Caring Science, Lifeworld Led Care and Medical Humanities

The Faculty of Health and Social Care will be hosting two leading lifeworld research experts from Linnaeus University, Sweden 11 – 15 February 2013 as part of an Erasmus exchange. The purpose of the exchange is to build links in lifeworld led care and to forge collaboration for research, teaching and curriculum development, with a particular focus on learning from Swedish ideas about ‘Caring Science’.

Lise-Lotte Ozolins (RN, MNsc, PhD) is senior lecturer in the School of Health and Caring Sciences at Linnaeus University, Växjö, Sweden. Lise- Lotte leads a Lifeworld based Health Care Clinic where undergraduate students undertake key placements. Her research focuses on the phenomenology of touch in health care and how phenomenology can support the understanding of Caring Science. She is a key member of the European Academy of Caring Science and is pursuing collaborations in Lifeworld- led Care and Education.

Ulrica Horberg is Senior Lecturer in the School of Health and Caring Sciences at Linnaeus University, Växjö, Sweden. Ulrica leads the Lifeworld Centre for Health, Care and Learning (HCL). Her research interests include: forensic psychiatric care and how families can be a resource for care in this context, learning in health and social care and the intertwining of theory and praxis. Ulrica is a key member of the European Academy of Caring Science and is pursuing collaborations in Lifeworld- led Care and Education.

More information about the European Academy of Caring Science is available here: www.pubcare.uu.se/care/eacs

Seminars

During their visit they are undertaking a Seminar as part of the Cross Faculty Seminar Series in Medical Humanities, on Wednesday 13th February in Derwent Room 3 at 4.30pm.

The phenomenon of touch in healthcare contexts – a complex caring movement

A Swedish doctoral thesis by Lise-Lotte Ozolins explored the phenomenon of touch and described its meaning from a lifeworld perspective in the healthcare context. The intention was to deepen the understanding of the meanings of touch in the field of caring science. Based on 54 variations, in the form of interviews in varied healthcare contexts, touch showed a powerful and complex phenomenon. To understand more of the complexity a philosophical illumination was carried out to highlight questions of interest in the caring of patients, such as; how could it be understood that touch can be both awakening of rhythm and balance in life, as well as intruding and frightening? How can carers in touch with patients support wellbeing in a meaningful caring space? Texts from Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Les Todres were helpful to expand the understanding of caring touch. The philosophical illuminations shows how the reversibility of touch, and thus also the movement between individuality and being a part of humanity, between being in focus or in the background, to feel or be felt, between to see and to be seen, cuts through all the meanings of the phenomenon and is basic to understanding the character of the phenomenon of touch. Touch means a flowing movement in a phenomenal field that stretches between what may be described as liberating and restraining. The phenomenon of touch may be described as a complex caring movement; an interplay between lived bodies as a foundation to understand health, suffering, well-being, and care.

To be strategically struggling against resignation – The lived experience of being cared for in forensic psychiatric care

The paper focuses on the forensic psychiatric care of mentally disordered offenders from the patients’ experiences of their life situation in forensic psychiatric wards. To be referred to care in forensic psychiatric services can be seen as one of the most comprehensive encroachments society can impose upon a person’s life, as it entails a limitation of the individual’s freedom with no time limit. The paper is based on a study with the aim to describe patients’ experiences of their life situation at forensic psychiatric wards, with a focus on care. Eleven qualitative interviews have been carried out with patients at one of six main forensic clinics in Sweden. The analysis was based on the Reflective Lifeworld Research approach, founded on phenomenology. Results show how forensic psychiatric care can be non-caring with only moments of good care. By use of different strategies, the patients struggle to adapt to the demands of the caregivers in order to gain privileges. At the same time the patients are lacking meaningful and close relationships and long to get away from the system of forensic care. Being cared for entails a struggle against an approaching overwhelming sense of resignation. The paper highlights the need for more knowledge, understanding and support in order to provide health promoting and, in other respects, good care to patients in forensic psychiatric care.

