2009
Cowley, Sarah; Dowling, Sandra; Caan, Woody
Too little for early interventions? Examining the policy-practice gap in English health visiting services and organization Journal Article
In: Primary Health Care Research & Development, vol. 10, no. 2, pp. 130–142, 2009, ISSN: 1477-1128, 1463-4236, (Publisher: Cambridge University Press).
Abstract | Links | BibTeX | Tags: children’s services, early child development, Early interventions, health inequalities, health visiting, Policy-practice gap
@article{cowley_too_2009,
title = {Too little for early interventions? Examining the policy-practice gap in English health visiting services and organization},
author = {Sarah Cowley and Sandra Dowling and Woody Caan},
doi = {10.1017/S146342360900111X},
issn = {1477-1128, 1463-4236},
year = {2009},
date = {2009-04-01},
urldate = {2009-04-01},
journal = {Primary Health Care Research & Development},
volume = {10},
number = {2},
pages = {130–142},
abstract = {Aim
This paper explores the variable provision of English health visiting services, despite government emphasis on the need to reduce health inequalities through early interventions and provide support to families with pre-school children.
Background
There is increasing evidence of the importance to later health of early child development; that is from prenatal to eight years of age. In this population group, the strongest evidence for health improvement emphasizes support for families (especially mothers) until the infant is at least two to three years of age. In the last four to five years, English government policy has focused strongly on this important life stage, particularly noting its relevance in reducing health inequalities. Simultaneously, the health visiting workforce, arguably the occupational group most closely associated with this form of work, has reduced by 10%; and there is evidence of extreme variability in the way services are provided across the country.
Methods
Three sources of data were analysed to discover whether the variation in health visiting services relates to need, levels of deprivation or whether other factors are influential in planning provision. The ratio of health visitors to pre-school children was mapped to indices of multiple deprivations across 144 Primary Care Trusts. Survey data were examined for evidence of links, or not, to levels of deprivation and, finally, 30 Children and Young People’s Plans (CYPPs) were analysed to explore strategic planning about the distribution and type of services.
Findings
Health visiting service provision appears unrelated to areas of deprivation; although, the survey data offered some evidence that individual practitioners focused efforts on the most deprived clients on their caseloads, regardless of location. At a strategic level, the CYPPs made little mention of pre-school children or their needs and offered only limited descriptions of preventive health services. Policy recommendations are made about strengthening service provision in this field.},
note = {Publisher: Cambridge University Press},
keywords = {children’s services, early child development, Early interventions, health inequalities, health visiting, Policy-practice gap},
pubstate = {published},
tppubtype = {article}
}
Aim
This paper explores the variable provision of English health visiting services, despite government emphasis on the need to reduce health inequalities through early interventions and provide support to families with pre-school children.
Background
There is increasing evidence of the importance to later health of early child development; that is from prenatal to eight years of age. In this population group, the strongest evidence for health improvement emphasizes support for families (especially mothers) until the infant is at least two to three years of age. In the last four to five years, English government policy has focused strongly on this important life stage, particularly noting its relevance in reducing health inequalities. Simultaneously, the health visiting workforce, arguably the occupational group most closely associated with this form of work, has reduced by 10%; and there is evidence of extreme variability in the way services are provided across the country.
Methods
Three sources of data were analysed to discover whether the variation in health visiting services relates to need, levels of deprivation or whether other factors are influential in planning provision. The ratio of health visitors to pre-school children was mapped to indices of multiple deprivations across 144 Primary Care Trusts. Survey data were examined for evidence of links, or not, to levels of deprivation and, finally, 30 Children and Young People’s Plans (CYPPs) were analysed to explore strategic planning about the distribution and type of services.
Findings
Health visiting service provision appears unrelated to areas of deprivation; although, the survey data offered some evidence that individual practitioners focused efforts on the most deprived clients on their caseloads, regardless of location. At a strategic level, the CYPPs made little mention of pre-school children or their needs and offered only limited descriptions of preventive health services. Policy recommendations are made about strengthening service provision in this field.
This paper explores the variable provision of English health visiting services, despite government emphasis on the need to reduce health inequalities through early interventions and provide support to families with pre-school children.
Background
There is increasing evidence of the importance to later health of early child development; that is from prenatal to eight years of age. In this population group, the strongest evidence for health improvement emphasizes support for families (especially mothers) until the infant is at least two to three years of age. In the last four to five years, English government policy has focused strongly on this important life stage, particularly noting its relevance in reducing health inequalities. Simultaneously, the health visiting workforce, arguably the occupational group most closely associated with this form of work, has reduced by 10%; and there is evidence of extreme variability in the way services are provided across the country.
Methods
Three sources of data were analysed to discover whether the variation in health visiting services relates to need, levels of deprivation or whether other factors are influential in planning provision. The ratio of health visitors to pre-school children was mapped to indices of multiple deprivations across 144 Primary Care Trusts. Survey data were examined for evidence of links, or not, to levels of deprivation and, finally, 30 Children and Young People’s Plans (CYPPs) were analysed to explore strategic planning about the distribution and type of services.
Findings
Health visiting service provision appears unrelated to areas of deprivation; although, the survey data offered some evidence that individual practitioners focused efforts on the most deprived clients on their caseloads, regardless of location. At a strategic level, the CYPPs made little mention of pre-school children or their needs and offered only limited descriptions of preventive health services. Policy recommendations are made about strengthening service provision in this field.
Portillo, Mari Carmen; Corchón, Silvia; López-Dicastillo, Olga; Cowley, Sarah
Evaluation of a nurse-led social rehabilitation programme for neurological patients and carers: An action research study Journal Article
In: International Journal of Nursing Studies, vol. 46, no. 2, pp. 204–219, 2009, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: action research, Advancement of nursing role, Evaluation, Social rehabilitation
@article{portillo_evaluation_2009,
title = {Evaluation of a nurse-led social rehabilitation programme for neurological patients and carers: An action research study},
author = {Mari Carmen Portillo and Silvia Corchón and Olga López-Dicastillo and Sarah Cowley},
doi = {10.1016/j.ijnurstu.2008.09.012},
issn = {0020-7489},
year = {2009},
date = {2009-02-01},
urldate = {2009-02-01},
journal = {International Journal of Nursing Studies},
volume = {46},
number = {2},
pages = {204–219},
abstract = {Background
Very few neurological rehabilitation programmes have successfully dealt with patients’ and relatives’ social needs. Furthermore, the nurses’ contribution in those programmes is poor or unclear.
Objectives
To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers.
Design
In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home.
Settings
Two neurological wards of a hospital in Spain.
Participants The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives).
Methods
The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses.
Results
The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses’ attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved.
Conclusions
This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses’ knowledge, experience and role in psychosocial care.},
keywords = {action research, Advancement of nursing role, Evaluation, Social rehabilitation},
pubstate = {published},
tppubtype = {article}
}
Background
Very few neurological rehabilitation programmes have successfully dealt with patients’ and relatives’ social needs. Furthermore, the nurses’ contribution in those programmes is poor or unclear.
Objectives
To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers.
Design
In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home.
Settings
Two neurological wards of a hospital in Spain.
Participants The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives).
Methods
The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses.
Results
The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses’ attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved.
Conclusions
This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses’ knowledge, experience and role in psychosocial care.
Very few neurological rehabilitation programmes have successfully dealt with patients’ and relatives’ social needs. Furthermore, the nurses’ contribution in those programmes is poor or unclear.
Objectives
To determine the rationale, effectiveness and adequacy of a nurse-led social rehabilitation programme implemented with neurological patients and their carers.
Design
In this action research study Hart and Bond's experimental and professionalizing typologies were applied through Lewinian cycles. A social rehabilitation programme was planned, based on the results of an in-depth baseline assessment of the context and individual needs. The programme focused on increasing the level of acceptance/adaptation of the disease through verbal and written education, easing the discharge planning, and offering social choices based on the social assessment of individual needs and possibilities at home.
Settings
Two neurological wards of a hospital in Spain.
Participants The programme evaluation included 27 nurses, and two groups of patients and relatives (control group=18 patients and 19 relatives, intervention group=17 patients and 16 relatives).
Methods
The two groups of patients and relatives were compared before and after discharge to determine the effectiveness of the programme. Socio-demographic forms, semi-structured interviews, participant observations, and validated scales to measure activities of daily living and social life were used, and data were analysed using content (QSR Nudist Vivo, v.2.0) and statistical (SPSS v. 13.0) analyses.
Results
The new programme resulted in social care being integrated in daily practice and developed knowledge about social rehabilitation. This had a positive impact on nurses’ attitudes. Patients and relatives had more realistic expectations and positive attitudes towards social life, and developed a wider variety of choices for social changes. Better adaptation, and more coping skills and satisfaction were achieved.
Conclusions
This rehabilitation programme was feasible and effective. Patients and relatives benefited from better understanding of the socialisation process, as a result of advancing nurses’ knowledge, experience and role in psychosocial care.
Bliss, Julie; Cowley, Sarah; While, Alison
Interprofessional working in palliative care in the community: a review of the literature Journal Article
In: Journal of Interprofessional Care, vol. Vol 14, no. 3, pp. 281–290, 2009, ISSN: 1356-1820.
Abstract | Links | BibTeX | Tags:
@article{bliss_julie_interprofessional_2009,
title = {Interprofessional working in palliative care in the community: a review of the literature},
author = {Julie Bliss and Sarah Cowley and Alison While},
doi = {10.1080/jic.14.3.281.290},
issn = {1356-1820},
year = {2009},
date = {2009-01-01},
urldate = {2009-01-01},
journal = {Journal of Interprofessional Care},
volume = {Vol 14},
number = {3},
pages = {281–290},
abstract = {In the United Kingdom (UK) a range of professionals, who are employed within both statutory and non-statutory organisations, provide palliative care in the community. This paper explores how interprofessional working between these practitioners is facilitated, and considers how language and philosophies of care can impact upon the working relationship between professionals. It is suggested that often the difficulties experienced when working with another professional are outside the remit of the individuals involved. When working within large organisations within a legislative framework practitioners must be prepared to acknowledge the strengths of different groups, and to understand how these can be utilised to provide effective and appropriate palliative care.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In the United Kingdom (UK) a range of professionals, who are employed within both statutory and non-statutory organisations, provide palliative care in the community. This paper explores how interprofessional working between these practitioners is facilitated, and considers how language and philosophies of care can impact upon the working relationship between professionals. It is suggested that often the difficulties experienced when working with another professional are outside the remit of the individuals involved. When working within large organisations within a legislative framework practitioners must be prepared to acknowledge the strengths of different groups, and to understand how these can be utilised to provide effective and appropriate palliative care.
2008
Appleton, Jane V.; Cowley, Sarah
Health visiting assessment processes under scrutiny: A case study of knowledge use during family health needs assessments Journal Article
In: International Journal of Nursing Studies, vol. 45, no. 5, pp. 682–696, 2008, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Case study, Constructivist inquiry, health visiting, Knowledge, needs assessment, Professional judgement
@article{appleton_health_2008-1,
title = {Health visiting assessment processes under scrutiny: A case study of knowledge use during family health needs assessments},
author = {Jane V. Appleton and Sarah Cowley},
doi = {10.1016/j.ijnurstu.2006.12.009},
issn = {0020-7489},
year = {2008},
date = {2008-05-01},
urldate = {2008-05-01},
journal = {International Journal of Nursing Studies},
volume = {45},
number = {5},
pages = {682–696},
abstract = {Background
Accurate assessment of family health need is a core health visiting skill, requiring considerable knowledge and expertise. To date, there has been only limited empirical examination of the types of knowledge and ways of knowing which are likely to influence health visiting practice during family health needs assessments.
Objectives
This paper will present a detailed analysis of health visiting assessment processes and will explicate some of the many elements associated with the processes of identifying and assessing family health needs.
Design
An in-depth case study was undertaken to explore health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a professional judgement to offer a family extra support.
Settings
The study was conducted in three community Trust case sites in England, UK.
Methods and participants
The study was informed by a constructivist methodology. Data collection took place during 56 observed home visits to families receiving increased health visiting support and intervention. Following the home visits separate in-depth interviews were undertaken with the health visitors and the clients.
Results/Conclusions
This paper will explicate some of the many elements associated with the processes of identifying and assessing family health needs. It endeavours to unravel some of the complexity and intricacies of these processes and provide insights into health visitors’ practical ‘know-how’.},
keywords = {Case study, Constructivist inquiry, health visiting, Knowledge, needs assessment, Professional judgement},
pubstate = {published},
tppubtype = {article}
}
Background
Accurate assessment of family health need is a core health visiting skill, requiring considerable knowledge and expertise. To date, there has been only limited empirical examination of the types of knowledge and ways of knowing which are likely to influence health visiting practice during family health needs assessments.
Objectives
This paper will present a detailed analysis of health visiting assessment processes and will explicate some of the many elements associated with the processes of identifying and assessing family health needs.
Design
An in-depth case study was undertaken to explore health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a professional judgement to offer a family extra support.
Settings
The study was conducted in three community Trust case sites in England, UK.
Methods and participants
The study was informed by a constructivist methodology. Data collection took place during 56 observed home visits to families receiving increased health visiting support and intervention. Following the home visits separate in-depth interviews were undertaken with the health visitors and the clients.
Results/Conclusions
This paper will explicate some of the many elements associated with the processes of identifying and assessing family health needs. It endeavours to unravel some of the complexity and intricacies of these processes and provide insights into health visitors’ practical ‘know-how’.
Accurate assessment of family health need is a core health visiting skill, requiring considerable knowledge and expertise. To date, there has been only limited empirical examination of the types of knowledge and ways of knowing which are likely to influence health visiting practice during family health needs assessments.
Objectives
This paper will present a detailed analysis of health visiting assessment processes and will explicate some of the many elements associated with the processes of identifying and assessing family health needs.
Design
An in-depth case study was undertaken to explore health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a professional judgement to offer a family extra support.
Settings
The study was conducted in three community Trust case sites in England, UK.
Methods and participants
The study was informed by a constructivist methodology. Data collection took place during 56 observed home visits to families receiving increased health visiting support and intervention. Following the home visits separate in-depth interviews were undertaken with the health visitors and the clients.
Results/Conclusions
This paper will explicate some of the many elements associated with the processes of identifying and assessing family health needs. It endeavours to unravel some of the complexity and intricacies of these processes and provide insights into health visitors’ practical ‘know-how’.
Appleton, Jane V.; Cowley, Sarah
Health visiting assessment—unpacking critical attributes in health visitor needs assessment practice: A case study Journal Article
In: International Journal of Nursing Studies, vol. 45, no. 2, pp. 232–245, 2008, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Assessment principles, Constructivist enquiry, health visiting, needs assessment, Professional judgement
@article{appleton_health_2008,
title = {Health visiting assessment—unpacking critical attributes in health visitor needs assessment practice: A case study},
author = {Jane V. Appleton and Sarah Cowley},
doi = {10.1016/j.ijnurstu.2006.08.014},
issn = {0020-7489},
year = {2008},
date = {2008-02-01},
urldate = {2008-02-01},
journal = {International Journal of Nursing Studies},
volume = {45},
number = {2},
pages = {232–245},
abstract = {Background
Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK.
Objectives
The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry.
Design
A case study design informed by a constructivist methodology was used to examine health visitors’ professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
Settings
The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site.
Methods and participants
Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place.
Results/conclusions
The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors’ assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.},
keywords = {Assessment principles, Constructivist enquiry, health visiting, needs assessment, Professional judgement},
pubstate = {published},
tppubtype = {article}
}
Background
Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK.
Objectives
The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry.
Design
A case study design informed by a constructivist methodology was used to examine health visitors’ professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
Settings
The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site.
Methods and participants
Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place.
Results/conclusions
The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors’ assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.
Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK.
Objectives
The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry.
Design
A case study design informed by a constructivist methodology was used to examine health visitors’ professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
Settings
The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site.
Methods and participants
Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place.
Results/conclusions
The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors’ assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.
Cowley, Sarah
Specialist community public health nursing: new register, new opportunities, new challenges Journal Article
In: Journal of Japan Academy of Nursing Science, vol. 28, no. 1, pp. 107–110, 2008, (Publisher: 日本看護科学学会).
BibTeX | Tags:
@article{cowley_specialist_2008,
title = {Specialist community public health nursing: new register, new opportunities, new challenges},
author = {Sarah Cowley},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
journal = {Journal of Japan Academy of Nursing Science},
volume = {28},
number = {1},
pages = {107–110},
note = {Publisher: 日本看護科学学会},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Campling, Natasha; Grocott, Patricia; Cowley, Sarah
Disconnection: the user voice within the wound dressing supply chain Journal Article
In: Journal of Nursing Management, vol. 16, no. 2, pp. 204–213, 2008, ISSN: 1365-2834, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2834.2007.00818.x).
Abstract | Links | BibTeX | Tags: supply chain, users, wound dressings
@article{Campling2008,
title = {Disconnection: the user voice within the wound dressing supply chain},
author = {Natasha Campling and Patricia Grocott and Sarah Cowley},
doi = {10.1111/j.1365-2834.2007.00818.x},
issn = {1365-2834},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
journal = {Journal of Nursing Management},
volume = {16},
number = {2},
pages = {204–213},
abstract = {Aim
This study examined the user voice in England’s National Health Service (NHS) wound dressing supply chain.
Background
The impetus for this work came from involvement in a collaboration between industry and clinicians, entitled Woundcare Research for Appropriate Products. Experiences from that study highlighted the notable absence of research about the impact of the supply chain on the users of dressings.
Method
Interview data are presented following an outline of the grounded theory method used. These data were obtained from key stakeholders (n = 41) within the wound dressing supply chain such as nurses, manufacturers, distributors, professional organizations, government organizations and user groups.
Results
The consequences of supply disconnection revealed haphazard supply, unmet user needs and lack of information transfer between player groups.
