• Narrative collisions, sociocultural pressures and dementia: the relational basis of personhood reconsidered

      Tolhurst, Edward; Weicht, Bernhard; Kingston, Paul; Staffordshire University; University of Innsbruck; University of Chester (Wiley, 2017-02-08)
      The concept of personhood developed by Tom Kitwood highlights that the experience of dementia has relational dimensions that transcend the neurodegenerative impacts of the condition. This relational focus, however, has been narrowly conceptualised, with the impact of broader sociocultural factors on experience underplayed. The empirical exploration of interaction also requires reinforcement: a tendency for dyadic studies to portray findings in an individualised format hinders the interrogation of interpersonal negotiations. This article draws upon qualitative research that employed a joint interview approach, interviewing men with dementia and their spousal carers together. The focus on a dyadic case study from this research enables methodical exploration of the experience of living with dementia. This is realised by considering the socially-framed perspective of each person, and then how their perspectives are interwoven within interactional exchanges. This provides a platform for the evaluation of the current decontextualised notion of personhood and its implications. It is concluded that a sociologically informed perspective can help to reinforce the academic understanding of personhood.
    • A narrative review of fathers’ involvement during labour and birth and their influence on decision making

      Longworth, Mary K.; Furber, Christine; Kirk, Susan; University of Manchester (Elsevier, 2015-06-14)
      Objective to identify and critically review the research literature that has examined fathers׳ involvement during labour and birth and their influence on decision making. Design the review follows the approach of a narrative review. Systematic searches of electronic databases Social Services Abstract, Sociological Abstracts, ASSIA, CINAHL Medline, Cochrane library, AMED, BNI, PsycINFO, Embase, Maternity and Infant care, DH-Data and the Kings Fund Database were combined with manual searches of key journals and reference lists. Studies published between 1992 and 2013 examining fathers׳ involvement during intrapartum care were included in the review. Findings the findings of this review suggest that fathers׳ level of involvement during labour ranges from being a witness or passive observer of labour and birth to having an active supporting and coaching role. The findings also suggest that there are a number of facilitators and barriers to fathers׳ involvement during labour and birth. There are a limited number of studies that have examined fathers׳ involvement in decision making and specifically how fathers׳ influence decision making during labour and birth. Key conclusions future research needs to address the gap in the literature regarding fathers׳ involvement and influence on decision making to help midwives and obstetricians understand the process in order enhance the transition to parenthood for women and men.
    • A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

      Benbow, Susan M.; Eost-Telling, Charlotte; Kingston, Paul; University of Chester; Older Mind Matters (Cambridge University Press, 2021-02-24)
      We carried out a narrative review and thematic analysis of literature on the physical healthcare, mental healthcare and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States. Five themes were identified: experience of discrimination/ prejudice and disrespect; health inequalities; socioeconomic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/ prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a life course perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.
    • Narratives of personalisation in mental health: a collective case study

      Lovell, Andy; Coyle, David S. (University of Chester, 2016-11)
      This work describes the impact of personalisation on users and professional workers identities in four mental health care settings. The development and context of personalisation is identified and set within an emergent narrative of consumer choice and austerity. International personalisation research is compared and a discussion of UK mental health literature is presented. The social constructions of key participants are analysed through their narrative accounts as they undertook identity work while being involved with individual budget pilots, either as users, carers, brokers or mental health professionals. The work employs Stake’s collective case study as the method of combining semi-structured interview data taken from participants in four personalisation studies designed and led by this author between 2008-2011. Narrative social constructionist methods, positioning theory and story-line are used in the analysis to produce a framework of participants’ orientation to personalisation. The importance of nuance as opposed to binary construction towards personalisation is highlighted, as are the positioning actions of independent brokers for the success of personalisation. The importance of co-production and challenging professional asymmetry in health and social mental health care services is clearly made as are the implications for practice. The value of the proposed framework and possible future research are discussed.
    • Natural herd immunity should not be used as a means of pandemic control

