Recent Submissions

  • Crisis management for people with dementia at home: Mixed‐methods case study research to identify critical factors for successful home treatment

    Hopkinson, Jane; King, Amanda; Young, Lucy; McEwan, Kirsten; Elliot, Fiona; Hydon, Kate; Muthukrishnan, Sabarigirivasan; Tope, Rosie; Veitch, Anne; Howells, Cristie; et al. (Wiley, 2020-08-27)
    Best practice in dementia care is support in the home. Yet, crisis is common and can often result in hospital admission with adverse consequences. The objective of this mixed‐methods case study research was to identify the critical factors for resolving crisis for a person with dementia living at home. The research was an in‐depth investigation of what happens during crisis for people with dementia and how it is managed by a Home Treatment Crisis Team to resolution and outcome at 6 weeks and 6 months. The methods were; observation of crisis management for 15 patients with dementia (max three observations per patient, total 41), interviews with patients with dementia (n = 5), carers (n = 13) and professionals (n = 14, range one to six interviews per person, total 29), focus group (nine professionals), and extraction of demographics and medical history from medical records. Analysis focused on the identification of factors important for crisis resolution and avoidance of hospital admission. Critical factors for the Home Treatment Crisis Team to enable successful crisis resolution were: immediate action to reduce risk of harm, expertise in dementia care and carer education, communication skills to establish trust and promote benefits of home treatment, shared decision‐making, medication management, addressing the needs of carers independently of the person with dementia and, local availability of respite and other community services. The Home Treatment Crisis Team integrated the seven factors to deploy a biopsychosocial systems approach with embedded respect for personhood. This approach enabled crisis resolution for a person with dementia by creating a system of services, treatments, resources and relationships, ‘Safe Dementia Space’, in the community with avoidance of hospital admission in more than 80% of referrals. The identified critical factors for crisis resolution are important considerations in the design and delivery of home treatment services for people with dementia.
  • ‘Withness’: Creative spectating for residents living with advanced dementia in care homes

    Astell-Burt, Caroline; McNally, Theresa; Collard-Stokes, Gemma; Irons, J. Yoon; London School of Puppetry; University of Derby (Intellect, 2020-07-01)
    Aiming to illustrate the potential for puppetry as a useful resource in dementia care, the authors argue unusually that play with puppets derives not particularly from drama or theatre, but fundamentally from the performative relationship people have with objects. The puppeteers of the study achieved remarkable emotional connection with care-home residents through an experience of puppetry, which dissolved the unitary autonomy of the puppet, recontextualizing it relationally as the puppeteer-with-puppet-with-spectator. It is this ‘withness’ that ignited the creative spark of presence of the residents. For a moment of trust and child-like joy kinaesthetic memories stirred in them, appearing to break down emotional barriers between the person and the world around them and indicating comparatively longer-term therapeutic benefits.
  • Birth shock! What role might arts engagement have to play in antenatal and postnatal care?

    Hogan, Susan; University of Derby (Intellect, 2020-06-17)
    This article shares research findings for an Arts and Humanities Research Council project called The Birth Project (grant ref. AH/K003364/1). The Birth Project has been particularly interested to explore women’s personal experience of birth and the transition to motherhood using the arts, within a participatory arts framework. It ran experiential art-based groups for mothers and a further group for birthing professionals, each over a twelve-week period to solicit in-depth qualitative data. An innovative aspect of this endeavour has been the use of film as research data, as a means of answering the research questions (through selective editing) and as the primary mode of dissemination of the research results. Results elaborated and summarized here explore the ways women and birthing professionals found the intervention useful. The project analyses the distinctive contribution of the arts and concludes that arts engagement can play a vital role in both antenatal and postnatal care.
  • Behaving professionally in an age of political and corporate nonsense

    Jinks, Gavin; University of Derby (Human Givens Publishing, 2020-07-03)
    This article explores how a professional might practice in an ethical and value informed manner whilst also being able to subject to scrutiny practices that might be of questionable value. The background to this discussion is the exponential rise in digital communication and the rising power of large corporate organisations.
  • Cultivating learner aspirations and self-belief