Conclusions and implications for nursing management
These consequences explain the lack of user voice in the supply chain and have far-reaching implications for nursing management, through purchasing decisions and nurses’ management of wound care.},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2834.2007.00818.x},
keywords = {supply chain, users, wound dressings},
pubstate = {published},
tppubtype = {article}
}
Aim
This study examined the user voice in England’s National Health Service (NHS) wound dressing supply chain.
Background
The impetus for this work came from involvement in a collaboration between industry and clinicians, entitled Woundcare Research for Appropriate Products. Experiences from that study highlighted the notable absence of research about the impact of the supply chain on the users of dressings.
Method
Interview data are presented following an outline of the grounded theory method used. These data were obtained from key stakeholders (n = 41) within the wound dressing supply chain such as nurses, manufacturers, distributors, professional organizations, government organizations and user groups.
Results
The consequences of supply disconnection revealed haphazard supply, unmet user needs and lack of information transfer between player groups.
Conclusions and implications for nursing management
These consequences explain the lack of user voice in the supply chain and have far-reaching implications for nursing management, through purchasing decisions and nurses’ management of wound care.
This study examined the user voice in England’s National Health Service (NHS) wound dressing supply chain.
Background
The impetus for this work came from involvement in a collaboration between industry and clinicians, entitled Woundcare Research for Appropriate Products. Experiences from that study highlighted the notable absence of research about the impact of the supply chain on the users of dressings.
Method
Interview data are presented following an outline of the grounded theory method used. These data were obtained from key stakeholders (n = 41) within the wound dressing supply chain such as nurses, manufacturers, distributors, professional organizations, government organizations and user groups.
Results
The consequences of supply disconnection revealed haphazard supply, unmet user needs and lack of information transfer between player groups.
Conclusions and implications for nursing management
These consequences explain the lack of user voice in the supply chain and have far-reaching implications for nursing management, through purchasing decisions and nurses’ management of wound care.
Cowley, Sarah
Developing and measuring resilience for population health Journal Article
In: African Health Sciences, vol. 8, 2008, ISSN: 1729-0503.
BibTeX | Tags:
@article{cowley_developing_2008,
title = {Developing and measuring resilience for population health},
author = {Sarah Cowley},
issn = {1729-0503},
year = {2008},
date = {2008-01-01},
urldate = {2008-01-01},
journal = {African Health Sciences},
volume = {8},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2007
Cowley, Sarah
A funding model for health visiting (part 2): impact and implementation Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 80, no. 12, pp. 24–31, 2007, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Adolescent, Child, Child Health Services, Community Health Nursing, Economic, Health Care Rationing, Humans, Infant, Models, needs assessment, Newborn, Organizational Objectives, Preschool, Program Evaluation, United Kingdom
@article{cowley_funding_2007-1,
title = {A funding model for health visiting (part 2): impact and implementation},
author = {Sarah Cowley},
issn = {1462-2815},
year = {2007},
date = {2007-12-01},
urldate = {2007-12-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {80},
number = {12},
pages = {24–31},
abstract = {This is the second of two papers offering the information required to work out how to fund a health visiting service. The first paper gave the basic requirements, while this one identifies and explains the separate components of the service along with issues of scope and skillmix. In this way, it starts to describe the programmes embedded within a generic health visiting service, which is helpful in terms of what might be expected in terms of impact and outcomes. These are described with reference to the new Public Service Agreement targets and other relevant policy.},
keywords = {Adolescent, Child, Child Health Services, Community Health Nursing, Economic, Health Care Rationing, Humans, Infant, Models, needs assessment, Newborn, Organizational Objectives, Preschool, Program Evaluation, United Kingdom},
pubstate = {published},
tppubtype = {article}
}
This is the second of two papers offering the information required to work out how to fund a health visiting service. The first paper gave the basic requirements, while this one identifies and explains the separate components of the service along with issues of scope and skillmix. In this way, it starts to describe the programmes embedded within a generic health visiting service, which is helpful in terms of what might be expected in terms of impact and outcomes. These are described with reference to the new Public Service Agreement targets and other relevant policy.
Cowley, S.; Caan, W.; Dowling, S.; Weir, H.
What do health visitors do? A national survey of activities and service organisation Journal Article
In: Public Health, vol. 121, no. 11, pp. 869–879, 2007, ISSN: 0033-3506.
Abstract | Links | BibTeX | Tags: Child health, Early interventions, Health services, Health visitors, Maternal health
@article{cowley_what_2007,
title = {What do health visitors do? A national survey of activities and service organisation},
author = {S. Cowley and W. Caan and S. Dowling and H. Weir},
doi = {10.1016/j.puhe.2007.03.016},
issn = {0033-3506},
year = {2007},
date = {2007-11-01},
urldate = {2007-11-01},
journal = {Public Health},
volume = {121},
number = {11},
pages = {869–879},
abstract = {Background
Early interventions targeting health inequalities, and changing policies for mothers and pre-school children, have focused attention on existing interventions.
Objectives
To collect baseline data about current roles and activities undertaken by health visitors; and to understand the relationship between existing services and recommended practice shown in research about preventive programmes.
Methods A national postal survey was used to collect data about current roles and activities undertaken by health visitors across the UK (n=1459, 46% response rate).
Results
A description is provided of activities undertaken and the types of needs addressed by health-visiting services. The established health-visiting purpose of using a caseload of infants and pre-school children as a base from which to reach out to a wider community seems to be still in place, with difficulty. The major focus of their work was on primary and secondary prevention, but included provision for identified problems. Two main patterns of service provision were identified; one ‘comprehensive’ and one that was more restricted. The ‘restricted service,’ available in most places, was mainly reactive, with child protection and social factors predominant. Even the ‘comprehensive services’ were far lower in intensity than programmes shown, through research, to improve family wellness. In addition, less than half of respondents thought that it was always feasible to deliver services as planned.
Conclusions
The results question the premise, upon which universal provision rests, that all families receive a service offering proactive health promotion and the timely identification of additional health needs.},
keywords = {Child health, Early interventions, Health services, Health visitors, Maternal health},
pubstate = {published},
tppubtype = {article}
}
Background
Early interventions targeting health inequalities, and changing policies for mothers and pre-school children, have focused attention on existing interventions.
Objectives
To collect baseline data about current roles and activities undertaken by health visitors; and to understand the relationship between existing services and recommended practice shown in research about preventive programmes.
Methods A national postal survey was used to collect data about current roles and activities undertaken by health visitors across the UK (n=1459, 46% response rate).
Results
A description is provided of activities undertaken and the types of needs addressed by health-visiting services. The established health-visiting purpose of using a caseload of infants and pre-school children as a base from which to reach out to a wider community seems to be still in place, with difficulty. The major focus of their work was on primary and secondary prevention, but included provision for identified problems. Two main patterns of service provision were identified; one ‘comprehensive’ and one that was more restricted. The ‘restricted service,’ available in most places, was mainly reactive, with child protection and social factors predominant. Even the ‘comprehensive services’ were far lower in intensity than programmes shown, through research, to improve family wellness. In addition, less than half of respondents thought that it was always feasible to deliver services as planned.
Conclusions
The results question the premise, upon which universal provision rests, that all families receive a service offering proactive health promotion and the timely identification of additional health needs.
Early interventions targeting health inequalities, and changing policies for mothers and pre-school children, have focused attention on existing interventions.
Objectives
To collect baseline data about current roles and activities undertaken by health visitors; and to understand the relationship between existing services and recommended practice shown in research about preventive programmes.
Methods A national postal survey was used to collect data about current roles and activities undertaken by health visitors across the UK (n=1459, 46% response rate).
Results
A description is provided of activities undertaken and the types of needs addressed by health-visiting services. The established health-visiting purpose of using a caseload of infants and pre-school children as a base from which to reach out to a wider community seems to be still in place, with difficulty. The major focus of their work was on primary and secondary prevention, but included provision for identified problems. Two main patterns of service provision were identified; one ‘comprehensive’ and one that was more restricted. The ‘restricted service,’ available in most places, was mainly reactive, with child protection and social factors predominant. Even the ‘comprehensive services’ were far lower in intensity than programmes shown, through research, to improve family wellness. In addition, less than half of respondents thought that it was always feasible to deliver services as planned.
Conclusions
The results question the premise, upon which universal provision rests, that all families receive a service offering proactive health promotion and the timely identification of additional health needs.
Cowley, Sarah
A funding model for health visiting: baseline requirements–part 1 Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 80, no. 11, pp. 18–24, 2007, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Child, Child Health Services, Community Health Nursing, Economic, Financing, Government, Humans, Infant, Models, needs assessment, Nurse's Role, nursing, Nursing Evaluation Research, Poverty, Preschool, Primary Prevention, State Medicine, United Kingdom, Universal Health Insurance
@article{cowley_funding_2007,
title = {A funding model for health visiting: baseline requirements–part 1},
author = {Sarah Cowley},
issn = {1462-2815},
year = {2007},
date = {2007-11-01},
urldate = {2007-11-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {80},
number = {11},
pages = {18–24},
abstract = {A funding model proposed in two papers will outline the health visiting resource, including team skill mix, required to deliver the recommended approach of 'progressive universalism,' taking account of health inequalities, best evidence and impact on outcomes that might be anticipated.
The model has been discussed as far as possible across the professional networks of both the Community Practitioners' and Health Visitors' Association (CPHVA) and United Kingdom Public Health Association (UKPHA), and is a consensus statement agreed by all who have participated.},
keywords = {Child, Child Health Services, Community Health Nursing, Economic, Financing, Government, Humans, Infant, Models, needs assessment, Nurse's Role, nursing, Nursing Evaluation Research, Poverty, Preschool, Primary Prevention, State Medicine, United Kingdom, Universal Health Insurance},
pubstate = {published},
tppubtype = {article}
}
A funding model proposed in two papers will outline the health visiting resource, including team skill mix, required to deliver the recommended approach of 'progressive universalism,' taking account of health inequalities, best evidence and impact on outcomes that might be anticipated.
The model has been discussed as far as possible across the professional networks of both the Community Practitioners' and Health Visitors' Association (CPHVA) and United Kingdom Public Health Association (UKPHA), and is a consensus statement agreed by all who have participated.
The model has been discussed as far as possible across the professional networks of both the Community Practitioners' and Health Visitors' Association (CPHVA) and United Kingdom Public Health Association (UKPHA), and is a consensus statement agreed by all who have participated.
Cowley, Sarah A.
A salient visit Journal Article
In: Revista Da Escola De Enfermagem Da U S P, 2007.
@article{cowley_salient_2007,
title = {A salient visit},
author = {Sarah A. Cowley},
year = {2007},
date = {2007-10-01},
urldate = {2007-10-01},
journal = {Revista Da Escola De Enfermagem Da U S P},
abstract = {A salient visit},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A salient visit
Coyne, Imelda; Cowley, Sarah
Challenging the philosophy of partnership with parents: A grounded theory study Journal Article
In: International Journal of Nursing Studies, vol. 44, no. 6, pp. 893–904, 2007, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Hospitalised children, Nurses, Parent participation, Partnership
@article{coyne_challenging_2007,
title = {Challenging the philosophy of partnership with parents: A grounded theory study},
author = {Imelda Coyne and Sarah Cowley},
doi = {10.1016/j.ijnurstu.2006.03.002},
issn = {0020-7489},
year = {2007},
date = {2007-08-01},
urldate = {2007-08-01},
journal = {International Journal of Nursing Studies},
volume = {44},
number = {6},
pages = {893–904},
abstract = {Background
Parent participation is viewed as a pivotal concept to the provision of high quality nursing care for children and their families. Since the 1990's, the term ‘partnership with parents’ has increasingly been reported in the literature and adopted as a philosophy of care in most paediatric units in the United Kingdom.
Objectives
To explore children's, parents’, and nurses’ views on participation in care in the healthcare setting.
Design
Using grounded theory, data were collected through in-depth interviews, and participant observation. Sample consisted of eleven children, ten parents and twelve nurses from four paediatric wards in two hospitals in England.
Results
Most nurses assumed that parents would participate in care and viewed their role as facilitators rather than ‘doers’. Nurses reported that the ideology of partnership with parents did not accurately reflect or describe their relationships with parents. Parents could never be partners in care as control of the boundaries of care rested with the nurses. Parents felt compelled to be there and to be responsible for their children's welfare in hospital.
Conclusions
The pendulum of parent participation has swung from excluding parents in the past to making parents feel total responsibility for their child in hospital. It is argued that the current models or theories on parent participation/partnership are inappropriate or inadequate because they do not address important elements of children's, parents’ and nurses’ experiences in hospital.},
keywords = {Hospitalised children, Nurses, Parent participation, Partnership},
pubstate = {published},
tppubtype = {article}
}
Background
Parent participation is viewed as a pivotal concept to the provision of high quality nursing care for children and their families. Since the 1990's, the term ‘partnership with parents’ has increasingly been reported in the literature and adopted as a philosophy of care in most paediatric units in the United Kingdom.
Objectives
To explore children's, parents’, and nurses’ views on participation in care in the healthcare setting.
Design
Using grounded theory, data were collected through in-depth interviews, and participant observation. Sample consisted of eleven children, ten parents and twelve nurses from four paediatric wards in two hospitals in England.
Results
Most nurses assumed that parents would participate in care and viewed their role as facilitators rather than ‘doers’. Nurses reported that the ideology of partnership with parents did not accurately reflect or describe their relationships with parents. Parents could never be partners in care as control of the boundaries of care rested with the nurses. Parents felt compelled to be there and to be responsible for their children's welfare in hospital.
Conclusions
The pendulum of parent participation has swung from excluding parents in the past to making parents feel total responsibility for their child in hospital. It is argued that the current models or theories on parent participation/partnership are inappropriate or inadequate because they do not address important elements of children's, parents’ and nurses’ experiences in hospital.
Parent participation is viewed as a pivotal concept to the provision of high quality nursing care for children and their families. Since the 1990's, the term ‘partnership with parents’ has increasingly been reported in the literature and adopted as a philosophy of care in most paediatric units in the United Kingdom.
Objectives
To explore children's, parents’, and nurses’ views on participation in care in the healthcare setting.
Design
Using grounded theory, data were collected through in-depth interviews, and participant observation. Sample consisted of eleven children, ten parents and twelve nurses from four paediatric wards in two hospitals in England.
Results
Most nurses assumed that parents would participate in care and viewed their role as facilitators rather than ‘doers’. Nurses reported that the ideology of partnership with parents did not accurately reflect or describe their relationships with parents. Parents could never be partners in care as control of the boundaries of care rested with the nurses. Parents felt compelled to be there and to be responsible for their children's welfare in hospital.
Conclusions
The pendulum of parent participation has swung from excluding parents in the past to making parents feel total responsibility for their child in hospital. It is argued that the current models or theories on parent participation/partnership are inappropriate or inadequate because they do not address important elements of children's, parents’ and nurses’ experiences in hospital.
Cowley, Sarah; Grocott, Patricia
Research Design for the Development and Evaluation of Complex Technologies: An Empirical Example and Critical Discussion Journal Article
In: Evaluation, vol. 13, no. 3, pp. 285–305, 2007, ISSN: 1356-3890, (Publisher: SAGE Publications Ltd).
Abstract | Links | BibTeX | Tags:
@article{cowley_research_2007,
title = {Research Design for the Development and Evaluation of Complex Technologies: An Empirical Example and Critical Discussion},
author = {Sarah Cowley and Patricia Grocott},
doi = {10.1177/1356389007078629},
issn = {1356-3890},
year = {2007},
date = {2007-07-01},
urldate = {2007-07-01},
journal = {Evaluation},
volume = {13},
number = {3},
pages = {285–305},
abstract = {This article offers for wider discussion a description of the approach used in a situation where the gold standard of a randomized controlled trial (RCT) was not immediately feasible. It explains how the methods and research design of a developmental project known as `WRAP' (Woundcare Research for Appropriate Products) evolved, and discusses their implications for complex wound care evaluations.The project was guided by the UK Medical Research Council (MRC) framework for the development and evaluation of RCTs (MRC and Board, 2000).
It is proposed that dressing performance in chronic wound care may best be evaluated by a focus on the first two phases of the framework, theorizing and modelling, to design interventions and measurement tools, before proceeding to the third phase, exploratory trials.When the data generated in such trials are deemed valid and reliable, using specified criteria, alternative forms of evaluation to the randomized controlled trial, such as post-market surveillance studies, can follow.
It is also proposed that these adaptations of the MRC framework may apply to complex evaluations more generally.},
note = {Publisher: SAGE Publications Ltd},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This article offers for wider discussion a description of the approach used in a situation where the gold standard of a randomized controlled trial (RCT) was not immediately feasible. It explains how the methods and research design of a developmental project known as `WRAP' (Woundcare Research for Appropriate Products) evolved, and discusses their implications for complex wound care evaluations.The project was guided by the UK Medical Research Council (MRC) framework for the development and evaluation of RCTs (MRC and Board, 2000).
It is proposed that dressing performance in chronic wound care may best be evaluated by a focus on the first two phases of the framework, theorizing and modelling, to design interventions and measurement tools, before proceeding to the third phase, exploratory trials.When the data generated in such trials are deemed valid and reliable, using specified criteria, alternative forms of evaluation to the randomized controlled trial, such as post-market surveillance studies, can follow.
It is also proposed that these adaptations of the MRC framework may apply to complex evaluations more generally.
It is proposed that dressing performance in chronic wound care may best be evaluated by a focus on the first two phases of the framework, theorizing and modelling, to design interventions and measurement tools, before proceeding to the third phase, exploratory trials.When the data generated in such trials are deemed valid and reliable, using specified criteria, alternative forms of evaluation to the randomized controlled trial, such as post-market surveillance studies, can follow.
It is also proposed that these adaptations of the MRC framework may apply to complex evaluations more generally.
Lynam, M. Judith; Cowley, Sarah
Understanding marginalization as a social determinant of health Journal Article
In: Critical Public Health, vol. 17, no. 2, pp. 137–149, 2007, ISSN: 0958-1596, (Publisher: Taylor & Francis ).
