2002
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.
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.
1999
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.
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}
}
1996
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
Cowley, S.
Health promotion in the general practice setting Journal Article
In: Health visitor, vol. 68, no. 5, pp. 199–201, 1995, ISSN: 0017-9140.
@article{cowley_health_1995,
title = {Health promotion in the general practice setting},
author = {S. Cowley},
issn = {0017-9140},
year = {1995},
date = {1995-05-01},
urldate = {1995-05-01},
journal = {Health visitor},
volume = {68},
number = {5},
pages = {199–201},
abstract = {Two major studies of health promotion interventions in the general practice setting appear to show that nurses are less effective than doctors in influencing people to make necessary lifestyle changes. But, as this briefing argues, both studies were heavily dominated by the medical model. Such an approach, focusing on ill-health, not health, fails to take into account the wider social and economic factors influencing individuals' behaviours.
Far from indicating the need for greater input from doctors, the studies serve to reinforce arguments against the medical model in health. promotion, and underline the need for the health-oriented approach which now underpins all nursing education and training.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Two major studies of health promotion interventions in the general practice setting appear to show that nurses are less effective than doctors in influencing people to make necessary lifestyle changes. But, as this briefing argues, both studies were heavily dominated by the medical model. Such an approach, focusing on ill-health, not health, fails to take into account the wider social and economic factors influencing individuals' behaviours.
Far from indicating the need for greater input from doctors, the studies serve to reinforce arguments against the medical model in health. promotion, and underline the need for the health-oriented approach which now underpins all nursing education and training.
Far from indicating the need for greater input from doctors, the studies serve to reinforce arguments against the medical model in health. promotion, and underline the need for the health-oriented approach which now underpins all nursing education and training.
Cowley, Sarah
Professional development and change in a learning organization Journal Article
In: Journal of Advanced Nursing, vol. 21, no. 5, pp. 965–974, 1995, ISSN: 1365-2648, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.21050965.x).
Abstract | Links | BibTeX | Tags:
@article{cowley_professional_1995,
title = {Professional development and change in a learning organization},
author = {Sarah Cowley},
url = {https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1995.21050965.x},
doi = {10.1046/j.1365-2648.1995.21050965.x},
issn = {1365-2648},
year = {1995},
date = {1995-01-01},
urldate = {1995-01-01},
journal = {Journal of Advanced Nursing},
volume = {21},
number = {5},
pages = {965–974},
abstract = {There is a growing tendency for learning in the workplace to be seen as a managerial function rather than as the responsibility of educationalists As managers prepare to take a more active role in facilitating professional education, they need to consider the extent to which their organizational arrangements help or hinder the learning of professional skills There is a potential risk that the development of important clinical practice skills may be inadvertently overlooked, because of the kind of organizational arrangements in force This paper outlines alternative approaches to organizational development, explaining the basis for implementing ‘holographic principles’ when planning a system A situational analysis earned out in an inner-city community provider unit revealed an alternative, more directive and fragmented arrangement The analysis is used to illustrate how a focus on developing the organization as a learning environment during periods of rapid and multiple change can also help to promote clinical nursing skills},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.21050965.x},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There is a growing tendency for learning in the workplace to be seen as a managerial function rather than as the responsibility of educationalists As managers prepare to take a more active role in facilitating professional education, they need to consider the extent to which their organizational arrangements help or hinder the learning of professional skills There is a potential risk that the development of important clinical practice skills may be inadvertently overlooked, because of the kind of organizational arrangements in force This paper outlines alternative approaches to organizational development, explaining the basis for implementing ‘holographic principles’ when planning a system A situational analysis earned out in an inner-city community provider unit revealed an alternative, more directive and fragmented arrangement The analysis is used to illustrate how a focus on developing the organization as a learning environment during periods of rapid and multiple change can also help to promote clinical nursing skills
Cowley, Sarah
In health visiting, a routine visit is one that has passed Journal Article
In: Journal of Advanced Nursing, vol. 22, no. 2, pp. 276–284, 1995, ISSN: 1365-2648, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.22020276.x).
