http://hdl.handle.net/10197/3657 2017-10-31T09:53:33Z http://hdl.handle.net/10197/9007 The symptom phenotype of oncology outpatients remains relatively stable from prior to through one week following chemotherapy Miakowski, Christine; Cooper, Bruce A.; Aouizerat, Bradley; Furlong, Eileen; Fox, Patricia A.; et al. Some oncology outpatients experience a higher number of and more severe symptoms during chemotherapy (CTX). However, little is known about whether this high risk phenotype persists over time. Latent transition analysis (LTA) was used to examine the probability that patients remained in the same symptom class when assessed prior to the administration of and following their next dose of CTX. For the patients whose class membership remained consistent, differences in demographic and clinical characteristics, and quality of life (QOL) were evaluated. The Memorial Symptom Assessment Scale (MSAS) was used to evaluate symptom burden. LTA was used to identify subgroups of patients with distinct symptom experiences based on the occurrence of the MSAS symptoms. Of the 906 patients evaluated, 83.9% were classified in the same symptom occurrence class at both assessments. Of these 760 patients, 25.0% were classified as Low-Low, 44.1% as Moderate-Moderate and 30.9% as High-High. Compared to the Low-Low class, the other two classes were younger, more likely to be women and to report child care responsibilities, and had a lower functional status and a higher comorbidity scores. The two higher classes reported lower QOL scores. The use of LTA could assist clinicians to identify higher risk patients and initiate more aggressive interventions. 2017-05-01T00:00:00Z http://hdl.handle.net/10197/8776 The Impact of Supportive Supervision on the Implementation of HRM processes; A Mixed-Methods study in Tanzania Mwendwa, Purity; McAuliffe, Eilish; Uduma, Ogenna; Masanja, Honorati; Mollel, Henry Background: Supportive supervision is a key determinant of service quality and provider performance, and is particularly pertinent to low-resources settings where supervisors are pivotal to the performance of health workers. To strengthen the human resource management (HRM) function at district and health facility level we implemented the Support, Train and Empower Managers (STEM) project to increase the capacity of managers to support and supervise their staff in Tanzania. Methods: This study used a mixed-methods design, utilising data from health facilities to assess changes in practice and employing focus group discussions to explore perceptions of supervisors 12 months following implementation of STEM in three regions of Tanzania. The present study focused on the perceptions of supervisors on the implementation of supportive HRM processes and how these influenced the supervision practice. Results: The most notable behavioural change attributed to STEM was the introduction of systemic record keeping systems, including staff files and job descriptions. The systems led to an improved work environment and improved communication between health providers and supervisors. In-turn this eased the supervision process and saved on time spent supervising staff. Introduction of registers to monitor staff movement into and out of the facility reduced unexplained absences while availability of clear job descriptions led to more efficient use of HR. Conclusion: Supportive supervision can promote implementation of HRM policies leading to an enabling environment for management to support staff, thereby improving staff morale and retention. Lessons learned from STEM can be incorporated in rolling out such an intervention in other settings and can also enhance our knowledge about developing supportive supervision interventions. 2017-02-15T00:00:00Z http://hdl.handle.net/10197/8775 What Encourages Community Health Workers (CHWs) to Use Mobile Technologies for Health Interventions? Emerging Lessons from Rural Rwanda Mwendwa, Purity This paper explores the determinants of the utilisation of mobile phone technologies for public health (mHealth) through a June 2014 fieldwork among community health workers (CHWs) in rural Rwanda. Using a socio-technical approach, user, program and technical characteristics were tested and deemed influential in determining use. It focused on 72 CHWs in two districts in Southern Rwanda who were using the mHealth tool, RapidSMS. While not purporting to be a comprehensive evaluation of Rwanda¿s RapidSMS project, it makes three contributions to our understanding of mHealth: First, a combination of user centric approach and the socio-technical systems theory affords this study the ability to identify the multiplicity of factors most likely to impact CHWs use of RapidSMS. Second, the study identifies possible factors contributing to the relative success of RapidSMS in rural Rwanda and third, it identifies gaps that ought to be addressed in future mHealth research. This study reports the findings of those factors that were deemed most interesting, novel, counterintuitive- and least well established in the literature. Technical characteristics (reminders and alerts) were by far the strongest predicting factors of use. The user characteristic, age, had no apparent influence on utilization while supports though training and supervision (program characteristics) revealed mixed findings. These findings illustrate the uniqueness of each context and reiterate the need to consider social and technical factors when implementing mHealth projects. 2017-09-11T00:00:00Z http://hdl.handle.net/10197/8760 The eSMART study protocol: a randomised controlled trial to evaluate electronic symptom management using the advanced symptom management system (ASyMS) remote technology for patients with cancer Maguire, Roma; Fox, Patricia A.; McCann, Lisa; Furlong, Eileen; Buick, Alison; et al. Introduction While some evidence exists that real-time remote symptom monitoring devices can decrease morbidity and prevent unplanned admissions in oncology patients, overall, these studies have significant methodological weaknesses. The eSMART study (electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology) is designed to specifically address these weaknesses with an appropriately powered, repeated-measures, parallel-group stratified randomised, controlled trial (RCT) of oncology patients. Methods and analysis A total of 1,108 patients scheduled to commence first-line chemotherapy (CTX) for breast, colorectal, or haematological cancer will be recruited from multiple sites across 5 European countries. Patients will be randomised (1:1) to the ASyMS intervention (intervention group) or to standard care currently available at each site (control group). Patients in the control and intervention groups will complete a demographic and clinical questionnaire, as well as a set of valid and reliable electronic patient reported outcome measures (ePROMS) at enrolment, after each of their CTX cycles (up to a maximum of 6 cycles) and at 3, 6, 9 and 12 months after completion of their sixth cycle of CTX. Outcomes that will be assessed include: symptom burden (primary outcome), quality of life (QoL), supportive care needs, anxiety, self-care self-efficacy, work limitations, and cost effectiveness and, from a health professional perspective, changes in clinical practice (secondary outcomes). Ethics and dissemination eSMART received approval from the relevant ethics committees at all of the clinical sites across the 5 participating countries. In collaboration with the European Cancer Patient Coalition (ECPC), the trial results will be disseminated through publications in scientific journals, presentations at international conferences, and postings on the eSMART website and other relevant clinician and consumer websites. 2017-05-01T00:00:00Z http://hdl.handle.net/10197/8707 Consumer evaluations of processed meat products reformulated to be healthier - A conjoint analysis study Shan, Liran Christine; De Brún, Aoife; Henchion, Maeve; Li, Chenguang; Murrin, Celine; Wall, Patrick G.; Monahan, Frank J. Recent innovations in processed meats focus on healthier reformulations through reducing negative constituents and/or adding health beneficial ingredients. This study explored the influence of base meat product (ham, sausages, beef burger), salt and/or fat content (reduced or not), healthy ingredients (omega 3, vitamin E, none), and price (average or higher than average) on consumers' purchase intention and quality judgement of processed meats. A survey (n = 481) using conjoint methodology and cluster analysis was conducted. Price and base meat product were most important for consumers' purchase intention, followed by healthy ingredient and salt and/or fat content. In reformulation, consumers had a preference for ham and sausages over beef burgers, and for reduced salt and/or fat over non reduction. In relation to healthy ingredients, omega 3 was preferred over none, and vitamin E was least preferred. Healthier reformulations improved the perceived healthiness of processed meats. Cluster analyses identified three consumer segments with different product preferences. 