• The neoliberal university, social work and personalised care for older adults

      Carey, Malcolm; University of Chester
      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.
    • 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
    • Nursing theories 5: Gender theory

      Chapman, Hazel M.; University of Chester (EMAP, 2018-02-26)
      Origins of feminist and gender theory and their relevance to nursing practice
    • Nursing theories 6: Social Class

      Chapman, Hazel M.; University of Chester (EMAP, 2018-03-19)
      The origins and relevance of class theory for nursing
    • Nurturing

      Wilson, Frances; Woodhouse, Jan; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses the concept of nurturing in nursing.
    • Nutrition Knowledge, Dietary Patterns and Anthropometric Indices of Older Persons in Four Peri-urban Communities in Ga West Municipality, Ghana

      Faith Agbozo; Joyce Amardi-Mfoafo,; Helen Dwase; Basma Ellahi; Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana; Department of Family and Consumer Sciences, College of Agriculture and Consumer Sciences, University of Ghana, Legon, Accra ; Faculty of Health and Social Care, University of Chester, Chester, CH1 4BJ, UK. (African Health Sciences, 2018-09-30)
      ABSTRACT Background: Older adults are vulnerable to malnutrition due to sociologic, physiologic and anatomical effects of ageing. Objective: To investigate the influence of nutrition knowledge and dietary patterns on nutritional status of community-dwelling ambulatory older adults. Methods: This cross-sectional survey involved 120 elderly aged 60-70 years purposively selected from four peri-urban communities in Ga West municipality, Ghana. Nutrition knowledge was assessed using a structured questionnaire and dietary intakes obtained using a standardized food frequency questionnaire. BMI from weight/height measurements was proxy for nutritional status. Data was analyzed descriptively in SPSS. Associations were tested using correlation analyses (-1
    • 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
      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.