      Davidovitch, Nadav; Signorelli, Carlo; Chambaud, Laurent; Tenenbaum, Arianne; Reid, John; Middleton, John; ASPHER COVID-19 Task Force, Brussels, Belgium; School of Public Health, Ben Gurion University of the Negev, Be’er Sheva, Israel; Università Vita-Salute, San Raffaele (UniSR), Milan, Italy; École des Hautes Études en Sante Publique (EHESP), Rennes, France; Department of Public Health and Wellbeing, University of Chester, Chester, United Kingdom; Association of Schools of Public Health in the European Region – ASPHER, Brussels, Belgium
      Short opinion article advising against relying on natural herd immunity and need for vaccine derived population immunity. "We need to focus on using successful virus suppression strategies until we reach herd immunity with the new vaccines. We need to track the epidemiology of the virus using population serology, but it is dangerous, and unfounded in science, to advocate natural herd immunity as a means to pandemic control".
    • The neoliberal university, social work and personalised care for older adults

      Carey, Malcolm; University of Chester (Cambridge University Press, 2021-01-11)
      This article critically examines the impact of the neoliberal university upon social work education and practice relating to older people. It appraises market-led pedagogical reforms, including of the training of social workers who go on to work with older adults, such in support of policies including personalisation. Influence is drawn from the work of Nancy Fraser (2019): specifically, her understanding of ‘progressive neoliberalism’, or the improbable fusion of free market ideals with the politics of recognition to create a rejuvenated hegemonic bloc. This theoretical framework is utilized to analyse the prevalence of emancipatory constructs such as empowerment, participation, anti-oppression, equality, choice and independence within acutely underfunded, bureaucratic, and risk-averse fields of social care and social work. While benefiting some older ‘service users’, it is argued that personalisation policy regularly disadvantages or excludes older people within fragmented adult social care sectors. Progressive neoliberalism has helped to promote policies which envisage participative self-care whilst more often excluding or objectifying older adults, especially those with higher level needs.
    • Neoliberalism, managerialism and the reconfiguring of social work in Sweden and the United Kingdom

      Harlow, Elizabeth; Berg, Elizabeth; Barry, Jim; Chandler, John; University of Chester ; Lulea University of Technology ; University of East London ; University of East London (SAGE, 2013-07-01)
      This paper considers some of the ways in which neoliberalism, through the processes of managerialism, has impacted on the occupation of social work in Sweden and the UK. It is argued that there are similar implications in both countries, through the managerial drive for increased performance in economy, efficiency and effectiveness, but also in the development of evidence based practice. Whilst the key focus of the paper is on similarities between these two countries, differences are also noted. There is also recognition of the way in which resistance to the reconfiguration of social work is taking shape.
    • Nerve agents: A guide for emergency nurses. Part 1

      McGhee, Stephen; Finnegan, Alan P.; Clochesy, John; University of Miami; University of Chester
      Recent incidents in the UK and the alleged chemical attacks in Syria by the Bashar al-Assad regime have brought the subject of chemical weapons back into the public domain. To date these types of event have been relatively rare because terrorist plans to harm large numbers of people have mostly been thwarted. This is the first part of a two-part article on nerve agents. Part one gives an overview of these agents, their historical background and manufacture, and how the agents affect physiology. Part two, which will appear in the next issue, considers the pre-hospital response to the use of nerve agents, including effective triage and decontamination, and in-hospital treatment.
    • New challenges for an expanding generation of older persons with haemophilia

      O’Hara, Jamie; orcid: 0000-0001-8262-034X; Noone, Declan; orcid: 0000-0003-2183-4277; Kritikou, Persefoni; Myren, Karl-Johan; orcid: 0000-0003-2065-2930; Chaplin, Steve; orcid: 0000-0001-7508-5609; Hart, Daniel P; orcid: 0000-0001-9084-8598 (Walter de Gruyter GmbH, 2022-03-09)
      Abstract Background Increasing survival among people with haemophilia means that more individuals are at risk of developing age-related morbidity. Little is known about morbidity and health-related quality of life (HRQoL) in different age groups within a single large population of people with haemophilia. Aim This study aimed to explore the association between increasing age and comorbidity among people with haemophilia and to compare their HRQoL with that of a sample of the general population in England. Methods The prevalence of comorbidity recorded in medical records and HRQoL assessed by EQ-5D were compared by age group in participants in the Cost of Haemophilia in Europe: A Socioeconomic Survey study (CHESS) in Europe. HRQoL was compared with that of a sample of the general population taken from the 2012 Health Survey for England (HSE). Results Younger adults in CHESS were more likely to have received prophylaxis from an early age. The mean number of affected joints in younger adults was 1.0; participants aged 41–50 (1.25) and 51–60 years (1.41) had the highest mean number of affected joints. The prevalence of comorbidity was 36% in patients aged 18–30, 61% in 31–60-year-olds and 68% in those aged 61+. HRQoL impairment in young adults with haemophilia was comparable with that in the HSE population aged over 60. Conclusions Older people with haemophilia have impaired quality of life compared with younger adults and an increasing prevalence of several age-related disorders affecting mental health and cardiovascular and bone health. Young adults with haemophilia report impaired HRQoL comparable with that in a general population aged 61+.
    • A new device for the treatment of perineal wounds

