• Pain

      Barber, Paul; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses pain theories, physiology of pain, pain assessment, pharmacology, and alternative approaches to pain control.
    • Palliative care and the person with cancer

      Wyatt, Debbie; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses the relationship between palliative care and the person with cancer. The general principles of palliative care apply to those with cancer but there are a number of palliative care issues specific to the group or those caring for them.
    • Palliative care education

      Manford-Walley, Karen; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses how education for palliative care encompasses a wide variety of concepts and skills needed to match the diverse nature of care delivery. The education can be delivered at higher education institutions or in specialist settings in hospitals or within the community.
    • 'Paperwork': Its implications for community mental health nurses' practice

      Deacon, Maureen; University of Chester (University of Chester, 2011-09)
      This study aims to examine the real life documentary practices of community mental health nurses to enable a better understanding of the impact of paperwork on their nursing practice.
    • ‘Paradigm shift? Biomedical science and social work thinking’

      Carey, Malcolm; University of Chester (Routledge, 2019-07-17)
      This chapter examines the relationship between biomedical science and social work thinking. It looks at the similarities and differences between two unique but increasingly closely associated ‘helping professions’. As part of the discussion, the role of paradigm, power and ideological disparities and distinct traditions are stressed, as well as the impact of ongoing policy-led reforms which continue to bring each profession closer together.
    • Parental leave: Bad for breastfeeding?

      Wyndham, Delyth; University of Chester (Childhood Remixed, University Campus Suffolk, 2016-02)
      The latest UK parental leave reform introduced by the Children and Families Act 2014 could have an unintended impact on breastfeeding outcomes. The revised provision of up to 50 weeks shared leave was introduced in April 2015, with a view to encouraging parents to share infant care responsibilities more equally. This paper explores issues with definitions, policy shifts leading to the incremental change in entitlement and the potential for cascading policy failure.
    • Participatory action research: Moving beyond the mental health ‘service user’ identity

      Hutchinson, Andre; Lovell, Andy; Betsi Cadwaladr University Health Board ; University of Chester (Wiley-Blackwell, 2012-11-21)
      Contemporary models of involvement within statutory services pay little regard to the identity of individuals beyond the ‘service user’ label and in doing so unwittingly perpetuate and sustain the negative impact of mental illness. The aim of this paper is to discuss the process of a 3-year participatory action research study facilitated by a mental health nurse. It highlights the perspective of those involved as co-researchers, all having experience of accessing statutory mental health services. It identifies both the process and the impact of this type of involvement on them illustrating their move beyond an illness identity. The study involved them undertaking a series of interviews with other service users in relation to their life stories. They subsequently mapped and analysed the transcripts. In order that the people were enabled to undertake these roles the study included a process of interviewing and appointing service user researchers followed by a programme of training workshops, supervision and discussion group/ peer support. The accounts provided reflect the six researchers’ attempts to make sense of their experience and reveal the path of transformation through collaboration.
    • Peer mentoring and the role of the voluntary sector in [re]producing ‘desistance’: identity, agency, values, change and power

      Buck, Gillian; Keele University (Keele University, 2016-06-22)
      Despite much enthusiasm for the practice of peer mentoring by ex-offenders it has received very little empirical scrutiny. This thesis examines the micro dynamics and intimate interactions within these relationships. In doing so it highlights how mentors are often much more than functional additions to existing criminal justice systems. They are also presented as teachers, co-operators and critical agents. The narratives in this study highlight how dominant forms of knowledge often minimise or miss the lived experiences of crime and change. In contrast, peer mentors place lived experiences at the centre of their approach and in doing so they critically question exclusionary practices and re-humanise themselves and their peers. The work of peer mentors also highlights and at times challenges the hidden power dynamics that are subsumed when ‘regular’ interventions take place. But, mentoring cannot avoid or operate outside of these power relationships. It can and does generate other power dynamics. Whilst many of these complex relations remain hidden in current evaluations of the practice they are rendered visible here. Data were obtained from qualitative interviews with eighteen peer mentors, twenty peer mentees, four service coordinators and two Probation officers, who were drawn from a range of voluntary sector providers in the North of England. Observations of practice were also carried out, including: volunteer recruitment processes; training courses; and formal supervision sessions. Where possible mentors were also observed facilitating group work with their peers. The analysis of the data drew upon techniques of thematic analysis and critical discourse analysis focusing upon how mentoring was described, performed and justified by participants. As a result of this analysis five overarching themes emerged. These are: identity, agency, values, change and power.
    • The penal voluntary sector: a hybrid sociology