2017-09-01T00:00:00Z http://hdl.handle.net/10197/8469 The eSMART Project: real time symptom management in the oncology setting Fox, Patricia A.; Furlong, Eileen; Buick, Alison; Darley, Andrew; et al. In 2013 European Union funding was awarded for the eSMART (Electronic Symptom Management Using the ASyMS Remote Technology) study, to evaluate the use of mobile phone technology for management of chemotherapy symptoms in a two-part, pragmatic, RCT across fourteen European clinical sites, including four in the Republic of Ireland (ROI). 2016-01-01T00:00:00Z http://hdl.handle.net/10197/8347 The assessment and management of chemotherapy-related toxicities in patients with breast cancer, colorectal cancer, and Hodgkin and non-Hodgkin lymphomas: A scoping review Fox, Patricia A.; Darley, Andrew; Furlong, Eileen; et al. Purpose: The purpose of the eSMART (Electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology) study is to evaluate the use of mobile phone technology to manage chemotherapy-related toxicities (CRTs) in people with breast cancer (BC), colorectal cancer (CRC), Hodgkin's lymphoma (HL), and non-Hodgkin lymphoma (NHL)) across multiple European sites. One key objective was to review the published and grey literature on assessment and management of CRTs among patients receiving primary chemotherapy for BC, CRC, HL, and NHL to ensure that ASyMS remained evidence-based and reflected current and local practice. Methods: Three electronic databases were searched for English papers, with abstracts available from 01/01/2004-05/04/2014. For the grey literature, relevant clinical practice guidelines (CPGs)/evidence-based resources (EBRs) from the main international cancer organisations were reviewed as were symptom management (SM) protocols from the sites. Results: After full-text screening, 27 publications were included. The majority (n = 14) addressed fatigue and focused on BC patients. Relevant CPGs/EBRs were found for fatigue (n = 4), nausea/vomiting (n = 5), mucositis (n = 4), peripheral neuropathy (n = 3), diarrhoea (n = 2), constipation (n = 2), febrile neutropenia/infection (n = 7), palmar plantar erythrodysesthesia (PPE) (n = 1), and pain (n = 4). SM protocols were provided by >40% of the clinical sites. Conclusions: A need exists for empirical research on SM for PPE, diarrhoea, and constipation. Research is needed on the efficacy of self-care strategies in patients with BC, CRC, HL, and NHL. In general, consistency exists across CPGs/EBRs and local guidelines on the assessment and management of common CRTs. 2017-02-01T00:00:00Z http://hdl.handle.net/10197/8195 Evaluations of post-disaster recovery: A review of practice material Ryan, Roberta; Wortley, Liana; Ní Shé, Éidín This paper reviews evaluations of post-disaster recovery efforts. The focus is on operational material and other ‘grey literature’ from disasters that have occurred in Australia, New Zealand and internationally. We develop a typology that categorises disaster events and includes whether evaluations were undertaken; the methods used; and whether the evaluations focused on the processes or outcomes of the recovery program. The review finds a lack of evaluation of post-disaster recovery. Where evaluations have been conducted, they are mostly process- rather than outcomes-based. There is a need for guidance for post-disaster recovery programs to support evaluation practice to determine the effectiveness, efficiency and appropriateness of post-disaster recovery interventions. There is significant investment in post-disaster recovery programs, with little known of their effectiveness. This review identifies useful case studies and methods to evaluate post-disaster recovery efforts, and informs the development of a national post-disaster evaluation framework. 2016-12-01T00:00:00Z http://hdl.handle.net/10197/8166 Factors that influence clinicians' decisions to offer intravenous alteplase in acute ischaemic stroke patients with uncertain treatment indication: results of a discrete choice experiment De Brún, Aoife; Flynn, Darren; Ternent, Laura; et al. Background: Treatment with intravenous (IV) alteplase for eligible patients with acute ischemic stroke is underused and treatment rates vary across the UK. This study sought to elucidate factors influencing variation in clinicians' decision-making about this thrombolytic treatment. Methods: A discrete choice experiment (DCE) using hypothetical patient vignettes framed around areas of clinical uncertainty was conducted with UK-based clinicians. Mixed logit regression analyses were conducted on the data. Results: 138 clinicians completed the DCE. Seven patient factors were individually predictive of increased likelihood of immediately offering IV alteplase (compared to reference levels in brackets): stroke onset time 2 hours 30 minutes [50 minutes]; pre-stroke dependency mRS 3 [mRS 4]; systolic blood pressure 185mm/Hg [140mm/Hg]; stroke severity scores of NIHSS 5 without aphasia, NIHSS 14 and NIHSS 23 [NIHSS 2 without aphasia]; age 85 [68]; Afro-Caribbean [white]. Factors predictive of withholding treatment with IV alteplase were: age 95 [68]; stroke onset time of 4 hours 15 minutes [50 minutes]; severe dementia [no memory problems]; SBP 200mm/Hg [140 mm/Hg]. Three clinician-related factors were predictive of an increased likelihood of offering IV alteplase (perceived robustness of the evidence for IV alteplase; thrombolysing more patients in the past 12 months; and high discomfort with uncertainty) and one with a decreased likelihood (high clinician comfort with treating patients outside the licencing criteria). Conclusions: Both patient and clinician-related factors have a major influence on the use of alteplase to treat patients with acute ischaemic stroke. Clinicians' views of the evidence, comfort with uncertainty and treating patients outside the licence criteria are important factors to address in programmes that seek to reduce variation in care quality about treatment with IV alteplase. Further research is needed to further understand differences in clinical decision-making about treating patients with acute ischaemic stroke with IV alteplase. 2016-01-01T00:00:00Z http://hdl.handle.net/10197/8109 PReSaFe: a model of barriers and facilitators to patients providing feedback on experiences of safety De Brún, Aoife; Heavey, Emily; Waring, Justin; Dawson, Pamela; Scott, Jason Objective: The importance of involving patients in reporting on safety is increasingly recognised. Whilst studies have identified barriers to clinician incident reporting, few have explored barriers and facilitators to patient reporting of safety experiences. This paper explores patient perspectives on providing feedback on safety experiences. Design/Participants: Patients (n=28) were invited to take part in semi-structured interviews when given a survey about their experiences of safety following hospital discharge. Transcripts were thematically analysed using NVivo10. Setting: Patients were recruited from four hospitals in the UK. Results: Three themes were identified as barriers and facilitators to patient involvement in providing feedback on their safety experiences. The first, cognitive-cultural, found that whilst safety was a priority for most, some felt the term was not relevant to them because safety was the ‘default’ position, and/or because safety could not be disentangled from the overall experience of care. The structural-procedural theme indicated that reporting was facilitated when patients saw the process as straightforward, but that disinclination or perceived inability to provide feedback was a barrier. Finally, learning and change illustrated that perception of the impact of feedback could facilitate or inhibit reporting. Conclusions: When collecting patient feedback on experiences of safety, it is important to consider what may help or hinder this process, beyond the process alone. We present a staged model of prerequisite barriers and facilitators, and hypothesise that each stage needs to be achieved for patients to provide feedback on safety experiences. Implications for collecting meaningful data on patients' safety experiences are considered.                   2016-01-01T00:00:00Z http://hdl.handle.net/10197/8108 Weight stigma and narrative resistance evident in online discussions of obesity De Brún, Aoife; McCarthy, Mary; McKenzie, Kenneth; McGloin, Aileen This study sampled 2872 obesity-relevant comments from three years of interest from a multi-topic online message board. An inductive thematic analysis was conducted and three themes were evident: reactions and responses to obesity and obese bodies, diminished status of overweight/obese persons, and narrative resistance to an overweight/obese identity. Obesity stigma was pervasive and the discussion of the issue revealed it to be highly acceptable. Consistent with previous research, dominant representations of obese persons as lazy and unintelligent with poor self-control were evident. The analysis provided valuable insight into experiences of explicit stigma, the social and psychological repercussions of overt stigma and norms regarding the perception of obese bodies. There was a prevailing notion that the opinions and insights of overweight and obese persons on the issue of weight were not credible and were perceived as biased. Furthermore, individuals sought to distance themselves from the undesirable labels of 'overweight' and 'obese' by enacting narrative resistance to negotiate the social meaning of excess weight and endeavouring to place themselves on the ‘safe’ side of this boundary. These results highlight the pervasive nature of weight stigma and the social acceptability of such attitudes and beliefs. Furthermore, it highlights the richness of data that may be obtained by examining social media interactions as a window into the naturally-occurring discourse on obesity and stigma. 