Health Research & Scholarship @ Hull: February 2013

A University of Hull midwifery lecturer is joining a pioneering team of medics on a mission to spread the word of water birthing in India.

Natural births are comparatively rare in private hospitals in the country, where it is thought that as many as 80-90 per cent of all births in the country are by Caesarean section, compared to around just 25% in the UK.

But Julie Green, who is also a practising Supervisor of Midwives and the co-founder of Birth and Beyond Consultancy - a social enterprise created to offer a different approach to antenatal classes for parents-to-be - is hoping that a new birthing centre combined with specialised training for midwives may help to reduce that rate.

The team will be in the city of Indore for five weeks setting up the new labour unit at a private hospital, which will be officially opened by a leading Bollywood actress on International Women’s Day, March 8. The local midwives and medical staff will also be trained in how to support women in natural childbirth, thereby encouraging them to opt for less-medicalised care.

Julie Green said: “I am really excited to be involved in this project. When I heard how high the Caesarean section rates were I was really shocked. I’ve heard that many women are leaving hospitals after childbirth feeling depressed and even violated by their birth experience and that’s really heartbreaking. I’ve seen how empowering natural childbirth can be to women – it can have such a huge impact – that we really hope the new centre starts spreading the word about natural birth.

“The ultimate goal is to inspire a different culture across the country. In the past, I have worked in developing countries with the poorest of women, but this case is different as it will be a private hospital. We really believe that the way to change the culture is to start from the richer parts of society, with the trend eventually catching on and natural birth becoming better supported generally.”

Julie will also be training midwives to deliver the unique Birth and Beyond antenatal classes, taking the social enterprise to an international market for the first time. The classes are different to traditional structures, as they are delivered by childbirth educators with a professional background in midwifery or health visiting. They have proved so successful that the Hull Primary Care Trust has funded places for Hull mothers-to-be as its official antenatal education provider, while parents from other areas can pay for an extended series of sessions.

Julie added: “We’ve seen a lot of demand for our particular brand of classes so it is fantastic to be able to see this at work in a new country. Hopefully this will really reinforce the message to mums-to-be about being in control of how they birth their babies. It is also great for the organisation as we are hoping to expand this wider throughout this country.”

Carol Lambert is a registered midwife and was awarded a BSc 1^st class (Hons) in Midwifery at Hull. She is in her final year of her PhD. Her thesis is entitled: Influence of self in the context of decision-making in childbirth: An Interpretive Phenomenological study. Carol says:

My thesis is about exploring the social influences that surround women as they make decisions about where to birth their babies. The rationale for study originated from a clinical practice encounter. In caring for a woman who voiced clear choices of what she wanted for herself for the birth of her baby, these choices were dispelled in an instant when care was handed over to another practitioner temporarily. Questioning what had occurred in this situation and in the context of her care, I wanted to understand what impact midwives have on the decisions women make about birth.

Carol co-chaired the 2011 PhD Experience Conference with PhD student Gill Hughes (Faculty of Education). The ‘For students by students’ conference was a three day event and drew in 140 students from over 25 Universities, from 7 countries and across 3 continents and illustrated how PhD students, both multidisciplinary and internationally share the same issues and concerns within the process.

Carol has published during her PhD in both the British Journal of Midwifery and International Journal of Researcher Development. In 2011 she was awarded the Postgraduate Diploma in Research Training.

Graduate school conference link:

http://www2.hull.ac.uk/student/graduateschool/phdexperienceconference2012/phdexperienceconference2011.aspx

Carol has published:

Lambert C, Jomeen J, McSherry W (2010) Reflexivity: a review of the literature in the context of midwifery research British Journal of Midwifery 18, 321-326

Mercer T, Kythreotis A, Lambert C, Hughes G (2011) Student-led research training within the PhD: "PhD experience" conferences International Journal for Researcher Development 2, 152-166

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Amanda Sherratt is a Lecturer in the Faculty of Health & Social Care; describing her research projects she says:

My PhD considers how existing social processes which facilitate late presentations in gastroesophageal cancers may be counteracted. Geographical information systems (GIS) software will be used to develop a visuospacial dataset of geographical and epidemiological data relating to gastroesophageal cancers in Hull, Lincolnshire and the East Yorkshire region. Underpinned by the paradigm of scientific realist philosophy, an evaluation of current social contexts and mechanisms in health care will identify approaches which have historically enabled or disabled intended mechanisms of change. Strategies will then be developed from this analysis, to counteract late presenting gastroesophageal cancers within the region.
My research is important as it may be used to inform geographically and socially targeted health promotion strategies. If patients are made aware of the initial signs and symptoms of their disease, and therefore, present earlier to their GPs, they may gain a more favourable outcome.

