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Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [ABSTRACT FROM AUTHOR]

There is an increased need for accessible psychosocial interventions that support both people with dementia and their spouses. Recent research demonstrates the benefits of music therapy and caregiver-delivered music therapy for this population. This paper contributes to the emerging evidence base on telehealth music therapy for people with dementia outside of a COVID-19 era when in-person services were available. This exploratory phenomenological study explores the experiences of two couples who attended a six-week telehealth music therapy programme via two detailed case examples. Online semi-structured interviews with each couple were conducted pre and post intervention and analysed using Interpretative Phenomenological Analysis. Three shared themes emerged from the data analysis including (1) social isolation and lack of confidence linked to dementia diagnosis is worsened in rural locations, (2) song singing and song writing enables us to revisit happy memories, and (3) telehealth delivery increases access due to geographical location. The findings are presented in a narrative case study format to provide rich detailed descriptions of the music therapy programme and to illuminate the experiences of the participants. In both examples, telehealth delivery expanded access to music therapy (which was otherwise unavailable) and stimulated reminiscence which in turn encouraged meaningful engagement between the couple. The delivery of music therapy via telehealth, alongside in-person delivery, has the potential to expand access to music therapy to those who may not have access to or are no longer able to attend community support services due to geographical location, increased cognitive decline or reduced mobility. The successful delivery of telehealth music therapy is dependent on several factors including digital literacy, access to appropriate technological devices, caregiver support and level of cognitive decline. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Nurses' observation of patients in seclusion is essential to ensure patient safety.Patient observation in seclusion assists nurses in adhering to the requirements of mental health legislation and hospital policy.Direct observation and video monitoring are widely used in observing patients in seclusion.Coercive practices may cause distress to patient‐staff relations. What the paper adds to existing knowledge?: We add detailed information on specific observation methods in seclusion and compare them from the perspective of patients.Nurses communicating with patients ensures relational contact and that quality care is provided to patients even in the most distressed phase of their illness.Providing prior information to patients on observation methods in seclusion and the need for engaging patients in meaningful activities, while in seclusion are emphasized.Observation via camera and nurses' presence near the seclusion room made patients feel safe and gave a sense of being cared for in seclusion.Pixellating the video camera would give a sense of privacy and dignity. What are the implications for practice?: The overarching goal is to prevent seclusion. However, when seclusion is used as a last resort to manage risk to others, it should be done in ways that recognize the human rights of the patient, in ways that are least harmful, and in ways that recognize and cater to patients' unique needs.A consistent approach to relational contact and communication is essential. A care plan must include patient's preferred approach for interacting while in seclusion to support individualized care provision.Viewing panels (small window on the seclusion door) are important in establishing two‐way communication with the patient. Educating nurses to utilize them correctly helps stimulate relational contact and communication during seclusion to benefit patients.Engaging patients in meaningful activities when in seclusion is essential to keep them connected to the outside world. Depending on the patient's presentation in the seclusion room and their preferences for interactions, reading newspapers, poems, stories, or a book chapter aloud to patients, via the viewing panel could help ensure such connectedness.More focus should be placed on providing communication training to nurses to strengthen their communication skills in caring for individuals in challenging care situations.Patient education is paramount. Providing prior information to patients using a co‐produced information leaflet might reduce their anxiety and make them feel safe in the room.When using cameras in the seclusion room, these should be pixelated to maintain patients' privacy. Introduction: A lack of research investigating the specific role that various observational techniques may have in shaping the therapeutic relations in mental health care during seclusion warranted this study. Aim: The aim of the study was to explore patients' experience of different methods of observation used while the patient was in seclusion. Method: A retrospective phenomenological approach, using semi‐structured interviews, ten patients' experiences of being observed in the seclusion room was investigated. Colaizzi's descriptive phenomenological method was followed to analyse the data. Results: Communicating and engaging patients in meaningful activities can be achieved via the viewing panel. The camera was considered essential in monitoring behaviour and promoting a sense of safety. Pixelating the camera may transform patient view on privacy in seclusion. Discussion: The mental health services must strive to prevent seclusion and every effort should be made to recognise the human rights of the patient. The study reveals numerous advantages when nurses actively engage in patient communication during the process of observation. Implications for Practice: Different observation methods yield different benefits; therefore, staff education in using these methods is paramount. Empowering the patient with prior information on seclusion, engaging them in meaningful activities and proper documentation on patient engagement, supports the provision of individualised care in seclusion. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, Ireland implemented a series of stringent public health measures, including lockdowns and suspension of non‐urgent clinical services. Aims: To investigate the impact of the COVID‐19 pandemic on the demand for and delivery of speech and language therapy (SLT) services in Ireland in 2020. Methods & Procedures: Two iterations of a cross‐sectional, mixed‐methods online survey were distributed to speech and language therapists (SLTs) and SLT students in Ireland in the spring and autumn of 2020 using a combination of purposive and snowball sampling. The spring survey yielded 407 responses (including 14 from SLT students), while 197 respondents took part in the autumn (13 students). Survey analysis focused on questions related to the impact of the COVID‐19 pandemic on delivery and demand for SLT services (student responses were excluded from analysis owing to low response rate). The largest group in respect of experience were senior SLTs (58% in both surveys). The work settings most strongly represented were HSE primary care (34.4%) and disability services (26.5%) in the spring, and HSE primary care (39.1%), acute hospitals (22.8%) and disability services (20.8%) in the autumn. We used descriptive statistics, including distribution analysis, to analyse the quantitative data. Free text data were interrogated through a variant of a conventional qualitative content analysis. Outcomes & Results: In the spring, cessation of face‐to‐face services featured prominently (reported by 65.6% versus 14.2% in the autumn), across SLTs' work settings, except acute hospitals. Lower demand was reported by 42.5% in the spring, while in the autumn, 48.7% indicated that demand was higher. SLTs experienced large‐scale redeployment (spring: 45.9%, autumn: 38.4%), with HSE primary care SLTs redeployed most (spring: 71.7%; autumn: 62.3%). The need to suddenly pivot to telehealth was a significant challenge in terms of training, technology and logistics. New ways of working emerged and gradually, telehealth became more embedded. SLTs also had to adapt to working with evolving public health measures, such as space restrictions and personal protective equipment (PPE) requirements. Across the two survey iterations, SLTs reported tensions between demands and capacity: while referrals and demand initially decreased in the spring, this led to increased backlog and longer waiting lists, ongoing and increasing pressure on clinicians and services, and negatively impacted clients and families. Conclusions & Implications: The COVID‐19 pandemic had a significant negative impact on SLT services in Ireland. Going forward, the SLT profession and its services will require sustained support to mitigate long‐term negative consequences, such as increased waiting lists. WHAT THIS PAPER ADDS: What is already known on this subject: The negative impact of the COVID‐19 pandemic on SLT services has been examined in several countries. Ireland imposed more stringent pandemic‐management measures than many other countries, and it was therefore warranted to investigate how SLT services in the country were affected. What this study adds to the existing knowledge: Face‐to‐face SLT services effectively ceased in most non‐urgent contexts in spring 2020. This coincided with large‐scale redeployment of SLTs to non‐SLT contexts. By autumn 2020, demand had increased again, but not all services had recommenced, and redeployment was still a factor. Although SLTs adapted to the ongoing changes imposed by the pandemic, they voiced concern about increasing backlogs and longer waiting lists, ongoing and increasing pressure on both SLTs and services, and negative impacts on clients and families. What are the actual and clinical implications of this work?: The COVID‐19 pandemic had a significant negative impact on SLT services in Ireland. Going forward, the SLT profession and its services will require sustained support to mitigate long‐term negative consequences, such as increased waiting lists. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) do not always access specialist outpatient services in a timely manner in Ireland. The perspectives of people living with PD, relating to service access, are largely absent in the existing literature. Aim: To explore experiences of PD service access for people living with PD, using a qualitative approach. Methods: Purposive maximum variation sampling was used. Semi‐structured telephone interviews were conducted with 25 service users, including people with PD (n = 22) and supporting carers (n = 3). Informed consent was obtained from all participants. Interviews ranged in duration from 30 to 90 min. Data were managed in NVivo 12 and interpreted inductively using thematic analysis. The researchers were reflexive throughout the research process. The Consolidated Criteria for Reporting Qualitative Research checklist was employed to maximise transparency. Results: The findings highlight several key barriers to and facilitators of equitable and timely service access. Three key themes were identified comprising experiences of PD service access including 'geographical inequity', 'discriminatory practices', and 'public and private system deficits'. Together, these themes illustrate how a two‐tiered and under‐resourced health system lacks capacity, in terms of infrastructure and workforce, to meet PD needs for both public and private patients in Ireland. Conclusions: These findings point to problems for PD care, relating to (i) how the health system is structured, (ii) the under‐provision and under‐resourcing of specialist outpatient PD services, including medical, nursing, and multidisciplinary posts, and (iii) insufficient PD awareness education and training across health settings. The findings also show that telemedicine can provide opportunities for making access to certain aspects of PD care more flexible and equitable, but the feasibility and acceptability of technology‐enabled care must be assessed on an individual basis. Implications for policy, practice and research are discussed. Patient or Public Contribution: The design and conduct of this study were supported by an expert advisory group (EAG) of 10 co‐researchers living with PD. The EAG reviewed the interview schedule and the protocol for this study and provided detailed feedback from their perspective, to improve the methods, including the interview approach. The group also reviewed the findings of the study and contributed their insights on the meaning of the findings, which fed into this paper. [ABSTRACT FROM AUTHOR]

