• Understanding and working with challenging behaviour

      Ingram, Charles; Lovell, Andy; University of Chester (RCN Publishers, 2011-03)
      This article examines the theoretical approaches to understanding and managing individuals with a learning disability who display behaviours that challenge. The authors explain how drawing on these approaches can help professionals from different disciplines to provide effective, patient-centred care.
    • Understanding and working with people with learning disabilities who self-injure

      Heslop, Pauline; Lovell, Andy; University of Bristol ; University of Chester (Jessica Kingsley, 2012-11-15)
      Adopting a predominantly psychological approach, this book provides carers with up-to-date information and resources to provide appropriately individualised care to people with learning disabilities who self-injure. Understanding and Working with People with Learning Disabilities who Self-Injure synthesises traditional (behavioural) and newer (psychological) approaches to understanding self-injury, drawing on psychoanalytic and social theory to provide practical guidelines for more sustained and effective support. It suggests that motivations for self-injury may be similar for people with and without learning disabilities, and draws on case work examples to suggest person-centred techniques that encourage communication particularly important with people who do not use verbal communication - and recovery. The book covers a range of specific needs, including people with autism who self-injure, and emphasises the views of people with learning disabilities themselves and their families about what has worked best, and why. At the end of each chapter, a variety of practical implications for the provision of support are given. This book is for those supporting people with learning disabilities who self-injure and will be a useful resource for social workers, psychologists, counsellors, learning support workers, nurses and social and health care students.
    • Understanding Blogging Motivations in Palliative Care Using Maslow’s Hierarchy of Needs.

      Ngwenya, Nothando; Kingston, Paul; Mills, Stella; Africa Health Research Institute, KwaZulu Natal, South Africa; University of Chester; Staffordshire University (Inderscience, 2018-09-24)
      The pervasive use and potential of weblogs has increased the field of social health informatics and is becoming increasingly difficult to ignore. The prevalence of these technologies for narrative use brings about the fusion of diverse schools of thought on motivation. One proven model is that of Maslow, whose theory of needs has an intuitive appeal in understanding bloggers’ needs and motivations. This paper considers theoretical and practical blogging experiences for palliative care users through the embracement of Maslow’s hierarchy of needs. Palliative care patients, carers and clinicians were interviewed about their weblogs and data qualitatively analysed. The results indicate that the experience of maintaining a weblog is therapeutic for individuals and fulfils needs hierarchically from the lowest to the highest as outlined in Maslow’s theory.
    • Understanding depression

      Khan, Nahim; University of Chester (Chemist and Druggist, 2016-07-11)
      Quiz on use of the NICE guidelines on depression
    • Understanding minimum and ideal factor levels for participation in physical activities by people with haemophilia: An expert elicitation exercise.

      Martin, Antony P; orcid: 0000-0003-4383-6038; Burke, Tom; Asghar, Sohaib; Noone, Declan; Pedra, Gabriel; orcid: 0000-0002-2023-5224; O'Hara, Jamie (2020-04-08)
      The benefits of physical activity (PA) for people with haemophilia (PWH) may include improvements in joint, bone and muscle health. However, the factor VIII activity level required to avoid a bleeding episode associated with PA is unknown. To elicit the opinion of clinical experts on the minimum level and ideal factor VIII activity ('level') required to avoid a bleeding episode during participation in different types of PA for PWH. Based on the 2017 National Hemophilia Foundation PA descriptions, clinical experts estimated a minimally acceptable and an ideal factor level at which a bleed could be avoided. The uncertainty around estimates was quantified using an approach to construct a probability distribution to represent expert opinion. Minimum and ideal factor level increased with higher risk PA, whether or not joint morbidity was present, as did the experts' uncertainty in their estimates (ie the range between lowest and highest estimates for minimum and ideal levels). Mean minimum levels ranged from 4% to 48% for low to high risk for people without joint morbidity, and from 7% to 47% for those with joint morbidity. For ideal factor levels, corresponding figures were 9%-52% and 12%-64%, respectively. To support a patient-centric outcome, expert opinion indicates that the clinical norm of 0.01 IU/mL (1%) trough level is insufficient. It is anticipated that introducing a more targeted approach to meet the needs of patients who are increasingly physically active will benefit patients further in addition to recent treatment advances. [Abstract copyright: © 2020 John Wiley & Sons Ltd.]
    • Understanding of the Care Act 2014 among carers of adults with learning disabilities

      Gant, Valerie; University of Chester (RCN Publishing, 2017-05-26)
      The Care Act (2014) gave new rights to carers for assessment and aimed to provide a structure for a more personalised approach to care and support (DoH, 2014). The UK population is an aging one and research indicates that people with learning disabilities are part of this longevity (Emerson and Hatton, 2008; Foster and Boxall, 2015; Walker and Ward, 2013) with the majority of people with learning disabilities remaining in family care for many years (Cairns, et al. 2013; Gant, 2010). Thus carers are frequently providers of care for their relative with a learning disability and take on many levels of responsibility, often lasting for decades. This paper describes a research study involving 9 carers of adults with learning disabilities to establish their views on this piece of legislation, its likely significance to them and their relatives, and provides a forum for discussion and debate in terms of possible implications for practice.
    • Understanding perineal pain: Women's descriptions

