• Safeguarding and qualitative research

      Jones, Alun; Steen, Mary; University of Chester (Elsevier, 2013-01-07)
      Qualitative research is a potent method used by researchers to gain an insight and understanding into the thoughts, feelings, views and experiences of both patient’s and healthcare professionals. The narrative data offered through conversational methods of qualitative research can provide rich and deep descriptions of healthcare and so act as a guide to further research or offer different views and considerations for professional practice. Nonetheless, safeguards are a paramount issue particularly if studies involve inexperienced researchers.
    • Scoping review: contribution of intellectual disability nurses

      Mafuba, Kay; Foster, Marc; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; City University, London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
      Aims and objectives The objective of this scoping literature review was to summarise evidence on the contribution of intellectual disability (ID) nurses to improving the health and well-being of children, adults and older people with IDs, now and for the future. Review question The scoping literature reviews seeks to answer the following question; What ID nursing-led interventions are in place to respond to the changing needs of people living with IDs, and what is the impact of these interventions Conclusions The limited number of publications identifying the interventions undertaken by ID nurses in relation to maternity, children, older adults and end of life care need to be addressed by the profession. The lack of evidence to demonstrate the impact and effectiveness of interventions undertaken by ID nurses pose a challenge for intellectual disability nurses and the profession, whose wider contribution is ambiguous in wider health and social care practice. The interventions undertaken by ID nurses need to be understood in the context of the complexity and changing needs of people with IDs, as well as the introduction of the new NMC standards for pre-registration nurse education in the UK. Recommendations Given the complexity of health, poorer health, higher rates of co-morbidity, inequalities in health, poor access to health services and higher rates of premature mortality experienced by people with IDs, we recommend that urgent research is undertaken to further clarify ID nurse interventions, more specifically in relation to maternity, children, older adult, and end of life care.
    • Screening and public health

      Mabhala, Mzwandile A.; University of Chester (SAGE, 2008-11-20)
      This book chapter discusses general criteria for a screening programme, appraisal and quality control, and the criteria for the evaluation of screening.
    • Screening, Diagnosis, and Management of Patients With Alcohol Use Disorders at Bwindi Community Hospital, Uganda.

      Kuule, Yusufu; Dobson, Andrew E.; Harries, Anthony D.; Mutahunga, Birungi; Stewart, Alex G.; Wilkinson, Ewan (2018-05-24)
      Introduction: The harmful use of alcohol is a growing global public health concern, with Sub-Saharan Africa at particular risk. A large proportion of adults in Uganda consume alcohol and the country has a high prevalence of alcohol use disorders (AUD), almost double that for the African region as a whole. Bwindi Community Hospital, in rural western Uganda, recently introduced a program of screening, diagnosis and management of AUD and we assessed how this worked. Methods: This was a cross-sectional study in three departments (out-patients, adult in-patients and sexual & reproductive health) of Bwindi Community Hospital assessing numbers of patients screened, diagnosed and treated with AUD between January 2014 and June 2017. Data sources included the hospital electronic data base and departmental case files. Frequencies and proportions are reported and odds ratios used to compare specific factors associated with medical interventions. Results: Altogether, 82,819 patients attended or were admitted to hospital, of whom 8,627 (10.4%) were screened and 273 (3.2%) diagnosed with AUD. The adult in-patient department recorded the largest number with AUD (n = 206) as well as a consistent increase in numbers in the last 18 months of the study. Of those with AUD, there were 230 (84%) males, 130 (48%) aged 36-60 years, and 131 (48%) with medical non-alcohol related diagnostic categories. Medical/supportive interventions included guidance and counselling to 168 (62%), community social support to 90 (33%), mental health service referrals for 75 (27%), detoxification for 60 (22%) and referral to Alcoholics Anonymous for 41 (15%). There were 36 (15%) patients who received no medical/supportive interventions, with significantly higher proportions in patients with surgical alcohol-related disease and pregnancy-related conditions (P < 0.05). Conclusion: Bwindi Community Hospital has implemented a program for AUD in three departments, with most individuals screened and managed in the adult in-patient department. While a variety of interventions were given to those with AUD, 15% received no intervention and this deficiency must be addressed. Program performance could improve through better screening processes, ensuring that 100% of those with AUD receive a medical/supportive intervention and raising public awareness.
    • Self-administered Homeopathy part 2: A follow up study