Accessible summary: This paper focuses on the transition stories of young people with intellectual disabilities.People with intellectual disabilities have the lowest participation rates in further education training and employment.A model of supported transition places the young person at the centre of the process.Young people with intellectual disabilities have the same dreams and aspirations for their lives as everybody else.This paper found that the model of supported transition aligns with proposed national polices in the Republic of Ireland. Background: The principal destinations for school leavers with intellectual disabilities from special schools in Ireland are further education (FE) through providers such as the National Learning Network or training and employment (TE) within adult day services and rehabilitation centres. In 2015, a number of inherent barriers to participation in FE/TE for young people with intellectual disabilities were identified. These were found to be linked to attitudes, stigma and low expectations of their capabilities. This resulted in the development of a supported transition model WALK PEER (Providing Equal Employment Routes). Methods: This study explored the experiences of school leavers with intellectual disabilities who were engaging with the WALK PEER model. Data were collected from a purposive sample of 31 students with intellectual disabilities from two special schools: Group 1 (Pre‐transition) students in the penultimate year of formal education, Group 2 (Transitioning) students in the final year of formal education and Group 3 (Post‐transition) had left school two years previously. Findings: Engaging in the supported transition programme provided young people with access to information, options, confidence and some of the hard and soft skills required for successful transition into education and employment contexts. Conclusions: The findings demonstrate a strong correlation between support programmes, transition planning and positive transitions, which is critical if young people with intellectual disabilities are to realise their goals. The research proposes a new model of "Supported Transition" that has clear implications for the development of a national transition policy as directed by the Comprehensive Employment Strategy. [ABSTRACT FROM AUTHOR]

