"It's a whole package" : Type 2 diabetes and what it means for the body, life and self of people of Indian origin in New Zealand : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology (with an endorsement in Health Psychology) at Massey University, Albany, New Zealand

Type 2 diabetes represents a considerable health problem for the Indian population group in New Zealand. In order to minimise the risk posed by this disease, recommended therapeutic goals include glycaemic control, maintaining a healthy weight and strict control of blood pressure. Culturally derived understandings of the illness and options for management will affect the way in which the person of Indian origin reacts to diabetes. This study looked at the way in which Type 2 diabetes is constructed and positioned while reflecting on how Indian culture might affect the way in which diabetes is interpreted and experienced. Seven males and five females, identifying themselves as being of Indian origin and managing Type 2 diabetes without the use of insulin were selected for the study. Semi-structured interviews were taped, transcribed and analysed using a reflexive approach to Foulcauldian discourse analysis Understanding diabetes begins through describing and accounting for the diabetic body which is believed to be different to other bodies. The way in which the person with diabetes might chose to control the disease and minimise harm to the body is validated by particular beliefs in cause and nature. As a result, the person with diabetes is able to construct a constantly evolving picture of the way in which the disease develops, what can be expected of it and what diabetes means for them, for their families and social connections. All this takes place within the particular social and cultural perceptual system of the person of Indian origin and the environment within which they live their every-day lives. The person with diabetes is actively engaged in processing new information, weighing options and defining who they are, not merely as someone with diabetes but as multi-dimensional individuals. Drawing on different constructions of the self, to justify and explain actions taken, opens up or limits access to opportunities to make changes and embrace new behaviors to manage their diabetes

‘There’s no pill to help you deal with the guilt and shame’: Contemporary experiences of HIV in the United Kingdom

© The Author(s) 2017. The experience of living with HIV, in the global north, has changed significantly over the past 20 years. This is largely the result of effective biomedical methods of treatment and prevention. HIV is now widely considered to be a long-term condition like many others – it has been argued that HIV has been ‘normalised’. Drawing on online qualitative survey data, with respondents aged 18–35 years, diagnosed with HIV in the past 5 years, this research explores contemporary subjective experiences of being diagnosed, and living, with HIV in the United Kingdom. The data reveal ambiguous experiences and expectations, as the ‘normative’ status of HIV exists alongside ongoing experiences of fear, shame and stigma – maintaining its status as the most ‘social’ of diseases. In rendering HIV ‘everyday’, the space to articulate (and experience) the ‘difference’ which attaches to the virus has contracted, making it difficult to express ambivalence and fear in the face of a positive, largely biomedical, discourse. In this article, the concepts of normalisation and chronicity provide an analytical framework through which to explore the complexity of the ‘sick role’ and ‘illness work’ in HIV

Developing theoretical rigour in inter professional education

In this chapter, the author explores the meaning of theory and the role it plays in the development of interprofessional education. The chapter explores specifically the utility of the theory of social capital in the field and uses this as a case theory to present the dimensions of theoretical quality that is proposed as essential to the advancement of research, evaluation and curriculum development in this arena

Strengthening nursing, midwifery and allied health professional leadership in the UK - a realist evaluation