Abstract | Links | BibTeX | Tags: Bourdieu, culture and health, exclusion, health inequalities, Marginalization, social determinants of health
@article{lynam_understanding_2007,
title = {Understanding marginalization as a social determinant of health},
author = {M. Judith Lynam and Sarah Cowley},
doi = {10.1080/09581590601045907},
issn = {0958-1596},
year = {2007},
date = {2007-06-01},
urldate = {2007-06-01},
journal = {Critical Public Health},
volume = {17},
number = {2},
pages = {137–149},
abstract = {Population-based studies have drawn attention to the associations between social and material disadvantage and poor mental and physical health over the life course, thereby contributing to inequalities in health. More recently, research in Britain has demonstrated that the effects of such disadvantage are cumulative through childhood and has shown that ‘ethnic minorities’ are at particular risk.
This study gathered data from persons at risk, specifically first-generation migrant teenaged girls and their mothers, in Britain and Canada, and identified marginalization as a central feature of their relationships with others. Bourdieu's theoretical perspective is drawn on to examine the processes that contribute to marginalization and the conditions of broader society that sustain and reproduce them. It was the participants’ experience that their potential goes unrecognized, their opportunities to develop new relationships curtailed and possibilities to acquire new competences were eclipsed by others’ assumptions about them.
The authors illustrate the social processes that contribute to the creation of tensions between seeking to belong and being assigned to the margins and consider their attendant influences on health. Taking direction from Bourdieu they illustrate ways in which discourses of marginalization and marginalizing practices associated with them can be interrupted, and in so doing work towards redressing processes that create a context for health inequalities.},
note = {Publisher: Taylor & Francis },
keywords = {Bourdieu, culture and health, exclusion, health inequalities, Marginalization, social determinants of health},
pubstate = {published},
tppubtype = {article}
}
Population-based studies have drawn attention to the associations between social and material disadvantage and poor mental and physical health over the life course, thereby contributing to inequalities in health. More recently, research in Britain has demonstrated that the effects of such disadvantage are cumulative through childhood and has shown that ‘ethnic minorities’ are at particular risk.
This study gathered data from persons at risk, specifically first-generation migrant teenaged girls and their mothers, in Britain and Canada, and identified marginalization as a central feature of their relationships with others. Bourdieu's theoretical perspective is drawn on to examine the processes that contribute to marginalization and the conditions of broader society that sustain and reproduce them. It was the participants’ experience that their potential goes unrecognized, their opportunities to develop new relationships curtailed and possibilities to acquire new competences were eclipsed by others’ assumptions about them.
The authors illustrate the social processes that contribute to the creation of tensions between seeking to belong and being assigned to the margins and consider their attendant influences on health. Taking direction from Bourdieu they illustrate ways in which discourses of marginalization and marginalizing practices associated with them can be interrupted, and in so doing work towards redressing processes that create a context for health inequalities.
This study gathered data from persons at risk, specifically first-generation migrant teenaged girls and their mothers, in Britain and Canada, and identified marginalization as a central feature of their relationships with others. Bourdieu's theoretical perspective is drawn on to examine the processes that contribute to marginalization and the conditions of broader society that sustain and reproduce them. It was the participants’ experience that their potential goes unrecognized, their opportunities to develop new relationships curtailed and possibilities to acquire new competences were eclipsed by others’ assumptions about them.
The authors illustrate the social processes that contribute to the creation of tensions between seeking to belong and being assigned to the margins and consider their attendant influences on health. Taking direction from Bourdieu they illustrate ways in which discourses of marginalization and marginalizing practices associated with them can be interrupted, and in so doing work towards redressing processes that create a context for health inequalities.
Dowling, Sandra; Manthorpe, Jill; Cowley, Sarah
Working on person-centred planning: From amber to green light? Journal Article
In: Journal of Intellectual Disabilities, vol. 11, no. 1, pp. 65–82, 2007, ISSN: 1744-6295, (Publisher: SAGE Publications Ltd).
Abstract | Links | BibTeX | Tags:
@article{dowling_working_2007,
title = {Working on person-centred planning: From amber to green light?},
author = {Sandra Dowling and Jill Manthorpe and Sarah Cowley},
doi = {10.1177/1744629507073999},
issn = {1744-6295},
year = {2007},
date = {2007-03-01},
urldate = {2007-03-01},
journal = {Journal of Intellectual Disabilities},
volume = {11},
number = {1},
pages = {65–82},
abstract = {This article reviews the practice and policy based literature on person-centred planning in learning disability services in England. Its aim is to identify the implications for the workforce in practice.
The analysis found that implementation is often described as partial or slow and characterizes reasons for this at a number of levels, including the slow pace of change in service culture and power relations, immutable funding structures, services’ inflexible infrastructures, high levels of staff turnover and lack of training, inexperience among service management, inadequate staff supervision, and ambiguity among some stakeholders. Little substantial critique exists of the model itself.
Analysis of the literature further reveals that the implementation of person-centred planning in practice is assisted by policy encouragement, service development and investment, favourable case reports and personal accounts, practitioner enthusiasm and positive evaluations.
This article explores these to consider what facilitates the adoption of new elements of practice.},
note = {Publisher: SAGE Publications Ltd},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This article reviews the practice and policy based literature on person-centred planning in learning disability services in England. Its aim is to identify the implications for the workforce in practice.
The analysis found that implementation is often described as partial or slow and characterizes reasons for this at a number of levels, including the slow pace of change in service culture and power relations, immutable funding structures, services’ inflexible infrastructures, high levels of staff turnover and lack of training, inexperience among service management, inadequate staff supervision, and ambiguity among some stakeholders. Little substantial critique exists of the model itself.
Analysis of the literature further reveals that the implementation of person-centred planning in practice is assisted by policy encouragement, service development and investment, favourable case reports and personal accounts, practitioner enthusiasm and positive evaluations.
This article explores these to consider what facilitates the adoption of new elements of practice.
The analysis found that implementation is often described as partial or slow and characterizes reasons for this at a number of levels, including the slow pace of change in service culture and power relations, immutable funding structures, services’ inflexible infrastructures, high levels of staff turnover and lack of training, inexperience among service management, inadequate staff supervision, and ambiguity among some stakeholders. Little substantial critique exists of the model itself.
Analysis of the literature further reveals that the implementation of person-centred planning in practice is assisted by policy encouragement, service development and investment, favourable case reports and personal accounts, practitioner enthusiasm and positive evaluations.
This article explores these to consider what facilitates the adoption of new elements of practice.
Appleton, Jane; Caan, Woody; Cowley, Sarah; Kendall, Sally
Busting the bureaucracy: lessons from research governance in primary care Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 80, no. 2, pp. 29–32, 2007, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Child, Child Advocacy, decision making, Documentation, Ethics Committees, Guidelines as Topic, Health Care Reform, Health Services Needs and Demand, Humans, Multicenter Studies as Topic, Nursing Research, Organizational, Organizational Case Studies, Organizational Innovation, Organizational Policy, Peer Review, Primary Health Care, Research, Research Design, Research Support as Topic, State Medicine, Time Factors, United Kingdom
@article{appleton_busting_2007,
title = {Busting the bureaucracy: lessons from research governance in primary care},
author = {Jane Appleton and Woody Caan and Sarah Cowley and Sally Kendall},
issn = {1462-2815},
year = {2007},
date = {2007-02-01},
urldate = {2007-02-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {80},
number = {2},
pages = {29–32},
abstract = {This paper provides a critical discussion of the research governance approval processes faced in a nationally-funded primary care health service survey.
The study is investigating how a range of English primary care organisations are addressing child protection and safeguarding children responsibilities in the light of a wealth of policy directives following publication of the report of Lord Laming's inquiry into the death of Victoria Climbié in 2003.
The principal investigator is a member of a local research ethics committee and has a good working knowledge of the Research Governance Framework. However, following multi-centre research ethics committee approval, a whole catalogue of difficulties emerged in gaining research governance approval for this study from primary care organisations.
These challenges and our lessons for primary care are outlined in an organisational case study with the intention of generating debate around this fundamental stage in the research process. With the current restructuring of primary care, we believe the time is right to streamline research governance procedures.},
keywords = {Child, Child Advocacy, decision making, Documentation, Ethics Committees, Guidelines as Topic, Health Care Reform, Health Services Needs and Demand, Humans, Multicenter Studies as Topic, Nursing Research, Organizational, Organizational Case Studies, Organizational Innovation, Organizational Policy, Peer Review, Primary Health Care, Research, Research Design, Research Support as Topic, State Medicine, Time Factors, United Kingdom},
pubstate = {published},
tppubtype = {article}
}
This paper provides a critical discussion of the research governance approval processes faced in a nationally-funded primary care health service survey.
The study is investigating how a range of English primary care organisations are addressing child protection and safeguarding children responsibilities in the light of a wealth of policy directives following publication of the report of Lord Laming's inquiry into the death of Victoria Climbié in 2003.
The principal investigator is a member of a local research ethics committee and has a good working knowledge of the Research Governance Framework. However, following multi-centre research ethics committee approval, a whole catalogue of difficulties emerged in gaining research governance approval for this study from primary care organisations.
These challenges and our lessons for primary care are outlined in an organisational case study with the intention of generating debate around this fundamental stage in the research process. With the current restructuring of primary care, we believe the time is right to streamline research governance procedures.
The study is investigating how a range of English primary care organisations are addressing child protection and safeguarding children responsibilities in the light of a wealth of policy directives following publication of the report of Lord Laming's inquiry into the death of Victoria Climbié in 2003.
The principal investigator is a member of a local research ethics committee and has a good working knowledge of the Research Governance Framework. However, following multi-centre research ethics committee approval, a whole catalogue of difficulties emerged in gaining research governance approval for this study from primary care organisations.
These challenges and our lessons for primary care are outlined in an organisational case study with the intention of generating debate around this fundamental stage in the research process. With the current restructuring of primary care, we believe the time is right to streamline research governance procedures.
Cowley, Sarah
Principles of British health visiting Journal Article
In: Revista da Escola de Enfermagem da USP, vol. 41, no. spe, pp. 756, 2007, ISSN: 0080-6234.
@article{cowley_principles_2007,
title = {Principles of British health visiting},
author = {Sarah Cowley},
issn = {0080-6234},
year = {2007},
date = {2007-01-01},
urldate = {2007-01-01},
journal = {Revista da Escola de Enfermagem da USP},
volume = {41},
number = {spe},
pages = {756},
abstract = {Principles of British health visiting},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Principles of British health visiting
2006
Whittaker, Karen A.; Cowley, Sarah
Evaluating health visitor parenting support: validating outcome measures for parental self-efficacy Journal Article
In: Journal of Child Health Care, vol. 10, no. 4, pp. 296–308, 2006, ISSN: 1367-4935, (Publisher: SAGE Publications Ltd).
Abstract | Links | BibTeX | Tags:
@article{whittaker_evaluating_2006,
title = {Evaluating health visitor parenting support: validating outcome measures for parental self-efficacy},
author = {Karen A. Whittaker and Sarah Cowley},
doi = {10.1177/1367493506067882},
issn = {1367-4935},
year = {2006},
date = {2006-12-01},
urldate = {2006-12-01},
journal = {Journal of Child Health Care},
volume = {10},
number = {4},
pages = {296–308},
abstract = {Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere.
This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test–re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions.
The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.},
note = {Publisher: SAGE Publications Ltd},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere.
This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test–re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions.
The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.
This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test–re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions.
The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.
Coyne, Imelda; Cowley, Sarah
Using grounded theory to research parent participation Journal Article
In: Journal of Research in Nursing, vol. 11, no. 6, pp. 501–515, 2006, ISSN: 1744-9871, (Publisher: SAGE Publications Ltd).
Abstract | Links | BibTeX | Tags:
@article{coyne_using_2006,
title = {Using grounded theory to research parent participation},
author = {Imelda Coyne and Sarah Cowley},
doi = {10.1177/1744987106065831},
issn = {1744-9871},
year = {2006},
date = {2006-11-01},
urldate = {2006-11-01},
journal = {Journal of Research in Nursing},
volume = {11},
number = {6},
pages = {501–515},
abstract = {There are many interpretations and applications of the grounded theory method which have contributed to different understandings of grounded theory and different versions of how the key components (theoretical sampling, constant comparative analysis and theoretical saturation) should be implemented. The esoteric terminology coupled with the matrix style of the analysis process can be challenging for new researchers.
This paper uses data from a study on parent participation to illustrate the application of the key components of grounded theory. Grounded theory provides clear guidelines on how to analyse qualitative data and so is a rigorous method that provides structure and direction to the researcher. However, theoretical sampling with vulnerable groups can be problematic and requires further discussion and debate from other users of grounded theory.},
note = {Publisher: SAGE Publications Ltd},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There are many interpretations and applications of the grounded theory method which have contributed to different understandings of grounded theory and different versions of how the key components (theoretical sampling, constant comparative analysis and theoretical saturation) should be implemented. The esoteric terminology coupled with the matrix style of the analysis process can be challenging for new researchers.
This paper uses data from a study on parent participation to illustrate the application of the key components of grounded theory. Grounded theory provides clear guidelines on how to analyse qualitative data and so is a rigorous method that provides structure and direction to the researcher. However, theoretical sampling with vulnerable groups can be problematic and requires further discussion and debate from other users of grounded theory.
This paper uses data from a study on parent participation to illustrate the application of the key components of grounded theory. Grounded theory provides clear guidelines on how to analyse qualitative data and so is a rigorous method that provides structure and direction to the researcher. However, theoretical sampling with vulnerable groups can be problematic and requires further discussion and debate from other users of grounded theory.
Hanafin, Sinéad; Cowley, Sarah
Quality in preventive and health-promoting services: constructing an understanding through process Journal Article
In: Journal of Nursing Management, vol. 14, no. 6, pp. 472–482, 2006, ISSN: 1365-2834, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2934.2006.00671.x).
Abstract | Links | BibTeX | Tags: community nursing, prevention, process, public health, Service quality
@article{hanafin_quality_2006,
title = {Quality in preventive and health-promoting services: constructing an understanding through process},
author = {Sinéad Hanafin and Sarah Cowley},
doi = {10.1111/j.1365-2934.2006.00671.x},
issn = {1365-2834},
year = {2006},
date = {2006-01-01},
urldate = {2006-01-01},
journal = {Journal of Nursing Management},
volume = {14},
number = {6},
pages = {472–482},
abstract = {Aim
To develop a model of service quality for health-promoting services.
Background
In assessing quality, there are difficulties in taking account of the views of multiple stakeholders, the process of the service and the organizational context within which the service is provided. This study set out to address these difficulties.
Methods
A collective case study that incorporated national data from public health nurses (n = 946; response rate 54%) and public health nurse managers (n = 24; response rate 75%) and four case study sites which included data collected from 27 mothers with infants. Results A model of service quality that takes account of multiple stakeholder constructions, organizational context, service process and consequences was developed.
Conclusions
Seven steps of process coupled with five concepts around which quality is judged can provide a basis for understanding service quality in a predominantly preventive and health-promoting type service.},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2934.2006.00671.x},
keywords = {community nursing, prevention, process, public health, Service quality},
pubstate = {published},
tppubtype = {article}
}
Aim
To develop a model of service quality for health-promoting services.
Background
In assessing quality, there are difficulties in taking account of the views of multiple stakeholders, the process of the service and the organizational context within which the service is provided. This study set out to address these difficulties.
Methods
A collective case study that incorporated national data from public health nurses (n = 946; response rate 54%) and public health nurse managers (n = 24; response rate 75%) and four case study sites which included data collected from 27 mothers with infants. Results A model of service quality that takes account of multiple stakeholder constructions, organizational context, service process and consequences was developed.
Conclusions
Seven steps of process coupled with five concepts around which quality is judged can provide a basis for understanding service quality in a predominantly preventive and health-promoting type service.
To develop a model of service quality for health-promoting services.
Background
In assessing quality, there are difficulties in taking account of the views of multiple stakeholders, the process of the service and the organizational context within which the service is provided. This study set out to address these difficulties.
Methods
A collective case study that incorporated national data from public health nurses (n = 946; response rate 54%) and public health nurse managers (n = 24; response rate 75%) and four case study sites which included data collected from 27 mothers with infants. Results A model of service quality that takes account of multiple stakeholder constructions, organizational context, service process and consequences was developed.
Conclusions
Seven steps of process coupled with five concepts around which quality is judged can provide a basis for understanding service quality in a predominantly preventive and health-promoting type service.
2005
Hanafin, Sinéad; Cowley, Sarah
Service configuration and quality of Irish public health nursing Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 78, no. 12, pp. 433–436, 2005, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Child Health Services, Humans, Infant, Ireland, Newborn, Personnel Staffing and Scheduling, Public health nursing, Quality of Health Care, Resource Allocation, Task Performance and Analysis
@article{hanafin_service_2005,
title = {Service configuration and quality of Irish public health nursing},
author = {Sinéad Hanafin and Sarah Cowley},
issn = {1462-2815},
year = {2005},
date = {2005-12-01},
urldate = {2005-12-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {78},
number = {12},
pages = {433–436},
abstract = {This paper presents findings from a national study of the Irish public health nursing service and focuses, in particular, on issues relating to service configuration.
The findings are drawn mainly from a national questionnaire of public health nurses (PHNs) working with families with infants (n=613; response rate 54 per cent) and the data were gathered in 1999/2000. The average ratio of public health nurse (PHN) to population size was found to be 1:3997 with a range between 500 and 16,500. The vast majority of respondents (85 per cent) had responsibility for five or more client groups including the elderly, those requiring clinical nursing care, terminal nursing care, psychiatric care, school nursing and the organisation of the home help service.
Statistically significant differences between and within health board areas in the extent to which other nurses were available to the service led to a conclusion that in these circumstances a standardised service across individual PHN areas is not possible. The findings highlight the importance of the principle of vertical equity where service configuration is determined by population composition and need.},
keywords = {Child Health Services, Humans, Infant, Ireland, Newborn, Personnel Staffing and Scheduling, Public health nursing, Quality of Health Care, Resource Allocation, Task Performance and Analysis},
pubstate = {published},
tppubtype = {article}
}
This paper presents findings from a national study of the Irish public health nursing service and focuses, in particular, on issues relating to service configuration.
