• Excellent cross-cultural validity, intra-test reliability and construct validity of the Dutch Rivermead Mobility Index in patients after stroke undergoing rehabilitation

      Roorda, L.D.; Green, J.R.; De Kluis, K.R.; Molenaar, I.W.; Bagley, Pamela J.; Smith, J.; Geurts, A.C. (2008)
      OBJECTIVE: To investigate the cross-cultural validity of international Dutch-English comparisons when using the Dutch Rivermead Mobility Index (RMI), and the intra-test reliability and construct validity of the Dutch RMI. METHODS: Cross-cultural validity was studied in a combined data-set of Dutch and English patients undergoing rehabilitation after stroke, who were assessed with the Dutch version of the RMI and the original English RMI, respectively. Mokken scale analysis was used to investigate unidimensionality, monotone homogeneity model fit, and differential item functioning between the Dutch and the English RMI. Intra-test reliability and construct validity were studied in the Dutch patients by calculating the reliability coefficient and correlating the Dutch RMI and the Dutch Barthel Index. RESULTS: The RMI was completed for Dutch (n = 200) and English (n = 420) patients after stroke. The unidimensionality and monotone homogeneity model fit of the RMI were excellent: combined Dutch-English data-set (coefficient H = 0.91); Dutch data-set (coefficient H = 0.93); English data-set (coefficient H = 0.89). No differential item functioning was found between the Dutch and the English RMI. The intra-test reliability of the Dutch RMI was excellent (coefficient rho = 0.97). In a sub-sample of patients (n = 91), the Dutch RMI correlated strongly with the Dutch Barthel Index (Spearman's correlation coefficient rho = 0.84). CONCLUSION: The Dutch RMI allows valid international Dutch-English comparisons, and has excellent intra-test reliability and construct validity.
    • Exercise and physical activity in asylum seekers in Northern England; using the theoretical domains framework to identify barriers and facilitators

      Haith-Cooper, Melanie; Waskett, Catherine; Montague, Jane; Horne, Maria (2018)
      Background: Many asylum seekers have complex mental health needs which can be exacerbated by the challenging circumstances in which they live and difficulties accessing health services. Regular moderate physical activity can improve mental health and would be a useful strategy to achieve this. Evidence suggests there are barriers to engaging black and minority ethnic groups in physical activity, but there is little research around asylum seekers to address the key barriers and facilitators in this group. Methods: A two stage qualitative study used semi-structured interviews underpinned by the Theoretical Domains Framework. The interviews were conducted in voluntary sector groups in four towns/ cities in Northern England. Purposive sampling recruited 36 asylum seekers from 18 different countries. Interviews were audio recorded, transcribed verbatim and subject to framework analysis. Stage two involved a nominal group technique with five key stakeholders including asylum seekers and those that work with them. They followed a four stage process to rank and reach consensus on the key barrier to undertaking physical activity/ exercise that could be addressed locally through a future intervention. Results: A number of barriers and facilitators were identified including a lack of understanding of the term physical activity and recommended levels but knowledge of the health benefits of physical activity/ exercise and the motivation to increase levels having engaged with activities back home. Living as an asylum seeker was considered a barrier due to the stress, poverty and temporary nature of living in an unfamiliar place. The outcome of the nominal group technique was that a lack of knowledge of facilities in the local area was the prevailing barrier that could be addressed. Conclusions: Public health practitioners could develop interventions which capitalise on the motivation and knowledge of asylum seekers to encourage an increase in physical activity which may in turn reduce the breadth and depth of mental health needs of this group.
    • Expanding training capacity for radiographer reporting using simulation: Evaluation of a pilot academy project