Abstract | Links | BibTeX | Tags:
@article{cowley_health_1995-1,
title = {In health visiting, a routine visit is one that has passed},
author = {Sarah Cowley},
doi = {10.1046/j.1365-2648.1995.22020276.x},
issn = {1365-2648},
year = {1995},
date = {1995-01-01},
urldate = {1995-01-01},
journal = {Journal of Advanced Nursing},
volume = {22},
number = {2},
pages = {276–284},
abstract = {Pressure on British health workers to be more explicit in articulating the function, purpose and outcome of their role has increased with the introduction of general management and shift to a market-place orientation, since implementation of the NHS and Community Care Act (1990) However, a recurring theme in the history of health visiting has been the difficulty which practitioners experience in trying to explain exactly what it is that they do
This has often been portrayed as a major failing, and possibly even a reason to discontinue the service This paper will offer a potential explanation for this difficulty, and suggest that the management of uncertainty and ambiguity are central to the role It will draw on a grounded theory study which explored how health visitors choose which approach to use in any particular situation encountered in their work The analysis suggested that health visiting's central focus is on situations which are unpredictable, ambiguous or anomalous
The study revealed an approach to health promotion which requires a highly developed ability to cope in a safe and therapeutic way with shifting, uncertain and ill-defined health needs, and to recognize and respond to complex, potentially risk-filled situations Drawing on examples which illustrate the implications of these concepts in practice, the paper suggests that, much as midwives have long claimed that a‘normal delivery is one that is over, so in health visiting a ‘routine visit’ can only be recognized as such once it has taken place Nevertheless, it will be contended that the particular approach to practice revealed in this study represents a valuable and necessary aspect of health promotion, which has the potential to ensure relevance and acceptability, and which maximizes unexpected opportunities for prevention},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.22020276.x},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pressure on British health workers to be more explicit in articulating the function, purpose and outcome of their role has increased with the introduction of general management and shift to a market-place orientation, since implementation of the NHS and Community Care Act (1990) However, a recurring theme in the history of health visiting has been the difficulty which practitioners experience in trying to explain exactly what it is that they do
This has often been portrayed as a major failing, and possibly even a reason to discontinue the service This paper will offer a potential explanation for this difficulty, and suggest that the management of uncertainty and ambiguity are central to the role It will draw on a grounded theory study which explored how health visitors choose which approach to use in any particular situation encountered in their work The analysis suggested that health visiting's central focus is on situations which are unpredictable, ambiguous or anomalous
The study revealed an approach to health promotion which requires a highly developed ability to cope in a safe and therapeutic way with shifting, uncertain and ill-defined health needs, and to recognize and respond to complex, potentially risk-filled situations Drawing on examples which illustrate the implications of these concepts in practice, the paper suggests that, much as midwives have long claimed that a‘normal delivery is one that is over, so in health visiting a ‘routine visit’ can only be recognized as such once it has taken place Nevertheless, it will be contended that the particular approach to practice revealed in this study represents a valuable and necessary aspect of health promotion, which has the potential to ensure relevance and acceptability, and which maximizes unexpected opportunities for prevention
This has often been portrayed as a major failing, and possibly even a reason to discontinue the service This paper will offer a potential explanation for this difficulty, and suggest that the management of uncertainty and ambiguity are central to the role It will draw on a grounded theory study which explored how health visitors choose which approach to use in any particular situation encountered in their work The analysis suggested that health visiting's central focus is on situations which are unpredictable, ambiguous or anomalous
The study revealed an approach to health promotion which requires a highly developed ability to cope in a safe and therapeutic way with shifting, uncertain and ill-defined health needs, and to recognize and respond to complex, potentially risk-filled situations Drawing on examples which illustrate the implications of these concepts in practice, the paper suggests that, much as midwives have long claimed that a‘normal delivery is one that is over, so in health visiting a ‘routine visit’ can only be recognized as such once it has taken place Nevertheless, it will be contended that the particular approach to practice revealed in this study represents a valuable and necessary aspect of health promotion, which has the potential to ensure relevance and acceptability, and which maximizes unexpected opportunities for prevention
Cowley, Sarah; Bergen, Ann; Young, Kathryn Rose; Kavanagh, Anne
Exploring Needs Assessment in Community Nursing Journal Article
In: 1995, ISSN: 0017-9140.
