• Perineal tears and episiotomy: How do wounds heal?

      Steen, Mary; UCLan/Royal College of Midwives (Mark Allen Publishing, 2007-05-01)
      The care of perineal wounds is an important aspect of postnatal care. This article focuses on the healing of perineal wounds, describes tissue trauma, different types of wounds and classification of perineal wounds. Wound healing, factors that can prevent healing and the need to provide adequate pain relief that will have no adverse effect on healing are discussed in detail.
    • Perineal trauma: How do we evaluate its severity?

      Steen, Mary (MIDIRS, 1998-06)
      This article discusses a new tool designed in her unit for assessing the scale of perineal trauma
    • Person-centred healthcare research: A personal influence

      Chapman, Hazel M.; University of Chester (Foundation of Nursing Studies, 2018-05-16)
      Personal commentary on text: McCormack, B., van Dulmen, S., Eide, H., Skovdahl, K., Eide, T. (Ed.) (2017). Person-centred healthcare research. Chichester, United Kingdom: Wiley-Blackwell.
    • Personal grooming (beyond hygiene): a grounded theory study.

      Mason, Tom; Gidman, Janice; Mason-Whitehead, Elizabeth; Boulton, Michael J.; Woodhouse, Jan (University of Chester, 2015-10)
      Background: We are very individualistic in how we present ourselves to the world. Whilst we are healthy and self-caring we have control over the way we undertake self-groom. Once we need care the situation may change. In the setting of health and social care the emphasis has been on hygiene; aspects of personal grooming [PG] may be overlooked. Few studies exist in the health and social care literature that explore this crucial daily activity of living. Aim: This study aims to address the imbalance on what is known of PG. It seeks to thoroughly explore the concept of PG, identifying the normative activities involved, and the age-related behaviours that occur across the lifespan. Methods: Utilising a grounded theory [GT] methodology, an eclectic data collection approach was taken. Consequently a pilot group, four focus groups (child-focused; males 18-45; females 18-45; over-46), and a visual methodology formed the first phase of the study. The second phase consisted of a formal concept analysis, drawing on literature and data from the focus groups. The final phase of the study involved one-to-one semi-structured interviews with retired persons. A total of 26 participants took part in the study and both genders were represented. Analysis was undertaken using the range of coding consistent with a GT approach and the notion of constant comparison. Findings: New knowledge on PG emerged; an academic definition of PG; PG was found to have ‘four elements’: hygiene, appearance management behaviours, body modification and enhancement. There was a ‘spectrum’ of grooming recognised, which ranged from the wild, un-groomed state to that of being over-groomed. The term ‘allo-grooming’, which means grooming of another, was used to explore the part families play in social learning about PG. A timeline of PG behaviours was created to illustrate how PG changes over the lifespan. Additionally, information on grooming activities, other than those of hygiene, was recorded. Implications: PG is complex and the ‘one-size-fits-all’ approach of concentrating on hygiene may not meet the needs of service users. Some body areas, for example, are not included in the published documents that help to guide care services. There appears to a gap in educational programmes of health and social care workers, in respect to PG. Recommendations for practice, policy, education and further research are proposed.
    • PERSONAL NARRATIVES OF AGING.

      Taylor, Louise; Bailey, Jan; Kingston, Paul; Eost-Telling, Charlotte (2019-11-08)
      AbstractThis presentation reflects on self-written narratives from respondents to a mass observation directive, focusing on the experiences of growing older. Narrative methods are theoretically and methodologically diverse, and are helpful in social research to understand events or happenings in human lives. This data presents accounts from a heterogeneous sample in the form of self-penned responses. These experience-centred narratives bring stories of personal understanding into being by means of the first person description of past, present, future or imaginary experiences. This presentation will focus on the findings with reference to physical and mental impacts, both real and anticipated. We will also explore themes arising from the data including gender differences, age-cohort effects and stigma. The data can be used to inform Health and Social Care education and practice, particularly in co-producing appropriate person-centred services with older people.
    • The Perspective of Socioeconomic Inequalities and Infectious Disease in 21st Century

      Massey, Alan; Mabhala, Mzwandile A.; University of Chester (OMICS Group International, 2016-04-20)
      At the turn of the new century, the United Nations set a series of global health goals to be achieved by 2015. Amongst the eight Millennium Development Goals (MDGs), goal six aimed to combat HIV, malaria and other diseases.
    • Perspectives on supporting fathers affected by postnatal depression and a history of violence

      Keeling, June J.; Laws, Thomas; University of Chester; University of Salford (Mark Allen Healthcare, 2018-01-23)
      Intimate partner violence during the perinatal period is a significant public health problem that remains under-screened, under-diagnosed and under-treated. The establishment of evidence based guidelines to aid Health Visitors in providing provide support for couples experiencing violence has been hampered by the complex interplay between maternal and paternal mental health problems and violence. Our study explored the experiences of UK fathers voluntarily engaged with services designed to redeem their ideation to violence. The findings indicate that a tendency to violence was increased by stresses associated with the transition to parenthood. Men felt pressured by concerns for their partners' mental health, changes to their relationship with the mother, sleep disturbances and the burden of infant care they assumed when the mother could no longer cope. Health Visitors are ideally situated to assess for factors linked to the emergence of violence and pre-empt the support needed to minimise its occurrence.
    • Phenomenological characteristics of autobiographical memories: responsiveness to an induced negative mood state in those with and without a previous history of depression.

