Theseshttp://hdl.handle.net/10034/6230312024-03-28T19:57:06Z2024-03-28T19:57:06ZManagers' Perspectives of an Effective Health and Social Care Worker in the Independent Sector: An Ethnographic StudyKendall-Corry, Raymond J.http://hdl.handle.net/10034/6284612024-02-01T01:44:51Z2023-08-01T00:00:00ZManagers' Perspectives of an Effective Health and Social Care Worker in the Independent Sector: An Ethnographic Study
Kendall-Corry, Raymond J.
Aim: This thesis presents an ethnographic investigation into the perceptions of managers in the independent health and social care sector regarding the characteristics of effective health and social care workers. The study investigates the managerial perspective of the values, skills, knowledge, and functional behaviours regarded essential for providing high-quality care services to adults who may be at risk. Using an ethnographic methodology, the study seeks to glean rich and nuanced insights from managers who play a central role in moulding and supervising the Health and Social Care workforce. Background: Health and social care workers require a variety of skills and knowledge for them to be perceived as effective by their managers. The skill and behavioural requirements range from the practicalities of supporting people with their daily living tasks, including clinical support, to high levels of emotional intelligence to support the sociological, psychological, and emotional wellbeing of people who access health and social care services. Health and social care frontline workers require a sophisticated level of emotional intelligence with positive, personal attributes such as patience, kindness, empathy, and compassion. Methodological approach: An interpretive, ethnographic design was adopted for the study incorporating symbolic interactionism with social constructionism as a lens with which to analyse the outcomes from the research question. Individual, semistructured ethnographic interviews were conducted with ten managers (n=10), and 18 two focus groups were held in which participants were asked to identify the characteristics that, in their opinion, constitute an effective frontline worker. The leadership focus groups included eleven managers in total (n=5 + n=6) therefore twenty-one participants in total (n=21) plus field notes thus achieving triangulation. The data was analysed using Ricoeur’s thematic analysis framework. Findings: Communities of practice are naturally inherent in well performing teams. On a service level this is brought about through the behaviours of effective frontline workers, creating cultures of effective communication and continual, shared learning to enhance the lives of their service users. One may suggest a culture of experiential learning begins through the metamorphic, liminal experience of integrating staff members into the organisational culture. Liminality is present in the experience of individual workers, teams and the ‘living organisation’. It is a catalyst, in which processes happen spontaneously, leading to consideration of 21st century healthcare and compassion in caring; essential for the transformative, person-centred healthcare required in contemporary practice. Recommendations: Recommendations included the development of a professional identity through communities of practice, an educational push towards enhancing staff self-actualisation, and the cultivation of organisational culture, all of which would lead to compassionate care with a focus on facilitating service user safety and happiness.
2023-08-01T00:00:00ZExploring engagement: A Constructivist grounded theory study of pregnant woman’s engagement with antenatal care health services in rural IndiaChaudhary, Dikshahttp://hdl.handle.net/10034/6283992024-01-31T14:47:17Z2023-11-01T00:00:00ZExploring engagement: A Constructivist grounded theory study of pregnant woman’s engagement with antenatal care health services in rural India
Chaudhary, Diksha
Background: Safe motherhood, a woman experiencing a healthy pregnancy experience, with a positive outcome and healthy living of women and newborns are an integral concern for global public health (WHO, 2016). The estimated global maternal mortality rate is 211 deaths per 100 000 live births and approximately 810 mothers died each day worldwide in 2017 from preventable maternal complications (WHO et al., 2019). Only 52% of women reported to have attended at least four ANC visits as per NFHS 4 (2015-16), along with 17% of Indian women who never contacted health facilities for visits (NFHS4a, 2017).
Methodology: The research study has adopted Kathy Charmaz’s Constructivist Grounded Theory methodology.
Methods: In-depth semi-structured interviews were conducted with eight initial purposive samples of pregnant women. The data was simultaneously analysed to gather preliminarily concepts which further guided the theoretical sampling of sixteen pregnant women and eight healthcare workers. All 32 interviews were audio-recorded with the permission and consent of the participant. The three stages of coding in Constructivist Grounded Theory methodology, Initial coding, Focused coding, and Theoretical coding were followed for data analysis.
Findings: The core category consists of interrelated sub-categories; perceived Benefits and importance of Antenatal care health services; pregnant women and Health worker interaction and structural factors as a barrier to antenatal care. Pregnant women especially for a full and partial ANC, perceived ANC as an opportunity to gain assurance about their well-being. Family presence is crucial in women's ANC decision-making. A positive relationship with healthcare providers significantly influences ANC engagement. ASHA community health workers act as a crucial bridge between the community and the health system is one of the important social processes which encourage women. Women preferred the Ultrasound over complete ANC services and recognized it as a core component to reassure both the baby and the woman. Family members especially elder female strongly influenced women’s decision-making. Health worker-pregnant women interaction is pivotal, fostering trust and encouraging ANC acceptance.
Conclusion: The study reveals varying perceptions of ANC among full, partial, and non-attenders, shaped by diverse factors influencing their engagement. A prevalent theme is the predominant view of ANC as curative rather than preventive care, reflecting a significant social process. Pregnancy is often seen as a normal, healthy event, affecting decision-making. Lack of autonomy emerged as a significant predictor for ANC utilization, highlighting the need for women-cantered care.
