2003
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.
Cowley, Sarah
Public health in policy and practice: a sourcebook for health visitors and community nurses Book
Bailliere Tindall, Edinburgh, 2003, ISBN: 978-0-7020-2317-0.
Abstract | BibTeX | Tags: Administration; Community health nursing, Community health services, Great Britain, Great Britain; Community health nursing; Environmental health; Medical policy, Great Britain; Medical policy, Great Britain; Public health
@book{cowley_public_2003,
title = {Public health in policy and practice: a sourcebook for health visitors and community nurses},
author = {Sarah Cowley},
isbn = {978-0-7020-2317-0},
year = {2003},
date = {2003-01-01},
urldate = {2003-01-01},
publisher = {Bailliere Tindall},
address = {Edinburgh},
abstract = {This book is a key text for health visitors and other community health nurses for whom public health is the key issue for future practice. It examines and defines public health nursing, explores its theoretical basis and provides a guide to practice issues. A range of perspectives will be provided, each evaluated to demonstrate their rationale and implications for practice. Chapters are included on epidemiology, assessment, planning, as well as examples of practice working with both individuals and on a community-wide level.},
keywords = {Administration; Community health nursing, Community health services, Great Britain, Great Britain; Community health nursing; Environmental health; Medical policy, Great Britain; Medical policy, Great Britain; Public health},
pubstate = {published},
tppubtype = {book}
}
This book is a key text for health visitors and other community health nurses for whom public health is the key issue for future practice. It examines and defines public health nursing, explores its theoretical basis and provides a guide to practice issues. A range of perspectives will be provided, each evaluated to demonstrate their rationale and implications for practice. Chapters are included on epidemiology, assessment, planning, as well as examples of practice working with both individuals and on a community-wide level.
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}
}
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.
Cowley, Sarah
The tyranny of crisis intervention Journal Article
In: Nursing Management, vol. 9, no. 3, 2002, (Publisher: Nursing Management).
Abstract | Links | BibTeX | Tags:
@article{cowley_tyranny_2002,
title = {The tyranny of crisis intervention},
author = {Sarah Cowley},
doi = {10.7748/nm.9.3.11.s8},
year = {2002},
date = {2002-06-01},
urldate = {2002-06-01},
journal = {Nursing Management},
volume = {9},
number = {3},
abstract = {Sarah Cowley warns against allowing urgent tasks to take priority over routine care in health visiting
Fears that serious child abuse, or even murder, may happen if the response to a crisis situation is either inadequate or inappropriate overshadow the routine basis of much health visiting work. Hammond1 [illegible word] that the greatest danger is in ting urgent things crowd out the important, for a constant tension exists between these two: whereas the important task must rarely be done today, or even this week, there is endless pressure from urgent things, demanding instant action.
},
note = {Publisher: Nursing Management},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Sarah Cowley warns against allowing urgent tasks to take priority over routine care in health visiting
Fears that serious child abuse, or even murder, may happen if the response to a crisis situation is either inadequate or inappropriate overshadow the routine basis of much health visiting work. Hammond1 [illegible word] that the greatest danger is in ting urgent things crowd out the important, for a constant tension exists between these two: whereas the important task must rarely be done today, or even this week, there is endless pressure from urgent things, demanding instant action.
Fears that serious child abuse, or even murder, may happen if the response to a crisis situation is either inadequate or inappropriate overshadow the routine basis of much health visiting work. Hammond1 [illegible word] that the greatest danger is in ting urgent things crowd out the important, for a constant tension exists between these two: whereas the important task must rarely be done today, or even this week, there is endless pressure from urgent things, demanding instant action.
Baraitser, Paula; Fettiplace, Rachael; Dolan, Frances; Massil, Helen; Cowley, Sarah
Quality, mainstream services with proactive and targeted outreach: A model of contraceptive service provision for young people Journal Article
In: BMJ Sexual & Reproductive Health, vol. 28, no. 2, pp. 90–93, 2002, ISSN: 2515-1991, 2515-2009, (Publisher: British Medical Journal Publishing Group Section: Original articles).
Abstract | Links | BibTeX | Tags:
@article{baraitser_quality_2002,
title = {Quality, mainstream services with proactive and targeted outreach: A model of contraceptive service provision for young people},
author = {Paula Baraitser and Rachael Fettiplace and Frances Dolan and Helen Massil and Sarah Cowley},
doi = {10.1783/147118902101196018},
issn = {2515-1991, 2515-2009},
year = {2002},
date = {2002-04-01},
urldate = {2002-04-01},
journal = {BMJ Sexual & Reproductive Health},
volume = {28},
number = {2},
pages = {90–93},
abstract = {Introduction
High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service.
Methods
Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service.
Results
The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold.
Conclusion
This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.},
note = {Publisher: British Medical Journal Publishing Group
Section: Original articles},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction
High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service.
Methods
Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service.
Results
The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold.
Conclusion
This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.
High teenage pregnancy rates in the UK reflect low levels of contraceptive use. Young people have a negative perception of contraceptive services and experience significant practical barriers to their use. Dedicated young people's services are considered an effective way to improve access. However it is costly to provide two parallel services (one for older and one for young clients) and competition for resources between two services limits the opening hours of both. In this way access by clients of all ages may be reduced. We have piloted an alternative approach. We provide quality mainstream services (open to clients of all ages) with extended hours and no appointment necessary. This is combined with targeted outreach to facilitate access by the under-25s. The outreach programme includes the development of close links between the clinic and local schools, youth services, social services and voluntary sector organisations. This paper presents one part of the evaluation of this service.
Methods
Patients registering in the 6 months before and 18 months after the development of the new service completed an anonymous questionnaire. This collected demographic details and data on their source of information about the service.
Results
The number of clients of all age groups registering at the new service in the first year doubled. The number of new users aged under 16 years increased by 12-fold in the first 18 months. The number of young people citing a school sex education class as their source of information about the clinic increased by more than five-fold.
Conclusion
This model of contraceptive service provision significantly increases service access by young people. It represents an effective alternative to dedicated services for young people.
Cowley, Sarah; Bliss, Julie; Mathew, Alison; McVey, Gillian
Effective interagency and interprofessional working: facilitators and barriers Journal Article
In: International Journal of Palliative Nursing, vol. 8, no. 1, pp. 30–39, 2002, ISSN: 1357-6321, (Publisher: Mark Allen Group).
Abstract | Links | BibTeX | Tags: Barrier, Communication, Facilitator, Interaction, Location of services, Organization
@article{cowley_effective_2002,
title = {Effective interagency and interprofessional working: facilitators and barriers},
author = {Sarah Cowley and Julie Bliss and Alison Mathew and Gillian McVey},
doi = {10.12968/ijpn.2002.8.1.10234},
issn = {1357-6321},
year = {2002},
date = {2002-01-01},
urldate = {2002-01-01},
journal = {International Journal of Palliative Nursing},
volume = {8},
number = {1},
pages = {30–39},
abstract = {In the UK the provision of palliative care is not the sole responsibility of the National Health Service (NHS); there is an overlap with continuing care, which falls within the remit of local authority social services departments. In addition, hospice and palliative care services are often considerably dependent on charities. Interagency and interdisciplinary working are, therefore, central to the successful delivery of palliative care.
A multiple (four case) case study design was used to explore the provision of palliative and continuing care. The analysis identified the antecedents, structures and processes involved in the delivery of interprofessional working, along with the consequences of these in either a good model or one where problems were likely to prevail. Individual activities, roles and specific service configurations seemed far less significant than the overall culture, stability and long-term commitment to a service in a given area. Time is required for new service configurations to stabilize so that staff are able to overcome barriers and develop the necessary facilitators for quality care provision.},
note = {Publisher: Mark Allen Group},
keywords = {Barrier, Communication, Facilitator, Interaction, Location of services, Organization},
pubstate = {published},
tppubtype = {article}
}
In the UK the provision of palliative care is not the sole responsibility of the National Health Service (NHS); there is an overlap with continuing care, which falls within the remit of local authority social services departments. In addition, hospice and palliative care services are often considerably dependent on charities. Interagency and interdisciplinary working are, therefore, central to the successful delivery of palliative care.
