1,134 results
Search Results
2. Improving access of young adults with experience of homelessness to primary care dental services in the UK: A realist synthesis.
- Author
-
Ahmadyar M, Rai T, Daly B, and Wong G
- Subjects
- Dental Care, Humans, Primary Health Care, United Kingdom, Young Adult, Communication, Ill-Housed Persons
- Abstract
Objective: To understand why, how and under what circumstances interventions lead to improved access of young adults with experience of homelessness (YAEH) to primary care dental services in the UK., Methods: We followed a realist, theory-driven methodology. It involved locating existing theories, searching for evidence, document selection, data extraction/appraisal and evidence synthesis. We searched scientific databases and grey literature sources. We used these data and relevant substantive theories to develop explanations of how, why and under what circumstances interventions lead to desired outcomes. We presented these explanations in the form of context-mechanism-outcome configurations (CMOCs). The CMOCs were incorporated in an overarching programme theory, which was iteratively developed and refined throughout the realist synthesis., Results: We used 106 scientific and 18 grey literature records to synthesize 61 CMOCs. Our revised programme theory highlights the importance of four main considerations: 'preparing a service', 'producing and disseminating information', 'outreach activities' and 'facilitating interactions'. When designing dental programmes for YAEH, we recommend considering the importance of prior service planning (including resourcing of emergency dental care, training staff and incorporating safety measures), creating positive experiences, flexibility, patient-centeredness, being informative and reassuring, creating an enabling environment (including strong communication, building rapport and avoiding negative judgements), having realistic expectations and designing services that empower patients., Conclusions: Improving dental access of YAEH requires attention to multiple levels. Services can achieve positive outcomes by understanding the complexity of YAEH lives, and creating contextual circumstances that encourage their attendance., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
3. Improving quality of referral letters from primary to secondary care: a literature review and discussion paper.
- Author
-
Tobin-Schnittger, Patrick, O’Doherty, Jane, O’Connor, Ray, and O’Regan, Andrew
- Subjects
- *
FAMILY medicine , *MEDICAL information storage & retrieval systems , *PSYCHOLOGY information storage & retrieval systems , *MEDICAL referrals , *MEDLINE , *ONLINE information services , *PRIMARY health care - Abstract
Background: Referral letters sent from primary to secondary or tertiary care are a crucial element in the continuity of patient information transfer. Internationally, the need for improvement in this area has been recognised. This aim of this study is to review the current literature pertaining to interventions that are designed to improve referral letter quality. Methods: A search strategy designed following a Problem, Intervention, Comparator, Outcome model was used to explore the PubMed and EMBASE databases for relevant literature. Inclusion and exclusion criteria were established and bibliographies were screened for relevant resources. Results: A total of 18 publications were included in this study. Four types of interventions were described: electronic referrals were shown to have several advantages over paper referrals but were also found to impose new barriers; peer feedback increases letter quality and can decrease ‘inappropriate referrals’ by up to 50%; templates increase documentation and awareness of risk factors; mixed interventions combining different intervention types provide tangible improvements in content and appropriateness. Conclusion: Several methodological considerations were identified in the studies reviewed but our analysis demonstrates that a combination of interventions, introduced as part of a joint package and involving peer feedback can improve. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
4. Genetics professionals' experiences of facilitating parent/child communication through the genetic clinic.
- Author
-
Keenan KF, McKee L, and Miedzybrodzka Z
- Subjects
- Adaptation, Psychological, Adolescent, Adult, Child, Child, Preschool, Female, Health Personnel, Humans, Male, United Kingdom, Communication, Genetic Counseling, Genetic Predisposition to Disease, Parent-Child Relations, Professional-Family Relations
- Abstract
While guidelines advise genetic health professionals to support and encourage family communication about genetic risk, there can be professional uncertainty when advising parents about communication with children. We sought to explore genetic health professionals' views and experiences of facilitating parent/child communication in clinical practice, particularly in relation to adult-onset inherited conditions. Twenty-three in-depth interviews were conducted with United Kingdom genetic health professionals. Thematic analysis identified four main themes: offer professional involvement, encourage early disclosure, take a limited role, and challenges. Overall, our findings demonstrate a wide variation in genetic health professionals approaches to the provision of disclosure advice to parents, ranging from professionals who offered their communication skills and expertise, to those who took a limited role and reflected they were struggling, or even felt stuck. Giving tailored advice to parents about the timing of disclosure i.e. when to tell children, was a particular challenge because of the variability in children's maturity and coping styles. Nevertheless, we identified a range of strategies which were drawn upon by participants to facilitate parent/child communication in the genetic clinic. In conclusion, study results indicate that this remains a challenging and sensitive area, in which genetics professionals express a need for more resources and the clinical time to undertake this work. Further research is needed to develop and evaluate interventions which assist parent/child communication about serious inherited conditions and to help develop professionals' confidence and skills in this area., (© 2019 National Society of Genetic Counselors.)
- Published
- 2020
- Full Text
- View/download PDF
5. Clinical dental technicians in the United Kingdom: A qualitative understanding of the experiences, of practices and challenges of communication for dental professionals.
- Author
-
Curtis S, Gurveer J, and Gallagher JE
- Subjects
- Delivery of Health Care, Humans, Qualitative Research, United Kingdom, Communication, Dental Technicians
- Abstract
Aim: To investigate the roles and relationships of registered Clinical Dental Technicians (CDTs) in the dental team and healthcare systems, and their perspective as a professional group in the United Kingdom (UK)., Methods: This qualitative study was conducted following a national questionnaire survey of CDTs, 18 of whom participated in semi-structured interviews; they were purposively sampled to represent the diversity and demography of CDTs. A topic guide, informed by the literature and survey findings, guided discussions which were recorded and transcribed verbatim. Drawing upon phenomenological and cultural relativistic theories, thematic analysis was conducted, thus enabling an "analytic story" of the lived experience to emerge., Results: Clinical dental technicians expressed pride, passion and satisfaction in their work yet feel misunderstood in their role. Experiences of being accepted and incorporated into the wider dental profession are strained. Ultimately, there is a complex web of inter-dependence between all actors-a triadic relationship-bounded by policymakers and regulators which directly impacts on best practice and the balance between collaboration and autonomy. Looking to the future, Ideal practice may involve different models of care, with examples of good practice emerging., Conclusion: This paper provides a unique examination of the lived experience, feelings and relationships of CDTs. The perceptions of their role, their inter-professional relations and the progression as a professional group must be addressed, and their potential to work collaboratively actively engaged to serve our ageing population., (© 2019 Gerodontology Association and John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF
6. The Interface Between South Asian Culture and Palliative Care for Children, Young People, and Families-a Discussion Paper.
- Author
-
Brown, Erica, Patel, Reena, Kaur, Jasveer, and Coad, Jane
- Subjects
- *
PALLIATIVE treatment , *MEDICAL care standards , *ASIANS , *BLACK people , *CINAHL database , *COMMUNICATION , *CULTURE , *HEALTH , *HEALTH services accessibility , *HEALTH status indicators , *HINDUISM , *ISLAM , *RELIGION & medicine , *MEDLINE , *MINORITIES , *PEDIATRICS , *INFORMATION resources , *SYSTEMATIC reviews , *CULTURAL competence , *PSYCHOLOGY - Abstract
A fundamental element of quality healthcare is that provision is accessible to all users and culturally sensitive to them. However, there is evidence to suggest that there is inequity of provision across all cultures. Furthermore, there is a paucity of published research in the United Kingdom concerning palliative care for minority ethnic families with a life-threatened or life-limited child or young person. The article sets out to discuss the findings of a literature review and, drawing on current work by the Centre for Children and Families Applied Research at Coventry University under the leadership of Professor Jane Coad, to explore the interface between South Asian cultures and the experience of palliative care services of children, young peoples, and families. All families require a broad range of services which are appropriately delivered and accessible throughout the trajectory of their child's illness. The literature review findings reveal that how families understand concepts such as health and disease arise from the complex interaction between personal experience and cultural lifestyle including language, family values, and faith. There is an urgent need to involve South Asian families in research in order to provide a robust evidence-base on which to develop service provision so that care is matched to the unique needs of individuals concerned. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
7. Republished paper: Assessment of doctors' consultation skills in the paediatric setting: the Paediatric Consultation Assessment Tool.
- Author
-
R J Howells
- Subjects
- *
COMMUNICATION , *VIDEOS , *PEDIATRICS , *MEDICAL screening , *INFORMATION sharing - Abstract
OBJECTIVE: To determine the utility of a novel Paediatric Consultation Assessment Tool (PCAT). DESIGN: Developed to measure clinicians' communication behaviour with children and their parents/guardian, PCAT was designed according to consensus guidelines and refined at a number of stages. Volunteer clinicians provided videotaped real consultations. Assessors were trained to score communication skills using PCAT, a novel rating scale. SETTING: Eight UK paediatric units. PARTICIPANTS: 19 paediatricians collected video-recorded material; a second cohort of 17 clinicians rated the videos. MAIN OUTCOME MEASURES: Itemised and aggregated scores were analysed (means and 95% confidence intervals) to determine measurement characteristics and relationship to patient, consultation, clinician and assessor attributes; generalisability coefficient of aggregate score; factor analysis of items; comparison of scores between groups of patients, consultations, clinicians and assessors. RESULTS: 188 complete consultations were analysed (median per doctor = 10). 3 videos marked by any trained assessor are needed to reliably (r>0.8) assess a doctor's triadic consultation skills using PCAT, 4 to assess communication with just children or parents. Performance maps to two factors – "clinical skills" and "communication behaviour"; clinicians score more highly on the former (mean (SD) 95% CI 0.52 (0.075)). There were significant differences in scores for the same skills applied to parent and child, especially between the ages of 2 and 10 years, and for information-sharing rather than relationshipbuilding skills (2-tailed significance <0.001). CONCLUSIONS: The PCAT appears to be reliable, valid and feasible for the assessment of triadic consultation skills by direct observation. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
8. Expanding student nurse placement activity in Welsh care homes: An evaluation study.
- Author
-
Williams, Sharon, Caley, Lynne, Kingdom‐Mills, Sarah, Cassidy, Simon, and Jones, Lesley
- Subjects
HOME care services ,SCHOOL environment ,QUALITATIVE research ,INTERNSHIP programs ,INTERVIEWING ,GOVERNMENT agencies ,NURSING education ,NURSING care facilities ,THEMATIC analysis ,RESEARCH methodology ,COMMUNICATION ,PROFESSIONAL employee training ,STUDENT attitudes ,STAKEHOLDER analysis ,NURSING students ,RESIDENTIAL care - Abstract
Aim: Expanding and sustaining student nurse placements outside of the acute sector is a universal challenge. This paper aims to evaluate the Care Home Education Facilitator Role introduced in one area of Wales, United Kingdom, and to report on the outcomes achieved from this novel role. Methods: Semi‐structured interviews were undertaken with key stakeholders including the Care Home Education Facilitator postholder leading the pilot, care home managers, higher education institutions' placement managers/coordinators, student nurses and national health service staff. Results: Five key areas were identified, which included timing of introducing the post and establishing a clear rationale and understanding of the intention of the role. The benefits, challenges and suggested improvements to the Care Home Education Facilitator initiative are provided. Conclusion: Introducing the role of the Care Home Education Facilitator to work closely with key stakeholders resulted in increased placements for student nurses, but investing time in developing relationships with these stakeholders was critical to the success of the role. Summary statement: What is already known about this topic? There is a universal shortage of clinical placements for nursing students, particularly within a care home setting.The number of studies exploring how we might grow the number of nurses needed in this setting is limited. What this paper adds? This study evaluated a novel initiative introduced in South Wales, United Kingdom, that focuses on the development of nursing placements in the care home setting.Engaging with stakeholders involved in the development and implementation of the Care Home Education Facilitator initiative, a roadmap was provided to illustrate the stepped approach required to support an active care home placement including key governance arrangements. The implications of this paper: For those involved in identifying and developing student placements, this study provides valuable insight to a role that can help increase student numbers in a care setting often overlooked.It identifies viable career options for nurses at the point of registration.The role assists with widening networks for the care homes across health and social care sectors. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
9. The experiences of people with liver disease of palliative and end‐of‐life care in the United Kingdom—A systematic literature review and metasynthesis.
