• Maintaining a safe environment

      Chapman, Hazel M.; Whittam, Susan; University of Chester (Elsevier, 2019-03-30)
      INTRODUCTION Managing our own safety is thought to be a basic survival skill, which all individuals possess. We are not aware of managing our physiological homeostasis (for example, ensuring that our body cells are supplied with sufficient oxygen to produce the energy they need to function), and spend years learning to calculate and avoid risk from the external environment, The ability to control safety, including physiological homeostasis, and using physical ability and intellectual ability to manage risk, depends on a person’s stage in their lifespan development, their physical and mental wellbeing, their cognitive ability and the ability to control environmental factors such as housing, traffic, pollutants and even conflict. Throughout the world there are many differences in the types of hazards and risks that people are exposed to and just as many differences in the way that people manage their own safety. The inclusion of this AL in the Roper et al (1996, 2000) model is to draw your attention to the importance of being able to recognise the threats that exist to human survival and wellbeing and identify the impact that this may have upon any individual at any given time in their lives. In order to develop the knowledge that you need to apply it to your nursing practice, you will also need to read about the underlying physiology (how the body functions), pathophysiology (the disease process), psychology (thoughts, feelings and behaviours) and nursing practice in more depth. Several health psychology and psychology for nursing texts are referred to throughout this chapter, but physiology, pathophysiology and nursing practice are underpinned by core texts (Brooker & Nicol, 2011; Waugh & Grant, 2014). By understanding the processes involved in maintaining a safe internal and external environment for the person, you will learn to assess risk and plan care to maintain the safety of your patients. The model helps us to develop our understanding by focusing upon three key areas: • the human body's ability to protect itself and the biological mechanisms that it employs to carry this out • the ability that individuals have to make choices and take action to keep safe and free from danger • the identification and understanding of the dangers and hazards that exist in the surrounding environment (including the health care environment) and how they pose a threat to individual safety and wellbeing. These three areas will be discussed throughout this chapter within the framework of the model and will help to develop an understanding of the AL and enable nursing interventions to be as individualised and effective as possible. Often concern for our own health and safety only becomes heightened when we become ill, have an accident or hear about a tragedy or event that has had terrible human consequences. However, patient safety is essential for high quality health care, and a requirement in the United Kingdom Code for Nurses, Midwives and Health Visitors (Nursing and Midwifery Council, 2015) is to make the care and safety of people our main concern. Therefore, in nursing, we need to be able to assess and prevent risk, whether it arises from the person’s own health needs, or from the care we give and the way in which we give it. By using the framework of the Roper et al (1996, 2000) model in the following way we can begin to examine and identify how complex and varied health and safety issues really are and also identify the interrelatedness that exists between the other ALs. This chapter will therefore focus on the following: 1 The model of living • maintaining a safe environment in health and illness across the lifespan • dependence and independence in the activity of maintaining a safe environment • factors influencing the activity of maintaining a safe environment. 2 The model for nursing • the nursing care of individuals with health problems that affect their ability to undertake the activity of maintaining a safe environment • understanding of the hazards in the health care setting and how to promote patient safety effectively
    • Making normal birth a reality

      Steen, Mary; Walsh, Denis; University of Central Lancashire/Royal College of Midwives (APEO - Associacao Portuguesa Enfermeiros Obstetras, 2007-05-05)
      This article describes and discusses an conference paper given at the Dia Internacional do Enfermeiro de Saude Materna e Obstetrica, Viseu, Portugal. It highlights that many childbearing women in the 21st century now fear birth and the RCM's concerns that both women and maternity care professionals have become more dependent on technology during childbirth. This instigated the RCM's campaign for normal birth, which aims to inspire and support normal birth practice to maximise opportunities for women to experience normal birth and to reduce unncessary medical interventions. The importance of being with woman is stressed and a social model versus medical model of care is compared. Midwife's skills such as 'sussing out labour' and 'intuition' is explored as is 'working with pain' rather than a pain relief approach and 'holistic approaches to support normal birth practices are also discussed. In particular, active birth and the use of complementary therapies are reviewed. Midwives around the world can play an important role in making normal birth a reality once again.
    • Making sense of complexity: a qualitative investigation into forensic learning disability nurses' interpretation of the contribution of personal history to offending behaviour