BibTeX | Tags:
@article{cowley_exploring_1995,
title = {Exploring Needs Assessment in Community Nursing},
author = {Sarah Cowley and Ann Bergen and Kathryn Rose Young and Anne Kavanagh},
issn = {0017-9140},
year = {1995},
date = {1995-01-01},
urldate = {1995-01-01},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, Sarah
Health-as-process: a health visiting perspective Journal Article
In: Journal of Advanced Nursing, vol. 22, no. 3, pp. 433–441, 1995, ISSN: 1365-2648, (_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.22030433.x).
Abstract | Links | BibTeX | Tags:
@article{cowley_health-as-process_1995,
title = {Health-as-process: a health visiting perspective},
author = {Sarah Cowley},
url = {https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1995.22030433.x},
doi = {10.1046/j.1365-2648.1995.22030433.x},
issn = {1365-2648},
year = {1995},
date = {1995-01-01},
urldate = {1995-01-01},
journal = {Journal of Advanced Nursing},
volume = {22},
number = {3},
pages = {433–441},
abstract = {Health visitors are community nurses who define their role specifically in terms of health promotion, although they have often found difficulty in explaining how their seemingly diffuse and unfocused practice achieves this The grounded theory study reported here set out to uncover some of the hidden processes and features embedded within health visiting, so the practice might be more clearly articulated This paper reports one aspect of that study, which suggests that health visitors treat health as a lifelong process, involving the accumulation and use of ‘resources for health’ The relevance of approaches which appeared both caring and educational will be set in the context of therapeutic nursing and adult education theories Historically, health visitors have links with both nursing and health education, the analysis presented here helps to clarify the relationships between these different areas of work The paper will explain how treating health as a process allows multiple competing views and ideas about health and health promotion to be integrated into a manageable form, thus allowing positive health to be promoted within a broad, acceptable socio-cultural context However, the analysis also highlighted various points at which treating health as a process contradicts the firmly measurable requirements of the market-orientated health service Nevertheless, where health visitors are sufficiently skilled, and are permitted by their employing authorities to use this approach, it may serve to protect clients from intrusive and accusing interventions, made in the name of health promotion},
note = {_eprint: https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2648.1995.22030433.x},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Health visitors are community nurses who define their role specifically in terms of health promotion, although they have often found difficulty in explaining how their seemingly diffuse and unfocused practice achieves this The grounded theory study reported here set out to uncover some of the hidden processes and features embedded within health visiting, so the practice might be more clearly articulated This paper reports one aspect of that study, which suggests that health visitors treat health as a lifelong process, involving the accumulation and use of ‘resources for health’ The relevance of approaches which appeared both caring and educational will be set in the context of therapeutic nursing and adult education theories Historically, health visitors have links with both nursing and health education, the analysis presented here helps to clarify the relationships between these different areas of work The paper will explain how treating health as a process allows multiple competing views and ideas about health and health promotion to be integrated into a manageable form, thus allowing positive health to be promoted within a broad, acceptable socio-cultural context However, the analysis also highlighted various points at which treating health as a process contradicts the firmly measurable requirements of the market-orientated health service Nevertheless, where health visitors are sufficiently skilled, and are permitted by their employing authorities to use this approach, it may serve to protect clients from intrusive and accusing interventions, made in the name of health promotion
Billings, Jennifer Ruth; Cowley, Sarah
Approaches to community needs assessment: a literature review Journal Article
In: Journal of Advanced Nursing, vol. 22, no. 4, pp. 721–730, 1995, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags:
@article{billings_approaches_1995,
title = {Approaches to community needs assessment: a literature review},
author = {Jennifer Ruth Billings and Sarah Cowley},
doi = {10.1046/j.1365-2648.1995.22040721.x},
issn = {1365-2648},
year = {1995},
date = {1995-01-01},
urldate = {1995-01-01},
journal = {Journal of Advanced Nursing},
volume = {22},
number = {4},
pages = {721–730},
abstract = {In the light of the growing awareness of professionals in the community of the need to undertake health needs assessments of the population, this literature review sets out to explore, delineate and critically analyse the various approaches to community needs assessment, to facilitate a greater understanding of their strengths and weaknesses