      Tomczak, Philippa; Buck, Gillian; University of Nottingham; University of Chester (Oxford Academic, 2019-01-09)
      The penal voluntary sector (PVS) is an important, complex, under-theorised area. Its non-profit, non-statutory organisations are highly significant in the operation of punishment around the world, yet ill-understood. Burgeoning scholarship has begun to examine specific parts of the sector, particularly individualised service delivery. We offer a five paradigm framework which more fully conceptualises the PVS, including different types of service delivery and important campaigning work. Our hybrid framework applies and extends Burrell and Morgan’s (1979) influential four paradigm model of social theory, which maps the theoretical diversity underpinning varying organisational activities. Our framework i) provides ideal-types which illustrate the range, fluidity and hybridity of PVS programmes and practices, and ii) highlights the (potential) roles of brokers in (re)directing activity.
    • People with learning disabilities who engage in self-injury

      Lovell, Andy; University College Chester (Mark Allen Publishing, 2004-07-01)
      This journal article represents some of the findings of the author's research into the relationship between self-injury and learning disability. It identifies the key theoretical discourses associated with the phenomenon, before elaborating on the main principles of each and identifying resultant intervention strategies. These interventions, psychotropic medication, mechanical restraint, and the behavioural approach are subsequently described. Case-study methodology was employed since this enabled the examination over time of these intervention strategies in the lives of individuals fulfilling the necessary criteria of persistent self-injury and significant communication difficulties. The findings of the research suggest a frequently piecemeal approach to self-injury, with arbitrary selection of behavioural intervention approaches, a continued reliance on powerful medication, and ambivalence concerning the use of mechanical restraint. Nurses were often skilled in working from a behavioural perspective, but were hindered by complex family circumstances and a failure to gain the confidence of direct care staff. There was also a lack of appreciation about the relationship between the individual and his/her self-injury, and recognition of the nature of the intransigence.
    • The perceived psychological stressors and coping behaviours in university students, on a pre-registration programme.

      Mitchell, Andrew E. P.; University of Chester (Emerald Publishing, 2020-05-20)
      The purpose was to investigate perceived stressors and coping behaviours in student nurses on a pre-registration programme of study. Stress in student nurses has been identified with decreased emotional well-being and poor academic achievement. The significance of stress and coping behaviours in students during training has implications for education and practice. The present study recruited eighty seven pre-registration student nurses in a cross sectional design. Bivariate and multivariate analyses assessed the differences in field and year of study and the students’ perceived stress and coping behaviours. The findings showed that stress is a significant issue in nurse training. Fifty-three percent of the participants had levels higher than the mean. Interestingly, the present study found that high perceived stress was associated with avoidance behaviours. The most common type of perceived stress and ranked by highest factor were from written assignments and a lack of professional skills and knowledge. Their peer group and everyday life activities were shown as potential ways of coping with stressors. Thus, it seems reasonable to focus support on decreasing avoidant and enhancing stress-reducing behaviours. Psychological stress and coping behaviours must be considered together as perceived stress is bound by the ability to ameliorate stress by managing helpful and unhelpful behaviours. The findings may suggest that a potential benefit could come from the provision of helpful strategies such as peer group support and reduction of avoidant behaviours. Also, there seems to be a need for greater mental health literacy in dealing with stress during training.
    • The perceptions and experiences of e-learning within undergraduate healthcare education: A case study