      Skellern, Joanne; Lovell, Andrew; University of Chester; University of Derby
      Background: There is growing recognition that an individual’s personal history can be extremely influential in shaping his/her future experience, though there has been limited exploration in the context of learning disability and offending behaviour. Method: Research questions related to participant interpretation of offending behaviour and individual and service responses. A series of focus groups comprising learning disability forensic nurses were conducted across all secure settings, high, medium and low. Results: Three themes were produced: interpreting offending behaviour; the impact of personal history; responding therapeutically. The difficulties relating to understanding the relationship between offending behaviour and personal history significantly informed the construction of the most effective therapeutic relationships. Conclusions: An increased focus on the impact of someone’s background might inform nursing as it seeks to deliver care to individuals with increasingly complex needs in a time of service transition.
    • Making Sense of Health Improvement and Well-being

      Wilson, Frances; Massey, Alan; Mabhala, Mzwandile A.; University of Chester (McGraw-Hill / Open University Press, 2014-10-01)
      This chapter explores concepts and definitions of health, health improvement, and well-being. These concepts will be deconstructed and critiqued in the context of underpinning theory and evidence of the individual, community and population approaches to health improvement and well-being. This is undertaken to allow the reader to appreciate the differences and similarities of these concepts. It will allow the reader to appreciate the contribution of these concepts to providing health, public health to the promotion of health improvement and well-being. The use of case studies will facilitate the integration of these concepts with practice in the fields of health, improvement, and well-being
    • The management of children and family social workers in England: reflecting upon the meaning and provision of support

      Harlow, Elizabeth; University of Chester (Sage, 2015-09-28)
      In England in 2010, the then Children’s Workforce Development Council introduced an initiative which aimed to support front line social work managers in the performance of their role. This article reflects on the way in which support was interpreted and implemented by the Children’s Workforce Development Council and the local authorities that participated in the project, but also the relevance of the project for the social work profession in England at the time.
    • Management of modules and programmes

      Wilkins, Maureen; University of Chester (SAGE, 2010-10-29)
      This book chapter the importance of quality assurance and enhancement, good preparation, learning environment, and student support systems in good module and programme management.
    • Managing change

      Meredith, Linda; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses strategies for change management in the healthcare context.
    • Managing risk: A qualitative study of community-based professionals working with learning-disabled sex offenders

      Hutchinson, John; Lovell, Andy; Mason, Tom; University of Chester (2012-02-19)
      This study reports on research conducted to examine how community practitioners manage the difficulties of risk assessment in relation to people with a learning disability and a history of sexually offensive or abusive behaviour. Semi-structured interviews were conducted with a number of key professionals from various disciplines, all currently involved in the assessment process with the aim of determining potential referral to community settings. Data analysis revolved around a thematic exposition of factors influencing the relationship between the objective science of psychiatric investigation and the subjective interpretation of real-world practicalities in working with this group. Findings surrounded three major themes, frame conflict, relating to the difficulties of decision making in this area, therapeutic performance, whereby professionals were expected to engage in some form of active intervention, and safety outcomes, involving consideration of the problematic nature of judging the likelihood of re-offending.
    • Managing technology

      Hosker, Neil; Hinman, Peter; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses how technological developments have transformed the quality of patient care and the benefits and drawbacks it has brought.
    • Manifesto for change

      Carlisle, Caroline; Watkins, Caroline; Mason, Tom; Whitehead, Elizabeth; University of Liverpool ; Manchester University ; Caswell Clinic/University of Glamorgan ; Chester College of Higher Education (Routledge, 2001-07-12)
      This book chapter offers suggestions for healthcare professionals working with people who may be stigmatised. It offers suggestions on how practice may be taken forward in the areas of education, reserch and development, and individual professional practice.
    • Marginalised groups

      Mason-Whitehead, Elizabeth; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses marginalised groups and social exclusion.
    • Maternal health & well-being project

