The practice of solidarity through the arts: inter-relations and shared moments of creation in Share My Table

In 2017 the Scottish Refugee Council and Tramway embarked on a collaborative participatory arts project seeking to explore the upsurge in media coverage around issues of migration. Share My Table took a multi-artform approach, with performance and visual art providing the foundation for the exploration. This article, written from the position of artist researcher, shifts the lens away from the artistic or performance outputs of this participatory project, and instead reflects and theorises the working practices which emerged throughout the Share My Table project. By drawing on bell hooks’s work on practices of freedom (1994), and James Thompson’s call for a re-focusing towards affect, beauty and care (2011, 2015), the author argues for participatory practice’s radical potential. Ultimately, the how of participatory work, the careful and ethical attention on the doing can activate solidarity in relation to the asylum regime

The practice of solidarity through the arts: inter-relations and shared moments of creation in Share My Table

In 2017 the Scottish Refugee Council and Tramway embarked on a collaborative participatory arts project seeking to explore the upsurge in media coverage around issues of migration. Share My Table took a multi-artform approach, with performance and visual art providing the foundation for the exploration. This article, written from the position of artist researcher, shifts the lens away from the artistic or performance outputs of this participatory project, and instead reflects and theorises the working practices which emerged throughout the Share My Table project. By drawing on bell hooks’s work on practices of freedom (1994), and James Thompson’s call for a re-focusing towards affect, beauty and care (2011, 2015), the author argues for participatory practice’s radical potential. Ultimately, the how of participatory work, the careful and ethical attention on the doing can activate solidarity in relation to the asylum regime

Parents’ and carers’ experiences of transition and aftercare following a child's discharge from a paediatric intensive care unit to an in-patient ward setting:A qualitative systematic review

Objectives: To explore parents’ experiences of transition and aftercare following their child’s discharge from a pediatric intensive care unit to an inpatient ward.Methods: A qualitative systematic review was conducted. Electronic databases CINAHL, MEDLINE, EMBASE, Psych INFO, and ASSIA were searched for qualitative studies with no date limits imposed. Methodological quality was assessed using the JBI QARI standardised critical appraisal instrument. Data were extracted into a standardised data extraction tool. Findings were pooled using a meta-aggregative approach.Results: Four studies were included in the final review that included a total of 95 participants. Fortynine findings were extracted and through an iterative process resulting in four synthesised findings being developed. These included: (1) Dynamic emotional response pre, peri and post-transfer; (2) Involvement in care absent but fundamental to functioning; (3) Changes in care delivery and environment provoking adverse emotions; and (4) Transition as a physical, emotional and social balancing act.Conclusion: Transitioning from the pediatric intensive care unit to an in-patient ward can be a challenging time for parents, exposing them to a turbulent emotional and social status, and depleting their personal resources. Parents are aware of differences in the organisation and delivery of care between clinical areas which can compound the adversity experienced. Health professionals need to provide targeted support in order to mitigate these negative emotional, physical and social effects experienced

Implementing routine provider-initiated HIV testing in public health care facilities in Kenya: a qualitative descriptive study of nurses\u27 experiences

Routine \u27provider-initiated testing and counselling\u27 (PITC) for HIV has been implemented amidst concern over how consent, confidentiality and counselling (the 3C’s) can be maintained in underresourced health care settings. In Kenya, PITC has been rolled out since 2005, HIV prevalence is 7.1% and over 86% of adults have not been tested. Kenyan nurses are the main cadre implementing PITC but little is known about their experiences of incorporating HIV testing into everyday practice and the challenges faced in maintaining the 3’Cs within their work environments. This study aimed to explore these issues and adopted a qualitative multi-method design using a convenience sampling approach. Two focus group discussions (total n=12) and 13 in-depth individual interviews were undertaken with nurses from 11 different public health care facilities in Nairobi and its surrounding areas (including in- and out-patient settings). Data were analysed thematically. Nurses identified a range of personal, client and health system challenges in the everyday application of PITC. These included: (i) the contradictions of normalising a highly stigmatised disease and the difficulty of providing client centred care within a routinised and target oriented work culture; (ii) the challenge of dealing with ethically complex client situations in which the principles of the 3C’s could be difficult to uphold; and, (iii) lack of time, resources, space and recognition within workplace environments (especially in-patient settings) that, likewise, led to problems with maintaining the 3C’s. In-patient nurses in particular identified problems associated with testing in a multi-disciplinary context, suggesting that other health professionals appeared to routinely flout the PITC guidelines. In conclusion, this study shows that the process of translating policy into practice is invariably complex and that more research is needed to explore PITC practices, particularly in in-patient settings. Nurses require supervision and support to negotiate the challenges and to fulfil their roles effectively

The importance of HIV specialist services for African women living with HIV in Nottingham: results of a qualitative study

This article reports the results of a qualitative study of the experiences of African women living with HIV in Nottingham, UK. Globally, sub-Saharan Africa is the region most severely affected by the HIV pandemic [1]. This pattern is also reflected in the UK where African migrants make up 27% of those diagnosed with HIV despite the fact that they constitute less than 1% of the population [2-4]. Healthcare staff play a central role in meeting the prevention and care needs of people living with HIV/AIDS [5]. In contexts of increasing migration, health workers are called upon to recognise the diverse cultural, social, economic and political histories of their patients, and to understand how these interface with their current living situation, including their HIV-related health and treatment needs [6]. Relatively little research has been conducted to investigate the health experiences of migrant populations living with HIV in the UK, or on their patterns of access to, and utilisation of, HIV treatment and care [7]. Findings from the available, but limited, studies indicate that African migrants tend to present later than other population groups for HIV testing and treatment [8]. This is attributed to a number of obstacles to seeking or accessing care, including individual/community characteristics (such as AIDS-associated stigma, lack of perceived risk and denial), and factors associated with service and welfare provision in the host country--such as perceived discrimination, language and cultural differences, financial constraints and uncertain legal/immigration status [8-10]

