RSS 1.0Health and Social Care
The Faculty of Health and Social Care has a long history at University of Chester, being established in the early 1990s as the School of Nursing and Midwifery. A wide variety of programmes are delivered by the Faculty including foundation degrees, undergraduate degrees and postgraduate degrees. All branches (adult, mental health, learning disability and child) of pre-registration nursing can be undertaken, as well as pre-qualification courses in Midwifery and Social Work. Social Work programmes are available at both undergraduate and masters levels. The Faculty also offers a wide ranging and exciting portfolio of post-qualifying programmes with an inter-professional focus. Within the Faculty, research is viewed as integral to the working life of staff, in partnership with local and regional providers of care. The Faculty has a research office which coordinates the activity of the Faculty. The strategic focus is on further development in community/primary care, users and carers support and inter-professional learning. There are opportunities to register for a PhD, with supervision from recognised experts in their field. Individual Professors, Readers and Teaching Fellows lead their own research developments in subjects closely related to practice-based care. These include clinical interventions in eating disorders, supporting individuals with learning disabilities in the penal system, interventions in forensic mental health, supporting carers and users of services, safety factors for single practitioners in the community and pedagogical research.
This collection is licenced under a Creative Commons licence. The collection may be reproduced for non-commerical use and without modification, providing that copyright is acknowledged.
Recent Submissions
-
Effectiveness of Angiotensin Receptor Blockers (ARB) and Hydrochlorothiazide compared to ARB Monotherapy in the control of Hypertension among adult patients: A systematic review and meta-analysisBackground: Hypertension (HTN) is a global disease of public health concern. It is considered a major cause of morbidity and mortality worldwide. The global and regional recommendations for the management of high blood pressure are complicated, with an increasing call for several adequate measures to commence treatment, increase the dosage, or introduce a new class of medication. Evidence suggests that most people with HTN require more than one drug regime to achieve blood pressure goals, with a greater percentage of patients reporting only having access to monotherapy. This work evaluated the combined effectiveness of angiotensin receptor blockers (ARBs) and hydrochlorothiazide (HCTZ) compared to ARB monotherapy in an uncontrolled hypertensive patients. Methods: The search involved screening through databases such as Cochrane Library, PubMed, CINAHL, Embase, Medline, and the Web of Science, medical journals, and international registry on clinicals from the WHO were searched for primary studies not older than 13 years. Randomized control trials (RCTs) comparing the effectiveness of ARB/HCTZ versus ARB monotherapy in hypertensive patients were selected. Care was taken to include only studies that lasted at least four weeks. Meta-analysis was conducted on RevMan 5.3 statistical application software, following data extraction. Data quality and risk of bias assessment were also all assessed. A total of seven RCTs were considered for this study involving 4814 participants. Results: The result from the intervention arm revealed that ARB/HCTZ combination resulted in a higher rate of target blood pressure achievement when compared to ARB monotherapy relative risk (RR) = 1.53, 95% confidence interval (CI) (1.42, 1.65), with p < 0.00007. The adverse effects observed in the intervention arm were not significant. Conclusion: The ARB/HCTZ combination therapy was more effective in lowering and controlling blood pressure when compared to ARB monotherapy without significant adverse drug effects reported by the participants. Health workers should therefore recommend ARB/HCTZ combination therapy for patients with uncontrolled hypertension.