Dual Sensory Loss and learning disability is a historically neglected area of social work practice. This paper presents one element of a research study conducted with a health and social care provider in Northern Ireland. It explored staff experiences of assessing adults and children with a dual sensory loss and learning disability. Two sensory disability team managers, eight social workers and two rehabilitation officers were interviewed across sensory disability, learning disability and children with disability teams. Current levels of engagement and ways in which more inclusive services and practices could be developed were explored. Staff views indicate that there is minimal engagement between staff and service users with unique, complex needs. Staff use a range of tools, resources and skills in an attempt to promote inclusion and engagement. The paper concludes that to promote engagement staff need to develop their practice, making effective use of tools and resources. Staff skills and knowledge can be enhanced through training which is targeted, relevant and specific. There needs to be commitment to sharing good practice and cascading learning throughout teams. This will enable service users to have input into their own assessments which will form the cornerstone of all ongoing interventions. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well‐being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia‐related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development. Aims: To establish the current practices of SLTs managing dementia‐related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered. Methods & Procedures: An anonymous, cross‐sectional web‐based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open‐ended questions were analysed using conventional content analysis. Outcomes & Results: A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self‐rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources. Conclusions & Implications: The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well‐being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper addsWhat is already known on the subjectResearch indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice.What this paper adds to existing knowledgeThis paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints.What are the potential or actual clinical implications of this work?These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia‐related dysphagia and mealtime difficulties effectively. [ABSTRACT FROM AUTHOR]

Alternative education provision in Ireland is under-researched. This paper is a qualitative investigation of the perspectives of a purposive sample of ten teachers on curriculum, pedagogy and assessment in their respective alternative settings of a voluntary education centre, a Youthreach centre and a post-primary special school. 'Funds of knowledge' ideas contribute to the theoretical framework of the study [Moll, Luis C., Cathy Amanti, Deborah Neff, and Norma Gonzalez. 1992. 'Funds of Knowledge for Teaching: Using a Qualitative Approach to Connect Homes and Classrooms.' Theory Into Practice 31 (2): 132–141]. The findings in this paper focus on: (1) how curriculum is enacted and mediated in alternative education settings; (2) the pedagogical decisions of teachers as they strive to connect their students to learning and (3) the tensions in assessment practices as teachers and alternative settings attempt to provide authentic and yet certified evidence of learning through the formal state assessment processes. This article is timely as it offers a view of the under-researched area of alternative settings in Ireland. [ABSTRACT FROM AUTHOR]

Despite the benefits of utilising community‐based care services (CBS) for people with dementia and their caregiver being well established, people with dementia and caregivers use fewer services in comparison to other people in need of care. While societal, cultural and logistical factors effecting caregiver use of CBS are frequently studied, research of internal emotional barriers, mental limitations created by one's own self that prevents open communication of thoughts and feelings, and their effect on CBS use is limited. This paper explores internal emotional barriers on caregivers' use of CBS within the Irish Healthcare System. Professional Healthcare Providers were also interviewed as a preliminary indicator of their awareness of these internal emotional barriers and their impact on caregivers' use of CBS. Using interpretive description methodology, interviews with 20 caregivers and fourteen dementia professional healthcare providers were transcribed and a thematic analysis methodology applied to illuminate themes/patterns within participants' subjective perceptions of caregivers emotional barriers to using CBS. Four themes emerge: reluctance to question general practitioner (GP) authority; embarrassment during level of care requirement reviews; sense of obligation to provide all care; and fear of stigma. Caregivers interviewed were reluctant to communicate concerns with professional healthcare providers (PHPs), thereby reducing the PHP's awareness of these barriers and delaying/preventing use of CBS. As key gatekeepers within the care pathway, GPs should address the uneven power dynamic with the caregiver through user‐centred models of care, which actively encourage open dialogue, and receive training to identify the indicative behaviours of internal emotional barriers and empower the caregiver to communicate their feelings/concerns directly. [ABSTRACT FROM AUTHOR]

Mental health nursing in the forensic services is perceived as stressful as there is often a tension between therapeutic and custodial processes. Clinical supervision has been discussed as a support strategy for nurses. The aim of this paper is to explore forensic mental health nurses understanding of clinical supervision and their perception of its utility within their practice. A qualitative descriptive method was used and 10 mental health nurses were interviewed with the aid of an interview guide. Qualitative data was analysed using a thematic approach culminating in the emergence of three themes. Participants talked about the tension between caring and custodial roles within the forensic services which was stressful and created difficulties in the maintenance of a therapeutic relationship. Clinical supervision was seen as a necessary support to assist nurses working in the forensic services. The findings support the premise that there is a tension between therapeutic and custodial practices. Acknowledgement of the complexities of working within the forensic services and the provision of clinical supervision within a confidential, non-judgemental relationship may assist nurses in the provision of care and the maintenance of therapeutic relationships. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to outline a knowledge translation (KT) case study undertaken as part of a multi-component research programme aimed at evaluating new parenting supports in the earliest years. The study aimed to: explore the influencing factors relating to research use in an early years context; and to use the findings, at least in part, to execute an integrated KT plan – to promote stakeholder engagement, greater research visibility and to enhance the understanding of findings emerging from the research programme. Design/methodology/approach: A mixed-methods study was embedded within a large-scale, longitudinal research programme. In the present study, a national survey (n = 162) was administered to stakeholders working with children and families throughout Ireland. A series of one-to-one interviews were also undertaken (n = 37) to amplify the survey findings. Also, one focus group was carried out with parents (n = 8) and one with members of the research team (n = 3). Several dissemination strategies were concurrently developed, executed and evaluated, based partly on survey and interview findings and guided by the knowledge translation planning template (Barwick, 2008; 2013; 2019). Findings: The main factors influencing the dissemination of evidence, as identified by the stakeholders – were: a lack of resources; an under-developed understanding of research use and dissemination; insufficient collaboration and communication; and conflicting stakeholder priorities. Despite these challenges, the research programme was found to benefit from a multi-component KT plan to achieve the outlined dissemination goals. Practical implications: The KT planning process allowed the research team to be more accountable, introspective and to work more efficiently. This helped increase the likelihood of more targeted and successful dissemination of the research findings, delivering a better return on research investment. Originality/value: This is the first study of its kind (to our knowledge) to provide important insights for stakeholders in Ireland and elsewhere about how to improve the dissemination process. Effective KT planning can ultimately help to bridge the research-policy-practice gap and enable the effective translation of high-quality evidence in the early years' sector to enhance outcomes for families in the shorter and longer-term. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

