed to the idea that the things we wear express the kind of person we are, or would like to be seen as, and the notion that many women are fascinated by shoes has entered popular consciousness. The idea of exploring women’s identities through footwear emerged and we felt that shoes could be a route into identity that women would find meaningful, interesting and enjoyable. We were surrounded by women offering to be our participants! The pilot study involved four women between the ages of approx 30 and 45, two of whom were passionate about shoes and two for whom shoes were more of a practical necessity. We used pictures of various shoes as elements in a role construct repertory test, using triads and dyads to elicit constructs and interviewing the women further about the constructs that emerged. We found that, regardless of the women’s level of interest in shoes, the method was very successful in quickly leading to important identity dimensions of meaning for the women. So what I’m reporting today is a follow-up study. We wanted to get an idea of whether the kinds of issues that had been raised in our pilot sample were shared by other women, and to try out the grid as a way of getting further information about the relationships between constructs that we might potentially analyse.

Purpose: To use participatory research strategies to facilitate multiple stakeholder involvement in a community-wide public health workshop;\ud - To use workshop outcomes to inform the design and execution of a subsequent public health research project in a deprived English Local Authority area.\ud \ud Background: There is widespread acceptance of the need for effective local community engagement to achieve public health goals. In this paper, we describe how, prior to undertaking a commissioned public health project, we drew on principles of Appreciative Inquiry (a participative approach that values those involved as experts in their own lives and therefore as key actors in health improvement solutions) to work with both a wide variety of professionals and community members to inform our research approach and design.\ud \ud Methods: A half day community wide workshop event was held to explore national and local challenges in responding to different public health needs from the perspective of both key professional stakeholders and local community groups. The event was run as a knowledge café and utilised principles of action inquiry. Activities undertaken by delegates included reflective group discussion, photo-elicitation and interactive question and answer sessions. . \ud \ud Conclusions: Broad stakeholder involvement in the workshop events worked to build relationships between different groups, as well as enhancing their capacity to represent their own interests in wider arenas. Delegate feedback was overwhelmingly positive and outcomes from the workshop were used to inform the focus for qualitative inquiry in subsequent phases of the research.

The aim of this research has been the examination of the long term psychological consequences of\ud admission to the Intensive Care Unit (ICU) for critical illness. The major objectives were first,\ud psychometric assessment at specified intervals post-discharge, using the General Health\ud Questionnaire, Rosenberg Self Esteem scale, and the Impact of Event Scale, and secondly\ud identification of ICU related variables which influence psychological wellbeing and recovery.\ud \ud \ud The design was prospective and used survey methods. Seventy-two patients were recruited from the\ud ICU at St James's University Hospital in Leeds. Data were collected at six weeks, six months and\ud twelve months post-discharge. The initial analysis produced evidence of discrimination between\ud subgroups, in particular age, length of stay in ICU, admission severity, indication for admission,\ud communication, pre-existence of cancer, and the use of muscle relaxant drugs. Further analysis by\ud way of a logistic regression identified four factors which may have predictive properties - age,\ud admission severity, trauma and pre-existence of cancer. Patients from younger age groups reported\ud more post traumatic stress symptoms than older patients; patients with pre-existing cancer also\ud reported fewer post traumatic stress symptoms. Patients admitted following trauma reported poorer\ud psychological outcome. Admission severity was negatively associated with psychological\ud dysfunction, with those who were sickest on admission reporting fewer problems.\ud \ud \ud Symptoms of post traumatic stress disorder were found in a number of patients; at final follow-up\ud 27% of the surviving sample had medium levels, and 27% high levels of post traumatic stress\ud symptoms.\ud \ud \ud ICU patients form a fragile group to study and sample attrition was considerable. Nevertheless the\ud findings are of interest to this developing research area and suggestions are made regarding their\ud utilisation.