• Developing an Australia wide approach to IPE leadership and sustainability

      Moran, Monica; Forman, Dawn; O’Keefe, Maree; Steketee, Carole; Rogers, Gary D.; Dunston, Roger; University of Western Australia, Geraldton, Australia; University of Derby; University of Adelaide, Australia; University of Notre Dame, Fremantle, Australia; et al. (Springer International Publishing, 2020-07-28)
      Australia is a country and a continent. Whilst health standards are ranked amongst the best in the world, its immense size and distributed population creates unique challenges for the delivery of integrated health and social care services.
    • Developing and maintaining leadership, resilience and sustainability in interprofessional collaboration

      Forman, Dawn; University of Derby (Springer International Publishing, 2020-07-28)
      Interprofessional collaboration has grown significantly in health care organisations, becoming a critical part of the way in which health and social care is delivered. It is now seen as an essential part of effective health care delivery. Health professionals can be assigned to designated teams due to the increasing complexity of health care delivery, or more commonly a number of professionals with different expertise work together in collaborations which can be configured over some distance (Thistlethwaite, Dunston, & Yassine in Journal of Interprofessional Care 32:745–751, 2019).
    • Governance options for effective interprofessional education: Exposing the gap between education and healthcare services

      O’Keefe, Maree; Forman, Dawn; Moran, Monica; Steketee, Carole; The University of Adelaide, Australia; University of Derby; The University of Western, Australia; The University of Notre Dame Australia (Informa UK Limited, 2020-07-24)
      The increase in interprofessional models of collaborative practice and identification of health services as interprofessional organisations, sits somewhat awkwardly with traditional governance systems for both health services and educational institutions. Whereas health services have a primary focus on assuring competence and safety for health care practice, educational institutions have a primary focus on assuring academic standards within specific qualifications. Bridging the gap between these two systems with a workable option has proven challenging, especially in relation to interprofessional education (IPE). Given the need to ensure ‘work ready’ graduates within a more interprofessional and collaborative workforce, it is important to review the quality assurance governance models that are in place and to consider which of these existing governance systems, if either, is the more appropriate model for enabling and supporting IPE. This paper describes current issues in relation to governance for quality assurance, summarises the current state of research in the field and discusses potential governance options moving forward. Given that existing governance models are not meeting the challenges of IPE, there is a need to achieve greater alignment between the academic and health service governing systems.
    • Metabolic syndrome among type 2 diabetic patients in Sub-Saharan African countries: A systematic review and meta-analysis.

      Shiferaw, Wondimeneh Shibabaw; Akalu, Tadesse Yirga; Gedefaw, Mihretie; Anthony, Denis; Kassie, Ayelign Mengesha; Misganaw Kebede, Worku; Mulugeta, Henok; Dessie, Getenet; Aynalem, Yared Asmare; Debre Berhan University, Ethiopia; et al. (Elseveir, 2020-07-23)
      PubMed, Web of Science, African Journals Online, Google Scholar, Scopus, and Wiley Online Library databases from inception to April 27, 2020 were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, and 95% confidence interval across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation. All statistical analyses were done using STATA™ Version 14 software.
    • Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

      Shoesmith, Wendy; Chua, Sze Hung; Giridharan, Beena; Forman, Dawn; Fyfe, Sue; University Malaysia Sabah, Kota Kinabalu, Malaysia; Ministry of Health, Kota Kinabalu, Malaysia; Curtin University, Miri, Sarawak, Malaysia; University of Derby (Springer Science and Business Media LLC, 2020-06-19)
      There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia. In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers. The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute). This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.
    • Digital-based self-management interventions for people with osteoarthritis: Systematic review with meta-analysis