    Jinks, Gavin; Harber, Denise; University of Derby (2020-07-13)
    The research team believes that to be a successful learner, the individual has to commit to the desired outcome in two ways: s/he has to want it, so it has to be relevant and important to her/him, and s/he has to believe that s/he can be successful. The team believe that both aspirations and self-belief are affected by personal influences, cultural/community influences and structural and societal influences. The team wishes to find reasons why significant numbers of school students don’t succeed in school, why many university students "drop out" of courses or don’t achieve the standard of which they are capable, and why adults fail to engage with the community activities. The team acknowledges that the influences on prospective learners of their families, their social and cultural groups, their local communities, and wider society in general are significant, but seek to establish whether low aspirations and poor self-belief are fixed or can be changed if leaders of learning and teachers create a culture of success in their settings, and develop a growth mindset in learners. This session explores the characteristics required for a positive learning culture, and the behaviours "teachers" might utilise in order to develop aspirations and self-belief in leaners.
  • A feasibility study of non-invasive continuous estimation of brachial pressure derived from arterial and venous lines during dialysis

    Stewart, Jill; Walker, Thomas; Eldehini, Tarek; Horner, Daniela Viramontes; Lucas, Bethany; White, Kelly; Muggleton, Andy; Selby, Nicholas M; Taal, Martin W; Stewart, Paul; et al. (IEEE, 2020)
    Intradialytic haemodynamic instability is a significant clinical problem, leading to end-organ ischaemia and contributing to morbidity and mortality in haemodialysis patients. Non-invasive continuous blood pressure monitoring is not part of routine practice but may aid detection and prevention of significant falls in blood pressure during dialysis. Brachial blood pressure is currently recorded intermittently during haemodialysis via a sphygmomanometer. Current methods of continuous non-invasive blood pressure monitoring tend to restrict movement, can be sensitive to external disturbances and patient movement, and can be uncomfortable for the wearer. Additionally, poor patient blood circulation can lead to unreliable measurements. In this study we performed an initial validation of a novel method and associated technology via a feasibility study to continuously estimate blood pressure using pressure sensors in the extra-corporeal dialysis circuit, which does not require any direct contact with the person receiving dialysis treatment.\\ The paper describes the development of the measurement system and subsequent \emph{in vivo} patient feasibility study with concurrent measurement validation by \emph{Finapres Nova} experimental physiological measurement device. We identify a mathematical function to describe the relationship between arterial line pressure and brachial artery BP, which is confirmed in the patient study. The methodology presented requires no interfacing to proprietery dialysis machine systems, no sensors to be attached to the patient directly, and to be robust to patient movement during treatment and also to the effects of the cyclical pressure waveforms induced by the hemodialysis pump. This represents a key enabling factor to the development of a practical continuous blood pressure monitoring device for dialysis patients.
  • Patient centred care in diagnostic radiography (Part 1): Perceptions of service users and service deliverers

    Hyde, Emma; Hardy, Maryann; University of Derby (Elsevier, 2020-06-13)
    There is growing awareness of the importance of patient centered care (PCC) in health care. Within Radiography in the UK, elements of PCC are embedded within professional body publications and guidance documents. However, there is limited research evidence exploring whether perceptions of PCC are equivalent between those delivering (radiographers) and those experiencing (patient) care. This study aimed to address this gap by determining compatibility in perceptions of PCC between those using and those delivering radiography services. This is the first step in developing measurable indicators of PCC in diagnostic radiography. A multi-method two stage approach was undertaken using survey and interview data collection techniques. Ethical approval was granted by University of Derby College of Health & Social Care Ethics committee. This paper reports Stage 1 of the study, the online, cross sectional survey. Participants were asked to indicate their level of agreement to a series of attitudinal statements using a 5-point Likert scale. Statements were paired, but not co-located to increase validity. Participants were invited to provide free text comments to supplement their responses. Stage 2 of the project is reported separately. Survey responses were received from all 3 participant subgroups. A minimum response rate of 30 participants per sub-group was set as a target. Response rates varied across subgroups, with only radiography managers failing to meet the expected response threshold. Wide disparity between perceptions of service users and those delivering radiography services on what constitutes high quality PCC was evident. It is evident that there is still work required to ensure parity between expectations of service users and deliverers on what constitutes high quality PCC. Further work is required to identify measurable service delivery outcomes that represent PCC within radiographic practice.
  • The schwartz center rounds: supporting mental health workers with the emotional impact of their work.