Honorary Graduates for the Faculty

Terence Ryan

Professor Terence Ryan

Professor Steven Ersser, Dean of the Faculty of Health & Social Care and Professor of Nursing & Dermatology Care presented Professor Ryan:

Professor Terence Ryan is one of the world’s foremost leaders and visionaries in dermatology and indeed in the field of health care generally, having been a tireless lifelong champion of the field. He is a renowned clinical academic in the field of dermatology and has held several international leadership posts in the field- seeking to improve the quality of life of people living with skin disease worldwide. His scholarly contribution to the field of dermatology, skin health, community dermatology and lymphology has been prolific and highly influential. Terence Ryan has been Honorary President of the International Society of Dermatology. In 2007 he received one of the highest international accolades in the field, the “Distinguished Services Award” of The International League of Dermatological Societies.

On retirement in1997 as a Consultant Dermatologist in Oxford, he became an Emeritus Professor of Dermatology at Oxford University, and at Oxford Brookes University, reflecting his strong collaborative links with and as champion of nursing and its academic development. He served as Vice Warden of Templeton Green College, Oxford for 7 years, promoting academic development in health care. He holds honorary international appointments at the Jefferson Medical School, Philadelphia; Limerick and Beijing and Nanjing (Peking) Universities.

Professor Ryan is also a humanitarian leader- having been a tireless advocate for the sick, poor and marginalised in developing countries- and in particular has been a champion for the development of community dermatology. He remains active in the field as Chair of the International Society of Dermatology WHO Task Force on Community Dermatology. Whilst Chair of the International Foundation for Dermatology, he took an active role in bringing dermatology, sexually transmitted diseases and leprosy into general health services of the developing world.  He advises the World Health Organisation Global Alliance on the elimination of lymphatic filariasis, which is a major disease affecting millions and one that impacts on sufferers’ skin and their quality of life. Prof Ryan has promoted the integration of traditional health with Western medicine and worked to support the retraining of village health care workers in the fields of skin care, sexual health and leprosy. Prof Ryan was also a Medical Advisor to the St Francis Leprosy Guild and was a member of the LEPRA Medical Board. His wider contribution to health care community has been recognised by the St John Ambulance Association as a Knight of St John and for his international work by the Rotary Club -as a Paul Harris Fellow.

Aside to his recognition in medicine he has always been an active champion of the nursing service and opportunities for nurses within Universities. Indeed, previously he sought to influence the Oxford Medical School to embrace University education for nurses and, despite the obstacles; he went on to support interdisciplinary clinical academic involvement of nursing at the National Institute of Nursing in Oxford and Oxford Brookes University.

Terence Ryan has been an inspired health care and academic leader to a wide range of health professionals and community health workers. Over the last 14 years he has been an active supporter of the International Skin care Nursing Group. On a personal note, Terence Ryan has also served as a long-term mentor to me supporting me to take up the first Chair in nursing and dermatology care worldwide. He is active supporter of our Research Group here at Hull and is actively advising some of our research students.

Professor Ryan has been at the forefront of dermatology worldwide and skin health over the past few decades. His leadership, vision and commitment to improving the health care of people in resource poor and developed countries –has been exemplary and an inspiration to many. His wider view of health care and public health, his international perspective and profound belief in the importance of interdisciplinary working, education and research –highlights his shared values with the University of Hull and our Faculty of Health & Social which has a growing interest in skin health, global health, community and sexual health.
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Carolyn Roberts

Lady Carolyn Roberts

Professor Kathleen Galvin, Professor of Nursing Practice, of the Faculty of Health & Social Care presented Lady Roberts:

Lady Carolyn Roberts is an exceptional leader in nursing and health visiting, having dedicated a lifetime's work to delivering enhanced clinical services and to improving the healthcare experience of patients and public, especially the disadvantaged. She has also played an important national role in advising the government on the safety and licensing of medicines and in focussing attention on the ethics of patient care – a topic of considerable media attention in recent months.

Born in Leeds, Carolyn's early career was spent not on hospital wards but in the offices of the computer giant, IBM. Her Damascene conversion took place when she was being treated for a severe reaction to ampicillin and saw at first hand the transformational effects of high-quality patient care. She qualified as a registered nurse at Leeds General Infirmary and went on to train as a health visitor at Leeds University.

Primary health care has been the backbone of her outstanding career, initially as a health visitor and then as a researcher investigating the role of health visitors in promoting the well-being of older people. Her research set out to overcome professional and institutional boundaries by encouraging staff to work in both hospital and community settings, as a means of achieving continuous and co-ordinated care. This pioneering work was underpinned by her MSc in Health Administration and Research from Hull University. More recently, she has applied her organisation and research expertise to Leeds, Wakefield, Sheffield and Oxford health authorities, bringing together skills and knowledge in clinical practice, research, education, management and policy to the considerable benefit of the agencies concerned. She has made it her business to break down barriers – whether these are related to social class, race or gender – and to improve the standards of ethical practice in both health and social care.

