Research involving children : recent developments and current trends in thinking

Children today hold an important place in society and are valued for what they offer. They represent society’s hopes for the future. Children in the western world have rights today, but historically this has not always been the case. In the UK, children are protected by the Children Acts of 1989 and 2004, and by various other charters, guidelines and government policies concerning their health and welfare. Internationally, organisations such as UNICEF and Save the Children were set up to confer protection and oversee support to children as the most vulnerable group of a population in war or disaster zones (Greig et al, 2007). However, this happy state of affairs (the positive view) with regard to children is by no means universal. We need to be mindful that many children, both in the UK and further afield, still suffer the debilitating effects of poverty, hardship and hunger, they lack basic amenities such as water, sanitation and healthcare, or access to a basic education, and many are subject to violence, abuse and neglect

Interpretative phenomenological analysis (IPA) : a qualitative methodology of choice in healthcare research

This paper focuses on the teaching of the qualitative method, Interpretative Phenomenological Analysis (IPA), to healthcare professionals (HCPs). It introduces briefly the philosophical background of IPA and how it has been used within healthcare research, and then discusses the teaching of IPA to HCPs within received educational theory. Lastly, the paper describes how IPA has been taught to students/trainees in some specific healthcare professions (clinical psychology, medicine, nursing and related disciplines). In doing this, the paper demonstrates the essential simplicity, paradoxical complexity, and methodological rigour that IPA can offer as a research tool in understanding healthcare and illness from the patient or service user perspective

Review : pearls of wisdom : using the single case study or ‘gem’ to identify strategies for mediating stress and work-life imbalance in healthcare staff

This paper […] reads well, offering a detailed exploration of one participant’s experiences of coping with stress, and the work-life balance, as a professional workingI read this paper with interest. It forms part of a larger qualitative study examining work-life balance among National Health Service (NHS) staff, through exploring a single case, Arial, using interpretative phenomenological analysis (IPA). A strength of this paper is that it reads well, offering a detailed exploration of one participant’s experiences of coping with stress, and the work–life balance, as a professional working in today’s task-oriented NHS. in today’s task orientated NHS

Exam success at undergraduate and graduate-entry medical schools : is learning style or learning approach more important? : A critical review exploring links between academic success, learning styles, and learning approaches among school-leaver entry (“traditional”) and graduate-entry (“nontraditional”) medical students

Phenomenon: The literature on learning styles over many years has been replete with debate and disagreement. Researchers have yet to elucidate exactly which underlying constructs are measured by the many learning styles questionnaires available. Some academics question whether learning styles exist at all. When it comes to establishing the value of learning styles for medical students, a further issue emerges. The demographics of medical students in the United Kingdom have changed in recent years, so past studies may not be applicable to students today. We wanted to answer a very simple, practical question: what can the literature on learning styles tell us that we can use to help today's medical students succeed academically at medical school? Approach: We conducted a literature review to synthesise the available evidence on how two different aspects of learning—the way in which students like to receive information in a learning environment (termed learning “styles”) and the motivations that drive their learning (termed learning “approaches”)—can impact on medical students' academic achievement. Findings: Our review confirms that although learning “styles” do not correlate with exam performance, learning “approaches” do: those with “strategic” and “deep” approaches to learning (i.e., motivated to do well and motivated to learn deeply respectively) perform consistently better in medical school examinations. Changes in medical school entrant demographics in the past decade have not altered these correlations. Optimistically, our review reveals that students' learning approaches can change and more adaptive approaches may be learned. Insights: For educators wishing to help medical students succeed academically, current evidence demonstrates that helping students develop their own positive learning approach using “growth mind-set” is a more effective (and more feasible) than attempting to alter students' learning styles. This conclusion holds true for both “traditional” and graduate-entry medical students

Understanding the role of patient and public involvement in renal dietetic research

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations of attendance, the informational and physical needs of these service users. Service users wanted to share their experiences with people who would listen and were in a position to help make the changes. This gave them a sense of purpose and autonomy in their treatment and helped them cope with living with renal disease in society. However, feelings of doubt as to whether they could personally ‘make a difference’ as a co-researcher, were common. Consulting service users enabled the research team to recruit more people to interviews to explore motivation considering the unique personal and social needs of this service user group. Service users may need additional and continued support if they are to successfully take part in a clinical study research advisory group

