Health Science

A qualitative study to evaluate breast care nursing in North Wales from the user perspective

R Carnwell et al. — Thu, 12 Jul 2012 04:28:37 PDT

Background to the study: Breast care services for Wales developed in response to government requirements that breast cancer care should be delivered only by specialist multi-disciplinary teams in cancer units treating at least 100 new breast cancer patients per year.

Study aims: A study was conducted to evaluate the Breast Care Nursing Service within North Wales from the perspectives of both staff and patients. This paper presents the findings of the second stage of the patient survey, the aim of which was to investigate patients’ experiences using a qualitative interview.

Methodological issues: Thirteen patients were interviewed using a semi-structured interview guide developed from the findings of the patient questionnaire survey.

Findings/Conclusion: Although patients valued the BCNS service for the support offered around the time of diagnosis, improvements were also identified. Initial referral could be improved by training practice nurses and district nurses in recognising early signs of breast cancer. BCNSs could provide support and supervision in this role. During diagnosis and treatment, BCNSs could be more proactive in providing information and support to women and their families. Further research is needed in order to develop a tool to determine how patients would like this need to be assessed. Finally, improvements in follow up care require either additional resources in the form of BCNSs, or more involvement of community nurses in performing certain procedures and offering long-term support.

An action research study of the development of a Competency Framework in the context of district nursing

Joanne Pike et al. — Mon, 30 Jan 2012 08:03:14 PST

This report presents the results of a collaborative action research study into the development and perceived usefulness of a competency framework in the context of district nursing.

A Practical Guide to Care Planning in Health and Social Care

Marjorie Lloyd — Fri, 17 Jun 2011 00:59:46 PDT

A Practical Guide to Care Planning in Health and Social Care was written for anyone who wants to improve their care planning skills or who wants to know more about the care planning process. It is written in plain language to suit people who are new to care planning but explores in depth some of the issues that arise when planning good quality care. Each chapter focuses upon different parts of the care planning process giving them equal attention and there are samples provided throughout the book. There are also free blank care plans available to download from the publisher’s website so that students can practice their skills in this very important part of health and social care practice. Reference is made to health and social care policy and to professional and educational standards, in order to demonstrate the need for quality service provision within health and social care practices and the importance of good care planning skills.

Empowerment in the interpersonal field: discourses of acute mental health nurses

Marjorie Lloyd — Mon, 04 Apr 2011 06:31:16 PDT

Social policy greatly influences the working environment of mental health nurses but in practice can be difficult to translate. Empowerment of service users is one area that is constantly significant in policy, locally and nationally, yet quite difficult to define in practice. This ethnomethodological study explored the practice of 10 mental health nurses working in an acute admissions unit. Through semi-structured interviews, the nurses were asked to discuss the taken-for-granted methods of empowerment with individual service users, their families and with work colleagues. The results were thematically analysed and compared with international findings, which reflected an awareness among mental health nurses of empowering practice in four areas. These were: Working with mental illness, Making connections, Responsibility and Teamworking.

Culture shift: carer empowerment and cooperative inquiry

Marjorie Lloyd — Thu, 31 Mar 2011 03:55:59 PDT

Government policy has directed local services to address the needs of carers as a way of maintaining care in the community. This study was initiated to enable carers to develop an information pack based upon their identified needs. Cooperative inquiry was the method used to ensure full participation of the carers. Group meetings were already in existence through a charity organization who provides a carers support network. The first author participated in a number of carers group meetings. Cooperative inquiry was used to clarify a number of themes identified and reflective cycles ensured that those themes remained relevant. It was found that carers did want to be involved in their relative's care, not as passive recipients but as collaborative care providers. To do this they need to be fully informed of the processes of care provision. Carers need information that is relevant, easily accessible and obtainable in varying degrees of comprehension. This study suggests that a culture shift within mental health nursing is necessary if professionals are to recognize that a perceived lack of support may lead to a breakdown in relationships between the carer, the person being cared for and the professionals.

Public Health Nutrition from principles to practice, M Lawrence and Worsley T, McGraw Hill, 2007 Book Review

Lynne Kennedy — Thu, 17 Feb 2011 01:39:45 PST

This Article is a book review and does not have an abstract.