The review commences by highlighting its complex nature, and attempting to define what is meant by ‘needs assessment’ from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics
It continues by putting forward an argument for the use of the community health profile, being a multi-focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources
The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy
Throughout the review, issues are discussed with reference to the current political context in the United Kingdom Equally important is the community nurse perspective, which is integrated into the arguments where appropriate},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In the light of the growing awareness of professionals in the community of the need to undertake health needs assessments of the population, this literature review sets out to explore, delineate and critically analyse the various approaches to community needs assessment, to facilitate a greater understanding of their strengths and weaknesses
The review commences by highlighting its complex nature, and attempting to define what is meant by ‘needs assessment’ from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics
It continues by putting forward an argument for the use of the community health profile, being a multi-focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources
The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy
Throughout the review, issues are discussed with reference to the current political context in the United Kingdom Equally important is the community nurse perspective, which is integrated into the arguments where appropriate
The review commences by highlighting its complex nature, and attempting to define what is meant by ‘needs assessment’ from the differing perspectives of three dominant approaches, namely sociology, epidemiology and health economics
It continues by putting forward an argument for the use of the community health profile, being a multi-focal approach to needs assessment, combining quantitative with qualitative data, and proceeds with a discussion of strengths and weaknesses related to its compilation, in particular factors relating to reliability and validity of data sources
The consumer perspective is also reviewed, as are issues surrounding the ethics of data collection and problems concerning aggregation of the numerous data sources into meaningful policy
Throughout the review, issues are discussed with reference to the current political context in the United Kingdom Equally important is the community nurse perspective, which is integrated into the arguments where appropriate
1994
Cowley, S.
Collaboration in health care: the education link Journal Article
In: Health visitor, vol. 67, no. 1, pp. 13–15, 1994, ISSN: 0017-9140.
@article{cowley_collaboration_1994,
title = {Collaboration in health care: the education link},
author = {S. Cowley},
issn = {0017-9140},
year = {1994},
date = {1994-01-01},
urldate = {1994-01-01},
journal = {Health visitor},
volume = {67},
number = {1},
pages = {13–15},
abstract = {Collaboration is high on the current policy agenda. It is often suggested that 'shared learning' within multi-disciplinary teams, across sectors and different service agencies, will help to improve collaboration. But education has a wider role than one of simply teaching different groups together, writes Sarah Cowley. Improved inter-disciplinary working can be achieved by ensuring that each professional feels valued for their particular role and skills.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Collaboration is high on the current policy agenda. It is often suggested that 'shared learning' within multi-disciplinary teams, across sectors and different service agencies, will help to improve collaboration. But education has a wider role than one of simply teaching different groups together, writes Sarah Cowley. Improved inter-disciplinary working can be achieved by ensuring that each professional feels valued for their particular role and skills.
1993
Cowley, S.
Supporting dying people Journal Article
In: Nursing times, vol. 89, no. 42, pp. 52–55, 1993, ISSN: 0954-7762.
@article{cowley_supporting_1993,
title = {Supporting dying people},
author = {S. Cowley},
issn = {0954-7762},
year = {1993},
date = {1993-10-01},
urldate = {1993-10-01},
journal = {Nursing times},
volume = {89},
number = {42},
pages = {52–55},
abstract = {A descriptive interview survey was carried out to identify and assess the needs of dying people and their families and to see how far those needs were met by services available in the district. The main carers were interviewed six months after the death, and the majority said they were satisfied with care offered. However, a detailed analysis of comments made in response to the open-ended questions that were asked sheds light on the difficulties faced by many people in gaining access to services.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
A descriptive interview survey was carried out to identify and assess the needs of dying people and their families and to see how far those needs were met by services available in the district. The main carers were interviewed six months after the death, and the majority said they were satisfied with care offered. However, a detailed analysis of comments made in response to the open-ended questions that were asked sheds light on the difficulties faced by many people in gaining access to services.