      Steen, Mary; Calvert, Jan; Leeds Teaching Hospitals NHS Trust (Mark Allen Publishing, 2007-06-01)
      This paper discusses a follow up study that used a semi-structured interview technique to further explore the experiences of women and their partners following the use of a specifically chosen homeopathic kit that included ten remedies that were self-administered.The interview data demonstrated that women and several birth partners experienced positive emotional, psychological and physical benefits from using the kit of homeopathic remedies. Implications: Self administered homeopathic remedies have the potential to promote a women-led approach to childbirth and an active supportive role for the birth partner. The findings will form the foundations to undertake further research in this field.
    • Service user and carer involvement

      Williams, Terry; Phipps, Dianne; Forum for Carers and Users of Services in Cheshire and Merseyside ; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses partnerships between users/carers and higher education.
    • Serving within the British army: research into mental health benefits

      Finnegan, Alan; Finnegan, Sara; McGee, Paula; Srinivasan, Mike; Simpson, Robin; University of Chester (Mark Allen Group, 2011-10-28)
      The mental health (MH) of soldiers remains extremely newsworthy and is regularly featured in high profile media forums that focus on post-traumatic stress disorder. However, the authors feel that there are distinct benefits to serving within the Army, and that it provides effective occupational medical, MH and welfare support. This research study explores potential benefits and stressors of being in the Army and provides an overview of Army mental health services (AMHS) through the perspectives of AMHS personnel, 84% of which were nurses. The study indicated that the Army can provide a protective community, sharing a bond based on common values and experiences. The Army can provide soldiers with career opportunities that are not available in civilian life, and there are opportunities to develop an employment profile, enhanced by internal and external educational training, and encapsulated within a progressive career pathway. The Army can also be seen to offer an escape route, preventing soldiers entering a life of crime, and supplying the stable family these soldiers had never experienced. The provision of leadership, within an environment where soldiers are valued and stigma is not tolerated can potentially shield against MH problems.
    • Sexual health in mental health practice

      Bates, Jo; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to consider the concept of sexual health; identify some of the most prevalent sexually transmitted infections; discuss contraceptive methods; and explore the role of the mental health practitioner in facilitating good sexual health.
    • Sexual violence against migrants and asylum seekers. The experience of the MSF clinic on Lesvos Island, Greece.

      Mabhala, Mzwandile; Belanteri, Rea; Hinderaker, Sven Gudmund; Wilkinson, Ewan; Episkopou, Maria; Timire, Collins; De Plecker, Eva; Takarinda, Kudakwashe; Van den Bergh, Rafael; Médecins Sans Frontières-Operational Centre Brussels; University of Bergen; University of Chester; International Union Against Tuberculosis and Lung Disease; AIDS and TB Department, Harare;
      Sexual violence can have destructive impact on the lives of people. It is more common in unstable conditions such as during displacement. On the Greek island of Lesvos, Médecins Sans Frontières provided medical care to survivors of sexual violence among the population of asylum seekers arriving there. This study aimed to describe the patterns of sexual violence reported by migrants and asylum seekers and the clinical care provided to them. Methods This is s a descriptive study using routine program data. The study population consisted of migrants and asylum seekers treated for conditions related to sexual violence at the Médecins Sans Frontières clinic on Lesvos Island (September 2017-January 2018). Results We enrolled 215 survivors of sexual violence who reported and were treated, of whom 60 (28%) were male. The majority of incidents reported (90%) were cases of rape; 174 (81%) of survivors were from Africa and 185 (86%) occurred over a month before presentation. Half the incidents (118) occurred in transit, mainly in Turkey, and 76 (35%) in the country of origin; 10 cases (5%) on Lesvos were also observed. The perpetrator was known in 23% of the cases. Only XXX received mental health care, and the need exceeded the capacity of available mental care services. Conclusion Even though the majority of cases delayed seeking medical care after the incident, it is crucial that access to mental health services is guaranteed for those in need. Such access and protection measures for people in transit need to be put in place along migration routes, including in countries nominally considered safe, and secure routes need to be developed.
    • Sexual Violence on Public Transportation: A Threat to Women’s Mobility in Bangladesh