- Author
-
Beresford, Cathy J., Gelling, Leslie, Baron, Sue, and Thompson, Linda
- Subjects
META-synthesis ,CAUSES of death ,TERMINAL care ,PATIENT-centered care ,EXPERIENCE ,LIVER diseases ,SELF-efficacy ,COMMUNICATION ,RESEARCH funding ,LITERATURE reviews ,THEMATIC analysis ,PALLIATIVE treatment ,GREY literature ,SYMPTOMS - Abstract
Background: Liver disease is a growing health concern and a major cause of death. It causes multiple symptoms, including financial, psychological and social issues. To address these challenges, palliative care can support people alongside active treatment, and towards the end of life, but little is known about the care experiences of individuals with liver disease in the United Kingdom. This review aimed to explore the palliative and end‐of‐life care experiences of people with liver disease in the United Kingdom. Method: A systematic review was conducted using a five‐stage process and following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. Searches were across Web of Science, Scopus, EBSCO and grey literature until 10 May 2023. The review was registered through International Prospective Register of Systematic Reviews (PROSPERO). NVivo 12.5 was used to facilitate data analysis (systematic review registration: PROSPERO CRD42022382649). Results: Of 6035 papers (excluding duplicates) found from searches, five met the inclusion criteria of primary research related to adults with liver disease receiving palliative and/or end‐of‐life care in the United Kingdom, published in English. Reflexive thematic analysis of the data was conducted. The themes identified were the experiences of people with liver disease of relating to healthcare professionals, using services, receiving support, and experiences of information and communication. These were connected by an overarching concept of disempowerment versus empowerment, with the notion of person‐centred care as an important feature. Conclusion: This review has found variations in the care experiences of people with advanced liver disease towards the end of life and an overall lack of access to specialist palliative care services. Where services are designed to be person‐centred, experiences are more empowering. Further research is needed but with recognition that it is often unclear when care for people with liver disease is palliative or end‐of‐life. Patient and Public Contribution: An online public involvement workshop was held on 18 April 2023 through Voice (2023). This included four people with liver disease and four carers to discuss the review findings and to design a qualitative research study to further explore the topic. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. Involving older adults and unpaid carers in the research cycle: reflections on implementing the UK national standards for public involvement into practice.
- Author
-
Jones, Catrin Hedd, Seddon, Diane, Algar-Skaife, Katherine, Maddock, Carol, and Green, Stephanie
- Subjects
EXPERIMENTAL design ,PATIENT participation ,HUMAN research subjects ,CAREGIVERS ,RESEARCH evaluation ,PARTICIPANT-researcher relationships ,STAKEHOLDER analysis ,PATIENT selection ,PRIORITY (Philosophy) ,LEADERSHIP ,DEMENTIA patients ,DEMENTIA ,AGING ,RESEARCH funding ,COMMUNICATION ,INTERPROFESSIONAL relations ,MEDICAL research ,STANDARDS - Abstract
Purpose: This paper aims to share how the Centre for Ageing and Dementia Research co-designs research within a national programme of work to improve the lives of older adults and those affected by dementia. Through examples of this work, the authors identify the barriers and enablers to participatory approaches and lessons to inform future involvement activities. Design/methodology/approach: This study reflects on implementing the UK National Standards for Public Involvement into practice. Of international relevance, the observations span the research process from research prioritisation and design to research implementation and knowledge exchange. Findings: This study demonstrates the importance of using a relational approach, working toward a common purpose and engaging in meaningful dialogue. Only through offering choice and flexibility and actively learning from one another can co-design lead to synergistic relationships that benefit everyone. Research limitations/implications: Key implications for researchers engaged in patient and public involvement are be receptive to other people's views and acknowledge expertise of those with lived experience alongside those with academic expertise. Training, resources and time are required to effectively support involvement and meaningful relationships. A nominated contact person enables trust and mutual understanding to develop. This is an ongoing collective learning experience that should be embedded throughout the entire research process. Originality/value: This paper demonstrates how the standards are implemented with people who are often excluded from research to influence a national programme of work. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
11. The use of Intermediaries (communication specialists) at Parole Board oral hearings in England and Wales.
- Author
-
O'Mahony, Brendan M., Milne, Rebecca, and Smith, Kevin
- Subjects
LEGAL procedure ,OCCUPATIONAL roles ,CRIMINALS ,PRISONERS ,CRIME victims ,CORRECTIONAL personnel ,EXPERIENCE ,PROBATION ,COMMUNICATION ,CRIMINAL justice system ,HONESTY ,SOCIAL support - Abstract
Purpose: The purpose of this paper is to find out what role intermediaries have in facilitating communication with victims and prisoners at Parole Board (PB) oral hearings. Design/methodology/approach: A survey was designed and administered to 39 PB members to find out their perceptions of, and experiences with, the use of intermediaries. Frequency tables and verbatim quotations are used to report the results. Findings: Overall, participants had not experienced any use of intermediaries with victims or family members presenting victim personal statements at an oral hearing. Further, there had been limited use of intermediaries for prisoners attending oral hearings. Nevertheless, there was a good recognition of a range of communication needs that a prisoner might present with at a hearing. There was also general support for the use of intermediaries with some caution about possible delays to procedural fairness. Practical implications: The early identification of communication support needs for prisoners and victims attending an oral hearing is essential. The PB should raise awareness with the PB Membership about the role of intermediaries. The PB should continue to develop guidance and policy surrounding intermediaries. Prison lawyers and HM Prison and Probation Service may require specialist training in identifying communication needs in vulnerable prisoners and identifying when a communication specialist might be required for an oral hearing. Originality/value: To the best of the authors' knowledge, this is the first published paper examining the role of intermediaries at PB oral hearings. It builds on the evidence base of the use of intermediaries in other criminal justice contexts. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
12. Scoping communication training in undergraduate children's nursing programmes: A mixed method study examining delivery methods and content.
- Author
-
Kennedy M, Bray L, Saron H, and Brady LM
- Subjects
- Humans, Ireland, United Kingdom, Surveys and Questionnaires, Child, Self Report, Education, Nursing, Baccalaureate, Curriculum, Pediatric Nursing education, Communication, Students, Nursing psychology
- Abstract
Aim: The aim of this study was to scope communication curriculum reported as currently being delivered within undergraduate children's nursing programmes across the Republic of Ireland and the United Kingdom., Background: Communication between a children's nurse and a child/young person influences a child/young person's healthcare experience. Despite an identified need for a comprehensive and effective communication curriculum within undergraduate nursing, there is a notable gap of understanding of the delivery and content of communication training within children's nursing curricula., Design: A mixed method, online anonymous self-report survey design was adopted., Methods: Programme Leads of undergraduate children's nursing programmes in the Republic of Ireland and the United Kingdom were asked to report on how communication training is delivered to students on undergraduate children's nursing programmes. The Checklist for Reporting of Survey Studies (CROSS) was used for the reporting of this study., Results: Thirty-two programme leads completed the survey (51 % response rate). Findings show variability in the delivery and content of communication training across Higher Educational Institutions. Core communication modules featured across all nursing programmes, however, only two programme leads reported delivering standalone child-centred communication modules. Communication training was not always delivered by an educator with professional experience of children and young people in healthcare. Curriculum capacity had an impact on the delivery of communication training, with clinical practice being relied on to supplement child specific communication training. Programme leads highlighted the need for greater inclusion of child voice in shaping and delivering undergraduate children's nurse education., Conclusions: This study shows that while communication is covered as a core part of the undergraduate nursing curriculum across the Republic of Ireland and the United Kingdom, it generally lacks a focus on children and young people and is not always supported by educators with professional experience of children and young people in healthcare. More work needs to focus on equipping undergraduate children's nurses with the unique skills needed to communicate effectively with children and young people and incorporate learnings into nursing pedagogy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
13. Perspectives of healthcare professionals and people living with HIV in dialogue: on information sharing to improve communication at the consultation.
- Author
-
Claisse C, Kasadha B, and Durrant AC
- Subjects
- Humans, Male, Female, United Kingdom, Adult, Surveys and Questionnaires, Middle Aged, Referral and Consultation, Professional-Patient Relations, Attitude of Health Personnel, HIV Infections psychology, HIV Infections therapy, Information Dissemination methods, Health Personnel psychology, Qualitative Research, Communication
- Abstract
We report on a qualitative Group Survey study involving four healthcare professionals (HCPs) and eight people living with HIV who were recipients of care in the United Kingdom (UK). The survey aimed to bring participants' perspectives into dialogue and establish consensus about how communication between HCPs delivering HIV care and their patients could be improved in the context of the routine care consultation. Responses from both parties were anonymously collated, thematically analysed, and shared back with participants in two subsequent survey rounds to support consensus-building on matters of concern and identify thematic insights. In this paper, we report three themes for informing future designs of tools and services to support communication between patients and HCPs: Patient-clinician relationship for trusted sharing; Self-reporting psychosocial information to support Whole-person care; and Perceived barriers for online trusted sharing with HCPs. Our findings highlight key areas of concern and further investigation is needed to understand how self-reported information may be meaningfully captured, interpreted and processed by HCPs in ways that are trusted by patients who voice privacy and security concerns.