Cowley, S
Skill mix: value for whom Journal Article
In: Health visitor, vol. 66, no. 5, pp. 166–8, 171, 1993, ISSN: 0017-9140.
BibTeX | Tags:
@article{cowley_skill_1993,
title = {Skill mix: value for whom},
author = {S Cowley},
issn = {0017-9140},
year = {1993},
date = {1993-05-01},
urldate = {1993-05-01},
journal = {Health visitor},
volume = {66},
number = {5},
pages = {166–8, 171},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cowley, S.
Counting practice: the impact of information systems on community nursing Journal Article
In: Journal of Nursing Management, vol. 1, no. 6, pp. 273–278, 1993, ISSN: 1365-2834.
Abstract | Links | BibTeX | Tags:
@article{cowley_counting_1993,
title = {Counting practice: the impact of information systems on community nursing},
author = {S. Cowley},
doi = {10.1111/j.1365-2834.1993.tb00226.x},
issn = {1365-2834},
year = {1993},
date = {1993-01-01},
urldate = {1993-01-01},
journal = {Journal of Nursing Management},
volume = {1},
number = {6},
pages = {273–278},
abstract = {The act of collecting data is not neutral, it exerts an influence on the activity it is intended to reflect. This paper examines three basic assumptions which underpin the collection of information for minimum data-sets from community nurses, and suggests that influence has the potential to drive practitioners towards a model of practice which is fundamentally flawed.
The paper criticizes the use of a single episode of care as the base unit of activity in a long-term, continuing service. It argues that the focus on single individuals as recipients of a service is inappropriate for family- or community-based nursing. Further, it challenges the idea that the complex, multi-faceted and compound interactions encompassed within community nursing practice can be separated into single activities to be counted or measured.
It concludes that identified deficiencies in the information systems stem from an inadequate base of theoretical knowledge, and not from personal failings on the part of managers or their staff. It warns that the inappropriate basis for collecting information may promote insensitive and ineffective community nursing practice.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The act of collecting data is not neutral, it exerts an influence on the activity it is intended to reflect. This paper examines three basic assumptions which underpin the collection of information for minimum data-sets from community nurses, and suggests that influence has the potential to drive practitioners towards a model of practice which is fundamentally flawed.
The paper criticizes the use of a single episode of care as the base unit of activity in a long-term, continuing service. It argues that the focus on single individuals as recipients of a service is inappropriate for family- or community-based nursing. Further, it challenges the idea that the complex, multi-faceted and compound interactions encompassed within community nursing practice can be separated into single activities to be counted or measured.
It concludes that identified deficiencies in the information systems stem from an inadequate base of theoretical knowledge, and not from personal failings on the part of managers or their staff. It warns that the inappropriate basis for collecting information may promote insensitive and ineffective community nursing practice.
The paper criticizes the use of a single episode of care as the base unit of activity in a long-term, continuing service. It argues that the focus on single individuals as recipients of a service is inappropriate for family- or community-based nursing. Further, it challenges the idea that the complex, multi-faceted and compound interactions encompassed within community nursing practice can be separated into single activities to be counted or measured.
It concludes that identified deficiencies in the information systems stem from an inadequate base of theoretical knowledge, and not from personal failings on the part of managers or their staff. It warns that the inappropriate basis for collecting information may promote insensitive and ineffective community nursing practice.
Mackenzie, A.; Twinn, S.; Cowley, S.
Shared practice in community nursing Journal Article
In: Senior Nurse, vol. 13, no. 4, pp. 36–38, 1993, ISSN: 0265-9999.
