• Workplace Health and Well-Being

      Massey, Alan; University of Chester (Springer Nature, 2019-09-06)
      The problems related to the process of industrialisation such as biodiversity depletion, climate change and a worsening of health and living conditions, especially but not only in developing countries, intensify. This chapter looks at the role of workplaces in the drive for global sustainability through the World Health Organisations healthy workplace framework
    • Evaluating unmet needs in patients undergoing surgery for colorectal cancer: A patient reported outcome measures (PROMS) study.

      Sutton, P A; Bourdon-Pierre, R; Smith, C; Appleton, N; Lightfoot, T; Gabriel, C; Richards, B; Mohamed, S; Mason-Whitehead, E; Hulbert-Williams, N J; Vimalachandran, D (2019-03-03)
      Patient reported outcome measures (PROMs) are self-reported measures of patients' health status or health related quality of life at a single point in time. We aimed to evaluate the use of a colorectal PROM, and conducted a focus group to further explore this and other unmet needs in our patient population treated surgically for colorectal cancer. A multidisciplinary research group consisting of colorectal surgeons, nurse specialists, psychologists, sociologists and patient representatives devised a composite tool of new and existing outcome measures which was piloted in our local population (n=35). Participants were subsequently invited to attend a semi-structured focus group during which the PROM was reviewed and an unmet needs analysis performed. Thematic analysis of focus group transcripts was undertaken for emergent themes. Initial consensus was for a tool including the EQ-5D, FACT-C, the distress thermometer, a validated measure of stigma, an unmet needs analysis, and questions assessing the psychological impact of cancer. Median and IQR values suggested all metrics were discriminatory with the exception of FACT-C. All participants agreed the tool was acceptable, and reflected the current state of their health and emotions. Thematic analysis of focus group transcripts identified four major themes: Physical symptoms, emotional response, information provision and coping mechanisms. Through expert consensus, local piloting and patient focus groups we have evaluated a novel PROM for colorectal cancer. Furthermore, through our direct engagement with patients we have identified several unmet needs which we are currently exploring within the clinical service. This article is protected by copyright. All rights reserved. [Abstract copyright: This article is protected by copyright. All rights reserved.]
    • Some ethical limitations of privatising and marketizing social care and social work pro-vision in England for children and young people

      Carey, Malcolm; University of Chester (Taylor and Francis, 2019-03-01)
      This article analyses the negative ethical impact of privatisation, alongside the ongoing mar-ketisation of social care and social work provision for children and young people in England. It critically appraises the implications of a market-based formal social care system, which in-cludes the risk-averse and often detached role of social workers within ever more fragmented sectors of care. Analysis begins with a discussion of background policy and context. The ten-dency towards ‘service user’ objectification and commodification are then detailed, followed by a discussion of the limiting of choice for service users. Service and social fragmentation, and the often severely restricted ‘life chances’ of many children and young people in care, are then deliberated. The concluding discussion reiterates the moral implications of marketisation in relation to ethical frameworks, including those associated with autonomy, informed choice, social exclusion and social justice. The tendency towards children increasingly being utilised as a means to an end within business-orientated sectors of care is highlighted, alongside ethi-cal questions asked about the State’s purpose in providing a community of support.
    • The emergence of accelerated resolution therapy for treatment of post-traumatic stress disorder: A review and new subgroup analyses

      Kip, Kevin E.; orcid: 0000-0002-6401-0051; Berumen, Jessica; Zeidan, Amina R.; Hernandez, Diego F.; Finnegan, Alan P. (Wiley, 2019-01-25)
    • Issues of Ageing, Social Class, and Poverty

      Carey, Malcolm (Routledge, 2019-01-18)
      This chapter examines some ethical and political challenges generated by the increasingly complex needs of an ageing society upon social work. It concentrates on the UK as a case study and critically evaluates related age-graded policies and practices relating to social work and care. The chapter includes a discussion of the on-going ethical tensions between social diversity within an ageing society and the shrinking of formal care provision.
    • 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.
    • Beating the blues with pleasurable activity

      Mitchell, Andrew E. P.; University of Chester (Philip Allan, 2019)
      In this article Chartered Psychologist, Andrew Mitchell explains how behavioural activation (BA) can be used to treat depression
    • Registered nurses’ experiences of communicating respect to patients: influences and challenges

      Clucas, Claudine; Chapman, Hazel Margaret; Lovell, Andrew; University of Chester (SAGE Publications, 2019)
      Background: Respectful care is central to ethical codes of practice and optimal patient care, but little is known on 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 United Kingdom 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 interpersonal influences on communicating respect, and sheds light on challenges involved, helping provide practical insights to support respectful care.
    • Stigma: a linguistic analysis of the UK red-top tabloids press’s representation of schizophrenia