      Steen, Mary; Royal College of Midwives/University of Central Lancashire (Mark Allen Publishing, 2008-06-01)
      Women perceive, describe and react to pain differently; it cannot be easily quantified. Pain is a private and personal experience to the individual. It is, therefore, impossible for another person to know exactly what someone else’s pain feels like. When measuring pain there is a need to assess both the intensity and the quality of the pain to gain an insight into a person’s experience of pain. Therefore during a PhD Study which involved the investigation of the effectiveness of localised cooling treatments to alleviate perineal pain, women were asked to describe the pain as well as the intensity (Steen & Marchant, 2007). The quality of pain was measured by asking the woman to describe the pain in her own words. These words were analysed as pain descriptors under the themes of sensory, affective, evaluative and miscellaneous as described by the McGill Pain Scale. In addition, intensity, discomfort, physical symptoms, metaphors used and links to the expectations of the woman were considered. (Melzack & Wall, 1996). This article will give an overview of the pain syndrome, discuss measurement of pain methods and the use of word descriptors to assess the quality of pain. The assessment of perineal pain and women’s descriptions will be further explored. This insight will give an understanding of the pain experience of women who have perineal trauma following childbirth and this may lead to further research and the development of a specific evaluating tool.
    • Understanding the association between teenage pregnancy and inter-generational factors: A comparative and analytical study

      Whitehead, Elizabeth; University of Chester (Elsevier, 2007-06-27)
      This article aims to identify the number of teenage pregnant women who also have mothers who became pregnant when they were in their teenage years and to explore the importance of this intergenerational experience on the teenagers themselves, their significant family, friends and society as a whole.
    • Understanding the Determinants of homelessness through examining the life stories of homeless people and those who work with them: a qualitative research protocol

      Mabhala, Mzwandile A.; Ellahi, Basma; Massey, Alan; Kingston, Paul; University of Chester (Insight Medical Publishing Group, 2016-07-04)
      There has been a sharp increase in homelessness following recent UK welfare and other social policy reforms; these reforms included public expenditure reductions, compounded by benefit cuts which lowered/capped housing benefits and weakened welfare protection and the housing safety net. The increase occurred despite efforts by the government and charitable organisations to mitigate it, which raises questions about their strategies’ effectiveness and about policymakers’ understanding of homelessness. This study aims to gain insight into the determinants of homelessness through examining the life stories of homeless people and those who work with them. Constructivist grounded theory (CGT) is used to develop a theoretical explanation of the determinants of homelessness. Qualitative in-depth semi-structured interviews are being conducted in several centres for homeless people in the north west of England, UK. Initial analysis of the stories of homeless people reveals four determinants of homelessness: home and childhood environments; experiences during school life; type of social lifestyle; and opportunities for access to social goods. Participants see their homelessness as a manifestation of fundamental determinants of social inequalities such as education; income inequality; unemployment and welfare; barriers to housing and other services; crime and living environment.
    • Understanding violence when the perpetrator has an intellectual disability: The perceptions of professionals

      Lovell, Andy; Skellern, Joanne; University of Chester (SAGE, 2017-12-18)
      Aim: The research sought to enhance professional understanding of the violence perpetrated by some people with an intellectual disability. Background: The violent behaviour exhibited by some people with intellectual disabilities remains poorly understood, particularly with regard to a clear and informative definition. Design: A qualitative study investigating the views and perceptions of professionals working directly with people with an intellectual disability in different settings. Methods: 22 semi-structured interviews were undertaken with professionals from a variety of backgrounds and four themes were generated through data analysis. Findings: Themes produced comprised the degree of intellectual disability, impulsivity, intentionality and unpredictability. Findings indicated tension between understanding violence as purposeful and explaining it in relation to the intellectual disability and/or additional conditions. Conclusion: Intellectual disability is central to understanding the impact of the other three themes, though there is a professional reluctance to use such knowledge as evidence to inform practice.
    • University-Trust collaboration: A secure learning disability service in transition

      Lovell, Andy; University of Chester (RCN Publishers, 2011-06)
      This article describes how a research project, looking at the management of change within a learning disability service in transition from medium to low security, confirms the importance of staff involvement in the process.
    • The use of a mobile app in health visiting to support school readiness

      Lee, Fiona; Wright, Paula; University of Chester; Bridgewater Foundation Trust (Mark Allen Group, 2016-08-24)
      Starting school is a major milestone in family life, and there is increasing awareness that a child who is ‘ready for school’ when they begin full-time education is more likely to reach their full potential. This is not only in terms of academic achievement, but also social and behavioural skills, which have an impact later in adulthood (UNICEF, 2012). Health visitors’ responsibilities include supporting parents to maximise their child’s health and development from birth onwards—a complex and challenging remit for which they need to be continually developing engaging strategies and tools (Department of Health, 2009). This article reviews the collaborative development of a school readiness mobile app for Bridgewater Community Foundation NHS Trust. The project won the prestigious 2016 Journal of Health Visiting Award for School Readiness, and the University of Chester was recognised as a key collaborator in this innovative development. The article seeks to inspire health visiting colleagues to search for collaborative partners to address school readiness in an engaging way with parents.
    • The Use of Language in Hospice Care and the Impact on Patients and Families