Carolyn’s understanding and appreciation of the ethical concerns of the general public led to her appointment as a trustee of the ETHOX Foundation, and to a six-year term as its chair. An independent registered charity, the Foundation exists to enhance the communication and ethical decision-making skills of medical and nursing professionals. It enjoys strong links with the Universities of Oxford and Warwick, as well as having had a seat on the Associate Parliamentary Health Group – a valuable conduit to government ministers and NHS executives which Carolyn has fully exploited. As chair, Carolyn set out to strengthen the governance and sustainability of ETHOX and to develop its influence on the ethics of care. This work led to her becoming a founding member of the Royal College of Nursing Ethics Committee. She is also a Fellow of Royal Society of Medicine, an Invited Fellow of the Royal Society of Arts and a member of the City Women’s Network. 

In 2007 Carolyn was invited to become the first nurse member of the Commission on Human Medicines, which advises the UK Government on the safety, quality, efficacy and licensing of medicines. Described as a ‘superb’ Commissioner, she has added a unique perspective to the workings of the Commission, based on her role as a nurse prescriber and her extensive experience of both the nursing profession, and the field of health care ethics. Carolyn has also served on a number of the Commission’s Expert Advisory Groups since 2003. 

An exemplary and passionate nurse, Carolyn has been unstinting in her efforts to enhance the quality of health and social care – as practitioner, researcher, senior manager and nurse prescriber. 

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Scholarship [January 2013]

Fiona Cowdell

Fiona Cowdell and Steven Ersser published:

Cowdell F,Ersser SJ, Gradwell C, Thomas PW (2012 The Person-Centered Dermatology Self-Care IndexA Tool to Measure Education and Support Needs of Patients With Long-term Skin Conditions JAMA Dermatology 148, 1251-1256



Steven Ersser

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Peter Draper

Peter Draper published:

Holloway M, Adamson S, Argyrou V, Draper P, Mariau D (2013) "Funerals aren't nice but it couldn't have been better". The makings of a good funeral Mortality 







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One of our students Gillian Hebblewhite, a 3rd year Learning Disability Nurse who  won the Pre-registration/Pre-qualifying student award published:

Hebblewhite, G. (2012) Grief in the transition from oral to enteral feeding among children Learning Disability Practice 15 (10) pp12-16

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Janet Kelly published:

Kelly J (2012) Military Healthcare Battlefield Immunity,  J R Army Med Corps 158: 308-312

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Kate Galvin

Kate Galvin published:

Galvin, K.T. & Todres, L (2012). Caring and Wellbeing: A Lifeworld Approach.  Routledge.

Borbasi S, Galvin K T, Adams T, Todres L, Farrelly B (2012) Demonstration of the usefulness of a theoretical framework for humanising care with reference to a residential aged care service in Australia, Journal of Clinical Nursing doi:10.1111/j.1365-2702.2012.04256.x

Galvin K,Prendergast M (Guest editors) (2012) Creative Approaches to Research Special Issue Poetic Inquiry 5:2 

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Mark Hayter

Mark Hayter published:

Cutler L, Hayter M, Ryan T (2013) A critical review and synthesis of qualitative research on patient experiences of critical illness Intensive and Critical Care Nursing 17, doi: 10.1016/j.iccn.2012.12.001

Lo SF, Hayter M, Hu WY (2012) Symptom burden and quality of life in patients with malignant fungating wounds Journal of Advanced Nursing  68,  1312–1321

Hayter M, Jackson D, Carter B, Nyamathi A (2012) The three development phases of addressing sexuality in nursing care: Where do we go from here? Contemporary Nurse 42, 187-189

Al kalaldeh M, Watson R, Hayter M (2012) A review of current guideleines in enteral nutrition in the critically ill patient European Scientific Journal December edition 8, 1857 – 7881

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Amanda Sherratt

Amanda Sherratt published:

Sherratt A (2013) Antibiotics in Ophthalmology International Journal of Ophthalmic Practice 3, 260-263.