      Harcus, J.W.; Snaith, Beverly (2019-11)
      Introduction: Whilst there is increasing demand on radiology services in the UK, pressures are restricting the expansion of the multi-professional workforce. A pilot academy for radiography reporting was established to augment the traditional university and clinical education in a simulated environment using focussed teaching and real image worklists in a dedicated environment away from departments. Methods: Located at a facility to replicate the clinical reporting environment, the emphasis of the nine-month pilot was to provide extensive ‘hands-on’ training to eight trainees. Evaluation of the academy was undertaken through focus groups, telephone interviews, and online surveys to consider the experiences of the trainees and their managers and mentors. Results: There was overwhelming support for the academy from trainees, mentors, and managers. Key benefits included relieving pressures on department and mentors; providing an intense, structured, and safe environment to learn; and, perhaps most importantly, an extensive and cohesive peer-support network. Issues identified included conflict within departments due to differences in reporting style and the need for greater collaboration between the university, academy, and departments. Conclusion: The use of simulation in education is widely researched, however, there are a number of key factors that need to be considered when implementing it into practise. Peer-support and reflection is seen as essential for its success. Extensive dedicated time to focus on reporting alongside peers can support the development of these skills away from the clinical environment and as such can reduce pressure on service delivery and positively influence learner outcomes.
    • Expectations and realities of Student Nurses' Experiences of negative Behaviour and Bullying in Clinical Placement and the Influences of Socialisation Processes.

      Hoel, H.; Giga, Sabir I.; Davidson, M.J. (2007)
      This paper explores nursing students' experiences and perceptions of negative behaviour and bullying in clinical placement measured against expectations at the start of their education. It explores their understanding and how they make sense of their circumstances and their experiences of negative behaviour, emphasizing socialization processes and factors which may prevent or reproduce negative behaviour and bullying. To this end, a focus group study was conducted, and this revealed that many students felt exploited, ignored or were made to feel unwelcome, although few reported personal experience of bullying. These frequent but less severe negative experiences appear to play a key role in institutionalizing an unwelcoming culture within which bullying could easily be triggered or take hold. Students' coping mechanisms may also contribute to reproducing such negative behaviour. The paper concludes that while the vulnerable position of student nurses might offer some protection against outright bullying, it is unable to shield them from unfriendly and negative behaviour, with implications for their learning and professional socialization. If student nurses respond to their experiences by suppressing their feelings and developing a hard front, such responses may themselves contribute to a reproduction of such behaviour with implications for personal wellbeing and retention rates.
    • The experience of living with stroke and using technology: opportunities to engage and co-design with end users

      Nasr, N.; Leon, B.; Mountain, Gail; Nijenhuis, S.M.; Prange, G.B.; Sale, P.; Amirabdollahian, F. (2016)
      Purpose: We drew on an interdisciplinary research design to examine stroke survivors’ experiences of living with stroke and with technology in order to provide technology developers with insight into values, thoughts and feelings of the potential users of a to-be-designed robotic technology for home-based rehabilitation of the hand and wrist. Method: Ten stroke survivors and their family carers were purposefully selected. On the first home visit, they were introduced to cultural probe. On the second visit, the content of the probe packs were used as prompt to conduct one-to-one interviews with them. The data generated was analysed using thematic analysis. A third home visit was conducted to evaluate the early prototype. Results: User requirements were categorised into their network of relationships, their attitude towards technology, their skills, their goals and motivations. The user requirements were used to envision the requirements of the system including providing feedback on performance, motivational aspects and usability of the system. Participants’ views on the system requirements were obtained during a participatory evaluation. Conclusion: This study showed that prior to the development of technology, it is important to engage with potential users to identify user requirements and subsequently envision system requirements based on users’ views.
    • Experiences and Outcomes Among Undergraduate Health Professional Higher Education Students With Protected Characteristics: Disability, Gender, and Ethnicity

