Search

Aims and objectives: The aim of this study was to explore health care assistants' (HCAs) role and influence on student nurses' clinical learning experience. Objectives induded the identification of pertinent issues relating to HCAs and students' learning in the clinical environment; the exploration of the differences and similarities of the work student nurses and HeA, their perceptions and experiences of roles and the identification of the impact of the HCAs role on the quality of student's clinical learning. Theoretical framework: To understand the relationship between HCA's and student nurses a symbolic interactionist framework was adopted, which is concerned with how people define and redefine themselves and their situation. Method: A three phased sequential exploratory mixed method research design was used, which involved a combination of prioritised qualitative and quantitative research approaches. In the first phase focus groups and interviews were undertaken witb 45 purposively selected student nurses whilst a questionnaire was disseminated in phase two to 439 students from both adult and mental health branch. The final phase involved oneto- one semi-structured interviews witb a III HCAs across private and public clinical settings. Results from the first analysis were used to inform the second phase of data collection and similarly, results from the second analysis were used to inform the third phase of data collection. Results: The study findings have provided an in sight into a range of contextual issues that influence the interactions and relationship between HCAs and student nurses which have a positive and negative influence on clinical learning experience and roles. Results demonstrate that HCAs playa major part in the education of student nurses with regards basic, clinical, and non-clinical tasks, with and without the approval of registered staff. Their participation was justified based on mentor unavailability, their closeness to the student and the patient. Conclusion: Mechanisms of workforce planning need to pay particular attention to the expanding role of assistants as it has the potential to alter patterns of work and affect current educational approaches.

Background: Changes in societal culture, demographics and illness patterns have necessitated a reorientation in approaches to care of those with life limiting illness. Present systems of care predicated on professional input are unsustainable and have been associated with limits in access to services and a fragmentation of care processes. A public health approach to palliative care (PC) that re-orientates care towards the public, as drivers in identifying care priorities and partners in finding solutions to care issues, is widely advocated. A central tenet of such a collaborative approach is a consensus as to the meaning and remit of PC. Research to date looking at public knowledge and attitudes to PC has measured levels of knowledge focusing on older populations. There has been a lack of studies gauging the understanding of PC by younger adult populations. Investigating this population will help to tailor education and policy interventions aimed at empowering young people as citizens, advocates and mediators in the care of those with life limiting illness. Aim: To examine young people’s knowledge, attitudes and perceptions of palliative care within the context of a public health approach. Methods: An explanatory mixed methods two-phased design study was undertaken with university students aged 18-29 years and was based on a broad socioecological perspective. Phase one, an online survey (n=859), underpinned by the Theory of Planned Behaviour and a review of the literature, measured attitudes and perceptions of PC, knowledge was also measured using a validated scale (PaCKS). Phase two further explored perceptions of PC and employed semi-structured interviews with a purposive sample of survey respondents who agreed to be interviewed (n=24). Findings: Phase One: Just over eight in ten respondents (83%, n=710) had heard of the term PC. Sixty-eight per cent wanted to know more about PC with only 36% (n=313) reporting that they knew where to find relevant information. Phase Two: qualitative exploration demonstrated issues relating to terminology, with participants relating PC with end of life care and a subject for consideration later in life. Participants rarely recounted the benefits of early initiation of PC and the rehabilitative aspects of PC. Prior experience and exposure to PC was an important factor in shaping attitudes and, while welcoming the opportunity to discuss PC, protective subjective norms prohibited more open discussion. Conclusions: Young people in the study demonstrated a readiness to engage with PC. They suggested future public health approaches to PC aimed at engaging young people should ensure the dissemination of early and accurate information relating to populations that may require PC, the timing, delivery and outcomes of care. The results of this study suggest how public health initiatives can target the societal norms that, in aiming to protect young people, fail to recognise their potential as assets in positively influencing the environment in which people with life limiting illness live and die.

Aims: To explore how social media can be used to foster an effective connection for potential early intervention in suicide prevention and to construct a subsequent theory grounded in the perceptions of young people. Theoretical Perspective: A hybrid theoretical position was adopted for this study, linking the initial workings of Durkheim (2002 [1897]) with contemporary psychological models of suicide (Joiner, 2005; O'Connor, 2011 and Klonsky and May, 2015); underpinned by the theory of human relatedness (Hegarty et al. 1993). Method: This qualitative study incorporated a Constructivist Grounded Theory methodology (Charmaz, 2014) across three stages. Stage One: 15 Focus groups explored how young people (n=119) used social media and whether it enhanced a sense of belonging during times of emotional difficulty. Stage Two: Individual Interviews (n=20) explored how young people experienced social media when feeling suicidal and whether the experience enhanced their sense of connectedness. Stage Three: Integration of findings to develop a theory for early intervention and engagement prior to suicidal behaviour. Findings: Social media connectedness can act as an early intervention and protective buffer against suicide ideation for young people when seven conditions (Control, Authenticity, Power, Understanding, Maintenance, Time and Proximity) that influence the degree of connection are present. The severity of experienced suicidality was key. Online presence would likely remain or increase with low-moderate suicidal ideation; moderate to severe suicide intention would most likely see withdrawal from social media. Conclusions: The constructed theory from this study details how effective online connectedness can facilitate help-seeking behaviour during the early stages of suicide ideation. The insight provided by the young people contributes to the extant knowledge base, highlighting opportunities for future social media-based prevention in the broader Suicidology field.