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Roger Watson published:

Al kalaldeh M, Watson R, Hayter M (2012) A review of current guidelines in enteral nutrition in the critically ill patient European Scientific Journal 8, 1857 – 7881

Ski CF, Thompson DR, Hare DL, Stewart AG, Watson R (2012) Cardiac Depression Scale: Mokken scaling in heart failure patients Health and Quality of Life Outcomes 10:141 http://www.hqlo.com/content/10/1/141

Deary IJ, Watson R, Booth T, Gale CR (2012, December 10). Does Cognitive Ability Influence Responses to the Warwick-Edinburgh Mental Well-Being Scale? Psychological Assessment doi:10.1037/a0030834

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Faculty lecturer scoops prestigious leadership award

Dr Likupe (2nd left) with Faculty colleagues

Dr Gloria Likupe was awarded £12,500 by the Department of Health under the prestigious Mary Seacole Leadership Award in recognition of her work in black and ethnic minority communities. The money will fund a project entitled 'Developing a communication model for ethnic minority elders and health care workers'.

Commenting on the award Dr Likupe says:

Britain is becoming more multicultural as more people from both the old and new commonwealth and eastern European counties decide to settle in Britain. This diversity has brought new cultures and tastes that are part of the British life.

However very few people are aware of the problems that ethnic minorities face as they age in a different culture. Most do not speak English as a first language and the ethnic older person my therefore be anxious that they will lose the ability to speak English as they get older.  Some may not speak English at all and communication with health care professionals and professionals from other services may therefore present a significant problem as the minority elder may not be able to participate fully in the community to obtain the services that they need.

Mary Seacole recognised the needs of the vulnerable and offered her services to care for wounded soldiers in the Crimean war.  Her selfless motivation and determination was so strong that although she was not supported at the time due to attitudes that prevailed regarding her gender and colour, she borrowed money to make the 4,000-mile journey by herself. She distinguished herself treating battlefield wounded, often nursing wounded soldiers from both sides while under fire.

Although she was honoured in her life time along with the nurse pioneer Florence Nightingale, she was largely forgotten, but since 1994 her name is being held in esteem again thanks to the Department of Health which established awards in her honour. These awards are given to nurses who have shown a passion to promote the heath of ethnic minorities thorough various projects including research. 

Traditionally the city of Hull has not had a large population of ethnic minorities. However this situation is changing rapidly as larger numbers of ethnic minorities decide to settle in the area. Hull will therefore experience similar problems as some Southern and Midlands’ cities with large ethnic minorities.  The Department of Health has recognised this by awarding me the prestigious Mary Seacole Award to develop a communication model for black and Asian minority elders in Hull. Information will be sought from both elders and health care workers to identify communication barriers and enhancers.  Usually older people  are not asked how they would like to be cared for, it is taken for granted that care prescribed for them by care givers is adequate. My model seeks to challenge this assumption by asking older ethnic minorities what would enhance their care in terms of communication.  Those who provide care will be allowed to voice what they perceive as challenges for looking at this particular group and how these can be overcome.

Research seminar series

Faculty of Health and Social Care Research and Scholarship Seminar Series 2013

Wednesday 16 January 2013

12.30 pm

Dearne building (MR1)

Foucault and sexuality

Professor Mark Hayter

University of Hull

Wednesday 30 January 2013

12.30 pm

Dearne building (MR1)

Making questionnaires better with item response theory

Professor Roger Watson

University of Hull

Wednesday 13 February 2013

12.30 pm

Dearne building (MR1)

A Foucauldian view on the professionalisation

of nursing in Singapore

Dr Jennifer Loke

University of Hull

Wednesday 27 February 2013

12.30 pm

Dearne building (MR1)

NIHR Research Design Service – how it can help you

Dr Yvonne Birks

The NIHR Research Design Service for Yorkshire and the Humber, University of York

Wednesday 13 March 2013

12.30 pm

Dearne building (MR1)

Sufferers’ perspectives on eating disorders

Professor Marie Reid

University of Hull

  University of Hull • November 2012

South African visitor to the faculty

At the end of 2012 the Faculty hosted a visit by Professor Mavis Malaudzi Head of Department in Nursing at the University of Pretoria.

Professor Malaudzi met many of the staff with a view to establishing collaboration between her department and the Faculty.  Earlier in the year Professor Steven Ersser, Dean of the Faculty visited Mavis and colleagues in Pretoria and further visits by academics from Hull are planned.