      Mitchell, Andrew E. P.; University of Chester (Vizja Press & IT, 2016-06-30)
      In this study we investigated the relative accessibility of phenomenological characteristics in autobiographical memories of 104 students with and without a previous history of a depression. Participants recalled personal events that were elicited with cue words and then asked to rate these personal events for a number of phenomenological characteristics. The characteristics were typicality, rumination, valence, importance of others, expectancy, desirability, and personal importance. The effects of previous history of depression (without history or with previous history of depression) and self-reported mood (pre- and post-negative mood induction) on autobiographical recall was examined by employing a mixed factor design. Self-reported mood was measured as a manipulation check, before and after Mood Induction Procedure. Typicality, rumination and personal importance showed significant interaction effects in those with a history of depression. Ordinal regression supported the finding that those with a history of depression had a higher chance of typicality and personal importance than those without a history of depression. The results indicate that recall of autobiographical characteristics is in part dependent on induced negative mood state and on previous history of depression. The findings may prompt future research into targeted interventions that reduce individual tendencies for heightened cognitive reactivity in negative mood states for those with a history of depression.
    • A phenomenological exploration of nursing students’ experience of raising a care concern in clinical practice

      Cooper, Elizabeth (University of ChesterUniversity of Chester, 2020-01)
      UK pre-registration healthcare students are expected to raise a care concern about unsafe situations whilst in clinical practice. The UK’s NHS is in the midst of a change to an open, honest and transparent culture which responds to a professional’s concern about patient care, to improve safety and prevent harm. Central to this change is improving the experience of registered healthcare professionals whose decision to raise a care concern is influenced by the organisational culture; this can create a difficult moral choice. The experience of nursing students who decide to raise a care concern has received little attention, and this study sought to explore this under-researched area. A literature review was undertaken which identified that the experience of nursing students who had raised a care concern had not been previously examined. To guide this study, Clarke Moustakas’ (1994) transcendental phenomenological methodology was used to explore nursing students’ lived experience of raising a care concern. Ten nursing students with experience of raising a care concern in clinical practice voluntarily participated in the study. Open interviews conducted between December 2016 and October 2017 were audio recorded and transcribed, exposing individual narratives of raising a care concern in clinical practice. The transcripts were analysed to produce a composite description which summarises nursing students’ lived experience, reflecting four themes or essences: 1) patient centred concern; 2) deciding how to act; 3) having emotional strength; and 4) feedback and support. These typify what it is like for nursing students to raise a care concern whilst in clinical practice. The findings were critically examined and suggest that compassion may motivate nursing students to act when faced with an unsafe situation, seeking to stop patient harm and suffering. Recognising this moral motivation, students described the relevance of emotional strength when dealing with the emotionally complex experience of facing difficult situations, with feedback and support providing comfort plus moral and emotional satisfaction. This study also explores the implications for professional practice, specifically the impact upon future teaching and learning approaches to facilitate nursing students’ ability to detect and act upon unsafe situations; providing listening opportunities to support students in clinical practice; and valuing nursing students who raise a care concern as role models and local clinical leaders. Recommendations include a new national campaign to improve the likelihood of nursing students raising care concerns and updating UK professional guidance.
    • A phenomenological investigation of pre-qualifying nursing, midwifery and social work students’ perceptions of learning from patients and clients in practice settings

      Newton, Jethro; Mason, Tom; Gidman, Janice (University of LiverpoolUniversity of Chester, 2009-08)
      Government policies have emphasised the importance of patient and client involvement in all aspects of health and social care delivery, with a corresponding impetus for their involvement in the education of practitioners. Professional education programmes adopt andragogical, student-centred approaches and incorporate both academic and practice based learning and assessments. Practice experience is recognised as a crucial aspect of student learning and has become a major focus of quality reviews in health and social care education. Whilst it might seem self-evident that students on practice placements will learn from their interactions with patients and clients, this is a relatively neglected area for formal modeling, evaluation and research. This study, therefore, explores pre-qualifying nursing, midwifery and social work students’ experiences of learning from patients and clients during practice placements. The research project is underpinned by a descriptive phenomenological approach and the extensive data are analysed using phenomenological reduction (Giorgi, 1989a; 1989b). Two key themes and six categories emerged from the data. The first theme is presented as the ‘Ways of Learning’ and this comprises the categories of: facilitation of learning; critical incidents/patient stories; and role modeling. The second theme is presented as the ‘Nature of Learning’ and comprises three categories: professional ideals; professional relationships; and understanding patients’ and clients’ perspectives. It is evident that contemporary theories, including andragogy, social learning, experiential, reflective and transformative learning theories, remain relevant to professional education. The new knowledge obtained in this research is that the most powerful learning opportunities result from unplanned, informal learning opportunities involving interactions with patients and clients. However, this is not fully explained by these contemporary learning theories. This thesis will, therefore, argue that complexity theory is relevant to the requirements of professional education programmes. It will present an overarching framework to explain the data from this study and will propose strategies to harness the complexity inherent in this important aspect of student learning.
    • Physical health assessment in mental health practice