The findings are drawn mainly from a national questionnaire of public health nurses (PHNs) working with families with infants (n=613; response rate 54 per cent) and the data were gathered in 1999/2000. The average ratio of public health nurse (PHN) to population size was found to be 1:3997 with a range between 500 and 16,500. The vast majority of respondents (85 per cent) had responsibility for five or more client groups including the elderly, those requiring clinical nursing care, terminal nursing care, psychiatric care, school nursing and the organisation of the home help service.
Statistically significant differences between and within health board areas in the extent to which other nurses were available to the service led to a conclusion that in these circumstances a standardised service across individual PHN areas is not possible. The findings highlight the importance of the principle of vertical equity where service configuration is determined by population composition and need.
The findings are drawn mainly from a national questionnaire of public health nurses (PHNs) working with families with infants (n=613; response rate 54 per cent) and the data were gathered in 1999/2000. The average ratio of public health nurse (PHN) to population size was found to be 1:3997 with a range between 500 and 16,500. The vast majority of respondents (85 per cent) had responsibility for five or more client groups including the elderly, those requiring clinical nursing care, terminal nursing care, psychiatric care, school nursing and the organisation of the home help service.
Statistically significant differences between and within health board areas in the extent to which other nurses were available to the service led to a conclusion that in these circumstances a standardised service across individual PHN areas is not possible. The findings highlight the importance of the principle of vertical equity where service configuration is determined by population composition and need.
Roche, Brenda; Cowley, Sarah; Salt, Niki; Scammell, Amy; Malone, Mary; Savile, Philippa; Aikens, Daphine; Fitzpatrick, Susan
Reassurance or judgement? Parents' views on the delivery of child health surveillance programmes Journal Article
In: Family Practice, vol. 22, no. 5, pp. 507–512, 2005, ISSN: 0263-2136.
Abstract | Links | BibTeX | Tags:
@article{roche_reassurance_2005,
title = {Reassurance or judgement? Parents' views on the delivery of child health surveillance programmes},
author = {Brenda Roche and Sarah Cowley and Niki Salt and Amy Scammell and Mary Malone and Philippa Savile and Daphine Aikens and Susan Fitzpatrick},
doi = {10.1093/fampra/cmi046},
issn = {0263-2136},
year = {2005},
date = {2005-10-01},
urldate = {2005-10-01},
journal = {Family Practice},
volume = {22},
number = {5},
pages = {507–512},
abstract = {Background
The first year of a child's life is a crucial time for child development. Current guidance about child health surveillance and health promotion programmes emphasises a partnership approach between health professionals and parents when it comes to child health care. Parents' voices have been largely absent from discussions about local child health programmes. For partnership working to be effective and for local services to be able to evolve effectively parents' views are vital.Objectives. This study aimed to explore parents' views on the child health surveillance and health promotion programmes offered during the first year of their child's life. The study aimed to be consumer-led through the involvement of lead parents in all stages of the research process.
Methods
This study employed a qualitative methodology of focus groups and individual interviews. 35 participants were drawn from three general practices using a snowball sampling technique. Eligibility was determined as parents with a child under the age of one year or expecting a baby within the study timescale and registered at one of the 3 general practices. Focus groups were led by three ‘parent-researchers’ and individual interviews were conducted by a researcher. All focus groups and interviews were tape-recorded, transcribed and analysed using Atlas.Ti.
Results
Several main themes were identified in this study. Firstly, when discussing scheduled health checks for children under one year of age parents expressed more positive feelings for the eight-week check which was seen to be comprehensive and informative rather than the eight-month check which was viewed as bureaucratic and less reassuring. Secondly, parents clearly articulated a need for reassurance and support from health professionals involved in child health surveillance and health promotion programmes. Thirdly, a crucial professional in the delivery of these programmes was the health visitor. Whilst parents expressed support for the concept of health visitors some health visitors were seen as bureaucratic and as making judgements of need based on socio-economic factors. Finally, some parents spoke of feeling excluded from accessing support as they were deemed not to be ‘in need’.
Conclusions
Wider concepts of partnership working between health professionals and parents, and, needs assessment are important to this study. Crucial elements of the partnership appear to be missing and this coupled with needs assessments that leave parents feeling excluded mean that there are discrepancies between expectations and experiences of parents. These issues require consideration in order to improve services and experiences.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background
The first year of a child's life is a crucial time for child development. Current guidance about child health surveillance and health promotion programmes emphasises a partnership approach between health professionals and parents when it comes to child health care. Parents' voices have been largely absent from discussions about local child health programmes. For partnership working to be effective and for local services to be able to evolve effectively parents' views are vital.Objectives. This study aimed to explore parents' views on the child health surveillance and health promotion programmes offered during the first year of their child's life. The study aimed to be consumer-led through the involvement of lead parents in all stages of the research process.
Methods
This study employed a qualitative methodology of focus groups and individual interviews. 35 participants were drawn from three general practices using a snowball sampling technique. Eligibility was determined as parents with a child under the age of one year or expecting a baby within the study timescale and registered at one of the 3 general practices. Focus groups were led by three ‘parent-researchers’ and individual interviews were conducted by a researcher. All focus groups and interviews were tape-recorded, transcribed and analysed using Atlas.Ti.
Results
Several main themes were identified in this study. Firstly, when discussing scheduled health checks for children under one year of age parents expressed more positive feelings for the eight-week check which was seen to be comprehensive and informative rather than the eight-month check which was viewed as bureaucratic and less reassuring. Secondly, parents clearly articulated a need for reassurance and support from health professionals involved in child health surveillance and health promotion programmes. Thirdly, a crucial professional in the delivery of these programmes was the health visitor. Whilst parents expressed support for the concept of health visitors some health visitors were seen as bureaucratic and as making judgements of need based on socio-economic factors. Finally, some parents spoke of feeling excluded from accessing support as they were deemed not to be ‘in need’.
Conclusions
Wider concepts of partnership working between health professionals and parents, and, needs assessment are important to this study. Crucial elements of the partnership appear to be missing and this coupled with needs assessments that leave parents feeling excluded mean that there are discrepancies between expectations and experiences of parents. These issues require consideration in order to improve services and experiences.
The first year of a child's life is a crucial time for child development. Current guidance about child health surveillance and health promotion programmes emphasises a partnership approach between health professionals and parents when it comes to child health care. Parents' voices have been largely absent from discussions about local child health programmes. For partnership working to be effective and for local services to be able to evolve effectively parents' views are vital.Objectives. This study aimed to explore parents' views on the child health surveillance and health promotion programmes offered during the first year of their child's life. The study aimed to be consumer-led through the involvement of lead parents in all stages of the research process.
Methods
This study employed a qualitative methodology of focus groups and individual interviews. 35 participants were drawn from three general practices using a snowball sampling technique. Eligibility was determined as parents with a child under the age of one year or expecting a baby within the study timescale and registered at one of the 3 general practices. Focus groups were led by three ‘parent-researchers’ and individual interviews were conducted by a researcher. All focus groups and interviews were tape-recorded, transcribed and analysed using Atlas.Ti.
Results
Several main themes were identified in this study. Firstly, when discussing scheduled health checks for children under one year of age parents expressed more positive feelings for the eight-week check which was seen to be comprehensive and informative rather than the eight-month check which was viewed as bureaucratic and less reassuring. Secondly, parents clearly articulated a need for reassurance and support from health professionals involved in child health surveillance and health promotion programmes. Thirdly, a crucial professional in the delivery of these programmes was the health visitor. Whilst parents expressed support for the concept of health visitors some health visitors were seen as bureaucratic and as making judgements of need based on socio-economic factors. Finally, some parents spoke of feeling excluded from accessing support as they were deemed not to be ‘in need’.
Conclusions
Wider concepts of partnership working between health professionals and parents, and, needs assessment are important to this study. Crucial elements of the partnership appear to be missing and this coupled with needs assessments that leave parents feeling excluded mean that there are discrepancies between expectations and experiences of parents. These issues require consideration in order to improve services and experiences.
Bidmead, Christine; Cowley, Sarah
Evaluating family partnership training in health visitor practice Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 78, no. 7, pp. 239–245, 2005, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Attitude of Health Personnel, Clinical Competence, Community Health Nursing, Continuing, Cooperative Behavior, Data Collection, Data Interpretation, Education, Employee Performance Appraisal, England, Family, Health Services Needs and Demand, Humans, Nonverbal Communication, nursing, Nursing Education Research, Nursing Methodology Research, Nursing Staff, Pilot Projects, Professional-Family Relations, Program Evaluation, qualitative research, Research Design, Statistical, Surveys and Questionnaires, Videotape Recording
@article{bidmead_evaluating_2005,
title = {Evaluating family partnership training in health visitor practice},
author = {Christine Bidmead and Sarah Cowley},
issn = {1462-2815},
year = {2005},
date = {2005-07-01},
urldate = {2005-07-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {78},
number = {7},
pages = {239–245},
abstract = {The second paper in this series of two on partnership examines the effects of family partnership (parent adviser) training which builds on health visitors' skills to facilitate partnership working with parents.
This study was utilised as a pilot to identify a suitable method, to explore the interaction processes of health visitors who had undergone the training. The study draws together both quantitative and qualitative methods to seek to understand processes in depth.
Three health visitors, who were part of a training group of 12, took part in the qualitative research using stimulated recall methodology. The quantitative data was collected from the whole training group using the Constructions of Helping questionnaire and the course evaluation form.
The findings suggest that the family partnership training may be effective in enhancing partnership working in health visiting and that the stimulated recall methodology is an effective method of identifying the processes of interaction. The triangulation of methods led to an understanding that change in practice is dependent on the insight of the practitioner and that this may be able to be measured to some extent by the use of different methods.},
keywords = {Attitude of Health Personnel, Clinical Competence, Community Health Nursing, Continuing, Cooperative Behavior, Data Collection, Data Interpretation, Education, Employee Performance Appraisal, England, Family, Health Services Needs and Demand, Humans, Nonverbal Communication, nursing, Nursing Education Research, Nursing Methodology Research, Nursing Staff, Pilot Projects, Professional-Family Relations, Program Evaluation, qualitative research, Research Design, Statistical, Surveys and Questionnaires, Videotape Recording},
pubstate = {published},
tppubtype = {article}
}
The second paper in this series of two on partnership examines the effects of family partnership (parent adviser) training which builds on health visitors' skills to facilitate partnership working with parents.
This study was utilised as a pilot to identify a suitable method, to explore the interaction processes of health visitors who had undergone the training. The study draws together both quantitative and qualitative methods to seek to understand processes in depth.
Three health visitors, who were part of a training group of 12, took part in the qualitative research using stimulated recall methodology. The quantitative data was collected from the whole training group using the Constructions of Helping questionnaire and the course evaluation form.
The findings suggest that the family partnership training may be effective in enhancing partnership working in health visiting and that the stimulated recall methodology is an effective method of identifying the processes of interaction. The triangulation of methods led to an understanding that change in practice is dependent on the insight of the practitioner and that this may be able to be measured to some extent by the use of different methods.
This study was utilised as a pilot to identify a suitable method, to explore the interaction processes of health visitors who had undergone the training. The study draws together both quantitative and qualitative methods to seek to understand processes in depth.
Three health visitors, who were part of a training group of 12, took part in the qualitative research using stimulated recall methodology. The quantitative data was collected from the whole training group using the Constructions of Helping questionnaire and the course evaluation form.
The findings suggest that the family partnership training may be effective in enhancing partnership working in health visiting and that the stimulated recall methodology is an effective method of identifying the processes of interaction. The triangulation of methods led to an understanding that change in practice is dependent on the insight of the practitioner and that this may be able to be measured to some extent by the use of different methods.
Bidmead, Christine; Cowley, Sarah
A concept analysis of partnership with clients Journal Article
In: Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association, vol. 78, no. 6, pp. 203–208, 2005, ISSN: 1462-2815.
Abstract | BibTeX | Tags: Clinical Competence, Communication, Community Health Nursing, Concept Formation, Cooperative Behavior, Empathy, Humans, Judgment, Models, Negotiating, Nurse-Patient Relations, Nurse's Role, nursing, Nursing Theory, Parents, Patient Participation, Pediatric Nursing, Philosophy, Power, Psychological, Social Support, Supervisory, Trust
@article{bidmead_concept_2005,
title = {A concept analysis of partnership with clients},
author = {Christine Bidmead and Sarah Cowley},
issn = {1462-2815},
year = {2005},
date = {2005-06-01},
urldate = {2005-06-01},
journal = {Community Practitioner: The Journal of the Community Practitioners' & Health Visitors' Association},
volume = {78},
number = {6},
pages = {203–208},
abstract = {The aim of this first paper of two about partnership working with clients is to define and clarify partnership as it is practised within health visiting, by identifying the central notions of partnership working in practice.
The aim of the second paper will be to describe an evaluation of a training course in partnership working for health visitors. Partnership is a word in common usage within the health professions but its meaning is ill-defined.
A literature search was undertaken to identify ways in which previous authors have used the concept within nursing, counselling and health visiting. Rodgers' approach to concept analysis was undertaken to seek clarity for the concept. This revealed the ways in which various authors have used the word, an analysis of its defining attributes, surrogate terms, antecedents, consequences and a concluding definition.
The results showed that partnership with clients in health visiting can be defined as a respectful, negotiated way of working together that enables choice, participation and equity, within an honest, trusting relationship that is based in empathy, support and reciprocity. It is best established within a model of health visiting that recognises partnership as a central tenet. It requires a high level of interpersonal qualities and communication skills in staff who are, themselves, supported through a system of clinical supervision that operates within the same partnership framework.},
keywords = {Clinical Competence, Communication, Community Health Nursing, Concept Formation, Cooperative Behavior, Empathy, Humans, Judgment, Models, Negotiating, Nurse-Patient Relations, Nurse's Role, nursing, Nursing Theory, Parents, Patient Participation, Pediatric Nursing, Philosophy, Power, Psychological, Social Support, Supervisory, Trust},
pubstate = {published},
tppubtype = {article}
}
The aim of this first paper of two about partnership working with clients is to define and clarify partnership as it is practised within health visiting, by identifying the central notions of partnership working in practice.
The aim of the second paper will be to describe an evaluation of a training course in partnership working for health visitors. Partnership is a word in common usage within the health professions but its meaning is ill-defined.
A literature search was undertaken to identify ways in which previous authors have used the concept within nursing, counselling and health visiting. Rodgers' approach to concept analysis was undertaken to seek clarity for the concept. This revealed the ways in which various authors have used the word, an analysis of its defining attributes, surrogate terms, antecedents, consequences and a concluding definition.
The results showed that partnership with clients in health visiting can be defined as a respectful, negotiated way of working together that enables choice, participation and equity, within an honest, trusting relationship that is based in empathy, support and reciprocity. It is best established within a model of health visiting that recognises partnership as a central tenet. It requires a high level of interpersonal qualities and communication skills in staff who are, themselves, supported through a system of clinical supervision that operates within the same partnership framework.
The aim of the second paper will be to describe an evaluation of a training course in partnership working for health visitors. Partnership is a word in common usage within the health professions but its meaning is ill-defined.
A literature search was undertaken to identify ways in which previous authors have used the concept within nursing, counselling and health visiting. Rodgers' approach to concept analysis was undertaken to seek clarity for the concept. This revealed the ways in which various authors have used the word, an analysis of its defining attributes, surrogate terms, antecedents, consequences and a concluding definition.
The results showed that partnership with clients in health visiting can be defined as a respectful, negotiated way of working together that enables choice, participation and equity, within an honest, trusting relationship that is based in empathy, support and reciprocity. It is best established within a model of health visiting that recognises partnership as a central tenet. It requires a high level of interpersonal qualities and communication skills in staff who are, themselves, supported through a system of clinical supervision that operates within the same partnership framework.
Grocott, P; Browne, N; Cowley, S
Quality of life: Assessing the impact and benefits of care to patients with fungating wounds Journal Article
In: WOUNDS, vol. 17, no. 1, pp. 8–15, 2005, ISSN: 1044-7946.
@article{grocott_quality_2005,
title = {Quality of life: Assessing the impact and benefits of care to patients with fungating wounds},
author = {P Grocott and N Browne and S Cowley},
issn = {1044-7946},
year = {2005},
date = {2005-01-01},
urldate = {2005-01-01},
journal = {WOUNDS},
volume = {17},
number = {1},
pages = {8–15},
abstract = {Fungating malignant wounds are caused by tumor infiltration of the skin. Unless amenable to anti-cancer treatments, the infiltration extends, the wounds advance, and the management goals are palliative. Palliative care optimizes quality of life (QoL) through the control of physical symptoms and attention to patients' psychosocial needs. Quality of life in the context of palliative care and fungating wounds may therefore be conceptualized in terms of focused outcomes of interventions, including dimensions, such as hope, meaning, and self-esteem.
Two disease-specific measurement tools have been identified and can be used to assess and measure the outcomes of fungating wound management together with the impact of the condition on the individual: the Wound and Symptoms Self-Assessment Chart (WoSSAC) and Treatment Evaluation by LE Roux's method (TELER(R)). Both focus on the palliative management of fungating wounds, and although not located in the QoL literature, they address QoL issues. The tools differ fundamentally in their approaches to assessment and measurement, which center on the differences between generic and individualized models of measurement and include the generalization of attributes and use of fixed-item formats.
The conceptual framework that underpins the TELER system relates to key themes drawn from the QoL literature. These themes focus on the individual, reconciliation of expectations and hopes, needs as defined by individuals with health-care professionals, and continuous QoL assessment.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Fungating malignant wounds are caused by tumor infiltration of the skin. Unless amenable to anti-cancer treatments, the infiltration extends, the wounds advance, and the management goals are palliative. Palliative care optimizes quality of life (QoL) through the control of physical symptoms and attention to patients' psychosocial needs. Quality of life in the context of palliative care and fungating wounds may therefore be conceptualized in terms of focused outcomes of interventions, including dimensions, such as hope, meaning, and self-esteem.