      Steen, Mary; University of Central Lancashire/Royal College of Midwives/Leeds Teaching Hospitals NHS Trust (2006-05-12)
      It is important that women receive information and advice about normal birth practices and healthy lifestyles. In the United Kingdom,the Royal College of Midwives Campaign for Normal Birth, ‘aims to inspire and support normal birth practice’(RCM, 2005) and the Department of Health has acknowledged that ‘Healthy mothers are key for giving healthy babies a healthy start in life’.(DoH, 2004) This presentation describes a holistic health and fitness programme specifically designed to raise awareness of the health benefits of normal birth and the general health and wellbeing of women, their babies and their families.
    • Maternal health & well-being project

      Steen, Mary; Leeds Teaching Hospitals NHS Trust/Leeds City Council (2005)
      A Maternal Health & Well-Being Initative that involved workshops and exercise classes that promoted normal birth and public health.
    • Maternal mental health: Stigma and shame

      Steen, Mary; Jones, Alun; University of Chester ; University of Chester (Medical Education Solutions Ltd, 2013-06-01)
      For some vulnerable women, a major life event such as becoming pregnant can bring out a predisposition to mental illness. Receiving mental health care can invoke stigma and shame in varied and complex ways causing a sense of entrapment.
    • Maternal nutritional status, food intake and pregnancy weight gain in Nepal

      Acharya, Ojaswi; Zotor, Francis B.; Chaudhary, Pushpa; Amuna, Paul; Ellahi, Basma; Action Contre La Faim; University of Health and Allied Sciences; Nepal Society of Obstetricians and Gynecologists; University of Greenwich; University of Chester (SAGE, 2016-03-07)
      Poor maternal nutrition during pregnancy may predispose to intrauterine growth restriction (IUGR), immunological and metabolic adaptations which manifest as low birth weight and increase the risk of adult non-communicable disease. This study examined the relationships between maternal nutritional status, food intake and pregnancy weight gain (PWG) which may account for risk of low birth weight (LBW) in Nepal.
    • The maze of midwife practice

      Steen, Mary; Royal College of Midwives/UCLan (2005-11)
      This presentation discusses the role of a midwife and debates whether she practises as an expert,a specialist or obstetric nurse. Essential midwifery practice focuses on autonomy, normality, holistic care, woman centredness and respecting differences. 'Every Midwife Matters', the challenges and barriers to midwifery care in the UK in the 21st century are explored and debated.
    • Measure of the Rate at which Mortality in Type 2 Diabetes Mellitus Occurs: Protocol for a Systematic Review.

      Nwaneri, Chukwuemeka; Cooper, Helen; Bowen-Jones, David; Agwu-Umahi, Olanike; Osho, A. Temitope; University of Chester; Arrowe Park Hospital; Alder Hey Children's NHS Foundation Trust (Teerthanker Mahaveer University, 2014-07-01)
      Introduction: Type 2 diabetes is the third largest cause of mortality in the United Kingdom, with about 50% of patients’ having developed complications at time of diagnosis. We consider that the evidence which explores the actual hazard ratios of mortality has not been consistent. n this paper we discuss methodology and review the most recent accurate data on mortality in type 2 diabetes. Methods: A systematic review will be undertaken aimed at synthesis of evidence of relative risk of mortality in type 2 diabetes, using the Centre for Reviews and Dissemination guidelines. We will explore conflicting and unanswered questions in relation to mortality. The primary outcome is all-cause, overall-cause or total mortality expressed as hazard ratios. Sub-groups will also be explored; age, gender, socio-economic factors and causes of death. We will review abstracts published after 1990 in the English language. Our data source will include electronic databases; the Cochrane library, the Centre for Reviews and Dissemination, Medline/PubMed, and other grey literature. The study populations are type 2 diabetes patients whose mortality outcome, expressed as hazard ratio, has been evaluated. Data extraction will be undertaken by one reviewer and triangulated by the second and third reviewer. The quality of the included studies will be evaluated in accordance with the inclusion/exclusion criteria; methodological quality that meets the critical appraisal framework and the relevance to the research questions. Evidence from data will be synthesised through a descriptive epidemiological review from included studies; meta-analysis will be used if appropriate. Result & Conclusion: We expect to pool homogenous studies of large population cohorts which explore the hazard ratio of mortality, and to summarise the evidence of the actual mortality risk in type 2 diabetes, with limited bias. This will help direct future research in areas of unanswered questions and may influence healthcare policy decisions.
    • Measurement instruments