Research Question
How can health systems counteract the correctible geographical and epidemiological forces which facilitate late presentation gastroesophageal cancer?
Sub Questions

What are the key features and main attributes of the populations in late presentation of gastroesophageal cancer?
How can these key attributes be utilised to develop services which will counteract late presenting gastroesophageal patients?
What strategic mechanisms currently exist to enable public information exchange?
How may they be evaluated in the context of early presentation and referral?

Study Design
A 3 phase mixed methodology approach is proposed, using initial datasets from the National Cancer Registry.

Phase 1 - will scope the data and the clinical environment. The development of clinical and educational networks which will support the project is key to this project. Collaborative partnerships have been developed with the University of Hull Faculty of Health and Social Care, and the Department of Geography alongside the Graduate School. Local and Regional referral trusts have also participated. Hull and East Yorkshire, North Lincolnshire and Doncaster and South Humber Trust representatives have engaged with initial scoping processes. Discussions have been held in these networks, to facilitate data collection. I will undertake research training modules at post graduate level, to underpin this work. Ethics approval will be sought through the University of Hull Ethics Committee and methodology will be based upon the initial scoping project and literature review.

Phase 2 - this phase will use quantitative evaluation of initial datasets, to gain information about gastroesophageal cancers in the catchment area of the regional referral centre. Baseline characteristics of the population will be transcribed into ARCGIS software for visuospacial mapping. Patient participation will be integral to this process, as steering groups which include researchers, gastrointestinal cancer patients and their carers will be invited to feed back.
Phase 3 - this final phase will form a realistic evaluation of contexts, mechanisms and outcomes which facilitate late presenting gastroesophageal cancers in our region. Based on the findings from phases 1 and 2, strategic mechanisms which currently exist to enable public information exchange will be evaluated in the context of early presentation and referral. The thesis will be written throughout the project, but this final phase will see a concentration on output and dissemination of findings.

Sample
Retrospective data on gastroesophageal cancer sufferers have been provided by the regional cancer registry and the sample (n=2588) dates from 1998 – 2010.

Ethics
Ethics approval has been provided through formal processes in the Regional Cancer Network. Further ethical approval is being sought through the University of Hull’s Ethics committee. Adherence to policies relating to data management, retrieval and storage will be maintained throughout.
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Alvisa Palese is a Registered Nurse in Italy. After graduation, she completed her Masters in Nursing Science at the University of Verona and then she was appointed as an Associate Professor in Nursing Science at the University of Udine where she teaches at the Bachelors Nursing degree level, ‘Evidence Based Nursing’ and ‘Fundamentals of Nursing’. She is also involved in other Italian universities where she teaches at the advanced level. In addition, she is a member of Italian research networks and organisations aiming to develop the nursing profession.
She started her PhD in the middle of 2012 and she is currently defining her research question. Alvisa says' “I decided to undertake the challenge of a Nursing PhD program at Hull University because it is a rich and stimulating academic environment, which allows me to develop many international relations with its diverse group of post-graduate research students, excellent supervisors and great opportunities also in the role of part-time student... I am working on my research question which will probably be focused on the development and evaluation of a complex intervention in the context of nursing. When it will be defined together with my supervisor, I will post it! "

Alvisa's areas of research up to now were issues related to the nursing work-force, the experience of patients with brain neoplasm and the study of individual and organisational factors influencing academic success/failure among nursing students.

The following articles has been accepted or published in recent months:

Palese A, Dante A, Tonzar L, Balboni B. The N2N instrument to evaluate healthy work environments: an Italian validation. International Archives of Occupational and Environmental Health (Accepted letter February 5th 2013).
Dante A, Fabris S, Palese A. on behalf of RIASI research group. Time-to-event analysis of individual variables associated with nursing students’ academic failure: A longitudinal study. Advances in Health Sciences Education (Accepted Letter, January 30th 2013).
Palese A, Carlevaris E, Zanini A, Morandin A, Carpanelli I, Dante A. Hidden outpatient oncology Nursing Minimum Data Set: findings from an Italian multi-method study. European Journal of Nursing Oncology, S1462-3889(12)00123-8. doi: 10.1016/j.ejon.2012.11.006.
Bortoluzzi G, Caporale L. Palese A. Does participative leadership reduce the onset of mobbing risk among nurse working teams? Journal of Nursing Management (Accepted letter, October 26th 2012).
Palese A, Cecconi C, Moreale R, Skrap M. Pre-operative stress, anxiety, depression and coping strategies adopted by patients experiencing their first or recurrent brain neoplasm: an explorative study Stress and Health. Stress & Health 2012; 28(5):416-25.
Palese A, Mesaglio M, De Lucia P, Guardini I, Dal Forno M, Vesca R, Boschetti B, Noacco M, Salmaso D. Nursing effectiveness in Italy: findings from a grounded theory study. Journal of Nursing Management, 2012, DOI: 10.1111/j.1365-2834.2012.01392.x.
Dante A, Rizzi L, Ianderca B, Palese A. Why do university students not choose a nursing degree at matriculation? An Italian cross-sectional study. International Nursing Review, DOI: 10.1111/j.1466-7657.2012.01037.x.
Ronco M, Iona L, Bulfone G, Palese A. Patient education outcomes in surgery: a systematic review from 2004 to 2010. International Journal of Evidence-Based Healthcare, 2012;10(4):309-23.
Palese A, Coletti S, Dante A. Publication efficiency among the higher impact factor nursing journals in 2009: a retrospective analysis. International Journal of Nursing Studies, 2012 Sep 22. doi:pii: S0020-7489(12)00294-5. 10.1016/j.ijnurstu.2012.08.019.
Palese A, Aidone E, Dante A, Pea F. Occurrence and extent of bruising according to duration of administration of subcutaneous Low-Molecular-Weight Heparin: a quasi-experimental case-crossover study. The Journal of Cardiovascular Nursing, 2012 Jun 29. [Epub ahead of print].
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Chen Yanhua is an associate professor in China and a registered nurses and matron in charge of an infectious disease department. She says:

The UK is not new to me, but Hull is brand new to me and my little boy. We meet many new friends and one old one who is Professor Roger Watson who is now my supervisor.

I can’t help but express my great appreciation to the people, the students and the staff in the university, and the people in the community and the church who guide and accompany us through the hard new journey to sort out the PhD courses and a good primary school for my child and doctors and bank affairs. Now we are settling down.

It is time for my PhD study now. My research is about mentorship which is universally acknowledged as an imperative approach to help the personal and professional development of nursing students and staff and to maintain public safety and ensure high quality nursing care. In China it there is an urgent need to strengthen mentorship while students are in their final year placement. I am confident that I will be well supported as Roger and Andrea Hilton, my second supervisor, are always there when I am wandering about. I believe my studies here will be successful and life here will be colourful and interesting with so many helpful people and the active academic atmosphere in the university.

Chen Yanhua has published two English papers and some Chinese academic paper. The English papers are:

Watson R, Yanhua C, Ip MY, Smith GD, Wong TK, Dearty IJ (2013) The structure of stress: confirmatory factor analysis of a Chinese version of the Stressors in Nursing Sudents Scale (SINS) Nurse Education Today 33, 160-165

Yanhua C, Watson R (2011) A review of clinical competence assessment in nursing Nurse Education Today 31, 832-836

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Tzu-Pei Yeh is from Taiwan:

I am delighted to work with my supervisors – Roger Watson and Judith Dyson, and also to study in a supportive environment with supportive staff - especially the Research Administrator Jeanette Gilchrist.

I worked as a cancer nurse for five years, and I have been a research nurse for nine months in cancer clinical trials. I am also a qualified oncology nurse and cancer nurse case manager in Taiwan. The only previous research that I have done is my master dissertation. The reason I pursue this PhD degree is because I hope I have the ability to complete any nursing research that emerges from my clinical work experience; also to help my colleagues if they wish to do their own research.

Nursing in Taiwan is being transformed from a low status occupation to a professional career, and it will be a great honour if I can devote myself to promoting the image and position of nursing in Taiwan. All the training that I have in my PhD course will help me to extend my vision as well as developing the ability to do nursing research with confidence. The PhD degree may bring more opportunities of various kinds of nursing work to me in the future; thus I appreciate my family’s support, the supervision from Roger and Judith, and all the conferences, lectures and learning resources in the Faculty of Health and Social Care.

The title of my research is: The relationship between personality and job stress, burnout, satisfaction and resilience in Taiwanese cancer nurses. Understanding the relationship between nurses’ personalities, stress and burnout level and job satisfaction in one specific clinical setting such as cancer nursing is essential to establish effective interventions to support nurses, to improve their work environment and extend the tenure of staying in nursing-related occupations. By examining the relationship between personality, job stress, burnout, satisfaction and resilience in this research, personality measurements may become an important and essential tool when recruiting new nurses and planning nursing careers.

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Wednesday, 27 February 2013

Visiting Professors in Hong Kong

Friday, 22 February 2013

Making a natural childbirth splash in India

Thursday, 14 February 2013

Roger Watson's STTI Refelections on Nursing Leadership blog

Friday, 8 February 2013

Wednesday, 6 February 2013

Meet our research students