This paper provides an evaluation of the Heart of Living and Dying (HLD) Initiative. This initiative is a group process that attempts to bring Advance Care Planning (ACP) into the public domain. It encourages participants to consider what matters to them in their living along with their hopes, preferences, and wishes for their final years and end-of-life care. An inductive, interpretive, and naturalistic approach allowed the researcher to study these phenomena in their natural setting i.e., the community. This qualitative study used 5 focus groups with 17 people and employed thematic data analysis to identify key themes. All participants in the HLD speak from a personal perspective irrespective of any professional background. It transpired that 16 respondents worked in health and social care, which subsequently became noteworthy in the findings. Three key themes were identified: (a) feeling emotionally safe enough to have such sensitive conversations is vital; (b) participating in the HLD process increases the confidence of those participants who worked in health and social care, to undertake ACP conversations and (c) planning ahead is a complex, staged process rather than a single record-making event. The Covid-19 pandemic crisis reinforced the need to upstream ACP initiatives such as the HLD, as the norm for everyone, since all of us will one day die. It is recommended that the HLD be incorporated within ACP training given that the experiential nature of it and the use of groups was reported to build confidence in facilitating ACP conversations. A virtual HLD process needs to be developed to adapt to restrictions on gatherings due to Covid 19. [ABSTRACT FROM AUTHOR]

Physical inactivity levels are rising globally. In response, public health investigators have sought to design and implement effective interventions to raise levels of physical activity in populations, communities and individuals. Usually, such interventions are built around theories of behaviour change in which notions of motivation and incentivisation loom large. Drawing on focus group evidence derived in the context of a cluster RCT aimed at increasing levels of physical activity in the workplace, this paper offers a critical look at the factors that seemingly stimulate and sustain that activity. In particular, using novel methods of data analysis we illustrate how motives and motivation – often interpreted as a driving force 'in' individuals – can be more usefully seen as distributed; as a property of systems (incorporating technologies, organisational structures, and social interaction) rather than of persons. In our discussion, we outline various theoretical as well as empirical grounds for making such claims and conclude by drawing out the implications of our work for public health policy and research. [ABSTRACT FROM AUTHOR]

A plethora of government policies impacting older people in the United Kingdom (UK) have been strongly influenced by the rhetoric that service users should be actively involved in their social care; including decisions and delivery. User involvement is integral to the government's current drive to make service more "person‐centred" or "personalised" in adult social care. However, there has been little engagement with the broader Northern Ireland public on future adult social care policies. It has been suggested that knowing preferences for the type of future care and where and how it should be provided can be valuable for service users, providers and policy‐makers. Using a qualitative approach, this paper draws on data collected from three focus groups with people aged over 60 who are not in receipt of social care services. The focus groups took place between April 2016 and January 2017. The findings demonstrate that participants had limited knowledge and understanding of the current social care system in Northern Ireland. In addition, participants had not thought about their possible future care needs. The findings emphasise the importance of promoting and engaging the public in social care debates, particularly at a time when the need for reform of the health and social care system has been identified in Northern Ireland. [ABSTRACT FROM AUTHOR]

Abstract: Social isolation and loneliness are common experiences of ageing in rural communities. Policy responses and interventions for social isolation and loneliness in later life are shaped by sociocultural understandings of place, relationships and social interaction. This study examined how representations of rural community in Ireland influenced the focus, relationships and activities within a befriending intervention designed to tackle social isolation and loneliness. Through a qualitative case study conducted in 2014, the symbolic meaning of the intervention was explored using interviews and focus groups with participants (8 befriended, 11 befrienders and 3 community workers) from one befriending programme in rural Ireland. Reflected in the programme was a representation of a rural community in decline with concern for the impact on older people. There was a valuing of the traditional community defined by geographical place, perceptions of similarity among its members, and values of solidarity and mutual support. The befriending intervention represented a commitment to intra‐community solidarity and a desire by many for authentic befriending relationships that mirrored understandings of relationships within the traditional community. Identifying and alleviating social isolation and loneliness imply a set of normative values about community and the optimal social relationships within community. This paper proposes that there is a need to consider the role played by understandings of community in shaping context‐sensitive interventions to counter social isolation and loneliness in later life. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Caring for people with dementia and responsive behaviours is challenging; however, little is known of nurses' experiences of responsive behaviours., What does this paper add to existing knowledge? To demonstrate understanding nurses need to be aware of their own actions, thoughts, attitudes and reactions., Time, education and management support are essential in enabling a person-centred approach., A decision regarding the place of care is difficult to come to, and given the drive to a person-centred approach, there is a need to consider the views of people with dementia., What are the implications for practice? Nursing staff supporting people with dementia should engage more frequently in reflective practice, ongoing education and decision-making., Service providers/managers need to have an understanding of the complexities of caring for a person with dementia and responsive behaviours and provide their staff with relevant supports and education that is accessible to all staff., Abstract Introduction Caring for people with dementia and responsive behaviours can challenge nurses, and little is known of their experiences. Aims To explore nurses' views of supporting people with dementia and responsive behaviours in long-stay facilities. Methods A qualitative descriptive study utilizing in-depth audio-recorded interviews of nine nurses, recruited from private and public care facilities. Qualitative content analyses conducted involving iterative comparisons of transcripts, summaries and memos, where coding, key quotes and tables were developed to determine themes. Results Four themes emerged: recognizing and understanding responsive behaviour, resources and interventions to support people with dementia and responsive behaviour, the impact of education on nursing practice and the care environment. Discussion Availability of staff, adequate time and financial restraints hinder nurses' ability to provide care. Access to ongoing education and being able to provide one-to-one care was valued as dementia-specific education changed nursing practice. Implications for practice Place of care was seen as dependent on the type of responsive behaviour in question, the duration of the behaviour and the impact of the behaviour on the person, other residents and staff. Dementia education needs to be accessible to all staff, and a collaborative approach is necessary in order to develop management guidelines and support strategies. [ABSTRACT FROM AUTHOR]