Two disease-specific measurement tools have been identified and can be used to assess and measure the outcomes of fungating wound management together with the impact of the condition on the individual: the Wound and Symptoms Self-Assessment Chart (WoSSAC) and Treatment Evaluation by LE Roux's method (TELER(R)). Both focus on the palliative management of fungating wounds, and although not located in the QoL literature, they address QoL issues. The tools differ fundamentally in their approaches to assessment and measurement, which center on the differences between generic and individualized models of measurement and include the generalization of attributes and use of fixed-item formats.
The conceptual framework that underpins the TELER system relates to key themes drawn from the QoL literature. These themes focus on the individual, reconciliation of expectations and hopes, needs as defined by individuals with health-care professionals, and continuous QoL assessment.
Two disease-specific measurement tools have been identified and can be used to assess and measure the outcomes of fungating wound management together with the impact of the condition on the individual: the Wound and Symptoms Self-Assessment Chart (WoSSAC) and Treatment Evaluation by LE Roux's method (TELER(R)). Both focus on the palliative management of fungating wounds, and although not located in the QoL literature, they address QoL issues. The tools differ fundamentally in their approaches to assessment and measurement, which center on the differences between generic and individualized models of measurement and include the generalization of attributes and use of fixed-item formats.
The conceptual framework that underpins the TELER system relates to key themes drawn from the QoL literature. These themes focus on the individual, reconciliation of expectations and hopes, needs as defined by individuals with health-care professionals, and continuous QoL assessment.
2004
Appleton, Jane V; Cowley, Sarah
The guideline contradiction: health visitors’ use of formal guidelines for identifying and assessing families in need Journal Article
In: International Journal of Nursing Studies, vol. 41, no. 7, pp. 785–797, 2004, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Guidelines, health visiting, needs assessment, Professional judgement, targeting
@article{appleton_guideline_2004,
title = {The guideline contradiction: health visitors’ use of formal guidelines for identifying and assessing families in need},
author = {Jane V Appleton and Sarah Cowley},
doi = {10.1016/j.ijnurstu.2004.03.006},
issn = {0020-7489},
year = {2004},
date = {2004-09-01},
urldate = {2004-09-01},
journal = {International Journal of Nursing Studies},
volume = {41},
number = {7},
pages = {785–797},
abstract = {The aim of this paper is to examine health visitors’ use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
With the increasing emphasis on targeted health visiting, a case study was used to explore the extent to which health visitors in three case sites use needs assessment guidelines in the assessment of family health need. The findings indicate how the presence of core visiting protocols hints at elements of control by managers, leading to conflicts in the relationship between professional judgements and official guidelines.
Despite a management ethos of guideline formulation, several contradictions exist for which these guidelines are a focus. These include: little involvement of health visitors in guideline development, some staff not informed about the existence of formal guidelines, little evidence of guidelines contributing to improved client outcomes and their limited use by many health visitors in practice. Thus, even when guidelines exist, no accurate predictions can be made about health visitors’ knowledge of or use of such guidelines in practice.},
keywords = {Guidelines, health visiting, needs assessment, Professional judgement, targeting},
pubstate = {published},
tppubtype = {article}
}
The aim of this paper is to examine health visitors’ use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
With the increasing emphasis on targeted health visiting, a case study was used to explore the extent to which health visitors in three case sites use needs assessment guidelines in the assessment of family health need. The findings indicate how the presence of core visiting protocols hints at elements of control by managers, leading to conflicts in the relationship between professional judgements and official guidelines.
Despite a management ethos of guideline formulation, several contradictions exist for which these guidelines are a focus. These include: little involvement of health visitors in guideline development, some staff not informed about the existence of formal guidelines, little evidence of guidelines contributing to improved client outcomes and their limited use by many health visitors in practice. Thus, even when guidelines exist, no accurate predictions can be made about health visitors’ knowledge of or use of such guidelines in practice.
With the increasing emphasis on targeted health visiting, a case study was used to explore the extent to which health visitors in three case sites use needs assessment guidelines in the assessment of family health need. The findings indicate how the presence of core visiting protocols hints at elements of control by managers, leading to conflicts in the relationship between professional judgements and official guidelines.
Despite a management ethos of guideline formulation, several contradictions exist for which these guidelines are a focus. These include: little involvement of health visitors in guideline development, some staff not informed about the existence of formal guidelines, little evidence of guidelines contributing to improved client outcomes and their limited use by many health visitors in practice. Thus, even when guidelines exist, no accurate predictions can be made about health visitors’ knowledge of or use of such guidelines in practice.
Hanafin, Sinéad; Cowley, Sarah; Griffiths, Peter
An application of the mini review to a complex methodological question: how best to research public health nursing and service quality? Journal Article
In: International Journal of Nursing Studies, vol. 41, no. 7, pp. 799–811, 2004, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Ireland, Methodology, Mini review, Public health nursing, Service quality
@article{hanafin_application_2004,
title = {An application of the mini review to a complex methodological question: how best to research public health nursing and service quality?},
author = {Sinéad Hanafin and Sarah Cowley and Peter Griffiths},
doi = {10.1016/j.ijnurstu.2004.03.007},
issn = {0020-7489},
year = {2004},
date = {2004-09-01},
urldate = {2004-09-01},
journal = {International Journal of Nursing Studies},
volume = {41},
number = {7},
pages = {799–811},
abstract = {This paper describes a mini review which enabled the identification of a suitable methodology to undertake a study about quality in the public health nursing in the Republic of Ireland.
Reviews of literature increasingly adopt the methods of systematic review. In general, these methods have been developed to answer clearly focussed clinical questions. In this paper, we adopt the key elements of systematic review, comprehensive identification of relevant material and selection based on objectively defined validity, to a different type of question, that of an appropriate methodology to examine quality in the public health nursing service. In doing so, we demonstrate that questions of clinical effectiveness are but one application for systematic review.},
keywords = {Ireland, Methodology, Mini review, Public health nursing, Service quality},
pubstate = {published},
tppubtype = {article}
}
This paper describes a mini review which enabled the identification of a suitable methodology to undertake a study about quality in the public health nursing in the Republic of Ireland.
Reviews of literature increasingly adopt the methods of systematic review. In general, these methods have been developed to answer clearly focussed clinical questions. In this paper, we adopt the key elements of systematic review, comprehensive identification of relevant material and selection based on objectively defined validity, to a different type of question, that of an appropriate methodology to examine quality in the public health nursing service. In doing so, we demonstrate that questions of clinical effectiveness are but one application for systematic review.
Reviews of literature increasingly adopt the methods of systematic review. In general, these methods have been developed to answer clearly focussed clinical questions. In this paper, we adopt the key elements of systematic review, comprehensive identification of relevant material and selection based on objectively defined validity, to a different type of question, that of an appropriate methodology to examine quality in the public health nursing service. In doing so, we demonstrate that questions of clinical effectiveness are but one application for systematic review.
Browne, Natasha; Grocott, Patricia; Cowley, Sarah; Cameron, Janice; Dealey, Carol; Keogh, Anne; Lovatt, Ann; Vowden, Kathryn; Vowden, Peter
Woundcare Research for Appropriate Products (WRAP): validation of the TELER method involving users Journal Article
In: International Journal of Nursing Studies, vol. 41, no. 5, pp. 559–571, 2004, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Chronic wounds, Clinical note-making system, Dressing performance, Outcome measurement, User involvement, Validation
@article{browne_woundcare_2004,
title = {Woundcare Research for Appropriate Products (WRAP): validation of the TELER method involving users},
author = {Natasha Browne and Patricia Grocott and Sarah Cowley and Janice Cameron and Carol Dealey and Anne Keogh and Ann Lovatt and Kathryn Vowden and Peter Vowden},
doi = {10.1016/j.ijnurstu.2003.12.009},
issn = {0020-7489},
year = {2004},
date = {2004-07-01},
urldate = {2004-07-01},
journal = {International Journal of Nursing Studies},
volume = {41},
number = {5},
pages = {559–571},
abstract = {Woundcare Research for Appropriate Products (WRAP) is a novel collaboration WRAP between industry and clinicians, funded by the Engineering and Physical Research Sciences Council.
WRAP objectives included the development and testing of methodologies to identify patients’ and clinicians’ needs with respect to wound dressings for exudate management. The management of exudate was the focus because it was demonstrated to be the pivotal problem for patients and clinicians in a study of malignant wounds, and is a recurring problem in other wound types. A clinical note-making system (Treatment Evaluation by Le Roux's method—TELER®) was validated as a method of collecting observational data of dressing performance in the context of total patient care, thereby involving the users of dressing products.
The validation process was a form of consensus where multiple sources of data were used to define patient problems, within the TELER indicators, to measure a change or lack of change in the problems during a period of treatment and care and to draw conclusions about dressing performance and patient experiences.},
keywords = {Chronic wounds, Clinical note-making system, Dressing performance, Outcome measurement, User involvement, Validation},
pubstate = {published},
tppubtype = {article}
}
Woundcare Research for Appropriate Products (WRAP) is a novel collaboration WRAP between industry and clinicians, funded by the Engineering and Physical Research Sciences Council.
WRAP objectives included the development and testing of methodologies to identify patients’ and clinicians’ needs with respect to wound dressings for exudate management. The management of exudate was the focus because it was demonstrated to be the pivotal problem for patients and clinicians in a study of malignant wounds, and is a recurring problem in other wound types. A clinical note-making system (Treatment Evaluation by Le Roux's method—TELER®) was validated as a method of collecting observational data of dressing performance in the context of total patient care, thereby involving the users of dressing products.
The validation process was a form of consensus where multiple sources of data were used to define patient problems, within the TELER indicators, to measure a change or lack of change in the problems during a period of treatment and care and to draw conclusions about dressing performance and patient experiences.
WRAP objectives included the development and testing of methodologies to identify patients’ and clinicians’ needs with respect to wound dressings for exudate management. The management of exudate was the focus because it was demonstrated to be the pivotal problem for patients and clinicians in a study of malignant wounds, and is a recurring problem in other wound types. A clinical note-making system (Treatment Evaluation by Le Roux's method—TELER®) was validated as a method of collecting observational data of dressing performance in the context of total patient care, thereby involving the users of dressing products.
The validation process was a form of consensus where multiple sources of data were used to define patient problems, within the TELER indicators, to measure a change or lack of change in the problems during a period of treatment and care and to draw conclusions about dressing performance and patient experiences.
Cowley, Sarah; Houston, Anna
Contradictory agendas in health visitor needs assessment. A discussion paper of its use for prioritizing, targeting and promoting health Journal Article
In: Primary Health Care Research & Development, vol. 5, no. 3, pp. 240–254, 2004, ISSN: 1477-1128, 1463-4236, (Publisher: Cambridge University Press).
Abstract | Links | BibTeX | Tags: empowerment, health promotion, health visiting, prioritizing, public health, targeting
@article{cowley_contradictory_2004,
title = {Contradictory agendas in health visitor needs assessment. A discussion paper of its use for prioritizing, targeting and promoting health},
author = {Sarah Cowley and Anna Houston},
doi = {10.1191/1463423604pc209oa},
issn = {1477-1128, 1463-4236},
year = {2004},
date = {2004-07-01},
urldate = {2004-07-01},
journal = {Primary Health Care Research & Development},
volume = {5},
number = {3},
pages = {240–254},
abstract = {This paper was motivated by the adverse results of a study that evaluated implementation of a structured health needs assessment tool in health visiting. It examines the conceptual basis of three approaches to needs assessment, exploring their relevance to the purpose of health visiting and their links with prioritizing, targeting and promoting health in practice.
It is intended to help health visitors, their managers and service commissioners to explain and understand the different requirements and expectations in each approach.British Government policy emphasizes that targeting and prioritizing are the means by which inequalities can be redressed and resources directed towards those in greatest need. Needs assessment processes are increasingly invoked as the mechanism through which health visiting services can best be deployed.
Health visitors are expected to help identify service priorities and to target their efforts effectively and efficiently. Access to services and user empowerment are also important aspects of the NHS modernization agenda. These concepts are fundamental to health promotion, which has been the consistent underlying purpose of the health visiting service since its inception.In this discussion paper, three approaches to needs assessment are unravelled, which focus on prioritizing, targeting and health promotion. It is suggested that these different purposes relate, in turn, to the expectations and requirements of public health, organizational efficiency and user empowerment.
There are important benefits associated with each of the three approaches, but their underlying principles, purposes and requirements differ. Failure to appreciate such differences can lead to misunderstandings, confusion and even offence. A single instrument cannot successfully meet the expectations of all three approaches to needs assessment. Instead, a needs assessment system is necessary, to meet the contradictory requirements of public health, organizational efficiency and user empowerment.},
note = {Publisher: Cambridge University Press},
keywords = {empowerment, health promotion, health visiting, prioritizing, public health, targeting},
pubstate = {published},
tppubtype = {article}
}
This paper was motivated by the adverse results of a study that evaluated implementation of a structured health needs assessment tool in health visiting. It examines the conceptual basis of three approaches to needs assessment, exploring their relevance to the purpose of health visiting and their links with prioritizing, targeting and promoting health in practice.
It is intended to help health visitors, their managers and service commissioners to explain and understand the different requirements and expectations in each approach.British Government policy emphasizes that targeting and prioritizing are the means by which inequalities can be redressed and resources directed towards those in greatest need. Needs assessment processes are increasingly invoked as the mechanism through which health visiting services can best be deployed.
Health visitors are expected to help identify service priorities and to target their efforts effectively and efficiently. Access to services and user empowerment are also important aspects of the NHS modernization agenda. These concepts are fundamental to health promotion, which has been the consistent underlying purpose of the health visiting service since its inception.In this discussion paper, three approaches to needs assessment are unravelled, which focus on prioritizing, targeting and health promotion. It is suggested that these different purposes relate, in turn, to the expectations and requirements of public health, organizational efficiency and user empowerment.
There are important benefits associated with each of the three approaches, but their underlying principles, purposes and requirements differ. Failure to appreciate such differences can lead to misunderstandings, confusion and even offence. A single instrument cannot successfully meet the expectations of all three approaches to needs assessment. Instead, a needs assessment system is necessary, to meet the contradictory requirements of public health, organizational efficiency and user empowerment.
It is intended to help health visitors, their managers and service commissioners to explain and understand the different requirements and expectations in each approach.British Government policy emphasizes that targeting and prioritizing are the means by which inequalities can be redressed and resources directed towards those in greatest need. Needs assessment processes are increasingly invoked as the mechanism through which health visiting services can best be deployed.
Health visitors are expected to help identify service priorities and to target their efforts effectively and efficiently. Access to services and user empowerment are also important aspects of the NHS modernization agenda. These concepts are fundamental to health promotion, which has been the consistent underlying purpose of the health visiting service since its inception.In this discussion paper, three approaches to needs assessment are unravelled, which focus on prioritizing, targeting and health promotion. It is suggested that these different purposes relate, in turn, to the expectations and requirements of public health, organizational efficiency and user empowerment.
There are important benefits associated with each of the three approaches, but their underlying principles, purposes and requirements differ. Failure to appreciate such differences can lead to misunderstandings, confusion and even offence. A single instrument cannot successfully meet the expectations of all three approaches to needs assessment. Instead, a needs assessment system is necessary, to meet the contradictory requirements of public health, organizational efficiency and user empowerment.
Cowley, Sarah
An open letter to Dr Stephen Ladyman... Journal Article
In: Community Practitioner, vol. 77, no. 3, pp. 113–114, 2004.
BibTeX | Tags:
@article{cowley_open_2004,
title = {An open letter to Dr Stephen Ladyman...},
author = {Sarah Cowley},
year = {2004},
date = {2004-03-01},
urldate = {2004-03-01},
journal = {Community Practitioner},
volume = {77},
number = {3},
pages = {113–114},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Heath, Helen; Cowley, Sarah
Developing a grounded theory approach: a comparison of Glaser and Strauss Journal Article
In: International Journal of Nursing Studies, vol. 41, no. 2, pp. 141–150, 2004, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Analytic approaches, Grounded theory, Research methodology
@article{heath_developing_2004,
title = {Developing a grounded theory approach: a comparison of Glaser and Strauss},
author = {Helen Heath and Sarah Cowley},
doi = {10.1016/S0020-7489(03)00113-5},
issn = {0020-7489},
year = {2004},
date = {2004-02-01},
urldate = {2004-02-01},
journal = {International Journal of Nursing Studies},
volume = {41},
number = {2},
pages = {141–150},
abstract = {Novice qualitative researchers are often unsure regarding the analysis of their data and, where grounded theory is chosen, they may be uncertain regarding the differences that now exist between the approaches of Glaser and Strauss, who together first described the method.
These two approaches are compared in relation to roots and divergences, role of induction, deduction and verification, ways in which data are coded and the format of generated theory. Personal experience of developing as a ground theorist is used to illustrate some of the key differences.
A conclusion is drawn that, rather than debate relative merits of the two approaches, suggests that novice researchers need to select the method that best suits their cognitive style and develop analytic skills through doing research.},
keywords = {Analytic approaches, Grounded theory, Research methodology},
pubstate = {published},
tppubtype = {article}
}
Novice qualitative researchers are often unsure regarding the analysis of their data and, where grounded theory is chosen, they may be uncertain regarding the differences that now exist between the approaches of Glaser and Strauss, who together first described the method.
These two approaches are compared in relation to roots and divergences, role of induction, deduction and verification, ways in which data are coded and the format of generated theory. Personal experience of developing as a ground theorist is used to illustrate some of the key differences.
A conclusion is drawn that, rather than debate relative merits of the two approaches, suggests that novice researchers need to select the method that best suits their cognitive style and develop analytic skills through doing research.
These two approaches are compared in relation to roots and divergences, role of induction, deduction and verification, ways in which data are coded and the format of generated theory. Personal experience of developing as a ground theorist is used to illustrate some of the key differences.
A conclusion is drawn that, rather than debate relative merits of the two approaches, suggests that novice researchers need to select the method that best suits their cognitive style and develop analytic skills through doing research.