- Published
- 2024
- Full Text
- View/download PDF
14. Trust and temporality in participatory research.
- Author
-
Armstrong, Andrea, Flynn, Emma, Salt, Karen, Briggs, Jo, Clarke, Rachel, Vines, John, and MacDonald, Alistair
- Subjects
MEETINGS ,PROFESSIONAL practice ,MINORITIES ,TIME ,RESEARCH methodology ,DIGITAL technology ,SOCIAL media ,SOCIAL justice ,INTERVIEWING ,ACTION research ,RESEARCH funding ,INTERPERSONAL relations ,SOUND recordings ,COMMUNICATION ,THEMATIC analysis ,POVERTY ,TRUST ,ADULT education workshops - Abstract
This paper argues that trust cannot be taken for granted in long-term participatory research and promotes greater consideration to conceptualizing the trusting process as fluid and fragile. This awareness by researchers can reveal to them how the passing of time shapes and reshapes the nature of trusting relationships and their constant negotiation and re-negotiation. The paper draws together literature from different disciplines on the themes of trust, temporality and participatory research and outcomes from interviews and workshops undertaken for The Trust Map project to focus on two key moments that reveal the fragility of trust. These are the subtlety of disruption and trust on trial and trust at a distance. We discuss how trust was built over time through processes of interaction that were continually tested, incremental and participatory. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
15. The role of the clinical nurse specialist in stoma care: A modified Delphi consensus.
- Author
-
Burch, Jennie, Bird, Andrew, and Thorpe, Gabrielle
- Subjects
NURSES ,CONSENSUS (Social sciences) ,PROFESSIONAL autonomy ,OCCUPATIONAL roles ,MEDICAL personnel ,INTERPROFESSIONAL relations ,LEADERSHIP ,WORK environment ,PATIENT care ,NURSING education ,NURSING ,DESCRIPTIVE statistics ,CONFIDENCE ,NURSE practitioners ,VOTING ,THEMATIC analysis ,NURSING practice ,CLINICAL competence ,NURSING research ,COMMUNICATION ,ROLE models ,QUALITY of life ,OSTOMY ,DELPHI method ,EXPERTISE ,HEALTH education ,SOCIAL support ,HEALTH promotion ,WOUND care - Abstract
Introduction: The role of the clinical nurse specialist is complex but is defined differently across the world. The role of clinical nurse specialist stoma care is undefined and it is uncertain what aspects of the role are included in the general day‐to‐day working role. Aims: The aim was to gain consensus opinion to answer the research question: 'What is the role of the clinical nurse specialist in stoma care?' Design: Delphi consensus. Methods: Previous data gained from a scoping review and expert consultation was utilized to form role statements. At a UK conference the 13 statements and 173 sub‐categories were voted upon. Consensus was agreed if 75% of voters voted agree or strongly agree. Two stages of voting occurred with results from the first vote being shared in the second voting session. Results: All 13 statement and most (150/193) statement sub‐categories reached consensus, with 20 sub‐categories added during voting session one. Conclusions: The four pillars of advanced practice were met by the 13 statements with clinical and education reaching higher consensus and agreement than leadership/management and research. The results of the consensus study provide a clearer articulation of the clinical nurse specialist stoma care role, which is complex and multifaceted which has not been described previously. Implications for Practice: Consideration of role evolution is made possible, to gain a greater expertise in the scope of practice it is necessary to include prescribing, management and research which could improve service delivery and optimize patient outcomes. There was no patient or public contribution, which in hindsight would have potentially improved the process but it was considered that patients might not recognize the full role of the nurse, understanding only aspects of the role that were patient‐centred. Patient or Public Contribution: No patients or public were involved in any aspect of this paper—in hindsight this might have been useful. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
16. Including the values of UK ethnic minority communities in policies to improve physical activity and healthy eating.
- Author
-
Gafari, Olatundun, Stokes, Maria, Agyapong-Badu, Sandra, Alwan, Nisreen A., Calder, Philip C., McDonough, Suzanne, Tully, Mark A., and Barker, Mary
- Subjects
FAMILIES & psychology ,ENVIRONMENTAL health ,RISK assessment ,HEALTH services accessibility ,COMMUNITY health services ,QUALITATIVE research ,RESEARCH funding ,MENTAL health ,LABOR productivity ,HEALTH policy ,SOCIOECONOMIC factors ,INTERVIEWING ,WORK environment ,STATISTICAL sampling ,REGULATION of body weight ,PSYCHOLOGICAL adaptation ,POPULATION geography ,COVID-19 vaccines ,DESCRIPTIVE statistics ,SOCIAL attitudes ,THEMATIC analysis ,RACISM ,NON-communicable diseases ,HEALTH behavior ,FOOD habits ,RESEARCH methodology ,COMMUNICATION ,MINORITIES ,HEALTH promotion ,COMPARATIVE studies ,PHYSICAL activity ,CULTURAL pluralism ,ACCESS to information ,MEDICAL care costs ,NUTRITION ,DIET ,DISEASE risk factors - Abstract
Physical activity and healthy eating are important for physical and mental health, yet long-standing inequalities constrain the ability of ethnic minorities in the United Kingdom (UK) to adopt these behaviours. Programmes aimed to improve these behaviours have also often not been engaged with by these communities. This study therefore aimed to: (1) identify the values underlying the physical activity and healthy eating behaviours of UK ethnic minorities and (2) explore how structural, socio-economic and environmental factors interact with these values to influence their physical activity and healthy eating behaviours. The study adopted a relativist ontological and subjectivist epistemological philosophical assumption. Qualitative interviews were used to address research objectives. A total of 10 group and five individual interviews were conducted with 41 participants. All participants were from an ethnic minority background (Black, Asian or Mixed according to the UK Office for National Statistics classification), recruited purposively and aged between 18 and 86 years and were living in England and Wales. Data were analysed using inductive thematic analysis. Community engagement was embedded throughout the study. We found that culture and family, community and social life, and health are important values underlying the physical activity and healthy eating behaviours of UK ethnic minority communities. External factors, including racism and access (geographical, social and economic), interact with these values to drive health behaviours. Using an illustrative guide, we conclude the paper with policy and practice recommendations on how public health programmes on physical activity and healthy eating can be aligned with these values to ensure relevance for ethnic minority communities. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. 'There was nothing, just absolute darkness': Understanding the needs of those caring for children and young people with complex neurodisability in a diverse UK context: A qualitative exploration in the ENCOMPASS study.
- Author
-
Prest, Kirsten, Wilson, Emma, Vassiliadou, Io, Ali, Sayeeda, Lakhanpaul, Monica, Morris, Christopher, Tann, Cally, Harniess, Phillip, Lewis‐Jackson, Sasha, Kuper, Hannah, and Heys, Michelle
- Subjects
- *
FAMILIES & psychology , *HOLISTIC medicine , *HEALTH services accessibility , *COMMUNITY health services , *PATIENTS' families , *MEDICAL personnel , *HUMAN services programs , *QUALITATIVE research , *RESEARCH funding , *PEDIATRICIANS , *CHILD health services , *INTERVIEWING , *PSYCHOLOGICAL adaptation , *CEREBRAL palsy , *NEUROLOGICAL disorders , *PATIENT-centered care , *THEMATIC analysis , *RESEARCH methodology , *COMMUNICATION , *PARENTS of children with disabilities , *PSYCHOLOGY of caregivers , *NEEDS assessment , *SOCIAL support , *PSYCHOSOCIAL factors , *CHILDREN - Abstract
Background: Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme ('Ubuntu') to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data. Methods: Two rounds of semi‐structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open‐ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data‐driven inductive thematic analysis. Results: Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate. Conclusions: The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
18. A qualitative evidence synthesis of the experiences and perspectives of communicating using augmentative and alternative communication (AAC).
- Author
-
Broomfield, Katherine, Harrop, Deborah, Jones, Georgina L., Sage, Karen, and Judge, Simon
- Subjects
- *
MEDICAL care research , *QUALITATIVE research , *RESEARCH funding , *CINAHL database , *EVALUATION of medical care , *DESCRIPTIVE statistics , *DECISION making , *SYSTEMATIC reviews , *THEMATIC analysis , *MEDLINE , *FRUSTRATION , *COMMUNICATION devices for people with disabilities , *COMMUNICATION , *SOCIAL values , *HEALTH outcome assessment , *DATA analysis software , *PSYCHOLOGY information storage & retrieval systems , *ERIC (Information retrieval system) - Abstract
This paper presents a review of the existing qualitative research literature concerning people's experience of communicating using augmentative and alternative communication (AAC). The aims of conducting this review were to find out more about the values and outcomes that are important to people about the AAC they use to support their communication. This review was conducted to provide a deeper understanding of these experiences to inform the development of a patient-reported outcome measure (PROM). A qualitative evidence synthesis of existing qualitative research literature was undertaken to explore and appraise current knowledge about the experiences of people who use AAC. From 115 qualitative research reports 19 papers were identified that responded directly to the research question and aims of the review. Data were identified that could be organized within an a priori framework consisting of the constructs of values, outcomes, and context. The review has resulted in a deeper, analytical understanding of the experiences of people who require AAC. The results indicate a set of concepts that can be used to inform the development of a PROM. A PROM can be used to assist clinicians and researchers to better understand the perspectives of people who require AAC and evaluate interventions. The results also encourage professionals to reconsider the terminology and methods used when working alongside people who require AAC and to reflect on the multidimensional factors that influence people's experience of communication. Patient-reported outcome measures (PROMs) can be useful tools to support clinician-patient communication, facilitate shared decision making and establish priorities for rehabilitation. It can be difficult to engage people who have complex communication difficulties in decisions about the important outcomes to them from using augmentative and alternative communication (AAC). This qualitative evidence synthesis provides a deeper understanding of the experiences and perspectives of people who use AAC. The results will be used to inform the development of a PROM which can be used to facilitate shared decision-making, and evaluate AAC interventions from the perspective of the people who use these technologies. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
19. The use of digital devices by district nurses in their assessment of service users.
- Author
-
Williams, Francesca
- Subjects
OCCUPATIONAL roles ,NURSING ,DIGITAL technology ,MOBILE apps ,ATTITUDE (Psychology) ,CHANGE ,PATIENT-centered care ,NURSE-patient relationships ,DOCUMENTATION ,COMMUNICATION ,NURSES ,OCCUPATIONAL adaptation ,COMMUNITY health nursing ,EQUIPMENT & supplies - Abstract
District nursing services are relentless in adapting to change and continuously seek different methods to improve the care they offer to service users. One of the relatively new changes where adaptation has been necessary is the use of digital devices to record assessments and work in real time. As documented in The NHS Long Term Plan (NHS) (2019), the NHS is being required to grow into the new digital age and, subsequently, district nurses (DNs) have needed to embrace the use of a paper-lite system. Although beneficial overall, the use of technology is a threat to the person-centred nursing approach used in assessment, which is the highest fundamental value in nursing. This article will seek to conceptualise the importance of a person-centred initial assessment with a service user who has either a long-term and/or a lifelong condition whilst considering the use of digital devices, benefits, and drawbacks of their use. It will emphasise the role of the DN, encompassing the multidisciplinary services throughout, whilst also considering any recommendations for further development. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
20. UK paediatric speech and language therapists' perceptions on the use of telehealth in current and future clinical practice: An application of the APEASE criteria.
- Author
-
Charlton, Jenna, Gréaux, Mélanie, Kulkarni, Amit, Dornstauder, Melanie, and Law, James
- Subjects
- *
SPEECH therapists , *NATIONAL health services , *PROFESSIONAL practice , *INTERPROFESSIONAL relations , *COST effectiveness , *MENTAL health , *MEDICAL care , *LEADERSHIP , *DESCRIPTIVE statistics , *PEDIATRICS , *TELEMEDICINE , *SURVEYS , *THEMATIC analysis , *ATTITUDES of medical personnel , *MATHEMATICAL models , *COMMUNICATION , *TECHNOLOGY , *THEORY , *STAKEHOLDER analysis , *COVID-19 pandemic , *SPEECH therapy - Abstract
Background: Telehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists' (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective. Methods: An online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis. Results: Four hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. Conclusions: Outcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow. WHAT THIS PAPER ADDS: What is already known on this subject: The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear. What this paper adds to existing knowledge: The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists' (SLTs') perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance. What are the potential or actual clinical implications of this work?: UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
21. Encountering the hostile environment: Recently arrived Afghan migrants in London.
- Author
-
RYAN, LOUISE, LÓPEZ, MARÍA, and DALCEGGIO, ALESSIA
- Subjects
IMMIGRANTS ,EMIGRATION & immigration ,RESEARCH funding ,QUALITATIVE research ,GOVERNMENT policy ,ECOLOGY ,PSYCHOLOGY of refugees ,GOVERNMENT agencies ,GOAL (Psychology) ,EXPERIENCE ,COMMUNICATION ,PUNISHMENT ,PUBLIC administration ,COMMITMENT (Psychology) ,HOTELS ,HOUSING ,REFUGEES ,HUMANITARIANISM - Abstract
Following the dramatic evacuation from Kabul airport in August 2021, the UK government proclaimed its commitment to a 'warm welcome' for Afghans. In this paper we draw on original qualitative research to explore the emerging experiences of evacuees, and other recent arrivals, during their first year in London. Using the narratives of our Afghans participants, as well as insights from key stakeholders, we show how they navigated slow, opaque bureaucratic processes and lack of communication with official agencies. As a result of these lengthy processes, many thousands of evacuees remained in temporary hotel accommodation for protracted periods. Drawing on the concept of 'everyday bordering', we explore the extent to which Afghan resettlement policies are achieving their objectives. We consider how such policies are birthed within a punitive immigration system, which is designed to 'wear down' migrants in the UK, regardless of their reason for migration. Moreover, we argue that the ad hoc response of the Home Office and the Foreign Office has created 'false distinctions' between categories of Afghan refugees, reinforcing notions of 'deserving' versus 'underserving' migrants. This distinction allows the government to present itself as humanitarian, 'rescuing' people from Afghanistan, while simultaneously maintaining its commitment to the 'hostile immigration environment'. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
22. Comparing service user perspectives of an early intervention in psychosis service before and during COVID-19 lockdowns: a service evaluation.