Professor Malaudzi delivered a Faculty seminar on the concept of Ubunto and Ethics.  Ubuntu is a South African philosophy about relationships and allegiances and Professor Malaudzi's seminer examined the application of Ubuntu to the nursing curriculum.

New Hull Editor for Journal of Advanced Nursing

Professor Mark Hayter Professor of Sexual and Reproductive Health in the Faculty here at Hull has been appointed Editor of Journal of Advanced Nursing.

Already an Editor of several years experience on Journal of Clinical Nursing Mark joins Wiley-Blackwell's flagship journal.  JAN is the highest cited academic nursing journal in the world.  Mark brings his experience as an academic to the journal in addition to extensive international experience, principally in the Far East and South East Asia.

Mark says: I'm delighted to join the Journal of Advanced Nursing Editorial team and look forward to working with them to build on the significant achievements of the journal.  This appointment realises an ambition to edit an international journal at the top of my field. The Journal of Advanced Nursing is recognised instantly as a source of high quality, ground-breaking nursing research globally.  I am glad to be in a position to contribute to its substantial international influence and impact.

Arts for Health: Towards well-being within the experience of stroke recovery

Kathleen Galvin and Caroline Ellis- Hill (Principal Investigator)

The Research for Patient Benefit Funding stream have funded a feasibility study of an RCT of an Arts for Health group intervention to support self confidence and psychological well-being following stroke.  The research is in collaboration with our practice partners, Royal Bournemouth & Christchurch Hospitals (RBCH) NHS Foundation Trust and Cambridge Community Services NHS Trust (CCS), Bournemouth University.

The proposal was instigated by Robin Cant, a stroke survivor. While working on the NIHR-Stroke Research Network (SRN) Rehabilitation Clinical Subgroup, he recognised that there was very little research into his experienced loss of confidence in life, a ‘hidden’ area of great importance to him. Through discussions with other stroke survivors it became apparent that this was a common experience. Currently NHS services focus on physical recovery and practical support in rehabilitation; however, the ‘hidden’ psychological aspects such as loss of self-confidence (Cant, 1997; Salter et al., 2008) are not addressed. As Harry Clarke said in a recent NHS document (2011) Psychological care after stroke "We’re not just legs and arms and a mouth…we are human beings with a mixture of emotions. All these feelings…self esteem, self worth, confidence, identity …they’re all under attack after a stroke…you can feel vulnerable, frightened and you can lose yourself." p4.

In an Arts for Health (AfH) approach, people are supported in small groups to feel safe to express themselves through creative activity. This allows them to explore their life situation and start to resolve ‘hidden’ psychological aspects. Creative arts offer the advantage of allowing people to express themselves without words. AfH interventions have been shown to be helpful in GP practices for people with low self-esteem/low confidence; however, to date they have not been tested after stroke.

A large interdisciplinary team led by Caroline Ellis- Hill are planning a national study to test whether AfH is beneficial for stroke survivors following hospital discharge. To aid planning we will carry out a  study of AfH randomly allocating half of our sample of stroke survivors to either AfH alongside usual care OR usual care only, to see if a) the methods we are planning work b) the ways of assessing participants' wellbeing, mood, quality of life, confidence and use of health services are appropriate c) stroke survivors want to take part and d) they value the intervention.  .

We have two centres (Bournemouth/Cambridgeshire) to allow testing of our procedures related to working across different geographical areas, and recruitment from different settings (hospital & community) and aim to  inform a future multicentre trial in which we will recruit from a variety of stroke service settings. The team comprise expertise in the following domains: people who have survived stroke, stroke rehabilitation, psychological aspects of stroke, trial design and management, qualitative research, the arts, medical humanities and health economics. The research will use qualitative methods and will also measure positive well-being and capability, including demographic, stroke-related, mood, wellbeing and quality of life domains as well as health service use and process measures. These data will help us to plan the methodology for the full national trial to test if

AfH is beneficial and to explore in what ways it is useful.

References

Cant, R. Rehabilitation following a stroke: a participant perspective. Disabil Rehabil

1997;19: 297-304.

Salter K, Hellings C, Foley N, Teasell R. The experience of living with stroke: A

qualitative meta-synthesis J Rehabil Med 2008;40: 595-602.

NHS Improvement-stroke. Psychological care after stroke Improving stroke services

for people with cognitive and mood disorders Leicester: NHS Improvement; 2011.