      Safari, Reza; Jackson, Jessica; Sheffield, David; University of Derby (JMIR Publications Inc., 2020-06)
      Osteoarthritis (OA) is not curable but the symptoms can be managed through Self-management programmes. Due to the growing burden of arthritis to the health system, and the need to ensure high quality integrated services, delivering Self-management programmes through digital technologies could be an economic and effective community-based model of care. To analyze the effectiveness of digital-based self-management programs on patient outcomes in people with OA. Seven online databases and three grey literature databases were searched for randomized controlled trials (RCT) assessing digital-based structured self-management programs (D-SMP) on self-reported outcomes including pain, function, disability, and health-related quality of life in people with OA. Two reviewers independently screened the search results and reference list of identified papers and related reviews. Data about the intervention components and delivery, and behavioral change techniques were extracted. Meta-analysis, risk of bias sensitivity analysis and subgroup analysis were performed where appropriate. The GRADE approach was used to assess the quality of evidence. Eight studies were eligible including 2687 people with OA. Self-management programs were delivered via telephone plus audio/video, internet or mobile app. D-SMP compared to Treatment As Usual control group resulted in a significant, homogeneous, moderate reduction in pain (SMD -0.28, 95% CI -0.38 to -0.18) and improvement in physical function (-0.26 95% CI -0.35 to -0.16) at post-treatment. The D-SMP effect reduced slightly at 12 months follow-up but remained significant and moderate. Using the GRADE approach, the quality of evidence was rated as ‘moderate’. D-SMPs may result in a moderate improvement in pain symptoms and function in people with OA delivered. Further research is required to confirm the findings of the review and assess the effects of D-SMPs on other health-related outcomes. Clinical Trial: PROSPERO: CRD42018089322
    • Against all odds—why UK mothers’ breastfeeding beyond infancy are turning to their international peers for emotional and informative support

      Jackson, Jessica; Hallam, Jenny; University of Derby (Informa UK Limited, 2020-04-01)
      The health benefits of breastfeeding are well documented and current recommendations are that women should breastfeed their child for two years and beyond. Despite this the UK has the lowest initiation breastfeeding rates in the world. Additionally, a considerably small percentage of women who do successfully initiate go on to breastfeed past infancy. This could in part be explained by the lack of support women receive when breastfeeding an older child. In this study we provide insight into women’s experiences of healthcare interventions during the transition from breastfeeding an infant to a toddler. We conducted semi-structured interviews with 24 women with experience of breastfeeding at least one child past the age of twelve months. We used a theory driven thematic analysis to identify pertinent themes that ran through the interviews. As mothers progressed through their breastfeeding journey they faced increased social stigma. They also experienced a change in attitudes from healthcare professionals as support was replaced by judgement. This negatively impacted upon trust in healthcare professionals and the advice they offered. In response, the women turned to volunteering organizations and closed social media groups for emotional support and healthcare advice. These women experienced specific issues regarding breastfeeding in toddlerhood as opposed to infancy. They needed specialized interventions tailored for this. Social media was highlighted as a useful platform for supporting women who breastfeed beyond infancy. It allowed these women to feel part of a supportive international community and gain access to practical advice. Healthcare professionals should explore ways to engage in digital platforms to provide support to mothers’ breastfeeding beyond infancy.
    • Photography

      Hogan, Susan; University of Derby (Routledge, 2020-02-24)
    • Group singing improves quality of life for people with Parkinson’s: an international study

      Irons, J. Yoon; Hancox, Grenville; Vella-Burrows, Trish; Han, E-Y; Chong, H-J; Sheffield, David; Stewart, Donald E; University of Derby; Sing to Beat Parkinson's, Cantata Canterbury Trust; Canterbury Christ Church University, Kent; et al. (Taylor & Francis, 2020-02-05)
      Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson’s (PwPs) in Australia, UK and South Korea. The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson’s health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p < .05. ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson’s. The findings are encouraging and warrant further research using more robust designs.
    • Learning and change within person-centred therapy: Views of expert therapists

      Renger, Sue; Macaskill, Ann; Naylor, Bill; Sheffield Hallam University; University of Derby (Wiley, 2020-01-12)
      Traditionally in Person-centred Therapy (PCT) clients are counselled for as long as required. It is a non-directive process. Recently, financial constraints have introduced time limits for therapy in health care, so it seemed appropriate to revisit the practice of PCT in the current UK context. The aim was to explore the concepts of learning and change within PCT and to consider whether learning is facilitated. Five experienced person-centred therapists, who were involved in educating therapists, participated in semi-structured interviews. Questions explored their views on learning and change in therapy, whether learning processes can be facilitated in PCT - both philosophically and practically, and the outcomes of PCT. Therapists were not specifically asked about time pressure but rather it was left to see if it emerged as an issue. Ten major themes emerged; learning and change, goals, learning process, PCT process, issues on non-directivity, questioning, outcomes, assessment and diagnosis, and other methods used. The issue of time pressure permeated many of these themes. Views were often contradictory reflecting the inconclusive views in the literature, particularly in relation to how clients learn and the relationship between change and learning.
    • Unnatural women: reflections on discourses on child murder and selective mortal neglect