-
Experiences and unmet needs among caregivers of children living with autism spectrum disorder in Nigeria: A qualitative study using the socio-ecological modelIntroduction: This study examines the experiences and unmet needs of caregivers of children with autism spectrum disorder in Nigeria. With a high prevalence in Nigeria, autism spectrum disorder poses a heavy economic burden on society and the patients’ families, with limited social interactions and stigma. Despite this, the unmet needs and psychosocial burdens of autism spectrum disorder on caregivers have been understudied in Nigeria. The study contributes evidence and raises interest in this area of research. Methods: This qualitative study was conducted among twenty-three purposively selected caregivers. Questions from the PREPARE and Zarit Burden Interview tools were adapted for the interview and discussion guides. Data were collected among caregivers of pupils in selected special needs schools in Cross River State, Nigeria. Inductive and deductive approaches were used for the analysis using NVivo 20 pro. The socio-ecological model was used to generate the themes and quotes. Results: The study generated four themes and eleven sub-themes across four levels of the socio-ecological model. Findings from our study showed that caregivers of children undergo significant emotional distress, disbelief, and fear at the early stage of diagnosis. Furthermore, families and friends had difficulty comprehending or accepting their children’s diagnosis, which further created tension and misunderstanding. Socio-cultural contexts such as stigma and isolation were not uncommon in the society. Conclusion: Given the burden of the psychological demand and stigma attached to caregivers and children with autism, there is an urgent need for a tailor-made intervention with the key interplay of individual, interpersonal, societal/institutional, and policy in Nigeria. Advocacy efforts and awareness chaired by caregivers should be strengthened across all levels of the society in Nigeria.
-
Knowledge and attitude of women towards breast cancer screening in resource-limited setting in women aged 18–45 yearsBreast cancer incidence is on the rise regardless of several interventions available for its management. This scenario may be worse in resource-limited countries. This study, therefore, aimed to evaluate the knowledge and attitude of women towards Breast Cancer Screening (BCS) in Aminu Kano Teaching Hospital (AKTH), Kano State, a typically resource-limited state in Nigeria. This was a cross-sectional study. The study population comprised female individuals aged 18–45 years attending the Antenatal and Postnatal clinics of AKTH. An adopted questionnaire instrument was used to extract vital information on the knowledge and attitude of women towards breast cancer screening in the Antenatal and Postnatal clinics of AKTH. Our findings showed that there is much awareness about BCS, even though most participants’ knowledge about the methods and timing of the scan is low. Much enlightenment is achieved through the availability of print and electronic media on BCS. A better attitude is shown when trained personnel conduct BCS. A good number of participants who have knowledge are yet to translate their knowledge and attitudes into practice. Based on our findings, coordinated and timely awareness campaigns should be organized by local health authorities to improve knowledge and attitude towards BCS.
-
Comparative study of hypertension, diabetes, dementia and smoking in military veterans and non-veterans: a quantitative study using primary healthcare dataIntroduction: Primary healthcare (PHC) patient medical records contain Systematised Nomenclature of Medicine-Clinical Terms (SNOMED-CT) that include information regarding diagnosis, demographics and veterans’ status. This study intended to identify, analyse and compare the prevalence of type 2 diabetes, hypertension, dementia and smoking tobacco in veterans and non-veterans, including stratification by age and gender. Methods: The authors partnered with 13 PHC practices with a population of 137 410 patients. Staff extracted matched veteran and non-veteran SNOMED-CT data from patient medical records; then sent the authors anonymised data in an amalgamated format between October 2023 and January 2024. Patients were from a local community and therefore social and environmental factors would be similar. Submitted information was inputted into an SPSS database 28 for analysis which included descriptive and inferential statistics to indicate statistical significance. Results: In total, 5458 PHC electronic records were examined comprising 2729 veterans and 2729 demographically matched for age and gender non-veterans. Each group contained 86.4% (N=2359) men and 13.6% (N=370) women. The mean age was 63.8 years (SD 17.7). Rates of hypertension were 20.9% in veterans compared with 17.6% in non-veterans (p=0.002). Type 2 diabetes mellitus was 8.3% in veterans compared with 6.4% in non-veterans (p=0.007). Dementia was 2.1% of veterans compared with 2.5% of non-veterans (p=0.32). Smoking was 11.8% of veterans compared with 10.6% of non-veterans (p=0.16). Conclusion: These results reveal that veterans were statistically more likely to be diagnosed with hypertension and diabetes. This study should assist in a better understanding of the healthcare needs of the veteran population to potentially inform better patient-centred care. However, the effectiveness of using PHC patient medical records requires increased efforts to improve data quality which needs improved PHC staff knowledge, consistency in SNOMED-CT coding, better veteran medical e-record registration and coding and better data transmission between the Defence Medical Services and PHC.