- Author
-
Sakaria, Nikita, Sanderson, Christopher, Watkins, Simon, and Boynton, Victoria
- Subjects
WORK ,EARLY medical intervention ,MENTAL health services ,HEALTH attitudes ,SATISFACTION ,T-test (Statistics) ,INTERVIEWING ,QUESTIONNAIRES ,MEDICAL care ,DESCRIPTIVE statistics ,STAY-at-home orders ,THEMATIC analysis ,RESEARCH methodology ,COMMUNICATION ,PSYCHOSES ,COMPARATIVE studies ,CONFIDENCE intervals ,PATIENTS' attitudes ,COVID-19 pandemic ,EXPERIENTIAL learning ,SOCIAL participation - Abstract
Purpose: This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018). Design/methodology/approach: This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke's (2006) thematic analysis. Findings: Data showed participants were largely satisfied with all areas of the service with "work or education", "living skills", and "addictions" scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in "social activities" compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery. Research limitations/implications: This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.'s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time. Originality/value: The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. Gaze‐speech coordination during social interaction in Parkinson's disease.
- Author
-
Hodgson, Timothy L., Hermens, Frouke, and Ezard, Gemma
- Subjects
- *
SPEECH evaluation , *EYE muscles , *NATIONAL health services , *DISABILITIES , *CONVERSATION , *TASK performance , *RESEARCH funding , *EYE movement measurements , *PARKINSON'S disease , *MOVEMENT disorders , *DESCRIPTIVE statistics , *PSYCHOLOGY of movement , *GAMES , *SOCIAL skills , *COMMUNICATION , *NEUROPSYCHOLOGICAL tests , *ANALYSIS of variance , *INTERPERSONAL relations , *SPEECH disorders , *COMPARATIVE studies , *EYE movements , *COGNITION - Abstract
Background: Parkinson's disease (PD) can affect social interaction and communication as well as motor and cognitive processes. Speech is affected in PD, as is the control of voluntary eye movements which are thought to play an important role in 'turn taking' in conversation. Aims: This study aimed to measure eye movements during spoken conversation in PD to assess whether differences in patterns of eye gaze are linked to disrupted turn taking and impaired communication efficiency. Methods & Procedure: Eleven participants with mild PD and 14 controls completed a two‐player guessing game. During each 3 min game turn, one of the players had to guess the names of as many objects as possible based only on the other player's description. Eye movements were recorded simultaneously in both participants using mobile eye trackers along with speech onset and offset times. Outcomes & Results: When people with PD played the role of describer, the other player guessed fewer objects compared to when controls described objects. When guessing objects, people with PD performed just as well as controls. Analysis of eye fixations showed that people with PD made longer periods of fixation on the other player's face relative to controls and a lower number of such 'gaze on face' periods. Conclusions & Implications: A combination of oculomotor, cognitive and speech abnormalities may disrupt communication in PD. Better public awareness of oculomotor, speech and other deficits in the condition could improve social connectedness in people with Parkinson's. WHAT THIS PAPER ADDS: What is already known on this subject?: Parkinson's disease is known to affect the control of voluntary eye movements. Direction of eye gaze is important in spoken conversation as a cue to turn‐taking, but no studies have examined whether eye movements are different during communication in people with Parkinson's. What this paper adds to existing knowledge?: People with Parkinson's showed longer periods of eye fixation during conversations compared to controls. Delays and overlaps between speech turns were also affected in patients. What are the clinical implications of this work?: Better knowledge of the effect of the disease on eye gaze control amongst clinicians may help improve communication and social connectedness for patients in the future. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
24. Telehealth administration of narrative and procedural discourse: A UK and US comparison of traumatic brain injury and matched controls.
- Author
-
Cruse, Nicole, Piotto, Victor, Coelho, Carl, and Behn, Nicholas
- Subjects
- *
HEALTH services accessibility , *COMPARATIVE grammar , *TASK performance , *PHONOLOGICAL awareness , *SAMPLE size (Statistics) , *APHASIA , *TELEREHABILITATION , *MANN Whitney U Test , *DESCRIPTIVE statistics , *TELEMEDICINE , *DISCOURSE analysis , *SOCIAL integration , *CASE-control method , *QUALITY of life , *COMMUNICATION , *BRAIN injuries , *SPEECH disorders , *DATA analysis software , *EMPLOYMENT reentry , *COVID-19 pandemic , *INTER-observer reliability , *NONPARAMETRIC statistics , *RELIABILITY (Personality trait) - Abstract
Background: Impaired discourse production is commonly reported for individuals with traumatic brain injury (TBI). Discourse deficits can negatively impact community integration, return to employment and quality of life. COVID‐19 restrictions have reduced in‐person assessment services for people with communication impairments. Advances in telehealth may help speech and language therapists (SLTs) to assess monologic discourse more systematically and improve access to services for patients who may find it difficult to attend in‐person. Aims: To examine the feasibility of telehealth administration of narrative and procedural discourse tasks with individuals with TBI and matched controls. Methods & Procedures: A total of 20 individuals with TBI and 20 healthy controls, aged 18–55 years, were directly recruited from the UK and indirectly recruited from the US. For participants with TBI, time post‐injury was at least 3 months with no diagnosis of aphasia. Control participants were matched for sex and as closely as possible for age. Feasibility of measures was based upon the time to administer both narrative tasks, the report of any technological problems, and participant feed. Discourse samples were transcribed verbatim and analysed using story grammar analysis (for narrative discourse) and identification of propositions (for procedural discourse). Interrater reliability was calculated using percentage agreement for 50% of the data. Non‐parametric analyses were used to analyse the performance of the two groups. Outcomes & Results: Narrative and procedural discourse samples were collected via telehealth in approximately 10 min with no reported technical difficulties or complaints from any participants. For narrative discourse performance, there were significant differences for the TBI and control groups for measures of complete episodes (p < 0.001) and missing episodes (p = 0.005). No significant group differences were noted for any of the procedural discourse measures. Conclusions & Implications: Results support the feasibility of collecting discourse samples via telehealth. Although the participants' discourse performance distinguished the TBI and control groups on the narrative task, no differences between the groups were noted for the procedural task. The narrative discourse task may have been more difficult than the procedural task, or video cue support reduced the cognitive load of the procedural task. This finding suggests the use of more complex procedural tasks without video cue support may be needed. WHAT THIS PAPER ADDS: What is already known on this subject: Although little research has explored the feasibility of administering discourse assessments for individuals with TBI via telehealth, some studies have found that discourse interventions can be feasibly administered via telehealth. It is also well established that individuals with TBI struggle with the supra‐structural and macro‐linguistic elements of discourse production. Both procedural and narrative discourse tasks have been found to differentiate individuals with TBI from healthy controls. What this paper adds to existing knowledge: Few studies have investigated the feasibility of, and procedures for, administering discourse tasks via telehealth. Additionally, the inclusion of multiple types of discourse tasks to parse cognitive–communication abilities is lacking in the current literature. Findings from this study support that narrative and procedural discourse can be feasibly sampled via telehealth and that international collaboration for research on this topic can facilitate such studies. Individuals with TBI performed more poorly on three measures of narrative discourse. No differences between groups were identified for the procedural task. What are the potential or actual clinical implications of this work?: Telehealth assessment for discourse provides flexibility for both the individual with TBI and the speech–language therapist and does not compromise the quality of data collected. The administration of discourse tasks and collection of data was not time‐consuming and was well accepted by the study participants. Additionally, international research collaboration not only expands potential participation in research but increases the opportunity to recruit and study more diverse groups. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
25. The Views of Practitioners on Care Act Easements during the Covid-19 Pandemic.
- Author
-
Thomas, Emily, Baginsky, Mary, and Manthorpe, Jill
- Subjects
PUBLIC welfare laws ,SOCIAL workers ,COMMUNITY health services ,SOCIAL worker attitudes ,COMMUNICATION ,INTERPROFESSIONAL relations ,COVID-19 pandemic ,SOCIAL case work - Abstract
The easements of the Care Act 2014, permitted by the Coronavirus Act 2020, were in place in very few English local authorities and then only for a short time, but they still rippled across the wider social care workforce. This paper reports findings from interviews with social workers in ten non-easement authorities and with other professionals in easement and non-easement authorities to explore their understandings of easements and their reflections on their use and impact on practice. The interview data are set in the context of a wider study that explored decision-making about the adoption of easements in local authorities. Frontline practitioners (N = 30) confirmed confusion about easements and suspicion that they were a retrograde step in people's entitlements to care and support. These views were also set in a context of lack of pandemic preparedness in social care and reflections that the care system was already fragile after a sustained period of reductions to local authority budgets and rising need. Both a robust care infrastructure was needed, as well as better crisis or disaster preparedness and planning. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
26. Co‐designing a theory‐informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community‐based participatory research study (LISOLO MALAMU).