      Gant, Valerie; University of Chester (Sage, 2017-07-01)
      Whilst there is an expanding literature and a growing knowledge-base relating to patient and family experiences in hospice settings (1,2,3), there is a much more limited corpus reflecting the first-person perspective of patients and their families. These accounts can be helpful in highlighting perceived gaps between current practice and family needs (4). This narrative account reflects upon the perspective of a hospice patient’s family during her last week of life and notes how the actions and language of staff members and volunteers had a major impact on the overall experience and subsequent grieving processes of family members.
    • Use of storytelling and audio podcasts in qualitative research

      Sutton, Julie E.; University of Chester (RCNI, 2019-08-01)
      The author discusses the use of service user story telling through the medium of audio podcasts, in service evaluation. The author argues this is an effective way to promote service user participation in service improvement projects and highlights how audio podcasts can stimulate emotional connections in service evaluators leading to informed identification of priorities for change
    • User involvement

      Dulson, Julie; University of Chester (SAGE, 2008-03-17)
      This book chapter discusses user involvement policy, the user involvement continuum, and barriers to user involvement and their solutions.
    • Using and developing evidence in health and social care practice

      Chapman, Hazel M.; University of Chester (Sage, 2020)
      [A] Overview This chapter outlines the processes of developing evidence-based practice and carrying out research and highlights the similarities and differences between the two. This chapter aims to increase your skills and motivation in utilising research evidence to improve your practice, introduce you to the process of research and develop your research skills. [A] Learning Outcomes At the end of this chapter you will be able to: • Critique research papers. • Share best practice with your colleagues. • Assist with research in practice. • Develop your research skills with a view to becoming a researcher.
    • Using codes of ethics for disabled children who communicate non-verbally - some challenges and implications for social workers

      Carey, Malcolm; Prynallt-Jones, Katherine A.; University of Chester (Taylor & Francis, 2018-02-09)
      This article evaluates the use of professional codes of ethics by social workers specialising in work with disabled children who communicate non-verbally. It draws upon phenomenological interviews and other studies to highlight challenges faced by practitioners in a complex role which demands high-levels of skills and knowledge. Supporting other research, codes of ethics were rarely utilised by practitioners who typically maintain a vague appreciation while often compelled to focus upon pragmatic and quick responses to a complex role. Despite this, it is argued that principle-based frameworks embedded within codes of ethics carry important political implications. These include the potential to strengthen existing utilitarian and bioethical discourses embedded in policy or dominant professional narratives, and which can at times marginalise or exclude disabled children.
    • Using consultative methods to investigate professional–client interaction as an aspect of process evaluation

      Hogard, Elaine; University of Chester (American Evaluation Association, 2007-07-01)
      This article discusses a consultative method called reconstitutive ethnography, which is considered useful for the in-depth description and analysis of the interaction between a professional and client in the delivery of a health or social care program.
    • Using visual methodology: Social work student's perceptions of practice and the impact on practice educators.

      Bailey-McHale, Julie; Bailey-McHale, Rebecca; Caffrey, Bridget; Macleand, Siobhan; Ridgway, Victoria; University of Chester; Kirwin Maclean Associates (Taylor & Francis, 2018-06-21)
      Practice learning within social work education plays a significant part in students’ educational journey. Little is understood about the emotional climate of placements. This paper presents a small scale qualitative study of 13 social work students’ perceptions of their relationship with a practice educator (PE) and 6 PE’s perceptions of these emotional experiences. Visual methodology was employed over a two-phased research project, first social work students were asked to draw an image of what they thought practice education looked like, phase two used photo eliciation, PEs were then asked to explore the meaning of these images. Results demonstrated that social work students focused on their own professional discourse, the identity of PEs, power relationship and dynamics between themselves and PEs, the disjointed journey and practice education in its entirity. Whilst the PEs shared their personal views of practice education and reflected on this, both groups had a shared understanding of practice education including its values and frustrations. Keywords: social work placements, visual methodology, practice educators
    • Vaginal breech birth or Caesarean?

      Steen, Mary; Kingdon, Carol; Royal College of Midwives/University of Central Lancashire (2007-11-08)
      This presentation will firstly explore the evidence in supporting the phenomenal shift in clinical practice from vaginal breech birth to routine caesarean breech birth, in particular the impact of a single research trial, the Term Breech Trial (TBT) on current worldwide policy and practice. Secondly, will explore the best available evidence for the use of External Cephalic Version (ECV)and moxibustion to turn a breech baby to a cephalic presentation as this may reduce a woman’s risk of having a caesarean section.