      Brownsell, Michael D. (University of Chester, 2016-03)
      Introduction: The use of e-learning in healthcare education is being increasingly advocated and used, but can prove challenging. The need to explore educator’s experience and student perspectives in relation to this area of pedagogy was identified as a relevant area of study Study Aim: To explore and critically analyse the perspectives and experiences of healthcare educators and students regarding e-learning. Design: A mixed methods exploratory case study of one HEI’s use of e-learning. Methods: Quantitative descriptive data was collected through educator and student questionnaires from 34 academics and 127 students across four university departments delivering undergraduate healthcare related programmes. A sample of 12 module web spaces and associated documentation was reviewed. The data sets were considered in relation to the thematic analysis of 16 semi-structured educator interviews and 6 healthcare student focus groups. Results: Educator and student needs are interwoven during undergraduate healthcare provision. Differing educational philosophies, practices and culture across the cases created opportunities and challenges with e-learning. Two differing, yet potentially complimentary definitions of e-learning existed within and across the four departments which produced either congruence or conflict toward the varied e-learning approaches. Student respondents selectively engaged in what was primarily educator controlled e-learning. Conclusions: The findings highlighted the need for agreement and understanding of philosophical and pedagogical underpinnings which define and shape e-learning by educators and students, along with an awareness of differing professional cultures across which e-learning is required to operate. Originality / Value: The findings of this study offer a deeper understanding of the effect on educator and student engagement in e-learning of differing higher education and professional practice education cultures. A model is offered as a response to particular issues faced by the study respondents; whilst non-generalisable the model may serve as an enlightening guide for educators who are introducing or applying constructivist e-learning practices within undergraduate healthcare provision and benefit the student experience.
    • Perceptions of care and caring: An orthopaedic perspective

      Mason-Whitehead, Elizabeth; Mason, Tom; Flynn, Sandra D. (University of Liverpool (University of Chester)Countess of Chester NHS Trust, 2013-05)
      “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn life around,” (Leo F Buscaglia 1924-1998). Caring is a universal phenomenon (Leininger, 1988a, 1991) that influences the way we think, feel and act and is the focus of debate worldwide. Studied since the days of Florence Nightingale and reflected in the literature are numerous theoretical opinions in the search for a comprehensive understanding of caring in the health experience of human beings (Newman et al., 1991). This ethnographic thesis has a caring science perspective (caring in orthopaedics) with the aim of acquiring a greater understanding of perceptions of caring in an orthopaedic clinical setting from both patient and health care professional perspectives. There is a wealth of literature relating to caring which attempts to define and interpret its meaning from several theoretical perspectives. In respect of institutional or professional caring, nursing has historically been synonymous with the notion of care and caring, modest research has been attributed to caring amongst other health care professionals in the wider context. The study used a sequential exploratory mixed methods design and was underpinned by Watson’s Theory of Transpersonal Care in order to discover and illuminate the essential caring behaviours valued by both care givers and care recipients. A total of 30 patients and 53 health care professionals consisting of doctors, nurses, physiotherapists and occupational therapists participated in the study through a three stage approach consisting of questionnaires, observation and semi-structured interviews. The findings revealed both similarities and differences between patients and health care professionals relating to the importance of positive caring behaviours revealed during caring interactions. The questionnaires disclosed that patients statistically rated caring behaviours demonstrated by health care professionals lower than the professionals rated themselves. The data analysis from the participant observation and semi-structured interviews established that although all of the caring caratives according to Watson’s Theory of Care were evident in caring interactions they varied as to the number of times they were exhibited by the respected health care professional groups. Overall patient perception of caring focused upon behaviours related to the caring carative ‘assurance of human presence’ whilst health care professionals considered caring behaviours relating to the caring carative ‘respectful deference’ as the most important. This thesis highlights the need of the patient to feel ‘cared for’ and ‘cared about’ and in today’s modern health care system caring should not be monopolised by one profession but instead the caring concept embraced and the caring dais shared by other professions.
    • PERCEPTIONS OF DEMENTIA

      Kingston, Paul; Taylor, Louise; Eost-Telling, Charlotte; Bailey, and Jan (Oxford University Press (OUP), 2019-11-08)
      Abstract This paper considers narratives of 143 respondents (“Observers”) to a Mass Observation Project Directive exploring individuals’ perceptions of dementia. Perceptions of dementia held by “Observers” with experience of dementia and those without differed sharply. “Observers” with experience of dementia offered insight into living with and caring for a person with dementia, and the impact this had on their lives and personal relationships. Whereas, “Observers” with no direct experience of dementia focused more on common disease symptoms such as memory loss and reflected idealised views of care. “Observers” often feared being diagnosed with dementia themselves. This suggests education to facilitate care planning and ameliorate fears held by the public is required.
    • Perineal tears and episiotomy: How do wounds heal?