A multiple (four case) case study design was used to explore the provision of palliative and continuing care. The analysis identified the antecedents, structures and processes involved in the delivery of interprofessional working, along with the consequences of these in either a good model or one where problems were likely to prevail. Individual activities, roles and specific service configurations seemed far less significant than the overall culture, stability and long-term commitment to a service in a given area. Time is required for new service configurations to stabilize so that staff are able to overcome barriers and develop the necessary facilitators for quality care provision.
A multiple (four case) case study design was used to explore the provision of palliative and continuing care. The analysis identified the antecedents, structures and processes involved in the delivery of interprofessional working, along with the consequences of these in either a good model or one where problems were likely to prevail. Individual activities, roles and specific service configurations seemed far less significant than the overall culture, stability and long-term commitment to a service in a given area. Time is required for new service configurations to stabilize so that staff are able to overcome barriers and develop the necessary facilitators for quality care provision.
Baraitser, Paula; Dolan, Frances; Feldman, Rayah; Cowley, Sarah
Sexual health work in a playground: Lessons learnt from the evaluation of a small-scale sexual health project Journal Article
In: BMJ Sexual & Reproductive Health, vol. 28, no. 1, pp. 18–22, 2002, ISSN: 2515-1991, 2515-2009, (Publisher: British Medical Journal Publishing Group Section: Original articles).
Abstract | Links | BibTeX | Tags:
@article{baraitser_sexual_2002,
title = {Sexual health work in a playground: Lessons learnt from the evaluation of a small-scale sexual health project},
author = {Paula Baraitser and Frances Dolan and Rayah Feldman and Sarah Cowley},
doi = {10.1783/147118902101195956},
issn = {2515-1991, 2515-2009},
year = {2002},
date = {2002-01-01},
urldate = {2002-01-01},
journal = {BMJ Sexual & Reproductive Health},
volume = {28},
number = {1},
pages = {18–22},
abstract = {Objective
To evaluate a sexual health outreach programme in an adventure playground.
Design
A qualitative approach to evaluation is appropriate for a sexual health project where outcomes are unpredictable, difficult to define in numerical terms and the small scale of the intervention means that an impact on indices such as teenage pregnancy rates is unlikely. The data collection techniques used were the outreach worker's diary, questionnaires and interviews with youth workers, and a focus group with young people.
Results
Work in young people's leisure space requires flexible working in disrupted environments and a responsive approach to diverse individual needs. The outreach worker successfully engaged boys and girls in sexual health discussions. As a result of the project, youth workers' confidence in discussing sexual health issues and ability to refer to the clinic increased.
Conclusion
Clinical staff providing a sexual health outreach service for young people offer a knowledge of sexual health and local clinical services and an opportunity to build positive relationships between clinics and local community organisations. The relationships help youth workers to raise sexual health issues with young people and to refer problems appropriately. Clinical staff doing outreach work may require additional skills to work in young people's leisure space, for example, the ability to negotiate the content of sessions and to tolerate disruption. A qualitative approach to evaluation effectively documents a range of project outcomes, including those which were unforeseen and which could not have been documented through the collection of numerical data. It also provides a detailed description of the process of project implementation, which aids replication.},
note = {Publisher: British Medical Journal Publishing Group
Section: Original articles},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Objective
To evaluate a sexual health outreach programme in an adventure playground.
Design
A qualitative approach to evaluation is appropriate for a sexual health project where outcomes are unpredictable, difficult to define in numerical terms and the small scale of the intervention means that an impact on indices such as teenage pregnancy rates is unlikely. The data collection techniques used were the outreach worker's diary, questionnaires and interviews with youth workers, and a focus group with young people.
Results
Work in young people's leisure space requires flexible working in disrupted environments and a responsive approach to diverse individual needs. The outreach worker successfully engaged boys and girls in sexual health discussions. As a result of the project, youth workers' confidence in discussing sexual health issues and ability to refer to the clinic increased.
Conclusion
Clinical staff providing a sexual health outreach service for young people offer a knowledge of sexual health and local clinical services and an opportunity to build positive relationships between clinics and local community organisations. The relationships help youth workers to raise sexual health issues with young people and to refer problems appropriately. Clinical staff doing outreach work may require additional skills to work in young people's leisure space, for example, the ability to negotiate the content of sessions and to tolerate disruption. A qualitative approach to evaluation effectively documents a range of project outcomes, including those which were unforeseen and which could not have been documented through the collection of numerical data. It also provides a detailed description of the process of project implementation, which aids replication.
To evaluate a sexual health outreach programme in an adventure playground.
Design
A qualitative approach to evaluation is appropriate for a sexual health project where outcomes are unpredictable, difficult to define in numerical terms and the small scale of the intervention means that an impact on indices such as teenage pregnancy rates is unlikely. The data collection techniques used were the outreach worker's diary, questionnaires and interviews with youth workers, and a focus group with young people.
Results
Work in young people's leisure space requires flexible working in disrupted environments and a responsive approach to diverse individual needs. The outreach worker successfully engaged boys and girls in sexual health discussions. As a result of the project, youth workers' confidence in discussing sexual health issues and ability to refer to the clinic increased.
Conclusion
Clinical staff providing a sexual health outreach service for young people offer a knowledge of sexual health and local clinical services and an opportunity to build positive relationships between clinics and local community organisations. The relationships help youth workers to raise sexual health issues with young people and to refer problems appropriately. Clinical staff doing outreach work may require additional skills to work in young people's leisure space, for example, the ability to negotiate the content of sessions and to tolerate disruption. A qualitative approach to evaluation effectively documents a range of project outcomes, including those which were unforeseen and which could not have been documented through the collection of numerical data. It also provides a detailed description of the process of project implementation, which aids replication.
Hanafin, Sinéad; Houston, Anna M.; Cowley, Sarah
Vertical equity in service provision: a model for the Irish public health nursing service Journal Article
In: Journal of Advanced Nursing, vol. 39, no. 1, pp. 68–76, 2002, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags: community, funding, horizontal equity, needs, nursing, policy, public health, Republic of Ireland, service provision, vertical
@article{hanafin_vertical_2002,
title = {Vertical equity in service provision: a model for the Irish public health nursing service},
author = {Sinéad Hanafin and Anna M. Houston and Sarah Cowley},
doi = {10.1046/j.1365-2648.2002.02243.x},
issn = {1365-2648},
year = {2002},
date = {2002-01-01},
urldate = {2002-01-01},
journal = {Journal of Advanced Nursing},
volume = {39},
number = {1},
pages = {68–76},
abstract = {Aims
This paper analyses the policy and conceptual basis of public health nursing service provision in the Republic of Ireland and situates it within an international context. It draws on the principles of horizontal and vertical equity in proposing a new model of public health nursing service provision. It gives the reader an understanding of a model of service delivery underpinned by the principle of vertical equity.
Background issues
The Public Health Nurse in the Republic of Ireland has a wide remit encompassing primary, secondary and tertiary care at the level of the individual, family and community. The changing sociological and demographic nature of society in Ireland has impacted on a service that has largely remained unchanged since 1966. Since 1997 four review bodies have provided recommendations that are incompatible with each other. There remains a need to find a solution to the overwhelming demands placed on the public health nursing service in the Republic of Ireland.
Key issues
The public health nursing service goes beyond the provision of a purely clinical nursing service. Communities differ in demography, epidemiology, environment, history, composition, support and most importantly needs. Using three exemplars a new model for the public health nursing service is explicated. This model has as its main focus the needs of the community it serves.
Conclusions
A service underpinned by the principle of vertical equity can be used to deliver locally based, needs driven public health nursing services. The application of such a model would make the public health nursing service more flexible and responsive to local need. Public health nursing composition and provision must be determined using the principal of vertical equity determined by the needs of the community it serves.},
keywords = {community, funding, horizontal equity, needs, nursing, policy, public health, Republic of Ireland, service provision, vertical},
pubstate = {published},
tppubtype = {article}
}
Aims
This paper analyses the policy and conceptual basis of public health nursing service provision in the Republic of Ireland and situates it within an international context. It draws on the principles of horizontal and vertical equity in proposing a new model of public health nursing service provision. It gives the reader an understanding of a model of service delivery underpinned by the principle of vertical equity.
Background issues
The Public Health Nurse in the Republic of Ireland has a wide remit encompassing primary, secondary and tertiary care at the level of the individual, family and community. The changing sociological and demographic nature of society in Ireland has impacted on a service that has largely remained unchanged since 1966. Since 1997 four review bodies have provided recommendations that are incompatible with each other. There remains a need to find a solution to the overwhelming demands placed on the public health nursing service in the Republic of Ireland.