Browne, Natasha; Grocott, Patricia; Cowley, Sarah
The wound dressing supply chain within England's National Health Service: unravelling the context for users Journal Article
In: Journal of Nursing Management, vol. 12, no. 1, pp. 51–61, 2004, ISSN: 1365-2834.
Abstract | Links | BibTeX | Tags: supply chain, wound dressings
@article{browne_wound_2004,
title = {The wound dressing supply chain within England's National Health Service: unravelling the context for users},
author = {Natasha Browne and Patricia Grocott and Sarah Cowley},
doi = {10.1046/j.1365-2834.2003.00436.x},
issn = {1365-2834},
year = {2004},
date = {2004-01-01},
urldate = {2004-01-01},
journal = {Journal of Nursing Management},
volume = {12},
number = {1},
pages = {51–61},
abstract = {Aim
To explore the representation of user needs (nurses and patients, both individuals and groups) at the industrial (wound dressing manufacture) and National Health Service interface.
Main issues
The wound dressing supply chain is outlined, tracking organizational changes. The methods that are used to transfer user information between industries that produce dressings and those using the products are reviewed in terms of their ability to communicate what users need from dressings. Organizational policies and systems are outlined, with the focus on their role in facilitating the communication of user needs.
Conclusion
Methods for generating user information that can directly inform dressing design are needed together with interactive communication routes within the supply chain, specifically between users, manufacturers, purchasers and suppliers. This will facilitate dual benefits for nursing management through improvements in purchasing decisions and nurses’ management of wound care.},
keywords = {supply chain, wound dressings},
pubstate = {published},
tppubtype = {article}
}
Aim
To explore the representation of user needs (nurses and patients, both individuals and groups) at the industrial (wound dressing manufacture) and National Health Service interface.
Main issues
The wound dressing supply chain is outlined, tracking organizational changes. The methods that are used to transfer user information between industries that produce dressings and those using the products are reviewed in terms of their ability to communicate what users need from dressings. Organizational policies and systems are outlined, with the focus on their role in facilitating the communication of user needs.
Conclusion
Methods for generating user information that can directly inform dressing design are needed together with interactive communication routes within the supply chain, specifically between users, manufacturers, purchasers and suppliers. This will facilitate dual benefits for nursing management through improvements in purchasing decisions and nurses’ management of wound care.
To explore the representation of user needs (nurses and patients, both individuals and groups) at the industrial (wound dressing manufacture) and National Health Service interface.
Main issues
The wound dressing supply chain is outlined, tracking organizational changes. The methods that are used to transfer user information between industries that produce dressings and those using the products are reviewed in terms of their ability to communicate what users need from dressings. Organizational policies and systems are outlined, with the focus on their role in facilitating the communication of user needs.
Conclusion
Methods for generating user information that can directly inform dressing design are needed together with interactive communication routes within the supply chain, specifically between users, manufacturers, purchasers and suppliers. This will facilitate dual benefits for nursing management through improvements in purchasing decisions and nurses’ management of wound care.
Browne, N.; Grocott, P.; Cowley, S.; Cameron, J.; Dealey, C.; Keogh, A.; Lovatt, A.; Vowden, K.; Vowden, P.
The TELER system in wound care research and post market surveillance Journal Article
In: The EWMA Journal, vol. 4, no. 1, pp. 26–32, 2004, ISSN: 1609-2759, (Number: 1).
BibTeX | Tags:
@article{browne_teler_2004,
title = {The TELER system in wound care research and post market surveillance},
author = {N. Browne and P. Grocott and S. Cowley and J. Cameron and C. Dealey and A. Keogh and A. Lovatt and K. Vowden and P. Vowden},
issn = {1609-2759},
year = {2004},
date = {2004-01-01},
urldate = {2004-01-01},
journal = {The EWMA Journal},
volume = {4},
number = {1},
pages = {26–32},
note = {Number: 1},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah; Mitcheson, Jan; Houston, Anna M.
Structuring health needs assessments: the medicalisation of health visiting Journal Article
In: Sociology of Health & Illness, vol. 26, no. 5, pp. 503–526, 2004, ISSN: 1467-9566.
Abstract | Links | BibTeX | Tags: conversation analysis, Foucault, health needs assessment, health visiting, medicalisation, resistance, surveillance
@article{cowley_structuring_2004,
title = {Structuring health needs assessments: the medicalisation of health visiting},
author = {Sarah Cowley and Jan Mitcheson and Anna M. Houston},
doi = {10.1111/j.0141-9889.2004.00403.x},
issn = {1467-9566},
year = {2004},
date = {2004-01-01},
urldate = {2004-01-01},
journal = {Sociology of Health & Illness},
volume = {26},
number = {5},
pages = {503–526},
abstract = {This paper draws on Foucault to understand the changing discourse and impact of structured ‘health needs assessments’ on health visiting practice.
Literature about this activity makes little mention of the long-standing social purposes of health visiting, which include surveillance of vulnerable and invisible populations, providing them, where needed, with help and support to access protective and supportive services. Instead, the discourse has been concerned primarily with an epidemiological focus and public health, which is associated with risk factors and assessments.
The use of pre-defined needs assessment schedules suggests that health visiting activity can be sanctioned and clients’ needs serviced only if they reach the threshold of pre-determined, epidemiologically-defined risk. Their effect on practice is examined through a conversation analysis of ten health visitor/client interactions using two different structured needs assessment tools.
The study indicates that the health visitors, like their clients, were controlled by institutional expectations of their role; analysis of their conversations shows how they achieved the requirements of the organisational agenda. Structuring client needs and health visiting practice through the use of formal needs assessment tools emphasises the epidemiological focus of the health service above the need to arrange support for vulnerable individuals. In this respect, it serves as a marker in the continued medicalisation of health visiting.},
keywords = {conversation analysis, Foucault, health needs assessment, health visiting, medicalisation, resistance, surveillance},
pubstate = {published},
tppubtype = {article}
}
This paper draws on Foucault to understand the changing discourse and impact of structured ‘health needs assessments’ on health visiting practice.
Literature about this activity makes little mention of the long-standing social purposes of health visiting, which include surveillance of vulnerable and invisible populations, providing them, where needed, with help and support to access protective and supportive services. Instead, the discourse has been concerned primarily with an epidemiological focus and public health, which is associated with risk factors and assessments.
The use of pre-defined needs assessment schedules suggests that health visiting activity can be sanctioned and clients’ needs serviced only if they reach the threshold of pre-determined, epidemiologically-defined risk. Their effect on practice is examined through a conversation analysis of ten health visitor/client interactions using two different structured needs assessment tools.
The study indicates that the health visitors, like their clients, were controlled by institutional expectations of their role; analysis of their conversations shows how they achieved the requirements of the organisational agenda. Structuring client needs and health visiting practice through the use of formal needs assessment tools emphasises the epidemiological focus of the health service above the need to arrange support for vulnerable individuals. In this respect, it serves as a marker in the continued medicalisation of health visiting.
Literature about this activity makes little mention of the long-standing social purposes of health visiting, which include surveillance of vulnerable and invisible populations, providing them, where needed, with help and support to access protective and supportive services. Instead, the discourse has been concerned primarily with an epidemiological focus and public health, which is associated with risk factors and assessments.
The use of pre-defined needs assessment schedules suggests that health visiting activity can be sanctioned and clients’ needs serviced only if they reach the threshold of pre-determined, epidemiologically-defined risk. Their effect on practice is examined through a conversation analysis of ten health visitor/client interactions using two different structured needs assessment tools.
The study indicates that the health visitors, like their clients, were controlled by institutional expectations of their role; analysis of their conversations shows how they achieved the requirements of the organisational agenda. Structuring client needs and health visiting practice through the use of formal needs assessment tools emphasises the epidemiological focus of the health service above the need to arrange support for vulnerable individuals. In this respect, it serves as a marker in the continued medicalisation of health visiting.
2003
Hanafin, Sinad; Cowley, Sarah
Multidisciplinary communication in the Irish public health nursing service: a study Journal Article
In: British Journal of Community Nursing, vol. 8, no. 12, pp. 544–549, 2003, ISSN: 1462-4753, (Publisher: Mark Allen Group).
Abstract | Links | BibTeX | Tags:
@article{hanafin_multidisciplinary_2003,
title = {Multidisciplinary communication in the Irish public health nursing service: a study},
author = {Sinad Hanafin and Sarah Cowley},
doi = {10.12968/bjcn.2003.8.12.11850},
issn = {1462-4753},
year = {2003},
date = {2003-12-01},
urldate = {2003-12-01},
journal = {British Journal of Community Nursing},
volume = {8},
number = {12},
pages = {544–549},
abstract = {Public health nurses (PHNs) in the Republic of Ireland work as part of a multidisciplinary team in the delivery of community-care services. Good interdisciplinary communication is therefore vital to enable them to offer the best possible care to their clients.
This article reports on one section of a national survey of PHNs who work with families with infants. The findings suggest that although in general, PHNs reported good working relationships with other professionals – particularly with speech therapists, area medical officers and community welfare officers – the same could not be said for hearing and eye specialists. Feedback also varied according to professional group, with less than one third of PHNs reporting they always received feedback from GPs, eye specialists or social workers.
A significant statistical correlation was found between reported working relationships and the frequency that feedback was received. These findings have implications for communication and teamworking in primary care in the Republic of Ireland and elsewhere.},
note = {Publisher: Mark Allen Group},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Public health nurses (PHNs) in the Republic of Ireland work as part of a multidisciplinary team in the delivery of community-care services. Good interdisciplinary communication is therefore vital to enable them to offer the best possible care to their clients.
This article reports on one section of a national survey of PHNs who work with families with infants. The findings suggest that although in general, PHNs reported good working relationships with other professionals – particularly with speech therapists, area medical officers and community welfare officers – the same could not be said for hearing and eye specialists. Feedback also varied according to professional group, with less than one third of PHNs reporting they always received feedback from GPs, eye specialists or social workers.
A significant statistical correlation was found between reported working relationships and the frequency that feedback was received. These findings have implications for communication and teamworking in primary care in the Republic of Ireland and elsewhere.
This article reports on one section of a national survey of PHNs who work with families with infants. The findings suggest that although in general, PHNs reported good working relationships with other professionals – particularly with speech therapists, area medical officers and community welfare officers – the same could not be said for hearing and eye specialists. Feedback also varied according to professional group, with less than one third of PHNs reporting they always received feedback from GPs, eye specialists or social workers.
A significant statistical correlation was found between reported working relationships and the frequency that feedback was received. These findings have implications for communication and teamworking in primary care in the Republic of Ireland and elsewhere.
Baraitser, Paula; Dolan, Frances; Cowley, Sarah
Developing Relationships Between Sexual Health Clinics and Schools: More than clinic nurses doing sex education sessions? Journal Article
In: Sex Education, vol. 3, no. 3, pp. 201–213, 2003, ISSN: 1468-1811, (Publisher: Routledge).
Abstract | Links | BibTeX | Tags:
@article{baraitser_developing_2003,
title = {Developing Relationships Between Sexual Health Clinics and Schools: More than clinic nurses doing sex education sessions?},
author = {Paula Baraitser and Frances Dolan and Sarah Cowley},
doi = {10.1080/1468181032000119096},
issn = {1468-1811},
year = {2003},
date = {2003-11-01},
urldate = {2003-11-01},
journal = {Sex Education},
volume = {3},
number = {3},
pages = {201–213},
abstract = {Linking schools with sexual health clinics facilitates clinic access by young people. This paper documents the process of developing one such link and its impact on clinic use.
Multiple data collection strategies were used to document a developing school/clinic relationship and constant comparative analysis was used to develop hypotheses from the data as follows:
* A few teachers have a good knowledge of local sexual health services and extensive experience of referring to them.
* Most tutors (despite their pastoral role) have little knowledge of local sexual health services and no experience of referring to them.
* Organising work in the school is difficult because teachers have little non-teaching time and a variable commitment to sex and relationship education.
* The link between the clinic and the school has facilitated access to the clinic by school pupils.
* Outreach work is more effective when young people meet the outreach worker repeatedly in different settings.
Each hypothesis is presented with its supporting data. This information is consistent with what is known about the benefits of school/clinic links and adds to what is known about the process of developing and maintaining such links.},
note = {Publisher: Routledge},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Linking schools with sexual health clinics facilitates clinic access by young people. This paper documents the process of developing one such link and its impact on clinic use.
Multiple data collection strategies were used to document a developing school/clinic relationship and constant comparative analysis was used to develop hypotheses from the data as follows:
* A few teachers have a good knowledge of local sexual health services and extensive experience of referring to them.
* Most tutors (despite their pastoral role) have little knowledge of local sexual health services and no experience of referring to them.
* Organising work in the school is difficult because teachers have little non-teaching time and a variable commitment to sex and relationship education.
* The link between the clinic and the school has facilitated access to the clinic by school pupils.
* Outreach work is more effective when young people meet the outreach worker repeatedly in different settings.
Each hypothesis is presented with its supporting data. This information is consistent with what is known about the benefits of school/clinic links and adds to what is known about the process of developing and maintaining such links.
Multiple data collection strategies were used to document a developing school/clinic relationship and constant comparative analysis was used to develop hypotheses from the data as follows:
* A few teachers have a good knowledge of local sexual health services and extensive experience of referring to them.
* Most tutors (despite their pastoral role) have little knowledge of local sexual health services and no experience of referring to them.
* Organising work in the school is difficult because teachers have little non-teaching time and a variable commitment to sex and relationship education.
* The link between the clinic and the school has facilitated access to the clinic by school pupils.
* Outreach work is more effective when young people meet the outreach worker repeatedly in different settings.
Each hypothesis is presented with its supporting data. This information is consistent with what is known about the benefits of school/clinic links and adds to what is known about the process of developing and maintaining such links.
Mitcheson, Jan; Cowley, Sarah
In: International Journal of Nursing Studies, vol. 40, no. 4, pp. 413–426, 2003, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Control, Conversational analysis, empowerment, health promotion, health visiting, needs assessment, Participation
@article{mitcheson_empowerment_2003,
title = {Empowerment or control? An analysis of the extent to which client participation is enabled during health visitor/client interactions using a structured health needs assessment tool},
author = {Jan Mitcheson and Sarah Cowley},
doi = {10.1016/S0020-7489(02)00107-4},
issn = {0020-7489},
year = {2003},
date = {2003-05-01},
urldate = {2003-05-01},
journal = {International Journal of Nursing Studies},
volume = {40},
number = {4},
pages = {413–426},
abstract = {The demand for explicitness in the way health visitors target their services has given rise to a plethora of different health needs assessment tools (HNATs). This paper describes an in-depth conversational analysis of the use in practice of these structured health needs assessment tools (HNATs) in two different NHS Community Trusts in England.
These HNATs aimed to enable clients to participate in the assessment of their own health needs, as well as fulfilling the political requirements of justifying the expenditure of health visitor time where needs are identified. However, conversational analysis of 10 interactions showed that use of the instruments was associated with a failure to either identify needs that are relevant to the client or to enable clients to participate in the process. Use of the structured instrument simultaneously emphasises the significance of a professional lead, instead of client participation, and minimises the importance of inter-personal relationships and communication.
In one site, a directly controlling style was apparent in the practice of health visitors who were, themselves, explicitly controlled by their managers. In the other site, professional expertise was emphasised, and a covert assessment style acted to disempower clients. The controlling nature of the interactions, the number of missed cues and the possibility of distress caused by the insensitivity of questioning style are all potentially harmful side effects of using structured instruments to assess needs. The problems seem to stem from the use of a pre-determined list of questions that form the basis for assuming that any family's health promotion needs can be categorised and predicted in advance.
In conclusion, therefore, it is recommended that health visitors should use the open, conversational style of needs assessment that has been shown to be effective and acceptable, rather than an approach based on a structured instrument.},
keywords = {Control, Conversational analysis, empowerment, health promotion, health visiting, needs assessment, Participation},
pubstate = {published},
tppubtype = {article}
}
The demand for explicitness in the way health visitors target their services has given rise to a plethora of different health needs assessment tools (HNATs). This paper describes an in-depth conversational analysis of the use in practice of these structured health needs assessment tools (HNATs) in two different NHS Community Trusts in England.
These HNATs aimed to enable clients to participate in the assessment of their own health needs, as well as fulfilling the political requirements of justifying the expenditure of health visitor time where needs are identified. However, conversational analysis of 10 interactions showed that use of the instruments was associated with a failure to either identify needs that are relevant to the client or to enable clients to participate in the process. Use of the structured instrument simultaneously emphasises the significance of a professional lead, instead of client participation, and minimises the importance of inter-personal relationships and communication.
In one site, a directly controlling style was apparent in the practice of health visitors who were, themselves, explicitly controlled by their managers. In the other site, professional expertise was emphasised, and a covert assessment style acted to disempower clients. The controlling nature of the interactions, the number of missed cues and the possibility of distress caused by the insensitivity of questioning style are all potentially harmful side effects of using structured instruments to assess needs. The problems seem to stem from the use of a pre-determined list of questions that form the basis for assuming that any family's health promotion needs can be categorised and predicted in advance.
In conclusion, therefore, it is recommended that health visitors should use the open, conversational style of needs assessment that has been shown to be effective and acceptable, rather than an approach based on a structured instrument.
These HNATs aimed to enable clients to participate in the assessment of their own health needs, as well as fulfilling the political requirements of justifying the expenditure of health visitor time where needs are identified. However, conversational analysis of 10 interactions showed that use of the instruments was associated with a failure to either identify needs that are relevant to the client or to enable clients to participate in the process. Use of the structured instrument simultaneously emphasises the significance of a professional lead, instead of client participation, and minimises the importance of inter-personal relationships and communication.
In one site, a directly controlling style was apparent in the practice of health visitors who were, themselves, explicitly controlled by their managers. In the other site, professional expertise was emphasised, and a covert assessment style acted to disempower clients. The controlling nature of the interactions, the number of missed cues and the possibility of distress caused by the insensitivity of questioning style are all potentially harmful side effects of using structured instruments to assess needs. The problems seem to stem from the use of a pre-determined list of questions that form the basis for assuming that any family's health promotion needs can be categorised and predicted in advance.