- Author
-
Crawshaw, Alison F., Kitoko, Lusau M., Nkembi, Sarah L., Lutumba, Laura M., Hickey, Caroline, Deal, Anna, Carter, Jessica, Knights, Felicity, Vandrevala, Tushna, Forster, Alice S., and Hargreaves, Sally
- Subjects
EDUCATION of refugees ,VACCINATION ,COVID-19 ,IMMUNIZATION ,NOMADS ,HEALTH services accessibility ,COVID-19 vaccines ,ATTITUDE (Psychology) ,COMMUNITY health services ,INTERVIEWING ,MEDICAL care ,QUALITATIVE research ,CONCEPTUAL structures ,MEDICAL protocols ,PHILOSOPHY of education ,COMMUNITY-based social services ,COMMUNICATION ,VACCINE hesitancy ,RESEARCH funding ,MEDICAL needs assessment - Abstract
Introduction: Disparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. Methods: This study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants. Results: Thirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions: Our study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. Patient or Public Contribution: Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
27. Interventions to promote ageing in place: developing the Village model in Manchester.
- Author
-
Doran, Patty, Goff, Mhorag, and Phillipson, Chris
- Subjects
FOCUS groups ,LEADERSHIP ,COMMUNITY support ,INTERVIEWING ,ETHNOLOGY research ,SOCIAL isolation ,AGING in place ,AGING ,ACTION research ,COMMUNICATION ,INTELLECT ,HEALTH ,DESCRIPTIVE statistics ,METROPOLITAN areas - Abstract
Purpose: The Village model, most extensively developed in the USA, is an innovative response to ageing populations and older adults who wish to remain living independently within their community. The "Urban Villages" participatory action research study aimed to test the potential of the Village model to work with groups of older adults in two economically deprived, inner-city neighbourhoods in Manchester, UK. Design/methodology/approach: Participatory methods were used to work with residents to, first, adapt the Village model to the Manchester setting, and second, to develop and deliver community projects that supported ageing in place. The study aimed to involve marginalised individuals and groups in the co-design, leadership and implementation of the projects. Ethnographic methods were applied to observe and reflect on the development of "Urban Villages". Interviews and focus groups were organised to gather the views of the residents involved in the community projects. Findings: Residents were supported to develop and test seven projects, all aimed at reducing social isolation and supporting ageing in place. The study provides new insights into challenges related to co-production with older people in deprived neighbourhoods. These challenges are presented under the following headings: individual capacity and expectations; collective capacity including communication and knowledge; and the capacity of place. Originality/value: To date, only a limited amount of literature is available showing how co-production with older adults can be realised when working with marginalised groups and deprived communities. The paper explores the potential of participatory approaches to develop age-friendly initiatives through strengthening the capacity of older adults to age in place. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
28. WAS THERE A NATIONAL PRESS IN THE UK IN THE SECOND WORLD WAR?
- Author
-
O'Malley, Tom
- Subjects
PRESS ,BRITISH history ,WORLD War II ,COMMUNICATION ,HISTORY of newspapers ,TWENTIETH century - Abstract
This article considers whether there was a national press before and during the Second World War. After considering the terms used by historians to describe the UK national press, and how it is defined, it looks at aspects of the industry that made it appear national and those which did not. The question of just how national the press was between 1939 and 1945 is then addressed, followed by some concluding comments. It argues that the wartime press was characterised by a high degree of uniformity in terms of organisation, co-operation and content, throwing into relief the more diffuse nature of the industry before and after. The idea of the national press downplays the extent to which newspapers varied considerably in readership, geographical reach, political and social significance. It obscures the important role of the provincial press, abstracting mass circulation London daily morning papers, from their place within an evolving network of mass communications. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
29. Editorial.
- Author
-
Campbell, Jim and Pinkerton, John
- Subjects
ABUSE of older people ,CHILD welfare ,COMMUNICATION ,EDITORS ,PUBLIC welfare ,SERIAL publications ,SOCIAL case work ,SOCIAL work research - Abstract
The authors discuss the role of the journal in exploring the social work profession's many dimensions. They state that a journal should reveal the ambiguities and conflict in relationships between social work, the state, politics and civil society. They inform that the British Journal of Social Work publishes papers that help in understanding how social work research can be enhanced through innovative methodologies and new theoretical ideas. An introduction to the issue is also provided.
- Published
- 2012
- Full Text
- View/download PDF
30. Cultures of Listening: Psychology, Resonance, Justice.
- Author
-
Motzkau, Johanna F. and Lee, Nick M.
- Subjects
CULTURE ,PSYCHOLOGY ,EXPERIENCE ,COMMUNICATION ,LISTENING - Abstract
Listening, as a general psychological capacity, is a key aspect of perception, communication and experience. However, listening researchers frequently characterize it as a neglected, misunderstood and ill-defined phenomenon. This is a significant problem because questions of listening pervade social inequalities and injustices, as this paper demonstrates in the context of UK child protection practices. Exploring concepts of listening within and beyond psychology, the paper illustrates how a lack of overall theorization can contribute to inequality and injustice within applied listening practices. To address this, the paper theorizes listening in the spirit of Whiteheadian process ontology, drawing on the work of Nancy and Bonnet. Based on this, it develops the concept of 'Cultures of Listening' (CoL), which provides a tool for the critical analysis of troubled listening practices, indicating how they can be challenged and transformed. Within CoL, listening is not a mere aspect of auditory perception or communication, but each instant of listening is considered as shaped by and expressing political, social and experiential circumstances, that is, cultures. The paper demonstrates the theoretical, critical and applied value of CoL by offering a detailed analysis of the role of listening within troubled UK child protection practices. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
31. A systematic scoping review of early interventions for parents of deaf infants.
- Author
-
Wright, B., Hargate, R., Garside, M., Carr, G., Wakefield, T., Swanwick, R., Noon, I., and Simpson, P.
- Subjects
DEAF children ,PARENT-infant relationships ,DEAF people ,PARENTS ,CHILD development ,INFANTS ,HEARING ,NEWBORN screening ,RESEARCH ,RESEARCH methodology ,SYSTEMATIC reviews ,MEDICAL cooperation ,EVALUATION research ,PARENTING ,COMPARATIVE studies ,COMMUNICATION ,PARENT-child relationships - Abstract
Background: Over 90% of the 50,000 deaf children in the UK have hearing parents, many of whom were not expecting a deaf child and may require specialist support. Deaf children can experience poorer long-term outcomes than hearing children across a range of domains. After early detection by the Universal Newborn Hearing Screening Programme, parents in the UK receive support from Qualified Teachers of the Deaf and audiologists but resources are tight and intervention support can vary by locality. There are challenges faced due to a lack of clarity around what specific parenting support interventions are most helpful.Methods: The aim of this research was to complete a systematic scoping review of the evidence to identify early support interventions for parents of deaf infants. From 5577 identified records, 54 met inclusion criteria. Two reviewers screened papers through three rounds before completing data extraction and quality assessment.Results: Identified parent support interventions included both group and individual sessions in various settings (including online). They were led by a range of professionals and targeted various outcomes. Internationally there were only five randomised controlled trials. Other designs included non-randomised comparison groups, pre / post and other designs e.g. longitudinal, qualitative and case studies. Quality assessment showed few high quality studies with most having some concerns over risk of bias.Conclusion: Interventions commonly focused on infant language and communication followed by parental knowledge and skills; parent wellbeing and empowerment; and parent/child relationship. There were no interventions that focused specifically on parent support to understand or nurture child socio-emotional development despite this being a well-established area of poor outcome for deaf children. There were few UK studies and research generally was not of high quality. Many studies were not recent and so not in the context of recent healthcare advances. Further research in this area is urgently needed to help develop evidence based early interventions. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
32. Red information scientist: the information career of J.D. Bernal.
- Author
-
Dave Muddiman
- Subjects
SCIENTISTS ,INFORMATION science ,COMMUNICATION - Abstract
John Desmond Bernal (1901-1970) was one of the most eminent scientists of his generation; he also became, in mid-twentieth century Britain, an important political figure - the leading public spokesperson of "red" science. One remarkable but hitherto underexplored aspect of his career is a lifelong interest in scientific communication, documentation and information science. Utilising records in the Bernal archive in Cambridge, UK, this paper assesses Bernal's information career. It explores Bernal's initial interest in scientific documentation in the 1930s and examines his blueprint for the reform of scientific communication in Britain, advanced in Bernal's 1939 work, The Social Function of Science. It details his subsequent role, in 1945-1949, as figurehead of a co-ordinated but unsuccessful left-wing campaign to establish an Institute of Scientific Information in Britain. It analyses Bernal's later theoretical papers in information science, and describes his support, in the 1950s and 1960s, for an emerging information profession. Bernal, it concludes, can justifiably be regarded as a major influence on twentieth century information science, above all because of his pioneering focus on the social dimensions of the discipline. [ABSTRACT FROM AUTHOR]
- Published
- 2003
- Full Text
- View/download PDF
33. Corporate perspectives on CSR disclosure: audience, materiality, motivations.
- Author
-
Gulko, Nadia and Hyde, Catriona
- Subjects
SOCIAL accounting ,DISCLOSURE ,SOCIAL responsibility of business ,BUSINESS enterprises ,CORPORATION reports - Abstract
The lack of uniform non-voluntary corporate social responsibility (CSR) disclosure standards and the complexity around different stakeholder demands have resulted in considerable flexibility in corporate compliance with CSR reporting. Covering a wide range of CSR dimensions, this paper investigates corporate views on CSR disclosure. Evidence presented is based on an online survey with 278 corporate professionals, who are familiar with corporate reporting in the UK, such as CSR professionals, managers, CEOs, CFOs and non-executive directors. The findings reveal the primacy of shareholder and institutional investor needs in CSR disclosure decisions. Some practitioners believe multiple reports are needed to ensure appropriate dissemination of CSR information. Fair business practice and environment-related information are perceived as the most important items to disclose. Whilst financial information remains paramount, the relative importance of reporting non-financial information has increased significantly, with the key areas relating to governance, health and safety, environmental impact and pollution control, and human rights information. For many participants, mandatory regulation is considered as the only way for CSR reporting to be taken seriously on the corporate level. This paper contributes to the limited studies that investigate the views of practitioners by means of primary data. The study complements the literature on CSR disclosure by intensifying the clarity of the understanding of corporate perspectives on CSR and by identifying potential factors that influence CSR reporting decisions in the UK context. The findings strengthen the arguments of prior studies about what items of information should be included in CSR reports and how to disclose the company's CSR information in a more substantive way. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
34. The National Institute for Health and Care Excellence information specialist development pathway: Developing the skills, knowledge and confidence to quality assure search strategies.
- Author
-
Levay, Paul, Walsh, Nicola, and Foster, Louise
- Subjects
INFORMATION services standards ,PROFESSIONAL peer review ,AFFINITY groups ,PROFESSIONS ,CONFIDENCE ,COVID-19 ,DATABASE searching ,PROFESSIONAL employee training ,EXECUTIVES ,CONTINUING education ,PROFESSIONAL competence ,QUALITY assurance ,INTERPERSONAL relations ,COMMUNICATION ,INFORMATION retrieval - Abstract
Quality assurance (QA) is an important process in ensuring that systematic reviews and other evidence syntheses are supported by a high‐quality search. This paper describes how the National Institute for Health and Care Excellence (NICE) in the UK established a development pathway to ensure its information specialists had the skills, knowledge and confidence to undertake search QA. The key component of the pathway is that it blends technical knowledge with interpersonal skills. The pathway develops technical skills in the early steps before using peer support activities to build confidence while undertaking a range of searches. QA is effective when the search lead communicates the contextual information that has influenced search development. QA is treated as a collaboration to get the right search for the review. The key requirements for search QA, alongside technical knowledge, are communication, collaboration and negotiation skills. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
35. The nexus of immigration regulation and health governance: a scoping review of the extent to which right to access healthcare by migrants, refugees and asylum seekers was upheld in the United Kingdom during COVID-19.
- Author
-
Van Hout, M.C., Madroumi, R., Andrews, M.D., Arnold, R., Hope, V.D., and Taegtmeyer, M.