Dietetic helpers in the community: the Bolton Community Nutrition Assistants Project

Lynne Kennedy et al. — Mon, 14 Feb 2011 07:23:01 PST

Study objective: To explore the role of 'Community Nutrition Assistants' (CNAs) in helping to increase coverage, by increasing access to local community dietetic services, and to bring about positive changes in the determinants of healthy eating, within low income areas of Bolton, England. Study design: A descriptive evaluation of programme development and field-testing (1995-1997) in the community. Non-experimental design. Setting: community, less affluent neighbourhoods in Bolton, North West England. Subjects: 1272 people in total, individuals and members of community groups, recorded as CNA contacts during 2 discreet monitoring periods; an opportunistic or purposive sampling strategy was used; subjects were randomly selected for group interview (n=8) and telephone interviews (n=41) out of a traceable sample of contacts (n=94) over a randomly selected 1month collection period. Findings: compared with professional only service, CNAs efforts resulted in a fourfold increase in coverage of community nutrition services in the local community. CNAs demonstrated unique attributes, which positively influence their ability to work well with local people, but particularly those considered hard to reach. At least half the subjects interviewed reported positive behaviour changes such as changes to foods bought, cooking methods or foods eaten in the home. Conclusions: This study has shown some benefits in training local people to work alongside existing community dietitians. This may help to reduce inequalities in health, address barriers to healthy eating experienced by low income families, and improve cost effectiveness. Before expansion continues on an ad hoc basis further research is needed to test generalisability, to assess health outcomes, and to quantify the value of using local people. The findings here are useful in guiding further developments.

Politics and Health

Clare Bambra et al. — Mon, 14 Feb 2011 06:16:44 PST

The discipline of politics examines the debates, ideas and institutions that surround community organisation and collective decision making about resources. In this chapter, the contribution of politics to health studies is examined. The first part of the chapter considers how politics is defined and how this underpins the various strands of political science. It also examines some of the key concepts of political study: power, ideology, democracy, government and the state. It also explores what contribution politics has and can make to health studies. The second part considers some of the theoretical and methodological approaches within politics. It looks at political ideologies, how they offer competing definitions of politics, varied views of the social and political world, and divergent views on health and health improvement. A case study explores how recent changes in many contemporary societies, associated in particular with neo-liberal economic policies, have led to a greater emphasis on freedom through choice. Individuals are called upon to take a greater role in self-care and risk management in relation to their bodies. At the same time the development of large multi-national companies has given rise to a system of production whereby their size and dominance have provided them with an ability to structure the food market.

Community involvement at what cost? – Local appraisal of a pan-European nutrition promotion programme in low-income neighbourhoods

Lynne Kennedy — Fri, 11 Feb 2011 03:33:29 PST

In the UK, government has committed itself to improving health and reducing inequalities in health. For the first time, issues such as food poverty will be addressed by tackling the causes of poverty and wider determinants of ill health. The time has never been better, therefore, for health and local authorities to work collaboratively to promote and improve health. Community involvement is also paramount to sustainable programmes. However, such a dramatic shift in policy and greater emphasis on public health requires health professionals themselves to adopt a different approach.

The World Health Organisation recommends a health promotion approach as a framework for action. But despite the existence of this framework there is little evidence that a wider understanding of health promotion and the necessary practical experience has been achieved. This has weakened the potential impact of health promotion and has possibly encouraged inappropriate use of health promotion principles in practice.

This refers to a programme of work titled the European Food and Shopping Research Project (SUPER-project) during the period 1989-1997. SUPER was established under the WHO European network of Healthy Cities, to help local projects implement the principles of health promotion (WHO, 1986). This paper describes the SUPER -project and its implementation in Liverpool (1989-1997), where levels of unemployment, deprivation and ill health are amongst the highest in the UK. Participation in SUPER is appraised to identify the various benefits and obstacles involved and to identify links with progress at the local level. This appraisal is discussed and the use, and potential misuse, of participatory appraisal techniques to elicit information and mobilise communities is examined.

