Giroscope Housing Organisation: a study of tenant satisfaction

Giroscope is an award winning community based housing organisation in West Hull that buys and renovates empty properties to provide rental accommodation for people in housing need. Giroscope was conceived by a group of students and unemployed people in 1985 in response to the problem of homelessness in Hull and established as a limited company and workers co-operative in 1986. Initially set up to provide accommodation for its founders only, Giroscope has since expanded and now lets 30 properties. It remained a workers’ co-operative until January 2007 when it was converted to a registered charity. With a view to reviewing and improving the quality of their service Giroscope approached us in January 2007 and invited us to carry out an independent tenants’ satisfaction survey. We were commissioned to undertake a comprehensive study of tenant satisfaction, with particular emphasis on the quality of the repairs and maintenance service, as this is an area in which Giroscope have recently been trying to make improvements

Trends in teenage pregnancy in England and Wales: how can we explain them?

Teenage pregnancy is associated with adverse social and physical outcomes for both mother and child. We drew on various sources-birth and abortion statistics from the Office for National Statistics, data from the National Survey of Sexual Attitudes and Lifestyles, and routinely collected data from family planning clinics-to identify trends in England and Wales and their possible determinants. The rate of teenage sexual activity has increased steadily and consistently over the past four decades, whilst the rate of teenage fertility has shown greater variation. When the teenage fertility rate is calculated against the denominator of sexually active women, rather than the total sample of teenage women, the underlying trend in teenage fertility over the past four decades has been downwards, though not consistently so. Fluctuations in the teenage fertility rate seem to track intervention-related factors such as access to, and use of, contraceptive services and the general climate surrounding the sexual health of young people

Staff training in integrated sexual health services

Coordination of family planning and GUM services has the potential to boost the effectiveness of bot

Providing sexual health services in England: meeting the needs of young people

ABSTRACT There is an on-going debate among health professionals, policy-makers and politicians, as to the optimal way of delivering sexual health services to young people. There is as yet, no consensus on their best patterns of organisation or configuration. This study uses qualitative and quantitative research methods, to explore both the views of young people accessing sexual health services, expressed through in-depth interview, and variations in client satisfaction with different characteristics of service delivery, expressed through completion of a questionnaire. The key research questions are: How does young people’s satisfaction with sexual health services vary with the age-dedication of the service; that is, whether it serves young people only, or all ages? How does young people’s satisfaction with sexual health services vary with the integration of the service; that is, whether family planning and genito-urinary services are offered separately, or together? How does young people’s satisfaction with sexual health services vary with the location of the service; that is, in community or hospital based services? In the qualitative component, in-depth interviews were conducted with 25 young people recruited from a purposively selected sample of young people’s services. In the survey, a total sample of 1166 was achieved. Of these, 36% were attending an integrated contraceptive and STI service and 64% were attending a more traditional ‘separate’ service. 48% attended a service dedicated to young people and 52% an all-age service. 50% attended a hospital-based service and 50% a service located in the community. Of the total sample, 22% were male and 78% female. The analysis has been done not on a comparison of services in their entirety, but on a comparison of key features of their organisation, that is, whether they are provided separately as contraceptive and STI sessions or services, or whether these aspects of sexual health provision are integrated in sessions or services (integration); on whether they are run exclusively for young people or for all ages (dedication); and on whether they are located in the community or in a hospital setting (location). Recommendations are made for future service development and delivery and implications for policy are discussed

Sexuality education in different contexts: limitations and possibilities

Purpose - Sexuality education is a controversial and contested issue that has evoked wide debate on the question of its aims, contents, methods, pedagogy and desired outcomes. This editorial aims to provide a brief commentary, positioning the contributions to this Special Issue of Health Education within the research landscape concerning sexuality education in schools internationally. Design/methodology/approach - The idea for this Special Issue was born in Odense, Denmark, in October 2012, during the 4th European Conference of Health Promoting Schools. The Conference Programme and the debates during the sessions demonstrated the need for a wider discussion of sexuality education, particularly within the framework of the health-promoting school. There was recognition of the need to endorse positive and wide socio-ecological views of health, including sexual health and a critical educational approach to sexuality education. The conference delegates and the members of the Schools for Health in Europe Research Network were invited to submit a paper for the Special Issue, and the invitation was also sent through other networks and research communities globally. The invitation resulted in papers being submitted beyond Europe and the Special Issue took an interesting global turn. This networking process also resulted in the identification of a number of key international subject-specific experts who took on the role of independent reviewers. Findings -Following the review and editorial process six papers were accepted for the Special Issue. The papers highlight contrasts, tensions, potentials and barriers embedded in the ways sexuality education is delivered to children and young people internationally. Examples are drawn from Russia, Wales, China and the USA; they identify historical and structural issues related to the implementation of comprehensive progressive approaches. Topics discussed include the importance of appropriate content, theoretical/conceptual frameworks, modes of delivery, timing, attitudes from key stakeholders and the need for comprehensive evaluation of innovative approaches to the delivery of sexual education. Originality/value - The Special Issue provides a unique blend of evaluations of practical examples of pioneering programmes, research using qualitative, quantitative and mixed method designs, and critical conceptual discussions related to sexuality education and factors that influence it. The Special Issue addresses sexuality education from a life course perspective; some of the individual papers focus on young children and some on lifelong learning. All the papers point to the importance of understanding structural, socio-historical, political and cultural factors influencing sexuality education

Uses of routine data sets in the evaluation of health promotion interventions: opportunities and limitations

Practitioners are under constant pressure to evaluate their work. In the current environment, health professionals frequently have limited time and financial resources, and opportunities for using existing data sets must be exploited. Routinely collected data provide a potentially useful resource for use in this context. The aim of this paper is to discuss the potential uses of routinely collected data in the evaluation of health promotion interventions. Opportunities for and limitations of routine data are discussed, drawing on examples primarily from the field of sexual health, to demonstrate principles which are also relevant in other areas of health care