-
Commentary: Relationship between resilience, social support and psychological well-being in nursing studentsIn the United Kingdom and internationally, the nursing workforce currently needs more nurses due to challenges in recruiting and retaining them (Buchan and Catton, 2023). Nursing is known for its demanding nature, which exposes nurses to acute and chronic stressors. This could potentially lead to conditions such as depression, anxiety, secondary traumatic stress and burnout (Mitchell, 2024a).
-
Distribution and predictors of haemophilia-related costs in the United Kingdom: analysis of the CHESS I and CHESS II burden of illness studiesBackground: Few studies have evaluated direct medical or societal costs of haemophilia in the United Kingdom (UK), and how patient characteristics impact future costs is uncertain. Cost predictors were identified and examined using cross-sectional data from the CHESS I and II studies. Methods: Patient- and physician-reported outcomes were analysed for UK adult males aged ≤ 65, with haemophilia A or B and no recent clinical trial participation. Demographics, haemophilia type and severity, inhibitors, annual bleed rate (ABR), problem joints (PJs), treatment type, and comorbidities, were utilised in regression analyses. Health-related quality of life was assessed using EQ-5D. Generalised linear models estimated expected non-drug haemophilia-related direct medical costs (DMC) and societal costs (non-drug DMC, direct non-medical and indirect costs). Average marginal effects (AMEs) determined predictors of cost. Results: Costs for 378 patients were analysed. Mean age was 33 years and 79% (299) had haemophilia A. Mean annual per-patient DMC were £165,001 (including factor treatment costs) and £4,091 when excluding factor replacement treatment costs (non-drug DMC). Mean annual per-patient non-treatment societal costs were £11,550 (standard deviation £20,171) among those with data available (n = 51). Number of PJs, ABR, and treatment regimen were significant determinants of haemophilia-related non-drug DMC (all P < 0.001). Non-drug DMC increased as ABR increased (AMEs were £2,018 for ABR 1–5, £3,101 for ABR 6–10 and £5,785 for ABR ≥ 11, vs. ABR 0) and by £1,869 per additional PJ. No significant predictors of non-drug haemophilia-related societal costs were identified. Mean EQ-5D score was 0.66, with lower scores observed for people with haemophilia B (0.48) compared with haemophilia A (0.71) and with increasing haemophilia severity. Conclusions: UK direct medical and societal costs of haemophilia are substantial. Non-drug DMC were particularly associated with ABR and number of PJs. These findings may be useful for real-world evaluations of the economic burden of haemophilia in the UK.
-
Peer mentoring as an overlooked health and social care methodPeer mentoring, delivered by people with shared experiences, has grown rapidly across the globe in recent decades (Munn-Giddings and Borkman, 2017). This (multi)national development is underpinned by ‘lived experience’ movements pressing for democratic inclusion, and consumerist notions of user involvement as a lever of efficiency and effectiveness (Beresford 2002). Peer mentoring is a ‘method’ to implement the ‘theory’ of lived experience involvement and the closely related theories of participation, and coproduction, but it has largely been overlooked in health and social care texts and consequently in professional training. To bridge this gap, this chapter will introduce lived experience involvement in health and social care and examples of peer mentoring, before focusing on criminal justice as a case study to explore how the strengths of peer mentoring can be harnessed and the pitfalls avoided.
-
All our justice: People with convictions and ‘participatory’ criminal justiceCriminalised people play varied roles in the development and delivery of criminal justice services and advocacy around the world, yet rarely feature in texts on service user involvement. The chapter explores how people with lived experiences of the criminal justice system are involved with, and too often excluded from, formal criminal justice knowledge production. We reflect on ‘leaders’ with lived experiences and how they produce, contribute to and constitute criminal justice knowledges. These reflections highlight the importance of being sensitive to the needs of people sharing their shame/trauma-invoking life experiences, offering substantial opportunities beyond volunteering or insecure contracts and real commitments to power sharing. As a single ‘user voice’ is not possible, it is also important that a range of perspectives are represented from activist/practitioner to managerial levels. Importantly, this should include black and minority ethnic men and women, who are overrepresented as recipients of punishment and underrepresented as leaders and influencers, with or without lived experience.
