To investigate the perceptions and experience of Pakistani women who have urinary incontinence problems.Data were collected from a sample group of six Pakistani women with incontinence problems. A female Miripuri Punjabi speaker conducted and recorded semi-structured interviews with the women. The interviewer interpreted these recordings onto another tape. Data were then analysed and categorised.The women had low self-esteem and also felt sinful because of their incontinence. Muslim women are obliged to perform ritual cleansing and prayer five times a day. If they pass urine or faeces, or experience incontinence, they become unclean and prayer is denied until the act of ritual cleansing is repeated. The women used prayer to relieve stress caused by incontinence, but being unclean denied them this comfort, thus increasing stress. Some participants had become secretive and isolated. The women had developed three strategies to help them live with incontinence: risk reduction to reduce the number of incidents; management, which focused on coping with incontinent episodes; and problem-sharing with other women. Their inhibitions and language limitations prevented them from disclosing their problems clearly to health professionals and fully understanding advice they received. These inhibitions were reduced when they were treated by a female health professional. Having an interpreter present also increased satisfaction with treatment.To provide an effective continence service to Pakistani women with incontinence, it is necessary for healthcare professionals to understand their cultural and religious identities.
Summary We explore the potential of mindfulness-based cognitive therapy, a skills-based intervention that provides participants with sustainable tools for adaptive responses to stress and negative mood, for the large group of young people with depression or anxiety who only partially or briefly respond to currently available first-line interventions.
Many have argued that the development of evidence-based policing (EBP) depends on those in law enforcement agencies receiving appropriate training in research methodologies and data analysis. Despite this, there are few detailed accounts of such training and its delivery. This paper describes and evaluates the contribution of training workshops for police officers and staff in driving forward EBP. The workshops, developed based on a model used in healthcare, sought to provide attendees with the knowledge, skills, and confidence to engage with research evidence during their work, and sat within a wider plan for organisational change within one force in England. We outline the development and delivery of the workshops, which were undertaken using an action research approach, and assess their impact including subsequent changes to practice. Finally, we consider the role these workshops played within organisational change, and reflect on how EBP can be promoted within academic-police collaborations.
Parent carers of children with special educational needs or disability are at risk of poorer mental and physical health. In response to these needs, we codeveloped the 'Healthy Parent Carers' (HPC) programme. This study examined the views and experiences of participants in the HPC feasibility trial to inform programme refinement.HPC is a peer-led group-based intervention (supported by online materials) for primary carers of disabled children, encouraging behaviours linked with health and well-being. It was delivered by two lead and six assistant peer facilitators in six community sites (one lead and one assistant per group) in South West England over six or 12 sessions. Control participants had online materials only. The trial involved 47 intervention and 45 control parent carers (97% female and 97% white) and eight facilitators (one male).A preplanned mixed methods process evaluation using questionnaires and checklists (during and after the intervention), qualitative interviews with participants after intervention (n=18) and a focus group with facilitators after trial.HPC was highly acceptable to participants and facilitators and experiences were very positive. Participants reported that the programme increased awareness of what parent carers could and could not change and their self-efficacy to engage in health-promoting behaviours. The intended mechanisms of action (social identification and peer support) matched participants' expectations and experiences. Control participants found the online-only programme flexible but isolating, as there were no opportunities to share ideas and problem solve with peers, the key function of the programme. Areas for improvement were identified for programme content, facilitator training and delivery.HPC was acceptable, well received and offers considerable potential to improve the health of parent carers. Under the pandemic, the challenge going forward is how best to maintain reach and fidelity to function while delivering a more virtual programme.ISRCTN151144652.
Many nurses are extending their roles in line with the Government's NHS Plan. In the outpatient hysteroscopy service in one trust nurses are now undertaking diagnostic hysteroscopy. This has improved continuity of care for patients and allowed the nurses to combine their traditional nursing role of providing information and reassurance with performing the procedure.