      Hogan, Susan; University of Derby (Demeter Press, 2020-01)
      While the existence of maternal ambivalence has been evident for centuries, it has only recently been recognized as central to the lived experience of mothering. This accessible, yet intellectually rigorous, interdisciplinary collection demonstrates its presence and meaning in relation to numerous topics such as pregnancy, birth, Caesarean sections, sleep, self-estrangement, helicopter parenting, poverty, environmental degradation, depression, anxiety, queer mothering, disability, neglect, filicide and war rape. Its authors deny the assumption that mothers who experience ambivalence are bad, evil, unnatural, or insane. Moreover, historical records and cross-cultural narratives indicate that maternal ambivalence appears in a wide range of circumstances; but that it becomes unmanageable in circumstances of inequity, deprivation and violence. From this premise, the authors in this collection raise imperative ethical, social, and political questions, suggesting possibilities for vital cultural transformations. These candid explorations demand we rethink our basic assumptions about how mothering is experienced in everyday life.
    • Exploring public perspectives of e-professionalism in nursing

      Jackson, Jessica; University of Derby (RCN Publishing Ltd., 2019-12-02)
      Background E-professionalism is a term used to describe the behaviours of healthcare professionals, including nurses, in the online environment. While a range of professional guidance on the use of online social media platforms is available, there has been little research into the perspectives of patients and the public more generally on nurses’ e-professionalism. Aim To explain what, how and why the public make decisions about the acceptability of nurses’ online behaviours and e-professionalism, and to make recommendations for nurses on managing the information they share online. Method This was a mixed-method critical realist study. Participants in a survey (n=53) and two focus groups (n=8) discussed and rated the acceptability of five vignettes related to nurses’ online behaviours based on real-life examples. Findings The participants generally thought that nurses are entitled to have a personal life and freedom of speech and to promote causes they believe to be important, even if these were not aligned with their own beliefs. Participants unanimously considered the use of profane language against any individuals or groups to be unacceptable. Conclusion The public make decisions on the acceptability of nurses’ online behaviours based on a range of complex factors, including social and individual values, attitudes and beliefs, as well as their intent and consequences. Recommendations for nurses on how to manage the information they share online include: using separate platforms for personal, educational and professional purposes; using functions that control who can ‘tag’ and share their posts; and ensuring any information they share that relates to healthcare or nursing practice is up to date and evidence based.
    • Routledge international handbook of nurse education

      Dyson, Sue E.; McAllister, Margaret; University of Derby; Central Queensland University (Routledge, 2019-11-26)
      While vast numbers of nurses across the globe contribute in all areas of healthcare delivery from primary care to acute and long-term care in community settings, there are significant differences in how they are educated, as well as the precise nature of their practice. This comprehensive handbook provides a research-informed and international perspective on the critical issues in contemporary nurse education. As an applied discipline, nursing is implemented differently depending on the social, political and cultural climate in any given context. These factors impact on education, as much as on practice, and are reflected in debates around the value of accredited programmes, and on-the-job training, apprenticeship, undergraduate and postgraduate pathways into nursing. Engaging with these debates amongst others, the authors collected here discuss how, through careful design and delivery of nursing curricula, nurses can be prepared to understand complex care processes, complex healthcare technologies, complex patient needs and responses to therapeutic interventions, and complex organizations. The book discusses historical perspectives on how nurses should be educated; contemporary issues facing educators; teaching and learning strategies; the politics of nurse education; education for advanced nursing practice; global approaches; and educating for the future. Bringing together leading authorities from across the world to reflect on past, present and future approaches to nurse education and nursing pedagogy, this handbook provides a cutting-edge overview for all educators, researchers and policy-makers concerned with nurse education.
    • Nurses' knowledge and practice of pressure ulcer prevention and treatment: an observational study

