• 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
    • Practice change and development: An insider view - a grounded theory study on the nature of nursing practice change

      Mason, Tom; Fallows, Stephen; Thomas, Mike; Meredith, Linda (University of Liverpool (University of Chester)University of Chester, 2012-04)
      Change is a common feature of nursing, influenced by prevailing governments as part of their political agendas. These changes have impacted both on the context within which nursing takes place as well as on the actual role of the nurse. For change agents who are implementing these changes, it is imperative that they are aware of how nurses respond to change in order that they can plan the most effective strategies. This thesis investigated how nurses understand their own practice changes, the process that they undergo, how resistance to change manifests and if nursing rituals have an impact on the process. Finally the thesis made recommendations based on the findings to facilitate effective practice change and development. The study was conducted in two parts. In-depth interviews with eight nurses from one acute NHS Trust made up the first part of the study. A further two interviews were conducted with eleven mental health nurses from an early intervention team in one NHS Mental Health Partnership Trust, and this constituted the second part of the study. Constructivist grounded theory was the research method employed in the design of the study. An underpinning theoretical framework of structural anthropology with specific reference to the work of Levi-Strauss was used to present the final grounded theory. The study found that nurses understood the process of practice change as a spiral with the most significant aspects of practice change at the bottom. These were the day-to-day changes that may or may not lead to permanent change. At the top of the hierarchy and of least significance were the changes imposed by their employing organisations or nationally. The overall personal process of practice change and development was identified from the study as a process that centres on the experiences that participants have in their workplace, a process of sense making, learning and intuition. A Practice Change Model in the form of a continuum was developed that described how nurses respond to practice change and development. The significance of this study is that the thesis was able to identify strategies for promoting effective practice change and development, aimed at nurses in practice, change agents at an organisational and national level, and the clinical link role within higher education.
    • Pre-admission nursing assessment in a Welsh medium secure unit (1991–2000): Part 1 - an analysis of practice and cost

      Watt, Andrew; Topping-Morris, Barry; Mason, Tom; Rogers, Paul; Institute of Cardiff, University of Wales ; Caswell Clinic, Glanrhyd Hospital ; Glanrhyd Hospital / University of Glamorgan / Chester College of Higher Education ; Institute of Psychiatry / Glanrhyd Hospital (Elsevier, 2003-04-16)
      This article discusses the practice of pre-admission assessments and details a method for estimating the cost of forensic nursing assessments in terms of the investment of nursing time.
    • Predictors of mortality and survival in type 1 diabetes: a retrospective cohort study of type 1 diabetes mellitus (T1D) in the Wirral Peninsula

      Akata, Eloho (University of ChesterUniversity of Chester, 2019-05)
      Background: The prevalence of T1D is rising, despite improvements in the management of this condition. It presents a risk of premature and excess mortality, which impacts survival and life expectancy. Aim: The study aim was to assess mortality, identify predicting risk factors for mortality and survival in T1D in the Wirral. A systematic review was done to establish present current evidence of all-cause and cause-specific mortality amongst T1D patients. Methods: A retrospective cohort study design, 1786 patients diagnosed with T1D extracted from the Wirral Diabetes Register (WDR). The follow-up period was between 1st of January, 2000 to 31st December, 2012. The primary outcome measured was all-cause mortality. Results: 1458 participants with T1D meet the inclusion criteria, after a follow-up period of 12 years, 113(7.75%) deaths were recorded. While the incidence rate was steady over the study period, the prevalence rate continued to increase over the study period. Significant predictors of mortality in this cohort were age of diagnosis, duration of diabetes, HbA1c,systolic blood pressure (SBP), diastolic blood pressure (DBP), and triglyceride levels. The predicting risk gender, age at diagnosis, duration of T1D, BMI, serum creatinine levels, SBP, total cholesterol, LDL, HDL, TC\HDL, and LDL\HDL showed a linear increase in mortality risk. IMD and DBP followed a U-shaped relationship with relative and absolute mortality, while HbA1c levels reveal a sinusoidal pattern with the highest risk of mortality at the levels ≤ 5.9% (41 mmol/mol). The risk of mortality for the predicting risk factors for this study ranged between 5% and 9%. Maximal risk of mortality of 9% was recorded in the predicting risks of smoking, BMI, SBP, and DBP. The risk of mortality of 8% was recorded for IMD, serum creatinine, total cholesterol, TG, LDL\HDL ratio, and TSH. The risk of mortality of 7% was recorded for the predicting variables of HbA1c, HDL, LDL, and TC\HDL ratio. The minimum risk of mortality of 5% was recorded for the predictor variable of the duration of diabetes. The significant predictors of mortality were the age at diagnosis, duration of diagnosis, systolic and diastolic blood pressure, HbA1c. The burden of mortality rest disproportionately with females who had higher relative risk of mortality of 4 times that of their male counterparts, however, the burden of premature mortality as recorded by the years of potential life lost was slightly higher in males (1797[53.6%]) as compare to females (1553[46.4%]). Of the 113 deaths recorded for the cohort that indicated a proportion of 7.75% of the total T1D patients, records for only 37 participants were retrieved. The principal cause of death in this cohort was malignancy-related 8 deaths (21.6%), this was followed by cardiovascular disease and sepsis, each having 6 deaths (16.2%) respectively. Cerebrovascular disease accounted for 5 deaths (13.5%). Death from diabetes complications (hypoglycaemia) was recorded in 1 patient (2.7%). There were marked reductions in life expectancy for this cohort. Life expectancy at 40 years for females was to an average age mortality of 66.2 years as compared to males 78.3 years. There has been improved survival for T1D in this cohort, 77.185 years [95% CI: 75.191 – 79.179] in males and 76.011 years [95% CI: 73.169 – 78.000] in females. The systematic review highlighted increased mortality in those with T1D as compared to the general population, females showed greater risk of vascular complications as compared to the males with T1D. 35 studies were included. Results showed all-cause mortality RR 3.73 (95% CI 3.19, 4.36) compared to general population, with gender specific mortality RR 1.17 (95% CI 1.06, 1.29). For cause specific mortality risk (overall and gender specific): cardiovascular v disease RR 3.48 (95% CI 3.14, 3.86) and RR 1.41 (95% CI 0.92, 2.17); renal disease RR 1.06 (95% CI 0.89, 1.26) and RR 0.63 (95% CI 0.38, 1.04); neoplasms RR 1.03 (95% CI 0.92, 1.16) and RR 1.18 (95% CI 0.75, 1.86); cerebrovascular disease according to gender RR 0.99 (95% CI 0.66, 1.48), and accidents and suicides according to gender RR 2.30 (95% CI 1.31, 4.06). Conclusion In conclusion, the study highlighted significant mortality risk in females as compared to their male counterparts; there has been progress in the survival of patients with T1D. However, life expectancy remains reduced as compared to those without the condition. Prevalence of T1D continues to increase, and the complex interplay of the predictor variables support the need for an individualised approach to care.
    • Pregnancy and birth: Everything you need to know

      Steen, Mary; University of Chester (Dorling Kindersley, 2011-03-01)
      This book provides, practical and visual information that is written in plain English. Pregnancy, birth and following birth is covered in detail. The care and support during pregnancy, birth and the transition to parenthood is described and discussed.It is a comprehensive guide and a useful resource that pregnant women and their partners will find easy to understand.