BibTeX | Tags: Baccalaureate, Community Health Nursing, Curriculum, Education, Humans, nursing, Public health nursing
@article{mackenzie_shared_1993,
title = {Shared practice in community nursing},
author = {A. Mackenzie and S. Twinn and S. Cowley},
issn = {0265-9999},
year = {1993},
date = {1993-01-01},
urldate = {1993-01-01},
journal = {Senior Nurse},
volume = {13},
number = {4},
pages = {36–38},
keywords = {Baccalaureate, Community Health Nursing, Curriculum, Education, Humans, nursing, Public health nursing},
pubstate = {published},
tppubtype = {article}
}
1991
Cowley, Sarah
A symbolic awareness context identified through a grounded theory study of health visiting Journal Article
In: Journal of Advanced Nursing, vol. 16, no. 6, pp. 648–656, 1991, ISSN: 1365-2648.
Abstract | Links | BibTeX | Tags:
@article{cowley_symbolic_1991,
title = {A symbolic awareness context identified through a grounded theory study of health visiting},
author = {Sarah Cowley},
doi = {10.1111/j.1365-2648.1991.tb01722.x},
issn = {1365-2648},
year = {1991},
date = {1991-01-01},
urldate = {1991-01-01},
journal = {Journal of Advanced Nursing},
volume = {16},
number = {6},
pages = {648–656},
abstract = {The purpose of the study, which is not yet complete, was one of theory building or conceptualization. This was needed because of a lack of information about how health visitors identify which approach to use within any particular situation
An overview of the method of grounded theory explains how data were collected and analysed.Then, one major aspect of the emerging theory – a symbolic awareness context which seems to surround and influence interactions between health visitors and their clients – is outlined.
The analysis suggests that, when the interaction is examined in context, any one question, purpose or topic selected by health visitor or client as a specific focus, forms only a relatively small component part of the whole. Strategies which enhance openness and consonance within the context are detailed. The awareness context has implications for health visiting practice and organization},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The purpose of the study, which is not yet complete, was one of theory building or conceptualization. This was needed because of a lack of information about how health visitors identify which approach to use within any particular situation
An overview of the method of grounded theory explains how data were collected and analysed.Then, one major aspect of the emerging theory – a symbolic awareness context which seems to surround and influence interactions between health visitors and their clients – is outlined.
The analysis suggests that, when the interaction is examined in context, any one question, purpose or topic selected by health visitor or client as a specific focus, forms only a relatively small component part of the whole. Strategies which enhance openness and consonance within the context are detailed. The awareness context has implications for health visiting practice and organization
An overview of the method of grounded theory explains how data were collected and analysed.Then, one major aspect of the emerging theory – a symbolic awareness context which seems to surround and influence interactions between health visitors and their clients – is outlined.
The analysis suggests that, when the interaction is examined in context, any one question, purpose or topic selected by health visitor or client as a specific focus, forms only a relatively small component part of the whole. Strategies which enhance openness and consonance within the context are detailed. The awareness context has implications for health visiting practice and organization
1990
Cowley, Sarah
Continuing care. Who qualifies for terminal care? Journal Article
In: Nursing times, vol. 86, pp. 29–31, 1990.
BibTeX | Tags:
@article{cowley_continuing_1990,
title = {Continuing care. Who qualifies for terminal care?},
author = {Sarah Cowley},
year = {1990},
date = {1990-05-01},
urldate = {1990-05-01},
journal = {Nursing times},
volume = {86},
pages = {29–31},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
1988
Cowley, S.
In search of a model for health visiting Journal Article
In: Health Visitor, vol. 61, no. 5, pp. 149–151, 1988, ISSN: 0017-9140.
BibTeX | Tags: Child, Community Health Nursing, Family, Female, Humans, Male, Models, Nursing Process, Theoretical
@article{cowley_search_1988,
title = {In search of a model for health visiting},
author = {S. Cowley},
issn = {0017-9140},
year = {1988},
date = {1988-05-01},
urldate = {1988-05-01},
journal = {Health Visitor},
volume = {61},
number = {5},
pages = {149–151},
keywords = {Child, Community Health Nursing, Family, Female, Humans, Male, Models, Nursing Process, Theoretical},
pubstate = {published},
tppubtype = {article}
}