Key issues
The public health nursing service goes beyond the provision of a purely clinical nursing service. Communities differ in demography, epidemiology, environment, history, composition, support and most importantly needs. Using three exemplars a new model for the public health nursing service is explicated. This model has as its main focus the needs of the community it serves.
Conclusions
A service underpinned by the principle of vertical equity can be used to deliver locally based, needs driven public health nursing services. The application of such a model would make the public health nursing service more flexible and responsive to local need. Public health nursing composition and provision must be determined using the principal of vertical equity determined by the needs of the community it serves.
This paper analyses the policy and conceptual basis of public health nursing service provision in the Republic of Ireland and situates it within an international context. It draws on the principles of horizontal and vertical equity in proposing a new model of public health nursing service provision. It gives the reader an understanding of a model of service delivery underpinned by the principle of vertical equity.
Background issues
The Public Health Nurse in the Republic of Ireland has a wide remit encompassing primary, secondary and tertiary care at the level of the individual, family and community. The changing sociological and demographic nature of society in Ireland has impacted on a service that has largely remained unchanged since 1966. Since 1997 four review bodies have provided recommendations that are incompatible with each other. There remains a need to find a solution to the overwhelming demands placed on the public health nursing service in the Republic of Ireland.
Key issues
The public health nursing service goes beyond the provision of a purely clinical nursing service. Communities differ in demography, epidemiology, environment, history, composition, support and most importantly needs. Using three exemplars a new model for the public health nursing service is explicated. This model has as its main focus the needs of the community it serves.
Conclusions
A service underpinned by the principle of vertical equity can be used to deliver locally based, needs driven public health nursing services. The application of such a model would make the public health nursing service more flexible and responsive to local need. Public health nursing composition and provision must be determined using the principal of vertical equity determined by the needs of the community it serves.
Hean, S; Cowley, S; Forbes, A; Griffiths, P
An examination of the potential to Identify an instrument reflecting measurable attributes of social capital Technical Report
London Report to Health Development Agency. Florence Nightingale S, 2002.
BibTeX | Tags:
@techreport{hean_examination_2002,
title = {An examination of the potential to Identify an instrument reflecting measurable attributes of social capital},
author = {S Hean and S Cowley and A Forbes and P Griffiths},
year = {2002},
date = {2002-01-01},
urldate = {2002-01-01},
address = {Report to Health Development Agency. Florence Nightingale S},
institution = {London},
keywords = {},
pubstate = {published},
tppubtype = {techreport}
}
2001
Grocott, Patricia; Cowley, Sarah
The palliative management of fungating malignant wounds – generalising from multiple-case study data using a system of reasoning Journal Article
In: International Journal of Nursing Studies, vol. 38, no. 5, pp. 533–545, 2001, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Case study, Fungating malignant wounds, Generalisation, System of reasoning
@article{grocott_palliative_2001,
title = {The palliative management of fungating malignant wounds – generalising from multiple-case study data using a system of reasoning},
author = {Patricia Grocott and Sarah Cowley},
doi = {10.1016/S0020-7489(00)00098-5},
issn = {0020-7489},
year = {2001},
date = {2001-10-01},
urldate = {2001-10-01},
journal = {International Journal of Nursing Studies},
volume = {38},
number = {5},
pages = {533–545},
abstract = {The project focused on individual experiences, from 45 participants, of living with a fungating wound and the performance of wound dressings in reducing the impact of the wounds on daily living. A case study design was adopted. This posed a key methodological challenge in the form of the contentious epistemological issue, characterised in the literature as the ‘nomothetic–idiographic dilemma’.
This issue concerns the nature of knowledge generated from an individual case and its generalisability. A system of reasoning was adopted as the analytic strategy, within a theory-driven evaluation, to abstract general issues from the case study data to construct explanations of symptom control and dressing performance. The latter were generalised beyond the individual cases with the use of theory. This paper focuses on the methodological issues that are inherent in the use of a case study design and the nature of the evidence generated. The system of reasoning is described and illustrated using data from a single participant with advanced uterine cancer and a fungating nodule in the groin.},
keywords = {Case study, Fungating malignant wounds, Generalisation, System of reasoning},
pubstate = {published},
tppubtype = {article}
}
The project focused on individual experiences, from 45 participants, of living with a fungating wound and the performance of wound dressings in reducing the impact of the wounds on daily living. A case study design was adopted. This posed a key methodological challenge in the form of the contentious epistemological issue, characterised in the literature as the ‘nomothetic–idiographic dilemma’.
This issue concerns the nature of knowledge generated from an individual case and its generalisability. A system of reasoning was adopted as the analytic strategy, within a theory-driven evaluation, to abstract general issues from the case study data to construct explanations of symptom control and dressing performance. The latter were generalised beyond the individual cases with the use of theory. This paper focuses on the methodological issues that are inherent in the use of a case study design and the nature of the evidence generated. The system of reasoning is described and illustrated using data from a single participant with advanced uterine cancer and a fungating nodule in the groin.
This issue concerns the nature of knowledge generated from an individual case and its generalisability. A system of reasoning was adopted as the analytic strategy, within a theory-driven evaluation, to abstract general issues from the case study data to construct explanations of symptom control and dressing performance. The latter were generalised beyond the individual cases with the use of theory. This paper focuses on the methodological issues that are inherent in the use of a case study design and the nature of the evidence generated. The system of reasoning is described and illustrated using data from a single participant with advanced uterine cancer and a fungating nodule in the groin.
Cowley, Sarah; Andrews, Andrew
A scenario-based analysis of health visiting dilemmas Journal Article
In: Community Practitioner, vol. 74, no. 4, pp. 139, 2001, ISSN: 1462-2815, (Publisher: Redactive Publishing Ltd.).
BibTeX | Tags:
@article{cowley_scenario-based_2001,
title = {A scenario-based analysis of health visiting dilemmas},
author = {Sarah Cowley and Andrew Andrews},
issn = {1462-2815},
year = {2001},
date = {2001-01-01},
urldate = {2001-01-01},
journal = {Community Practitioner},
volume = {74},
number = {4},
pages = {139},
note = {Publisher: Redactive Publishing Ltd.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2000
Cowley, S; Bergen, A; Young, K; Kavanagh, A
Generalising to theory: the use of a multiple case study design to investigate needs assessment and quality of care in community nursing Journal Article
In: International Journal of Nursing Studies, vol. 37, no. 3, pp. 219–228, 2000, ISSN: 0020-7489.
Abstract | Links | BibTeX | Tags: Case study, community nurses, needs assessment, Policy-practice gap, Theoretical framework
@article{cowley_generalising_2000,
title = {Generalising to theory: the use of a multiple case study design to investigate needs assessment and quality of care in community nursing},
author = {S Cowley and A Bergen and K Young and A Kavanagh},
doi = {10.1016/S0020-7489(99)00073-5},
issn = {0020-7489},
year = {2000},
date = {2000-06-01},
urldate = {2000-06-01},
journal = {International Journal of Nursing Studies},
volume = {37},
number = {3},
pages = {219–228},
abstract = {This paper outlines the detail of the case study method used in a project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act, 1990.
It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.
The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a ‘policy-practice gap’ might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for ‘generalising to theory’ illustrated.},
keywords = {Case study, community nurses, needs assessment, Policy-practice gap, Theoretical framework},
pubstate = {published},
tppubtype = {article}
}
This paper outlines the detail of the case study method used in a project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act, 1990.
It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.
The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a ‘policy-practice gap’ might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for ‘generalising to theory’ illustrated.
It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.
The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a ‘policy-practice gap’ might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for ‘generalising to theory’ illustrated.
Cowley, Sarah; Bergen, Ann; Young, Kate; Kavanagh, Ann
A taxonomy of needs assessment, elicited from a multiple case study of community nursing education and practice Journal Article
In: Journal of Advanced Nursing, vol. 31, no. 1, pp. 126–134, 2000, ISSN: 1365-2648, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.2000.01252.x).