    Allen, Deborah; Spencer, Graham; McEwan, Kirsten; Catarino, Francisca; Evans, Rachael; Crooks, Sarah; Gilbert, Paul; University Hospitals Derby & Burton NHS; Derbyshire Healthcare NHS Foundation Trust; University of Derby (Wiley, 2020-05-15)
    In healthcare settings there is an emotional cost to caring which can result in compassion-fatigue, burnout, secondary trauma and compromised patient care. Innovative workplace interventions such as the Schwartz Rounds offer a group reflective practice forum for clinical and non-clinical professionals to reflect on the emotional aspects of working in healthcare. Whilst the Rounds are established in medical health practice, this study presents an evaluation of the Rounds offered to mental health services. The Rounds were piloted amongst 150 mental health professionals for 6 months and evaluated using a mixed-methods approach with standardised evaluation forms completed after each Round and a focus group (n=9) at one-month follow-up. This paper also offers a unique six-year follow-up of the evaluation of the Rounds. Rounds were rated as helpful, insightful, relevant and at six years follow-up Rounds were still rated as valuable and viewed as embedded. Focus groups indicated that Rounds were valued because of the opportunity to express emotions (in particular negative emotions towards patients that conflict with the professional care-role), share experiences, and feel validated and supported by colleagues. The findings indicate that Schwartz Rounds offer a positive application in mental healthcare settings. The study supports the use of interventions which provide an ongoing forum in which to discuss emotions, develop emotional literacy, provide peer-support and set an intention for becoming a more compassionate organisation in which to work.
  • Assessing the feasibility of public engagement in a smartphone app to: improve wellbeing through nature connection and map wellbeing across urban green spaces

    McEwan, Kirsten; Richardson, Miles; Sheffield, David; Ferguson, Fiona; Brindley, Paul; University of Derby; University of Sheffield (Taylor & Francis, 2020)
    Aside from practical interventions such as providing green infrastructure to improve air quality or water contamination and reduce flooding, wellbeing interventions to increase engagement with the natural environment are one of the fastest growing ways of improving human and environmental health. This feasibility study assessed a novel Smartphone app wellbeing intervention. Over 30 days the app prompted adults, including those seeking help for a common mental health problem, to notice the good things about urban green or built spaces (control condition). Self-referral was successful with 885 people downloading the app, 435 supplying baseline data and 50 supplying post-intervention data. However, the low number of observations (M=6 per participant) indicates that 30 days is too long to remain engaged. There were significant improvements in wellbeing and nature connection, but no difference between green and built space conditions. Limitations, future recommendations regarding improving engagement and marketing to lower socio-economic status groups are discussed.
  • Where the wild things are! Do urban green spaces with greater avian biodiversity promote more positive emotions in humans?

    Cameron, Ross; Brindley, Paul; Mears, Meagan; McEwan, Kirsten; Ferguson, Fiona; Sheffield, David; Jorgensen, Anna; Riley, J; Goodwick, J; Ballard, L; et al. (Elsevier, 2020-01-22)
    Urban green space can help mitigate the negative impacts of urban living and provide positive effects on citizens’ mood, health and well-being. Questions remain, however, as to whether all types of green space are equally beneficial, and if not, what landscape forms or key features optimise the desired benefits. For example, it has been cited that urban landscapes rich in wildlife (high biodiversity) may promote more positive emotions and enhance well-being. This research utilised a mobile phone App, employed to assess people’s emotions when they entered any one of 945 green spaces within the city of Sheffield, UK. Emotional responses were correlated to key traits of the individual green spaces, including levels of biodiversity the participant perceived around them. For a subsample of these green spaces, actual levels of biodiversity were assessed through avian and habitat surveys. Results demonstrated strong correlations between levels of avian biodiversity within a green space and human emotional response to that space. Respondents reported being happier in sites with greater avian biodiversity (p < 0.01, r = 0.78) and a greater variety of habitats (p < 0.02, r = 0.72). Relationships were strengthened when emotions were linked to perceptions of overall biodiversity (p < 0.001, r = 0.89). So, when participants thought the site was wildlife rich, they reported more positive emotions, even when actual avian biodiversity levels were not necessarily enhanced. The data strengthens the arguments that nature enhances well-being through positive affect, and that increased ‘engagement with nature’ may help support human health within urban environments. The results have strong implications for city planning with respect to the design, management and use of city green spaces.
  • Shifting identities: exploring occupational identity for those in recovery from an eating disorder