Previous research identifies the increased exposure of birth children of foster carers to experiences of separation, grief, and loss due to the transient nature of foster care, but little is known about how birth children manage this loss. This paper reports findings from a qualitative study that examined the retrospective experiences of 15 adult birth children of foster carers (aged between 18 and 28 years) in Ireland. Findings suggest that birth children experience grief and loss when foster children leave their families. They report experiencing a range of emotional responses such as guilt, blame, and sadness. A reluctance to discuss their emotional responses with either their parents or foster care professionals was also reported. Instead, birth children developed strategies to manage the loss, such as distancing themselves from the foster care process. The study highlights the importance of social workers and foster carers explaining to birth children why foster children are leaving and, where possible, maintaining contact between birth children and foster children. Additionally, findings indicate the need for birth children to have safe nonjudgmental spaces to discuss their emotional reactions to loss. [ABSTRACT FROM AUTHOR]

Background: This paper reports on a research study to inform the development of a specialist role to support front line public health nurses (PHNs) working with vulnerable families and at risk children in Ireland. Aims: This study aimed to investigate the position of a leading role and explore the implications of such change. Methods: Focus group and semi-structured individual interviews were conducted with ten purposively selected participants in public health nursing, social work and a nongovernmental children's organisation working in disadvantaged areas in Dublin. Results: Assistant directors of public health nursing are in a key position to inform decisions regarding the children's services. Conclusion: Access to support and appropriate supervision are fundamental resource requirements for PHNs who work with vulnerable families and at risk children. The introduction of a specialist-leading role to support these PHN's is essential to sustaining best practice. [ABSTRACT FROM AUTHOR]

Aim To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. Background Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. Method(s) A descriptive, qualitative approach was utilised. A purposeful sample of ten nurses participated in individual, semi-structured interviews. Results Participants were committed to promoting safety in navigating challenges in introducing, complying and accepting the value of the World Health Organization surgical safety checklist in concordance with best practice. Participants moved from task completion to embracing the checklist as an effective surgical safety checking tool. Challenges were identified around roles and responsibilities in overseeing the completion of the checklist. Conclusion(s) The management of processes is critical when implementing any safety initiative. This paper highlights the complexity and challenges in implementing the World Health Organization surgical safety checklist, contributing to global discussions around translating policy into practice. Implications for nursing management The effective implementation of a checklist requires a coordinated management approach in collaboration with team members. These approaches will support learning experiences contributing to a shared understanding of the change being implemented by all team members. [ABSTRACT FROM AUTHOR]

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help-seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help-seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty-two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi-structured interviews. As a result of negative initial help-seeking experiences in Ireland, most participants engaged in long periods of self-management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help-seeking as helping professionals' failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice. Key Practitioner Messages: Turning points, such as illness and bereavement, and the desire to provide for children, influence the help-seeking of survivors of ICA., Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help-seeking., General awareness of ICA can help practitioners in low-threshold services prevent against culturally insensitive practice., Peer support networks can provide uniquely trusted signposting towards formal interventions. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the support experiences of older people who have been abused in Ireland. Design/methodology/approach – Recruited through dedicated elder abuse services, nine older people who had experienced elder abuse participated in in-depth, semi-structured interviews. The data were analysed using thematic content analysis. Findings – The study highlighted the help-seeking pathways of abused older people and revealed that few older people sought help for themselves and most were unaware of the services available to support and protect older people. Data analysis identified the range and type of help received from family, friends, voluntary and statutory services, as well as the perceived barriers to accessing help and support. Research limitations/implications – The research did not include abused older people who lacked mental capacity or who had experienced self-neglect, criminal victimisation by strangers or who had not received statutory support services. This field may benefit from future research that seeks to examine the support experiences of these groups. Practical implications – Family, staff and professionals who care for older people need to be cognisant of the signs of elder abuse, and bring them to the attention of older people should they have concerns, as older people may not always recognise that they are being abused. Originality/value – The paper contributes to our understanding of the support needs of older people in Ireland and the perceived barriers to accessing help and support. [ABSTRACT FROM AUTHOR]