Context: Care homes in the UK were hit badly by the COVID-19 pandemic, with numerous outbreaks and deaths of residents and staff.Objectives: To capture the impact of the pandemic on care home staff well-being and share insights and learning about how to optimise support for the workforce.Methods: Fifteen senior care staff from care homes looking after older people in England were interviewed between December 2020 and March 2021, when the sector was still under strict restriction measures.The topic guide was developed in consultation with care home staff.Interviews were transcribed and analysed using a reflexive thematic analysis approach to identify themes and sub-themes of the impact on staff well-being. Findings:The impact of the pandemic was overwhelmingly negative, with those interviewed reporting both mental and physical health implications.We identified three themes: emotional exhaustion (upset and trauma, increased responsibility and workload, feelings of guilt); frustration (feeling misunderstood, undervalued, unrecognised, abandoned); and relationships (the importance of supportive working relationships within the care home and with external agencies).Limitations: Staff interviewed were managers or in other senior roles; it would be beneficial to synthesise this research with studies involving other care home staff and residents and their relatives.Given the disparate nature of the care home sector, a larger sample may have identified additional insights. Implications:This study provides insight into the resilience of care home staff during the pandemic and challenges to this; this could help to inform future efforts as to support of the workforce and sector.
ABSTRACT The close relationship between children's vocabulary size and their later academic success has led researchers to explore how vocabulary development might be promoted during the early school years. We describe a study that explored the effectiveness of naturalistic classroom storytelling as an instrument for teaching new vocabulary to 6- to 9-year-old children. We examined whether learning was facilitated by encountering new words in single versus multiple story contexts, or by the provision of age-appropriate definitions of words as they were encountered. Results showed that encountering words in stories on three occasions led to significant gains in word knowledge in children of all ages and abilities, and that learning was further enhanced across the board when teachers elaborated on the new words’ meanings by providing dictionary definitions. Our findings clarify how classroom storytelling activities can be a highly effective means of promoting vocabulary development.
Parents of disabled children report poorer inpatient experiences when they stay in hospital, and some staff report finding communicating with disabled children challenging. This study tested the feasibility of implementing a training package for staff on paediatric wards to improve communication with disabled children, especially those with communication difficulties, and their families. The package was developed with parent carers and clinicians, and comprises a manual, a video of parent carers talking about real experiences, discussion points and local resources. The 50-minutes training is intended for in-house delivery by local facilitators.Thirteen training sessions were delivered in paediatric wards across four hospitals in England, totalling 123 staff who took part. Participants completed questionnaires before (n = 109) and after (n = 36) training, and a sample of champions (senior clinicians) and facilitators were interviewed at the end of the study.Facilitators found the training easy to deliver, and participants felt they took away important messages to improve their practice. After the training, further changes were reported at an organizational level, including offering further training and reviewing practices.This study provides supporting evidence for the implementation of a low-cost, minimal-resource training package to support staff communication with children and their families in hospitals. It provides promising indication of impact on behavioural change at the individual and organizational level.Parent carers identified the need and helped to develop the training, including featuring in the training video. They were also consulted throughout the study on research design, delivery and reporting.
Background A proportionate universal (PU) approach to early years’ service provision has been advocated to improve children’s health and development and to reduce health inequality, by ensuring that services provide timely and high-quality parenting support commensurate with need. Process-oriented research is critical to examine the factors that contribute to, or hinder, the effective delivery/implementation of such a model in community-based family services. This study aimed to assess the delivery, acceptability and feasibility of a new PU parenting intervention model (called E-SEE Steps), using the Incredible Years® (IY) parent program, when delivered by trained health/family service staff in three “steps”—one universal step (the IY Babies Book), and two targeted steps (group-based IY Infant and Toddler programs). Methods An embedded mixed-methods process evaluation within a pragmatic parallel two-arm, assessor blinded, randomized controlled trial was conducted in community services in four local authorities in England. The process evaluation used qualitative data gathered via interviews and focus groups with intervention arm parents who were offered the targeted steps (n = 29), practitioners (n = 50), service managers (n = 7) and IY program mentors (n = 3). This was supplemented by quantitative data collected using group leader pre-training (n = 50) and post-delivery (n = 39) questionnaires, and research notes of service design decisions. Results The E-SEE Steps model was acceptable to most parents, particularly when it was accompanied by engagement strategies that supported attendance, such as providing childcare. Practitioners also highlighted the positive development opportunities provided by the IY training and supervision. However, participant views did not support the provision of the IY Babies book as a standalone universal component, and there were barriers to eligible parents—particularly those with low mood—taking up the targeted programs. Service providers struggled to align the PU model with their commissioned service contracts and with their staff capacity to engage appropriate parents, including tackling common barriers to attendance. Conclusions Despite general enthusiasm and support for delivering high-quality parenting programs in community services in the England, several barriers exist to successfully delivering IY in a proportionate universal model within current services/systems.
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