      McClelland, Gabrielle T.; Horne, Maria; Dearnley, Christine A.; Raynsford, Justine; Irving, Donna (2015)
      The Dean of the School of Health Studies at the University of Bradford, requested a review of the experiences and outcomes amongst undergraduate health professional higher education students with protected characteristics (as defined by the Equality and Human Rights Commission, 2010). The rational for this work was the University of Bradford’s recognition that all students are entitled to a valuable and rewarding university experience regardless of age, ability, gender or ethnicity. Across the higher education sector nationally, it has been suggested that whilst many students benefit from positive outcomes and experiences, some do not. This literature review was undertaken, as a precursor to a wider project, in order to report on current published research illustrating examples of negative and positive student experiences and outcomes in health higher education. Objectives - To review available literature in order to examine the relationship between undergraduate health professional students with protected characteristics and their experiences and outcomes in health higher education. - To identify and report examples of good practice relating to the review aims Method The literature review was undertaken systematically, using a protocol-based approach between 31.01.14 and 31.07.14. Only primary or secondary research data were included in the review. Databases and search terms were pre-specified and literature published between 2010 and 2014 was retrieved. Data bases searched included CINAHL, Medline, ERIC, BHI ASSIA and the Higher Education Academy. Papers were screened at title and abstract against exclusion criteria and eligible papers were included in the review. Results Thirty seven papers were included in this review. Data were broadly organized and displayed through the Equality and Human Rights Commission (2010) protected characteristics categories. These included the presentation of three categories: disability, gender and ethnicity. No papers relating to age were included. Data describing both negative and positive student experiences and outcomes was presented in the context of medical, nursing and allied health professions. Discussion Findings were presented in a narrative format. Included literature predominantly centred on pre-registration nursing students and ethnicity. There were more examples of negative student experiences and outcomes with fewer positive examples to report. Further empirical and secondary research focusing on age, disability, gender and ethnicity is required. The review also highlights the need to examine each protected characteristic student group independently to enable closer examination of specific issues.
    • The experiences of pregnant migrant women in detention: A qualitative study

      Arshad, F.; Haith-Cooper, Melanie; Palloti, P. (2018-09)
      Background: Pregnant migrant women held in detention centres in the UK can be particularly vulnerable. They may have poor physical and mental health, which is exacerbated by their incarceration, and are at a disproportionally increased risk of maternal and perinatal mortality. Unpublished studies have found that pregnant migrant women have poor experiences in detention. Aim: To explore pregnant migrant women's experiences of living in detention. Method: Four migrant women who had been held in detention while pregnant and two volunteer health professionals were interviewed. Findings: Results suggest that migrant women have very poor experiences in detention. Four key themes emerged: ‘challenges to accessing UK healthcare’, ‘exacerbation of mental health conditions, ‘feeling hungry’ and ‘lack of privacy’. Conclusion: These findings could be used to review maternity care in detention and ensure that detention staff understand the experiences of detained pregnant women so that the needs of this vulnerable group can be met.
    • An exploration of migrant women’s perceptions of public health messages to reduce stillbirth in the UK: a qualitative study

      Stacey, T.; Haith-Cooper, Melanie; Almas, Nisa; Kenyon, C. (2021-05)
      Background: Stillbirth is a global public health priority. Within the United Kingdom, perinatal mortality disproportionately impacts Black, Asian and minority ethnic women, and in particular migrant women. Although the explanation for this remains unclear, it is thought to be multidimensional. Improving perinatal mortality is reliant upon raising awareness of stillbirth and its associated risk factors, as well as improving maternity services. The aim of this study was to explore migrant women’s awareness of health messages to reduce stillbirth risk, and how key public health messages can be made more accessible. Method: Two semi-structured focus groups and 13 one to one interviews were completed with a purposive sample of 30 migrant women from 18 countries and across 4 NHS Trusts. Results: Participants provided an account of their general awareness of stillbirth and recollection of the advice they had been given to reduce the risk of stillbirth both before and during pregnancy. They also suggested approaches to how key messages might be more effectively communicated to migrant women. Conclusions: Our study highlights the complexity of discussing stillbirth during pregnancy. The women in this study were found to receive a wide range of advice from family and friends as well as health professionals about how to keep their baby safe in pregnancy, they recommended the development of a range of resources to provide clear and consistent messages. Health professionals, in particular midwives who have developed a trusting relationship with the women will be key to ensuring that public health messages relating to stillbirth reduction are accessible to culturally and linguistically diverse communities.
    • An exploration of online access by non-traditional students in higher education: A case study.

      Dearnley, Christine A.; Dunn, G.; Watson, S. (2006)
      The nature of Higher Education (HE) has seen many changes throughout the last decade. The agenda for widening participation in HE has led to an increase in the number of students with a broader range of educational backgrounds. At the same time there has been a surge in the development of digitalisation and the convergence of computing and telecommunications technologies available for use in education. This paper discusses the outcomes of a case study, conducted in a School of Health Studies within a northern English University, which identified the extent to which `non-traditional¿ students access on-line learning facilities, such as virtual learning environments and library networks, and what factors enhanced or formed barriers to access. `Non-traditional¿ students, for the purpose of this study, were defined as mature students who were returning to higher education after a considerable break. The outcomes indicated that skill deficit is a major obstacle for many `non-traditional¿ students. The paper explores this issue in depth and suggests potential ways forward for the delivery of technology supported learning for `non-traditional¿ students in Higher Education.
    • An exploration of the impact of SARS-CoV-2 (COVID-19) restrictions on marginalised groups in the UK