2014-01-01T00:00:00Z http://hdl.handle.net/10197/8107 Exploring coverage of the 2008 Irish dioxin crisis in Irish and UK newsprint media De Brún, Aoife; Shan, Liran Christine; Regan, Áine; McConnon, Áine; Wall, Patrick G. The 2008 dioxin crisis occurred as a result of contamination of Irish pork. The event had significant implications for Ireland’s economy and the reputation of its agricultural industry, as well as raising concerns for human health. This study describes the results of a content analysis of Irish and UK newspaper coverage of the 2008 Irish dioxin crisis, as this is likely to provide insight into how public perceptions of this issue were shaped. Articles from 16 print publications were systematically sampled for the period December 2008 to February 2009. The resulting data set of 141 articles was examined using a coding protocol developed based on previous research and refined during piloting. Results indicated that the dioxin crisis was primarily portrayed by the media as an industry/economic crisis, dominant in 26.9% of articles in the sample. Within this dominant portrayal, the agricultural industry was frequently cited as being in crisis (42.6%); however, the implications of the crisis on the wider economic environment also received attention (17.7%). Differences between Irish and UK-based media were also examined, revealing that while the Irish media most frequently described the crisis in terms of its impact on the industry and economy, the UK media were more likely to portray the crisis as a risk to health. These dominant media messages and message framings have implications for the public understanding of the issue in each country and potential consequences regarding perception of the adequacy of existing food policy and regulatory oversight. 2016-03-07T00:00:00Z http://hdl.handle.net/10197/8106 'Fat is your fault': Gatekeepers to health, attributions of responsibility and the portrayal of gender in the Irish media representation of obesity De Brún, Aoife; McCarthy, Mary; McKenzie, Kenneth; McGloin, Aileen We investigated the representation of obesity in the Irish media by conducting an inductive thematic analysis on newspaper articles (n=346) published in 2005, 2007 and 2009 sampled from six major publications. The study analysed the media's construction of gender in discussions of obesity and associated attributions of blame. Three dominant themes are discussed: the caricatured portrayal of gender, women as caregivers for others, and emotive parent-blaming for childhood obesity. Men were portrayed as a homogenous group; unaware and unconcerned about weight and health issues. Dieting and engaging in preventative health behaviours were portrayed as activities exclusively within the female domain and women were depicted as responsible for encouraging men to be healthy. Parents, specifically mothers, attracted much blame for childhood obesity and media messages aimed to shame and disgrace parents of obese children through use of emotive and evocative language. This portrayal was broadly consistent across media types and served to reinforce traditional gender roles by positioning women as primarily responsible for health. This analysis offers the first qualitative investigation into the Irish media discourse on obesity and indicates a rather traditional take on gender roles in diet and nutrition. 2013-03-01T00:00:00Z http://hdl.handle.net/10197/8105 The emergence and portrayal of obesity in The Irish Times: Content analysis of obesity coverage, 1997-2009 De Brún, Aoife; McKenzie, Kenneth; McCarthy, Mary; McGloin, Aileen Both global obesity prevalence rates and media attention to obesity have increased significantly in recent years. The current study examined the representation of obesity in The Irish Times, from 1997 to 2009. A quantitative content analysis was conducted on 479 articles to examine how the causes, consequences, and solutions to obesity have been portrayed and how obesity has been described. A frame analysis was also conducted to examine the dominant frames over time. It was found that attention to obesity was positively correlated with time, indicating coverage has increased significantly over the period examined. Regarding reported causes and solutions, the behavioral frame has been dominant, though environmental and mixed-frame stories have become more frequent. The presence of the genetic frame was consistently low. The study provides an overview of how the issue is being represented in Ireland's paper of record and informs health communicators of the dominant and trending messages and the implications for individuals' formation of illness representations. 2012-01-01T00:00:00Z http://hdl.handle.net/10197/8104 Examining the Media Portrayal of Obesity Through the Lens of the Common Sense Model of Illness Representations De Brún, Aoife; McCarthy, Mary; McKenzie, Kenneth; McGloin, Aileen This study examined the Irish media discourse on obesity by employing the Common Sense Model of Illness Representations. A media sample of 368 transcripts was compiled from newspaper articles (n = 346), radio discussions (n = 5), and online news articles (n = 17) on overweight and obesity from the years 2005, 2007, and 2009. Using the Common Sense Model and framing theory to guide the investigation, a thematic analysis was conducted on the media sample. Analysis revealed that the behavioral dimensions of diet and activity levels were the most commonly cited causes of and interventions in obesity. The advertising industry was blamed for obesity, and there were calls for increased government action to tackle the issue. Physical illness and psychological consequences of obesity were prevalent in the sample, and analysis revealed that the economy, regardless of its state, was blamed for obesity. These results are discussed in terms of expectations of audience understandings of the issue and the implications of these dominant portrayals and framings on public support for interventions. The article also outlines the value of a qualitative analytical framework that combines the Common Sense Model and framing theory in the investigation of illness narratives. 2014-11-08T00:00:00Z http://hdl.handle.net/10197/8099 Developing a Measure of Intellectual Capital fit: an Approach to Improve Business Processes Arru, Matteo Accounting standards acknowledge the importance of Intangible Assets in evaluating a Company Value. In this period of turbulent markets, the capacity of a company to resist is strictly connected to its ability to leverage and develop its Intellectual Capital. This article makes a point in the literature about Intangible assets as a strategic asset for companies' development. We will show how the adoption of proper Knowledge Management practices can help the exploitation of the intangible asset as a key competitive factor. Intellectual capital is an asset difficult to measure. However, the intellectual capital is relevant when producing value for an organization. The approach that we have developed at Corvinus University, and we are testing in different business contexts is promising to provide an indication of the real fit of competencies between individuals and the required knowledge necessary to run an organization. 8th European Conference on Intellectual Capital – ECIC 2016, Ca' Foscari University of Venice, Italy, 12-13 April 2016 2016-04-13T00:00:00Z http://hdl.handle.net/10197/8081 Application of Process Ontology to improve the funding allocation process at the European Institute of Innovation and Technology Arru, Matteo This studio explains the application through the application of the ProKEx architecture is used to improve the process of allocation of funding at the European Institute of Innovation and Technology (EIT). The mission of the EIT is to grow and capitalize on the innovation capacity and capability of actors from higher education, research, business and entrepreneurship from the EU and beyond through the creation of highly integrated Knowledge and Innovation Communities (KICs). This case offers the scenario of a complex application where a fragmented process with several actors is dealing with the different domains of knowledge of each KIC. Starting from the Business Process Model, applying text-mining techniques we extract the ontology elements from the activity description and converted into an Ontology of the process domain. By the critical analysis of the information contained in the model, we gain the relevant information to improve the current approach. Third International Conference, EGOVIS 2014, Munich, Germany, 1-3 September 2014 2014-09-03T00:00:00Z http://hdl.handle.net/10197/7795 Book Review: Dynamic Positions in Birth: A fresh look at how women's bodies work in labour by Margaret Jovitt Curtin, Mary Overall, this is a great book which is easy to read and supports midwives with the evidence behind their decision making . The author’s passion for birth and position ing in labour and birth is clear and feels almost motivational at times. An excellent book for a midwife who wants to maintain professional reading or a midwife who wishes to gently remind themselves of the anatomy and physiology of the pelvis in order to support women to birth in the position that they want to. 2015-10-01T00:00:00Z http://hdl.handle.net/10197/7794 Book Review: The evolution of the human placenta by Michael L. Power and Jay Schulkin, Johns Hopkins University Press Curtin, Mary The book discusses embryology at a high level and any practitioner reading this book would need to be up to date with their biological knowledge of the embryo in the very early stages of pregnancy. The combination of scientific language, the minimal use of pictures, a lack of glossary (including abbreviations) and the length of each chapter means that it can be difficult to follow. Added to this, the large amount of discussion that is dedicated to all placental animals and not just humans means that this book struggles to hold the interest of the reader for long periods. 