• Cancer patients’ respect experiences in relation to perceived communication behaviours from hospital staff: analysis of the 2012-2013 National Cancer Patient Experience Survey

      Clucas, Claudine; University of Chester (Springer, 2015-10-05)
      Purpose: Respect experiences are poorly understood despite respect being central to professionalism in healthcare and patient well-being, and needed for optimal patient care. This study explores which patient-perceived communication behaviours from hospital staff contribute most to cancer patients’ respect experiences and account for variation in their experience by socio-demographic and clinical characteristics. Methods: Secondary analysis of data from the 2012-2013 National Cancer Patient Experience Survey of 45191 patients with a primary cancer diagnosis treated in English National Health Service trusts providing adult acute cancer services who provided data on experienced respect and dignity. Results: Both autonomy-supportive and caring/emotionally sensitive behaviours were associated with reported respect, although the latter showed stronger associations and accounted for most differences in reports of respect between patient groups. Differences in respect were found by gender, race/ethnicity, age, the presence of long-standing conditions, treatment response, time since first treated for cancer (p<.001), employment and type of cancer (p<.05). Conclusions: The study questions the tendency to conceptualise respect primarily in terms of autonomy-supportive behaviours and shows the relative contribution of autonomy-supportive and caring/emotionally sensitive behaviours in explaining disparities in respect experiences. More attention should be paid to affective communication behaviours from hospital staff to reduce disparities in respect experiences.
    • Differential Effects of Single and Double Parental Death on Child Emotional Functioning and Daily Life in South Africa

      Sherr, Lorraine; Croome, Natasha; Clucas, Claudine; Brown, Elizabeth; University College London; University of Chester; Mad About Art Kynsa, SA (Child Welfare League of America, 2014-01-01)
      There is a high level of orphaning in Africa due to war, violence, and more recently HIV and AIDS. This study examines parental death in South African children and examines the differential impact on child functioning of double, single and non-orphanhoods. Bereavement, depression, behavior problems, and violence were examined in a consecutive sample of 381 children/adolescents (51.2% girls) between 8 and 19 years of age (M = 12.8). Parental death experience was high; 70 (17.5%) reported the death of one parent, and a further 24 (6%) reported the death of both. Group comparisons showed double orphans had elevated depression, worse psychosocial functioning, were more likely to be kept home from school for household chores, and were more likely to be slapped. Single orphans were more similar to the non-orphans than the double orphans on most scores. Our study reveals that parental loss should be studied with more fine-grained definitions and that emotional sequelae should be addressed.
    • Evaluation of Follow-Up Effects of the International Child Development Programme on Caregivers in Mozambique

      Skar, Ane-Marthe Solheim; Sherr, Lorraine; Clucas, Claudine; von Tetzchner, Stephen; University of Chester (2014-04)
      Parenting programs have been used to good effect in many settings, yet few are systematically introduced and evaluated in developing countries. This study explores the relative long-term effect of participation in the International Child Development Programme (ICDP) in a group of caregivers in Mozambique. A quasi-experimental design was used to compare caregivers who had completed an ICDP course (n = 75) with a sociogeographically matched comparison group participants (n = 62) who had not followed any parenting program. Both groups completed a questionnaire about parenting, attitudes toward the child and the child’s behavior, self-efficacy, life quality, and mental health. The ICDP group reported better parenting skills, fewer conduct problems in their children, and better child adjustment than the comparison group, as well as a shift in physical punishment away from hitting. The ICDP group had higher self-efficacy scores, better health and life quality, and lower scores on mental health difficulties. The follow-up differences between caregivers who had and had not attended the ICDP course indicate that course attendance may result in observable benefits in parenting and mental health scores. The data are cross-sectional and the caregivers were interviewed postintervention only, and more research is therefore needed.
    • How can Respectfulness in Medical Professionals be Increased? A Complex but Important Question.

      Clucas, Claudine; St Claire, Lindsay; University of Chester; University of Bristol (Springer Verlag, 2016-12-14)
      Respectfulness is demanded of doctors and predicts more positive patient health-related outcomes but research is scarce on ways to promote it. This study explores two ways to conceptualize unconditional respect from medical students, defined as respect paid to people on the basis of their humanity, in order to inform strategies to increase it. Unconditional respect conceptualized as an attitude suggests that unconditional respect and conditional respect are additive, whereas unconditional respect conceptualized as a personality trait suggests that people who are high on unconditional respect afford equal respect to all humans regardless of their merits. One-hundred and eighty one medical students completed an unconditional respect measure then read a description of a respect-worthy or a non-respect-worthy man and indicated their respect towards him. The study found a main effect for unconditional respect and a main effect for target respect-worthiness but no interaction between the two when respect paid to the target was assessed, supporting the attitude-based conceptualization. This suggests that unconditional respect can be increased through relevant interventions aimed at increasing the relative salience to doctors of the human worth of individuals. Interventions to increase unconditional respect are discussed.
    • The impact of a parenting guidance programme for mothers with an ethnic minority background