    Dark, Esther; Carter, Sarah; University of Derby (Emerald, 2019-11-23)
    The purpose of this paper is to explore the nature, transition and formation of occupational identity for those in recovery from eating disorders (EDs). Semi-structured “episodic” interviews were carried out with six women, self-identifying in recovery from an ED. Narrative-type-analysis produced a distilled narrative of participant’s accounts, before use of thematic analysis compared and extracted pertinent themes. During recovery from an ED, significant shifts occurred in occupational identities, moving from sole identification with the ED, to a greater understanding of self; facilitated by increased engagement in meaningful occupations, adapting occupational meaning, connecting with self and others and the importance of becoming and belonging. This is the first known piece of research exploring occupational identity in relation to EDs. The findings are applicable to occupational therapists and add to the growing body of qualitative research into ED's.
  • Are you using simulation in radiography? If not, why not?

    Shiner, Naomi; University of Derby (2018-01-31)
  • The good things in urban nature: A thematic framework for optimising urban planning for nature connectedness

    McEwan, Kirsten; Ferguson, Fiona J; Richardson, Miles; Cameron, Ross; University of Derby (2019-11-06)
    Green interventions which connect people with nature to improve wellbeing are increasingly being applied to tackle the current crisis in mental health. A novel Smartphone app intervention was evaluated amongst adults (n = 228) including (n = 53) adults with common mental health problems, with the aim to improve wellbeing through noticing the good things about urban nature. The app prompted participants once a day over 7 days to write notes about the good things they noticed in urban green spaces. Notes were thematically analysed and ten themes emerged. The three themes with the greatest representation were: i) wonder at encountering wildlife in day-to-day urban settings; ii) appreciation of street trees; and iii) awe at colourful, expansive, dramatic skies and views. Through combining the above themes with the pathways to nature connectedness this paper provides an extended framework of activities to inform activity programming, nature engagement media content, and ‘green health’ interventions. Moreover, the findings have strong implications for optimising city planning, design and management for the wellbeing of both humans and wildlife.
  • The use of simulation and moulage in undergraduate diagnostic radiography education: A burns scenario

    Shiner, Naomi; University of Derby (Elsevier, 2019-01-08)
    There is a national drive to increase allied health professions simulation training. However, there is a paucity of literature within diagnostic radiography in relation to clinical simulation. No research could be found regarding the impact of simulation in radiography with complex clinical burns scenarios.This research aims to explore the perceptions of radiography undergraduate students regarding their preparedness for the complex care requirements in imaging examinations of clinical burns cases using a mixed methods approach. A small-scale simulation-based teaching session was developed in a Scottish HEI, using role play and moulage to create realism. Twenty-eight undergraduate student radiographers participated in the scenario. Students completed pre- and post-scenario questionnaires using Likert scale and free response data. Focus groups were undertaken three months after the simulation to obtain rich qualitative data. Common themes were identified via a process of initial coding and a 6-phase thematic analysis. Thematic analysis demonstrated a marked increased perception of preparedness post-scenario; students felt more prepared to undertake their role in the imaging of complex care patients (Likert scoring increased with both mode and median post-scenario). Common themes that were identified were patient centeredness, realism and learning. Within this limited pilot project, the use of simulation was an effective means of preparing students to understand their role within the complex care setting (with respect to the traumatic realism of burns) in preparedness for professional practice. Additionally, students related to the practical understanding of the complexity of human factors that exist within clinical practice.
  • Can simulation impact on first year diagnostic radiography students' emotional preparedness to encounter open wounds on their first clinical placement: A pilot study

    Shiner, Naomi; University of Derby (Elsevier, 2019-05-11)
    This study reports on the use of moulage within a simulation to introduce first year diagnostic radiography students to open wounds in preparation for clinical practice. A mixed-method quasi-experimental design was used. Visual Analogue Scales were used to capture state feelings at the point of seeing open wounds. Interpretative Phenomenological Analysis was used to draw themes from focus groups and an interview following clinical placement. The simulation reduced negative feelings whilst emotional preparedness, distraction and excitement increased. Five major themes were identified including emotional engagement, engagement with wound, building relationships, developing professional self and simulation impact. The use of moulage and a simulation provides an opportunity to explore initial reactions. Students actively reflect on this experience during clinical practice changing practice. The impact of open wounds can be long lasting and support from radiographers should allow these new experiences to be processed reducing the risk of burnout.
  • Is there a role for simulation based education within conventional diagnostic radiography? A literature review