Key health & lifestyle areas: current rates & past trends (For Government PSA targets arising from ‘Choosing Health’ white paper priorities) NSMC Report 12

This paper is part of work contributing to the independent National Review of healthrelated programmes and social marketing campaigns that was first announced as part of the Public Health White Paper ‘Choosing Health’. The work was undertaken by the National Social Marketing Centre and was published in June 2006. The discussion and consultation that fed into the development of that White Paper had highlighted a number of concerns. Two of particular relevance to this work were: • A growing realisation that continuing with existing methods and approaches was not going to deliver the type of impact on key health-related behaviours that was needed. • Other comparable countries appeared to be achieving more positive impacts on behaviours by using and integrating a more dynamic customer-focused social marketing approach into their methods. As a result, it was agreed that a National Review should be undertaken to examine the potential of social marketing approaches to contribute to both national and local efforts, and to review current understanding and skills in the area among key professional and practitioner groups. The National Consumer Council was asked to lead this work as they had been key advocates for a more consumer-focused approach. It was also recognised that an independent aspect to the review would be important so that existing practice across the Department of Health could be considered and recommendations developed. To inform the National Review a range of research methods and approaches were used. This report is one of a range of research and review reports that have informed the National Review

A qualitative study exploring the experiences and emotional responses of female community continence link workers and female patients in relation to performing clean intermittent self-catheterisation

Aim: This paper represents a report of a study designed to explore the experiences of female community continence link nurses in relation to female catheterisation and their psychological and educational preparedness to teach it. The lived experiences and emotional responses of female patients learning to perform Clean Intermittent Self-Catheterisation (CISC) are also examined. Background: There is general consensus that CISC should be considered in preference to indwelling catheterisation wherever feasible. Published literature has tended to focus on quality of life issues and technical and physical aspects. There has been less investigation into patients’ initial perceptions of CISC, and into their subsequent experiences of learning the technique. There has also been minimal investigation into how community continence link nurses feel about female CISC and into their perceived ability to teach it. Design: This qualitative study used a phenomenological research design. Method: A series of semi-structured, in-depth interviews were held with a self-selected sample of female continence link nurses and adult female patients performing CISC aged 34-64 years. Interviews were tape recorded and transcribed verbatim. Data were analysed using the ‘Framework’ method and recurrent themes identified. Results: The lived experiences of nurses in relation to the catheterisation of female patients were categorized into themes: the nurses’ emotional responses, their own and others’ coping mechanisms, visualisation of the female urethra, the approach adopted by their mentor and their knowledge deficit around CISC. Six recurrent themes were also identified from the patient sample: grief and loss, lack of knowledge (regarding female anatomy, bladder dysfunction and catheters), negative associations and stigma, psychological aversion and embarrassment, nursing approaches and coping mechanisms. Conclusion: Nurse recognised that although they felt competent in providing sensitive, individualised care for patients requiring in-dwelling catheterisation, they lacked the underpinning skills and knowledge to enable them to assess patients and feel confident in teaching CISC. Explicit recognition of their own and others’ psychological coping mechanisms promotes an individualised approach which translates into an enhanced experience for the patient. For the patients, loss of normal bladder function may represent a devastating event, and trigger emotional responses associated with grief and loss. Patients may experience a range of reactions whilst learning CISC, including embarrassment and aversion, which may not dissipate over time. However, psychological distress is not inevitable, and varies enormously between individuals. The nursing approach is vital, as individualised, empathic care is recognised and valued

Supporting carers of people affected by cancer and other long-term conditions at end of life

Background Macmillan Cancer Support has funded an intervention in Lincolnshire whereby carers of people affected by cancer and other long-term conditions at end-of-life are offered a bespoke package of support. The objectives of the study were (1) to explore the experiences of those in receipt of the intervention and (2) to inform the funders of particular strengths and weaknesses of their service. Method 10 in-depth interviews with carers in receipt of the intervention were conducted. Data were analysed using framework analysis. Results The service appeared to be meeting a specific need, in that, it focused specifically on the needs of the carer, something not being met elsewhere. A positive outcome that has arisen from the carers involvement is that they have felt reassured through having background support. All those interviewed reported that the personal attributes and specialist skills of those delivering the service had influenced their satisfaction. Participants also remarked on how they were signposted to a range of useful sources which helped to streamline communication between the carer and other health and social care services. Conclusion The evaluation found this to be a successful intervention within a social care setting. The participants had no overtly negative opinions on the service in its current format and all held it in a high regard. Participants felt that both the content and delivery were excellent. It is recommended that further evaluation be conducted once the service has become more fully established. Acknowledgements We are grateful to Macmillan Cancer Support for funding this research. Additionally, we would like to express our gratitude to the carers who took the time to take part in an interview

Implementing performance improvement through the enterprise culture

The purpose of this article is to evaluate performance improvements made through a case study of a rural English hospital’s emergency department within the framework of the enterprise culture—the NHS adoption of the private sector’s performance improvement best practice. Additionally, the process of the research and the significant barriers encountered are documented to inform future researchers of potential drawbacks when considering this type of research. An intervention addressing local performance issues was defined by medical consultants. A pathway to care for emergency care patients requiring clinical observation for more than four hours—but not admission as a hospital inpatient—was created. The efficacy of the intervention was evaluated by measuring compliance to the pathway standards and conducting an ethnographic study and semi-structured interviews. Structural barriers to research caused by lack of staff availability were encountered. Additionally, although improvement from the intervention was encouraging, the ability of the people within the system to consistently enact the process caused performance issues against expected targets