Abstract | Links | BibTeX | Tags: Community health services, community nurses, health and social care, health and social needs assessment, multiple case study design
@article{cowley_taxonomy_2000,
title = {A taxonomy of needs assessment, elicited from a multiple case study of community nursing education and practice},
author = {Sarah Cowley and Ann Bergen and Kate Young and Ann Kavanagh},
doi = {10.1046/j.1365-2648.2000.01252.x},
issn = {1365-2648},
year = {2000},
date = {2000-01-01},
urldate = {2000-01-01},
journal = {Journal of Advanced Nursing},
volume = {31},
number = {1},
pages = {126–134},
abstract = {A taxonomy of needs assessment, elicited from a multiple case study of community nursing education and practice The role and expectations of community nurses in carrying out needs assessments changed when an internal quasi-market was introduced to the British health service under the National Health Service (NHS) & Community Care Act 1990.
This paper reports on a study commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment in the context of this legislation. A multiple case study design was utilized and four cases identified, incorporating the geographical variation in England. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (n=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors.
Participants were interviewed after the observation period (n=33 practitioners), to determine the extent of formality they attached to each assessment, and to elicit information about aspects which may be embedded in everyday practice. Single and multiple case analyses across the four cases used an iterative process of pattern-matching, replication logic and explanation building.
The preliminary analysis yielded a descriptive ‘taxonomy’ which could serve as a basis for classifying the variants of needs assessment and help to clarify the whole phenomenon. When applied further to the data, this revealed the complex interactions between the different ideals (relating to policy, nursing and ascribed worth), the various types (purpose, formality/specificity and complexity) and timing (in relation to client, service and practice issues) within needs assessment.},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.2000.01252.x},
keywords = {Community health services, community nurses, health and social care, health and social needs assessment, multiple case study design},
pubstate = {published},
tppubtype = {article}
}
A taxonomy of needs assessment, elicited from a multiple case study of community nursing education and practice The role and expectations of community nurses in carrying out needs assessments changed when an internal quasi-market was introduced to the British health service under the National Health Service (NHS) & Community Care Act 1990.
This paper reports on a study commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment in the context of this legislation. A multiple case study design was utilized and four cases identified, incorporating the geographical variation in England. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (n=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors.
Participants were interviewed after the observation period (n=33 practitioners), to determine the extent of formality they attached to each assessment, and to elicit information about aspects which may be embedded in everyday practice. Single and multiple case analyses across the four cases used an iterative process of pattern-matching, replication logic and explanation building.
The preliminary analysis yielded a descriptive ‘taxonomy’ which could serve as a basis for classifying the variants of needs assessment and help to clarify the whole phenomenon. When applied further to the data, this revealed the complex interactions between the different ideals (relating to policy, nursing and ascribed worth), the various types (purpose, formality/specificity and complexity) and timing (in relation to client, service and practice issues) within needs assessment.
This paper reports on a study commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment in the context of this legislation. A multiple case study design was utilized and four cases identified, incorporating the geographical variation in England. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (n=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors.
Participants were interviewed after the observation period (n=33 practitioners), to determine the extent of formality they attached to each assessment, and to elicit information about aspects which may be embedded in everyday practice. Single and multiple case analyses across the four cases used an iterative process of pattern-matching, replication logic and explanation building.
The preliminary analysis yielded a descriptive ‘taxonomy’ which could serve as a basis for classifying the variants of needs assessment and help to clarify the whole phenomenon. When applied further to the data, this revealed the complex interactions between the different ideals (relating to policy, nursing and ascribed worth), the various types (purpose, formality/specificity and complexity) and timing (in relation to client, service and practice issues) within needs assessment.
Cowley, Sarah; Buttigieg, Margaret; Houston, Anna
A first steps project to scope the current and future regulatory issues for health visiting Technical Report
UKCC 2000.
BibTeX | Tags:
@techreport{cowley_first_2000,
title = {A first steps project to scope the current and future regulatory issues for health visiting},
author = {Sarah Cowley and Margaret Buttigieg and Anna Houston},
year = {2000},
date = {2000-01-01},
urldate = {2000-01-01},
institution = {UKCC},
keywords = {},
pubstate = {published},
tppubtype = {techreport}
}
1999
Appleton, Jane; Cowley, Professor Sarah (Ed.)
The Search for Health Needs: Research for Health Visiting Practice Book
1999th edition, Palgrave Macmillan, 1999, ISBN: 978-0-333-72144-5.
@book{appleton_search_1999,
title = {The Search for Health Needs: Research for Health Visiting Practice},
editor = {Jane Appleton and Professor Sarah Cowley},
isbn = {978-0-333-72144-5},
year = {1999},
date = {1999-10-01},
urldate = {1999-10-01},
publisher = {Palgrave Macmillan},
edition = {1999th edition},
abstract = {'The search for health needs' was first identified in the 1970s as a key principle that informs and underpins the practice of health visiting. This book draws together pertinent research in this area, and presents it in such a way as to draw out the practical implications. The aim is to further good practice from an informed and evidence-based perspective.},
keywords = {},
pubstate = {published},
tppubtype = {book}
}
'The search for health needs' was first identified in the 1970s as a key principle that informs and underpins the practice of health visiting. This book draws together pertinent research in this area, and presents it in such a way as to draw out the practical implications. The aim is to further good practice from an informed and evidence-based perspective.
Norman, IJ; Cowley, S
The changing nature of nursing in a managerial age Book
Blackwell Science, Oxford, 1999, ISBN: 0-632-04252-4.
@book{norman_changing_1999,
title = {The changing nature of nursing in a managerial age},
author = {IJ Norman and S Cowley},
isbn = {0-632-04252-4},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
publisher = {Blackwell Science, Oxford},
abstract = {As an occupation, nursing is perceived by some as an emergent profession and by others as a managed service. For the former group, the key to quality improvement in nursing is to develop and promote that professionalism. For the latter group, the success of nursing as an occupation depends on its ability to colonise senior positions within the management hierarchy of health services. This text takes a fresh view on the debate at the heart of nursing. It considers the future for nursing within health care and social care and how it needs to adjust to its changing status and power in the context of social and health policy.
The book is organised into four sections. The first sets forth an ideal vision of nursing as a profession with caring as its core feature. The second section outlines threats to nursing as a caring profession posed by a managerial agenda within health care and social care services. The third and fourth sections reconsider the ideals and realities of professional nursing in the context of managerialism and the changing culture of health care provision.
This book makes a major contribution to current thinking about the nature of nursing as an occupation and its relevance and particular contribution to human well being. It should find a wide and appreciative audience among nurses and students, as well as other health care and social care professionals, and those involved in health service planning.},
keywords = {},
pubstate = {published},
tppubtype = {book}
}
As an occupation, nursing is perceived by some as an emergent profession and by others as a managed service. For the former group, the key to quality improvement in nursing is to develop and promote that professionalism. For the latter group, the success of nursing as an occupation depends on its ability to colonise senior positions within the management hierarchy of health services. This text takes a fresh view on the debate at the heart of nursing. It considers the future for nursing within health care and social care and how it needs to adjust to its changing status and power in the context of social and health policy.
The book is organised into four sections. The first sets forth an ideal vision of nursing as a profession with caring as its core feature. The second section outlines threats to nursing as a caring profession posed by a managerial agenda within health care and social care services. The third and fourth sections reconsider the ideals and realities of professional nursing in the context of managerialism and the changing culture of health care provision.
This book makes a major contribution to current thinking about the nature of nursing as an occupation and its relevance and particular contribution to human well being. It should find a wide and appreciative audience among nurses and students, as well as other health care and social care professionals, and those involved in health service planning.
The book is organised into four sections. The first sets forth an ideal vision of nursing as a profession with caring as its core feature. The second section outlines threats to nursing as a caring profession posed by a managerial agenda within health care and social care services. The third and fourth sections reconsider the ideals and realities of professional nursing in the context of managerialism and the changing culture of health care provision.
This book makes a major contribution to current thinking about the nature of nursing as an occupation and its relevance and particular contribution to human well being. It should find a wide and appreciative audience among nurses and students, as well as other health care and social care professionals, and those involved in health service planning.
Cowley, S
Purpose, process and power in public health nursing Journal Article
In: NURSING REVIEW-DUBLIN-, vol. 17, pp. 30–34, 1999, ISSN: 0790-0368, (Publisher: FACULTY OF NURSING-ROYAL COLLEGE OF SURGEONS OF IERLAND).