In conclusion, therefore, it is recommended that health visitors should use the open, conversational style of needs assessment that has been shown to be effective and acceptable, rather than an approach based on a structured instrument.
Mathew, Alison; Cowley, Sarah; Bliss, Julie; Thistlewood, Gillian
The development of palliative care in national government policy in England, 1986–2000 Journal Article
In: Palliative Medicine, vol. 17, no. 3, pp. 270–282, 2003, ISSN: 0269-2163, (Publisher: SAGE Publications Ltd STM).
Abstract | Links | BibTeX | Tags:
@article{mathew_development_2003,
title = {The development of palliative care in national government policy in England, 1986–2000},
author = {Alison Mathew and Sarah Cowley and Julie Bliss and Gillian Thistlewood},
doi = {10.1191/0269216303pm693oa},
issn = {0269-2163},
year = {2003},
date = {2003-04-01},
urldate = {2003-04-01},
journal = {Palliative Medicine},
volume = {17},
number = {3},
pages = {270–282},
abstract = {Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services.
As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined.
The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.},
note = {Publisher: SAGE Publications Ltd STM},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services.
As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined.
The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.
As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined.
The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.
Houston, Anna M.; Cowley, Sarah
Health needs assessment in the health visiting service and the impact on the ethnic community Journal Article
In: International Journal of Nursing Studies, vol. 40, no. 1, pp. 85–94, 2003, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags:
@article{houston_health_2003,
title = {Health needs assessment in the health visiting service and the impact on the ethnic community},
author = {Anna M. Houston and Sarah Cowley},
doi = {10.1016/S0020-7489(02)00040-8},
issn = {0020-7489},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {International Journal of Nursing Studies},
volume = {40},
number = {1},
pages = {85–94},
abstract = {The purpose of this article is to share the experience of using a health needs assessment tool in health visiting practice in Great Britain, with clients who do not speak English. This is an important issue in developing equity of practice across the growing multi-cultural and diverse populations of the United Kingdom. The paper outlines the findings relevant to these issues drawn from a wider study that used qualitative methods to observe and interview both health visitors and clients regarding the use of the tool. It focuses on one vignette to demonstrate the practical and difficult issues when a formal system is used to assess needs in clients who do not speak English as a first language.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The purpose of this article is to share the experience of using a health needs assessment tool in health visiting practice in Great Britain, with clients who do not speak English. This is an important issue in developing equity of practice across the growing multi-cultural and diverse populations of the United Kingdom. The paper outlines the findings relevant to these issues drawn from a wider study that used qualitative methods to observe and interview both health visitors and clients regarding the use of the tool. It focuses on one vignette to demonstrate the practical and difficult issues when a formal system is used to assess needs in clients who do not speak English as a first language.
Whittaker, Karen; Cowley, Sarah
Parenting support: Where does it fit with public Journal Article
In: Community Practitioner, vol. 76, no. 3, pp. 100–103, 2003.
@article{whittaker_karen_parenting_2003,
title = {Parenting support: Where does it fit with public},
author = {Karen Whittaker and Sarah Cowley},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Community Practitioner},
volume = {76},
number = {3},
pages = {100–103},
abstract = {With the growth in political awareness of the value and importance of appropriate parenting, work in this area has grown rapidly in the last five years. Not least, community health practitioners have been involved in a variety of specific parenting support initiatives that have taken various forms. Simultaneously there has been an earnest plea for health visitors to return back to population approaches for supporting health, and community development strategies are often cited as the means for achieving such goals. This paper explores how the practice of parenting support, can complement community development approaches for improving the health of whole communities and identifies a clear role for community practitioners},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
With the growth in political awareness of the value and importance of appropriate parenting, work in this area has grown rapidly in the last five years. Not least, community health practitioners have been involved in a variety of specific parenting support initiatives that have taken various forms. Simultaneously there has been an earnest plea for health visitors to return back to population approaches for supporting health, and community development strategies are often cited as the means for achieving such goals. This paper explores how the practice of parenting support, can complement community development approaches for improving the health of whole communities and identifies a clear role for community practitioners
Appleton, J; Cowley, S
Valuing professional judgement in health visiting Journal Article
In: Community practitioner, vol. 76, no. 6, pp. 215–220, 2003.
@article{appleton_valuing_2003,
title = {Valuing professional judgement in health visiting},
author = {J Appleton and S Cowley},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Community practitioner},
volume = {76},
number = {6},
pages = {215–220},
abstract = {Current health and social care policy highlights the importance of accurately identifying children in need and the needs of their families. This paper reports on one aspect of a study undertaken to examine health visitors' use of professional judgements and formal guidelines for identifying families requiring extra health visiting support.
The paper focuses specifically on health visitors' use of professional judgement in the assessment of family health need. A case-study strategy informed by a constructivist methodology was adopted to examine health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a judgement to offer a family extra support. Data collection took place during 56 visits to families receiving increased health visiting support and intervention. Following these home visits separate in-depth interviews were undertaken with health visitors and clients.
A key feature of the analysis was the fact that even when guidelines exist, in reality most health visitors use their own professional judgement in making family assessments. It is hoped that the paper will contribute to the knowledge base of health visiting by attempting to unpack some of the elements of professional judgement and consider its value in health visiting practice},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Current health and social care policy highlights the importance of accurately identifying children in need and the needs of their families. This paper reports on one aspect of a study undertaken to examine health visitors' use of professional judgements and formal guidelines for identifying families requiring extra health visiting support.
The paper focuses specifically on health visitors' use of professional judgement in the assessment of family health need. A case-study strategy informed by a constructivist methodology was adopted to examine health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a judgement to offer a family extra support. Data collection took place during 56 visits to families receiving increased health visiting support and intervention. Following these home visits separate in-depth interviews were undertaken with health visitors and clients.
A key feature of the analysis was the fact that even when guidelines exist, in reality most health visitors use their own professional judgement in making family assessments. It is hoped that the paper will contribute to the knowledge base of health visiting by attempting to unpack some of the elements of professional judgement and consider its value in health visiting practice
The paper focuses specifically on health visitors' use of professional judgement in the assessment of family health need. A case-study strategy informed by a constructivist methodology was adopted to examine health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a judgement to offer a family extra support. Data collection took place during 56 visits to families receiving increased health visiting support and intervention. Following these home visits separate in-depth interviews were undertaken with health visitors and clients.
A key feature of the analysis was the fact that even when guidelines exist, in reality most health visitors use their own professional judgement in making family assessments. It is hoped that the paper will contribute to the knowledge base of health visiting by attempting to unpack some of the elements of professional judgement and consider its value in health visiting practice
Cowley, Sarah; Houston, Anna M.
A structured health needs assessment tool: acceptability and effectiveness for health visiting Journal Article
In: Journal of Advanced Nursing, vol. 43, no. 1, pp. 82–92, 2003, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags: consumer views, health visiting, home visiting, structured health needs assessment, universal vs. selective, vulnerable families
@article{cowley_structured_2003,
title = {A structured health needs assessment tool: acceptability and effectiveness for health visiting},
author = {Sarah Cowley and Anna M. Houston},
doi = {10.1046/j.1365-2648.2003.02675.x},
issn = {1365-2648},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Journal of Advanced Nursing},
volume = {43},
number = {1},
pages = {82–92},
abstract = {Background
There is, nominally at least, a universal health visiting service in Great Britain, although the frequency of contacts may be severely restricted. Debates about whether home visiting should be universal or selective, therefore, focus on whether health visitors should use professional judgement or structured assessment tools to target attention within their caseload. Research attention has focused mainly on unstructured needs assessments and professional judgment or the development of assessment tools, so that the views of practitioners using structured instruments and their clients are not known.
Methods
A two-phase qualitative study examined the acceptability and effectiveness of a structured health needs assessment tool (HNAT) implemented in London. Views about the tool were elicited from 30 health visitors through telephone interview, and then 21 assessments were observed and tape-recorded; 19 clients were interviewed after the event. Data were evaluated for adequate coverage of views across the target population and analysed using the framework approach.
Findings
A range of views were expressed, but the HNAT caused anxiety and distress to, particularly, the most vulnerable clients. The structured format of the tool appeared to encourage the health visitors to question instead of listen. It did not help to identify all the needs and intruded into normal practice in an insensitive and unhelpful way.
Limitations
This study investigated only one form of structured HNAT. These are commonly used to prioritize undifferentiated needs of clients who have been offered an unsolicited, health promoting service. Our findings therefore do not apply to validated instruments used for screening or specific diagnostic purposes where a client has requested help with a problem.
Conclusions
Given the problems in use and potential for harm, this form of structured assessment tool appears unsuitable for routine use to determine the intensity of health visiting contacts.},
keywords = {consumer views, health visiting, home visiting, structured health needs assessment, universal vs. selective, vulnerable families},
pubstate = {published},
tppubtype = {article}
}
Background
There is, nominally at least, a universal health visiting service in Great Britain, although the frequency of contacts may be severely restricted. Debates about whether home visiting should be universal or selective, therefore, focus on whether health visitors should use professional judgement or structured assessment tools to target attention within their caseload. Research attention has focused mainly on unstructured needs assessments and professional judgment or the development of assessment tools, so that the views of practitioners using structured instruments and their clients are not known.
Methods
A two-phase qualitative study examined the acceptability and effectiveness of a structured health needs assessment tool (HNAT) implemented in London. Views about the tool were elicited from 30 health visitors through telephone interview, and then 21 assessments were observed and tape-recorded; 19 clients were interviewed after the event. Data were evaluated for adequate coverage of views across the target population and analysed using the framework approach.
Findings
A range of views were expressed, but the HNAT caused anxiety and distress to, particularly, the most vulnerable clients. The structured format of the tool appeared to encourage the health visitors to question instead of listen. It did not help to identify all the needs and intruded into normal practice in an insensitive and unhelpful way.
Limitations
This study investigated only one form of structured HNAT. These are commonly used to prioritize undifferentiated needs of clients who have been offered an unsolicited, health promoting service. Our findings therefore do not apply to validated instruments used for screening or specific diagnostic purposes where a client has requested help with a problem.
Conclusions
Given the problems in use and potential for harm, this form of structured assessment tool appears unsuitable for routine use to determine the intensity of health visiting contacts.
There is, nominally at least, a universal health visiting service in Great Britain, although the frequency of contacts may be severely restricted. Debates about whether home visiting should be universal or selective, therefore, focus on whether health visitors should use professional judgement or structured assessment tools to target attention within their caseload. Research attention has focused mainly on unstructured needs assessments and professional judgment or the development of assessment tools, so that the views of practitioners using structured instruments and their clients are not known.
Methods
A two-phase qualitative study examined the acceptability and effectiveness of a structured health needs assessment tool (HNAT) implemented in London. Views about the tool were elicited from 30 health visitors through telephone interview, and then 21 assessments were observed and tape-recorded; 19 clients were interviewed after the event. Data were evaluated for adequate coverage of views across the target population and analysed using the framework approach.
Findings
A range of views were expressed, but the HNAT caused anxiety and distress to, particularly, the most vulnerable clients. The structured format of the tool appeared to encourage the health visitors to question instead of listen. It did not help to identify all the needs and intruded into normal practice in an insensitive and unhelpful way.
Limitations
This study investigated only one form of structured HNAT. These are commonly used to prioritize undifferentiated needs of clients who have been offered an unsolicited, health promoting service. Our findings therefore do not apply to validated instruments used for screening or specific diagnostic purposes where a client has requested help with a problem.
Conclusions
Given the problems in use and potential for harm, this form of structured assessment tool appears unsuitable for routine use to determine the intensity of health visiting contacts.
Cowley, Sarah
Modernising health visiting education:potential, problems and progress Journal Article
In: Community Pract, vol. 76, pp. 418–422, 2003.
@article{cowley_modernising_2003,
title = {Modernising health visiting education:potential, problems and progress},
author = {Sarah Cowley},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Community Pract},
volume = {76},
pages = {418–422},
abstract = {This article explains the urgent need for change in health visitor education, due to an ageing and reducing workforce, increased needs and multiple demands for health visiting skills across health, social and educational services. This could herald a potentially exciting future for the profession, with a multi-disciplinary workforce educated to operate across sectors and in a range of roles.
Clear and demanding new educational standards have been established. If, in addition to a post-registration route, these could be obtained by direct entry students through a three-year degree or a two-year post-graduate qualification in health visting, this would enhance recruitment, increase multi-disciplinarity and enable health visiting to contribute fully to the new aganda.
These positive developments are being prevented by constraints within the Nursing and Midwifery Order 2001, which does not allow the regulation of health visiting as a profession in its own right},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This article explains the urgent need for change in health visitor education, due to an ageing and reducing workforce, increased needs and multiple demands for health visiting skills across health, social and educational services. This could herald a potentially exciting future for the profession, with a multi-disciplinary workforce educated to operate across sectors and in a range of roles.
Clear and demanding new educational standards have been established. If, in addition to a post-registration route, these could be obtained by direct entry students through a three-year degree or a two-year post-graduate qualification in health visting, this would enhance recruitment, increase multi-disciplinarity and enable health visiting to contribute fully to the new aganda.
These positive developments are being prevented by constraints within the Nursing and Midwifery Order 2001, which does not allow the regulation of health visiting as a profession in its own right
Clear and demanding new educational standards have been established. If, in addition to a post-registration route, these could be obtained by direct entry students through a three-year degree or a two-year post-graduate qualification in health visting, this would enhance recruitment, increase multi-disciplinarity and enable health visiting to contribute fully to the new aganda.
These positive developments are being prevented by constraints within the Nursing and Midwifery Order 2001, which does not allow the regulation of health visiting as a profession in its own right
Newland, Rita; Cowley, Sarah
Investigating how health visitors define vulnerability Journal Article
In: Community practitioner, vol. 76, no. 12, pp. 464, 2003, ISSN: 1462-2815, (Publisher: Redactive Publishing Ltd.).
@article{newland_investigating_2003,
title = {Investigating how health visitors define vulnerability},
author = {Rita Newland and Sarah Cowley},
issn = {1462-2815},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Community practitioner},
volume = {76},
number = {12},
pages = {464},
abstract = {The paper outlines the findings of a research project that sought to identify the components within health visitors' definitions of vulnerability and the influence these had on subsequent health visitor interventions with families within the community.
Twelve health visitors took part in semistructured interviews using a modification of the Critical Incident Technique. Ethical approval was gained from the ethics committees of the university and both community NHS trusts. Qualitative analysis identified the presence of specific themes, highlighting the features that informed the definition of vulnerability and the health visitors' subsequent actions. Vulnerability constituted a concept given to the identification of specific micro and macro levels of 'need' including social isolation, family size and composition and accommodation limitations.
The health visitors demonstrated an ability to articulate and justify their actions and make rational clinical decisions based on personal knowledge and experience. Their actions constituted a three-stage cyclical process in which an interpretation of the situation preceded the implementation and evaluation of the interventions},
note = {Publisher: Redactive Publishing Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The paper outlines the findings of a research project that sought to identify the components within health visitors' definitions of vulnerability and the influence these had on subsequent health visitor interventions with families within the community.
Twelve health visitors took part in semistructured interviews using a modification of the Critical Incident Technique. Ethical approval was gained from the ethics committees of the university and both community NHS trusts. Qualitative analysis identified the presence of specific themes, highlighting the features that informed the definition of vulnerability and the health visitors' subsequent actions. Vulnerability constituted a concept given to the identification of specific micro and macro levels of 'need' including social isolation, family size and composition and accommodation limitations.
The health visitors demonstrated an ability to articulate and justify their actions and make rational clinical decisions based on personal knowledge and experience. Their actions constituted a three-stage cyclical process in which an interpretation of the situation preceded the implementation and evaluation of the interventions
Twelve health visitors took part in semistructured interviews using a modification of the Critical Incident Technique. Ethical approval was gained from the ethics committees of the university and both community NHS trusts. Qualitative analysis identified the presence of specific themes, highlighting the features that informed the definition of vulnerability and the health visitors' subsequent actions. Vulnerability constituted a concept given to the identification of specific micro and macro levels of 'need' including social isolation, family size and composition and accommodation limitations.
The health visitors demonstrated an ability to articulate and justify their actions and make rational clinical decisions based on personal knowledge and experience. Their actions constituted a three-stage cyclical process in which an interpretation of the situation preceded the implementation and evaluation of the interventions
Hean, Sarah; Cowley, Sarah; Forbes, Angus; Griffiths, Peter; Maben, Jill
The M–C–M′ cycle and social capital Journal Article
In: Social Science & Medicine, vol. 56, no. 5, pp. 1061–1072, 2003, ISSN: 0277-9536, (Publisher: Elsevier).
@article{hean_mcm_2003,
title = {The M–C–M′ cycle and social capital},
author = {Sarah Hean and Sarah Cowley and Angus Forbes and Peter Griffiths and Jill Maben},
issn = {0277-9536},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
journal = {Social Science & Medicine},
volume = {56},
number = {5},
pages = {1061–1072},
abstract = {Social capital has become a popular term over the past two decades amongst researchers, policy makers and practitioners from varied disciplines. This popularity, however, has resulted in a great deal of confusion over the nature and application of social capital in different contexts. This confusion has made it difficult to identify and measure social capital within the evaluation of specific social and health programmes, one of the aims of which may be to stimulate social capital.
This paper identifies a theoretical model that seeks to capture the dynamic nature of social capital to assist in the development of research methods that will facilitate its measurement and exploration within such programmes. The model reported in the paper identifies the key components of social capital and expresses the relationship between those components in a dynamic system based on Marx's description of the process of capital (economic) exchanges expressed in the M-C-M' cycle.
The M-C-M' cycle is the transformation of money (M) into commodities (C), and the change of commodities back again into money (M') of altered value. The emphasis within the paper is on the capital element of the concept and its transactional nature with the aim of avoiding the pitfall of attributing social capital in relation to social behaviours in isolation of context and interaction. Importantly, the paper seeks to distinguish the central elements of social capital from some of the antecedent factors and outcomes often attributed to and confused with social capital adding to the problem of providing valid measurement.