    Shiner, Naomi; University of Derby (Elsevier, 2018-02-07)
    Simulation based education is advancing, but is there a role for it in Diagnostic Radiography? The aim of this literature review was to understand the use of simulation within conventional diagnostic radiography education to raise awareness of this pedagogical approach. Objectives were to identify the prevalence and stage of delivery in education; understand the variation of simulation and learning objectives informing its use; and review the perceptions of those using simulation in education and practice. The literature review used a systematic search strategy. Library Plus, CINAHL, ScienceDirect, Medline and Google Scholar were reviewed resulting in 703 articles. Inclusion and exclusion criteria were applied with initial review of title and abstract resulting in 22 articles. Fifteen articles were selected following full text review. Simulation was used for both pre-and post-registration education. Themes included inter-professional education, use of computer software and improving patient/practitioner interactions. Increased confidence and understanding of professional roles were common outcomes. Simulation is a valuable pedagogical approach for diagnostic radiography education. Staff training and careful implementation of each stage is required to achieve desired learning outcomes.
  • An overview of the types and applications of simulation-based education within diagnostic radiography and ultrasound at two higher education institutions

    Shiner, Naomi; Pantic, V; University of Derby; University of Leeds (The Society of Radiographers: Deeson Publishing, 2019-06-02)
    The aim of this research was to explore the use of SBE across two HEIs delivering diagnostic radiography and ultrasound programmes; to inform, inspire and encourage educators across HEIs and in clinical practice to implement the use of SBE to support students in their learning.
  • Patient involvement in pressure ulcer prevention and adherence to prevention strategies: An integrative review

    Ledger, Lisa; Worsley, Peter; Hope, Jo; Schoonhoven, Lisette; University of Derby; University of Southampton; Utrecht University (Elsevier, 2019-10-14)
    Chronic wounds including pressure ulcers represent a significant burden to patients and healthcare providers. Increasingly patients are required to self-manage their care but patient adherence to prevention strategies is a significant clinical challenge. It is important to increase understanding of the factors affecting patients’ ability and willingness to follow pressure ulcer prevention interventions. To investigate from a patient perspective the factors affecting adherence to pressure ulcer prevention strategies. Integrative Literature Review Data Sources: A systematic search of electronic databases (Athens, Pub Med, Web of Science, Science Direct, AMED, CINAHL, Cochrane Library, PsychInfo, Google Scholar, Delphis) was initially conducted in May 2017 (repeated August 2018). The methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) principles. The Noticing, Collecting, Thinking (NCT) model of qualitative data analysis was used to identify key themes. A total of twelve studies met the inclusion criteria and were included in the review. The majority of studies were qualitative and three key themes were identified: i) individual/daily lifestyle considerations, ii) patient involvement in the decision-making process, and iii) pain and/or discomfort. There is limited research that focuses on the patient view of factors affecting adherence to prevention measures, particularly in community settings. Individual and daily lifestyle considerations and involvement in decision-making around pressure ulcer care are important aspects from the patient perspective. Further research is necessary to explore which factors affect patient adherence in order to improve clinical practice and support patient involvement in preventative strategies.
  • Expressing suchness: on the integration of writing into a dance practice

    Collard-Stokes, Gemma; University of Derby (Intellect, 2019-07-01)
    This article details the unique pairing of dance and writing, the likes of which are often considered two very different beasts. It examines how approaches to movement improvisation have been used to form and inform innovative methods of entering into the act of writing from the experience of dance. The argument authenticates the current renewed appreciation for the possibilities of writing to enable further creative critical engagement. Consequently, the meeting of creativity and criticality is one in which the dancer playfully explores and examines the suchness of one’s dancing. Suchness is therefore understood as the unique sum of qualities experienced by the dancer – the point at which clarity and closeness facilitate connection through the images, feelings and sensations evoked by dance. In summary, the article outlines the relationship between dance and writing, before exploring the methods used to facilitate a dancer’s assimilation and validation of what happens for them when they dance.
  • How can arts-based research in dramatic performance illuminate understanding of the therapeutic relationship?

    Bird, Drew; University of Derby (Intellect, 2019-10-01)
    This article explores how Heuristic Inquiry (HI), harnessed for arts-based research using solo performance, deepened the author’s understanding of the therapeutic relationship. The research explores the rehearsal and devising process of nine performances to explore barriers to a playful encounter with the audience and client using the myth of Psyche and Cupid. Themes of seeking approval, technique and shame are considered as potential obstacles to forging a co-creative therapeutic alliance.

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