2023-11-01T00:00:00ZA Hermeneutic Study of a Paraprofessional Mental Health Initiative involving Medical Teams and Male Professional FootballersEllis, Caroline J.http://hdl.handle.net/10034/6279422023-07-29T02:48:09Z2023-07-01T00:00:00ZA Hermeneutic Study of a Paraprofessional Mental Health Initiative involving Medical Teams and Male Professional Footballers
Ellis, Caroline J.
The spotlight has only recently focussed on mental health in professional football. High-profile suicides alarmed the football community and players continue to take their own lives. Consequently, mental health disorders in professional football have become a topic of increasing interest in research, due to the serious consequences for quality of life, and the likelihood of the player’s predisposition to inflict serious self-harm.
Aims
Given the increased interest in and importance of mental health issues, mental health education and guidance for football medical teams is essential. The research aim was to investigate the role of the medical team in managing the mental health issues faced by male professional football players and establish whether a paraprofessional Solution Focussed Brief Therapy (SFBT) initiative could enhance that role. A total of thirty-four participants, working in Premier League and Championship level
professional football, took part in this two-phased study. Nineteen were contracted players, thirteen were members of medical teams and two were PFA representatives.
A Heideggerian hermeneutic approach was adopted and data was collected through fifteen in-depth interviews and four focus groups. In Phase 1, the problem of mental health disorders and mental healthcare in professional football was explored. In Phase 2, a pilot study investigated the feasibility of a SFBT intervention, delivered through a smartphone APP.
Results
All of the nineteen players declared mental health issues. De-selection, not injury, was the main reported issue. The majority of players and medics agreed that disclosing mental health problems could lead to de-selection from the team, for some further punishment, due to the value placed on maintaining a ‘mental toughness’. Therefore, if a sports psychologist was present at the club, the player may not seek help as it was dependent on trust in the individual. None of the players made use of the PFA counselling hotline, at any time, for mental health support.
The majority of players would speak to a member of the medical team if confidentiality was guaranteed. None of the medical team members had any mental health education, and yet engaged in unofficial paraprofessional mental healthcare. All medical team members thought paraprofessional mental health education would be of benefit. The SFBT APP intervention was unanimously well received as a paraprofessional mental healthcare aid.
Conclusions
The SFBT intervention indicated it was clearly possible to develop a paraprofessional mental healthcare supporting role for players. Mental health issues of professional footballers could be managed more effectively if the appropriate education and SFBT intervention, from inside the medical team, was in place. This could potentially save lives. Recommendations for future strategies and further research have been detailed.
2023-07-01T00:00:00ZAn exploration of the social and cultural functions of drinking alcohol within the home for professional middle-aged women: implications for public healthCowan-Williams, Gillian A.http://hdl.handle.net/10034/6278172023-12-13T01:34:37Z2022-10-01T00:00:00ZAn exploration of the social and cultural functions of drinking alcohol within the home for professional middle-aged women: implications for public health
Cowan-Williams, Gillian A.
Evidence suggests that middle-aged women in the UK are drinking more alcohol today than in previous generations, particularly those in professional roles. Similarly, the place of drinking is changing, too, with recent data suggesting that women within this age group are drinking more at home. From a public health perspective, liver disease is now the second leading cause of death in working-age people, and 5%-11% of breast cancer diagnoses in women are attributed to alcohol consumption. Research which seeks to understand why women within this demographic are drinking more at home remains limited. Alcohol research has, to date, focused primarily on younger people.
The qualitative study, situated within the interpretivist paradigm, sought to understand whether social and cultural changes have impacted middle-aged professional women’s consumption of alcohol in the home. Unstructured interviews were undertaken with ten middle-aged professional women. Interviews were recorded, transcribed, and analysed using thematic narrative analysis. Bourdieu’s theory of practice was used as a conceptual framework, and narratives further analysed through a Bourdieusian lens.
Findings indicate that alcohol is used as a means of relaxation, reward, and coping with pressure and stress, particularly for those with caring roles across ascendant and descendant generations. Increased availability, accessibility, and reduced cost have resulted in alcohol being part of the weekly supermarket shop. A positive portrayal of alcohol through both television and social media was found to increase consumption. Scepticism was displayed towards the government’s low-risk drinking guidelines. Furthermore, a lack of concern was noted regarding the potential detrimental impacts of alcohol consumption on health.
Viewed through a Bourdieusian lens, findings indicate that habitus became a structure that generated dispositions toward an expectation of drinking at home and a normalisation of that behaviour for the women. Accumulation of capital enabled the women to become “connoisseurs” within the social field of home drinking, differentiating their taste in what they viewed as socially acceptable alcohol consumption, notably wine. Within the field of home drinking, women who consumed alcohol felt at ease as they were conforming to the game's rules—conversely, those who tried to reduce their drinking experienced feelings of unease.
This research provides new insights into middle-age professional women who drink alcohol at home. Findings suggest that social and cultural changes have contributed to increased drinking at home for this population cohort. Recommendations for further research opportunities are made, and implications for public health policy and practice discussed. Highlighted is the need for future partnership approaches to tackle this increasing public health concern.
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