BibTeX | Tags:
@article{cowley_purpose_1999,
title = {Purpose, process and power in public health nursing},
author = {S Cowley},
issn = {0790-0368},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
journal = {NURSING REVIEW-DUBLIN-},
volume = {17},
pages = {30–34},
note = {Publisher: FACULTY OF NURSING-ROYAL COLLEGE OF SURGEONS OF IERLAND},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah; Billings, Jennifer Ruth
Resources revisited: salutogenesis from a lay perspective Journal Article
In: Journal of Advanced Nursing, vol. 29, no. 4, pp. 994–1004, 1999, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags: empowerment, health capital, health needs, health promotion, health visiting, lay perspective, public health, salutogenesis, social capital, social cohesion
@article{cowley_resources_1999,
title = {Resources revisited: salutogenesis from a lay perspective},
author = {Sarah Cowley and Jennifer Ruth Billings},
doi = {10.1046/j.1365-2648.1999.00968.x},
issn = {1365-2648},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
journal = {Journal of Advanced Nursing},
volume = {29},
number = {4},
pages = {994–1004},
abstract = {Health visitors are being pressured to move away from their traditional role in health promotion and public health to focus more closely on people with established clinical disorders. This is partly because of a paucity of theoretical explanations against which to assess interventions directed explicitly at promoting health rather than only preventing disease. However, there are growing public health concerns about increasing inequalities and rising numbers of disadvantaged groups in the UK as well.
This paper revisits a grounded theory study that revealed how, in the absence of a need for clinical intervention, health visitors appear to assess needs by treating health as a process fuelled by the accumulation and use of `resources for health'. Wider theories about salutogenesis (`health creation') and research showing the importance of health and social capital demonstrate the potential of this idea, and were combined with the health visiting study to create a theoretical framework for analytical purposes. Semi-structured interviews with the main carer in 50 families with resident children were analysed using this framework, to provide a lay perspective on how people consider they maintain their health.
The analysis demonstrated the usefulness of treating health as a process and of focusing on the development of health-related resources rather than only on presenting problems. The processes of developing capacity were shown to be more important than the presence or absence of specific resources. Links with personal empowerment were apparent; cultural patterns that evolved across generations and neighbourhoods revealed possible pathways to social cohesion. Practice approaches that enhance or inhibit the development of these health-creating resources were identified, and considered in the light of emerging public health needs.},
keywords = {empowerment, health capital, health needs, health promotion, health visiting, lay perspective, public health, salutogenesis, social capital, social cohesion},
pubstate = {published},
tppubtype = {article}
}
Health visitors are being pressured to move away from their traditional role in health promotion and public health to focus more closely on people with established clinical disorders. This is partly because of a paucity of theoretical explanations against which to assess interventions directed explicitly at promoting health rather than only preventing disease. However, there are growing public health concerns about increasing inequalities and rising numbers of disadvantaged groups in the UK as well.
This paper revisits a grounded theory study that revealed how, in the absence of a need for clinical intervention, health visitors appear to assess needs by treating health as a process fuelled by the accumulation and use of `resources for health'. Wider theories about salutogenesis (`health creation') and research showing the importance of health and social capital demonstrate the potential of this idea, and were combined with the health visiting study to create a theoretical framework for analytical purposes. Semi-structured interviews with the main carer in 50 families with resident children were analysed using this framework, to provide a lay perspective on how people consider they maintain their health.
The analysis demonstrated the usefulness of treating health as a process and of focusing on the development of health-related resources rather than only on presenting problems. The processes of developing capacity were shown to be more important than the presence or absence of specific resources. Links with personal empowerment were apparent; cultural patterns that evolved across generations and neighbourhoods revealed possible pathways to social cohesion. Practice approaches that enhance or inhibit the development of these health-creating resources were identified, and considered in the light of emerging public health needs.
This paper revisits a grounded theory study that revealed how, in the absence of a need for clinical intervention, health visitors appear to assess needs by treating health as a process fuelled by the accumulation and use of `resources for health'. Wider theories about salutogenesis (`health creation') and research showing the importance of health and social capital demonstrate the potential of this idea, and were combined with the health visiting study to create a theoretical framework for analytical purposes. Semi-structured interviews with the main carer in 50 families with resident children were analysed using this framework, to provide a lay perspective on how people consider they maintain their health.
The analysis demonstrated the usefulness of treating health as a process and of focusing on the development of health-related resources rather than only on presenting problems. The processes of developing capacity were shown to be more important than the presence or absence of specific resources. Links with personal empowerment were apparent; cultural patterns that evolved across generations and neighbourhoods revealed possible pathways to social cohesion. Practice approaches that enhance or inhibit the development of these health-creating resources were identified, and considered in the light of emerging public health needs.
Cowley, S
From population to people: public health in practice Journal Article
In: Community Practitioner, vol. 72, pp. 88–90, 1999, ISSN: 1462-2815, (Publisher: TG SCOTT).
BibTeX | Tags:
@article{cowley_population_1999,
title = {From population to people: public health in practice},
author = {S Cowley},
issn = {1462-2815},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
journal = {Community Practitioner},
volume = {72},
pages = {88–90},
note = {Publisher: TG SCOTT},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah; Billings, Jennifer Ruth
Identifying approaches to meet assessed needs in health visiting Journal Article
In: Journal of Clinical Nursing, vol. 8, no. 5, pp. 527–534, 1999, ISSN: 1365-2702.
Abstract | Links | BibTeX | Tags: evidence-based practice, health visiting, prevention, service evaluations, social exclusion
@article{cowley_identifying_1999,
title = {Identifying approaches to meet assessed needs in health visiting},
author = {Sarah Cowley and Jennifer Ruth Billings},
doi = {10.1046/j.1365-2702.1999.00293.x},
issn = {1365-2702},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
journal = {Journal of Clinical Nursing},
volume = {8},
number = {5},
pages = {527–534},
abstract = {An action research project, based in a single fundholding practice on the south coast of England, aimed to identify the health needs of families with resident children, then use the contracting system to redirect health visiting services to meet those needs. After assessing the health needs, it was necessary to assess the potential of a range of health visiting approaches that might be proposed to meet those needs.
This paper explains how the approaches were assessed for use in the local area and why funding for two additional, innovative posts was deemed necessary. Despite the unsophisticated evidence base for health visiting interventions, a case can be made for commissioning particular service approaches by using a combination of survey data and results from controlled and uncontrolled service evaluations.
The supportive focus of health visitor home visiting remains an appropriate use of existing resources, but the usual intensity of visiting may be insufficient for full effectiveness. To rationalize such services by targeting them only at individuals with established needs risks an exacerbation of deteriorating health trends across an area.
Alternatively, augmenting home visiting with a community development approach to improve the adverse social environments in which families live may help to change the underlying factors that contribute to ill-health and prove more widely cost-effective.},
keywords = {evidence-based practice, health visiting, prevention, service evaluations, social exclusion},
pubstate = {published},
tppubtype = {article}
}
An action research project, based in a single fundholding practice on the south coast of England, aimed to identify the health needs of families with resident children, then use the contracting system to redirect health visiting services to meet those needs. After assessing the health needs, it was necessary to assess the potential of a range of health visiting approaches that might be proposed to meet those needs.
This paper explains how the approaches were assessed for use in the local area and why funding for two additional, innovative posts was deemed necessary. Despite the unsophisticated evidence base for health visiting interventions, a case can be made for commissioning particular service approaches by using a combination of survey data and results from controlled and uncontrolled service evaluations.
The supportive focus of health visitor home visiting remains an appropriate use of existing resources, but the usual intensity of visiting may be insufficient for full effectiveness. To rationalize such services by targeting them only at individuals with established needs risks an exacerbation of deteriorating health trends across an area.
Alternatively, augmenting home visiting with a community development approach to improve the adverse social environments in which families live may help to change the underlying factors that contribute to ill-health and prove more widely cost-effective.
This paper explains how the approaches were assessed for use in the local area and why funding for two additional, innovative posts was deemed necessary. Despite the unsophisticated evidence base for health visiting interventions, a case can be made for commissioning particular service approaches by using a combination of survey data and results from controlled and uncontrolled service evaluations.
The supportive focus of health visitor home visiting remains an appropriate use of existing resources, but the usual intensity of visiting may be insufficient for full effectiveness. To rationalize such services by targeting them only at individuals with established needs risks an exacerbation of deteriorating health trends across an area.
Alternatively, augmenting home visiting with a community development approach to improve the adverse social environments in which families live may help to change the underlying factors that contribute to ill-health and prove more widely cost-effective.