2014-12-02T00:00:00Z http://hdl.handle.net/10197/7764 Doing relationships and sexuality education with young people in state care Hyde, Abbey; Fullerton, Deirdre; McKeown, Caroline; et al. Background: Existing literature indicates that young people in state care have particular sexual health needs that include addressing their social and emotional well-being, yet little has been published as to how these components of sex education are actually delivered by service-providers. Objective: The aim of this study was to analyse the processes involved in delivering relationship and sexuality education to young people in state care from the perspectives of a sample of service-providers with a role in sexual health-care delivery. Design: Qualitative methodological strategy. Setting: Service-delivery sites at urban and rural locations in Ireland. Method: A total of 22 service-providers were interviewed in depth, and data were analysed using a qualitative analytical strategy resembling modified analytical induction. Findings: Participants proffered their perceptions and examples of their practices of sex education in relation to the following themes: (1) acknowledging the multi-dimensional nature of sexual health in the case of young people in care; (2) personal and emotional development education to address poor self-esteem, emotional disconnectedness and an inability to recognise and express emotions; (3) social skills’ education as part of a repertoire of competencies needed to negotiate relationships and safer sex; (4) the application of positive social skills embedded in everyday social situations; and (5) factual sexuality education. Conclusion: Insights into service-providers’ perceptions of the multi-dimensional nature of the sexual health needs of young people in state care, and the ways in which these service-providers justified their practice make visible the complex character of sex education and the degree of skill required to deliver it to those in state care. 2017-03-01T00:00:00Z http://hdl.handle.net/10197/7651 Nurses', Physicians' and Radiographers' Perceptions of the Safety of a Nurse Prescribing of Ionising Radiation Initiative: A Cross-Sectional Survey Hyde, Abbey; Coughlan, Barbara; Naughton, Corina; Grehan, Jennifer; Kavanagh, Eoin; et al. Background: A new initiative was introduced in Ireland following legislative changes that allowed nurses with special training to prescribe ionising radiation (X-ray) for the first time. A small number of studies on nurse prescribing of ionising radiation in other contexts have found it to be broadly as safe as ionising radiation prescribing by physicians. Sociological literature on perceptions of safety indicate that these tend to be shaped by the ideological position of the professional rather than based on objective evidence. Objectives: To describe, compare and analyse perceptions of the safety of a nurse prescribing of ionising radiation initiative across three occupational groups: nursing, radiography and medicine. Design: A cross-sectional survey design. Settings: Participants were drawn from a range of clinical settings in Ireland. Sample: Respondents were 167 health professionals comprised of 49 nurses, 91 radiographers, and 27 physicians out of a total of 300 who were invited to participate. Non-probability sampling was employed and the survey was targeted specifically at health professionals with a specific interest in, or involvement with, the development of the nurse prescribing of ionising radiation initiative in Ireland. Methods: Comparisons of perspectives on the safety of nurse prescribing of ionising radiation across the three occupational groups captured by questionnaire were analysed using the Kruskal Wallis H test. Pairwise post hoc tests were conducted using the Mann Whitney U test. Results: While the majority of respondents from all three groups perceived nurse prescribing of ionising radiation to be safe, the extent to which this view was held varied. A higher proportion of nurses was found to display confidence in the safety of nurse prescribing of ionising radiation compared to physicians and radiographers with differences between nurses’ perceptions and those of the other two groups being statistically significant. Conclusion: That an occupational patterning emerged suggests that perceptions about safety and risk of nurse prescribing of ionising radiation are socially constructed according to the vantage point of the professional and may not reflect objective measures of safety. These findings need to be considered more broadly in the context of ideological barriers to expanding the role of nurses. 2016-06-01T00:00:00Z http://hdl.handle.net/10197/7646 The role of knowledge in the contraceptive behaviour of sexually active young people in state care Hyde, Abbey; Fullerton, Deirdre; Lohan, Maria; et al. Aim: To analyse the role of sex-focused knowledge in the contraceptive behaviour of sexually active young people in state care. Methods: The sample consisted of 19 care leavers (young people previously in state care) aged 18–22 years, 16 females and 3 males. In-depth interviewing was the method of data collection, and a qualitative strategy resembling modified analytical induction was used to analyse data. Findings: Findings indicated that a lack of information was not the sole or even the primary reason for engaging in unsafe sexual practices. Other factors such as ambivalence to becoming pregnant also featured in participants' accounts. Several participants conveyed a relatively weak sense of agency about consistently using contraception. A small number of participants expressed a strong determination to avoid pregnancy, and these appeared to have a level of anxiety about becoming pregnant that motivated them to engage with knowledge about contraception and its use. Conclusion: Lack of sex-focused information is just one aspect of a myriad of complex factors, including socioeconomic disadvantage and/or emotional deprivation, that influence contraceptive behaviour. 2016-06-01T00:00:00Z http://hdl.handle.net/10197/7608 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC): Composite Report of Findings. Report No. 6 Hyde, Abbey; Fullerton, Deirdre; Lohan, Maria; McKeown, Caroline; Dunne, Laura; Macdonald, Geraldine The aim of this report is to bring together the findings from the five standalone reports comprising the SENYPIC programme of research in one succinct report. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7607 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC). A Descriptive Mapping of Services Promoting Sexual Health among Young People in Care. Report No. 2 Fullerton, Deirdre; Hyde, Abbey; McKeown, Caroline; Dunne, Laura; Lohan, Maria; Macdonald, Geraldine This second report from the programme of research 'Report No. 2: A Descriptive Mapping of Services Promoting Sexual Health among Young People in Care' presents information on current services and initiatives relating to relationships and sexual health information and services that are currently available to young people in residential care and foster care. The information on the services presented was based on reports from the e-survey report (Report no. 1) and follow up interviews with service providers and social workers. While a range of services is presented in this report, and every effort was made for the e-survey to be inclusive, it is possible that some services were not captured. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7606 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC): The Perspectives of Key Service-Providers: A Qualitative Analysis. Report No. 3 Hyde, Abbey; Fullerton, Deirdre; McKeown, Caroline; Dunne, Laura; Lohan, Maria; Macdonald, Geraldine This report presents findings gathered by way of in-depth interviews with 22 service-providers engaged in direct or indirect provision of Relationships and Sexuality Education (RSE) or sexual healthcare to young people in care. The findings build on Reports No. 1 and No. 2. The report sets out that while many service-providers support the provision of comprehensive RSE to young people in care, many report issues relating to the legal and policy situation that cross-cuts their work, creating uncertainty about how to approach both RSE and the delivery of sexual healthcare. Organisational legacy issues and a lack of workable and pragmatic guidelines were perceived to be key barriers. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7605 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC). The Perspectives of Foster Carers and Birth Parents: A Qualitative Analysis. Report No. 4 Hyde, Abbey; Fullerton, Deirdre; Dunne, Laura; Lohan, Maria; Macdonald, Geraldine The report finds that fostering was largely a positive experience for foster carers, although experiences varied according to the young people involved. Foster carers were very aware that many YPIC had additional needs relating to emotional and social skills, and to address these needs they reported using family norms and household boundaries as a method of imparting social skills. The majority of foster carers engaged in a variety of approaches to RSE, and some reported use of covert references to sexual behaviour and use of humour when telling young people about the importance of safer-sex. What is particularly interesting about this report is that the indirect approaches to RSE delivered by foster carers mirrored those reported by parents of teenagers (not in care) who were interviewed for the 2009 research project 'Parents’ Approaches to Educating their Pre-adolescent and Adolescent Children about Sexuality'. What is clear from both reports is that parents and foster carers have additional supports and resource needs to support them in delivering RSE effectively to young people at-home, as current strategies were often indirect and not always effective. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7604 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC). The Perspectives of Care Leavers: A Qualitative Analysis. Report No. 5 Hyde, Abbey; Fullerton, Deirdre; Dunne, Laura; Lohan, Maria; Macdonald, Geraldine This report clearly identifies the particular vulnerabilities associated with young people in care (YPIC). Although YPIC are not a homogenous group and arrive in State care for a multiplicity of reasons, engaging in risky behaviours, including drugs, alcohol and early sexual behaviour when in care, was commonly reported by the participants. Almost all of the participants reported having had first sex before the age of 17. What is particularly concerning is that virtually none of the descriptions of early sexual experiences involved sexual competence on their part – that is, use of contraception; autonomy in decision-making; being equally willing as partner at the time of sex; and absence of regret following sex. With regard to relationships and sexuality education (RSE), care-leavers reported that different people played different roles in their lives and the level and quality of RSE delivery varied considerably. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7603 Sexual Health and Sexuality Education Needs Assessment of Young People in Care in Ireland (SENYPIC): A Survey of Service-provider Perspectives. Report No. 1 Fullerton, Deirdre; Hyde, Abbey; McKeown, Caroline; Lohan, Maria; Dunne, Laura; Macdonald, Geraldine This first report from the programme of research, ‘Report No. 1: A Survey of Service-provider Perspectives’ presents findings gathered by way of electronic survey (e-survey), which was circulated to those working with young people in care. The purpose of this approach was to gather information with as broad a range of service providers as possible to get a clear picture of needs from their particular perspective. The findings point to the broader psychosocial issues linked to the lives of many young people in care and how these are inextricably linked to sexual health and sex education needs. The results also identify a number of barriers faced by service providers in providing sexual health education and information and those working with young people in care. 2016-03-01T00:00:00Z http://hdl.handle.net/10197/7602 The perceived impact of interprofessional information sharing on young people about their sexual health care Hyde, Abbey; Fullerton, Deirdre; Lohan, Maria; Dunne, Laura; Macdonald, Geraldine; McKeown, Caroline; Healy, Maria; Howlin, Frances This paper presents the results from an analysis of data from service-providers and young adults who were formerly in state care about how information about the sexual health of young people in state care (YPISC) is managed. In particular, the analysis focuses on the perceived impact of information sharing between professionals on young people. Twenty two service-providers from a range of professions including social work, nursing and psychology, and 19 young people aged 18-22 years who were formerly in state care participated in the study. A qualitative approach was employed in which participants were interviewed in depth and data were analysed using modified analytical induction (Bogdan & Biklen 2007). Findings suggest that within the care system in which service provider participants worked, it was standard practice that sensitive information about a young person’s sexual health would be shared across team members, even where there appeared to be no child protection issues. However, the accounts of the young people indicated that they experienced the sharing of information in this way as an invasion of their privacy. An unintended outcome of a high level of information-sharing within teams is that the privacy of the young person in care is compromised in a way that is not likely to arise in the case of young people who are not in care. This may deter young people from availing themselves of the sexual health services. 2016-04-01T00:00:00Z http://hdl.handle.net/10197/7338 Teaching and learning in the biosciences: the development of an educational programme to assist student nurses in their assessment and management of patients with wounds Redmond, Catherine; Davies, Carmel; Cornally, Deirdre; Fegan, Marianne; O'Toole, Margaret Aims and objectives: The aim of this project was to develop an educational package for undergraduate student nurses that would provide them with the theoretical knowledge and clinical judgement skills to care for a patient with a wound. Background: Internationally there is concern over the adequacy of preparation of undergraduate nurses for the clinical skill of wound care. Deficits have also been identified in the underpinning biological sciences needed for this skill. Expectations associated with wound management have altered significantly in the last two decades with decision making around wound care coming under the scope of practice of nurses. The treatment and care options for patients with wounds must be based on a sound knowledge of how wounds are formed and healed. If nurses do not have the evidence-based knowledge, it can affect wound healing adversely leading to increased patient suffering, pain and delayed healing. From an organisational perspective, delayed healing will increase the cost of care. Design: This project used constructivism learning theory to provide a framework for the development of a wound care educational package for undergraduate Irish nurses in their penultimate year of training. Methods: Collaboration was formed with key stake holders. Pertinent curriculum content was mapped. Learning strategies to suit the incoming student learning styles were incorporated into newly developed theoretical content and practical skill sessions. Conclusion: The developed educational programme will assist student nurses in their care of patients with wounds. Relevance to clinical practice: This study provides a model that can be followed to develop small units of the study to keep abreast of changes in health care delivery and the changing scope of practice of nurses. It also contributes to the debate on the teaching and learning of biosciences as it highlights the depth of biological knowledge required as a basis for good evidence-based nursing care. 2015-08-01T00:00:00Z http://hdl.handle.net/10197/7204 The Academic Profession in Ireland Clarke, Marie; Drennan, Jonathan; Harmon, David; Hyde, Abbey; Politis, Yurgos This study examined the nature and extent of the changes experienced by the academic profession in Ireland in recent years. The report outlines current characteristics of the academic profession — those who teach and/or research — providing a profile of academics in Ireland. Three themes are investigated: the professional contexts of Irish academics, their teaching and research situations, and their experiences of governance and management within their institutions. 