Lay food and health worker involvement in community nutrition and dietetics in England: roles, responsibilities and relationship with professionals

Lynne A. Kennedy et al. — Mon, 10 Jan 2011 08:02:35 PST

Background- Community-based food initiatives have developed in recent years with the aim of engaging previously 'hard to reach' groups. Lay workers engaged in community nutrition activities are promoted as a cost-effective mechanism for reaching underserved groups. The main objective of the study was to explore perceptions and definitions of lay food and health worker (LFHW) helping roles within the context of National Health Service (NHS) community nutrition and dietetic services in order to define the conceptual and practical elements of this new role and examine the interface with professional roles. Findings - Narratives from both professionals and LFHWs indicated that the primary role for LFHWs was to encourage dietary change by translating complex messages into credible and culturally appropriate advice. Conclusions - The primary role of LFHWs in the 15 projects involved was to support existing NHS services to promote healthy eating amongst 'hard to reach' communities. The activities undertaken by LFHWs are strongly influenced by professionals and the NHS. Inherent to this is a fairly narrow interpretation of health, resulting in a limited range of practice.

Web 2.0 Technologies for Problem-Based and Collaborative Learning – a Case Study

Clive Buckley et al. — Fri, 17 Dec 2010 06:39:34 PST

Collaborative problem-based learning (PBL) has a well established history within medical and health care education. Undergraduate nursing students at the Glyndŵr University undertake PBL to explore ethical issues of health care; traditionally these students meet in person to discuss scenarios, provided by tutors, and present the product of their deliberations to the rest of the class. The geographical dispersion of the students has meant that most discussions have been limited to those times when the students are physically on campus by virtue of their timetabled classes. By using Web 2.0 technologies, students are able to collaborate at distance, at a time that suits them. This chapter describes how students have used these emerging technologies to share ideas and resources to prepare for class presentations; described also are the underpinning theories that inform this work together with an analysis of student use and feedback.

Using Web 2.0 Technologies to Build Learning Communities

Clive Buckley et al. — Tue, 05 Oct 2010 04:12:22 PDT

Web 2.0 technologies, such as wiki pages, have the potential to facilitate the formation of on-line communities of learning, especially useful when participants in that community are geographically dispersed and living in remote areas. This paper describes the authors’ work with undergraduate health studies students tasked to work collaboratively on a problem-based learning (PBL) project in which the students use wiki pages to share ideas and resources. The study examines how different groups of students make use of the wiki facility in terms of the level and nature of contribution. Work to date suggests that students readily adapt to the on-line community and, given sufficient instruction, utilize the wiki pages to work together constructively. Evidence indicates that, provided tutors are supportive and provide encouragement, the level of wiki activity is independent of whether contributions are formally assessed or not, however, the language style adopted by students does change when their work is being assessed. When the contributions are not assessed, students adopt a very informal language, reminiscent of the language used in instant messaging and SMS texting; when the work is assessed, students revert to the more formal language of the traditional classroom

Including the Excluded: Weathering the Storm

Richard Mottershead — Fri, 01 Oct 2010 08:00:45 PDT

It has been identified that populations of students within Higher Education often report much higher levels of the symptoms of depression than the norm for their age group. In addition, levels of symptoms for anxiety can also be higher amongst students. A study found that reported levels of moderate to severe anxiety among second year students were nearly twice that of the general population (Webb et al 1996). Another later study conducted discovered that students were 1.64 times more likely to experience symptoms of mental ill health than the general population (Harrison et al 1999).

Using Web 2.0 Technology for Problem Based Learning in Nurse Education

Angela Hastings et al. — Mon, 27 Sep 2010 01:35:27 PDT

CVs and interview techniques

Angela Hastings et al. — Fri, 24 Sep 2010 07:31:33 PDT

This is an easy to read step-by-step chapter on CV writing and tips when attending interviews. It is mainly focussed upon Health and Social Care students but many of the tips and guidelines would be relevant to other University students.