      Skar, Ane-Marthe Solheim; von Tetzchner, Stephen; Clucas, Claudine; Sherr, Lorraine; University of Oslo ; University of Oslo ; University College London ; University College London (de Gruyter, 2014-09-16)
      The current mixed-method study investigates the effects of a culturally adapted version of the International Child Development Programme (ICDP) with 135 mothers – 29 ethnic Pakistani mothers residing in Norway attending Urdu-language groups and a comparison group of 105 Norwegian mothers attending Norwegian-language groups. All mothers completed questionnaires on parenting and psychosocial health before and after attending the ICDP programme. In-depth interviews with a subgroup of 12 ethnic Pakistani mothers and 8 ethnic Norwegian mothers were analysed using thematic analysis. Before the ICDP programme, the Urdu-speaking mothers spent more time with the child, scored higher on distant child management and reported poorer mental health. Most changes over time were similar but significant for the Norwegian-speaking group only, which might imply that the minority mothers were in the process of change. In the interviews, the Urdu-speaking mothers’ emphasized enhanced communication and regulation, enhanced family relationships and life quality, whereas the Norwegian-speaking group told about increased consciousness and empowerment, and a more positive focus.
    • The long-term effectiveness of the International Child Development Programme (ICDP) implemented as a community-wide parenting programme

      Skar, Ane-Marthe Solheim; von Tetzchner, Stephen; Clucas, Claudine; Sherr, Lorraine; University of Oslo ; University of Oslo ; University College London ; University College London (Taylor and Francis, 2014-08-21)
      Short-term effectiveness of the International Child Development Programme (ICDP) for parents in the general population has been studied. The aim of this paper was to investigate the longer term impact of the ICDP programme on parents looking for sustained changes 6–12 months after the programme. For this, a nonclinical caregiver group attending the ICDP programme (N ¼ 79) and a nonattending comparison group (N ¼ 62) completed questionnaires on parenting, psychosocial functioning, and child difficulties before, on completion and 6–12 months after the ICDP programme. Analyses compare changes in scores over time. The results revealed that the ICDP group showed significantly improved scores on parenting measures, less loneliness, and trends towards improved self-efficacy compared to the comparison group 6–12 months after programme completion. The ICDP group also reported that their children spent significantly less time on television and computer games and a trend towards fewer child difficulties. Key positive effects sustained over time but at a somewhat lower level, supporting community-wide implementation of ICDP as a general parenting programme. It is concluded that more intensive training with follow-up sessions should be considered to sustain and boost initial gains.
    • Mothers and Fathers Attending the International Child Development Programme in Norway

      Clucas, Claudine; Skar, Ane-Marthe Solheim; Sherr, Lorraine; von Tetzchner, Stephen; University of Chester; University of Oslo; University College London (SAGE, 2014-08-19)
      Fathers are understudied in parent training studies. This study investigates whether mothers and fathers benefit equally from participating in the International Child Development Programme (ICDP) implemented as a community-wide programme in Norway in their parenting behaviour, perceived child difficulties and their psychosocial health. The questionnaire study used a pre-post design comparing 105 mothers and 36 fathers who attended a regular ICDP course. Results showed that the mothers and fathers differed on parenting behaviours prior to the course but showed similar changes, including on emotional and regulative aspects of parenting and autonomy supportive behaviours. However, only the mothers perceived a decrease in their child’s difficulties after the course while the fathers showed a greater increase in behaviours assumed to support the child’s meaning-making and in self-efficacy, and a greater decrease in anxiety after the course. ICDP courses appear to be a useful tool for supporting both mothers and fathers in their parenting role.
    • Paradoxical correlates of a facilitative parenting programme in prison—counter-productive intervention or first signs of responsible parenthood?

      Skar, Ane-Marthe Solheim; von Tetzchner, Stephen; Clucas, Claudine; Sherr, Lorraine; University of Oslo; University College London; University of Chester (Taylor and Francis, 2014-04-07)
      Purpose. Parenting programmes are rarely part of prisoners’ rehabilitation, and evaluations of such programmes are lacking. Methods. The present mixed-methods study investigates the International Child Development Programme (ICDP) with 25 incarcerated fathers and a comparison group of 36 community fathers through questionnaires administered before and after parenting courses. Interviews with 20 incarcerated fathers were analysed using thematic analysis. Results. Before the course, the prison group self-reported better parenting skills and poorer psychosocial health than the comparison group. Both groups improved on parenting strategies. On several measures the comparison group improved, while the prison group revealed the same or lower scores. The incarcerated fathers described becoming more aware of their paternal role but also saw the course as emotionally challenging. Conclusions. Some of the self-reported scores of the prison participants related to parental skills and psychosocial health decreased from ‘before’ to ‘after’ ICDP sensitization, pointing to the possibility that the ICDP courses may have contributed to overcoming a ‘prisonization process’, where the prisoner identity overshadows the parental identity, by making them more aware of their parental responsibilities. Due to the emerging possibility of counter-productive influences, a randomized controlled study is needed in the future to ascertain the parenting and recidivism-related effects of this programme.
    • Registered nurses’ experiences of communicating respect to patients: influences and challenges

