• The Therapeutic Lie: A reflective account illustrating the potential benefits when nursing an elderly confused patient

      Moncur, Thomas; Lovell, Andy; University of Chester (Australian Nursing & Midwifery Federation, 2018-02-31)
      This article explores, through case study examples from practice, the circumstances when it might be considered appropriate, even beneficial, to lie to patients.
    • Thinking nursing

      Mason, Tom; Whitehead, Elizabeth; University of Chester (Open University Press, 2003)
      This major textbook provides a unique one-stop resource that introduces nursing students to the disciplines that underpin nursing practice. The broad range of subjects covered includes sociology, psychology, anthropology, public health, philosophy, economics, politics and science.
    • This is how it feels: activating lived experience in the penal voluntary sector

      Buck, Gillian; Tomczak, Philippa; Quinn, Kaitlyn; University of Chester; University of Nottingham; University of Toronto (Oxford University Press, 2021-10-21)
      Increasing calls for ‘nothing about us without us’ envision marginalised people as valuable and necessary contributors to policies and practices affecting them. In this paper, we examine what this type of inclusion feels like for criminalised people who share their lived experiences in penal voluntary sector organisations. Focus groups conducted in England and Scotland illustrated how this work was experienced as both safe, inclusionary and rewarding and exclusionary, shame-provoking and precarious. We highlight how these tensions of ‘user involvement’ impact criminalised individuals and compound wider inequalities within this sector. The individual, emotional and structural implications of activating lived experience therefore require careful consideration. We consider how the penal voluntary sector might more meaningfully and supportively engage criminalised individuals in service design and delivery. These considerations are significant for broader criminal justice and social service provision seeking to meaningfully involve those with lived experience.
    • Tolerating violence: A follow up study to a survey identifying the extent of, and reasons for, the non-reporting of incidents of aggression in one NHS Trust

      Lovell, Andy; Skellern, Joanne; University of Chester (Kavanah, 2009-10)
      This paper reports on a study of people in NHS Trusts working with people with learning difficulties where aggression and violence is a concern.
    • ‘Tolerating violence’: A qualitative study into the experience of professionals working in one UK learning disability service

      Lovell, Andy; Skellern, Joanne; University of Chester (Wiley-Blackwell, 2013-05-06)
      This article reports on a qualitative follow-up study to a whole-population survey investigating the underreporting of violence within one learning disability service. The survey had identified a pronounced level of under-reporting but suggested an unexpected degree of complexity around the issue, which warranted further study. Design. A qualitative research design was employed. Semi-structured interviews were conducted with 22 professionals working in learning disability services; data were subsequently transcribed verbatim and subject to stringent thematic analysis. The findings confirmed that the decision to report an incident or not was complicated by professional interpretation of violence. Three themes were produced by the analysis: the reality of violence, change over time and (zero) tolerance. Conclusion. The study indicates that both experience of violence and ways of understanding it in relation to learning disability are shared across professional groups, although nurses are both more inured and generally more accepting of it. The study suggests that the relationship between learning disability nurses and service users with a propensity for violence is complicated by issues of professional background and concerns about the pertinence of zero tolerance. The availability of effective protocols and procedures is important, but services need also to acknowledge the more ambiguous aspects of the therapeutic relationship to fully understand under-reporting of service user violence in the context of learning disability.
    • A tool for assessing perineal trauma

      Steen, Mary; Cooper, Keith; Leeds Teaching Hospitals NHS Trust/Leeds Metropolitan University (Macmillan Magazines, 1997-10-02)
      The initial aim of this study was to develop a reliable visual tool to assist in the assessment of the severity of oedema and bruising in perineal trauma, using a categorical scale of `none', `mild', `moderate' and `severe'. A standardised set of photographs was selected by 10 clinically experienced midwives to represent these categories. The tool was tested in a clinical trial involving 77 women, recording and monitoring changes in the level of oedema and bruising during the first 48 hours following suturing of an episiotomy. The results demonstrated a statistically significant change for both oedema and bruising. However, the less experienced assessors reported some uncertainties in assessing a small proportion of women. A combined method, using this tool with a categorical scoring scale, was used to minimise difficulties in the assessment. Two pairs of midwives, one pair very experienced in assessing perineal trauma and the other less experienced, evaluated the combined method. The results showed a high level of agreement. The standard set of photographs and categorical scoring scale together resulted in a reliable and sensitive assessment tool to evaluate severity of perineal trauma.
    • Translating the power of Coverdell fellows to address global nursing challenges

