Respect in final-year student nurse–patient encounters – an interpretative phenomenological analysis

"This is an Version of Record of an article published by Taylor & Francis in Health Psychology and Behavioral Medicine: An Open Access Journal on 21 May 2014, available online: http://www.tandfonline.com/10.1080/21642850.2014.918513 This is an open-access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/ licenses/by/3.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.Very little is known regarding health-care professionals’ understanding and experiences of respect towards patients. The study aimed to explore student nurses’ understanding and experiences of respect in their encounters with patients. Semi-structured interviews were conducted with eight final-year student nurses with practice placements across different health-care trusts in the UK. Transcripts were analysed using interpretative phenomenological analysis (IPA). Three super-ordinate themes were identified: understanding of what it means to show respect, negotiating role expectations and personal attitudes in practice, and barriers related to the performance of the nursing role. The factors identified should be investigated further and addressed as they are likely to influence patients’ experiences of feeling respected in nurse–patient interactions and subsequently their well-being and health-related behaviours.Funded by an internal University of Chester gran

Person-centred healthcare research: A personal influence

Personal commentary on text: McCormack, B., van Dulmen, S., Eide, H., Skovdahl, K., Eide, T. (Ed.) (2017). Person-centred healthcare research. Chichester, United Kingdom: Wiley-Blackwell

The health consultation experience for people with learning disabilities: A constructivist grounded theory study based on symbolic interactionism

Aims. The aim of this study was to explore the effects of the health consultation experience for people with learning disabilities, particularly in terms of their self-concept Background. Annual health checks have been introduced as a reasonable adjustment for health providers to make in meeting the needs of people with learning disabilities, who experience significantly poorer health outcomes than the general population. Evaluation of the health consultation from the service user perspective can inform this service provision. Design. A constructivist grounded theory approach, based on symbolic interactionism, was used to explore the meaning of the health consultation experience for the person with learning disabilities, and its effects on their sense of self. Methods. Purposive and snowballing sampling was used to recruit 25 participants with learning disabilities through a GP practice, self-advocacy groups and a health facilitator. Nine individual interviews, three interviews with two participants, three focus groups (n=7, n=5 and n=3), and an audio-recorded health check consultation were carried out (with two participants interviewed twice and four attending two focus groups), as well as a member check used to assess the resonance of the findings. Data collection was undertaken in different primary care trusts across the north west of England. Data were subjected to constant comparative analysis, using a symbolic interactionist approach, to explore all aspects of the health consultation experience and its effects on the self. Findings. Current expectations, attitudes and feelings about health consultations were strongly influenced by previous experience. Participants negotiated their own reality within the consultation, which affected their self-concept and engagement with their health care. Respectful and secure health professional – service user relationships, developed over time, were central to an effective consultation. Perspectives on the consultation, and engagement within it, were co-constructed with a companion, who could help to promote the personhood of the service user with support from the health professional. Anxiety, embarrassment and felt stigma were identified as significant barriers to communication and engagement within the consultation. Conclusions. People with learning disabilities have similar health consultation needs and expectations to other people, but may have more difficulties in engaging with the process and building trusting relationships with the health professional, due to previous negative experiences, anticipated stigma and loss of self within health settings leading to a fear of disclosure. This, combined with difficulties in communication and cognitive processing, results in less satisfactory outcomes persisting over time. The effects of triadic consultations are generally positive, particularly where relatives or health facilitators are involved. However, continuity of companion as well as health professional is needed, and more service user engagement should be supported. Fundamental attitude change by health professionals, supported by specific educational initiatives to enhance their understanding of the service user perspective, is needed to reduce health inequalities. Participatory research by people with learning disabilities should inform future health care practice

Student nurses' views on respect towards service users — An interpretative phenomenological study.

Abstract/Summary Aim: To explore student nurses’ understanding and behaviours of respect towards patients in order to inform educational strategies to optimise respectful care. Background: There is a causal relationship between the perception of being treated with respect and patient satisfaction. Concerns over standards of care prompted a commissioned report into the quality of nurse education in the United Kingdom. Design: A hermeneutic phenomenological interview study was used to identify and interpret student nurses’ behaviours and understanding of respect towards patients. Setting: University health and social care faculty in the north-west of England, United Kingdom Participants: Eight third-year student nurses (adult branch), on different university sites, with practice placements across different healthcare trusts. Methods: Interviews about their understanding of respect and their behavioural intentions of respect towards patients were recorded and transcribed, then analysed using interpretative phenomenological analysis (IPA) to produce themes from the data. Findings: Three themes of relevance to nurse education were identified. Respect is a complex concept that is difficult to apply in practice. Students are not always aware of incongruence between their feelings of respect towards patients and their behaviours towards them. Role-modelling of respectful care is variable, and essential care is often learned from healthcare assistants. Discussion: Awareness of emotional responses and their relationship to patient perceptions of respect should be facilitated in theory and practice. Rehearsal of the application of respect involving emotional labour, and reflection in and on the practice of respectful care, are needed to address student learning needs. The theory-practice gap in relation to respect, variation in professional practice and the under-recognised importance of healthcare assistants in student nurse education, are barriers to the learning of respect to patients. Conclusions: Interactive education experiences are important to develop self-awareness and insight into respectful care. Mentorship in practice should encourage reflection in and on the practice of respect towards patients