      Steen, Mary; Cooper, Keith; Leeds Teaching Hospitals NHS Trust/Leeds Metropolitan University (Emap, 1999-02-01)
      This article describes the design, development and evaluation of a new cooling maternity gel pad for the alleviation of perineal pain. Specific details of laboratory investigations of cooling and warm curves for different gel compositions, microbiological challenge tests and MDSA data are discussed. A risk assessment for the designed established that the new device has a low hazard rating and negligible exposure potential. Women’s opinions of treatment effect are highly significant.
    • New Psychoactive Substances (NPS) – “legal highs”

      Khan, Nahim; University of Chester (2016-05-10)
      This is a short true/false quiz on legal highs
    • New psychoactive substances: the use and the associated health and social harm in Telford and Wrekin

      Mabhala, Mzwandile A.; University of Chester (Oxford University Press, 2017-10-20)
      Background: Although NPS use is increasing, the scale of their use and harms remains unclear. Reports from the United Kingdom show downward trends in drug use in England and Wales among 11 to 15-year-olds, but also a steady increase in NPS use. However, NPS use remains lower than that of many traditional illicit drugs. This paper presents the correlations between age and the awareness, use and accessibility of NPS in Telford and Wrekin local authority, England. Methods: A self-administered questionnaire completed by 204 participants assessed socio-demographic information and awareness, accessibility, effects, uses, and health and social harms of NPS. Their mean age was 25.7 years (SD = 10.9). Data analysis used the IBM SPSS statistical package version 21, with significance level set at p < 0.05 and confidence interval at 95%. Spearman’s correlation coefficiencies (rho) determined associations between variables. Results: Descriptive statistics showed that 85.8% of respondents were aware of NPS, 33% knew other users, and 9.8% had ever used it. 40.2% said that access to NPS was easy, 35.8% very easy. The study showed a rho of 0.3 between age and knowing of NPS (P ≤ 0.000); rho of 0.5 between age and knowing NPS users (P ≤ 0.000); rho of 0.28 between age and number of NPS users they knew (P ≤ 0.000); rho of 0.14 between age and the number of times they accept and consume NPS (P ≤ 0.040); rho of 0.042 between age and being offered NPS by someone you know (P = 0.548); rho of 0.11 between age and being offered NPS by strangers (P = 0.097); and rho of 0.08 between age and perceived ease of access to NPS (P = 0.253). Conclusion: While young people’s NPS use remains low, they are more likely to use them than the general population. Despite young people’s high levels of NPS awareness, their knowledge of higher numbers of NPS users raises concerns about their exposure. We recommend making more effort to prevent uptake of NPS amongst this group.
    • Not-patient and not-visitor: A metasynthesis of fathers’ encounters with pregnancy, birth and maternity care