Aims and objectives This paper describes the steps used in developing and piloting a structured education programme - the Structured Education Reminiscence-based Programme for Staff ( SERPS). The programme aimed to prepare nurses and care assistants to use reminiscence when caring for people with dementia living in long-term care. Reminiscence involves facilitating people to talk or think about their past. Background Structured education programmes are used widely as interventions in randomised controlled trials. However, the process of developing a structured education programme has received little attention relative to that given to evaluating the effectiveness of such programmes. This paper makes explicit the steps followed to develop the SERPS, thereby making a contribution to the methodology of designing and implementing effective structured education programmes. Design The approach to designing the SERPS was informed by the Van Meijel et al. (2004) model ( Journal of Advanced Nursing 48, 84): (1) problem definition, (2) accumulation of building blocks for intervention design, (3) intervention design and (4) intervention validation. Methods Grounded theory was used (1) to generate data to shape the 'building blocks' for the SERPS and (2) to explore residents, family and staff's experience of using/receiving reminiscence. Results Analysis of the pilot data indicated that the programme met its objective of preparing staff to use reminiscence with residents with dementia. Staff were positive both about the SERPS and the use of reminiscence with residents with dementia. Conclusions This paper outlines a systematic approach to developing and validating a structured education programme. Participation in a structured education programme is more positive for staff if they are expected to actively implement what they have learnt. Ongoing support during the delivery of the programme is important for successful implementation. Relevance to clinical practice The incorporation of client and professional experience in the design phase is a key strength of this approach to programme design. [ABSTRACT FROM AUTHOR]

Background: Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients' experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care. Methods: This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland's Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer. Results: We identified three overarching themes relevant to the purpose of this paper: (1) patients' experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment. Conclusions: Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored. [ABSTRACT FROM AUTHOR]

The worldwide growth in formal youth mentoring programmes over the past two decades is partly a response to the perception that young people facing adversity do not have access to supportive relationships with adults and positive role models in their communities to the degree they once had. Formal mentoring programmes facilitate the development of a friendship or ‘match’ between an older volunteer and a young person, with the objective of supporting the young persons’ personal and social development. Drawing on 66 semi‐structured interviews with young people, parents, mentors and caseworkers associated with nine youth mentoring matches in the Big Brothers Big Sisters Programme in Ireland, this paper analyses the forms of social support evident in the mentor–mentee relationships and highlights how the mentoring relationship was perceived to have impacted on the well‐being of the young people participating. The findings reflect the consensus in the mentoring literature that close, well‐established mentoring relationships have the potential to bring about meaningful change in the lives of young people. [ABSTRACT FROM AUTHOR]

This paper reports the findings from a Delphi Study undertaken to identify the research priorities in children's palliative care in Ireland. Palliative care for children is a small and highly specialised field of healthcare that focuses on improving the quality of life of children living with, or dying from, a life-limiting condition. Ideally, support for children requiring palliative care begins at the time of diagnosis, which for many children with life-limiting conditions can be from birth. There is a notable overlap between the needs of children requiring palliative care and those with disabilities and other complex care needs, resulting in care being provided by a range of voluntary and statutory agencies. As a new specialty, there is a need to develop an evidence-based approach to providing children's palliative care. In order to do this in a systematic way, identification of the research priorities in children's palliative care within Ireland is required. [ABSTRACT FROM AUTHOR]

Background Second-trimester miscarriage is defined as pregnancy loss after 12 and before 24 weeks’ gestation. Little is known about parents’ experiences of hospital care during a second trimester miscarriage in Ireland. Aims This study aimed to explore parents’ experiences of hospital care during a second-trimester miscarriage. Methods A focused ethnographic design was used. A series of semi-structured interviews were completed with 14 bereaved parents. The data were analysed using thematic network data analysis. Findings This paper discusses the global theme of relational and social experiences of miscarriage. Parents highlighted the need for compassionate care and expressed the importance of empathy and sensitivity from hospital staff to avoid further distress. Conclusions Compassionate care received by bereaved parents positively influenced their hospital experience, whereas a perceived lack of compassion or insensitivity had a lasting negative impact on bereaved parents. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives To understand Irish parents' experiences of the inter-hospital transfer of their acutely ill child from a regional hospital to a tertiary children's hospital. Background Much of the literature on inter-hospital transfer focuses on the medical outcome of children who have been transferred for specialist care. While parental presence during this journey is the focus of discussion papers, little is known about the experience of parents as service users. Design A qualitative design using a Husserlian phenomenological approach was adopted for this study. Methods Semi-structured interviews were conducted with ten parents between March and October 2014 to explore their experiences of parental presence during the transfer of an acutely ill child. Data were analysed using the modified Van Kaam method. Results Two key themes emerged 'don't put the parent out' and 'being a parent'. Given a choice, all parents interviewed would have wished to stay with their child during transfer and the findings portray the specific contribution of parents during the journey. Conclusions Not being permitted to travel with their acutely ill child had a negative effect on parents' perceptions of their ability to continue to parent their child during transfer to specialist paediatric services. To address this there is a need for parents to have the choice, when at all possible, to stay with their child at this time. Relevance to clinical practice There is a need to maximise the facilitation of parental presence in an Irish context through the introduction of guidelines to support staff involved in the transfer of an acutely ill child. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists can improve the quality of life of people receiving palliative care through the management of communication and swallowing difficulties (dysphagia). However, their role in this domain is poorly defined and little is understood about the current international professional practice in this field. Aims: To examine how speech and language therapists perceive their role in the delivery of palliative care to clients, to discover current international speech and language therapist practices and to explore the similarities and differences in speech and language therapists’ practice in palliative care internationally. This will inform professional clinical guidelines and practice in this area.Design:Anonymous, non-experimental, cross-sectional survey design.Participants:Speech and language therapists working with adult and paediatric palliative care populations in Republic of Ireland, United Kingdom, United States, Canada, Australia and New Zealand where the speech and language therapist profession is well established. Method: Purposive and snowball sampling were used to recruit participants internationally using gatekeepers. An online survey was disseminated using Survey Monkey (http://www.surveymonkey.com). Results: A total of 322 speech and language therapists responded to the survey. Speech and language therapist practices in palliative care were similar across continents. Current speech and language therapist practices along with barriers and facilitators to practice were identified. The need for a speech and language therapist professional position paper on this topic was emphasised by respondents. Conclusion: Internationally, speech and language therapists believe they have a role in palliative care. The speech and language therapist respondents highlighted that this area of practice is under-resourced, under-acknowledged and poorly developed. They highlighted the need for additional research as well as specialist training and education for speech and language therapists and other multidisciplinary team members in the area of palliative care. [ABSTRACT FROM AUTHOR]