Cowley, Sarah; Billings, Jennifer Ruth
Implementing new health visiting services through action research: an analysis of process Journal Article
In: Journal of Advanced Nursing, vol. 30, no. 4, pp. 965–974, 1999, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags: action research, community development, decision making, health needs, health visiting, home visiting, participant observation, structural processes
@article{cowley_implementing_1999,
title = {Implementing new health visiting services through action research: an analysis of process},
author = {Sarah Cowley and Jennifer Ruth Billings},
doi = {10.1046/j.1365-2648.1999.01180.x},
issn = {1365-2648},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
journal = {Journal of Advanced Nursing},
volume = {30},
number = {4},
pages = {965–974},
abstract = {An action research project based in a single fundholding practice on the South Coast of England aimed to identify needs relevant to families with resident children, then to use the contracting system to redirect health visiting practice to meet those needs. The naïvety of this plan was well recognised, so the processes that occurred during implementation of the proposed changes were recorded throughout. An analysis of these participant observation data revealed various organisational constraints and facilitators that arose during contract negotiations.
Two new full time health visiting posts were established, each with an innovative and somewhat controversial focus. One health visitor was employed to establish a community development project in an underserved area of the town, while the other was to provide a home visiting service for the families of school aged children.
The processes involved in structuring decisions about ‘health needs’ and how these are best met are analysed for each of the two new posts. The analysis reveals powerful influences that affect the implementation of new health visiting services.},
keywords = {action research, community development, decision making, health needs, health visiting, home visiting, participant observation, structural processes},
pubstate = {published},
tppubtype = {article}
}
An action research project based in a single fundholding practice on the South Coast of England aimed to identify needs relevant to families with resident children, then to use the contracting system to redirect health visiting practice to meet those needs. The naïvety of this plan was well recognised, so the processes that occurred during implementation of the proposed changes were recorded throughout. An analysis of these participant observation data revealed various organisational constraints and facilitators that arose during contract negotiations.
Two new full time health visiting posts were established, each with an innovative and somewhat controversial focus. One health visitor was employed to establish a community development project in an underserved area of the town, while the other was to provide a home visiting service for the families of school aged children.
The processes involved in structuring decisions about ‘health needs’ and how these are best met are analysed for each of the two new posts. The analysis reveals powerful influences that affect the implementation of new health visiting services.
Two new full time health visiting posts were established, each with an innovative and somewhat controversial focus. One health visitor was employed to establish a community development project in an underserved area of the town, while the other was to provide a home visiting service for the families of school aged children.
The processes involved in structuring decisions about ‘health needs’ and how these are best met are analysed for each of the two new posts. The analysis reveals powerful influences that affect the implementation of new health visiting services.
Cowley, Sarah; Houston, Anna
Health visiting and school nursing: the Croydon story Technical Report
Kings College London 1999.
BibTeX | Tags:
@techreport{cowley_health_1999,
title = {Health visiting and school nursing: the Croydon story},
author = {Sarah Cowley and Anna Houston},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
institution = {Kings College London},
keywords = {},
pubstate = {published},
tppubtype = {techreport}
}
Cowley, S
Health promotion for older people Book Section
In: Redfern, S; Ross, F (Ed.): Nursing Older People (4th edition), pp. 645–668, 1999.
BibTeX | Tags:
@incollection{cowley_health_1999-1,
title = {Health promotion for older people},
author = {S Cowley},
editor = {S Redfern and F Ross},
year = {1999},
date = {1999-01-01},
urldate = {1999-01-01},
booktitle = {Nursing Older People (4th edition)},
pages = {645–668},
keywords = {},
pubstate = {published},
tppubtype = {incollection}
}
1998
Cowley, S
Public health: the role of nurses and health visitors Journal Article
In: Health Visitor, vol. 71, no. 1, pp. 29–31, 1998.
BibTeX | Tags:
@article{cowley_public_1998,
title = {Public health: the role of nurses and health visitors},
author = {S Cowley},
year = {1998},
date = {1998-01-01},
urldate = {1998-01-01},
journal = {Health Visitor},
volume = {71},
number = {1},
pages = {29–31},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, SCS
Exploring Need: taking the marketing perspective Journal Article
In: Community Practitioner, vol. 71, pp. 244–247, 1998, ISSN: 1462-2815, (Publisher: TG SCOTT).
BibTeX | Tags:
@article{cowley_exploring_1998,
title = {Exploring Need: taking the marketing perspective},
author = {SCS Cowley},
issn = {1462-2815},
year = {1998},
date = {1998-01-01},
urldate = {1998-01-01},
journal = {Community Practitioner},
volume = {71},
pages = {244–247},
note = {Publisher: TG SCOTT},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Collinson, Suzan; Cowley, Sarah
An exploratory study of demand for the health visiting service within a marketing framework Journal Article
In: Journal of Advanced Nursing, vol. 28, no. 3, pp. 499–507, 1998, ISSN: 1365-2648, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1998.00698.x).
Abstract | Links | BibTeX | Tags: consumer knowledge, demand, health visiting, marketing, qualitative research, service value
@article{collinson_exploratory_1998,
title = {An exploratory study of demand for the health visiting service within a marketing framework},
author = {Suzan Collinson and Sarah Cowley},
doi = {10.1046/j.1365-2648.1998.00698.x},
issn = {1365-2648},
year = {1998},
date = {1998-01-01},
urldate = {1998-01-01},
journal = {Journal of Advanced Nursing},
volume = {28},
number = {3},
pages = {499–507},
abstract = {A small exploratory study was carried out to consider the concept of demand for the health visiting service from the clients’ perspective. Because of the internal market introduced to the British health system under the National Health Service and Community Care Act, the idea of ‘marketing’ was used as a conceptual framework to underpin the study.
Guided interviews were carried out with a sample of nine mothers of pre-school children to elicit the reasons why clients access the service, what they value about it and how they think it could be improved. A detailed qualitative analysis of these data indicates that demand for health visiting relates, in the first instance, to clients’ knowledge of the service.
This knowledge, and the extent to which the service meets their expectations, appear to influence the value the women place on health visiting and their subsequent use of it. A cycle is described, which illustrates critical points at which health visiting responses affect demand and use of service. The implications of the study for health visiting and for marketing the service are discussed.},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1998.00698.x},
keywords = {consumer knowledge, demand, health visiting, marketing, qualitative research, service value},
pubstate = {published},
tppubtype = {article}
}
A small exploratory study was carried out to consider the concept of demand for the health visiting service from the clients’ perspective. Because of the internal market introduced to the British health system under the National Health Service and Community Care Act, the idea of ‘marketing’ was used as a conceptual framework to underpin the study.
Guided interviews were carried out with a sample of nine mothers of pre-school children to elicit the reasons why clients access the service, what they value about it and how they think it could be improved. A detailed qualitative analysis of these data indicates that demand for health visiting relates, in the first instance, to clients’ knowledge of the service.
This knowledge, and the extent to which the service meets their expectations, appear to influence the value the women place on health visiting and their subsequent use of it. A cycle is described, which illustrates critical points at which health visiting responses affect demand and use of service. The implications of the study for health visiting and for marketing the service are discussed.
Guided interviews were carried out with a sample of nine mothers of pre-school children to elicit the reasons why clients access the service, what they value about it and how they think it could be improved. A detailed qualitative analysis of these data indicates that demand for health visiting relates, in the first instance, to clients’ knowledge of the service.
This knowledge, and the extent to which the service meets their expectations, appear to influence the value the women place on health visiting and their subsequent use of it. A cycle is described, which illustrates critical points at which health visiting responses affect demand and use of service. The implications of the study for health visiting and for marketing the service are discussed.
1997
Cowley, Sarah; Bliss, Julie
Preparing for specialist community nursing practice Journal Article
In: Nursing times, vol. 93, pp. 56–8, 1997.
BibTeX | Tags:
@article{cowley_preparing_1997,
title = {Preparing for specialist community nursing practice},
author = {Sarah Cowley and Julie Bliss},
year = {1997},
date = {1997-09-01},
urldate = {1997-09-01},
journal = {Nursing times},
volume = {93},
pages = {56–8},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah
Public health values in practice: the case of health visiting Journal Article
In: Critical Public Health, vol. 7, no. 1-2, pp. 82–97, 1997, ISSN: 0958-1596, (Publisher: Taylor & Francis _eprint: https://doi.org/10.1080/09581599708409081).