Experiences of African immigrant women living with HIV in the U.K.: implications for health professionals

In the U.K. immigrant women from Africa constitute an increasingly large proportion of newly diagnosed cases of HIV. A significant minority of these are refugees and asylum seekers. Very little is known about their experiences of living with HIV/AIDS, their psychosocial needs or their views of health care provision. This paper reports the results of a qualitative study that explored these issues by interviewing eight African women living with HIV in the British city of Nottingham. Women’s ability to live positively with HIV was found to be strongly shaped by their migration history, their legal status, their experience of AIDS-related stigma and their Christian faith. Significantly, health services were represented as a safe social space, and were highly valued as a source of advice and support. The findings indicate that non-judgemental, personalised health care plays a key role in encouraging migrant African women to access psychosocial support and appropriate HIV services

Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Introduction: With an increase in the population living with terminal illness, many patients are accessing EDs during the last days of their life. Yet EDs are often not well prepared to provide end-of-life (EOL) care. The aim of this review was to identify and synthesise studies that describe the views and experiences of emergency nurses in providing EOL care so as to understand the barriers and challenges that they face while caring for these patients and to identify factors that can support appropriate care delivery. Method: A qualitative meta-synthesis was undertaken using a thematic approach. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument tool. Five databases were searched in June 2016. Results: Eleven qualitative studies met the inclusion criteria and were assessed as having high quality. Sixty-nine findings were identified, combined into 11 descriptive themes and then synthesised into 3 analytical themes: (1) Incongruent ED environment and EOL care. (2) Lack of resources, systems and capacity. (3) EOL care as a rewarding act or an emotional burden. Conclusion: The review identified a need for: (1) Additional training for nurses. (2) The development of clear guidelines in the form of pathways and protocols. (3) Having a separate space for the dying. (4) Providing a supportive environment for staff dealing with high emotional burden and challenging workloads. In order to improve EOL care, organisations must work on the barriers that hinder care provision

\u27People are creating policy up there, they are not coming down\u27: nurses\u27 views on the expansion of routine provider-initiated HIV testing and counselling in Nairobi, Kenya.

In this report, we present selected findings from an exploratory piece of qualitative research on HIV testing that was undertaken in 2007-2008 with nurses in Nairobi, Kenya. At the same time, we share our own story of how this research came about and how NHIVNA research funding was able to lay the foundations for a larger study that will hopefully give voice to patients and HIV nurses in Nairobi and will develop HIV nursing research capacity in the country

Development and Fidelity Testing of the Test@Work Digital Toolkit for Employers on Workplace Health Checks and Opt-In HIV Testing

BACKGROUND: In the UK, few employers offer general health checks for employees, and opt-in HIV testing is rarely included. There is a need to provide evidence-based guidance and support for employers around health checks and HIV testing in the workplace. An Agile approach was used to develop and evaluate a digital toolkit to facilitate employers' understanding about workplace health screening. METHODS: The Test@Work toolkit development included an online survey (STAGE 1: n = 201), stakeholder consultation (STAGE 2: n = 19), expert peer review (STAGE 3: n = 24), and pilot testing (STAGE 4: n = 20). The toolkit includes employer guidance on workplace health promotion, workplace health screening, and confidential opt-in HIV testing with signposting to resources. Pilot testing included assessment of fidelity (delivery and engagement) and implementation qualities (attitudes, resources, practicality, acceptability, usability and cost). RESULTS: STAGE 1: The vast majority of respondents would consider offering general health checks in the workplace that included confidential opt-in HIV testing, and this view was broadly comparable across organisation types (n = 201; public: 87.8%; private: 89.7%; third: 87.1%). STAGES 2 and 3: Stakeholders highlighted essential content considerations: (1) inclusion of the business case for workplace health initiatives, (2) clear pathways to employer responsibilities, and (3) presenting HIV-related information alongside other areas of health. With regards presentation, stakeholders proposed that the toolkit should be concise, with clear signposting and be hosted on a trusted portal. STAGE 4: Employers were satisfied with the toolkit content, usability and utility. The toolkit had high fidelity with regards to delivery and employer engagement. Assessment of implementation qualities showed high usability and practicality, with low perceived burden for completion and acceptable cost implications. Very few resource challenges were reported, and the toolkit was considered to be appropriate for any type of organisation, irrespective of size or resources. CONCLUSIONS: Employers perceived the Test@Work toolkit to be useful, meaningful and appropriate for their needs. This digital resource could be used to support employers to engage with health screening and opt-in HIV testing within the context of workplace health promotion

How do nurses facilitate shared decision making in HIV care?: an exploratory study of UK nurses knowledge, perspective and experience of facilitating shared decision making in clinical practice

Shared Decision Making (SDM) enables clinicians to promote self-management and to empower patients with long-term health conditions. Whilst it has been reported in other health conditions, there is little empirical research on the nature and practice of SDM in HIV care. This project aimed to explore current views and practices amongst UK HIV Nurses regarding SDM. A mixed methods study utilised focus groups and an online survey to identify opportunities, challenges and training needs. Nurses are supportive of SDM but face patient related, organisation and health system challenges to implement it, especially in supporting complex patients. SDM is an important aspect of nursing care for people living with HIV. Nurses need more training and resources to implement SDM effectively. In order to develop such training and resources to better understand SDM in relation to HIV care, there is a need for research on patient perspectives and experiences in this area