Background: Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to 'engage' and 'empower' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the 'engagement' of the clinical teams who participate and vice-versa. Objective: This paper explores and examines the impact of a large-scale QI programme, the Productive Ward, on the 'work engagement' of the nurses and ward teams involved. Design/methods: Using the Utrecht Work Engagement Scale (UWES), we surveyed, measured and analysed work engagement in a representative test group of hospital-based ward teams who had recently commenced the latest phase of the national 'Productive Ward' initiative in Ireland and compared them to a control group of similar size and matched (as far as ispossible) on variables such as ward size, employment grade and clinical specialty area. Results: 338 individual datasets were recorded, n = 180 (53.6%) from the Productive Ward group, and n = 158 (46.4%) from the control group; the overall response rate was 67%, and did not differ significantly between the Productive Ward and control groups. The work engagement mean score (±standard deviation) in the Productive group was 4.33 (±0.88), and 4.07 (± 1.06) in the control group, representing a modest but statistically significant between-group difference (p = 0.013, independent samples t-test). Similarly modest differences were observed in all three dimensions of the work engagement construct. Employment grade and the clinical specialty area were also significantly related to the work engagement score (p < 0.001, general linear model) and (for the most part), to its components, with both clerical and nurse manager grades, and the elderly specialist areas, exhibiting substantially higher scores. Conclusions: The findings demonstrate how QI activities, like those integral to the Productive Ward programme, appear to positively impact on the work engagement (the vigour, absorption and dedication) of ward-based teams. The use and suitability of the UWES as an appropriate measure of 'engagement' in QI interventions was confirmed. The engagement of nurses and front-line clinical teams is a major component of creating, developing and sustaining a culture of improvement. [ABSTRACT FROM AUTHOR]

Vocal load related to heavy voice use in particular professions increases the risk of occupational voice disorders. Research on professional voice use has primarily focused on educators, singers, and call-centre advisors. This paper describes the daily experiences of professional soccer managers' occupational voice use through qualitative methods. Four global themes were identified: 1) voice uses, 2) factors affecting voice change, 3) impact of voice use, and 4) the importance of voice in soccer management. All describe the nature of soccer managers' vocal demands. Risk factors for voice disorders include intense and prolonged voice use in environments with adverse acoustic properties for speakers and poor phonation methods. Research on vocal behaviours and early prevention programmes for this population group is warranted. [ABSTRACT FROM AUTHOR]

Purpose – Despite the high incidence of aggressive behaviours among some individuals with intellectual disability, Ireland has paid little attention to the prevalence of aggressive behaviours experienced by Registered Intellectual Disability Nurses (RNID). Within services the focus is mainly on intervention and management of such behaviours. Therefore a disparity occurs in that these interventions and management strategies have become the exclusive concern. Resulting in aggressive behaviour being seen as a sole entity, where similar interventions and management strategies are used for ambiguously contrasting aggressive behaviours. Consequently the ability to document and assess-specific behaviour typologies and their prevalence is fundamental not only to understand these behaviour types but also to orient and educate RNIDs in specific behaviour programme development. The paper aims to discuss these issues. Design/methodology/approach – This study reports on a survey of the prevalence of verbal aggression, aggression against property and aggression against others experienced by RNIDs’ within four residential settings across two health service executive regions in Ireland. A purposeful non-random convenience sampling method was employed. Totally, 119 RNIDs responded to the survey which was an adaptation of Crocker et al. (2006) survey instrument Modified Overt Aggression Scale. Findings – The findings of this study showed the experienced prevalence rate of verbal aggression, aggression against property and aggression against others were 64, 48.9 and 50.7 per cent, respectively. Cross-tabulation of specific correlates identifies those with a mild and intellectual disability as displaying a greater prevalence of verbal aggression and aggression against property. While those with a moderate intellectual disability displayed a higher prevalence of aggression against others. Males were reported as more aggressive across all three typologies studied and those aged between 20 and 39 recorded the highest prevalence of aggression across all three typologies. The practice classification areas of challenging behaviour and low support reported the highest prevalence of aggression within all typologies. Originality/value – The health care of the person with intellectual disability and aggressive behaviour presents an enormous challenge for services. In-order to improve considerably the quality of life for clients, services need to take a careful considered pragmatic view of the issues for the person with intellectual disability and aggressive behaviour and develop realistic, proactive and responsive strategies. To do this, precise knowledge of the prevalence of aggressive behaviours needs to be obtained. This study is the first of its kind in the Republic of Ireland. [ABSTRACT FROM AUTHOR]