@article{cowley_public_1997,
title = {Public health values in practice: the case of health visiting},
author = {Sarah Cowley},
url = {https://doi.org/10.1080/09581599708409081},
doi = {10.1080/09581599708409081},
issn = {0958-1596},
year = {1997},
date = {1997-01-01},
urldate = {1997-01-01},
journal = {Critical Public Health},
volume = {7},
number = {1-2},
pages = {82–97},
note = {Publisher: Taylor & Francis
_eprint: https://doi.org/10.1080/09581599708409081},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Appleton, Jane V.; Cowley, Sarah
Analysing clinical practice guidelines. A method of documentary analysis Journal Article
In: Journal of Advanced Nursing, vol. 25, no. 5, pp. 1008–1017, 1997, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags:
@article{appleton_analysing_1997,
title = {Analysing clinical practice guidelines. A method of documentary analysis},
author = {Jane V. Appleton and Sarah Cowley},
doi = {10.1046/j.1365-2648.1997.19970251008.x},
issn = {1365-2648},
year = {1997},
date = {1997-01-01},
urldate = {1997-01-01},
journal = {Journal of Advanced Nursing},
volume = {25},
number = {5},
pages = {1008–1017},
abstract = {This paper will describe a method of documentary analysis used in a study examining the validity of clinical guidelines issued to health visitors to assist them in identifying families requiring increased health visitor support. This forms the preliminary work for a wider study examining how health visitors decide to increase support to vulnerable families.
Although a number of published research texts discuss the value of records and documents as important data sources for health service researchers, there is relatively little information available about the processes of documentary analysis. This paper offers one method for analysing clinical practice guidelines, it describes the development of a critique and analysis tool and expolres the strengths an weaknesses of this particular analysis instrument.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper will describe a method of documentary analysis used in a study examining the validity of clinical guidelines issued to health visitors to assist them in identifying families requiring increased health visitor support. This forms the preliminary work for a wider study examining how health visitors decide to increase support to vulnerable families.
Although a number of published research texts discuss the value of records and documents as important data sources for health service researchers, there is relatively little information available about the processes of documentary analysis. This paper offers one method for analysing clinical practice guidelines, it describes the development of a critique and analysis tool and expolres the strengths an weaknesses of this particular analysis instrument.
Although a number of published research texts discuss the value of records and documents as important data sources for health service researchers, there is relatively little information available about the processes of documentary analysis. This paper offers one method for analysing clinical practice guidelines, it describes the development of a critique and analysis tool and expolres the strengths an weaknesses of this particular analysis instrument.
Botes, S.; Cowley, S.; Hudson, R.
How community practitioners and health visitors can help address health inequalities Journal Article
In: Health Visitor, vol. 70, pp. 464–466, 1997, (ISBN: 0017-9140 Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS).
BibTeX | Tags:
@article{botes_how_1997,
title = {How community practitioners and health visitors can help address health inequalities},
author = {S. Botes and S. Cowley and R. Hudson},
year = {1997},
date = {1997-01-01},
urldate = {1997-01-01},
journal = {Health Visitor},
volume = {70},
pages = {464–466},
note = {ISBN: 0017-9140
Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, S
Rhetoric and reality: establishing a new agenda for community practice Journal Article
In: HEALTH VISITOR, vol. 70, pp. 414–416, 1997, ISSN: 0017-9140, (Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS).
BibTeX | Tags:
@article{cowley_rhetoric_1997,
title = {Rhetoric and reality: establishing a new agenda for community practice},
author = {S Cowley},
issn = {0017-9140},
year = {1997},
date = {1997-01-01},
urldate = {1997-01-01},
journal = {HEALTH VISITOR},
volume = {70},
pages = {414–416},
note = {Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah; Billings, Jenny
Family Health Needs Project Technical Report
King's College London, Department of Nursing Studies 1997.
BibTeX | Tags:
@techreport{cowley_family_1997,
title = {Family Health Needs Project},
author = {Sarah Cowley and Jenny Billings},
year = {1997},
date = {1997-01-01},
urldate = {1997-01-01},
institution = {King's College London, Department of Nursing Studies},
keywords = {},
pubstate = {published},
tppubtype = {techreport}
}
1996
Bergen, A.; Cowley, S.; Young, K.; Kavanagh, A.
English National Board for Nursing, Midwifery and Health Visiting, Publications Department, Victory House, 170 Tottenham Court Road, London W1P 0HA, England, United Kingdom 1996, (ERIC Number: ED414484).
Abstract | BibTeX | Tags: Clinical Diagnosis, Community health services, Educational Needs, Foreign Countries, Medical Care Evaluation, Medical Evaluation, Medical Services, needs assessment, Nurses, Nursing Education, Postsecondary Education, Teacher Improvement
@techreport{bergen_investigation_1996,
title = {An Investigation into the Changing Educational Needs of Community Nurses with Regard to Needs Assessment and Quality of Care in the Context of the NHS and Community Care Act, 1990},
author = {A. Bergen and S. Cowley and K. Young and A. Kavanagh},
year = {1996},
date = {1996-11-01},
urldate = {1996-11-01},
institution = {English National Board for Nursing, Midwifery and Health Visiting, Publications Department, Victory House, 170 Tottenham Court Road, London W1P 0HA, England, United Kingdom },
abstract = {A project examined the changing educational needs of community nurses in Britain with regard to needs assessment and quality of care in the context of the National Health Service and Community Care Act 1990.
Phase 1 clarified the term "needs assessment" through focus group discussions. Phase 2 used observations and interviews to examine educational preparation and practice of needs assessment by district nurses and health visitors and develop recommendations for future educational provision. In phase 3, a group of experts from interest groups scrutinized findings and proposals for recommendations that were subjected to a content analysis.
The ability to assess needs of individuals, families, and the local population served on the community nursing caseload appeared as a holistic endeavour. Certain aspects of needs assessment were learned better than others, perhaps due to a lack of clarity and understanding about some embedded features of need. Professional judgment required the development of critical skills and ability to conceptualise and articulate practice. The important role of the caseload-holding specialist teacher in the practice setting was highlighted.
Data suggested real difficulties in teaching in an uncertain and rapidly changing environment in community nursing education and practice. Upgrading the level of preparation for community practice teachers was recommended. (Appendixes include 250 references, discussion group materials, instruments, and data tables.) (YLB)},
note = {ERIC Number: ED414484},
keywords = {Clinical Diagnosis, Community health services, Educational Needs, Foreign Countries, Medical Care Evaluation, Medical Evaluation, Medical Services, needs assessment, Nurses, Nursing Education, Postsecondary Education, Teacher Improvement},
pubstate = {published},
tppubtype = {techreport}
}
A project examined the changing educational needs of community nurses in Britain with regard to needs assessment and quality of care in the context of the National Health Service and Community Care Act 1990.
Phase 1 clarified the term "needs assessment" through focus group discussions. Phase 2 used observations and interviews to examine educational preparation and practice of needs assessment by district nurses and health visitors and develop recommendations for future educational provision. In phase 3, a group of experts from interest groups scrutinized findings and proposals for recommendations that were subjected to a content analysis.
The ability to assess needs of individuals, families, and the local population served on the community nursing caseload appeared as a holistic endeavour. Certain aspects of needs assessment were learned better than others, perhaps due to a lack of clarity and understanding about some embedded features of need. Professional judgment required the development of critical skills and ability to conceptualise and articulate practice. The important role of the caseload-holding specialist teacher in the practice setting was highlighted.
Data suggested real difficulties in teaching in an uncertain and rapidly changing environment in community nursing education and practice. Upgrading the level of preparation for community practice teachers was recommended. (Appendixes include 250 references, discussion group materials, instruments, and data tables.) (YLB)
Phase 1 clarified the term "needs assessment" through focus group discussions. Phase 2 used observations and interviews to examine educational preparation and practice of needs assessment by district nurses and health visitors and develop recommendations for future educational provision. In phase 3, a group of experts from interest groups scrutinized findings and proposals for recommendations that were subjected to a content analysis.
The ability to assess needs of individuals, families, and the local population served on the community nursing caseload appeared as a holistic endeavour. Certain aspects of needs assessment were learned better than others, perhaps due to a lack of clarity and understanding about some embedded features of need. Professional judgment required the development of critical skills and ability to conceptualise and articulate practice. The important role of the caseload-holding specialist teacher in the practice setting was highlighted.
Data suggested real difficulties in teaching in an uncertain and rapidly changing environment in community nursing education and practice. Upgrading the level of preparation for community practice teachers was recommended. (Appendixes include 250 references, discussion group materials, instruments, and data tables.) (YLB)
Cowley, Sarah; Bergen, Ann; Young, Kate; Kavanagh, Ann
Establishing a framework for research: the example of needs assessment Journal Article
In: Journal of Clinical Nursing, vol. 5, no. 1, pp. 53–61, 1996, ISSN: 1365-2702, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2702.1996.tb00226.x).
Abstract | Links | BibTeX | Tags: community nursing, focus groups, needs assessment
@article{cowley_establishing_1996,
title = {Establishing a framework for research: the example of needs assessment},
author = {Sarah Cowley and Ann Bergen and Kate Young and Ann Kavanagh},
url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2702.1996.tb00226.x},
doi = {10.1111/j.1365-2702.1996.tb00226.x},
issn = {1365-2702},
year = {1996},
date = {1996-01-01},
urldate = {1996-01-01},
journal = {Journal of Clinical Nursing},
volume = {5},
number = {1},
pages = {53–61},
abstract = {• This paper explains the early planning stage of a study commissioned by the English National Board which will investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act 1990. • Two focus groups, comprising 22 participants altogether, generated data which were used to augment and clarify issues explored in an initial literature review. Some of the methodological issues are explained. • Traditional community nursing approaches to needs assessment appeared to value process and integration, while the new legislation emphasizes the separate-ness of assessment; there is a danger that it may be seen as a single event. The consumer views were both supportive and critical about each of the approaches; some important insights were gained, and a confident basis from which to launch the study identified. • The approach offers one possible way to clarify the starting point of a project when carrying out a standard literature review seems insufficient. This may occur with under-researched or rapidly changing phenomena, or if a field of interest is the subject of multiple interpretations or lack of consensus.},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2702.1996.tb00226.x},
keywords = {community nursing, focus groups, needs assessment},
pubstate = {published},
tppubtype = {article}
}
• This paper explains the early planning stage of a study commissioned by the English National Board which will investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act 1990. • Two focus groups, comprising 22 participants altogether, generated data which were used to augment and clarify issues explored in an initial literature review. Some of the methodological issues are explained. • Traditional community nursing approaches to needs assessment appeared to value process and integration, while the new legislation emphasizes the separate-ness of assessment; there is a danger that it may be seen as a single event. The consumer views were both supportive and critical about each of the approaches; some important insights were gained, and a confident basis from which to launch the study identified. • The approach offers one possible way to clarify the starting point of a project when carrying out a standard literature review seems insufficient. This may occur with under-researched or rapidly changing phenomena, or if a field of interest is the subject of multiple interpretations or lack of consensus.
Davis, Bryn D; Cowley, Sarah A; Ryland, Richard K
The effects of terminal illness on patients and their carers Journal Article
In: Journal of Advanced Nursing, vol. 23, no. 3, pp. 512–520, 1996, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags:
@article{davis_effects_1996,
title = {The effects of terminal illness on patients and their carers},
author = {Bryn D Davis and Sarah A Cowley and Richard K Ryland},
doi = {10.1111/j.1365-2648.1996.tb00013.x},
issn = {1365-2648},
year = {1996},
date = {1996-01-01},
urldate = {1996-01-01},
journal = {Journal of Advanced Nursing},
volume = {23},
number = {3},
pages = {512–520},
abstract = {As part of a larger study, this paper describes the development and design of a project looking at the experiences of the relatives and carers of terminally ill patients in one health authority, as a replication of a similar study undertaken in another area Following a description of the problems associated with studies into the problems of dying people and of the method used here, the results indicate that there are quite important effects on the household and carers, which include the problem of obtaining a diagnosis of terminal illness, and the actual process of dying
The study also highlights some of the effects of the terminal illness on the patients and their carers hi particular the results indicate that it was usually a spouse or the daughter who bore the brunt of the care, but that most preferred to retain their independence of the services as long as possible Often, carers (and the patients) were not fully appraised that a terminal stage had been reached Some doctors seemed reluctant (or found it difficult) to admit that such a stage had been reached
For many, the experience of dying was a very slow, distressing and often painful period, with serious limitations on their lifestyle imposed by the illness A number of these limitations could have been reduced if earlier diagnosis had been made or if community nursing or social services had been called in sooner},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
As part of a larger study, this paper describes the development and design of a project looking at the experiences of the relatives and carers of terminally ill patients in one health authority, as a replication of a similar study undertaken in another area Following a description of the problems associated with studies into the problems of dying people and of the method used here, the results indicate that there are quite important effects on the household and carers, which include the problem of obtaining a diagnosis of terminal illness, and the actual process of dying
The study also highlights some of the effects of the terminal illness on the patients and their carers hi particular the results indicate that it was usually a spouse or the daughter who bore the brunt of the care, but that most preferred to retain their independence of the services as long as possible Often, carers (and the patients) were not fully appraised that a terminal stage had been reached Some doctors seemed reluctant (or found it difficult) to admit that such a stage had been reached
For many, the experience of dying was a very slow, distressing and often painful period, with serious limitations on their lifestyle imposed by the illness A number of these limitations could have been reduced if earlier diagnosis had been made or if community nursing or social services had been called in sooner
The study also highlights some of the effects of the terminal illness on the patients and their carers hi particular the results indicate that it was usually a spouse or the daughter who bore the brunt of the care, but that most preferred to retain their independence of the services as long as possible Often, carers (and the patients) were not fully appraised that a terminal stage had been reached Some doctors seemed reluctant (or found it difficult) to admit that such a stage had been reached
For many, the experience of dying was a very slow, distressing and often painful period, with serious limitations on their lifestyle imposed by the illness A number of these limitations could have been reduced if earlier diagnosis had been made or if community nursing or social services had been called in sooner
Cowley, S
Reflecting on the past; preparing for the next century Journal Article
In: Health Visitor, vol. 69, pp. 313–316, 1996, ISSN: 0017-9140, (Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS).
BibTeX | Tags:
@article{cowley_reflecting_1996,
title = {Reflecting on the past; preparing for the next century},
author = {S Cowley},
issn = {0017-9140},
year = {1996},
date = {1996-01-01},
urldate = {1996-01-01},
journal = {Health Visitor},
volume = {69},
pages = {313–316},
note = {Publisher: PROFESSIONAL AND SCIENTIFIC PUBLICATIONS},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, S; Bergan, A; Young, K; Kavanagh, A
The changing nature of needs assessment in primary health care; cited in Bryans A, McIntosh J Journal Article
In: J Adv Nurs, vol. 24, pp. 24–30, 1996.
BibTeX | Tags:
@article{cowley_changing_1996,
title = {The changing nature of needs assessment in primary health care; cited in Bryans A, McIntosh J},
author = {S Cowley and A Bergan and K Young and A Kavanagh},
year = {1996},
date = {1996-01-01},
urldate = {1996-01-01},
journal = {J Adv Nurs},
volume = {24},
pages = {24–30},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Twinn, Sheila; Roberts, Barbara; Sarah, RGN
Community health care nursing: principles for practice Journal Article
In: (No Title), pp. 447–457, 1996.
BibTeX | Tags:
@article{twinn_community_1996,
title = {Community health care nursing: principles for practice},
author = {Sheila Twinn and Barbara Roberts and RGN Sarah},
year = {1996},
date = {1996-01-01},
urldate = {1996-01-01},
journal = {(No Title)},
pages = {447–457},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1995
Campbell, Fiona; Cowley, Sarah
Weights and Measures: Outcomes and Evaluation in Health Visiting Book
Community Practitioners' & Health Visitors' Association, 1995, ISBN: 978-1-872278-30-8.
BibTeX | Tags:
@book{campbell_weights_1995,
title = {Weights and Measures: Outcomes and Evaluation in Health Visiting},
author = {Fiona Campbell and Sarah Cowley},
isbn = {978-1-872278-30-8},
year = {1995},
date = {1995-10-01},
urldate = {1995-10-01},
publisher = {Community Practitioners' & Health Visitors' Association},
keywords = {},
pubstate = {published},
tppubtype = {book}
}