      Steen, Mary; UCLan/Royal College of Midwives (Mark Allen Publishing, 2007-05-01)
      The care of perineal wounds is an important aspect of postnatal care. This article focuses on the healing of perineal wounds, describes tissue trauma, different types of wounds and classification of perineal wounds. Wound healing, factors that can prevent healing and the need to provide adequate pain relief that will have no adverse effect on healing are discussed in detail.
    • Perineal trauma: How do we evaluate its severity?

      Steen, Mary (MIDIRS, 1998-06)
      This article discusses a new tool designed in her unit for assessing the scale of perineal trauma
    • Person-centred healthcare research: A personal influence

      Chapman, Hazel M.; University of Chester (Foundation of Nursing Studies, 2018-05-16)
      Personal commentary on text: McCormack, B., van Dulmen, S., Eide, H., Skovdahl, K., Eide, T. (Ed.) (2017). Person-centred healthcare research. Chichester, United Kingdom: Wiley-Blackwell.
    • Personal grooming (beyond hygiene): a grounded theory study.

      Mason, Tom; Gidman, Janice; Mason-Whitehead, Elizabeth; Boulton, Michael J.; Woodhouse, Jan (University of Chester, 2015-10)
      Background: We are very individualistic in how we present ourselves to the world. Whilst we are healthy and self-caring we have control over the way we undertake self-groom. Once we need care the situation may change. In the setting of health and social care the emphasis has been on hygiene; aspects of personal grooming [PG] may be overlooked. Few studies exist in the health and social care literature that explore this crucial daily activity of living. Aim: This study aims to address the imbalance on what is known of PG. It seeks to thoroughly explore the concept of PG, identifying the normative activities involved, and the age-related behaviours that occur across the lifespan. Methods: Utilising a grounded theory [GT] methodology, an eclectic data collection approach was taken. Consequently a pilot group, four focus groups (child-focused; males 18-45; females 18-45; over-46), and a visual methodology formed the first phase of the study. The second phase consisted of a formal concept analysis, drawing on literature and data from the focus groups. The final phase of the study involved one-to-one semi-structured interviews with retired persons. A total of 26 participants took part in the study and both genders were represented. Analysis was undertaken using the range of coding consistent with a GT approach and the notion of constant comparison. Findings: New knowledge on PG emerged; an academic definition of PG; PG was found to have ‘four elements’: hygiene, appearance management behaviours, body modification and enhancement. There was a ‘spectrum’ of grooming recognised, which ranged from the wild, un-groomed state to that of being over-groomed. The term ‘allo-grooming’, which means grooming of another, was used to explore the part families play in social learning about PG. A timeline of PG behaviours was created to illustrate how PG changes over the lifespan. Additionally, information on grooming activities, other than those of hygiene, was recorded. Implications: PG is complex and the ‘one-size-fits-all’ approach of concentrating on hygiene may not meet the needs of service users. Some body areas, for example, are not included in the published documents that help to guide care services. There appears to a gap in educational programmes of health and social care workers, in respect to PG. Recommendations for practice, policy, education and further research are proposed.
    • PERSONAL NARRATIVES OF AGING.

      Taylor, Louise; Bailey, Jan; Kingston, Paul; Eost-Telling, Charlotte (2019-11-08)
      AbstractThis presentation reflects on self-written narratives from respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first person description of past, present, future or imaginary experiences. This presentation will focus on the findings with reference to physical and mental impacts, both real and anticipated. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma. The data can be used to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.
    • The Perspective of Socioeconomic Inequalities and Infectious Disease in 21st Century

      Massey, Alan; Mabhala, Mzwandile A.; University of Chester (OMICS Group International, 2016-04-20)
      At the turn of the new century, the United Nations set a series of global health goals to be achieved by 2015. Amongst the eight Millennium Development Goals (MDGs), goal six aimed to combat HIV, malaria and other diseases.