Benefits arising from lay involvement in community-based public health initiatives: The experience from community nutrition

Lynne Kennedy — Wed, 08 Sep 2010 02:07:49 PDT

Aims: To explore the experiences of lay food and health workers (LFHW) and professionals involved in delivering local food and health initiatives, to improve understanding of the perceived benefits associated with their involvement and wider opportunities for promoting health. Study design: An interpretive qualitative inquiry. Setting: Community-based NHS LFHW programmes in 16 locations serving less-affluent neighbourhoods across England, UK. Subjects: Twenty nine (29) food and health professionals, 53 LFHW employed by and associated with the management or day-to-day implementation of 16 LFHW initiatives in the study. Findings: Salient benefits identified at service, individual lay worker and community levels were: increased service coverage and ability to reach the ‘hard to reach’; personal development; and enhanced social support. Conclusions: This study highlights previously unreported benefits related to the direct experiences of lay people used in community nutrition in the UK, which go beyond those associated with professional-led initiatives, suggesting the need to adopt a broader view of lay involvement in the UK public health workforce.

Evaluating the implementation of the WHO Healthy Cities Programme across Germany (1999-2002)

Klaus D. Plumer et al. — Tue, 07 Sep 2010 01:27:18 PDT

The WHO Healthy Cities Project (1988) is a well-known example of the setting-based approach to health promotion. Developed as a framework for translating the key principles of the Ottawa Charter for Health Promotion (1986) into practice, it is best characterized as a process for successfully encouraging healthy public policy. In 2001, the German Healthy Cities Network (HCN) commissioned a survey of the 52 local Healthy Cities programme Coordinators (HCC) to monitor progress and identify strengths and weaknesses associated with its implementation. Most (90%; 47/52) HCC participated in the survey. Several positive aspects of the Health Cities Programmes (HCP) in Germany were identified: during the first 5 years, it expanded rapidly; project coordinators felt highly engaged, despite limited resources; a combination of traditional and innovative approaches was adopted and applauded; and almost 75% of HCC felt that their efforts had been beneficial. Nonetheless, the following shortcomings were identified: increased resources required; greater clarification of concepts and strategies at the local level; stronger commitment to the Nine-Point Programme of Action; greater integration within the national HCN and the local political administrative system (PAS); better programme documentation and evaluation. In conclusion, the HCN in Germany has expanded and developed since its inception 20 years ago. German HCP will only improve if professionalism and quality of local work are improved, particularly in terms of strengthening their influence on the local PAS and on public policies.

The experience of health in an unequal society

P Alderson et al. — Fri, 09 Jul 2010 07:33:29 PDT

The Politics of Food and Health

Aunty Betty and the sunny day

Phil De Prez — Tue, 13 Apr 2010 04:05:40 PDT

Rodriguez (2002, p4) argues that no narrative is meant to be kept to oneself, it is for sharing with others and with this sharing comes a social infrastructure that bonds and binds each of us to others in a inimitable way, and furthermore, a concept which allows individuals to critically examine the repercussions and outcomes of their actions. If it is accepted that narratives are a means for the individual to address and share these issues, what are the underlying processes that may effect the reflection of these issues to form a narrative. It is the intention here to question what may be one of the underpinning requirements of an individual to work within a narrative framework, the concept of self awareness, and in particular the ability to communicate this awareness to others. Carson (2001, p199) states that ‘all situations can be described in a number of ways which reflect not just an author’s values, but also, more crucially, an authors’ identity’. This paper will question whether there is a singular unified ‘self’, or as James (1892) maintains, the individual is a highly complex social entity and that we display ‘as many different selves as people we interact with’ The concept of self awareness will be explored through relevant historical and contemporary literature in order to attempt to discover who in essence is writing the stories recounted in a narrative.

Critical social work practice a narrative approach

Karen D. Roscoe — Fri, 09 Apr 2010 06:49:14 PDT

This paper outlines the theory and approach of narrative therapy and applies this specifically to the context of contemporary practice in social work. This paper explores the use of externalising conversations to assist service users to re-author their lives. The problems inherent in adopting narrative approaches in Care Management is explored arguing that critical practice in social work requires a need to develop a language for practice which provides for recognition of the skilful activity of the work that social workers do.