      Mitchell, Andrew E. P.; University of Chester (SAGE, 2014-01-01)
      KEY POINTS • Measurement instruments enable the quantification of characteristics of interest to researchers • There are several methods of measuring characteristics, including scaling techniques • Any measurement instrument must be valid and reliable • Measurement instruments are important in healthcare research as they enable the measurement of attributes that are difficult to observe directly, such as cognitive and affective characteristics
    • Men and women’s perceptions and experiences of attending a managing abusive behaviour programme

      Steen, Mary; Downe, Soo; Graham-Kevan, Niki; University of Chester ; University of Central Lancashire ; University of Central Lancashire (Royal College of Midwives, 2009-12)
      Background: Domestic violence is a global and pernicious problem affecting all spheres of society. It has traditionally been seen as a social problem, but is now recognised to be a public health issue and reducing the incidence is a Priority Action 1 within Public Service Agreement 23. Sadly, domestic violence sometimes commences or escalates during pregnancy and during the transition to parenthood. It has been identified as a significant contributor to maternal and fetal morbidity and mortality, through both direct and indirect means. This paper describes the first phase of a study exploring the views of men and women, who had attended Start Treating Others Positively (STOP) a charity based in Leeds, UK. The adapted Appreciative Inquiry model of behavioural change underpins the work of STOP. Aim of the study: To explore the perceptions and experiences of participants attending STOP, to gain an insight of the effect this has had upon their ability to change their abusive behaviour to non-abusive and manage relationship conflict. Method: An exploratory study involving 20 participants (15 men and 5 women) who are parents and attending Start Treating Others Positively (STOP voluntarily. Ethics approval was granted by the university’s health ethics committee and guidance cited in the NHS Research Governance Framework was addressed throughout the study. Semi-structured interviews were undertaken during December 2007 and January 2008. An interview schedule of open and closed questions was used to gain an insight into respondents’ perceptions and experiences. Data were analysed by using a thematic analysis which entailed the identification of 6 primary emerging themes, 3 secondary core themes, then a final core theme, and the development of a synthesis statement. Findings: This first phase of this study explored the perceptions and experiences of 20 participants who attend STOP on how they have learnt to manage their behaviour to prevent themselves being abusive in their family relationships, and the impact this has had on their lives. Participants agreed that there were no excuses for domestic violence. Initially, six sub-themes emerged from the data: emotional regulation, emotional understanding, developing empathy skills, changed behaviour, developing conflict resolving skills, coping strategies. These were integrated into three overarching themes: emotional stability, cognitive empathy, conflict competency. Following synthesis, these were summarised into one phrase: ‘positive life skills’. The interviews demonstrated the participants had developed positive life skills whilst attending STOP to enable them to manage their emotions, behaviour and family relationship conflict. There was also evidence that these positive life skills were being taught to the participant’s own children Conclusions: Domestic violence has enormous implications for the health sector in general and within maternity services. Preventing future cases of domestic violence will reduce both maternal and fetal mortality and morbidity rates. The government has recognised the need to reduce the prevalence of domestic violence as a high priority, yet there is limited research to demonstrate effective preventative measures.
    • Mental Health and Primary Care

      Sharma, Vimal; University of Chester (Insight Medical Publishing Group, 2017-07-21)
      Mental ill-health is a leading cause of disability and most people with mental health problems approach their primary care doctors for help. One in four consultations in primary care is mainly due to mental health related issues. Yet mental health hasn’t received due attention so far in primary care setting. The main challenges in taking mental health services at primary care level include limited mental health specialists, low priority given to mental health, Inadequate training and skills of primary care workforce, Inadequate specialists’ support to primary care workers as well as negative attitude and stigma towards metal illness. Investing in work force’s training and education in identifying and managing mental disorders at primary care is the only way forward to address the huge treatment gap exists for mental illness. The use of technology and computers may assist this process further. An example is use of a pragmatic computer assisted diagnostic and treatment tool such as GMHAT/PC. Psychiatrists and other mental health professionals need to change their mind-set to work differently by supporting primary care workers, spending more time in training front line workers and taking some leadership in keeping the mental health agenda high up in policy makers’ list.