This paper is based on a study commissioned by the Department of Children and Youth Affairs in Ireland. It addresses the topic of recommendations emanating from child death inquiries and reviews; it looks at the factors which privilege some recommendations over others when it comes to implementation and explores whether a more collaborative approach to development might be more beneficial. As part of the study, the researchers to propose a new model for developing recommendations which will address the complexity of child protection practice, reflect its core principles and promote learning. The study found that recommendations were generally implemented when they fitted with social norms and aspiration of the time and particularly when they synchronised with policy developments that had already been initiated and required increased investment and public support to reach completion. The research drew a distinction between addressing and implementing recommendations, and overall found that a type of 'recommendation fatigue' had evolved following the succession if inquiries. It proposed that in the future, recommendations should be drafted in collaboration with key stakeholders which would provide the team with a range of expert knowledge strengthen the methodological rigour of the process and promote the likelihood that they would be feasible and realistic. The study proposed a new model of CLEAR recommendations (Case for change; Learning orientated: Evidence based; Assigning responsibility and easy to Review). Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Messages When inquiry or review recommendations are too numerous, impractical, expensive, lack relevance and are too far out of step with social norms, they are unlikely to be implemented, A collaborative approach can ensure that recommendations are informed by relevant sources of information, knowledge and expertise., Recommendations should be framed in a way that illustrates the rationale for change, promotes learning, cites evidence and identifies the organisations responsible for implementation. [ABSTRACT FROM AUTHOR]

Aim and objectives To explore the experiences of registered intellectual disability nurses caring for the older person with intellectual disability. Background Increased longevity for the older person with intellectual disability is relatively a new phenomenon with social and medical factors having significantly increased the lifespan. The ageing population of people with intellectual disability is growing in Ireland, and they are outliving or expected to outlive their family carers. Design A qualitative Heideggerigan phenomenological approach allowed the researcher become immersed in the essence of meaning and analyse how registered intellectual disability nurses working with the older person perceive, experience and express their experience of caring. Methods After ethical approval was granted, data were collected through semi-structured interviews from seven participants and were transcribed and analysed thematically using Burnard's framework for data analysis. Results Three key themes were identified: 'care delivery', 'inclusiveness' and 'client-focused care'. The study highlights the need for effective planning, an integrated approach to services and that the registered intellectual disability nurse needs to be integrated into the care delivery system within the health service to support client and family carers in the home environment. Conclusions Overall, the study shows the importance of teamwork, proactive planning, inclusion, attitudes, individualised care, knowing the person and best practice in providing care for older people with intellectual disability. Relevance to clinical practice This paper reports on the findings of a study which explored the experiences of caring for the older person with intellectual disability. Teamwork, proactive planning, client-centred approach and supporting clients living at home are important as ageing is inevitable. [ABSTRACT FROM AUTHOR]

Aims: This paper discusses the evaluation of a multi-sector oral health promotion intervention in the Republic of Ireland for children with disabilities. It argues that a lack of awareness about the context of interventions means that sometimes people's health concerns remain unaddressed through a lack of participation. This may actually increase rather than decrease health inequalities. Implementing qualitative methods to provide a context before proceeding with interventions may assist in providing approaches that are fit for purpose when trying to include people in health promotion. Methods: A purposive sample of 15 parents or carers of children with disabilities and 18 non-dental professionals were interviewed in either focus groups or on a one-to-one basis. Results: The qualitative analysis indicated that budget constraints were affecting joint working because non-dental professionals were overstretched, feeling that they only had the capacity to carry out day-to-day work with parents and children. The daily demands of caring for a child with disabilities for many parents meant that they were tied to a day-to-day existence. Conclusions: The qualitative evaluation suggested that an initial lack of knowledge about structural, procedural, and budgetary barriers, coupled with insight into the daily demands on parents caring for children with disabilities, meant that all parents were not enabled. Therefore, achieving the aims of the plan could not be a total success for all parents and children from the outset. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an exploration of the experiences of patients with end-stage kidney disease who were having haemodialysis. Background. The losses and lifestyle disruptions caused by end-stage kidney disease are a fundamental source of suffering for people. The hope of a transplant is an important factor in people's ability to cope with end-stage kidney disease and dialysis. Method. A Heideggerian phenomenological methodology was used. A purposive sample was selected of 16 patients with end-stage kidney disease having hospital-based haemodialysis therapy in the Republic of Ireland. Qualitative interviews were conducted in 2006-2007. Data were analysed using qualitative interpretive analysis. Findings. The overarching pattern identified was 'Waiting for a kidney transplant'. This pattern consisted of three themes: living in hope, uncertainty and being on hold. Participants described their experiences of living in hope while they waited for a kidney transplant. However, as the waiting time continued indefinitely, participants became uncertain, and this meant that they were unable to contemplate opportunities in the future. Moreover, the restrictions of haemodialysis therapy prevented them from performing many of the activities they had taken for granted in the past. Consequently, they described their experiences of being on hold while they waited for a kidney transplant. Conclusion. Nurses should engage in open and honest discussions with patients in relation to kidney transplantation so that they are able to recognize and address their concerns about kidney transplantation. [ABSTRACT FROM AUTHOR]

This study analyses the experiences of youth workers in dealing with challenging behaviour among young people. The findings from a qualitative approach to the collection and analysis of data from 45 research participants are presented. The paper begins by briefly exploring the context of youth work in Ireland and outlining the research process. This is followed by a discussion of the nature of challenging behaviours experienced by youth workers including the emergent area of challenging behaviour involving new technology. Other significant themes arising from the research data are discussed. These include issues such as the audience factor, the importance of individual work, the significance of understanding background factors leading to difficult behaviour, and the need to support staff through challenging encounters. Particular attention is given to highlighting the practice implications of the research in developing effective practice in the area of challenging behaviour. [ABSTRACT FROM AUTHOR]

Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men's health, with men tending to be seen as largely 'irresponsible' towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting 'irresponsibly' was what defined participants as 'real men'. The implications of these findings for men's health policy are discussed with specific reference to the recent publication of Ireland's National Men's Health Policy. [ABSTRACT FROM AUTHOR]