-
Training of food handlers using a virtual reality environment on handwashing is more effective than traditional training approaches in a randomized trialHandwashing is an essential prevention step in foodservice, This randomized comparative study assessed the effectiveness of three training methods -virtual reality (VR), Glo-Germ (GT), and traditional face-to-face training (CT)- in improving handwashing practices among foodservice workers (n = 129). Training focused on the World Health Organization’s 11-step handwashing process. Handwashing in the workplace was observed, in a pre- and post-test design, with microbiological swabs also taken. There was an increase in time spent on handwashing that was noticeable across all three groups (p < 0.05) with the highest in the VR group (50.16 ± 26.04 sec.). The mean number of handwashing steps increased across all groups, and the highest increase (8.91 ± 1.49 steps) was observed in the VR group. A statistically significant difference was observed among all groups regarding correctly performed steps, and the VR group showed the highest number of steps (p < 0.01). These findings suggest that VR-based training has value for enhancing hand hygiene practices in foodservice settings.
-
An Exploration of Physiotherapists’ Perceptions and Experiences of Risk in Discharge PlanningAn Exploration of Physiotherapists’ Perceptions and Experiences of Risk in Discharge Planning.
-
Women Prisoners Regulating Prisons: Did Corston Achieve Networked, Participatory Regulation?Prison regulators across scales hold potential to illuminate harms of imprisonment and influence alternatives, yet criminologists rarely engage with these mechanisms. We analyse prisoners’ participatory roles in the ‘transformative’ Corston Report (2007) and The Corston Report 10 Years On (Women in Prison, 2017), using actor-network-theory to guide document analysis. Corston called for a radically different, woman-centred approach to criminal justice, but women’s voices were often peripheral, or they were constructed as ‘pathetic’. There is unrealised potential for regulatory efforts to network imprisoned women and their families with other regulators, deepening understanding of problems connected to prisons, for broader social benefit.
-
Coproducing recovery with people affected by substance use and criminalizationThis study details the coproduction approach taken by Red Rose Recovery (RRR), a non-profit organization that coproduces recovery systems with people affected by substance use and criminalization. RRR is ‘lived-experience-led’ in that those who manage and work for the organization use their own experiences of recovery or desistance from crime to provide inspiration and hope to others. We explored people’s experiences of working with RRR using a ‘photovoice’ research design, where people use cameras to document their realities. Data were analysed collaboratively, offering a depth of insight into the perspectives of people involved. The images and words produced by photographers illustrate this article and indicate that, in contexts of pain, shame, exclusion, and disconnection, coproduced services can offer valued relationships, community, and a sense of belonging within built and natural environments.</jats:p>
-
Three and Twelve Month Body Mass Outcomes After Attendance at a Community-Based Weight Management Intervention in the North West of EnglandResearch suggests that commercial weight management services are efficacious in helping people manage their body mass, but they typically only include education and advice on physical activity. The objective of this analysis was to assess 3- and 12-month body mass after attendance at a community-based weight management programme delivered by a commercial slimming group, which included the provision of tailored physical activity sessions by a local leisure trust between January 2009 and November 2014. Methods: After institutional ethical approval and participants giving informed consent, a retrospective analysis of a 12-week multi-component intervention, tier 2 community weight management service for adults in Wigan, North West England, United Kingdom, was undertaken. Participants’ (n = 8514) mean ± SD age was 47.4 ± 14.3 years and starting body mass was 86.7 ± 14.3 kg. The main outcome measure was body mass (kg) at 0 months (baseline), 3 months (immediately post intervention) and 12 months. Significant differences in body mass were ascertained if p < 0.05 using repeated measures ANOVA with Bonferroni post hoc test, with effect sizes calculated using partial eta squared. To confirm and account for missing data, the Last Observation Carried Forward (LOCF) approach was used. Results: Repeated measures ANOVA showed a significant effect of time (p < 0.01, ηp2 = 0.36). Post hoc tests revealed there was a significant reduction in body mass from baseline to 3 months (86.7 ± 14.3 kg vs. 81.2 ± 13.6 kg) and baseline to 12 months (79.7 ± 14.0 kg). The difference between 3 months and 12 months was also significant. LOCF confirmed a significant effect of time (p < 0.01, ηp2 = 0.42), with all previously highlighted significant differences remaining. Conclusions: Significant reductions in body mass were reported at 3 and 12 months, providing evidence for the efficacy of the community weight management programme that included tailored physical activity opportunities for participants. Whilst comparisons to a resting control group cannot be made, partnerships between commercial slimming groups and local leisure providers should be encouraged and explored nationally.