      Bowen, Matt; Kinderman, Peter; Cooke, Anne; University of Chester; Liverpool University; Canterbury University (SAGE publications, 2019)
      Aims. Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods. Using corpus linguistic methods, a sample of newspaper articles over a 24 month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, whilst supported by statistical tests (Log-Likelihood) to compare the data sets and identify words with a high relative frequency. Results. Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. “schizo”) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to: acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency (n=108) and most commonly to name individuals who had committed acts of violence. Discussion. The study suggests that whilst the press have largely avoided the use of words that press guidance has steered them away from (e.g. “schizo” and “psycho”) that they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend.
    • Social Work Through Collaborative Autoethnography

      Gant, Valerie; Cheatham, Lisa; DiVito, Hannah; Offei, Ebenezer; Williams, Gemma; Yatosenge, Nathalie; University of Chester (Taylor & Francis, 2019)
      This paper discusses a research project involving 5 MA Social Work Students and 1 member of Social Work Academic Staff. Using narrative and taking a collaborative autoethnographical approach, this project highlights some of the feelings that students articulated following a 70 day placement experience. Findings include anxiety, powerlessness and frustration, together with growing confidence, recognition of their skills and a deeper understanding of the role of ‘self’ in social work. Raising issues of preparedness for practice placement, this paper has implications for both social work practice and social work education. Autoethnography (AE) is both a method of carrying out research and a methodology, specifically a qualitative methodology linked to ethnography and narrative inquiry. AE results in highly personalised narrative accounts of the researcher’s engagement with specific sociocultural contexts in the pursuit of knowing more about a phenomenon. Applying such a methodology to explore collaboratively issues of student lived experience of placement is a new and innovative use of this method.
    • Politicisation or Professionalisation? Exploring divergent aims within UK voluntary sector peer mentoring

      Buck, Gillian; University of Chester (Wiley, 2019)
      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.
    • Midwifery and psychological care

      Jones, Alun Charles (Mark Allen Group, 2018-12-02)
    • Diversity in ageing, reductive welfare and potential new ways of utilising ethics in social work with Older People

      Carey, Malcolm; University of Chester (Routledge, 2018-11-30)
      This chapter examines some ethical and political challenges generated by the increasingly complex needs of an ageing society upon social work. It concentrates on the UK as a case study and critically evaluates related age-graded policies and practices relating to social work and care. The chapter includes a discussion of the on-going tensions between social diversity within an ageing society and the shrinking of formal care provision, alongside the impact of professional codes of ethics.
    • The tyranny of ethics? Political challenges and tensions when applying ethical governance to qualitative social work research

      Carey, Malcolm; University of Chester (Taylor & Francis, 2018-11-29)
      This paper examines problems which current ethical governance processes generate for qualitative researchers within social work. It draws upon case studies and critical theory to detail the unpredictable and diverse nature of much social work qualitative research. It argues that too often this research is pitted against a narrow institutional focus placed on positivist-orientated empirical research and income generation. Overtly instrumental interpretations of ethics - often determined by realist and bioethical paradigms - can quickly inhibit the methodological dynamism required to meaningfully capture the complex and non-binary issues which social workers accommodate in their work and subsequent research. Arguments that policy-led, institutional and professional cultures have generated a conservative culture of risk-aversion within the neo-liberal university are also considered.
    • Being homeless in an unequal society: A qualitative analysis of stories of homeless people

      Mabhala, Mzwandile A. (Oxford University Press (OUP), 2018-11-21)
    • Exploring Preceptorship Programmes: Implications for Future Design

      Taylor, Louise M; Eost-Telling, Charlotte L; Ellerton, Annie; University of Chester (John Wiley & Sons Ltd, 2018-11-15)
      • Aims and objectives: To review and analyse current preceptorship programmes within NHS trusts in the North West of England. To evaluate the pedagogic rigour of the programme and suggest recommendations to inform the future design of preceptorship programmes. • Background: Enhancing the retention of newly qualified staff is of particular importance given that the journey from a new registrant to a competent healthcare professional poses a number of challenges, for both the individual staff member and organisations. • Design: A mixed methods evaluative approach was employed, using online questionnaires and content analysis of preceptorship documentation. • Methods: Forty-one NHS trusts across the North West region employing newly qualified nurses were invited to participate in the completion of an online questionnaire. In addition, preceptorship programme documentation was requested for inclusion in the content analysis. This study utilised the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. • Results: The response rate for the questionnaire was 56.1% (n=23). Eighteen trusts (43.9%) forwarded their programme documentation. Findings highlighted the wide variation in preceptorship programmes across the geographical footprint. • Conclusions: There were instances of outstanding preceptorship and preceptorship programmes where there was a clear link between the strategic vision, i.e., trust policy, and its delivery, i.e. preceptorship offering. There was no one framework that would universally meet the needs of all trusts, yet there are key components which should be included in all preceptorship programmes. Therefore, we would encourage innovation and creativity in preceptorship programmes, cognisant of local context. Relevance to clinical practice: The significant shortage of nursing staff in England is an ongoing issue. Recruitment and retention are key to ameliorating the shortfall, and formal support mechanisms like preceptorship, can improve the retention of newly qualified staff. Understanding current preceptorship programmes is an important first step in establishing the fundamental building blocks of successful preceptorship programmes and enabling the sharing of exemplary good practice across organisations.
    • Art therapy with refugee children: a qualitative study explored through the lens of art therapists and their experiences