      Saleh, Mohammad; Papanikolaou, Panos; Nassar, Omayyah; Shaheen, Abeer; Anthony, Denis; The University of Jordan; University of Leeds (Elsevier, 2019-10-25)
      To assess nurses’ knowledge on pressure ulcer (PU) prevention and treatment in Jordan, and the frequency of and factors influencing nurses’ implementation of PU prevention and treatment interventions. Highly educated and experienced nurses can provide effective PU care; however, previous studies highlighted poor knowledge and implementation of PU care. Design: A correlational study examining nurses’ knowledge of PU prevention and frequency of PU preventive actions in Jordanian hospitals. Participants were 377 nurses and 318 patients from 11 hospitals. Data were collected to quantify the frequency of nurses’ implementation of pressure ulcer prevention and treatment interventions for patients suffering from PUs and/or at risk of PU development using a self-reported cross-sectional survey and prospective 8-hour observation. For observed PU prevention while type of hospital and number of beds in units were significant it is not known without further work if this is replicable. For observed PU treatment, linear regression analysis revealed significant negative beta values for more than 50 beds in clinical unit (β=-2.49). The study addressed new factors, facilitating the provision of prevention and treatment strategies to PU development, including type of clinical institution and number of beds in clinical unit.
    • Using figured worlds to explore parents' attitudes and influences for choosing the content of primary school packed lunches

      Jackson, Jessica; Giles, David; Gerrard, Clarabelle; University of Derby (MAG Online Library, 2019-09-30)
      This study aimed to explore parents' attitudes toward the content of their child's packed lunch, school healthy eating policies, and their child's wishes. Furthermore, in this context, it also aimed to explore perceptions of health promotional materials and how these interventions interplayed with issues parents felt were important. The ideology of ‘figured worlds’ was used as a stance to consider the relationship between bounding structures within society and the individual positional identity. Focus groups interviews obtained qualitative data of parents' multiple viewpoints. Iterative categorisation was employed as a method of analysis to observed findings in the data in relation to the individuals as intersubjective beings and their behaviour influenced by environmental conditions. A cross selection of local schools and parenting network were approached. Snowballing techniques were implemented highlighting the inclusion criteria. Participants were required to have a child attending primary school who they provided a packed lunch for on a regular basis. Three umbrella themes were identified: ‘The parents ideal’, ‘The child's desires’, and ‘Inconsistencies of the governing school’. A fourth theme, ‘The health promotional intrusion’ provides insight into the parents' reality when being presented with health promotional materials. This study has highlighted the complex, conflicting interplay between parents' ideal for their child's diet, their child's desires and the governing approaches to encouraging healthier choices. This understanding is vital when designing specific interventions to meet the needs of individuals, which prevent, protect and promote a healthy lifestyle for children and their families.
    • A systematic review on the effects of group singing on persistent pain in people with long‐term health conditions

      Irons, J. Yoon; Sheffield, David; Ballington, Freddie; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (Wiley, 2019-09-23)
      Singing can have a range of health benefits; this paper reviews the evidence of the effects of group singing for chronic pain in people with long‐term health conditions. We searched for published peer‐reviewed singing studies reporting pain measures (intensity, interference and depression) using major electronic databases (last search date 31 July 2018). After screening 123 full texts, 13 studies met the inclusion criteria: five randomized controlled trials (RCTs), seven non‐RCTs and one qualitative study. Included studies were appraised using Downs and Black and the Critical Appraisals Skills Programme quality assessments. Included studies reported differences in the type of singing intervention, long‐term condition and pain measures. Due to the high heterogeneity, we conducted a narrative review. Singing interventions were found to reduce pain intensity in most studies, but there was more equivocal support for reducing pain interference and depression. Additionally, qualitative data synthesis identified three key linked and complementary themes: physical, psychological and social benefits. Group singing appears to have the potential to reduce pain intensity, pain interference and depression; however, we conclude that there is only partial support for singing on some pain outcomes based on the limited available evidence of varied quality. Given the positive findings of qualitative studies, this review recommends that practitioners are encouraged to continue this work. More studies of better quality are needed. Future studies should adopt more robust methodology and report their singing intervention in details. Group singing may be an effective and safe approach for reducing persistent pain and depression in people with long‐term health conditions.
    • Group singing has multiple benefits in the context of chronic pain: an exploratory pilot study

      Irons, J. Yoon; Kuipers, Pim; Wan, Aston; Stewart, Donald E; Health and Social Care Research Centre, University of Derby (Elsevier, 2019-09-05)
      This paper reports findings of a pilot singing intervention to assist people living with chronic pain. Pain Management Clinic out-patients participated in 10 weekly group singing sessions. Benefits of the intervention and its impact on participants’ (N=4) experience of pain were explored qualitatively. Three main themes comprising over 20 separate codes indicated physical, psychological and social dimensions associated with the intervention. People with chronic pain identify multiple benefits from participating in a group singing program. Group singing in chronic pain settings has multiple benefits; and can be a beneficial adjunct to conventional pain management care and nursing, which may positively complement clinical outcomes.
    • Which behavioural and exercise interventions targeting fatigue show the most promise in multiple sclerosis? A systematic review with narrative synthesis and meta-analysis