      Eshareturi, Cyril; Wareham, C.; Rattray, Marcus; Haith-Cooper, Melanie; McCarthy, R. (2021-08)
      Background: To contain the spread of COVID-19 within the UK over the past year, there have been a series of local and national lockdowns. These restrictions are likely to have impacted upon the health and well-being of marginalised groups who rely on now closed social and community support services to stay healthy. An understanding of the experiences of marginalised people is important; therefore, this study aimed to explore the impact of the COVID-19 restrictions on the health and well-being of marginalised groups in the UK. Methods: In summer 2020, a rapid telephone survey was conducted by trained, trusted volunteers with 76 participants who were from marginalised groups. As part of this survey, 64 participants consented to describe their experience of lockdown. These case studies were thematically analysed to identify patterns of meaning. Results: Findings indicate that lockdown led to the deterioration of health of participants, impacted adversely on their socio-economic positions and affected access to food and essential supplies. In addition, government public health messaging was considered confusing and inadequate. Conclusions: This study highlights the need for pathways into services which support marginalised groups to remain accessible during periods of restrictions and essential supplies and food to be mapped and protected for marginalised individuals within our local communities.
    • An exploration of tutors’ experiences of facilitating problem-based learning. Part 1: An educational research methodology combining innovation and philosophical tradition

      Haith-Cooper, Melanie (2003)
      The use of problem-based learning (PBL) in Health Professional curricula is becoming more wide spread. Although the way in which the tutor facilitates PBL can have a major impact on students’ learning (Andrews and Jones 1996), the literature provides little consistency as to how the tutor can effectively facilitate PBL ( Haith-Cooper 2000 ). It is therefore important to examine the facilitation role to promote effective learning through the use of PBL. This article is the first of two parts exploring a study that was undertaken to investigate tutors’ experiences of facilitating PBL. This part focuses on the methodology and the combining of innovative processes with traditional philosophical traditions to develop a systematic educational research methodology. The study was undertaken respecting the philosophy of hermeneutic phenomenology but utilised alternative data collection and analysis technique. Video conferencing and e-mail were used in conjunction with more traditional processes to access a worldwide sample. This paper explores some of the issues that arose when undertaking such a study. The second article then focuses on exploring the findings of the study and their implications for the facilitation of PBL.
    • An exploration of tutors’ experiences of facilitating problem-based learning. Part 2: Implications for the facilitation of problem-based learning

      Haith-Cooper, Melanie (2003)
      This paper is the second of two parts exploring a study that was undertaken to investigate the role of the tutor in facilitating problem-based learning (PBL). The first part focussed on the methodological underpinnings of the study. This paper aims to focus on the findings of the study and their implications for the facilitation of PBL. Six essential themes emerged from the findings that described the facilitation role. The tutors believed that their facilitation role was essentially structured around the decision of when to intervene and how to intervene in the PBL process. Modelling and non-verbal communication were seen as essential strategies for the facilitator. Underpinning these decisions was the need to trust in the philosophy of PBL. However, within many of the themes, there was a divergence of opinion as to how the role should actually be undertaken. Despite this, these findings have implications for the future role of PBL facilitators in Health Professional Education.
    • Exploratory study of fathers providing Kangaroo Care in a Neonatal Intensive Care Unit

      Dong, Q.; Steen, M.; Wepa, Dianne; Eden, A. (2022)
      Aim and Objectives: To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU). Background: Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs. Methods: Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study. Findings: Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: ‘Positive psychological connection’, ‘Embracing father-infant Kangaroo Care’ and ‘Challenges to father-infant Kangaroo Care’. Conclusion: The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father–infant KC within the fields of neonatal care. Relevance to Clinical Practice: It is important for nurses and other health professionals to support and enable fathers to give KC. Father–infant KC is recommended in neonatal care settings.
    • Exploring Diversity Management in Transnational Corporations Through the Lens of Migration and Expatriation