      Akthar, Zahra; Lovell, Andrew; University of Chester (Taylor and Francis, 2018-11-09)
      This article sets out to explore the use of art therapy with refugee children, from the perspective of art therapists and their experiences. Three semi-structured interviews were conducted to gain insights by capturing experiences and stories. Using thematic analysis, five themes were identified: (1) giving voice; (2) rebuilding trust, opening wounds; (3) sharing stories, healing pain; (4) exploring identity, discovering new-self; and (5) understanding art therapy. Upon reflection, two key aspects of art therapy were established, these were identified as: (1) providing refugee children with a safe space to heal and discover new-self, and (2) giving refugee children a voice to express and share stories. Despite the last of the five themes (understanding art therapy) being established as a factor that limits the use of art therapy, this has created an avenue for further research. From the findings, it was concluded that art therapy can be a useful form of psychotherapy for refugee children. Art therapy can provide these children with a safe space to heal, and give them a voice to be heard.
    • Inhibitor clinical burden of disease: a comparative analysis of the CHESS data.

      Oladapo, Abiola O; email: Abiola.Oladapo@shire.com; Lu, Mei; Walsh, Shaun; O'Hara, Jamie; Kauf, Teresa L (2018-11-09)
      BACKGROUND:Patients with hemophilia and inhibitors generally face greater disease burden compared to patients without inhibitors. While raising awareness of relative burden may improve the standard of care for patients with inhibitors, comparative data are sparse. Analyzing data drawn from the Cost of Haemophilia across Europe - a Socioeconomic Survey (CHESS) study, the aim of this study was to compare the clinical burden of disease in patients with severe hemophilia with and without inhibitors. Hemophilia specialists (N = 139) across five European countries completed an online survey between January-April 2015, providing demographic, clinical and 12-month ambulatory/secondary care activity data for 1285 patients. Patients with hemophilia who currently presented with inhibitors and those who never had inhibitors were matched on baseline characteristics via propensity score matching. Outcomes were compared between the two cohorts using a paired t-test or Wilcoxon signed-rank or McNemar's test. RESULTS:The proportion of patients who currently presented with inhibitors was 4.5% (58/1285). Compared to PS-matched patients without inhibitors, patients with inhibitors experienced more than twice the mean annual number of bleeds (mean ± standard deviation, 8.29 ± 9.18 vs 3.72 ± 3.95; p < .0001) and joint bleeds (2.17 ± 1.90 vs 0.98 ± 1.15; p < .0001), and required more hemophilia-related (mean ± standard deviation, 1.79 ± 1.83 vs 0.64 ± 1.13) and bleed-related hospitalizations (1.86 ± 1.88 vs 0.81 ± 1.26), hemophilia-related consultations (9.30 ± 4.99 vs 6.77 ± 4.47), and outpatient visits (22.09 ± 17.77 vs 11.48 ± 16.00) (all, p < .001). More than one-half (53.5%) experienced moderate/severe pain necessitating medication compared to one-third (32.8%) of patients without inhibitors (p = .01). CONCLUSIONS:Patients with hemophilia and inhibitors exhibited greater clinical burden and higher resource utilization compared to their peers without inhibitors. Strategies for improving the standard of care may alleviate burden in this population.
    • Knowledge translation and the power of the nursing academic conference

      Finnegan, Alan; McGhee, Stephen; Roxburgh, Michelle; Kent, Bridie; University of Chester; University of South Florida; University of Highlands and Islands; University of Plymouth (Elsevier, 2018-11-08)
      The national and international conference experiences present a unique learning opportunity. There are differing events that reflect the full nursing employment spectrum from clinical delivery, organizational and policy development and academia in education and research. Many conferences provide a platform for academics with differing levels of experience to come together and welcome contributions from students and all grades of post-registration nurses, educationalists, administrators, and researchers. In selecting the programme, the conference organisers will often circulate a calling notice and potential presenters will submit their abstracts to be blind peer reviewed. Therefore, conferences showcase the best of the best and provide the current perspective of areas of growth within the nursing sector. Conferences have a plethora of delivery routes ranging from posters, oral presentations (both short and long), panel discussions, key notes, seminars, exhibitions and workshops. These present an exceptional chance to listen, present, network and discuss nursing innovation and academic research.