      Steen, Mary; Downe, Soo; Bamford, Nicola; Edozien, Leroy; University of Chester ; University of Central Lancashire ; St Mary's Hospital, Manchester (Elsevier, 2011-08-06)
      The active engagement of fathers in maternity care is associated with long-term health and social benefits for the mother, baby and family. This study's aim was to identify and synthesise good quality qualitative research that explores the views and experiences of fathers who have encountered maternity care in high resource settings. A pre-determined search strategy identified 23 papers published between January 1999 and January 2010. Analysis was based on the metaethnographic techniques of Noblit and hare (1988) as amended by Downe et al, (2007). The emerging themes were: risk and uncertainty, exclusion, fear and frustation, the ideal and the reality, issues of support and experiencing transition.The following synthesis was generated from these themes:Most fathers in the included studies saw themselves as partner and parent, with a strong desire to support their partners and to be fully engaged with the process of becoming a father. However, the experience of maternity care was often as not-patient and not visitor. This situated them in an interstitial and undefined space (both emotionally and physically) with the consequence that many felt uncertain, excluded and fearful.
    • Nurse Education and the Military Veteran

      Finnegan, Alan; Currie, Jane; Ryan, Teresa; Steen, Mary; University of Chester; University of Sidney; Northwest Florida State College; University of South Australia (Australian Nursing & Midwifery Federation, 2018-04-23)
      No occupation is more dangerous than serving in a nation’s armed forces, where service-personnel may face atrocious conditions and events. Some experience mental health problems including Post Traumatic Stress Disorder, depression and anxiety. The spouse and children are exposed to frequent moves, and endure long periods separated from a partner or parent. Nurses are well placed to make a substantial difference in the care of veterans and their families, although many Veterans believe healthcare professionals “cannot understand” their experiences (Finnegan et al, 2017). To change this narrative, the UK has introduced a new under-graduate educational initiative. An initial single site pilot study was undertaken at the University of Chester, England in 2017. The aim was to produce educational sessions that provided student nurses with an insight into the Armed Forces Community (AFC) of serving personnel, veterans and their families, and construct an understanding of the biopsychosocial needs aligned to their care, health and wellbeing. The intent was to stimulate critical thinking to focus on the individual and family needs by encouraging a problem solving approach.
    • Nurses' experiences of communicating respect to patients: Influences and challenges

      Clucas, Claudine; Chapman, Hazel M.; Lovell, Andy; University of Chester (Sage, 2019-04-04)
      Background: Respectful care is central to ethical codes of practice and optimal patient care, but little is known about the 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 UK 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 inter-personal influences on communicating respect, and sheds light on challenges involved, helping provide practical insights to support respectful care. Conclusion: Findings stress the need for improved conceptualisations of respect in healthcare settings to formally recognise the complex attitudinal and socially constructed nature of respect and for appropriate professional training to improve its communication
    • Nurses’ perceptions of personal attributes required when working with people with a learning disability and an offending background: a qualitative study

      Lovell, Andy; Bailey, Jan; University of Chester (2016-07-21)
      Abstract Aim: To identify and discuss the personal attributes required by learning disability nurses to work effectively with people with an offending background in secure and community settings. Background: This paper was part of a larger research investigation into the nursing competencies required to work with people with an offending background. There are few existing studies examining the personal attributes necessary for working with this group. Design: A qualitative study addressing the perceptions of nurses around the personal attributes required to work with people with learning disabilities and an offending background. Methods: A semi-structured interview schedule was devised and constructed, and thirty-nine individual interviews subsequently undertaken with learning disability nurses working in high, medium, low secure and community settings. Data were collected over 1-year in 2010/11 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings: The thematic analysis produced three categories of personal attributes, named as looking deeper, achieving balance and connecting, each of which contained a further three sub-categories. Conclusion: Nursing of those with a learning disability and an offending background continues to develop. The interplay between personal history, additional background factors, nurses’ personal attributes and learning disability is critical for effective relationship building.
    • Nursing theories 1: person-centred care

      Chapman, Hazel M.; University of Chester (EMAP, 2017-11-06)
      Definition and description of person-centred care Implications of person-centred care for nursing practice
    • Nursing theories 2: Clinical supervision

      Chapman, Hazel M.; University of Chester (EMAP, 2017-11-27)
      Definition of clinical supervision Benefits of clinical supervision for patients and staff
    • Nursing theories 3: Nursing Models

      Chapman, Hazel M.; University of Chester (Emap, 2018-01-08)
      Origins and value of nursing models
    • Nursing theories 4: Adherence, compliance and concordance

      Chapman, Hazel M.; University of Chester (Emap, 2018-01-15)
      Explains adherence, compliance and concordance for nursing practice