• Using a feminist standpoint to explore women’s disclosure of domestic violence and their interaction with statutory agencies

      Mason, Tom; Keeling, June J. (University of ChesterUniversity of Chester, 2011-11)
      This thesis explores women’s disclosure of domestic violence, and is based on the findings of two research studies. The first study explored prevalence rates of domestic violence reported by women following childbirth. The subsequent narrative study explored women’s experiences of disclosure and their interactions with statutory agencies. The research was influenced by a feminist epistemology, recognizing the marginalisation of the women’s experiences from a subjugated relationship, addressing the power relationship between the researcher and participants and because of the significant disparity between gendered lives. The study was conducted in two parts. A survey of five hundred women in the immediate postnatal period within a large NHS Hospital participated in the first part of the study. The second study involved narrative interviews with fifteen women living within their own community who talked about their experiences of domestic violence and issues surrounding disclosure. Women’s stories about disclosure including the responses they received were influenced by cultural narratives. The theories of social power have been utilized as an explanatory framework and provide the theoretical basis of the analysis. The study found low levels of disclosure at two specific points along the pregnancy/childbirth continuum; during booking in clinic and in the immediate postnatal period. Furthermore, the findings revealed three specific tactics used by perpetrators to engage women in the early relational stage with the intentionality of exerting control and subjugation. These have been termed feeling special, feeling vulnerable and commitment. Whilst women talked of coercion and subjugation by their partners, they also talked of how their interactions with statutory agencies limited their agency. The significance of this study is that the thesis was able to challenge contemporary policies developed by statutory agencies in the provision of support to women who experience domestic violence. The thesis develops some understanding of the nature and role of cultural narratives and patterns of disclosure before suggesting new directions to further advance the findings presented. Finally, the thesis proposes recommendations to improve training for statutory agencies in providing a response to women disclosing domestic violence, suggesting a new direction in thinking about the facilitation of this training.
    • Utilising a Bourdieusian lens to explore emerging health visitor practice education experiences within the context of the Health Visitor Implementation Plan

      Gidman, Jan; Taylor, Lou; Haydock, Deborah (University of Chester, 2019-05-14)
      The Health Visitor Implementation Plan (HVIP) (DH, 2011a) changed the recruitment criteria for health visiting and the way health visitor (HV) practice placements were supported. Several universities offered accelerated '2+1' programmes, where a graduate with a health related degree obtained accreditation of prior learning and completed pre-registration nurse training in two rather than three years. This was then followed by a one-year post-registration Health Visitor programme. This widening of recruitment afforded a unique opportunity to explore the experiences of 2+1 HV students, practice teachers (PTs) and mentors, and emerging practice education models within the context of the HVIP. Findings are considered through the lens of Bourdieu’s theory of practice. The study adopted an interpretive phenomenological design to gain a deeper understanding of the experiences of students, PTs and mentors. In-depth semistructured conversational interviews were undertaken with four HV 2+1 students, two PTs and two mentors. Interviews were recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Findings viewed through a Bourdieusian lens indicate that policy change in the form of the HVIP affected the structure of the social field, resulting in a period of transition when some participants had difficulty adapting to the changed social context. Long arm models of practice education added to the complexity of the PT role, including the additional responsibility of overseeing numerous students and mentors. Mentors reported feeling under pressure, exacerbated by working in inexperienced teams; and frustration that their contribution to the HVIP was disregarded, compounded by a lack of opportunity for professional progression. Students undertaking different routes into nursing are affected by extrinsic views and this affects evolving habitus and enculturation. When students’ prior experience is valued, this strengthens the students’ perception of their ‘field’ position. Placement changes, particularly during consolidation, can be detrimental as they affect habitus formation and student learning and impact upon assessment processes. The research offers new insights into health visiting practice education and the impact of policy change on practice settings. The findings have implications outside health visiting in the current context of changes to nurse education and the introduction of the new NMC (2018b) standards for student supervision and assessment. New knowledge is offered with regards to the significance of transition periods, changing roles, and the potential impact upon the provision of student practice placements and those who support them. Recommendations are made for further areas of research, practice placement providers and HEIs.
    • Visual perceptions of ageing: A multi method and longitudinal study exploring attitudes of undergraduate nurses towards older people

      Mason-Whitehead, Elizabeth; McIntosh-Scott, Annette; Ridgway, Victoria (University of Chester, 2015-12)
      Ageism and negative attitudes are reported to be institutionally embedded in healthcare. The unprecedented increase in the older population together with social perceptions of later life presents all those involved in the delivery of healthcare with considerable challenges. It was therefore timely to examine attitudes and perceptions of healthcare professionals towards older people. This study presents a critical visual exploration of the perceptions of ageing of undergraduate nursing students at a University in the North of England, based on the findings of a three year longitudinal study. The research employed a pragmatic standpoint where mixed methodology was adopted to explore perceptions and included the use of an attitude towards older people scale (KOP) (Kogan, 1961), visual methods (participants were asked to draw a person aged 75), a Thurstone scale and photo elicitation. The research design and construct was influenced by the epistemology of constructionism and discourse analysis. The research was conducted alongside an undergraduate nursing programme, and followed the natural journey of 310 students from one intake and involved three waves of data collection. The study established that the majority of participants had moderately positive attitudes towards older people the beginning of the programme and that these had improved for a significant number by the end of the study programme. From the quantitative data it was determined that age, gender, educational qualifications, practice learning, branch of nursing and contact with older people influenced the participants’ overall attitude score. The use of visual methods provided a narrative of the participants’ perceptions of later life and appearance dominated the imagery via the physical depiction of ageing and the ascetics of clothing and grooming. The influence of role models was seen to impact upon the production of the image via the depiction of grandparents and people they knew and the drawings identified some older people being active. The visual findings established that the undergraduate nurses in the study viewed older people from a socially constructed phenomenon and used symbols (hairstyle, clothing, mobility aids) to depict old age. The nursing programme was found to positively alter perceptions. The research findings have led to recommendations based on three prominent themes; 1) implications for nurse education and practice, 2) gerontology education and research and 3) future use of the research methods.