-
Safeguarding care home residents and staff against infectious disease outbreaks: Development of a new toolkitThis commentary introduces the PROTECToolkit (referred to as the “Toolkit”) which aims to address the relevant factors associated with infectious disease outbreaks and infection prevention and control (IPC) in nursing and residential care homes.
-
Protocol: Assessing the outcomes and impact of Professional doctorate programmes in health and social care on the individual, their profession, their employing organisation and wider society: A comprehensive systematic reviewThis is the protocol for a Campbell systematic review. This review's objectives are to find out (in relation to health and/or social care): (1) What is known about the outcomes and impact of completing (or not completing) a professional doctorate in health and/or social care on the individual professional? (2) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on the employing organisation? (3) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on the profession? (4) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on service users and the wider society? (5) How do we use the findings from this review to inform educators, higher education institutions, professionals, investors in employing organisations and policymakers? (6) What further research will be needed to answer any knowledge gaps or recommendations? (7) Where possible, we will identify and report on any demographic data and discuss their relevance to the impact and outcomes from professional doctorates.
-
Enabling and embedding creative participation in child and family social workWe all have a need to be seen and heard. For children who have experienced disruption, harm, danger or trauma, this need is crucial and it is the job of child and family social work professionals to ensure this happens. The ability to make connections and ‘move' with children (Ferguson, 2016; Winter et al., 2017) requires trusting relationships with reliable practitioners, particularly when they have the power to make decisions on a child’s behalf (Cossar et al., 2016). However, research identifies that: > children can be unsure what is written in the plans designed to keep them safe > participation is infrequently embedded into everyday social work practice > the concept of wishes and feelings is often misunderstood. (Dillon et al., 2016; Dillon, 2021) Serious Case Reviews (now known as Child Safeguarding Practice Reviews) have consistently emphasised the missed opportunities of talking and listening to children in social work (for example, Laming, 2003; Rogers, 2013). Despite this, there remains an absence of practice guidance on ways to do this. The need to develop effective communication skills to improve the quality of everyday interactions with children is an important component of professional education and practice (Lefevre, 2018; Ruch et al., 2019). Just as all children are unique, each relationship and interaction between a child and practitioner will be distinctive and influenced by the child’s individual experiences. This practice tool considers the degree to which children can actively take part in decision-making processes that affect their safety and security. It focuses on: > keeping the child ‘visible’ (Ferguson, 2017) > encouraging deeper collaborative and relational encounters with children > providing examples of good practice, using a fictional and unfolding case study to explore how social workers can creatively facilitate children’s participation.
-
Participation in Child Protection: A Small-Scale Qualitative StudyThis small-scale qualitative study explores how children participate in their own child protection/child in need planning within a statutory setting in England. Their experience of participation and the impact that voicing their wishes and feelings had on outcomes are highlighted and discussed against a background of conflicting discourses of statutory safeguarding and empowering participation, barriers to engagement and hearing the child’s voice.