- Subjects
- *
IMMIGRATION law , *HEALTH services accessibility , *MEDICAL quality control , *PSYCHOLOGY of refugees , *HEALTH policy , *CINAHL database , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *THEMATIC analysis , *MIGRANT labor , *LITERATURE reviews , *COMMUNICATION , *RIGHT to health , *ONLINE information services , *HEALTH equity , *PSYCHOSOCIAL factors - Abstract
Complementing the well-established evidence base on health inequalities experienced by migrants, refugees and asylum seekers in the UK; we examined the extent to which their right to equal non-discriminatory access to health services (promotive, preventive, curative) was upheld during the COVID-19 pandemic. Arksey and O′Malley's scoping review framework. A comprehensive search was conducted on Medline, PubMed, and CINAHL using detailed MESH terms, for literature published between 01 January 2020 and 01 January 2024. The process was supported by a ten-page Google search and hand searching of reference lists. 42 records meeting the inclusion criteria were charted, coded inductively and analysed thematically in an integrated team-based approach. Dissonance between immigration regulation and health governance is illustrated in four themes: Health systems leveraged to (re)enforce the hostile environment; Dissonance between health rights on paper and in practice; Structural failures to overcome communication and digital exclusion; and COVID-19 vaccine (in)equity exacerbated fear, mistrust and exclusion. Migrants, refugees and asylum seekers encountered substantial individual, structural and policy-level barriers to accessing healthcare in the UK during COVID-19. Insecure immigration status, institutional mistrust, data-sharing and charging fears, communication challenges and digital exclusion impacted heavily on their ability to access healthcare in an equitable non-discriminatory manner. An inclusive and innovative health equity and rights-based responses reaching all migrants, refugees and asylum seekers are warranted if the National Health Service is to live up to its promise of ' leaving no one behind' in post-pandemic and future responses. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
36. Communication support in care homes for older adults: Views and reported practices of speech and language therapists and care home activities staff in the UK.
- Author
-
Davis, Lydia, Botting, Nicola, Cruice, Madeline, and Dipper, Lucy
- Subjects
- *
SPEECH therapists , *COMMUNICATIVE competence , *WORLD Wide Web , *QUALITATIVE research , *RESEARCH funding , *CONTENT analysis , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *SURVEYS , *MOTIVATION (Psychology) , *ATTITUDES of medical personnel , *PHYSICIAN practice patterns , *SOCIAL support , *NEEDS assessment , *DATA analysis software , *PSYCHOSOCIAL factors , *RESIDENTIAL care , *COVID-19 pandemic - Abstract
Background: Speech and language therapists (SLTs) and care home activities staff play key roles in managing and supporting the communication needs of older residents in care homes. However, the current practice and perspectives of these two professions in the United Kingdom has not been examined. Aims: To investigate the practice patterns and views of SLTs and activities staff working in UK care homes for older adults in relation to residents' communication needs. Methods and Procedures: Two online surveys, with 63 questions (SLT survey) and 46 questions (activities staff survey) in total, were created using the online platform Qualtrics. Participants were asked to consider their routine practice before COVID‐19. Results were analysed using descriptive statistics and qualitative content analysis. Outcomes and Results: A total of 116 valid responses were received from SLTs and 29 valid responses from activities staff. A high level of communication needs in care homes was reported by both participant groups, as was insufficient time and resources and lack of managerial encouragement in this area. SLTs reported that the majority of referrals to their service from care homes was for swallowing needs (70%). Cognitive communication difficulty was the most commonly reported communication need by SLTs (65%). Most SLTs (73%–87%) provided some level of communication intervention and considered management of residents' communication needs to be both part of the SLT role and a good investment of their time. Lack of confidence setting goals and providing direct intervention for communication needs was reported, with 25% feeling stressed at the thought of this. The main themes from free text responses about SLT service improvement were increased staff training, funding (of resources and specialist posts) and changes to service provision (referral criteria and accessibility/awareness of SLT service). Hearing impairment was the communication need most commonly reported by activities staff (43%). Participants demonstrated relatively high awareness of communication difficulty in residents and reported high levels of knowledge and confidence identifying and supporting residents' communication. Most (79%–89%) considered identifying and supporting the communication needs of residents to be part of their role and expressed interest in receiving further training in communication support. The reported activities staff data set may be positively biased. Conclusions and Implications: SLTs and activities staff were highly motivated to support the communication needs of care home residents. Increased training, time and resources dedicated to managing the communication needs of residents emerged as opportunities for service improvement across both data sets. WHAT THIS PAPER ADDS: What is already known on the subject: There is a high level of communication need amongst older care home residents. Social interaction and relationships are important factors contributing to quality of life in this population and rely on successful communication. Speech and language therapists (SLTs) and activities staff play key roles in managing and supporting the communication needs of this client group, but the current practice and perspectives of these professions in the United Kingdom has not been examined. What this study adds: A high level of communication need in care home residents was identified by both SLT and activities staff and both participant groups were motivated to address, identify and manage this need. However, insufficient time and resources, as well as a perceived lack of encouragement from managers to provide communication support/intervention, were reported by both groups. SLT practice was constrained by referral criteria and care pathways, which differed between services. Suggestions for SLT service improvement are reported. Clinical implications of this study: Targeted, ongoing staff training is required in care homes to improve the communication environment and develop care home staff capacity to support residents' communication needs. There is also a call for service level improvements to increase the range of SLT practice in care homes, including a greater focus on communication needs and more specialist (e.g., dementia) SLT roles. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
37. A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH.
- Author
-
Purcell C, McDaid L, Forsyth R, Simpson SA, Elliott L, Bailey JV, Moore L, and Mitchell KR
- Subjects
- Adolescent, Humans, Friends, United Kingdom, Peer Group, Interpersonal Relations, Sexual Health education, Social Media, Social Networking, School Health Services, Communication, Program Development methods
- Abstract
Background: The quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined., Methods: Drawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences., Results: Over 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders., Conclusions: STASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation., Trial Registration: ISRCTN97369178., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
38. Lost voices part 1: A narrative case study of two young men with learning disabilities disclosing experiences of sexual, emotional and physical abuse.
- Author
-
Digman, Carmel
- Subjects
SEX crime laws ,PSYCHOLOGICAL abuse ,MENTAL health ,PSYCHOLOGY of People with disabilities ,PEOPLE with intellectual disabilities ,SOCIAL case work - Abstract
Accessible Summary: Two young men who have learning disabilities were students at a college. While they were there, they were sexually abused by people who were meant to care for them.When they tried to tell people, some people would not listen. Some people listened but could not understand them.They became mentally ill because of the abuse. Then, some people started to listen and help them tell their stories. Then, the police and the courts said that the two young men could not give evidence in court because of their learning disabilities.This paper matters because it writes about ways to protect people with learning disabilities from people who abuse them. We need to try and help people who have been abused to tell their stories. We need to make sure those stories are listened to. Two young men disclosed emotional, sexual and physical abuse while attending college and living with Shared Lives carers in the UK. This paper provides a narrative account of the period when the two men were exposed to the abuse, the disclosures, the investigation and the legal and safeguarding investigation outcomes. A second paper describes the therapeutic response and outcomes for the men. A review of the literature on abuse and learning disabilities highlights the difficulties in conducting research in this area. Authors find significant barriers exist to disclosing abuse and to being believed. Prosecutions are rare despite evidence that abuse may be widespread towards people with learning disabilities. This paper considers the narrative experience of the two young men, the barriers they faced to being heard and believed and how their personal accounts were discounted and eventually lost to the investigation. Lessons for practice are considered for learning disability mental health and social care professionals, education, police and legal services. Further research suggestions are made. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
39. Managing ovarian hyperstimulation syndrome: A qualitative interview study with women and healthcare professionals.
- Author
-
Lumley, Elizabeth, O'Cathain, Alicia, Drabble, Sarah, Pye, Clare, Brian, Kate, and Metwally, Mostafa
- Subjects
INFERTILITY treatment ,FERTILITY clinics ,ATTITUDES of medical personnel ,RESEARCH methodology ,PATIENT decision making ,OVARIAN hyperstimulation syndrome ,INTERVIEWING ,HEALTH status indicators ,QUALITATIVE research ,SEVERITY of illness index ,DYSPNEA ,PSYCHOLOGY of women ,HEALTH ,INFORMATION resources ,QUALITY assurance ,SOUND recordings ,DESCRIPTIVE statistics ,COMMUNICATION ,RESEARCH funding ,WORRY ,DATA analysis software ,THEMATIC analysis ,EDEMA ,PSYCHOLOGICAL distress ,DISEASE management ,SYMPTOMS - Abstract
Aim: To explore the experiences of women who have had ovarian hyperstimulation syndrome, and healthcare professionals who care for them. Background: Ovarian hyperstimulation syndrome is a side effect of fertility treatment. Little research exists internationally that explores the experiences of women who have had this condition, or the healthcare professionals who manage it. Design: Qualitative study using semi‐structured interviews. Methods: Eighteen interviews with women who had experienced ovarian hyperstimulation syndrome (n = 10) and healthcare professionals (n = 8) in six UK fertility centres. Framework analysis was used. This paper is reported following COREQ guidelines. Results: Women described a range of symptoms and severity, sometimes experiencing worrying physical health problems such as abdominal swelling and shortness of breath. The combination of the symptoms, and their management, on delaying future fertility treatment could cause emotional distress. Healthcare professionals at different centres described variation in practice, which generally involved 'active monitoring' until symptoms became severe, when women would be hospitalised. Women expressed feeling 'left in limbo' while waiting for symptoms to improve or worsen, and described a lack of control during this waiting period. Healthcare professionals felt they provided adequate information about ovarian hyperstimulation syndrome and its management. This, however, did not align with women's perceptions that information, including potential delays to their fertility treatment, was missing. There was similar mismatch between women's and healthcare professionals' views of decision‐making about fertility treatment following ovarian hyperstimulation syndrome, including women's concerns about having to make rushed, unplanned decisions about their fertility treatment when they did not feel adequately informed to do so. Conclusion: Ovarian hyperstimulation syndrome and its management can have a significant physical and emotional impact on women, and influence their fertility treatment. Improvements could be made to the information women receive about this condition, its management and its implications for wider fertility treatment. Implications for the profession and/or patient care: Nurses have the skills and knowledge to support women through the physical and emotional stresses of fertility treatment. Therefore, they are well placed to provide specialist information and support for OHSS and ensure women are fully informed about all aspects of the condition, including how its management might delay fertility treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