2015-05-01T00:00:00Z http://hdl.handle.net/10197/6052 Parents' constructions of communication with their children about safer sex Hyde, Abbey; Drennan, Jonathan; Butler, Michelle; Howlett, Etaoine; et al. Aims and objectives: To analyse how a sample of parents reportedly communicated with their adolescent and preadolescent children about safer sex (contraceptive and condom use). Background: Among the plethora of existing research available on parent–child communication about sexuality (more broadly), very few studies detail the substance and tenor of what parents actually convey specifically about safer sex.Design: The study adopted a qualitative methodology and involved interviewing 43 parents (32 mothers and 11 fathers). Data were analysed using modified analytical induction. Results: Findings indicated that although the majority of parents professed to being open about sexuality with their children, only a minority reportedly conveyed direct messages about contraception and condom use. Moreover, these direct messages appeared to be imparted at a superficial level. Parents were more likely to communicate such messages in a tacit manner through innuendo and intimation. The complacency that parents displayed about the need to undertake safer sex education with their adolescents arose from an understanding that this was covered adequately at school and the belief that their teenager was not in a romantic relationship. In addition, some parents expressed concern that discussing safer sex with teenagers might actually encourage sexual activity. Conclusion: We conclude that some parents may consider themselves to have engaged in sexuality education around safer sex when it appears to be predominantly surface-level education; that what constitutes ‘doing’ sexuality education is far from clear-cut may cast some light on why there is little consistency in the literature on the impact of parental communication on sexual health outcomes for young people. Relevance to clinical practice: For nurses engaged in sexuality health promotion with parents, we caution about presenting unequivocal messages to parents about the impact of parental communication about sexuality on adolescent sexual behaviour without due acknowledgement of the grey areas indicated in the literature. 2013-12-01T00:00:00Z http://hdl.handle.net/10197/6050 The development of a shared e-learning resource across three distinct programmes based at universities in England, Ireland and Scotland Hyde, Abbey; McGarry, Julie; Thompson, Sue; et al. Recent discourses embedded in higher education policies advocate institutional collaboration and globalisation, while inter-professional learning and student-centred learning have each found favour as good practice in educational delivery. In this article, we detail the process of developing a novel innovation that operationalized components of these key discourses and learning strategies. The innovation itself, a case study based set of vignettes, was created and rolled out across higher education institutions in England, Ireland and Scotland. The purpose of the innovation was to enable students from health sciences programmes at the three institutions in question to share resources in developing culturally sensitive care, and to communicate remotely with one another through a shared discussion board. The aspiration was to position students to develop their thinking from a wider repertoire of discourses than those immediately culturally and professionally available to them. We conclude that collaborations of this kind, though not without their drawbacks, can serve to mitigate tribalism, facilitate openness and increase transparency in higher education teaching. 2013-11-20T00:00:00Z http://hdl.handle.net/10197/4212 Gender differences in the responses of parents to their daughter's non-marital pregnancy Hyde, Abbey 1997-02-01T00:00:00Z http://hdl.handle.net/10197/4211 The medicalisation of childbearing norms: encounters between unmarried pregnant women and medical personnel in an Irish context Hyde, Abbey 1997-05-01T00:00:00Z http://hdl.handle.net/10197/4210 Marriage and motherhood: the contradictory position of single mothers Hyde, Abbey 1997-05-01T00:00:00Z http://hdl.handle.net/10197/4205 Single pregnant women's encounters in public: changing norms or performing roles? Hyde, Abbey This paper presents data on single pregnant women's encounters in public in an Irish context. Data were collected using in-depth interviews, which were analysed using a grounded theory strategy. The study was conducted in Dublin City and 51 unmarried women whose ages ranged from 16-36 participated. Findings suggested that while dominant public discourses on non-marital childbearing within the culture were negative (albeit challenged) at the time data were being collected, responses from others whom participants interacted with in verbal face-toface encounters in public were generally (though certainly not exclusively) experienced as positive in tone. An attempt is made to explain the discrepancy between the mainly negative macro messages and mainly positive micro messages by drawing on Erving Goffman's theory of dramaturgy; it would seem that at the micro-level of interaction, a 'performance' was being acted out that may be at variance with definitions of non-marital pregnancy expressed by those beyond the encounter. 2000-01-01T00:00:00Z http://hdl.handle.net/10197/4203 HIV-positive patients' experiences of stigma during hospitalisation Surlis, Siobhan; Hyde, Abbey The aim of the research to be presented in this article was to explore, within an Irish context, HIV positive patients' experiences of hospitalisation, and particularly their experiences of nursing care. This paper reports on one of the dominant themes to emerge in the study - the experience of stigma among persons living with HIV during their hospitalisation. A volunteer sample of 10 former in-patients of hospitals in the Republic of Ireland’s capital, Dublin, were interviewed in depth, and data were analysed using a qualitative content analysis. Findings indicate that while some participants experienced stigma from nurses, such stigma was stratified according to the means by which the disease had been contracted, with drug users expressing the greatest feelings of stigma from nurses. Data also suggest that the location of nursing care favoured by many participants was segregated care in specialist units, because it enabled them to avoid being discredited by other patients who did not have the virus, as well as potentially offering social support from like-situated others. Finally, patients experienced breaches in confidentiality because of institutional policies that made their disease conspicuous, and from some nurses' nonchalance in handling information about their disease. The analysis draws on Goffman's conceptualisations of stigma to explain the social process underlying participants' accounts. 2001-11-01T00:00:00Z http://hdl.handle.net/10197/4195 Social selection and professional regulation for Master's degrees for nurses Drennan, Jonathan; Hyde, Abbey Aim. This paper is a report of a study to understand the perspectives of two sets of stakeholders, namely clinical nursing providers and nursing academics, on how registered nurses should be selected for Master's degree programmes. Background. The proliferation of taught Master's programmes has led to concerns about a lowering of standards. Even with the expansion of professional Master's programmes, they remain one of the least researched areas of higher education. Method. The sampling strategy was a combination of convenience and snowball sampling. In-depth interviews were conducted in 2006-07 with 15 stakeholders and data were subjected to thematic content analysis. Findings. There were differences in service providers' and academics' perceptions of access to Master's level education for nurses. Service providers engaged in regulatory practices, as evidenced in the way in which potential candidates were judged to be suitable or not to undertake a Master's-level education. Academic participants, in contrast, tended to have far fewer concerns about the career plans of applicants and were more likely to invoke discourses of academic educational admission practices. Conclusion. The health services need highly skilled, educated workers whose abilities and knowledge make an impact on the provision of effective patient and client care. This level of education can be achieved through continuing education of the professions by taught Master's degrees. It is imperative that an effective partnerships between clinical service providers and academics are developed to promote understanding of their respective perceptions of admission to the degree. 2008-09-01T00:00:00Z http://hdl.handle.net/10197/4193 The fragmented discourse of the 'knowledgeable doer': nursing academics' and nurse managers' perspectives on a master's education for nurses Drennan, Jonathan; Hyde, Abbey There has been a proliferation of taught masters degrees for nurses in recent years, and like masters programmes in other disciplines, the aspirations of such educational endeavours are far from unanimous. This article reports on part of a wider study, and focuses on a qualitative analysis of the perspectives of two key sets of stakeholders, namely academic education providers, and senior clinical nursing personnel, on masters education for nurses. Fifteen participants were interviewed in depth, and data were subjected to a qualitative content analysis. Findings indicated that while both sets of participants invoked the discourse of the knowledgeable doer, that is, the notion of amalgamating a high level of theoretical knowledge with practical know how, there were also differences in how each group deployed this discourse. Academics tended to emphasise the knowing that or theoretical aspect of the discourse, whereas those in senior clinical roles adduced the practical component more strongly. We argue that the discourse of the knowledgeable doer is far from stable, unified and universally agreed, but rather comprises competing elements with some emphasised over others according to the subject position of the particular individual. We locate the diverse perspectives of the two sets of stakeholders within debates about the status of masters programmes in relation to vocational and liberal education. 