Pest-removal services provided by birds on subsistence farms in south-eastern Nigeria

To what extent birds provide the ecosystem service of pest control in subsistence farms, and how this service might depend on retained natural habitats near farmlands is unexplored in West Africa. To fill this knowledge gap, we placed plasticine mimics of insect pests on experimentally grown crops on the Mambilla Plateau, South Eastern Nigeria. We recorded bird attacks on the mimics and the proportion of mimics removed by birds. We also determined the influence of distance of crops from forest fragments on both attack and removal rates. We placed 90 potted plants of groundnut (Arachis hypogea) and bambara nut (Vigna subterranea) along 15 transects running 4.5 km from forest edge into open grassland. Each plant had six of the 540 mimics in total placed on their leaves. We inspected the potted plants weekly for 12 weeks to record (i) the presence of bird beak marks on mimics, and (ii) the number of missing mimics. Once a week we collected all the mimics from the plants and counted the number of assumed beak marks. After counting we replaced the mimics on the plants, mark free. We found a strong positive correlation between the abundance of insectivorous birds and the mean number of missing mimics and/or bird attack marks on mimics. However, this positive effect of insectivorous bird abundance on prey mimic attack/removal became less strong the farther they were from a forest fragment. We found increased predation rates and abundance of insectivorous birds closer to forest fragments. Our data suggest that pest predation may be a key ecosystem service provided by insectivorous birds on Nigerian farmlands. Farmlands that are closer to forest fragments may experience a higher rate of pest control by insectivorous birds than those further away, suggesting that retaining forest fragments in the landscape may enhance pest control services in sub-Saharan subsistence farms

Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation

Mafuba, K., Chapman, H., Kiernan, J., Kupara, D., Kudita, C. & Chester, R. (2023). Understanding the contribution of intellectual disabilities nurses: Paper 3 of 4 - evaluation. Journal of Intellectual Disabilities, vol(issue), pages. https://doi.org/10.1177/17446295231196588. Copyright © 2023 The Authors. Reprinted by permission of SAGE Publications.Abstract The overall objective of this research was to identify intellectual disability nursing interventions and their impact on the health and healthcare of people with intellectual disability. This is part 3 of a 4-part series. In this paper we report the findings from quantitative questions from an online survey of intellectual disability nurses. The objective of this part of the study was to evaluate intellectual disability nurses’ confidence in their understanding of the interventions they undertook. Quanitative data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants from 7 countries. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. The evaluation data suggest and demonstrate a lack of clarity among intellectual disability nurses of the interventions they can effectively undertake. There appears to be correlations between lack of role clarity and the types of employer organisations and countries. Further work needs to be undertaken by nurse leaders to ascertain and address this lack of clarity

Understanding the contribution of intellectual disabilities nurses. Paper 4 of 4 - Impacts of intellectual disability nursing interventions

© The Author(s) 2024.Internationally, there is a wide variety of roles and expectations for intellectual disabilities nurses, and the range of nursing interventions they undertake in this field has not been clearly identified. In this paper we report the impacts of intellectual nursing interventions from an online survey of intellectual disability nurses. An online survey, using voluntary response sampling was used to collect case study examples from 230 participants from seven countries. We identified 13 themes of the impacts, and 23 broad groups of case examples of intellectual disability nursing interventions with, pregnant women, children, adults, older adults, and people at the end of life. Awareness of the roles of intellectual disability nurses and their importance in addressing health inequalities and facilitating the use of mainstream services for people with intellectual disabilities will enable improved healthcare experience and healthcare outcomes for people with intellectual disabilities

Relative roles of genetic variation and phenotypic plasticity in the invasion of monkeyflower Erythranthre gutatta in New Zealand (2022-06-07)

Evolutionary processes which increase the probability of an introduced plant species becoming invasive include high levels of genetic diversity and phenotypic plasticity. Naturalised in New Zealand, monkeyflower, (Erythranthre gutatta ), a clonally spreading herb of waterways and seepage areas native to the Western USA, shows marked variation in a range of vegetative, reproductive and inflorescence traits. We used two common gardens differing in elevation to explore the relative contribution of genetic versus plastic variation within nine traits among 34 monkeyflower clones from across the New Zealand South Island. We looked for evidence of clinal variation across elevation gradients and for home site advantage. We found both high genetic diversity and trait plasticity explain the observed variation, although less evidence for adaptive plasticity. Most genetic variation was observed in the lowland garden (9m a.s.l.), where the overall trend was for above ground dry weight to be lower, and horizontal shoot length greater, than at the montane garden (560m a.s.l). We found no evidence of local adaptation to any of the measured environmental variables. However, we observed a pattern of higher biomass and higher plasticity at lower versus higher elevations and in clones originating from lower elevation sites.</jats:p

Understanding the contribution of intellectual disabilities nurses. Paper 1 of 4 -Scoping literature review

© The Author(s) 2023.The objective of this scoping review was to summarise evidence on the contribution of intellectual disabilities nurses to improve the health and well-being of children, adults and older people with intellectual disability, now and for the future. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used. We included 54 publications. We identified 154 interventions undertaken by intellectual disability nurses. We categorised the intellectual disability nursing interventions into three themes: effectuating nursing procedures, enhancing impact of services, and enhancing quality of life. Findings point to high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly updated. This will provide opportunities to engage more effectively in evidence-based practice