      Mazumder, Hoimonty; Pokharel, Bishant (Informa UK Limited, 2018-07-06)
    • Sexuality

      Baldwin, Moyra A.; Woodhouse, Jan; University of Chester (SAGE, 2011-01-01)
      This book chapter discusses palliative care and meeting sexuality needs.
    • Sexually transmitted infections among Rohingya refugees in Bangladesh.

      Hossain, Md M.; Sultana, Abida; Mazumder, Hoimonty; Munzur-E-Murshid (2018-07)
    • Siblings of Adults with Learning Disabilities: An Empirical Study

      Gant, Valerie; University of Chester (Social Work and Society, 2018-01-01)
      Adult siblings are frequently providers of care for their brother or sister with a learning disability* and many take on many levels of responsibility, which often lasts for decades. The majority of research focusing on siblings of people with learning disabilities comes from the perspective of those aged under 18. This paper draws on the work of Rawson (2012) and Pompeo (2009) to focus attention on adult siblings. This study, examined the relationships adult siblings have with their brother or sister with a learning disability. Fourteen participants were involved, in-depth interviews were conducted to gather data that was thematically analysed. The findings revealed that siblings want to be involved in the life of their brother or sister and to be seen as next of kin by professionals when their parents have died, but yet are unsure how best to approach this prospect. Based on these findings, implications for practitioners are discussed.
    • Simulated learning and objective structured clinical examinations

      McLaughlin, Andrea; University of Chester (SAGE, 2010-10-29)
      This book chapter discusses the benefits and challenges of simulated learning and how such learning can be assessed.
    • Sleep hygiene education and children with developmental disabilities:findings from a co-design study

      Sutton, Julie E.; Huws, Jaci C.; Burton, Christopher R.; University of Chester; Bangor University (SAGE publications, 2019-01-17)
      This qualitative study develops a programme theory demonstrating the complexity embedded in sleep hygiene education (SHE) as an intervention to improve sleep problems in children with developmental disabilities. In co-design workshops, eight parents and six sleep practitioners deliberated themes developed from findings of an earlier exploratory study of stakeholder perceptions of SHE. A SHE tool underpinned by programme theory was developed evidenced by midrange theories of change. Analytical themes were developed to explain the programme theory and the complexities of a successful SHE intervention: the need to legitimize children’s sleep problems and consider the nature of customization, knowledge sharing, health expectation and impact of sleep service rationing and gaming strategies on implementation success. Policy and practice implications include a need to raise the public profile of children’s sleep problems and promote parental involvement in intervention implementation. Further research is needed to test out this theory-driven framework for evaluating SHE.
    • A sleep hygiene tool for children with developmental disabilities

      Sutton, Julie Elizabeth; Huws, Jaci C; Burton, Christopher; University of Chester; Bangor University; Canterbury Christchurch University
      This article describes a co-design study to develop a sleep hygiene education tool for children with developmental disabilities and behavioural sleep problems. The tool is underpinned by a programme theory, which explains how sleep hygiene education should work to improve children’s sleep. In three co-design workshops, eight parents and six practitioners debated a preliminary sleep hygiene education tool, using themes developed from an earlier evidence review and exploratory study into parent and practitioner experiences of sleep hygiene education. This participatory research established stakeholder acceptability of the SHE tool and confirmed the often-hidden contextual factors that can help or hinder its success, informing the underpinning programme theory.
    • The Social and Health Inequalities Agenda

      Mabhala, Mzwandile A.; University of Chester (McGraw-Hill / Open University Press, 2014-10-01)
      How much the health and well-being of individuals and populations can be improved depends upon understanding the wider determinants of health and the social and health inequalities agenda. This chapter aims to build on the concepts introduced in chapter one and to explore the differences in health outcomes globally and across the UK. This will be achieved through an examination of up-to-date policy and publications such as Fair Society, Fair Lives – The Marmot Review (Department of Health [DH] 2010), Closing the Gap in a Generation (World Health Organization [WHO] 2008b), and The Impact of Inequality (Wilkinson 2005). Health outcomes can be measured, but how can health inequalities be reduced and health and well-being improved? What are the economic implications of impaired health, and how can strategic planning improve health and reduce inequalities?
    • Social Care Workers’ Experiences of Assessing Parents with Learning Disabilities: An Interpretative Phenomenological Analysis Study Based in the Northwest of England.