      Collins, Eve; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to discuss the importance of providing effective physical health assessments for individuals with mental health problems; explain the processes of conducting a comprehensive health history; and identify the health parameters which should be assessed as part of the physical examination for individuals with mental health propblems.
    • The physical health needs of individuals with mental health problems - setting the scene

      Drake, Mandy; University of Chester (SAGE, 2013-01-15)
      This book chapter aims to identify the main physical health conditions affecting individuals with mental health problems; explain the reasons for poor physical health among this client group; discuss the barriers to physical health improvement; provide an overview of the political agenda in relation to physical and mental health co-morbidity; and debate the mental health practitioner's role in physical health care.
    • Planning for a second wave pandemic of COVID-19 and planning for winter : A statement from the Association of Schools of Public Health in the European Region

      Middleton, John; Lopes, Henrique; Michelson, Kai; Reid, John; Wolverhampton University; Universidade Cato´lica; Fulda University; University of Chester
      Planning for a second wave pandemic of COVID-19 and planning for winter : A statement from the Association of Schools of Public Health in the European Region
    • Policy drivers

      Baldwin, Moyra A.; Wilson, Frances; University of Chester (2008-09)
      This powerpoint presentation discusses issues raised in developing and evaluating an education programme to meet the health and social care commissioning agenda of the twenty-first century.
    • Policy drivers

      Mabhala, Mzwandile A.; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses policy documents and policy drivers relating to palliative care.
    • Politicisation or Professionalisation? Exploring divergent aims within UK voluntary sector peer mentoring

      Buck, Gillian; University of Chester (Wiley, 2019-09-04)
      Meaningful ‘user involvement’ is an established aim of social work practice, and increasingly, an aspiration of criminal justice, yet there are unique challenges to participatory work within punitive contexts. Drawing upon a study of peer mentoring in the voluntary sector, this article unveils some core tensions related to (ex)service user involvement in criminal justice. Interviews with mentors, mentees, and key stakeholders, along with direct observations of practice, reveal that respondents often see their work as personal-political, emphasising the value of lived expertise and of collective action to address limiting social conditions. Simultaneously, however, mentoring is framed nationally and shaped locally by more established aims to correct, improve, and manage, individual ‘offenders’. There is, therefore, a fundamental tension between processes of politicisation, or coming together to assert a user voice and affect social change; and professionalisation, wherein mentors are co-opted into forms of practice they often critique.
    • Population Health Screening after Environmental Pollution

      Stewart, Alex G.; orcid: 0000-0002-4931-5340; email: dragonsteeth@doctors.org.uk; Wilkinson, Ewan; orcid: 0000-0002-2167-8756; email: ewilkinson@chester.ac.uk (MDPI, 2020-11-24)
      Following environmental pollution exposure, calls to screen the population for disease or disease markers are often made. Population screening is a cross-sectional review of a population to find latent cases or biomarkers of disease that indicate the possibility of disease development; it differs from environmental screening or an epidemiological survey. Recognized standard approaches have been developed over 60 years to ensure quality and effectiveness in complex programs. We surveyed the literature for papers on health screening following environmental exposures and checked them for reference to accepted criteria such as those of Wilson and Jungner. We applied these criteria to three situations covering source/hazard (arsenic contaminated land), pathway/exposure (radiation release), and receptor/disease (lead poisoning). We identified 36 relevant papers. Although across the papers the whole range of criteria were addressed, no paper or program utilized recognized criteria. Issues and gaps identified included limited strategic approaches, lack of treatment, environmental prevention being seen as the screening outcome instead of treatment of identified individuals, and programs which did not fit the World Health Organization screening description. Robust discussion in the literature is needed to consider the organization and role of health screening following environmental exposures.
    • Postures and positions in labour: Best practice

      Steen, Mary; Anker, Jo; RCM/UCLan; Leeds Teaching Hospitals NHS Trust (2008-05-21)
      This presentation discussed the evidence and demonstrated different postures and positions that women can adopt during labour.
    • The potential impact of extensive privatisation in the UK upon the ‘life chances’ of young people in care

      Carey, Malcolm; University of Chester (National Youth Agency, 2021-11-01)
      The article considers the potential impact of extensive privatisation in the UK upon the ‘life chances’ of young people in care