      Clucas, Claudine; Chapman, Hazel M.; Lovell, Andy; University of Chester (SAGE Publications, 2019-04-04)
      Background: Respectful care is central to ethical codes of practice and optimal patient care, but little is known on influences on and challenges in communicating respect. Research question: What are the intra- and inter-personal influences on nurses’ communication of respect? Research design and participants: Semi-structured interviews with 12 hospital-based United Kingdom registered nurses were analysed using interpretative phenomenological analysis to explore their experiences of communicating respect to patients and associated influences. Ethical considerations: The study was approved by the Institutional ethics board and National Health Service Trust. Findings: Three interconnected superordinate themes were identified: ‘private self: personal attitudes’, ‘outward self: showing respect’ and ‘reputational self: being perceived as respectful’. Respectful communication involved a complex set of influences, including attitudes of respect towards patients, needs and goals, beliefs around the nature of respectful communication, skills and influencing sociocultural factors. A tension between the outward self as intended and perceived presented challenges for nurses’ reputational self as respectful, with negative implications for patient care. Discussion: The study offers an in-depth understanding of intra- and interpersonal influences on communicating respect, and sheds light on challenges involved, helping provide practical insights to support respectful care.
    • Respect in final-year student nurse–patient encounters – an interpretative phenomenological analysis

      Clucas, Claudine; Chapman, Hazel M.; University of Chester (Taylor & Francis, 2014-05-21)
      Very little is known regarding health-care professionals’ understanding and experiences of respect towards patients. The study aimed to explore student nurses’ understanding and experiences of respect in their encounters with patients. Semi-structured interviews were conducted with eight final-year student nurses with practice placements across different health-care trusts in the UK. Transcripts were analysed using interpretative phenomenological analysis (IPA). Three super-ordinate themes were identified: understanding of what it means to show respect, negotiating role expectations and personal attitudes in practice, and barriers related to the performance of the nursing role. The factors identified should be investigated further and addressed as they are likely to influence patients’ experiences of feeling respected in nurse–patient interactions and subsequently their well-being and health-related behaviours.
    • Understanding self-respect and its relationship to self-esteem

      Clucas, Claudine; University of Chester (Sage, 2019-10-21)
      The concept of self-respect has received little attention in the psychological literature and is not clearly distinguished from self-esteem. The present research sought to empirically investigate the bases of self-respect by manipulating adherence to morals together with interpersonal appraisals, or task-related competence, in hypothetical scenarios (Studies 1a and 1b) and a situation participants relived (Studies 2 and 3). Participants’ levels of state self-respect and self-esteem were measured. Studies 1-3 found main effects of adherence to morals on self-respect, with self-respect mediating the effect of adherence to morals on self-esteem, but little support for competence and interpersonal appraisals directly influencing self-respect. Self-respect uniquely contributed to anticipated/felt self-esteem alongside competence or interpersonal appraisals. The pattern of results supports the conceptualisation of self-respect as a component of self-esteem associated with morally principled conduct, distinct from performance and social self-esteem. The findings have implications for our understanding of self-esteem and moral behaviour.
    • The value of self-respect for moral and social behaviour: Development of a trait self-respect measure

      Clucas, Claudine; Wilkinson, Heather; University of Chester (2017-05-05)
      Objective: Research into self-respect is scarce, possibly because self-respect and self-esteem are often treated as interchangeable in popular culture. However, there is evidence that self-respect is a component of global self-esteem that is attached to moral, principled and honourable behaviour, highlighting its unique role in predicting moral behaviour and well-being. The paper reports on the development of the trait self-respect scale (SRS) to stimulate research into this concept. Design: Following pilot work to develop the items, cross-sectional survey and lab-based data were collected to validate the SRS. Methods: Seven convenience adult samples (total N=841) completed the SRS online or in person alongside other validated scales. One sample (N=115) also underwent lab-based tasks measuring moral self-concept and cheating. Results: Exploratory and confirmatory factor analyses supported a one-factor structure. The SRS showed good internal consistency (α>.8 in all samples), convergent and discriminant validity. It correlated significantly with self-esteem (r=.40-.61), and with agreeableness, Machiavellianism, positive norm, moral identity internalisation and symbolisation (N=121), moral-based self-esteem, self-control, number of moral trait adjectives recalled in self-related processing (N=115) and religious status (N=230), adjusting for self-esteem. It did not correlate with amount of social comparison, or with competence and social self-esteem, adjusting for self-regard. Moreover, self-respect significantly predicted forms of pro-relationship behaviour, pro-social behaviour (N=114), cheating (self-reported and observed) and well-being (N=81) over and above self-esteem. Conclusion: Findings support the need to consider trait self-respect in investigations of well-being and moral and social functioning, and contribute to debates on the value of self-esteem.