Optimising the use of ICTs by health & social care professionals in the community

This research was commissioned as part of the Department of Health's Information and Communication Technology (ICT) Research Initiative, to identify ways in which ICTs might provide benefits to health and social care professionals working across boundaries and to the clients/ patients that they serve. The project aimed to examine the use of existing ICTs in supporting isolated users in the community (principally professionals but also lay users), and to consider ways in which use of such ICTs might be improved, focusing initially on non-person identifiable information. A single patient group was selected as the main focus of the study - older people (and their carers). This group was chosen because the needs of older people and their carers reflect those of the wider isolated populations served by health and social welfare professionals in terms of their clinical, psychological and social care needs. Other isolated groups might include the physically disabled, the mentally ill, or those socially and potentially service isolated through geography, lifestyles or other factors. Older people would be represented in all these categories. Therefore, a study focusing on the information needs of professionals who support older patients or clients should provide findings that are generalisable to other groups, such as those mentioned above. Furthermore, it was evident that this is an important group on which to focus in terms of inter-agency working because of the various policy initiatives that aim to enhance working between professionals across the health and social care interface in relation to older people

Young people’s preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England

Objective To undertake a comprehensive assessment of the strength of preferences among young people for attributes of emerging technologies for testing and treatment of asymptomatic chlamydia. Design Discrete choice experiment (DCE) with sequential mixed methods design. A staged approach to selection of attributes/levels included two literature reviews, focus groups with young people aged 16–24 years (n=21), experts’ review (n=13) and narrative synthesis. Cognitive testing was undertaken to pilot and adapt the initial questionnaire. Online national panel was used for final DCE survey to maximise generalisability. Analysis of questionnaire responses used multinomial logit models and included validity checks. Setting England. Participants 1230 young people aged 16–24 from a national online panel (completion rate 73%). Outcome measures ORs for service attributes in relation to reference levels. Results The strongest attribute influencing preferences was chlamydia test accuracy (OR 3.24, 95% CI 3.13 to 3.36), followed by time to result (OR 1.81, 95% CI 1.71 to 1.91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling and postal testing) over attendance at a testing location. For accessing treatment following a positive test result, there was a general preference for online (OR 1.21, 95% CI 1.15 to 1.28) versus traditional general practitioner (OR 1.18, 95% CI 1.12 to 1.24) or pharmacy (OR 1.15, 95% CI 1.10 to 1.22) over clinic services. For accessing a healthcare professional and receipt of antibiotics, there was little difference in preferences between options. Conclusions Both test accuracy and very short intervals between testing and results were important factors for young people when deciding whether to undergo a routine test for asymptomatic chlamydia, with test accuracy being more important. These findings should assist technology developers, policymakers, commissioners and service providers to optimise technology adoption in service redesign, although use of an online panel may limit generalisability of findings to other populations

Trapped in a disrupted normality : survivors' and partners' experiences of life after a sudden cardiac arrest

Aim of the study Advances in resuscitation science have resulted in a growing number of out-of-hospital cardiac arrest (OHCA) survivors. However, we know very little about the natural history of recovery and the unmet needs of survivors and their partners. This qualitative study sought to address this knowledge gap to improve understanding of the consequences of surviving cardiac arrest. Methods In-depth qualitative interviews were undertaken separately with survivors and their partners between 3 and 12-months following the cardiac arrest. An interpretative phenomenological approach (IPA) to data analysis was adopted. Developing themes were discussed between members of the research team. Results 8 survivors (41–79 years; 5 male; mean time 6.3 months post-hospital discharge) and 3 partners (1 male) were interviewed. The key (super-ordinate) theme of being ‘trapped in a disrupted normality’ was identified within the data. Five related subordinate themes included: existential impact, physical ramifications, emotional consequences, limiting participation in social activities and altered family roles. Conclusion Recovery for survivors is hindered by a wide range of physical, emotional, cognitive, social and spiritual challenges that disrupt perceptions of ‘normality’. Survivors and their carers may benefit from focussing on establishing a ‘new normal’ rather than striving to achieve a pre-cardiac social and physical position. Survivor-centred assessment should support rather than undermine this goal