40. Assessing parent interaction with deaf infants: A quantitative survey of UK professional practice.
- Author
-
Curtin, Martina, Morgan, Gary, Cruice, Madeline, and Herman, Rosalind
- Subjects
PROFESSIONAL practice ,INFERENTIAL statistics ,DEAFNESS ,PSYCHOLOGISTS ,QUANTITATIVE research ,PARENTING ,LANGUAGE acquisition ,COMMUNICATION ,DESCRIPTIVE statistics ,RESEARCH funding ,PARENT-child relationships ,DATA analysis software ,GOAL (Psychology) ,MEDICAL needs assessment ,CHILDREN - Abstract
Background: Between 90% and 95% of deaf children are born to hearing parents who often need support with how to adapt their communication. Parent–child interaction (PCI) is an important predictor of deaf children's future language development. It is therefore necessary for professionals to assess parents' strengths and needs to identify areas for intervention. Qualified teachers of the deaf (QToDs), speech and language therapists (SLTs), psychologists, and national deaf child and adolescent mental health (NDCAMHS) professionals regularly support families with deaf children. With no current evidence‐based tool available to assist with the assessment of PCI in deafness, it is important to gather information on current professional practice as this may differ from known practices within research. Aims: To survey the practices of UK‐based professionals in the assessment of PCI where the deaf infant is aged 0–3 years. Professionals were QToDs, SLTs, psychologists or psychiatrists and professionals working at NDCAMHS services. Methods & Procedures: After a pilot phase, an 85‐item survey was distributed electronically through a range of professional and social media networks. Survey items were based on a systematic review of PCI with deaf infants. Survey questions were focused on parent behaviours that were assessed, methods of assessment, goal planning and service provision. Analysis was conducted using descriptive and inferential statistics. Outcomes & Results: A total of 190 professionals from across the UK completed part 1 of the survey; this decreased to 148 in part 4. Respondents were primarily female, hearing, used spoken English and had 16 years or more experience. Results indicate that PCI is routinely assessed by a large proportion of professionals and there is a substantial overlap in which parent behaviours are assessed. Some parent behaviours are assessed that do not feature in the research. Methods of assessment are informal and predominantly consist of observation and note making, with professionals using their own skills and experience to analyse interaction. Goal setting practices were largely similar between professionals, with many jointly deciding goals with parents. Conclusions & Implications: This survey highlights the range of parent behaviours assessed by UK professionals in PCI with deaf children aged 0–3. This survey provides valuable information about and for professionals who assess PCI and set intervention goals with parents. Information from research and professional practice is important to consider in the design of a future PCI assessment. Implications are included for future research in this area. What This Paper Adds: What is already known on this subject: Parental involvement is one of the greatest predictors of deaf children's language outcomes. With many deaf children born to hearing parents, parents often need guidance with how to facilitate effective communication. A recent systematic review identified the range of parent behaviours and methods used to analyse PCI in international research studies, but little evidence or guidance exists on how professionals assess this phenomenon in practice. What this study adds: This is the first survey to generate large, valuable practice‐based evidence for the assessment of parents' communication behaviours as they interact with their deaf infants aged 0–3. The survey recruited a range of multidisciplinary professionals working on interaction within this field: SLTs, qualified teachers of the deaf, psychologists or psychiatrists, and professionals working within deaf child and adolescent mental health services. The study reports on which behaviours these professionals assess and how, and includes information on the goal setting behaviours of practitioners. Most respondents were highly experienced; the survey, therefore, reveals expert practice within the field. What are the potential or actual clinical implications of this work?: We recommend the following practice: (1) incorporate a range of parent‐based behaviours in PCI assessments, including establishing joint engagement and parental sensitivity, as well as communication‐focused behaviours; (2) video record PCI assessments where possible to enable professionals and parents to watch and reflect together; (3) following assessment, set parent‐focused goals in collaboration with families, ensuring parents' skills, particularly their strengths, are considered. All primary caregivers should be included in the process where possible; and (4) reassess PCI regularly (at least termly) to monitor and encourage families' progress. The timing of reviews should be discussed between parent and professional. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
41. How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience.
- Author
-
Garfield, Sara, Furniss, Dominic, Husson, Fran, Etkind, Mike, Williams, Marney, Norton, John, Ogunleye, Della, Jubraj, Barry, Lakhdari, Hanaa, and Dean Franklin, Bryony
- Subjects
MEDICATION error prevention ,ATTITUDE (Psychology) ,CAREGIVERS ,COMMUNICATION ,CONCEPTUAL structures ,DRUG interactions ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,MEDICAL personnel ,MEDICAL records ,PATIENTS ,PATIENT safety ,RESEARCH funding ,JUDGMENT sampling ,ACCESS to information ,THEMATIC analysis ,HEALTH care reminder systems ,MEDICATION therapy management ,PATIENTS' attitudes ,MEDICATION reconciliation - Abstract
Background Patients often carry medication lists to mitigate information loss across healthcare settings. We aimed to identify mechanisms by which these lists could be used to support safety, key supporting features, and barriers and facilitators to their use. Methods We used a mixed-methods design comprising two focus groups with patients and carers, 16 semistructured interviews with healthcare professionals, 60 semistructured interviews with people carrying medication lists, a quantitative features analysis of tools available for patients to record their medicines and usability testing of four tools. Findings were triangulated using thematic analysis. Distributed cognition for teamwork models were used as sensitising concepts. Results We identified a wide range of mechanisms through which carrying medication lists can improve medication safety. These included improving the accuracy of medicines reconciliation, allowing identification of potential drug interactions, facilitating communication about medicines, acting as an aide-mémoire to patients during appointments, allowing patients to check their medicines for errors and reminding patients to take and reorder their medicines. Different tools for recording medicines met different needs. Of 103 tools examined, none met the core needs of all users. A key barrier to use was lack of awareness by patients and carers that healthcare information systems can be fragmented, a key facilitator was encouragement from healthcare professionals. Conclusion Our findings suggest that patients and healthcare professionals perceive patient-held medication lists to have a wide variety of benefits. Interventions are needed to raise awareness of the potential role of these lists in enhancing patient safety. Such interventions should empower patients and carers to identify a method that suits them best from a range of options and avoid a 'one size fits all' approach [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
42. Embracing complexity: a sociotechnical systems approach for the design and evaluation of higher education learning environments.
- Author
-
Navarro-Bringas, Eduardo, Bowles, Graeme, and Walker, Guy H.
- Subjects
COGNITION ,COMMUNICATION ,HEALTH facility design & construction ,INVESTMENTS ,LEARNING ,SCHOOL environment ,SYSTEMS theory ,TECHNOLOGY ,UNIVERSITIES & colleges ,BUILT environment ,TASK performance - Abstract
Higher education institutions (HEI) have undergone fundamental changes driven by ICT developments, globalisation, and the advent of socio-constructivist pedagogic approaches. As a result, within the UK, capital investment in new and retrofitted facilities has reached a record expenditure. Recent research on user-related evaluations of facilities, particularly in HEI learning spaces, highlights the prevalence of evaluations dominated by reductionist approaches focused on measuring outcomes, on users, such as satisfaction, learning outcomes or engagement. These approaches have a major pitfall, neglecting the complexity of the dynamic relationships between people, spaces, technology, institutional structure and pedagogic practices. In response, this paper aims to propose a shift on current approaches by exploring the application of sociotechnical systems theory to learning space design and evaluation. Amid these, it is argued that Cognitive Work Analysis (CWA) offers promising alternatives to inform design and management of higher education learning spaces. Finally, within the paper, three CWA interventions are proposed and discussed, focusing on how these address previously identified shortcomings of predominant approaches used in HEI learning space design and evaluation. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
43. Acceptance in the Hearing Voices Movement: how might this be relevant for art therapy service-users?
- Author
-
Wood, Chris
- Subjects
ART therapy ,COMMUNICATION ,EXPERIENCE ,INTERPERSONAL relations ,PSYCHOSES ,AFFINITY groups ,SOCIAL support ,ACCEPTANCE & commitment therapy ,PATIENTS' attitudes - Abstract
This paper considers what is shared by voice-hearers in the Hearing Voices Movement (HVM) and by service-users in art therapy. Both highlight what they see as the value of acceptance, peer-support, and clear collaborative communication. The paper considers how research and literature informed by lived-experience in the HVM and, UK art therapy might strengthen practice. Life-stories by voice-hearers, included in the HVM literature, explain what has helped them and what is meant by acceptance within the movement. For those voice-hearers with a psychosis-related diagnosis, joining HVM could mean they find hope, even though the diagnosis means that they may face deep prejudice and some of their unusual experiences are frightening. The paper also looks at what art therapy clients voice as helpful: the support found in group work; art-making; and honest, collaborative styles of communication overlaps with much that is described and explored in the work of HVM. Although much smaller in scope, feedback given by art therapists to a professional regional-group provides additional indications that the profession is responsive to service-user perspectives, collaborative work, and to HVM. Plain-language summary This paper considers the Hearing Voices Movement in relation to adult mental health. Often people who hear voices receive a psychiatric diagnosis for which the primary treatment is medication. These diagnoses are known as 'psychosis-related'. In the psychiatric system, voice-hearers are not usually encouraged to speak about their unusual experiences. In the Hearing Voices Movement, those who hear voices are encouraged to speak about their voices and other unusual experiences and to find ways of coping with them. This paper looks at the literature of the Hearing Voices Movement to explore what 'accepting voices' means and how this may be relevant for art therapy clients. People who hear voices, family members, friends, health professionals, and social workers make up the movement and, they are all asked to work alongside one another in the interests of authentic collaboration aimed at improving the lives of voice-hearers. The paper also looks at what is said in life-stories by voice-hearers about the value of acceptance, peer-support, and clear collaborative communication. Even though some people with a psychosis-related diagnosis are afraid of their experiences and face damaging prejudice, joining the Hearing Voices Movement can mean they find hope. Also, the art-making, group work, and honest, collaborative styles of communication valued by art therapy clients overlaps with much of the work and research of the Hearing Voices Movement. Being respectfully accepted as a voice-hearer seems to help people feel that they can work towards a sense of control, self-direction, and self-acceptance in their lives. Feedback given by art therapists to a professional regional-group offers indications that the art therapy profession is responsive to service-user perspectives, collaborative work, and to the Hearing Voices Movement. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
44. From communication to co‐operation: Reconceptualizing social workers' engagement with children.
- Author
-
Ruch, Gillian, Winter, Karen, Morrison, Fiona, Hadfield, Mark, Hallett, Sophie, and Cree, Viv
- Subjects
CHILD welfare ,COMMUNICATION ,CONCEPTS ,DATABASE management ,EMOTIONS ,INTERPROFESSIONAL relations ,MEDICAL personnel ,BODY language ,PRACTICAL politics ,PROFESSIONAL employee training ,PROFESSIONAL ethics ,REFLECTION (Philosophy) ,RITES & ceremonies ,SOCIAL case work ,SOCIAL services ,PSYCHOLOGY of social workers ,EVIDENCE-based medicine ,PROFESSIONAL practice ,SOCIAL boundaries ,TASK performance ,PATIENTS' families ,SOCIAL worker attitudes - Abstract
Communicating and engaging with children is a foundational component of child care social work practice, but all too frequently, in the wake of serious incidents, it is the focus of criticism. Drawing on findings from a large‐scale ESRC‐funded research project conducted in the four U.K. nations, this paper explores, through a psychosocial analytic lens, how social workers anticipate, enact and reflect on their encounters with both children and their families. Close analysis of what social workers said about their practice alongside what they were observed to do in practice revealed perceptions, patterns and processes of communication that, first, minimize emotions and the complexity of the professional task and second, overly privilege verbal interaction. Drawing on Sennett's (2012) ideas this paper offers a reconceptualisation of this professional task, from a communicative to a co‐operative one. It affords and creates a space in which social workers can develop more attuned communicative practices that include rituals, gestures and the minimal use of force. The theoretical insights and evidence‐informed practice recommendations arising from this research have conceptual significance for the social work discipline and practical significance for the child care social work profession, across national and international contexts. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
45. Just a little bit of history repeating: the recurring and fatal consequences of lacking professional knowledge of acquired brain injury.