2009-05-01T00:00:00Z http://hdl.handle.net/10197/4192 Teaching reflection to nursing students: a qualitative study in an Irish context O'Connor, Aideen; Hyde, Abbey Teaching nursing students to reflect on their practice is now officially considered an essential component of nursing education in a number of countries. The aim of this study was to explore nurse teachers’ perceptions and experiences of using reflection with diploma nursing students in an Irish context. One of the central themes to emerge, upon which this article is based, is the manner in which reflection is actually taught and/or facilitated by nurse educators in diploma nursing programmes, and the factors that influence this. Intensive interviews were conducted with 11 nurse teachers and data were analysed using a strategy resembling grounded theory. Findings indicated that the teaching of reflection was influenced by structural and human resource requirements and a lack of organisational commitment within the schools of nursing. Reflective practice did not permeate throughout the curriculum, but was instead an isolated, episodic classroom activity. The prospect of integrating reflective practice, as taught in the schools, with nursing practice in the clinical realms was problematic because of a range of cultural impediments. The repressive culture within the schools of nursing seemed to subvert discussion and debate about the status of reflective practice in the nursing curriculum. 2007-02-17T00:00:00Z http://hdl.handle.net/10197/4190 Social regulation, medicalisation and the nurse's role: insights from an analysis of nursing documentation Hyde, Abbey; Treacy, Margaret P.; Scott, Anne P.; MacNeela, Padraig; Butler, Michelle; Drennan, Jonathan; Irving, Kate; Byrne, Anne Background: Medicine is recognised as a dominant source of governmentality and social regulation, and although nursing has been implicated in the same process, analytical work in this area has been sparse. Objectives: The article aims to present an analysis of nursing records in order to understand the structural and social processes that mediate the texts. Methods: 45 sets of nursing records drawn from four clinical sites in Ireland were subjected to a discourse analysis. Results: This article focuses on two main themes that were derived from data: (i) the manner in which nurses controlled, regulated and invigilated patients' activities of daily living and (ii) the way in which activities of daily living were mediated by a biomedical worldview in the clinical settings. Through the organising framework of Activities of Daily Living (ADLs), normative social practices relating to hygiene, eating and drinking, sleeping and so forth were surveyed and monitored within clinical settings. We construct qualitative categories around a range of ways that nurses assessed and judged patients' capacities at ADLs. Furthermore, it is argued that the framework of ADLs epitomises the medicalisation of normative social practices, whereupon the most mundane of normal functions become redefined as an actual or potential clinical pathology, legitimating nursing interventions. According to the nursing documentation, biochemical interventions in the form of various medications were the most dominant means through which nurses attempted to restore or improve the functional capacity of an ADL. Conclusion: We conclude by proposing that nurses' invigilation of patients' ADLs is not necessarily a repressive feature of nursing practice, but rather has the potential to be used to advocate on patients' behalf in certain circumstances. 2006-08-01T00:00:00Z http://hdl.handle.net/10197/4189 The politics of heterosexuality - a missing discourse in cancer nursing literature on sexuality: a discussion paper Hyde, Abbey In this article, a critique of cancer nursing literature on the issue of sexuality is presented, with particular reference to literature on cancers common to women. The paper begins with an account of two competing perspectives on sexuality. The first is a version of sexuality rooted in sexology, underpinned by biomedical science that makes a claim to having identified 'normal' sexuality. The second is a version of sexuality developed within feminist scholarship that tends to reject biological determinism as a basis for understanding sexuality, instead favouring constructionist perspectives, with the socio-political context of sexual relations problematised. The focus of the article then shifts to cancer nursing literature on sexuality that deals primarily with cancers common to women, to appraise the extent to which either of the above perspectives on sexuality is invoked. Within this body of nursing knowledge, I argue that there has largely been an uncritical endorsement of biomedical constructions of sexuality, rooted in orthodox sexology, with a dominant focus on sexual functioning and on sexual rehabilitation for women with cancer. Moreover, in this knowledge base, phallocentric heterosexuality over and above other forms of sexual expression is privileged, and the socio-political context of unequal gender power relations is largely excluded. References to the social sphere as a dimension of nursing care are focused almost exclusively on maintaining normality, and reflect the emphasis on functional restoration. The largely individualistic, uncritical and biocentric emphasis in this literature may serve inadvertently to reinforce and maintain existing gender inequalities in heterosexual relationships. Finally, I consider the difficulties for oncology nurses in dealing with contradictory truth claims or conventional wisdoms about sexuality from the disparate disciplines of which holism is comprised. 2007-02-01T00:00:00Z http://hdl.handle.net/10197/4188 Controlling response shift bias: The use of the retrospective pre-test design in the evaluation of a master's programme Drennan, Jonathan; Hyde, Abbey Student self-report measures of change are widely used in evaluation research to measure the impact and outcomes of an educational programme or intervention. Traditionally the measures used to evaluate the impact of an educational programme on student outcomes and the extent to which students change is a comparison of the student’s pre-test scores with their post-test scores. However, this method of evaluating change may be problematic due to the confounding factor of response shift bias. Response shift bias occurs when the student’s internal frame of reference of the construct being measured, for example research ability or critical thinking, changes between the pre-test and the post-test due to the influence of the educational programme. To control for response shift bias the retrospective pre-test method was used to evaluate the outcomes achieved from students completing a research module at master’s level. The retrospective pre-test method differs from the traditional pre-test-post-test design in that both post-test and pre-test perceptions of respondents are collected at the same time. The findings indicated that response shift bias was evident in student self-reports of change, especially in subjects the student had been previously exposed to at undergraduate level. The retrospective pre-test design found that the programme had significantly greater impact on outcomes that that identified using the traditional pre‐test–post‐test design leading to the conclusion that students may overestimate their ability at the commencement of an educational programme. The retrospective pre-test design is not a replacement for the traditional pre‐test–post‐test measures but may be a useful adjunct in the evaluation of the impact of educational programmes on student outcomes. 2008-11-15T00:00:00Z http://hdl.handle.net/10197/4187 Midwifery practice and the crisis of modernity: implications for the role of the midwife Hyde, Abbey; Roche-Reid, Bernadette Almost since its inception, the concept of modernity was found to display tensions between its emancipatory potential to liberate the human subject from the manacles of tradition, and the application of reason to co-ordinate and control the natural world through scientific knowledge. This paper presents a qualitative analysis of in-depth interviews with 12 midwives about their role in the Irish maternity services and argues that, in a period of late modernity, these tensions continue to manifest themselves in the context of the midwife's role. Although the contemporary period is marked by a loss of faith in scientific truths, widely contested obstetric knowledge and practices continue to exercise mastery over nature while undermining a central feature of the midwife's role-the liberation of the autonomous subject. Drawing on the theory of communicative action developed by the critical theorist Jurgen Habermas, it is argued that the midwife's role in facilitating the autonomous choices of women through communicative action is impeded by the colonization of the lifeworld of labour and childbirth by the technocratic system of obstetrics. Although participants reported that their role involved empowering women and facilitating choices through dialogue congruent with communicative action, data also suggested that participants used strategic communication with clients aimed at achieving particular ends. The use of strategic communication was linked to the way in which the midwife's role is determined to a large extent by the practices and protocols of obstetrics, and also to the notion of client passivity. The instrumental rationality of obstetrics is linked to an outcome orientation to power and money, and a political economy perspective of medicine. It appears that communicative action between midwives and obstetricians is important in bringing about structural changes to facilitate the conditions for communicative action between midwives and their clients. 