The model is presented as the basis for the measurement of social capital within a transactional process involving the investment of social resources in a cyclical process, which may result in net gains or losses. This process is described as the R-C-R' cycle following Marx's model of economic capital, with the focus being on the transfer of social resources (R) rather than money (M). R represents an internal resource held by individuals, C the external resource or commodity they obtain from the network and the R' the internal resource of altered value. The possibilities of the model in assisting in the measurement of social capital specifically in assessing formal networks are explored.},
note = {Publisher: Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Social capital has become a popular term over the past two decades amongst researchers, policy makers and practitioners from varied disciplines. This popularity, however, has resulted in a great deal of confusion over the nature and application of social capital in different contexts. This confusion has made it difficult to identify and measure social capital within the evaluation of specific social and health programmes, one of the aims of which may be to stimulate social capital.
This paper identifies a theoretical model that seeks to capture the dynamic nature of social capital to assist in the development of research methods that will facilitate its measurement and exploration within such programmes. The model reported in the paper identifies the key components of social capital and expresses the relationship between those components in a dynamic system based on Marx's description of the process of capital (economic) exchanges expressed in the M-C-M' cycle.
The M-C-M' cycle is the transformation of money (M) into commodities (C), and the change of commodities back again into money (M') of altered value. The emphasis within the paper is on the capital element of the concept and its transactional nature with the aim of avoiding the pitfall of attributing social capital in relation to social behaviours in isolation of context and interaction. Importantly, the paper seeks to distinguish the central elements of social capital from some of the antecedent factors and outcomes often attributed to and confused with social capital adding to the problem of providing valid measurement.
The model is presented as the basis for the measurement of social capital within a transactional process involving the investment of social resources in a cyclical process, which may result in net gains or losses. This process is described as the R-C-R' cycle following Marx's model of economic capital, with the focus being on the transfer of social resources (R) rather than money (M). R represents an internal resource held by individuals, C the external resource or commodity they obtain from the network and the R' the internal resource of altered value. The possibilities of the model in assisting in the measurement of social capital specifically in assessing formal networks are explored.
This paper identifies a theoretical model that seeks to capture the dynamic nature of social capital to assist in the development of research methods that will facilitate its measurement and exploration within such programmes. The model reported in the paper identifies the key components of social capital and expresses the relationship between those components in a dynamic system based on Marx's description of the process of capital (economic) exchanges expressed in the M-C-M' cycle.
The M-C-M' cycle is the transformation of money (M) into commodities (C), and the change of commodities back again into money (M') of altered value. The emphasis within the paper is on the capital element of the concept and its transactional nature with the aim of avoiding the pitfall of attributing social capital in relation to social behaviours in isolation of context and interaction. Importantly, the paper seeks to distinguish the central elements of social capital from some of the antecedent factors and outcomes often attributed to and confused with social capital adding to the problem of providing valid measurement.
The model is presented as the basis for the measurement of social capital within a transactional process involving the investment of social resources in a cyclical process, which may result in net gains or losses. This process is described as the R-C-R' cycle following Marx's model of economic capital, with the focus being on the transfer of social resources (R) rather than money (M). R represents an internal resource held by individuals, C the external resource or commodity they obtain from the network and the R' the internal resource of altered value. The possibilities of the model in assisting in the measurement of social capital specifically in assessing formal networks are explored.
2002
Cowley, Sarah; Hean, Sarah
Social capital in primary health care Journal Article
In: Primary Health Care Research & Development, vol. 3, no. 4, pp. 207–209, 2002, ISSN: 1477-1128, 1463-4236, (Publisher: Cambridge University Press).
Abstract | Links | BibTeX | Tags:
@article{cowley_social_2002,
title = {Social capital in primary health care},
author = {Sarah Cowley and Sarah Hean},
doi = {10.1191/1463423602pc116ed},
issn = {1477-1128, 1463-4236},
year = {2002},
date = {2002-10-01},
urldate = {2002-10-01},
journal = {Primary Health Care Research & Development},
volume = {3},
number = {4},
pages = {207–209},
abstract = {The ownership of capital is considered an advantage, and social capital may be viewed, simplistically, as the advantage gained by an individual or a group of individuals (such as a community) as a result of being part of a social network (Hean et al., 2002).
An elderly patient being given a lift to a surgery by her daughter, for example, has received practical support by virtue of the fact that she is part of a family network. It is not only practical support that is gained this way, however. An isolated parent, who has no friends to commiserate with the diffi culties in coping with a young crying baby, for example, is at a disadvantage compared to the person who can tap into informational, emotional and social support, quite apart from any practical help that may be available.
At a more general level, there is an advantage for those living in communities where everyone knows and trusts their neighbours, extending a helping hand in times of need in the realistic expectation that, when the situation is reversed, the favour will be returned. At this quite simple level, these situations will be very familiar to anyone working in primary health care. They are not only markers of advantage (or not) but are practical examples of social inequalities that in uence health. It is well recognized that service use in areas or by individuals vary according to the kinds of family and social networks available, and their accompanying local mores and norms.
The activities of promoting and developing trusting, supportive networks as local resources are considered essential by some in primary care, like health visitors or community development workers (Cowley and Billings, 1999a). However, such activities have, at times, been considered somewhat peripheral to the ‘main business’ of professional health care, which may be characterized as the diagnosis, treatment and care of people with medical problems (Cowley and Billings, 1999b). Even when prevention of such problems is recognized, the ability to demonstrate any beneficial health outcomes from the rather},
note = {Publisher: Cambridge University Press},
keywords = {},
pubstate = {published},
tppubtype = {article}
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The ownership of capital is considered an advantage, and social capital may be viewed, simplistically, as the advantage gained by an individual or a group of individuals (such as a community) as a result of being part of a social network (Hean et al., 2002).
An elderly patient being given a lift to a surgery by her daughter, for example, has received practical support by virtue of the fact that she is part of a family network. It is not only practical support that is gained this way, however. An isolated parent, who has no friends to commiserate with the diffi culties in coping with a young crying baby, for example, is at a disadvantage compared to the person who can tap into informational, emotional and social support, quite apart from any practical help that may be available.
At a more general level, there is an advantage for those living in communities where everyone knows and trusts their neighbours, extending a helping hand in times of need in the realistic expectation that, when the situation is reversed, the favour will be returned. At this quite simple level, these situations will be very familiar to anyone working in primary health care. They are not only markers of advantage (or not) but are practical examples of social inequalities that in uence health. It is well recognized that service use in areas or by individuals vary according to the kinds of family and social networks available, and their accompanying local mores and norms.
The activities of promoting and developing trusting, supportive networks as local resources are considered essential by some in primary care, like health visitors or community development workers (Cowley and Billings, 1999a). However, such activities have, at times, been considered somewhat peripheral to the ‘main business’ of professional health care, which may be characterized as the diagnosis, treatment and care of people with medical problems (Cowley and Billings, 1999b). Even when prevention of such problems is recognized, the ability to demonstrate any beneficial health outcomes from the rather
An elderly patient being given a lift to a surgery by her daughter, for example, has received practical support by virtue of the fact that she is part of a family network. It is not only practical support that is gained this way, however. An isolated parent, who has no friends to commiserate with the diffi culties in coping with a young crying baby, for example, is at a disadvantage compared to the person who can tap into informational, emotional and social support, quite apart from any practical help that may be available.
At a more general level, there is an advantage for those living in communities where everyone knows and trusts their neighbours, extending a helping hand in times of need in the realistic expectation that, when the situation is reversed, the favour will be returned. At this quite simple level, these situations will be very familiar to anyone working in primary health care. They are not only markers of advantage (or not) but are practical examples of social inequalities that in uence health. It is well recognized that service use in areas or by individuals vary according to the kinds of family and social networks available, and their accompanying local mores and norms.
The activities of promoting and developing trusting, supportive networks as local resources are considered essential by some in primary care, like health visitors or community development workers (Cowley and Billings, 1999a). However, such activities have, at times, been considered somewhat peripheral to the ‘main business’ of professional health care, which may be characterized as the diagnosis, treatment and care of people with medical problems (Cowley and Billings, 1999b). Even when prevention of such problems is recognized, the ability to demonstrate any beneficial health outcomes from the rather
Houston, Anna M; Cowley, Sarah
An empowerment approach to needs assessment in health visiting practice Journal Article
In: Journal of clinical nursing, vol. 11, no. 5, pp. 640–650, 2002, ISSN: 1365-2702.
Abstract | Links | BibTeX | Tags:
@article{houston_empowerment_2002,
title = {An empowerment approach to needs assessment in health visiting practice},
author = {Anna M Houston and Sarah Cowley},
doi = {10.1046/j.1365-2702.2002.00637.x},
issn = {1365-2702},
year = {2002},
date = {2002-09-01},
urldate = {2002-09-01},
journal = {Journal of clinical nursing},
volume = {11},
number = {5},
pages = {640–650},
abstract = {This paper examines the usefulness of an integrated approach to needs assessment using an empowerment framework, within a health visitor/client interaction, in the home setting. It is intended to demonstrate the existence of a flexible approach to assessing need that is based on research about necessary processes for carrying out health visiting.
The design of the tool described in this paper allows the use of professional judgement as well as fulfilling commissioning requirements to address health outcomes. Health promotion and empowerment are central to health visiting practice and should be reflected in the way needs are assessed. Many NHS trusts have introduced a system of targeting and prioritizing health visiting through a system of questioning to assess needs. This may reveal the work that health visitors do, but may also inhibit the open, listening approach required for client empowerment.
Different methods of assessing need can be used that do not compromise the commissioning requirements, the health visitor's duty of care or professional accountability. The empowerment approach is key to the philosophy of health visiting. There are ways of approaching needs assessment that do not compromise the ethos of partnership-working in a health promoting way.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper examines the usefulness of an integrated approach to needs assessment using an empowerment framework, within a health visitor/client interaction, in the home setting. It is intended to demonstrate the existence of a flexible approach to assessing need that is based on research about necessary processes for carrying out health visiting.
The design of the tool described in this paper allows the use of professional judgement as well as fulfilling commissioning requirements to address health outcomes. Health promotion and empowerment are central to health visiting practice and should be reflected in the way needs are assessed. Many NHS trusts have introduced a system of targeting and prioritizing health visiting through a system of questioning to assess needs. This may reveal the work that health visitors do, but may also inhibit the open, listening approach required for client empowerment.
Different methods of assessing need can be used that do not compromise the commissioning requirements, the health visitor's duty of care or professional accountability. The empowerment approach is key to the philosophy of health visiting. There are ways of approaching needs assessment that do not compromise the ethos of partnership-working in a health promoting way.
The design of the tool described in this paper allows the use of professional judgement as well as fulfilling commissioning requirements to address health outcomes. Health promotion and empowerment are central to health visiting practice and should be reflected in the way needs are assessed. Many NHS trusts have introduced a system of targeting and prioritizing health visiting through a system of questioning to assess needs. This may reveal the work that health visitors do, but may also inhibit the open, listening approach required for client empowerment.
Different methods of assessing need can be used that do not compromise the commissioning requirements, the health visitor's duty of care or professional accountability. The empowerment approach is key to the philosophy of health visiting. There are ways of approaching needs assessment that do not compromise the ethos of partnership-working in a health promoting way.
Cowley, Sarah; Pearson, Pauline
What's in a name? Health visiting is health visiting Journal Article
In: Community Practitioner, vol. 75, no. 8, pp. 304–307, 2002.
@article{cowley_sarah_whats_2002,
title = {What's in a name? Health visiting is health visiting},
author = {Sarah Cowley and Pauline Pearson},
year = {2002},
date = {2002-08-01},
urldate = {2002-08-01},
journal = {Community Practitioner},
volume = {75},
number = {8},
pages = {304–307},
abstract = {There is no mention of 'health visitors' or 'health visiting' at any point in the wording of the Nursing and Midwifery Order 2001 that, nevertheless, makes provision for regulation of the profession. It is argued that omitting the name of the profession from the statute leads to a confusing ambiguity and failure to recognise the extent of meaning embodied in the term 'health visiting.' This is explained by the way the term can be used as a noun, to signify the profession as a whole; as a verb which details activities undertaken by health visitors or as an adjective to describe matters, such as service organisation, pertaining to health visiting.
Provision in the statute to establish a register for 'community specialists in public health' increases the confusion because there is no such occupation or qualification. A quicker, clearer way of expanding the health visiting register is suggested as an alternative},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There is no mention of 'health visitors' or 'health visiting' at any point in the wording of the Nursing and Midwifery Order 2001 that, nevertheless, makes provision for regulation of the profession. It is argued that omitting the name of the profession from the statute leads to a confusing ambiguity and failure to recognise the extent of meaning embodied in the term 'health visiting.' This is explained by the way the term can be used as a noun, to signify the profession as a whole; as a verb which details activities undertaken by health visitors or as an adjective to describe matters, such as service organisation, pertaining to health visiting.
Provision in the statute to establish a register for 'community specialists in public health' increases the confusion because there is no such occupation or qualification. A quicker, clearer way of expanding the health visiting register is suggested as an alternative
Provision in the statute to establish a register for 'community specialists in public health' increases the confusion because there is no such occupation or qualification. A quicker, clearer way of expanding the health visiting register is suggested as an alternative
Grocott, Patricia; Cowley, Sarah; Richardson, Alison
Solving Methodological Challenges Using a Theory-driven Evaluation in the Study of Complex Patient Care Journal Article
In: Evaluation, vol. 8, no. 3, pp. 306–321, 2002, ISSN: 1356-3890, (Publisher: SAGE Publications Ltd).
Abstract | Links | BibTeX | Tags:
@article{grocott_solving_2002,
title = {Solving Methodological Challenges Using a Theory-driven Evaluation in the Study of Complex Patient Care},
author = {Patricia Grocott and Sarah Cowley and Alison Richardson},
doi = {10.1177/135638902401462457},
issn = {1356-3890},
year = {2002},
date = {2002-07-01},
urldate = {2002-07-01},
journal = {Evaluation},
volume = {8},
number = {3},
pages = {306–321},
abstract = {This article draws on two research designs, which were used in a study of the palliative management of malignant wounds, to demonstrate the inherent challenges in producing generalizable knowledge from a complex subject. The designs included quasi-experimentation and a form of theory- driven evaluation. The focus of the study was the performance of dressings to reduce the impact of the wounds on daily life. The convention for evaluating the outcomes of interventions is a controlled study design. This approach is considered the valid way of producing evidence that is generalizable.
An experimental design was therefore adopted to conduct a series of n = 1 quasi-experiments on wound dressing performance with qualitative methods to explore individual experiences. Problems with the methods, in particular the failure to capture complex inter-relationships between clinical problems and patient experiences, forced the researcher to abandon the experimental design. An alternative approach to measurement was adopted to maintain the study focus, the TELER® system of treatment evaluation, which includes indicators of patient-centred outcomes of care. The philosophical position of the study was reviewed. Consensus emerged as an unalterable, major in uence on the design and paradigmatic assumptions of the study. A `system of reasoning' was adopted to overcome the inherent relativist position of knowledge derived from this approach. The system abstracts general issues from case study data to construct theoretical explanations that may be consistent with, or challenge, current knowledge.
This article is based on the evolution of one particular study. However, it makes a more general contribution to evaluation research by explaining the rationale for a form of theory-driven evaluation that uses evidence, reason and theory to develop generalizable explanations from complex, individual case study data. The methodology is proposed for other complex situations where speci c and rigorous evidence, capable of generalization is needed.},
note = {Publisher: SAGE Publications Ltd},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This article draws on two research designs, which were used in a study of the palliative management of malignant wounds, to demonstrate the inherent challenges in producing generalizable knowledge from a complex subject. The designs included quasi-experimentation and a form of theory- driven evaluation. The focus of the study was the performance of dressings to reduce the impact of the wounds on daily life. The convention for evaluating the outcomes of interventions is a controlled study design. This approach is considered the valid way of producing evidence that is generalizable.
An experimental design was therefore adopted to conduct a series of n = 1 quasi-experiments on wound dressing performance with qualitative methods to explore individual experiences. Problems with the methods, in particular the failure to capture complex inter-relationships between clinical problems and patient experiences, forced the researcher to abandon the experimental design. An alternative approach to measurement was adopted to maintain the study focus, the TELER® system of treatment evaluation, which includes indicators of patient-centred outcomes of care. The philosophical position of the study was reviewed. Consensus emerged as an unalterable, major in uence on the design and paradigmatic assumptions of the study. A `system of reasoning' was adopted to overcome the inherent relativist position of knowledge derived from this approach. The system abstracts general issues from case study data to construct theoretical explanations that may be consistent with, or challenge, current knowledge.
This article is based on the evolution of one particular study. However, it makes a more general contribution to evaluation research by explaining the rationale for a form of theory-driven evaluation that uses evidence, reason and theory to develop generalizable explanations from complex, individual case study data. The methodology is proposed for other complex situations where speci c and rigorous evidence, capable of generalization is needed.
An experimental design was therefore adopted to conduct a series of n = 1 quasi-experiments on wound dressing performance with qualitative methods to explore individual experiences. Problems with the methods, in particular the failure to capture complex inter-relationships between clinical problems and patient experiences, forced the researcher to abandon the experimental design. An alternative approach to measurement was adopted to maintain the study focus, the TELER® system of treatment evaluation, which includes indicators of patient-centred outcomes of care. The philosophical position of the study was reviewed. Consensus emerged as an unalterable, major in uence on the design and paradigmatic assumptions of the study. A `system of reasoning' was adopted to overcome the inherent relativist position of knowledge derived from this approach. The system abstracts general issues from case study data to construct theoretical explanations that may be consistent with, or challenge, current knowledge.
This article is based on the evolution of one particular study. However, it makes a more general contribution to evaluation research by explaining the rationale for a form of theory-driven evaluation that uses evidence, reason and theory to develop generalizable explanations from complex, individual case study data. The methodology is proposed for other complex situations where speci c and rigorous evidence, capable of generalization is needed.