      Moss-Moris, R; Harrison, A.M; Safari, Reza; Norton, S; van der Linden, M.L; Picariello, F; Thomas, S; White, C; Mercer, T; University of Derby (Elsevier, 2019-08-28)
      Fatigue is a common and highly debilitating symptom of multiple sclerosis (MS). This meta-analytic systematic review with detailed narrative synthesis examined randomised-controlled (RCTs) and controlled trials of behavioural and exercise interventions targeting fatigue in adults with MS to assess which treatments offer the most promise in reducing fatigue severity/impact. Medline, EMBASE and PsycInfo electronic databases, amongst others, were searched through to August 2018. Thirty-four trials (12 exercise, 16 behavioural and 6 combined; n = 2,434 participants) met inclusion criteria. Data from 31 studies (n = 1,991 participants) contributed to the meta-analysis. Risk of bias (using the Cochrane tool) and study quality (GRADE) were assessed. The pooled (SMD) end-of-treatment effects on self-reported fatigue were: exercise interventions (n = 13) -.84 (95% CI -1.20 to -.47); behavioural interventions (n = 16) -.37 (95% CI -.53 to -.22); combined interventions (n = 5) -.16 (95% CI: -.36 to .04). Heterogeneity was high overall. Study quality was very low for exercise interventions and moderate for behavioural and combined interventions. Considering health care professional time, subgroup results suggest web-based cognitive behavioural therapy for fatigue, balance and/or multicomponent exercise interventions may be the cost-efficient therapies. These need testing in large RCTs with long-term follow-up to help define an implementable fatigue management pathway in MS.
    • Parental and health professional evaluations of a support service for parents of excessively crying infants

      Bamber, Deborah; Powell, Charlotte; Long, Jaqui; Garratt, Rosie; Brown, Jayne; Rudge, Sally; Morris, Tom; Bhupendra Jaicim, Nishal; Plachcinski, Rachel; Dyson, Sue E.; et al. (Springer Nature/ BMC, 2019-08-22)
      The ‘Surviving Crying’ study was designed to develop and provisionally evaluate a support service for parents of excessively crying babies, including its suitability for use in the United Kingdom (UK) National Health Service (NHS). The resulting service includes three materials: a website, a printed booklet, and a Cognitive Behaviour Therapy (CBT) programme delivered to parents by a qualified professional. This study aimed to measure whether parents used the materials and to obtain parents’ and NHS professionals’ evaluations of whether they are fit for purpose. Parents were asked about participating in a randomised controlled trial (RCT) to evaluate the materials fully in health service use. Methods: Participants were 57 parents with babies they judged to be crying excessively and 96 NHS Health Visitors (HVs). Parental use and parents’ and HVs’ ratings of the Surviving Crying materials were measured. Results: Thirty four parents reported using the website, 24 the printed booklet and 24 the CBT sessions. Parents mostly accessed the website on mobile phones or tablets and use was substantial. All the parents and almost all HVs who provided data judged the materials to be helpful for parents and suitable for NHS use. If offered a waiting list control group, 85% of parents said they would have been willing to take part in a full RCT evaluation of the Surviving Crying package. Discussion and conclusions: The findings identify the need for materials to support parents of excessively crying babies within national health services in the UK. The Surviving Crying support package appears suitable for this purpose and a full community-level RCT of the package is feasible and likely to be worthwhile. Limitations to the study and barriers to delivery of the services were identified, indicating improvements needed in future research.
    • Arts therapies and gender issues

      Hogan, Susan; University of Derby (Routledge, 2019-07-30)
      Arts Therapies and Gender Issues offers international perspectives on gender in arts therapies research and demonstrates understandings of gender and arts therapies in a variety of global contexts. Analysing current innovations and approaches in the arts therapies, it discusses issues of cultural identity, which intersect with sex, gender norms, stereotypes and sexual identity. The book includes unique and detailed case studies such as the emerging discipline of creative writing for therapeutic purposes, re-enactment phototherapy, performative practice and virtual reality. Bringing together leading researchers, it demonstrates clinical applications and shares ideas about best practice. Incorporating art, drama, dance and music therapy, this book will be of great interest to academics and researchers in the fields of arts therapies, psychology, medicine, psychotherapy, health and education. It will also appeal to practitioners and teachers of art, dance-movement, drama and music therapy.