2004-06-01T00:00:00Z http://hdl.handle.net/10197/4186 Sexuality as an aspect of nursing care for women receiving chemotherapy for breast cancer in an Irish context Lavin, Marie; Hyde, Abbey In this article, findings are presented from a study that aimed to explore the perceptions and experiences of a sample of nurses in addressing sexuality as an aspect of care for women receiving chemotherapy for breast cancer. A sample of 10 oncology nurses was selected from oncology units at three hospitals in Ireland, and each participant was interviewed in depth. A qualitative strategy was employed to analyse data. Findings indicated that participants tended to construct sexuality in broad terms, and were well aware of the effects of chemotherapy on a person's sexuality. In addition, they considered sexuality education to be a legitimate and important aspect of their role. However, they also revealed that they avoided addressing sexuality with patients, or encountered structural obstacles in doing so. Some participants expressed anger and frustration when discussing barriers to incorporating sexuality into their practice. A strong theme in data was participants' perceptions that they were not adequately prepared in either pre-registration or post-registration programmes to incorporate sexuality as a dimension of patient care, although post-registration programmes were more likely to furnish them with knowledge about sexuality. Finally, participants' views on sexuality care are considered in the context of Irish culture which until recently was dominated by Catholic Church teachings. 2006-02-01T00:00:00Z http://hdl.handle.net/10197/4185 Modes of rationality in nursing documentation: biology, biography and the 'voice of nursing' Hyde, Abbey; Treacy, Margaret P.; Scott, Anne P.; Butler, Michelle; Drennan, Jonathan; Irving, Kate; Byrne, Anne; MacNeela, Padraig; Hanrahan, Marian This article is based on a discourse analysis of the complete nursing records of 45 patients, and concerns the modes of rationality that mediated text-based accounts relating to patient care that nurses recorded. The analysis draws on the work of the critical theorist, Jurgen Habermas, who conceptualised rationality in the context of modernity according to two types: purposive rationality based on an instrumental logic, and value rationality based on ethical considerations and moral reasoning. Our analysis revealed that purposive rationality dominated the content of nursing documentation, as evidenced by a particularly bio-centric and modernist construction of the workings of the body within the texts. There was little reference in the documentation to central themes of contemporary nursing discourses, such as notions of partnership, autonomy, and self-determination, which are associated with value rationality. Drawing on Habermas, we argue that this nursing documentation depicted the colonisation of the sociocultural lifeworld by the bio-technocratic system. Where nurses recorded disagreements that patients had with medical regimes, the central struggle inherent in the project of modernity became transparent--the tension between the rational and instrumental control of people through scientific regulation and the autonomy of the subject. The article concludes by problematising communicative action within the context of nursing practice 2005-06-01T00:00:00Z http://hdl.handle.net/10197/4183 Women's accounts of heterosexual experiences in the context of menopause Hyde, Abbey; Nee, Jean; Butler, Michelle; Drennan, Jonathan; Howlett, Etaoine A number of biomedical models of female sexuality have emerged during the past few decades, and these have been challenged by feminist theorists who have tended to focus on the influence of contextual issues that mediate women's sexual experiences. In this article, a qualitative analysis of accounts relating to heterosexual experiences obtained from 25 menopausal women in Ireland through in-depth interviews is presented and considered in light of existing theoretical perspectives on sexuality. The average age of women in the sample was 54.2 years, and a diverse range of socioeconomic backgrounds was represented. We found that in describing their contemporary sexual experiences, contextual issues were brought heavily to bear as participants drew on discourses of personal history and biography, including previous relationships, to explain their current sexual experiences. However, a few women foregrounded physiological and biological reasons associated with hormonal changes to explain alterations in their sexual relationship, although overall, these were featured to a far lesser extent compared with their prominent position in biomedical menopause literature. A dominant feature of data was the influence of the discourse of the male sex drive, and many women explained their lesser interest in sexual activity compared with that of their partner in terms of men's nature. The findings suggested that for participants, anxiety around sexuality was socially produced either through the expectation to satisfy a partner, or by dominant discourses that defined sexual engagement as “healthy” and sexual apathy as “unhealthy.” 2011-09-08T00:00:00Z http://hdl.handle.net/10197/4181 The focus group method: insights from focus group interviews on sexual health with adolescents Hyde, Abbey; Howlett, Etaoine; Brady, Dympna; Drennan, Jonathan This article concerns the manner in which group interaction during focus groups impacted upon the data generated in a study of adolescent sexual health. Twenty-nine group interviews were conducted with secondary school pupils in Ireland, and data were subjected to a qualitative analysis. In exploring the relationship between method and theory generation, we begin by focusing on the ethnographic potential within group interviews. We propose that at times during the interviews, episodes of acting-out, or presenting a particular image in the presence of others, can be highly revealing in attempting to understand the normative rules embedded in the culture from which participants are drawn. However, we highlight a specific problem with distinguishing which parts of the group interview are a valid representation of group processes and which parts accurately reflect individuals' retrospective experiences of reality. We also note that at various points in the interview, focus groups have the potential to reveal participants' vulnerabilities. In addition, group members themselves can challenge one another on how aspects of their sub-culture are represented within the focus group, in a way that is normally beyond reach within individual interviews. The formation and composition of focus groups, particularly through the clustering of like-minded individuals, can affect the dominant views being expressed within specific groups. While focus groups have been noted to have an educational and transformative potential, we caution that they may also be a source of inaccurate information, placing participants at risk. Finally, the opportunities that focus groups offer in enabling researchers to cross-check the trustworthiness of data using a post-interview questionnaire are considered. We conclude by arguing that although far from flawless, focus groups are a valuable method for gathering data about health issues. 2005-12-01T00:00:00Z http://hdl.handle.net/10197/4180 Heterosexual experiences of secondary school pupils in Ireland: sexual coercion in context Hyde, Abbey; Drennan, Jonathan; Howlett, Etaoine; Brady, Dympna This paper reports on data from a wider study of young people's heterosexual experiences in Ireland, but focuses in particular on issues of sexual coercion. Data were gathered from 29 focus group interviews with 102 young women and 124 young men and were analysed using a qualitative research strategy. Drawing on concepts of social coercion and interpersonal coercion, we argue that both female and male participants reported a general sense of social coercion to lose their virginity by a certain age. However, narratives of interpersonal coercion were far stronger in the case of the young women compared with their male counterparts, while the young men reported a particular type of social coercion that propelled them to subscribe to conventional heterosexual male behaviour. We argue that while the distinction between social coercion and interpersonal coercion is far from watertight, it is a useful conceptual tool in identifying broad variations in women's and men's sexually coercive experiences. 2008-06-17T00:00:00Z