      McGhee, Stephen; Visovsky, Constance; Clochesy, John; Finnegan, Alan; University of South Florida; University of Chester (Elsevier, 2018-03-10)
      Academic opportunities to enter undergraduate nursing should include access for mature, experienced professionals who are prepared to care for an ever more diverse patient population and who can provide nursing expertise in the global arena. The Coverdell Fellowships in nursing are designed to actively support Returned Peace Corps Volunteers (RPCV) in developing nursing skills in such a way that supports the local community. Coverdell Fellows already have the skills and abilities enabling them to communicate with sensitivity and to develop therapeutic relationships with diverse global populations. Many Colleges of Nursing are currently faced with the challenge of providing students with opportunities which will allow them to become more globally aware and culturally competent. Thus, working with the Peace Corps, a highly respected organization with longstanding international experience, is an obvious step not only to bolster the nursing workforce, but also to develop a more globally sensitive and competent nursing workforce in the U.S. and abroad.
    • Trapped in discourse? Obstacles to meaningful social work education, research and practice within the neoliberal university

      Carey, Malcolm; University of Chester
      This article appraises the role of the neoliberal university in regulating social work education, research and practice. The dominance of governments and employers in determining social work education is highlighted, alongside the ascendancy of skills-based and vocational training. Moreover, it is proposed that research, associated learning, and practice are now more often moulded around essentialist science-based, behavioural or functionalist paradigms, which fit conveniently with free market, politically conservative and authoritarian agendas. The neoliberal university is increasingly able to rationally prepare social workers to fulfil narrow ideological objectives, which includes priority given to attempts to empower, pathologise, and scientifically manage structurally disadvantaged populations from minority groups. Reductive paradigms, nevertheless, can struggle to cope with social fragmentation and diversity, with social work students often ill prepared for many of the complex challenges which they later face as qualified practitioners. Analysis for the article draws from critical theory, and it is concluded that market-based discourses and related professional paradigms - and the symbolically constituted and hyperreal fantasies which they help to maintain - can prove difficult to escape. Social work continues to face a precarious future within university settings in which free market narratives, associated norms, targets, and labour insecurity prevail.
    • The trident: A three-pronged method for evaluating clinical, social and educational innovations

      Ellis, Roger; Hogard, Elaine; University of Chester (SAGE, 2006-07-01)
      This article describes a distinctive approach to programme evalution used in over forty funded evaluations in the Social and Health Evaluation Unit at the University of Chester. It categories the questions asked by evaluators into three main groups: those concerned with outcomes and impact; those concerned with process; and those representing the views of the stakeholders involved in the programme.
    • The trident: a three-pronged method for evaluating programmes and initiatives

      Ellis, Roger; Hogard, Elaine; University of Chester (Chester Academic Press, 2008)
      This book chapter discusses an approach to the evaluation of community safety initiatives.
    • Type 1 diabetes in young people: the impact of social environments on self-management issues from young people’s and parents’ perspectives.

      Spencer, Joy; Cooper, Helen; Milton, Beth; University of Chester; Liverpool University (SB Communications Group, 2014-02-08)
      In the UK, young people with type 1 diabetes generally have poor glycaemic control. Managing type 1 diabetes in young people is complex, and is underpinned by relationships with significant others in the social environments they inhabit. This qualitative study explores the social environments of young people with type 1 diabetes and their potential influence on glycaemic control. Twenty young people with type 1 diabetes and their parents (n=27) were interviewed about their experiences in the environments of the home, with friends (social), at school and in the diabetes clinic. It was found that the diabetes clinic was vital to the medical management of type 1 diabetes, and the family provided stable support for most young people with type 1 diabetes. However, there were barriers to self-management in school and social environments. It was concluded that each family had a unique story about the social factors in the environments they encountered that affected self-management of type 1 diabetes.
    • Type 1 diabetes mellitus in children and young people

      Cooper, Helen; University of Chester (2016-12-09)
      This article covers the following points: • Given the increasing prevalence, an up to date register, in line with the quality and outcomes framework, of those diagnosed with the condition in your area of practice should be maintained • Know the signs and symptoms to ensure rapid referral for diagnosis, treatment and effective long term management • Understand long term management as stipulated in NICE guidelines so you can engage with the patient and their family to reinforce the work undertaken in secondary care
    • 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.
    • Underlying thinking pattern profiles predict parent-reported distress responses in autism spectrum disorder

      Tollerfield, Isobel; Chapman, Hazel M.; Lovell, Andrew; Cheshire and Wirral Partnership NHS Foundation Trust; University of Chester (Springer, 29-05-2021)
      Appreciating autistic neurodiversity is important when supporting autistic people who experience distress. Specifically, use of a profiling model can reveal less visible autistic differences, including strengths and abilities. Binary logistic regressions showed that the likelihood of extreme distress responses could be interpreted based on parent-reported autistic thinking pattern profiles for 140 young people. Perspective-taking (specifically empathy), extreme demand avoidance, and over-sensory sensitivity each contributed to the combined regression models. From the clinical perspective of autism as a multi-dimensional and inter-connected construct, there may be implications for planning support and building positive self-understanding. Individually tailored adjustments and support strategies may be identified more easily after delineating variables found across four core aspects: sensory coherence, flexible thinking, perspective-taking, and regulation. Keywords: Autism; Distress; Profile; Strengths; Thinking patterns.
    • 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.