      Lovell, Andrew; Constance, Lyndsey J. (University of Chester, 2020-06-26)
      Aims: Qualitative research has identified a number of issues when working with parents with learning disabilities. Pre-conceived ideas, professional discrimination and a high percentage of children living away from the family home have featured heavily in the literature. However, less is known about the assessment process, and how practitioners adapt their skills to assess this parental group. The current study therefore aimed to gain an in-depth understanding of the assessment process, utilising a qualitative approach. The study focused upon the experiences of social care assessors from children’s and adult services, and sought to explore the following: the approach social care workers adopt when assessing parents with learning disabilities; if appropriate knowledge is embedded into practice to assess competently; experiences of the application of the PAMS 4.0; multi-disciplinary approach to assessment, and how this exhibits in practice. Method: Semi-structured interviews were carried out with fourteen frontline social care practitioners from children’s and adult services who had direct experience of assessing parents with learning disabilities. The transcripts of the interviews were analysed using Interpretative Phenomenological Analysis (IPA). Results: The analysis produced four master themes. These were; inadequate knowledge to understand complexities; hierarchy; reasonable adjustments; assessing parental ability. An analysis of these master themes and the related super-ordinate themes is presented. Discussion: The results are considered in light of the experiences of the participants, and how this impacts on the assessment of parents with learning disabilities. The study finds that whilst there is evidence the participants hold pre-conceived ideas, a lack of relevant skills and knowledge as well as an unstructured implementation of the Parenting Assessment Manual 4.0, are both contributing factors. Furthermore, problematic multi-agency working and managerial influences impact on the overall outcomes for parents with learning disabilities and their families.
    • Social conditions of becoming homelessness: qualitative analysis of life stories of homeless peoples

      Mabhala, Mzwandile A.; Asmait, Yohannes; Griffith, Mariska; University of Chester; Mount Sanai Healthcare System, New York, University of Chester (BioMed Central, 2017-08-22)
      Background It is increasingly acknowledged that homelessness is a more complex social and public health phenomenon than the absence of a place to live. This view signifies a paradigm shift, from the definition of homelessness in terms of the absence of permanent accommodation, with its focus on pathways out of homelessness through the acquisition and maintenance of permanent housing, to understanding the social context of homelessness and social interventions to prevent it. However, despite evidence of the association between homelessness and social factors, there is very little research that examines the wider social context within which homelessness occurs from the perspective of homeless people themselves. This study aims to examine the stories of homeless people to gain understanding of the social conditions under which homelessness occurs, in order to propose a theoretical explanation for it. Method Twenty-six semi-structured interviews were conducted with homeless people in three centres for homeless people in Cheshire North West of England. Results The analysis revealed that becoming homeless is a process characterised by a progressive waning of resilience capacity to cope with life challenges created by series of adverse incidents in one’s life. The data show that final stage in the process of becoming homeless is complete collapse of relationships with those close to them. Most prominent pattern of behaviours participants often describe as main causes of breakdown of their relationships are: 1. engaging in maladaptive behavioural lifestyle including taking drugs and/or excessive alcohol drinking 2. Being in trouble with people in authorities. Conclusion Homeless people describe the immediate behavioural causes of homelessness, however, the analysis revealed the social and economic conditions within which homelessness occurred. The participants’ descriptions of the social conditions in which were raised and their references to maladaptive behaviours which led to them becoming homeless, led us to conclude that they believe that their social condition affected their life chances: that these conditions were responsible for their low quality of social connections, poor educational attainment, insecure employment and other reduced life opportunities available to them.