Constructions of self-neglect.

Self-neglect can be understood as the failure to engage in those activities which a given culture deems necessary to maintain a socially accepted standard of personal and household hygiene and carry out activities needed to maintain health status. This failure to care for one’s self can be diagnosed as a medical syndrome. A synthesis of the Medical Model and Orem’s Theory of Self-Care provided the framework for stage one. This stage comprised a comparative survey of a group of self-neglecters and a comparison group identified by and drawn from the caseload of District Nurses. Many participating nurses practised in remote and rural settings. This geographical and cultural context may have influenced the relationships between nurses and patients and the way in which care was delivered. Self-neglecters had lower levels of self-care agency, were more likely to have a psychiatric disorder and have the nursing diagnoses of non-compliance and ineffective management of therapeutic regime. The self-neglect and comparison groups showed similar levels of independence and dependence in Activities of Daily Life functioning. The medical construction of self-neglect has come to dominate the discourse. The medicalisation of self-neglect obscures the fact that patients and professionals may have different ideas on what is and what is not self-neglect. The notion of self-neglect as a social construction was the theoretical perspective which provided the framework for stages two and three of the main study. This challenged the assumption implicit in the medicalisation of selfneglect that self-neglect is an objective a priori category. In stage two multiple-case study methods were employed to investigate other constructions of self-neglect. It was found that there were divergent views on self-neglect both between cases and across cases. A wide range of behaviours were classified as constituting self-neglect. It was concluded that self-neglect is a constructed phenomenon which is the product of social and individual normative judgements, which are themselves rooted in the dominant discourse on cleanliness, hygiene and self-care. These social judgements were investigated in a systematic way in stage three. Judgements regarding self-neglect and the degree to which individuals were perceived to have chosen to lead a neglecting lifestyle were proposed to be social judgements influenced by professional socialisation and cultural values. Stage three was a factorial survey investigating which variables or combination of variables influenced nurses’ judgements of self-neglect and choice in lifestyle. The variables investigated in the factorial survey were self- care status, functional status, gender, psychiatric illness, stated preference for lifestyle, and socio-economic status. Self-care status was the most important variable in judgements of self-neglect and a combination of functional status, stated preference for lifestyle and psychiatric status were the most important variables in judgements of choice of lifestyle. Psychiatric, general and student nurses had veiy similar patterns of judgements about self-neglect but general nurses were more likely to believe that self-neglect was an active lifestyle choice. The findings of the three stages challenge the existence of an objective medical diagnosis of self-neglect. The evidence suggests that self-neglect is a label applied to a wide range of behaviours and that there is disagreement between professionals and between professionals and patients about the existence of self-neglect in specific cases. It has also been shown that self-neglect is defined by the methods which are used to study this phenomenon. Different research methods produce a seemingly contradictory picture of selfneglect

Love Makes The World A Merry-Go-Round

https://digitalcommons.library.umaine.edu/mmb-vp/2036/thumbnail.jp

End of the Road

[Verse 1]Ev’ry road thro’ life is a long long road.Fill’d with joys and sorrows, tooAs you journey on how your heart will yearnFor the things most dear to you.With wealth and love ‘tis so,But onward we must go. [Verse 2]With a big stout heart to a long steep hill We may get there with a smile, With a good kind thought and an end in view We may cut short many a mile So let courage ev’ry day Be your guiding star alway. [Chorus]Keep right on to the end of the roadKeep right onto the endTho’ the way be long let your heart be strong,Keep right on round the bend. Tho’ you’re tired and wearyStill journey on till you come to your happy abode,Where all you love you’ve been dreaming ofWill be there at the end of the road. road

An evaluation of methods used to teach quality improvement to undergraduate healthcare students to inform curriculum development within preregistration nurse education: a protocol for systematic review and narrative synthesis

Background: Despite criticism, quality improvement (QI) continues to drive political and educational priorities within health care. Until recently, QI educational interventions have varied, targeting mainly postgraduates, middle management and the medical profession. However, there is now consensus within the UK, USA and beyond to integrate QI explicitly into nurse education, and faculties may require redesign of their QI curriculum to achieve this. Whilst growth in QI preregistration nurse education is emerging, little empirical evidence exists to determine such effects. Furthermore, previous healthcare studies evaluating QI educational interventions lend little in the way of support and have instead been subject to criticism. They reveal methodological weakness such as no reporting of theoretical underpinnings, insufficient intervention description, poor evaluation methods, little clinical or patient impact and lack of sustainability. This study aims therefore to identify, evaluate and synthesise teaching methods used within the undergraduate population to aid development of QI curriculum within preregistration nurse education. Methods/design: A systematic review of the literature will be conducted. Electronic databases, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (PsychINFO), Education Resources Information Centre (ERIC), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Applied Social Sciences Index and Abstracts (ASSIA), will be searched alongside reference list scanning and a grey literature search. Peer-reviewed studies from 2000-2014 will be identified using key terms quality improvement, education, curriculum, training, undergraduate, teaching methods, students and evaluation. Studies describing a QI themed educational intervention aimed at undergraduate healthcare students will be included and data extracted using a modified version of the Reporting of Primary Studies in Education (REPOSE) Guidelines. Studies will be judged for quality and relevance using the Evidence for Policy and Practice Information and Co-ordinating Centre's (EPPI) Weight of Evidence framework and a narrative synthesis of the findings provided. Discussion: This study aims to identify, evaluate and synthesise the teaching methods used in quality improvement education for undergraduate healthcare students where currently this is lacking. This will enable nursing faculty to adopt the most effective methods when developing QI education within their curriculum

A follow up to new approaches to providing practice placements in the pre-registration nursing programmes: A comparison study of the year one pilot students and their year 2 experience. The Final Report

Issues that may impact on student retention and attrition are multifactorial but a number of key areas have been highlighted, including the quality of support and learning experiences in practice settings. The first phase of this project (Roxburgh et al 2011), explored student, mentor and clinical manager perceptions of ‘Hub and Spoke placement models in Year One of a Pre-registration Nursing Programme. The funders Scottish Government Health Department, Recruitment and Retention Delivery Group agreed to commission further study of this cohort through Year 2 of the programme, when the hub and spoke allocation model was not used to support clinical placement allocation. Following the original pilot students through Year 2 of their programme, wherein they experienced a ‘traditional’ placement model, provided an opportunity to compare perceptions of both models and to build on and further explore the issues of belongingness, continuity, continuous support and quality of practice learning which had emerged from Phase 1 of the study

A proposed reductionist solution to address the methodological challenges of inconsistent reflexology maps and poor experimental controls in reflexology research: A discussion paper

Reflexology is a complex massage intervention, based on the concept that specific areas of the feet (reflex points) correspond to individual internal organs within the body. Reflexologists trained in the popular Ingham reflexology method claim that massage to these points, using massage techniques unique to reflexology, stimulates an increase in blood supply to the corresponding organ. Reflexology researchers face two key methodological challenges that need to be addressed if a specific treatment-related hemodynamic effect is to be scientifically demonstrated. The first is the problem of inconsistent reflexology foot maps; the second is the issue of poor experimental controls. This article proposes a potential experimental solution that we believe can address both methodological challenges and in doing so, allow any specific hemodynamic treatment effect unique to reflexology to experimentally reveal itself

What is the mechanism effect that links social support to coping and psychological outcome within individuals affected by prostate cancer? Real time data collection using mobile technology

Abstract Unmet support needs are prevalent in men affected by prostate cancer. Moreover, little is known about the optimal type of social support, or its mechanism effect between coping and emotional outcome in men affected by this disease to identify areas for clinical intervention. This study aimed to empirically test the propositions of social support theory in “real time” within individual men living with and beyond prostate cancer. Purposeful sub-sample from a larger prospective longitudinal study of prostate cancer survivors, took part in real time data collection using mobile technology. Self-reports were collected for 31 days prompted by an audio alarm 3 times per day (a total of 93 data entries) for each of the 12 case studies. Electronic data were analysed using time series analysis. Majority of response rates were >90%. Men reported a lack of satisfaction with their support over time. Testing the propositions of social support theory “within individuals” over time demonstrated different results for main effect, moderation and mediation pathways that linked coping and social support to emotional outcome. For two men, negative effects of social support were identified. For six men the propositions of social support theory did not hold considering their within-person data. This innovative study is one of the first, to demonstrate the acceptability of e-health technology in an ageing population of men affected by prostate cancer. Collectively, the case series provided mixed support for the propositions of social support theory, and demonstrates that “one size does not fit all”

Evaluation of Flying Start NHS

Introduction In January 2006 “Flying Start NHS”, a national web-based educational resource to support the transition from student to qualified practitioner for all newly qualified nurses, midwives and allied health professionals (NMAHP) joining NHS Scotland was launched. This report brings together the findings from a two-year evaluation which focussed on the impact and effectiveness of Flying Start NHS in supporting the recruitment, confidence and skills development of newly qualified nurses, midwives and allied health professionals within NHS Scotland. The evaluation was carried out be a research team from the University of the West of Scotland, the University of Stirling, and the University of Dundee

The Report of the Evaluation of Fitness For Practice Pre-Registration Nursing and Midwifery Curricula Project

1.1 Introduction The debate about the competence of newly qualified nurses and midwives has a long and contentious history. Much of this debate has not been informed by a strong evidence-base, but has often relied on anecdote, personal experience and deeply held opinion. Recently, Clark and Holmes (2007) reported findings that in England ward mangers have low expectations of newly qualified nurses, who themselves reported feeling poorly prepared for their new role. Whether this reflects an accurate picture of real competence is open to question and this potential disjuncture between judgements about competency and actual competency is at the heart of this evaluation. The wider political debate on pre-registration curricula shows little sign of disappearing with the current RCN General Secretary questioning the competence of newly qualified nurses (Snow & Harrison 2008). Such pronouncements by high-profile figures have characterised much of the debate around preregistration education since the Project 2000 curriculum. The literature outlined in this chapter will extend to exploring social cognitive theory (Bandura 1977). Many evaluations of pre-registration curricula are atheoretical and it is the intention of this evaluation to avoid such a significant limitation by explicitly locating the evaluation within a theoretical framework