-
Defining the Role of the Fire and Rescue Service in Mental Health Support for Older Adults: A Qualitative StudyIntroduction: Anxiety and depression in older adults (60+ years of age) are under‐diagnosed and under‐treated. Older adults are less likely to seek help for these problems due to a lack of awareness, difficulty accessing health care due to availability or disability and fear of loss of independence. Existing points of contact between older adults and non‐traditional services, for example, the Fire and Rescue Service (FRS), could provide opportunities to support help‐seeking for mental ill‐health. The FRS conduct Home Fire Safety Visits (HFSVs) with older adults and are well positioned to provide health‐related support. This study examines a range of perspectives on the potential role of the FRS in the identification of, and signposting for, anxiety and depression in older adults. Methods: This was a qualitative study carried out using mixed methods in West Midlands, UK. Semi‐structured interviews were conducted with older adults and health and social care providers (practitioners, managers, commissioners) to explore the acceptability of the FRS expanding its role to detect and signpost for anxiety and depression in older adults. Observations examined delivery of existing HFSVs to older adults. Data were combined and analysed using a reflexive thematic approach. Results: Eighteen health and social care providers and 8 older adults were interviewed; 10 HFSVs were observed. Two overarching themes were identified: (1) Potential role for the FRS and (2) Operationalising identification of mental health problems by FRS. Interviews and observations demonstrated how HFSVs offer a suitable opportunity to start conversations about mental health. All interview participants felt that although the FRS would be well placed to deliver an intervention, they would require training, support and a referral pathway co‐produced with and supported by health and social care partners. Conclusion: A whole‐system approach is needed if the FRS are to expand HFSVs to identify mental health problems in older adults and provide signposting to appropriate services. Patient or Public Contribution: J.S. is a public co‐investigator. A Patient Advisory Group contributed to the initial funding application, design and conduct of the study, including data analysis and advice on dissemination.
-
Priorities in Simulated Practice Learning PlacementsCommentary piece
-
Exploring the relationship between condition severity and health-related quality of life in people with haemophilia A across Europe: a multivariable analysis of data from the CHESS II studyBackground: Haemophilia A (HA; Factor VIII deficiency) is a congenital X-linked bleeding disorder characterized by trauma-related or spontaneous bleeding events, most notably arising within the intraarticular space and resulting in chronic inflammation and degeneration of affected joints. Endogenous clotting factor activity relative to normal levels determines the severity of HA symptoms, as mild (> 5–40%), moderate (1–5%), or severe (< 1%). Within the current environment of rapid evolution in HA management, we seek to understand the interplay of condition severity and health-related quality of life (HRQoL) to characterise and differentiate unmet needs among people with HA (PwHA). Methods: A generalised linear regression model (GLM) was developed to explore the relationship between HA severity and EQ-5D-5 L index score from adult HA patients sampled in the “Cost of Haemophilia across Europe – a Socioeconomic Survey II” (CHESS II) cross-sectional, retrospective burden of illness study among adults with hereditary haemophilia A or B from eight European countries. HA patients of any severity with no active inhibitors during the 12 months prior to data capture and a completeEQ-5D-5 L response were included. A base GLM model was specified with covariates for demographic and clinical characteristics (age, body mass index, country, employment, HA severity, annual bleeding rate, problem joints, and chronic pain). Results: Of 381 evaluable patients, 221 (58.0%) had severe HA, 96 (25.2%) had moderate HA, and 64 (16.8%) had mild HA. Among the covariates included in the GLM model and after controlling for haemophilia-related outcomes, a significant association was observed between mild HA and higher EQ-5D-5 L index score (average marginal effects, 0.084; p = 0.016) relative to severe HA. Patient country of residence and magnitude of HA-related chronic pain were also associated with significant differences in index scores, with the latter showing a negative relationship with HRQoL outcomes. Conclusions: Condition severity and chronic pain are significant predictors of HRQoL in PwHA. Durable bleeding protection and effective management of chronic pain have the potential to address unmet treatment needs in this population.
