• Older adults and violence: An analysis of domestic homicide reviews in England involving adults over 60 years of age

      Benbow, Susan M.; Bhattacharyya, Sarmishtha; Kingston, Paul; University of Chester; Older Mind Matters; Betsi Cadwaladr University Health Board (Cambridge University Press, 2018-01-11)
      Domestic Homicide Reviews (DHRs) are conducted when an individual aged 16 or over appears to have died from violence, abuse or neglect by a person to whom they are related or with whom they are in an intimate relationship or who is a member of the same household. DHRs aim to identify lessons to be learned, to improve service responses to domestic abuse, and to contribute to prevention of domestic abuse/ homicide. We submitted freedom of information requests to English Local Authorities to identify DHRs where victim, perpetrator, or both were aged over 60. Collected Reports and/ or Executive Summaries were thematically analysed. Analysis identified four key themes in the context of the key relationship and caring: major mental illness of the perpetrator; drug and/or alcohol abuse; financial issues; and a history of domestic abuse in key or family relationships. We analysed 14 adult family homicides, 16 intimate partner homicides, and five homicide-suicides. Age per se did not emerge as a significant factor in our analysis. Terminology needs to be standardised, and training/ education regarding risk assessment improved in relation to age, myths around ageing/ dementia, and stresses of caring. Management of mental illness is a key factor. A central repository of DHR Reports accessible for research and subject to regular review would contribute to maximising learning and improving practice.
    • Older adults and “scams”: Evidence from the Mass Observation Archive

      Bailey, Jan; Taylor, Louise; Kingston, Paul; Watts, Geoffrey E; University of Chester (Emerald, 2021-01-06)
      Purpose The issue of financial abuse is highlighted the Care Act (2014). One category of financial abuse is consumer fraud or “scams”. Evidence suggests that scams are becoming increasingly ubiquitous, yet how scams impact older adults remains under-researched. This paper reports the data from 80 older adults’ written response to a Mass Observation Archive Directive, commissioned in autumn 2015, focusing on scams. Study design/methodology/approach A qualitative approach was utilised with data captured via written responses to a set of questions. There was no limit on the length of written accounts and respondents remained anonymous. Data were analysed thematically, resulting in 4 key themes. Findings The data indicated scams impact individuals in terms of health and wellbeing, irrespective of whether they have experienced financial loss, and trigger implementation of strategies intended to avoid being defrauded. There was also evidence of scam related stigma with individuals who are defrauded being subject to derision and censure. Originality/value This paper adopts an original approach to collecting rich, candid data about an under-researched topic. The authors highlight that anti-scam interventions should equip individuals to identify and avoid scams without inciting fear or anxiety; proposing this may be facilitated by drawing on health and safety risk assessment protocol when designing anti-scam interventions. Social implications Individuals who have been victimised by fraudsters may need access to practical and emotional support. This requires the design of appropriate interventions and the stigma associated with being scammed to be addressed.
    • Older Trans Individuals’ Experiences of Health and Social Care and the Views of Healthcare and Social Care Practitioners: “They hadn’t a clue”

      Benbow, Susan M.; Kingston, Paul; University of Chester (Taylor and Francis, 2022-01-24)
      This study investigated older trans people’s experiences of health and social care, and the experiences and views of practitioners in order to inform service development. Sixteen trans adults aged over 50 from Cheshire and nearby were recruited via community organisations and interviewed individually or in focus groups. Interviews were audiotaped and transcribed with consent. Health and social care service practitioners were interviewed remotely or face-to-face. Data were analysed thematically supported by qualitative data analysis software. Three main themes were identified. ‘Levers’ indicated forces that influenced an individual’s contact with health and or social care positively or negatively, and encompassed five sub-themes: age; experiences good or bad; family/ close relationships; LGBT identity/ communities; and money/ finances. ‘Contextual forces’ encompassed societal forces that shape individuals’ encounters in care, lack the potential for positive influence, and are more closely allied to stereotypes/ myths: this theme included three sub-themes: discrimination/ hate; ignorance; and risk from others. ‘Positive practices’ encompassed five sub-themes, including learning/ training. In conclusion older age increases the importance of access to treatment for gender variance whilst simultaneously complicating it; older trans service users may be sensitive to potentially discriminatory experiences because of historical experiences; services should endeavour to understand individuals in the context of life history and psycho-social context; practitioners benefit from training in positive inclusive approaches to care; local community services are advantageous. Further research is needed with particular attention to social care, the experiences of trans men, and how to translate findings into person-centred practice, education and training.
    • On the road to social death: A grounded theory study of the emotional and social effects of honor killing on families—A Palestinian perspective

      Khatib, Salam; Edge, Dawn; Speed, Shaun; University Palestine; University of Manchester; University of Chester
      Despite high rates of domestic violence and increased rates of honor killing (HK) over the past decade, there is a paucity of empirical data about how HK affects family members. This study used grounded theory to explore the emotional and social effects of HK on 23 family members of murdered women and found that HK failed to achieve the restoration of honor. Following HK, families subsequently entered a protracted process of grief compounded by negative social interactions, which led to a form of “social death.” The road to social death was a painful and continuous social process, which, for many, never abated.
    • Oncology in mental health practice

      Deacon, Maureen; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to explain the relationships between mental health problems and cancer; explain the basics of cancer; discuss local cancer health policy and how it can act as guidance for supporting an individual; and explain how cancer screening, diagnosis, and treatment can be tailored in relation to a person's mental ill-health.
    • “Our feelings are valid”- reviewing the lesbian, gay, and bisexual affirmative approaches in a mental health setting.

      Broadway-Horner, Matthew; Kar, Anindya; University of Chester; Advanced Neuropsychiatry Institute, Kolkata (Taylor and Francis, 2022-02-07)
      In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.
    • 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.
    • Patient experience of electroconvulsive therapy (ECT): A systematic review

      Whyler, Jonathon; Bradley, Kirsty; Chapman, Hazel M.; Shaw, Elizabeth; Shetty, Amrith; Health Education England North West; Cheshire and Wirral Partnership NHS Foundation Trust; University of Chester
      In the United Kingdom, electroconvulsive therapy (can be administered according to NICE guidelines for depression, catatonia or severe/prolonged mania (2003 NICE, 2009). ECT was first used in the United Kingdom in 1939 Kalinowsky 1939 and its application and practice has been developed and modernised since. There is a considerable body of research into the efficacy of ECT, and the Royal College of Psychiatrists report that in 2018/2019 68 of patients were much or very much improved following ECT (RCPsych, 2020). It is known however that both public perception and media portrayal of ECT is generally negative (Griffiths and O’Neill Kerr, 2019). Discussion This review highlights patient experiences of ECT through the identification of seven themes The findings suggest that patient experience of ECT includes themes of fear, consent, decision making and autonomy. Patients were found to experience fear and anxiety in regards to the procedure, and studies described patients being poorly informed about ECT. Issues around the consent process were highlighted including those in which patients did not feel they had a choice with regards to treatment ECT was associated with memory loss and cognitive impairment which were captured in patient experience following treatment. In many studies however, ECT was also found to be a tolerable and effective treatment with an improvement in symptoms and patient satisfaction reported The experience of ECT was affected by knowledge and information provision and high standards of service provision, including supportive nursing.
    • 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.