Purpose: This paper aims to share the findings of a realist evaluation study that set out to identify how to strengthen nursing, midwifery and allied health professions (NMAHP) leadership across all health-care contexts in the UK conducted between 2018 and 2019. The collaborative research team were from the Universities of Bangor, Ulster, the University of the West of Scotland and Canterbury Christ Church University. Design/methodology/approach: Realist evaluation and appreciative inquiry were used across three phases of the study. Phase 1 analysed the literature to generate tentative programme theories about what works, tested out in Phase 2 through a national social media Twitter chat and sense-making workshops to help refine the theories in Phase 3. Cross-cutting themes were synthesised into a leadership framework identifying the strategies that work for practitioners in a range of settings and professions based on the context, mechanism and output configuration of realist evaluation. Stakeholders contributed to the ongoing interrogation, analysis and synthesis of project outcomes. Findings: Five guiding lights of leadership, a metaphor for principles, were generated that enable and strengthen leadership across a range of contexts. – “The Light Between Us as interactions in our relationships”, “Seeing People’s Inner Light”, “Kindling the Spark of light and keeping it glowing”, “Lighting up the known and the yet to be known” and “Constellations of connected stars”. Research limitations/implications: This study has illuminated the a-theoretical nature of the relationships between contexts, mechanisms and outcomes in the existing leadership literature. There is more scope to develop the tentative programme theories developed in this study with NMAHP leaders in a variety of different contexts. The outcomes of leadership research mostly focussed on staff outcomes and intermediate outcomes that are then linked to ultimate outcomes in both staff and patients (supplemental). More consideration needs to be given to the impact of leadership on patients, carers and their families. Practical implications: The study has developed additional important resources to enable NMAHP leaders to demonstrate their leadership impact in a range of contexts through the leadership impact self-assessment framework which can be used for 360 feedback in the workplace using the appreciative assessment and reflection tool. Social implications: Whilst policymakers note the increasing importance of leadership in facilitating the culture change needed to support health and care systems to adopt sustainable change at pace, there is still a prevailing focus on traditional approaches to individual leadership development as opposed to collective leadership across teams, services and systems. If this paper fails to understand how to transform leadership policy and education, then it will be impossible to support the workforce to adapt and flex to the increasingly complex contexts they are working in. This will serve to undermine system integration for health and social care if the capacity and capability for transformation are not attended to. Whilst there are ambitious global plans (WHO, 2015) to enable integrated services to be driven by citizen needs, there is still a considerable void in understanding how to authentically engage with people to ensure the transformation is driven by their needs as opposed to what the authors think they need. There is, therefore, a need for systems leaders with the full skillset required to enable integrated services across place-based systems, particularly clinicians who are able to break down barriers and silo working across boundaries through the credibility, leadership and facilitation expertise they provide. Originality/value: The realist evaluation with additional synthesis from key stakeholders has provided new knowledge about the principles of effective NMAHP leadership in health and social care, presented in such a way that facilitates the use of the five guiding lights to inform further practice, education, research and policy development

Utilization of evidence based practice principles to implement organizational values

Nursing job satisfaction is related to nursing retention. During this current nursing shortage, nursing leaders need to investigate ways to improve work environments to increase nurse satisfaction. Research has shown nurse job satisfaction greatly impacts the quality of patient care and nurse retention. This research project implemented a nursing model of practice that included organizational values that could be linked to improved job satisfaction. A nursing model derived from The Whole-Person Caring Model (Thornton) and using principles of Shared Governance, Empowerment and Crucial Communication was the independent variable used to measure changes in nurses\u27 perceptions of work environment and job satisfaction. In addition, principles of Transformational Leadership theory guided the intervention. The study was a sub-study of a larger action research project and used a pre-experimental one group pre/post study design, a nursing model of practice and principles of Transformational Leadership Theory to measure improvement in job satisfaction in a group of nurses at a large acute care medical center. The hypothesis tested in this sub-study was that the job satisfaction of nurses who experience the transformational leadership education intervention, crucial conversation training and empowerment trough shared governance will be greater following the implementation of these interventions compared to their job satisfaction prior to the educational intervention. Based on the results of the Adapted Perceived Nursing Work Environment Study pre/post survey and the NDQNI survey there was a change in job satisfaction post work environment transformation demonstrating that utilization of a nursing practice model inclusive of evidenced based practice principles for organizational values can make a difference for nurses

Determinants of Active Pursuit of Kidney Donation: Applying the Theory of Motivated Information Management

End stage renal disease (ESRD) is a growing epidemic impacting the United States. While the optimal treatment for ESRD is renal replacement, barriers exist making this treatment difficult and sometimes impossible for patients to pursue. One potential solution to existing barriers is to encourage patients to actively seek living donors. This is an inherently communicative and social process. The Theory of Motivated Information Management (TMIM) offers a framework for understanding factors that contribute to patients’ conversations about transplantation with their social networks. It is also possible that Patient Empowerment can add to this model, and inform future patient education. Specific variables related to the TMIM and Patient Empowerment are analyzed in bivariate and logistic regression analyses. Variables that were significant in bivariate analysis did not rise to the level of significance when included in a full logistic regression analysis. Study results and outcomes suggest that further research is warranted

A qualitative research on co-creating care pathways for Sarcoma and GIST by stimulating reflection

Introduction: Care Pathway Management intends to enhance the quality of care by restructuring care services. As recipients of care, patients have relevant experiential knowledge on the provision of care, but they are rarely involved in Care Pathway Management due to various barriers. This study aims to acquire insights into how patients can be meaningfully involved in Care Pathway Management. Methods: A case study was cond