• Social Justice and Global Perspectives on Health Improvement and Well-being

      Mabhala, Mzwandile A.; University of Chester (McGraw-Hill/ Open University Press, 2014-10-01)
      This chapter critically defines social justice. It openly declares that its analysis of social justice is situated within a particular political position, and explains why that position is taken in relation to public health and inequalities in health. It proposes that, in a just society, the primary function of the state should be to produce policies that enable all members of society to have fair and genuine access to opportunities to obtain the social goods that determine health and well-being. It goes on to critically review the literature on three differing theories of social justice – the libertarian, utilitarian, and egalitarian philosophies – particularly their fundamental claims regarding equality and fairness in the distribution of privilege and deprivation. It notes that egalitarian theories are consistent with the social justice principles of equality and fairness, on the understanding that egalitarian philosophy proposes an equal distribution of social goods; and as the evidence suggests that health inequalities are rooted on an uneven distribution of social goods, egalitarian theories are proposed as a suitable approach for addressing inequalities in health. Furthermore, evidence shows that egalitarian approaches, which place more emphasis on health – as opposed to healthcare or access to health services – provide a better solution to the social injustice of health inequalities. This chapter uses examples from the UK, South Africa and elsewhere to explain why egalitarian social justice principles provide a perfect fit with the practice of public health policy. It also justifies why health, as opposed to healthcare, has special moral importance for social justice in health inequalities; and argues that, if health and social policies are to have any chance of reducing health inequalities they will have to pay more attention to health rather than health services.
    • Social recovery therapy in combination with early intervention services for enhancement of social recovery in patients with first-episode psychosis (SUPEREDEN3): a single-blind, randomised controlled trial

      Fowler, David; Hodgekins, Jo; French, Paul; Marshall, Max; Freemantle, Nick; McCrone, Paul; Everard, Linda; Lavis, Anna; Jones, Peter B.; Amos, Tim; et al. (Elsevier, 2017-12-11)
      Background - Provision of early intervention services has increased the rate of social recovery in patients with first episode psychosis; however, many individuals have continuing severe and persistent problems with social functioning. We aimed to assess the efficacy of early intervention services augmented with social recovery therapy in patients with first-episode psychosis. The primary hypothesis was that social recovery therapy plus early intervention services would lead to improvements in social recovery. Methods - We did this single-blind, phase 2, randomised controlled trial (SUPEREDEN3) at four specialist early intervention services in the UK. We included participants who were aged 16–35 years, had non-affective psychosis, had been clients of early intervention services for 12–30 months, and had persistent and severe social disability, defined as engagement in less than 30 h per week of structured activity. Participants were randomly assigned (1:1), via computer-generated randomisation with permuted blocks (sizes of four to six), to receive social recovery therapy plus early intervention services or early intervention services alone. Randomisation was stratified by sex and recruitment centre (Norfolk, Birmingham, Lancashire, and Sussex). By necessity, participants were not masked to group allocation, but allocation was concealed from outcome assessors. The primary outcome was time spent in structured activity at 9 months, as measured by the Time Use Survey. Analysis was by intention to treat. This trial is registered with ISRCTN, number ISRCTN61621571. Findings Between Oct 1, 2012, and June 20, 2014, we randomly assigned 155 participants to receive social recovery therapy plus early intervention services (n=76) or early intervention services alone (n=79); the intention-to-treat population comprised 154 patients. At 9 months, 143 (93%) participants had data for the primary outcome. Social recovery therapy plus early intervention services was associated with an increase in structured activity of 8·1 h (95% CI 2·5–13·6; p=0·0050) compared with early intervention services alone. No adverse events were deemed attributable to study therapy. Interpretation - Our findings show a clinically important benefit of enhanced social recovery on structured activity in patients with first-episode psychosis who received social recovery therapy plus early intervention services. Social recovery therapy might be useful in improving functional outcomes in people with first-episode psychosis, particularly in individuals not motivated to engage in existing psychosocial interventions targeting functioning, or who have comorbid difficulties preventing them from doing so.
    • Social work students and dyslexia: outcomes from an empirical study and some implications for practice

      Gant, Valerie; Hewson, Michael; University of Chester (Taylor and Francis, 2022-09-07)
      Dyslexia is likely one of the most misunderstood conditions impacting on educational outcomes at all levels, in and across all practice and intellectual domains. This paper discusses a project carried out by two qualified social workers, one an academic involved in teaching and assessing social work students, the other a doctoral student with a formal diagnosis of dyslexia and dyspraxia. The research involved 9 social work students from 3 different universities who identified as having dyslexia. Semi structured interviews were held in order to identify challenges experienced by participants as well as any strategies they used to ameliorate them. The data from the interviews was coded and analysed, the findings indicated a range and variety of experiences. Participants described feeling anxious and questioned their ability to study social work, both in university and on placement. Feelings of exhaustion were noted, which indicated the need to examine and potentially to rebalance educators’ expectations across academic and practical roles, and to provide support for students to meet workload requirements particularly when on placement. Findings from the interviews were shared with academic staff and practice educators, additionally a ‘good practice’ guide was produced to support educators in placement as well as in universities
    • Social Work Students sharing practice learning experiences: Critical reflection as process and method.

      Walker, Jane; Gant, Valerie; University of Chester
      This paper offers a commentary regarding the centrality of critical reflection in social work before discussing a research project drawing on a sample of ten social work students as they approached the end of their social work training in one English university. The original intention of the research was to focus solely on students’ perceptions of critical reflection, but when using a more reflexive approach, we identified that participants utilised the focus groups as an opportunity to discuss their practice learning experiences per se before considering and discussing critical reflection. Most students were placed in child protection social work teams and discussed how they felt unprepared for such a fast-paced and stressful environment. Participants felt that the expectations some practitioners had of students were unrealistic, and not always commensurate with the Professional Capabilities Framework. Students highlighted the use of practice scenarios in developing their knowledge and skills particularly when considering their application of critical reflection. This study highlights the significance of adequate preparation for practice and argues for a more focused agenda for future research exploring the culture of learning, including those factors that inhibit students sharing their concerns as well as the training needs of educators
    • Social Work Students’ Perceptions of Ageing

      Ridgway, Victoria; University of Chester (Taylor and Francis, 2018-06-23)
      Little is understood about social work students or social workers’ perceptions of ageing in the UK. This paper presents a small-scale study of 20 master social work students’ perceptions of ageing during the first year of their programme. A mixed method approach was employed over a two-staged research project, in both stages the social work students were asked to complete Kogan’s (1961) Attitudes Towards Older People Scale (KATOPS) and draw a person aged 75. Results demonstrated that most students had neutral to positive attitudes towards older people at the beginning of the programme and these improved in stage two; all had positive attitudes. The drawings provided a visual narrative of their perceptions of older people, visual signifiers included physical signs of ageing. Fulfilment, emotion, family, individuality and appearance were emergent themes. Whilst the programme enhanced the students’ perceptions more work is needed to dispel the myths and stereotypes about ageing
    • Social Work Through Collaborative Autoethnography

      Gant, Valerie; Cheatham, Lisa; DiVito, Hannah; Offei, Ebenezer; Williams, Gemma; Yatosenge, Nathalie; University of Chester (Taylor & Francis, 2019-02-13)
      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.
    • Sociological concepts of public health

      Lovell, Andy; University of Chester (SAGE, 2009-08-07)
      This book chapter discusses the sociological contribution to community care, the rise of consumerism, and the impact of health promotion and the new public health.
    • Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca, Morocco: Cross-sectional study

      Elarbaoui, Maria; Jafri, Ali; Elkardi, Younes; Makhlouki, Houria; Ellahi, Basma; Derouiche, Abdelfettah; Hassan II University of Casablanca; Mohammed VI University of Health Sciences; University of Chester (Elsevier, 2022-06-14)
      In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Urine volume and creatinine excretion level were used to validate the completeness of the collected samples. The average urinary sodium excretion was 3.1 ± 0.1 g/day, 13.5% consumed less than 5g/day, while 69% consumed more than 5 g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1.83 ± 0.06 g/day, and more than 98% of the students consumed less than the adequate intake. The Na/K ratio is significantly higher than the recommended amounts. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt intake.
    • Some ethical limitations of privatisation within social work and social care in England for children and young people

      Carey, Malcolm; University of Chester (Routledge, 2019-07-01)
      The article considers some of the ethical impications of the ongoing privatisation of social care and social work services.
    • 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.
    • Some limits and political implications of participation within health and social care for older adults

      Carey, Malcolm; University of Chester (Cambridge University Press, 2018-03-14)
      This paper critically examines service user participation and involvement for older adults. It concentrates upon research and community-led engagement for older people, and maintains that despite extensive support and expansion, participation offers a complex form of governance and ideological control, as well as a means by which local governments and some welfare professions seek to legitimise or extend their activities. Some of the paradoxes of participation are discussed, including tensions that persist between rhetorical claims of empowerment, active citizenship and democratic engagement on one hand, despite tendencies towards risk-aversion, welfare retrenchment and participant ambivalence on the other. The paper also highlights practical problems in relation to participative research and community involvement, and questions arguments that participation may challenge the authority of welfare professionals. Critical theory is drawn upon to contextualise the role of participative narratives within wider welfare, including its role in moving debate away from ownership or redistribution while masking and validating policy related goals which can counter many older people’s needs. Tension is also noted between participation projects represented as resource to support ageing identities as opposed to those representing technologies for social regulation and conformity.
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      South Cheshire School of Nursing (South Cheshire School of Nursing, 2015-04-10)
    • Special observations in forensic psychiatric practice: Gender issues of the watchers and the watched

      Mason, Tom; Mason-Whitehead, Elizabeth; Thomas, Mike; Faculty of Health and Social Care, University of Chester (Blackwell, 2009-11-01)
      Special observations in psychiatric practice may create tensions for both the patient under surveillance and the staff undertaking the procedure. This study reports on special observations undertaken in forensic settings focusing specifically on the gender sensitive issues. The aim of the study was to investigate the specific gender issues relating to special observations in relation to those under the procedure and those engaged in observing. Three medium secure units in the UK formed the sampling frame, and the population studied was eight female and seven male clinical Registered nurses. Semi-structured interviews were conducted, audio tape recorded and transcribed for analysis. The analysis involved a Grounded Theory approach to explicate categories and formulte two overarching themes: (1) the psychosocial fusion; and (2) the private as spectacle. There are implications for practice in relation to policy formulation and the implementation of special observations following risk assessment and individual skill identification. It is concluded that gender issues are extremely important for all concerned in this intrusive practice.
    • Spontaneous concerns about risk and abuse reported by people with dementia and their carers

      Benbow, Susan M.; Kingston, Paul; University of Chester (Emerald, 2017-04-10)
      Purpose To look at concerns about risk/ abuse expressed spontaneously by people with dementia (PwD) and their carers in narratives describing their journeys with dementia. Method Thirty-five narratives were elicited from PwD, carers of PwD and couples where one partner was living with dementia as part of a study on the impact of producing narratives on PwD and their carers. Participants were found to allude to risk/ abuse, or specifically mention thoughts on risk and abuse in their narratives. A secondary analysis of the theme of risk/ abuse is reported here. Findings Concerns about risk/ exploitation were often expressed in the narratives, and covered a range of areas including driving; safety in the home; safety outdoors; falls; finances; risk to PwD from others; risk to others from PwD; potential or actual police incidents; and neglect. Research limitations The narratives were elicited as part of another project and participants were not asked directly about risk: themes reported here were brought up spontaneously by participants. Practical implications In relation to dementia a wide range of risk/ abuse issues is of concern to PwD and their carers, including driving and financial vulnerabilities. PwD and carers are prepared to talk about risk/ abuse when given an opportunity. It is important to investigate and understand experiences and concerns about risk/ abuse if they are to be addressed in health and social care practice. Originality The narratives offer unique insights into the concerns of PwD and family carers.
    • Stay Well in Wales Super Profiles: Who thinks what about the nation's health

      Sharp, Catherine A.; Hughes, Karen; Bellis, Mark; Di Lemma, Lisa; Public Health Collaborating Unit Bangor University; Public Health Wales; University of Chester
      Using a household and online survey, the views of 3,310 individuals in Wales (aged 16+ years) on 19 public health statements were gathered. Eight demographic and five health-related behaviour super profiles were created to explore differences in opinions across population groups.
    • Stigma

      Mason-Whitehead, Elizabeth; University of Chester (SAGE, 2010-10-15)
      This book chapter discusses whether or not to disclose a condition whilst in palliative care and the possibility that this may lead to social exclusion.
    • Stigma: a linguistic analysis of personality disorder in the UK popular press, 2008-2017.

      Bowen, Matt; University of Chester (Wiley, 2019-06-25)
      Introduction: Many people with a diagnosis of personality disorder experience stigma, and the press’ representations may contribute to those processes. To date little is known about how the press write about people with personality disorder and analysis of language used is often limited to checklists of words to avoid. Aim: The aim of the study was to explore the linguistic characteristics of press articles about personality disorder in popular tabloids in the UK and consider the implications for stigmatisation. Method: Corpus linguistics was used to examine a 50% sample of all articles published by the popular press in the UK, from 2008 to 2017, that referred to personality disorder (n=260). Results: The findings identified a range of words that constructed narratives of violence. Discussion: The method enabled the findings to expand the current level of knowledge in the field, identifying patterns in the use of the language of violence, which may contribute to the processes of self-stigma. Implications for Practice: Greater understanding of the messages in the press can sensitize nurses to common misconceptions about the disorder, how these may have become internalised and the need for psycho-social interventions to address the impact of self-stigma on self-esteem.
    • 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, 2019-05-10)
      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.
    • Stigma: content analysis of the representation of people with personality disorder in the U.K. popular press, 2001-2012.

      Bowen, Matt; University of Chester (Wiley, 2016-03-01)
      There is evidence that people with personality disorder are stigmatised within healthcare settings; however, little is known about the role that the media has played in the wider processes of stigmatisation. This research examines the degree to which the popular press in the United Kingdom have established a link between personality disorder and homicide, and the impact this may have had on the processes of stigmatisation. Using a content analysis approach, it was identified that there were 552 articles in the popular press, between 2001 and 2012, that made reference to personality disorder and 42% of those articles established a link with homicide. Comparison between two time periods, 2001-2006 and 2007-2012, identified that there was a significant reduction in the proportion of homicide articles (Pearson (5, n=552) = 5.64, p > .05), however, the effect size of this change was only small. These findings suggest that the press may have contributed to the processes of stigmatisation, and may have encouraged the general public to hold prejudicial attitudes towards people with a diagnosis of personality disorder.
    • Stigma: the representation of anorexia nervosa in UK newspaper Twitter feeds.

      Bowen, Matt; Lovell, Andrew; Waller, Rhian; University of Chester (Taylor and Francis, 2020-07-15)
      Background There is evidence that the representation of mental health in newspapers has an influence on readers’ attitudes, however, relatively little is known about how the industry presents accounts of anorexia nervosa. Further, the industry increasingly uses Twitter as a medium for reaching readers and this remains an under-examined area of research. Aims To explore the representation of anorexia nervosa in the UK national press’ Twitter feeds. Method Frame analysis was used to examine the manner in which anorexia nervosa was represented in the Twitter feeds of all national UK newspapers between 2009-2019 (n=332). This qualitative approach used Braun and Clarke’s stages of thematic analysis, while drawing on Van Gorp’s use of a frame matrix to support the definition of the news frames. Results The analysis identified four news frames: social model, illness model, stress-recovery model and clickbait model. Conclusions The newspapers drew on a range of perspectives in their representation of anorexia nervosa, which typically were not stigmatising in their accounts. However, there was a pattern of using sensationalistic images in some of the tweets, which may encourage readers to view people with anorexia nervosa as Other, and as a consequence contribute to stigmatisation.