- Author
-
Holloway, Mark and Norman, Alyson
- Subjects
DISEASE relapse ,PROFESSIONAL practice ,EXECUTIVE function ,TEAMS in the workplace ,PROFESSIONS ,SOCIAL workers ,FAMILIES ,MENTAL health ,TREATMENT effectiveness ,DOCUMENTATION ,INTERPROFESSIONAL relations ,COMMUNICATION ,DECISION making ,BRAIN injuries ,DISEASE complications ,SOCIAL services ,THEMATIC analysis ,NEEDS assessment ,HEALTH promotion ,DISCHARGE planning - Abstract
Purpose: The purpose of this paper is to review safeguarding adult reviews (SARs) pertaining to individuals with acquired brain injury (ABI) since 2014. This extended literature review also explores the lessons and recommendations from these reviews in relation to social work practice within the UK. Design/methodology/approach: The literature review reported and discussed findings across reviews and then used a thematic analysis to synthesise the findings and recommendations from the SARs reviews. Findings: This paper identified four main themes: a lack of awareness of the needs of those with ABI and their families and around the symptoms and nuances of brain injury, particularly executive impairment and mental capacity, among social workers; poor interdisciplinarity led to a lack of shared communication and decision-making with professionals with such knowledge; a poor understanding of aspects of the mental capacity legislation, particularly surrounding unwise decisions, led to inappropriate or absent mental capacity assessments; and a lack of professional curiosity led to a lack of action where intervention or assessment was required. Research limitations/implications: This review identifies significant shortcomings in social work practice, education and training within the UK with regards to ABI. Practical implications: This paper provides recommendations to current social work practice and highlights the need for significant improvements in pre-qualification and post-qualification training and supervision of social workers. Originality/value: To the best of the authors' knowledge, while there have been extensive reviews conducted on SARs, this is the only review that has focused solely on ABI. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
46. A bibliometric analysis of studies on technology‐supported learning environments: Hot topics and frontier evolution.
- Author
-
Jing, Yuhui, Wang, Chengliang, Chen, Zhaoyi, Shen, Shusheng, and Shadiev, Rustam
- Subjects
- *
SCHOOL environment , *SERIAL publications , *COMPUTER simulation , *RESEARCH funding , *EDUCATIONAL technology , *EDUCATION research , *DESCRIPTIVE statistics , *REFLECTION (Philosophy) , *MOTIVATION (Psychology) , *THEMATIC analysis , *BIBLIOMETRICS , *ONLINE education , *PUBLISHING , *COMMUNICATION , *COMPUTER assisted instruction , *LEARNING strategies , *ALTERNATIVE education - Abstract
Background Study: Technology‐supported learning environments, act as significant observational and enabling indicators for evaluating and encouraging the digital revolution of education, are of vital importance in current educational research. Keeping track of the dynamics of technology‐supported learning environment research allows for the enrichment of theoretical studies and a prompt innovation of talent‐training environments. Objectives: The present study carried out a bibliometric analysis of the core collection of WoS database over the last two decades. Method: This study is a bibliometric research. We applied CiteSpace and VOSviewer for co‐occurrence and evolution analysis. In addition, we extracted the fundamental ideas and thoughts through reading and analysis. Results: First, the study found that technology‐supported learning environment research is in a growth phase, with core journals such as Interactive Learning Environments or Computers & Education. The findings show that a core research team comprised of such scholars as Hwang Gwo‐Jen, Lester James C. and Wong Lung‐Hsiang. Key nations of publishing and research strength are from China, the United States, the United Kingdom and the Netherlands. Second, the hot topics in research on technology‐supported learning environments were virtual learning environments, technology‐enabled learning environments and interactive learning environments. Nine study specifics were derived from these three topics such as moulding function, generating scenario, stimulating sensation, effect verification, design idea, research reflection, inquiry and research, virtual community, and mixed environment. Lastly, the frontier evolution offers a pattern of development from enhancing performance to changing mode to incorporating experience. Conclusion: Looking ahead, our research recommendations for the field of technology‐supported learning environments include a multifaceted approach. We should aim to enhance research designs and methodologies, develop contemporary guiding theories and strive for a balanced representation across various educational domains, expanding our scope to encompass all academic disciplines. In terms of practical application, it is imperative to focus on the design and implementation of technology‐supported learning environments from three critical perspectives: "change‐demand," "student‐learning" and "online‐offline." These approaches will collectively ensure that technology‐supported learning environments are both innovative and responsive to the diverse needs of the educational landscape. Lay Description: What is already known about this topic: Technology‐supported learning environments are currently a focal and hot research topic in the field of education.Although numerous studies have been conducted on the learning environment of technical support, there has yet to be a systematic and comprehensive review of the related research. What this paper adds: This study provides a comprehensive review of research on the technology‐supported learning environments over the past two decades.This study primarily presents an overview of research on the technology‐supported learning environments over the past two decades, focusing on main literature, research strength, hot topics and frontier evolution. Implications for practice and/or policy: Researchers need to further advance research on technology‐supported learning environments by enriching research designs and methods, constructing up‐to‐date guiding theories and achieving a balance across different educational domains while extending the reach to all disciplines.Educational practitioners need to pay attention to the design and implementation of technology‐supported learning environments from the three viewpoints of "change‐demand," "student‐learning" and "online‐offline." [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
47. 'That's as hard a decision as you will ever have to make': the experiences of people who discussed Do Not Attempt Cardiopulmonary Resuscitation on behalf of a relative during the COVID-19 pandemic.
- Author
-
Tomkow, Louise, Dewhurst, Felicity, Hubmann, Michaela, Straub, Christina, Damisa, Efioanwan, Hanratty, Barbara, and Todd, Chris
- Subjects
FAMILIES & psychology ,CARDIOPULMONARY resuscitation ,MEDICAL quality control ,ATTITUDES of medical personnel ,RESEARCH methodology ,COMMUNICATIVE competence ,DO-not-resuscitate orders ,INTERVIEWING ,VIDEOCONFERENCING ,FAMILY attitudes ,RESEARCH funding ,PATIENT-family relations ,DECISION making ,QUALITY assurance ,THEMATIC analysis ,COVID-19 pandemic ,OLD age - Abstract
Background COVID-19 brought additional challenges to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, which was already a contentious issue. In the UK, reports of poor DNACPR decision-making and communication emerged in 2020, including from the regulator, the Care Quality Commission. This paper explores the experiences of people who discussed DNACPR with a healthcare professional on behalf of a relative during the coronavirus pandemic, with the aim of identifying areas of good practice and what needs to be improved. Methods a total of 39 people participated in semi-structured interviews via video conferencing software or telephone. Data were evaluated using Framework Analysis. Findings results are presented around three main themes: understanding, communication and impact. Participants' understanding about DNACPR was important, as those with better understanding tended to reflect more positively on their discussions with clinicians. The role of relatives in the decision-making process was a frequent source of misunderstanding. Healthcare professionals' communication skills were important. Where discussions went well, relatives were given clear explanations and the opportunity to ask questions. However many relatives felt that conversations were rushed. DNACPR discussions can have a lasting impact—relatives reported them to be significant moments in care journeys. Many relatives perceived that they were asked to decide whether their relative should receive CPR and described enduring emotional consequences, including guilt. Conclusion the pandemic has illuminated deficiencies in current practice around DNACPR discussion, which can have difficult to anticipate and lasting negative consequences for relatives. This research raises questions about the current approach to DNACPR decision-making. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
48. Relationship Quality Between Small and Medium-Sized Enterprise Partners During Threatening Times: The Role of Contact Frequency and Social Exchanges.
- Author
-
Trapp, N. Leila, Jørgensen, Poul Erik Flyvholm, Svendsen, Gert Tinggaard, and Skov, Line
- Subjects
SOCIAL exchange ,RELATIONSHIP quality ,SOCIAL interaction ,SMALL business ,BUSINESS to business electronic commerce ,BUSINESS partnerships ,TRADEMARKS - Abstract
The United Kingdom's European Union membership referendum, which marked the end of UK membership in the European Union, created much uncertainty amongst those British and European business practitioners who were accustomed to conducting trade with partners across The North Sea. This exogenous threat to business was subsequently compounded by another serious threat: the COVID-19 pandemic. Knowing that business-to-business (B2B) relationships are particularly important for the success of small- and medium-sized enterprises (SMEs), and that exogenous threats in the business environment can threaten these relationships, the purpose of this study is to examine whether frequent contact and social exchanges between partners on a range of topics, during threatening times, are positively linked to the relationship qualities of trust, satisfaction, and commitment. Guided by an explorative, expert interview with a Danish SME owner-manager (OM) who has a great deal of experience conducting business with UK partners, a questionnaire was developed to examine two variables which seemingly play central roles with regard to supporting business relationships during threatening times: contact frequency (how often partners are in contact), and contact scope (how often B2B partners talk together about topics which are social in nature). The questionnaire was administered to 193 Danish SME owners and managers who had British business partners at the time of the BREXIT referendum and the COVID-19 pandemic. The questionnaire revealed a positive relationship between contact frequency and relationship satisfaction and commitment, as well as a positive relationship between contact scope and relationship commitment. However, no significant relationships were found between contact frequency nor contact scope, on the one hand, and the level of trust between business partners on the other. This study has underscored the usefulness of studying social exchanges, and not just information exchanges, as they are an important, relationship-strengthening aspect of B2B communication. Indeed, while the central role played by informational exchanges in building quality relationships, including trusting relationships, is well-documented, this study increases our understanding of the value of social exchanges to business relationship quality; in particular, their noteworthy link to B2B partners' willingness to go to great lengths to maintain relationships during challenging times. Our findings indicate that simply being in contact with B2B partners and speaking about topics that are not directly related to business is not, on its own, a sufficient means of establishing trusting relationships; however, it is nonetheless worthwhile to take the time to nurture personal relationships with B2B partners. Just a modest amount of contact is positively related to relationship satisfaction, as well as relationship commitment, which can be crucial when unforeseen and threatening times inevitably arise in the business environment. Besides enhancing our understanding of the value of frequent and social exchanges in terms of relationship quality, this paper also illustrates a useful means of studying social aspects of business relationships, which are notoriously difficult to study. This is accomplished via a questionnaire study in which respondents are asked to concretely reflect upon and report on the frequency and nature of their contact with specific B2B partners. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
49. 'Wishes and feelings': Misunderstandings and missed opportunities for participation in child protection proceedings.
- Author
-
Dillon, Jo
- Subjects
SOCIAL participation ,FOCUS groups ,RESEARCH methodology ,SOCIAL workers ,CHILD behavior ,INTERVIEWING ,QUALITATIVE research ,CHILD welfare ,COMMUNICATION ,INTERPERSONAL relations ,SOCIAL services ,DATA analysis software ,LONGITUDINAL method ,PARENTS - Abstract
The gathering of 'wishes and feelings' in UK child protection proceedings (s.53 Children Act 2004) should highlight the child's opinion of social work intervention and services provided. However, with no statutory social work guidance on participation currently in place, children frequently miss opportunities to be involved in their own child protection planning. This paper is drawn from a 3‐year study into participation in child protection social work. It includes findings from qualitative interviews, and one focus group, with social workers, parents, children and participation workers, from three local authorities in the United Kingdom. The findings revealed some examples of significant gaps in service provision, particularly from the perspective and understanding of the child. The skewed translation of wishes and feelings legislation, along with its subsequent (and often inadequate) application to practice, prevents children from understanding and responding to social work intervention and can lead to idiosyncratic practice. This paper provides recommendations for a practical response to practitioner dilemmas regarding wishes and feelings and bridges the gap between research and practice. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
50. Five years of collaboration in the UK upstream oil and gas industry.
- Author
-
Green, Richard and Keogh, William
- Subjects
STRATEGIC alliances (Business) ,PETROLEUM industry ,GAS industry ,PETROLEUM product sales & prices ,ECONOMIC conditions in Great Britain ,COMMUNICATION - Abstract
Discusses the evolution of collaborative relationships between companies in the oil and gas industry in Great Britain from 1992 to 1998. Effect of a decline in oil prices on the industry; Contribution of the oil and gas industry to the British economy; Overview of the collaboration of companies in the industry; Characteristics of collaborative relationships, including frequent and open communication.
- Published
- 2000
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.