      Utam, Kingsley U.; Archibong, Uduak E.; Walton, S.; Eshareturi, Cyril (2020)
      In this study, we aim to develop an understanding of the similarity between migration and expatriation, identify both as elements in diversity, and draw attention to the additional layer of ethnic diversity created by the high number of top management expatriates in some Nigerian subsidiaries of transnational corporations. Using the qualitative research design, we thematically analysed data from semistructured interviews with six indigenous managers in four transnational corporations. We found a significant number of expatriate managers in two subsidiaries and a lack of diversity management framework to address the new layer of diversity as reflected in the unequal treatment of indigenous managers. We conclude that migration and expatriation are similar and could be better managed through effective diversity management framework.
    • Exploring the care needs of patients with advanced COPD: an overview of the literature

      Gardiner, C.; Gott, M.; Payne, S.; Small, Neil A.; Barnes, S.; Halpin, D.; Ruse, C.; Seamark, D. (2010)
      Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition worldwide and is associated with significant mortality. This paper gives an overview of the relevant literature regarding care needs in advanced COPD from the perspective of the patient or carer, and aims to explore the appropriateness of a palliative care approach in this group. Publications revealed that patients with COPD have a high symptom burden that impacts on quality of life and social functioning. Information provision in COPD is often lacking and the implications of diagnosis and prognosis are not routinely discussed. The impact on families and carers is considerable, many patients have significant care requirements which can affect family relationships. Although patients with COPD have regular contact with health services, access to specialist services and palliative care is poor. This paper highlights the need for increased provision for palliative care in COPD, alongside dedicated education and training for health professionals, and continued research to identify the most appropriate ways of delivering this care.
    • Exploring the delivery of antiretroviral therapy for symptomatic HIV in Swaziland: threats to the successful treatment and safety of outpatients attending regional and district clinics

      Armitage, Gerry R.; Hodgson, Ian J.; Wright, J.; Bailey, K.; Mkhwana, E. (2011)
      AIM: To examine the safety and acceptability of providing antiretroviral therapy (ART) in a resource poor setting. DESIGN: Two-stage observational and qualitative study. SETTING: Rural hospital in Southern Africa. METHODS: Structured observation using failure modes and effects analysis (FMEA) of the drug supply, dispensing, prescribing and administration processes. The findings from the FMEA were explored further in qualitative interviews with eight health professionals involved in the delivery of ART. To obtain a patient perspective, a stratified sample of 14 patients receiving ART was also interviewed. RESULTS: Key vulnerabilities in the process of ART provision include supply problems, poor packaging and labelling, inadequate knowledge among staff and lack of staff. Key barriers to successful patient adherence include transport inconsistency in supply and personal financial difficulties. There is, however, strong evidence of patient commitment and adherence. IMPLICATIONS AND CONCLUSION: Medication safety is relatively unexplored in the developing world. This study reveals an encouraging resilience in the health system and adherence among patients in the delivery of complex ART. The vulnerabilities identified, however, undermine patient safety and effectiveness of ART. There are implications for drug manufacturers; international aid agencies funding and supplying ART; and local practitioners. FMEA can help identify potential vulnerabilities and inform safety improvement interventions.
    • Exploring the health service response to women experiencing domestic violence in Wakefield: adopting a discursive approach

      Lavis, Victoria J.; Horrocks, Christine; Kelly, Nancy (University of Huddersfield, 2005-12)
      This report presents the findings of a research study exploring the health service response to domestic violence within Wakefield. Recent international, national and local research has identified domestic violence as a serious health care issue resulting in a wide range of long and short term health implications for women1 (Butler, 1995: Stark and Flitcraft, 1995, 1996: Campbell, 2002). The research highlights the changing face of domestic violence considering the implications of the recent reframing of domestic violence from a social care issue into an integrated health and social care issue (Glendinning, 2003). Explored is the impact of such changes for health policy makers, health professionals and women who having experienced domestic violence then access health care services in the District.
    • Exploring the obesity concerns of British Pakistani women living in deprived inner-city areas: A qualitative study

      Iqbal, Halima; West, Jane; McEachan, Rosemary; Haith-Cooper, Melanie (2022)
      British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner-city areas of Bradford. Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women-only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis.