‘Out of the Blue’ A qualitative evaluation of the Home-Start Perinatal Mental Health Project

Commissioned piece of research and report for the Home-Start Hertfordshire charityFinal Published versio

Queerying activism through the lens of the sociology of everyday life

The approaching 30th anniversary of the introduction of the 1988 Local Government Act offers an opportunity to reflect on the nature of lesbian, gay and bisexual (LGB) activism in Britain. The protests against its implementation involved some of the most iconic moments of queer activism. Important though they are, these singular, totemic moments give rise to, and are sustained by small, almost unobtrusive acts which form part of LGB people’s everyday lives. This article aims to contribute to a re-thinking of queer activism where iconic activism is placed in a synergetic relationship with the quieter practices in the quotidian lives of LGB people. The authors interrogate a series of examples, drawn from three studies, to expand ideas about how activism is constituted in everyday life. They discuss the findings in relation to three themes: the need to forge social bonds often forms a prompt to action; disrupting the binary dualism between making history and making a life; and the transformative potential of everyday actions/activism. The lens of the sociology of everyday life (1) encourages a wider constituency of others to engage in politics, and (2) problematises the place of iconic activism.Peer reviewe

Older Bisexual People: Implications For Social Work From The ‘Looking Both Ways’ Study

There is a growing social work literature about lesbian, gay, bisexual and transgender (LGBT) older people. However, research and guidance are predominantly based on the experiences of older gay men and, to a lesser extent, older lesbians. There is little to help practitioners work with older bisexual people. The Looking Both Ways study aimed to contribute to this gap in knowledge. We undertook in-depth purposely-sampled qualitative interviews with 12 people aged over 50, all of whom have bisexual relationship histories and half of whom also currently identify as bisexual. There were three main findings. Firstly, biphobia (prejudice against bisexual people) impacts on older people with bisexual histories in ways that may affect their wellbeing in later life. Secondly, concerns around receiving care are similar in some ways and different in others from the concerns of lesbians and gay men. Thirdly, people with bisexual relationship histories may have developed strong support networks and resilience, factors that may be very beneficial in later life. Three recommendations for social work professionals were identified: 1) understand biphobia, 2) recognise the legitimacy of concerns about receiving care, and 3) ask about support networks rather than assuming family support

Experiences of and responses to disempowerment, violence, and injustice within the relational lives of lesbian, gay, bisexual, transgender, and queer people

© 2020 The Author(s). The final, definitive version of this paper has been published in Journal of Sociology by Sage Publications Ltd. All rights reserved. It is available at: https://doi.org/10.1177/1440783320958812.This article introduces a special edition of the Journal of Sociology that aims to interrogate the ongoing entrenchment of hetero- and cis-normative borders, and the consequential manifestations of power, violence and in/justice experienced by lesbian, gay, bisexual, transgender and queer (LGBTQ) people in their relationships and family lives. The articles in this issue all explore different forms of violence, injustice, and persecution that continue to exist despite the success of many social justice campaigns in recent years for LGBTQ people. This article provides a synopsis of the research in this collection – research which demonstrates and expands our understandings of the complexities of LGBTQ lives around the globe negotiating empowerment, safety, and justice. We highlight the ongoing importance of this work as LGBTQ people around the world are experiencing the disproportionate impact of the Covid-19 pandemic.Peer reviewe

Women parenting together : motherhood and family life in same sex relationships

This study is based on joint and separate in-depth interviews with twenty (female) same sex couples who planned and had their children together in the context of their relationship. These families are one example of the increasing possibilities to live in non-traditional relationships and family forms, in contemporary Western societies. While lesbian and gay parents have a long history, there is little precedence for same sex couples setting up families 'from scratch' i.e. choosing to have children in the context of their relationship. These possibilities can be placed in the context of wider transformations of intimacy. There is widespread agreement that individualism in personal relationships has substantially increased, although opinions differ about the extent to which this individualism is essentially selfish. Lesbian parents, for example, have been portrayed as selfish individuals (Phillips, 1998) or alternatively as 'prime everyday experimenters' (Giddens, 1992), although the reality may be more nuanced than either of these polarities suggests. Overall, recent sociological research into both heterosexual and 'non-heterosexual' family lives suggests that transformations of intimacy are characterised by negotiated commitments and moral reasoning. However, to date, relatively little attention has been paid to the ways in which these themes may be modified by the presence of dependent children, particularly given the socially constructed nature of children's needs. Respondents in my study are involved in both innovative family practices and the care of dependent children. As such, they can offer new insights to the above debates. They present a radical departure from dominant conventions of heterosexual gendered family norms and the biological imperatives of reproduction. However, while working out new ways of doing family, these practices are located within deeply conventional moralities of motherhood, which leave little space within which to offer up new stories of doing family

Exploring caregivers’ experiences of caring for men with advanced prostate cancer in a resource-poor setting: a qualitative serial interview study

Background: Family caregivers who assume the responsibility of care for patients living with advanced diseases could have challenges especially in resource-poor settings. The bulk and responsibility for care are predominantly provided by the family caregivers within the informal sector. The family caregivers, therefore, could be described as the ‘general practitioners’ of the patients at home. Using a qualitative study, the experiences of the family caregivers caring for men with advanced prostate cancer were explored. Methods: Using serial qualitative approach, 23 in-depth individual and dyad interviews were conducted. Patients and their caregivers participated in repeat interviews approximately 2 months apart, across a period of up to 6 months. Transcribed interviews were analysed using thematic analysis. Findings: This paper focuses on the experiences of family caregivers in the light of inadequate resources for care. Two main themes emerged from the data: Challenges and burden of care, and the support and coping strategies adopted. The family caregivers expressed the overburden nature of the care, ‘feeling of being alone in the middle of a deep sea’, disruption of their lives, and unhappiness and the fear of an unknown future. On the other hand, they rely on the support of the social network of the extended family, their faith in God, and the positive aspect of living helped to mitigate some of the challenges. The belief in reciprocity and ‘giving back’ through caring for their loved ones were highlighted by participants. Conclusion: Generally, the informal social network helped in the care at home. However, the magnitude of the adverse changes in their lives and challenges associated with the caring role was dependent on factors such as the level of care required, financial and other resources available, and the coping mechanisms in place. Efforts to enhance existing social support systems are recommended

‘Out of the frying pan into the fire’: a qualitative study of the impact on masculinity for men living with advanced prostate cancer

© The Author(s), 2023. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/)Background: Studies have highlighted how advanced prostate cancer causes biographical disruption and presents challenges to masculine identities for men. This article draws on a wider study that focused on the experiences of men living with advanced prostate cancer and their caregivers. Although men’s experience of advanced illness is not overlooked in the literature, only a small body of work has taken an in-depth look at men’s experiences with advanced prostate cancer and their caregivers in a non-Westernised cultural and social context. Objective:: To explore how advanced prostate cancer impacts on men’s masculine identity from the perspective of patients and their caregivers. Methods:: A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results:: The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the ‘frying pan into the fire’. Conclusion:: This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men’s masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers. Objective: To explore how advanced prostate cancer impacts on men’s masculine identity from the perspective of patients and their caregivers. Methods: A qualitative study of men living with advanced prostate cancer (n = 23) and family caregivers (n = 23) in Ghana. We used the Consolidated Criteria for Reporting Qualitative Studies (COREQ) as the reporting guideline. Results: The findings from this study highlight profound challenges for most men to their masculine identities, from both the treatment and the symptoms of advanced prostate cancer within a non-Westernised, patriarchal society. Four main themes were developed. These were the impact on masculinity in terms of: (1) physical changes, (2) sexual ability, (3) socio-economic roles and (4) expressing emotions. Changes in physical appearance, feeling belittled, having no active sexual life and the inability to continue acting as provider and protector of the family made some men describe their situation as one of moving out of the ‘frying pan into the fire’. Conclusion: This study revealed the impact of advanced prostate cancer on masculine identity. These narratives add a new dimension to what is already known about the impacts on men’s masculine identities when dealing with advanced prostate cancer. This knowledge can help improve the care provided to men with advanced prostate cancer with emphasis on the cultures, beliefs and aspirations of these men and their caregivers.Peer reviewe

‘My wife is my doctor at home’: A qualitative study exploring the challenges of home-based palliative care in a resource-poor setting

© The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: Family caregiving is common globally, but when a family member needs palliative and end-of-life care, this requires knowledge and expertise in dealing with symptoms, medication, and treatment side effects. Caring for a family member with advanced prostate cancer in the home presents practical and emotional challenges, especially in resource-poor contexts, where there are increasing palliative cases without adequate palliative care institutions. Aim: The study explored palliative and end-of-life care experiences of family caregivers and patients living at home in a resource-poor context in Ghana. Design: This is a qualitative study using thematic analysis of face-to-face interviews at two-time points. Participants: Men living with advanced prostate cancer (n = 23), family caregivers (n = 23), healthcare professionals (n = 12). Findings: Men with advanced prostate cancer face complex issues, including lack of access to professional care and a lack of resources for homecare. Family caregivers do not have easy access to professional support; they often have limited knowledge of disease progression. Patients have inadequate access to medication and other practical resources for homecare. Caregivers may be overburdened and perform the role of the patient’s ‘doctor’ at home-assessing patient’s symptoms, administering drugs, and providing hands-on care. Conclusion: Home-based care is promoted as an ideal and cost-effective model of care, particularly in Westernised palliative care models. However, in resource-poor contexts, there are significant challenges associated with the implementation of this model. This study revealed the scale of challenges family caregivers, who lack basic training on aspects of caring, face in providing home care unsupported by healthcare professionals.Peer reviewedFinal Published versio

Women parenting together : motherhood and family life in same sex relationships

This study is based on joint and separate in-depth interviews with twenty (female) same sex couples who planned and had their children together in the context of their relationship. These families are one example of the increasing possibilities to live in non-traditional relationships and family forms, in contemporary Western societies. While lesbian and gay parents have a long history, there is little precedence for same sex couples setting up families 'from scratch' i.e. choosing to have children in the context of their relationship. These possibilities can be placed in the context of wider transformations of intimacy. There is widespread agreement that individualism in personal relationships has substantially increased, although opinions differ about the extent to which this individualism is essentially selfish. Lesbian parents, for example, have been portrayed as selfish individuals (Phillips, 1998) or alternatively as 'prime everyday experimenters' (Giddens, 1992), although the reality may be more nuanced than either of these polarities suggests. Overall, recent sociological research into both heterosexual and 'non-heterosexual' family lives suggests that transformations of intimacy are characterised by negotiated commitments and moral reasoning. However, to date, relatively little attention has been paid to the ways in which these themes may be modified by the presence of dependent children, particularly given the socially constructed nature of children's needs. Respondents in my study are involved in both innovative family practices and the care of dependent children. As such, they can offer new insights to the above debates. They present a radical departure from dominant conventions of heterosexual gendered family norms and the biological imperatives of reproduction. However, while working out new ways of doing family, these practices are located within deeply conventional moralities of motherhood, which leave little space within which to offer up new stories of doing family

Development and evaluation of an LGBT+ education programme for palliative care interdisciplinary teams

© 2021 The Authors. This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/Background: Despite national policy recommendations to enhance healthcare access for LGBT+ (lesbian, gay, bisexual, transgender, and those who do not identify as cisgender heterosexual) people, education on LGBT+ issues and needs is still lacking in health and social care curricula. Most of the available resources are focused on primary care, mental health, and sexual health, with little consideration to broader LGBT+ health issues and needs. The limited available educational programmes pertaining to LGBT+ individuals outside the context of sexual or mental health have mainly focused on cancer care or older adults. Aim: To support palliative care interdisciplinary teams to provide LGBT+ affirmative care for people receiving and needing palliative and end-of-life care. Methods: A 1½-h workshop was developed and evaluated using Kotter’s eight-step process for leading change. Across four hospices, 145 health and social professionals participated in the training. A quasi-experimental non-equivalent groups pre–post-test design was used to measure self-reported levels of knowledge, confidence, and comfort with issues, and needs and terminology related to LGBT+ and palliative care. Results:: There was a significant increase in the reported levels of knowledge, confidence, and comfort with issues, needs, and terminology related to LGBT+ and palliative care after attending the training. Most participants reported that they would be interested in further training, that the training is useful for their practice, and that they would recommend it to colleagues. Conclusion: The project illustrates the importance of such programmes and recommends that such educational work is situated alongside wider cultural change to embed LGBT+-inclusive approaches within palliative and end-of-life care services.Peer reviewe